Touch-cure activation by marketed universal resin luting cements of their associated primer to dentin.

PURPOSE: The aim of this study was to investigate the dentin shear bond strength (SBS) and bonding interface of three recently developed "universal" resin luting cements based on different modalities. METHODS: The dentin SBS and interfacial analysis of three recently launched "universal" resin luting cements, namely, G-Cem One, RelyX Universal and Panavia SA cement universal, were studied. All bonding protocols, including the previous use of their dedicated primer or universal adhesive in touch-cure mode or light-cure mode were performed. Variolink Esthetic LC used in conjunction with Scotchbond Universal Plus was used as a control group. For each group (n = 9), 10 specimens were tested for dentin SBS and two were examined by scanning electron microscopy. SBS were analyzed by two-way ANOVA followed by Dunnett's test. RESULTS: SBS values showed that the three "universal" resin luting cements tested exhibit different adhesive behaviors. G-Cem One with its touch-cure activated primer had a greater SBS to dentin (25.5 MPa) than that of the control group (22.1 MPa). CONCLUSION: "Universal" resin luting cements have variable efficacy when used in self-curing mode. The touch-curing mode is also of concern but may show high potential for some formulations.

Knowledge and Opinions of French Dental Students in Operative Dentistry - Management of Deep Carious Lesions.

PURPOSE: A questionnaire survey was recently undertaken among French dental students (FDSs) to investigate their practices, knowledge and opinions in various domains of minimal intervention (MI) in cariology. The present work focuses on management of deep carious lesions (DCLs). MATERIALS AND METHODS: The questionnaire was administered (Spring 2018) to all the fifth-year students of the 16 French dental schools. Descriptive analyses were performed. RESULTS: Among 1370 FDSs (response rate: 84.5%), hardness was the most commonly reported criterion for assessing the endpoint of carious tissue removal (53.9%), followed by firm dentin (40.0%). Regarding FDSs' opinion of leaving carious dentine under a restoration, 41.9% of the respondents agreed that carious tissues should always be removed completely. For an asymptomatic tooth with DCLs and exposed pulp, direct pulp capping was mainly chosen (93.9%). In a clinical case correctly diagnosed as a reversible pulpitis by 79.7% of respondents, nearly half of FDSs chose a one-step complete excavation (48.3%) followed by selective excavation (25.1%), then two-step complete excavation (20.9%) and a minority (5.7%) opted for pulpal therapy (biopulpotomy or endodontic treatment). CONCLUSION: The present results suggest an inadequate dissemination of MI concepts among FDSs towards DCL management. The present results show the need for a harmonisation and a reinforcement of teaching evidence-based MI according to the latest European recommendations.

Determining color for the direct restorative approach.

When implementing a direct composite resin (CR) restoration, the determination of color can be a challenging step. The reproduction of tooth shade is often a source of frustration for the practitioner. Dental color can be complex, and its accurate reproduction requires not only a good understanding of color by the practitioner but also the use of appropriate methods to achieve it. It is important to remember what tooth color parameters one is able to mimic with CRs. The purpose of this article is to demystify the errors attributable to standard tools, ie, shade guides, and above all to suggest a number of measures to avoid such errors.

Knowledge and Opinions of French Dental Students Toward Occlusal and Proximal Restorative Thresholds.

PURPOSE: To investigate the practices, knowledge and opinions of French dental students (FDSs) in various domains of minimal intervention (MI) in cariology. MATERIALS AND METHODS: A cross-sectional, questionnaire-based study was conducted in spring 2018 among all fifth-year French dental students (FDSs) from the 16 French dental schools. The present article focuses on restorative management. Statistical analyses (descriptive, chi-squared) were performed. RESULTS: The response rate was 84.5%. Overall, 97.4% of respondents would have operatively intervened for proximal and 83% for occlusal carious lesions, respectively, while non-or micro-invasive intervention would have been possible. Interestingly, 15% would completely open the occlusal fissures. For both occlusal and proximal lesions requiring a restoration, composite resin was indicated by over 95% of the respondents. In a clinical case, 51.6% of FDSs who rightly diagnosed an enamel carious lesion would operatively intervene. When FDSs could not diagnose the type of carious lesions, a high proportion of invasive actions were also reported (40%). FDSs who read scientific articles were more likely to consider the high importance of not filling sound teeth unnecessarily (p = 0.033). CONCLUSION: FDSs do not have sufficient awareness of MI guidelines regarding occlusal and proximal restorative thresholds. Efforts are required in dental schools to teach FDSs to postpone invasive/restorative strategies to later stages of carious progression. There is a need to strengthen prevention techniques and non-invasive options in the teaching of MI in cariology.

Knowledge and opinions of French dental students related to caries risk assessment and dental sealants (preventive and therapeutic).

OBJECTIVES: A national questionnaire study was performed to document knowledge and opinions of French dental students (FDSs) about minimal intervention (MI) in dentistry especially caries risk assessment (CRA) and dental sealants (DSs). MATERIALS AND METHODS: A questionnaire was administered to the fifth-year dental FDSs (n = 1370) from the 16 French dental schools. Descriptive and statistical analyses were performed. RESULTS: The response rate was 84.5%. A large majority of respondents (87.8%) linked MI with minimally invasive dentistry and 77.4% considered MI as a concept based on prevention. About 80% stated they use CRA in clinical practice, mostly without any specific form. If 80.4% of the respondents would base their treatment plans on CRA, only 55.1% would regularly plan preventive regimens according to individual risk level. However, while 96.6% declared they perform preventive DSs, only 44.3% considered therapeutic sealants as a routine treatment. Although 75.1% of FDSs stated that they had sufficient learning and training related to CRA, 55.9% thought that they need further education about preventive and therapeutic DSs. CONCLUSION: Although FDSs seem to be aware of the importance of CRA and preventive strategies, this study shows the need to harmonize the teaching in cariology according to the latest European recommendations. CLINICAL RELEVANCE: A national questionnaire study showed variability towards knowledge and opinions of FDSs related to MI in cariology. This may impact care provisions in their future professional life showing the urgent need to harmonize the teaching of MI in cariology in France.

Esthetic rehabilitation of the smile with partial laminate veneers in an older adult.

Bonded partial ceramic veneer is an interesting alternative to full buccal restoration in terms of tissue economy. However, its usage is restricted to patients with a low smile line (such as the elderly) due to the visibility of the tooth/restoration limit which is a key to the therapeutic decision.

Hierarchizing caries risk factors among first-year university students in Nice (France): a cross-sectional study.

BACKGROUND: The purpose of this study was to rank the risk factors for dental caries among first-year university students in Nice (France). METHODS: All first-year students are required to undergo a compulsory preventive medical examination. Among these students, volunteers were offered a dental visit. Information was collected through an interview followed by an oral examination. We assessed the volunteers' oral hygiene habits (daily toothbrushing frequency, type of toothbrush used, frequency of toothbrush replacement, place of toothpaste purchase, and flossing), daily health-related behaviors (number of main daily meals, daily sugary intakes, smoking, alcohol consumption, consumption of cannabis or other drugs), oral-health-related behaviors (self-reported oral health, dental visits during the past year, reason for the last dental consultation, and failure to seek dental care due to financial reasons), and oral health issues (dental crowding, oral hygiene, presence of caries, presence of pit and fissure sealant remnants). The dependent variable was the presence of at least one untreated carious lesion. The data were subjected to univariate analyses to select explanatory variables, and subsequently, a logistic regression was performed. RESULTS: Six hundred twenty-nine students aged 18.8±1.6 years were enrolled in this study. The sex ratio was 0.72, with a strong predominance of the female gender. Only 59.3% of the students had never experienced dental caries, while 22.4% had already undergone restorative procedures and did not have any carious lesion at the time of the examination, and 11.6% presented with carious lesions and had never been treated by a dentist. Lastly, 6.7% had carious lesions despite evidence of prior restorative procedures. The multivariate analysis revealed the following pejorative risk factors: failure to seek dental care due to financial reasons (OR:3.06, 95% CI: 1.40-6.70), poor oral hygiene revealed during the oral examination (OR:2.59, 95% CI: 1.60-4.20), and poor self-reported oral health (OR:2.43, 95% CI: 1.24-4.77). Conversely, the analysis revealed the following protective factors: preventive visits to the dentist (OR:0.63, 95% CI: 0.41-0.99), the use of an electric toothbrush (OR:0.36, 95% CI: 0.17-0.77), and sealant remnants (OR:0.22, 95% CI: 0.05-0.97). CONCLUSIONS: The highest-ranking caries risk factor for the study population was the financial barrier.

Comparison of macroscopic and microscopic (stereomicroscopy and scanning electron microscopy) features of bone lesions due to hatchet hacking trauma.

This experimental study examined the lesions produced by a hatchet on human bones (tibiae). A total of 30 lesions were produced and examined macroscopically (naked eye) and by stereomicroscopy. 13 of them were also analyzed using scanning electron microscopy. The general shape of the lesion, both edges, both walls, the kerf floor and the extremities were described. The length and maximum width of the lesions were also recorded. The microscopic analysis of the lesions led to the description of a sharp-blunt mechanism. Specific criteria were identified (lateral pushing back, fragmentation of the upraising, fossa dug laterally to the edge and vertical striae) enabling the forensic expert to conclude that a hacking instrument was used. These criteria are easily identifiable using scanning electron microscopy, but can also be observed with stereomicroscopy. Overall, lateral pushing back and vertical striae visible using stereomicroscopy and scanning electron microscopy signal the use of a hacking tool.

Inter- and Intra-Operator Reliability of Facial and Dental Measurements Using 3D-Stereophotogrammetry.

OBJECTIVES: The goal of this study was to assess the reproducibility of an innovative method for facial analysis with three-dimensional-stereophotogrammetry (3D-spg). METHODS: Twelve subjects with no obvious malocclusion participated in this study. For each of them, four photographs were acquired using the LifeViz(TM) , an absolute calibration 3D-spg system. The facial reconstructions were analyzed with the DermaPix(TM) image management software. Two different operators recorded distances between landmarks and each operator repeated the measurements after one week. The intra- and inter-examiner reproducibilities were assessed using the Intraclass Correlation Coefficient (ICC). RESULTS: This study showed reproducible intra and inter-examiners results for facial measurements (ICC comprised between 0.732 and 0.976) except for measurements that involve the inner part of the dental corridor (ICC comprised between 0.598 and 0.914). CONCLUSION: The measurements recorded by 3D-LifeViz(TM) system are accurate and reliable for research and clinical use. Moreover, it is simple and inexpensive compared with other 3D methods (laser scanner, 3D Computed Tomography, and 3D Cone Beam CT). CLINICAL SIGNIFICANCE: The inter- and intra-operator reliability of the LifeViz(TM) 3D-spg method was demonstrated. The LifeViz(TM) 3D-spg method might be a useful method to accomplish indirect 3D measurements that are relevant to dental and facial diagnosis. (J Esthet Restor Dent, 2016).