Deep Margin Elevation - A Retrospective Clinical Study.

PURPOSE: The aim of this retrospective study was to assess the short- to mid-term restorative and periodontal outcome of deep margin elevation (DME) performed using resin composite. MATERIALS AND METHODS: Twenty-eight teeth treated with DME and indirect adhesive restorations were followed-up for a mean of 25.4 months (minimum: 12 months). Clinical and radiographic examination assessed the adaptation of the DME material and indirect restorations, presence of recurrent caries or discoloration, periodontal health at DME and non-DME sites, and periapical health. RESULTS: The overall success rate was 96.6%. One tooth showed signs and symptoms of apical pathology after 34 months following DME. No caries, discoloration, or periodontal pockets were detected in any of the treated teeth. DME had no detrimental effect on the gingival/periodontal health or plaque accumulation. There was no correlation between the distance from the DME material to the marginal bone level and pocket depth, gingival inflammation, and plaque accumulation (p > 0.05). CONCLUSION: Deep margin elevation might be considered a safe procedure for teeth with deep subgingival proximal caries in the short- and mid-term.

Two-year clinical and radiographic evaluation of ACTIVA BioACTIVE versus Compomer (Dyract® eXtra) in the restoration of class-2 cavities of primary molars: a non-inferior split-mouth randomised clinical trial.

OBJECTIVES: The trial aimed to compare the clinical performance and radiographic success of ACTIVA BioACTIVE versus Compomer in restoring class-II cavities of primary molars. MATERIALS AND METHODS: A non-inferior split-mouth design was considered. A pre-calculated sample size of 96 molars (48 per group) with class-2 cavities of twenty-one children whose ages ranged from 5 to 10 years were randomly included in the trial. Pre-operative Plaque Index (PI), DMFT/dmft scores and the time required to fill the cavity were recorded. Over 24 months, the teeth were clinically evaluated every six months and radiographically every 12 months by two calibrated and blinded evaluators using the United States public health service (USPHS)-Ryge criteria. The two-sided 95% confidence interval (CI) for the difference in success rate was considered to assess non-inferiority, and the margin was set at -18%. The linear mixed model and Firth's logistic regression model were used for data analysis (P < 0.05). RESULTS: After 24 months, 86 teeth (43 per group) were evaluated. The mean PI score was 1.1(± 0.9), while DMFT/dmft was 0.35 (± 0.74) and 6.55 (± 2.25) respectively. The clinical and radiographic success rate of Dyract vs. ACTIVA was 95.3% and 88.3% vs. 93% and 86%, respectively. The two-sided 95% CI for the difference in success rate (-2.3%) was - 3.2 to 1.3% and didn't reach the predetermined margin of -18% which had been anticipated as the non-inferiority margin. Clinically, ACTIVA had a significantly better colour match (P = 0.002) but worse marginal discolouration (P = 0.0143). There were no significant differences regarding other clinical or radiographic criteria (P > 0.05). ACTIVA took significantly less placement time than Dyract, with a mean difference of 2.37 (± 0.63) minutes (P < 0.001). CONCLUSION: The performance of ACTIVA was not inferior to Dyract and both materials had a comparable high clinical and radiographic performance in children with high-caries experience. ACTIVA had a significantly better colour match but more marginal discolouration. It took significantly less time to be placed in the oral cavity. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov on 4 May 2018 (#NCT03516838).

Automotive Technology Revolutionized Restorative Dentistry Discovery of Alpha-diketone/Amine Catalyst: Part I.

A full account of early research that led to the discovery of the Alpha-diketone and Amine systems by two Imperial Chemical Industries (ICI) researchers. UK Chemists in the mid-sixties marked the beginning in the early development of a composite resin cured with visible light spectrum into a solid mass. Its incorporation into the newly developed Urethane based resin, led to conceiving the idea of developing the first light-activated restorative composite resin, which formed the prototype of modern composite restorative materials. How all that came about, and the ideas that were conceived and pursued in the development of these systems are discussed in detail.

Impact of repeated preheating of bulk-fill resin composite on postoperative hypersensitivity; a randomized controlled clinical trial.

BACKGROUND: This clinical study was conducted aiming to evaluate the impact of repeated preheating of bulk-fill resin composite on postoperative hypersensitivity. METHODS: A total of 105 eligible, consenting adults were recruited. Patients had posterior teeth suffering from proximal decay with no signs of irreversible pulpitis. Patients were prepared for Class II restorations and restored with bulk-fill resin composite. Patients were randomized into three groups of 35 patients according to the number of preheating cycles for the resin composite syringe used; group I: no preheating; control group at room temperature, group II: Resin composite preheated once, and group III: Resin composite preheated ten cycles. Patients were assessed for postoperative dentin hypersensitivity using the visual analogue scale (VAS) at three-time intervals: day one, one week and by the end of one month after restorative treatment. Statistical analysis was performed; ANOVA with a single factor was used to test for significance at a p value ≤ 0.05. For nonparametric data, the Kruskal‒Wallis test was used to compare the three testing groups. Friedman's test was used to study the changes within each group. Dunn's test was used for pairwise comparisons when the Kruskal‒Wallis test or Friedman's test was significant. RESULTS: The scores of the three groups through the three time intervals were almost zero except for the first day where VAS scores were recorded with maximum score of 3 for groups I and II. Groups II and III; there was no statistically significant change in hypersensitivity scores by time with P-values 0.135 and 0.368, respectively. However, for group I there was a significant difference from VAS score recorded on first day and the two following time intervals. CONCLUSION: The repeated preheating cycles of bulk-fill resin composite prior to curing had no adverse effect on the patients regarding postoperative dentin hypersensitivity. This information could be of utmost significance, as the same resin composite syringe can undergo numerous preheating cycles clinically before it is completely consumed with the advantage of improvement on the handling properties. TRIAL REGISTRATION: The protocol of the current study was registered at www. CLINICALTRIALS: gov , with the identification number NCT05289479 on 21/03/2022. All procedures involving human participants were performed in accordance with the ethical standards of the Research Ethics Committee of the Faculty of Dentistry, Minia University, Egypt, under the approval number 73/440 on 11/09/2020.

The effect of various inhaled asthma medications on the color stability of paediatric dental restorative materials.

BACKGROUND: The purpose of the study is to analyse the effects of different inhaled asthma medications (IAMs) on the color change of dental restorative materials (DRMs). METHODS: In total, 192 samples were taken from six different DRMs: [Filtek Z550 (nanohybrid composite), Fusio Liquid Dentin (Self-adhering flowable composite), Filtek Ultimate (nanofilled flowable composite), Dyract XP (compomer), Fuji II LC (resin-modified glass ionomer), Fuji IX Fast (self-cured-packable glass ionomer), (n = 32)]. After the initial color values (CIELab) of DRMs were measured by using a spectrophotometer, each sample was exposed to the same IAMs via nebulizer according to the four different inhaled therapies and measurements were repeated on the 7th & 21st days. RESULTS: In all IAM groups, DRM with the least amount of ΔE was nanohybrid composite, while the highest ΔE was found in Fuji II LC. Among all experimental groups, only Fuji II LC which was administered the combined medication, exceeded the clinically unacceptable threshold (ΔE = 3.3) on 7th & 21st days. CONCLUSIONS: Consequently, important factors affecting the susceptibility to color stability are the type of IAMs, the administration time-dosage, and the type of DRMs.

Predictors of apical periodontitis in root canal treated teeth from an adult Nepalese subpopulation: a cross-sectional study.

BACKGROUND: Endodontic literature search revealed that no study has been conducted to evaluate the prevalence of apical periodontitis (AP) in root canal treated teeth from an adult Nepalese population of Madhesh Province. Consequently, little is known about the extent and risk factors associated with it. This study aimed to determine AP prevalence in root canal treated teeth from an adult Nepalese subpopulation and to analyze the related risk factors including age, sex, tooth type, type of coronal restoration and quality of root canal treatment and coronal restoration as predictors of AP. METHODS: Digital panoramic radiographs were evaluated. Periapical status of 300 root canal-treated teeth was scored by using the periapical index. The quality of root canal treatment and coronal restorations were categorized as adequate or inadequate through radiographic and clinical evaluation. The data were analyzed using univariate and multivariate logistic regression models. RESULTS: Prevalence of AP in the present study was 31.7%. In 45.7% of the treated teeth, quality of root canal treatment was adequate whereas 46% of the cases had adequate coronal restorations. Multivariate logistic regression analysis revealed statistically significant associations and remarkably increased risk for AP in teeth with inadequate root canal treatment (odds ratio [OR] = 7.92; 95% CI: 3.96-15.82; p < 0.001) whereas lower risk for AP was found in females (OR = 0.51; 95% CI: 0.28-0.90; p = 0.021) and in teeth restored with crown (OR = 0.22; 95% CI: 0.09-0.51; p < 0.001) and filling (OR = 0.18; 95% CI: 0.08-0.42; p < 0.001). Quality of coronal restoration, tooth type and age of the patient were not found to be the predictors of AP. CONCLUSIONS: Within the limits of this study, a high prevalence of AP and poor overall quality of root canal treatment and coronal restoration was found in the subpopulation studied. Quality of root canal treatment, type of coronal restoration and sex of the patient are significant predictors of possible AP development in root canal treated teeth. Substantial efforts are needed to improve the endodontic treatment standards.

Clinical evaluation of resorbable polylactic acid (PLA) intracanal posts for primary incisor restoration. Randomized controlled clinical trial.

This randomized, controlled clinical trial compares the clinical performance of glass-fibre and resorbable polylactic acid (PLA) intracanal posts used to restore carious primary incisors in young patients. The study sample includes 180 primary upper central incisors of 90 children aged 3 to 4 years. All patients were randomly divided into two equal groups of 45 children who received PLA and glass-fibre (GFP) intracanal posts. The clinical assessment of incisor restorations was carried out immediately upon completion and at months 3, 6 and 12 according to the following criteria: anatomical form, marginal adaptation, surface roughness, marginal pigmentation, colour match, secondary caries and contact point. The Gingival Index (GI), the Bleeding Index (Cowell modification; mBI), and bite force (BF) were measured. At the 3-month follow-up, the occlusal BF of patients who received PLA posts was higher than the baseline; the GI and mBI scores were lower, by contrast (p < 0.05). This tendency was even more pronounced 6 and 12 months after the restoration. The incidence of side effects or symptoms (apical inflammation, cervical fracture, loosening of the crown) after the PLA posts was significantly lower than after the GFP (p < 0.05). No statistically significant differences were present between the two groups with respect to colour matching, anatomical form, marginal adaptation, marginal pigmentation, surface roughness, occlusal contact and secondary caries. Based on the results, applying PLA intracanal posts and cyanoacrylate to residual anterior crowns in young children can improve their gingival health, reduce side effects, and increase the likelihood of successful restoration.

Two-year evaluation of a nano-hybrid and a bulk-fill resin composite: a randomized, double-blind split-mouth clinical study.

OBJECTIVES: The aim of this study was to compare the 2-year clinical performance of a bulk-fill composite resin and a nano-hybrid-filled composite resin in 6-12-year-old children in a split-mouth design. MATERIALS AND METHODS: This randomized, split-mouth, and double-blind study was conducted on 89 patients aged 6-12 years with caries on bilateral mandibular first molars. In a split-mouth design, restorations of mandibular permanent molars were completed with nano-hybrid organically modified ceramic (ORMOCER)-based bulk-fill composite resin Admira Fusion x-tra (Voco GmbH, Cuxhaven, Germany) and nano-hybrid composite Grandio (Voco, Cuxhaven, Germany). Futurabond U single dose (Voco, Cuxhaven, Germany) was used with selective enamel etching. The clinical success of the restorations was evaluated using USPHS and FDI criteria at 6, 12, and 24-month follow-up controls. RESULTS: In the 2-year follow-up, all restorations were clinically acceptable. Grandio was significantly worse than Admira Fusion x-tra in terms of surface luster and superficial change (p < 0.05). Surface staining and color match scores increased in Admira Fusion x-tra compared with Grandio significantly (p < 0.05). CONCLUSIONS: Although both materials showed acceptable clinical performance over 2 years, a significant difference was observed between the surface luster, surface staining, marginal adaptation, and staining of the nano-hybrid composite placed with the incremental technique and the bulk-fill ORMOCER-based composite resin. CLINICAL RELEVANCE: As an alternative to nano-hybrid composite resins, using bulk-fill restorative materials, which can be indicated in the proper case, may contribute to shortening treatment procedures and increasing patient and physician comfort, leading to clinical success.

Sixty-month comperative evaluation of a glass hybrid restorative and a composite resin in non-carious cervical lesions of bruxist individuals.

OBJECTIVE: To compare the clinical performance of a glass hybrid (GH) restorative and a nano-ceramic composite resin (CR) in the restoration of non-carious cervical lesions (NCCLs) of bruxist individuals in a 60-month randomized clinical trial. MATERIALS AND METHODS: Twenty-five bruxist candidates having NCCLs were recruited in this clinical study. The depth, height (cervico-incisal), width (mesio-distal), internal angles of the NCCLs, degree of tooth wear (TWI) and gingival index (GI) were measured. One hundred-and-forty-eight NCCLs were restored either with a GH restorative (Equia Forte Fil) or a CR (Ceram.X One Universal). Modified USPHS criteria was used to evaluate restorations after 1 week and 12, 24, 36 and 60 months. Pearson's Chi-Square, Fisher's Exact and Cochran Q tests were run for analysis. Survival rates of the restorations were compared with Kaplan-Meier analysis (p < 0.05). RESULTS: After 60 months, 97 restorations in 15 patients were examined. The recall rate was 60.0%. Retention rates were 73.5% for CR and 66.7% for GH. A total of 29 restorations were lost (13CR (26.5%), 16GH (33.3%)). There was not a significant difference between tested restoratives in retention (p = 0.464), marginal adaptation (p = 0.856) and marginal discoloration (p = 0.273). There was no relationship between internal angle, depth, height or width and retention of the GH or CR restorations (p > 0.05). The increase in retention loss and marginal discoloration of both restorations over time were significant (p < 0.001). Sensitivity or secondary caries were not detected after 60 months. CONCLUSION: GH and nano-ceramic CR showed similar clinical performances in NCCLs after 60 months in patients with bruxism. CLINICAL SIGNIFICANCE: After 60 months, CR and GH materials showed clinically acceptable performances in restoration of NCCLs in patients with bruxism.

In Vitro Microleakage and Fracture Resistance of "Infinity Edge" and Cusp Reduction Preparation Designs for Moderate-sized Class II Composites.

AIM: This study aimed to evaluate the marginal microleakage and maximum occlusal fracture loads and fracture modes of two novel class II preparation designs, "infinity edge" and the "2.5 mm cusp reduction" preparations as compared to a traditional class II preparation without cuspal involvement. MATERIALS AND METHODS: Thirty extracted human mandibular molars were prepared for moderate-sized class II restorations with extensions into all occlusal grooves. Of these, ten class II preparations served as control. Ten were modified for a 2.5 mm even reduction of the cusps adjacent to the interproximal box. An additional 10 preparations were modified with an "infinity edge" bevel on the interproximal and occlusal portions. All teeth were restored utilizing a flowable bulk-fill composite in the apical portion of the interproximal box and 2-4 mm of heated bulk-fill composite in one increment for the remainder. All groups were cyclic loaded and thermocycled, then imaged with microcomputed tomography (µCT) before and after infiltration with a silver nitrate solution. Images were subtracted to obtain volumetric measurements of microleakage and reported as a percentage of the total volume from the apical extent of the proximal box. All groups were loaded to failure and fracture load and mode were recorded. RESULTS: No significant differences were found in microleakage volume as a percentage of total tooth volume; however, the "infinity edge" group had significantly greater microleakage in the proximal box compared to the traditional class II group. No significant differences were found in fracture load or mode between the groups. CONCLUSION: Traditional class II, 2.5 mm cuspal reduction, and "infinity edge" preparation designs have similar fracture loads as well as volumes of microleakage; however, an "infinity edge" preparation has a higher ratio of microleakage in the proximal box. CLINICAL SIGNIFICANCE: Clinicians should carefully consider the use of "infinity edge" margins, particularly on dentin in the apical extent of the proximal box. How to cite this article: Watson JC, Lien W, Raimondi JC, et al. In Vitro Microleakage and Fracture Resistance of "Infinity Edge" and Cusp Reduction Preparation Designs for Moderate-sized Class II Composites. J Contemp Dent Pract 2024;25(1):3-9.

Comparative Assessment of Marginal Micro Leakage of Different Esthetic Restorative Materials Used on Primary Teeth: An In-vitro Study.

AIM: The aim of the current investigation was to evaluate the marginal microleakage of various esthetic restorative materials applied to primary teeth. MATERIALS AND METHODS: A total of 75 noncarious primary molars that were removed for orthodontic intervention and teeth nearing exfoliation were chosen. One millimeter (mm) above the cementoenamel junction, on the buccal surface of the teeth, Class V cavities were prepared. William's graded periodontal probe was used to standardize cavity preparation on all teeth. 3 mm was the cavity's length, 2 mm in width, and 2 mm in depth. The teeth were then divided into three groups (25 samples in each group) according to the type of esthetic restorative material used. Group I: Resin-modified glass ionomer cement, Group II: Ormocer, Group III: Giomer. The samples underwent 500 cycles of thermocycling, with an immersion time of 60 seconds and a well time of 15 seconds, between 5 and 55°C. The samples were submerged in methylene blue dye for 24 hours at room temperature and dried. The samples were then divided into sections and examined with a stereomicroscope. Data was recorded and statistically analyzed. RESULTS: The least marginal microleakage was found in the ormocer group (1.22 ± 0.01) followed by resin-modified glass ionomer cement group (1.31 ± 0.07) and the giomer group (1.78 ± 0.03). There was a highly statistically significant difference found between resin-modified glass ionomer cement group and the ormocer group, resin-modified glass ionomer cement group and giomer group. And no significant difference was found between the ormocer group and the giomer group. CONCLUSION: The present study concluded that there was some amount of microleakage in primary teeth in all restorative materials examined in this in-vitro investigation. However, the marginal sealing ability of ormocer was found highest compared to resin-modified glass ionomer cement and Giomer materials. CLINICAL SIGNIFICANCE: The primary reason dental restorations fail, particularly in Class V cavities, is microleakage since the margins of these restorations are typically found in the dentin or cementum. Assessing microleakage is a crucial step in determining the marginal integrity of restorative materials. Developing methods and resources that reduce the adverse effects caused by the restorative marginal seal failing would benefit from this. How to cite this article: Al Ghwainem A, Alqarni AS. Comparative Assessment of Marginal Micro Leakage of Different Esthetic Restorative Materials Used on Primary Teeth: An In-vitro Study. J Contemp Dent Pract 2024;25(1):58-61.

Opinions of UK General Dental Practitioners on the Restoration of Posterior Root Filled Teeth: a Vignette Survey.

OBJECTIVE: To investigate factors which influence UK general dental practitioners (GDPs) when restoring posterior root filled teeth. METHOD: An electronic survey was designed to explore current strategies of treatment of posterior root filled teeth by UK-based GDPs working in primary care. Three vignette cases included in the questionnaire explored a variety of tooth, patient, and financial factors. The survey was distributed by email and social media platforms between December 2018 and February 2019. RESULTS: A total of 528 valid responses were collected. The majority of participants (84.1%) regularly restored posterior root filled teeth with an indirect restoration. Presence of persistent symptoms post root canal treatment (RCT) completion would impact the management of 85% of the surveyed respondents. Referral to a specialist, deferral of provision of the definitive restoration, and fear of litigation were reported by the GDPs as influencing factors. CONCLUSION: This survey highlights that decision making regarding restoration of root filled teeth is a multifactorial process. Tooth, patient, and financial factors were all shown to influence the restorative management of the posterior root filled teeth.

Optimizing fracture resistance of endodontically treated maxillary premolars restored with preheated thermos-viscous composite post-thermocycling, a comparative study. Part I.

PURPOSE: This research aimed to investigate fracture resistance of endodontically treated maxillary premolars restored using preheated thermo-viscous and fiber-reinforced bulk fill resin composite, in vitro. METHODOLOGY: Sixty sound human maxillary premolars were selected and divided randomly into 6 groups of ten teeth each (n = 10). Group 1; is the positive control with sound unprepared teeth (P), Group 2; is the negative control in which Mesio-occluso-distal (MOD) cavities were left unrestored (N), Group 3; includes the teeth restored by incremental packing with conventional nanohybrid composite (ChP), Group 4; includes teeth restored with short fiber reinforced bulk fill composite (EF), Group 5; includes teeth restored with preheated thermo-viscous bulk fill composite (VB), and Group 6; includes teeth restored using packable bulk fill composite (XF) Tested restorative materials were bonded with a universal adhesive in self-etch mode. Teeth were kept in distilled water for 24 h at 37 °C proceeded by thermocycling (5- 55 °C, 1200×). Teeth were then exposed to compressive load till fracture at a crosshead speed of 1 mm/min. One-way ANOVA followed by Tukey post-hoc test was implemented to compare between more than two groups in non-related samples. The significance level was established at α = 0.05 for both tests. RESULTS: Intact teeth significantly recorded the highest fracture resistance values among all groups. A significant difference was recorded among all the tested groups, with the EF recording the highest values, followed by the VB group then the XF group and ChP that recorded the lowest data. Negative control premolars significantly recorded the lowest fracture. CONCLUSIONS: After thermocycling, endodontically treated maxillary premolars restored with pre-heated thermos-viscous composite did not exhibit an increase in fracture resistance. Notably, our findings indicate that short fiber-reinforced composite demonstrated significantly higher fracture resistance compared to other types of composites assessed in this study. This suggests the potential superiority of short fiber-reinforced composite in enhancing the overall structural integrity of endodontically treated teeth subjected to occlusal forces.

Effect of composite radiopacity and margin location of the restoration on the diagnosis of secondary caries.

This research aimed to evaluate the effect of the radiopacity of a Bulk-Fill composite (X-TraFil, VOCO, Germany) and a Conventional composite (P60, 3M ESPE, USA) and assessment of the margin location in the enamel and dentin on the diagnosis of secondary caries. 76 intact premolars with MOD preparation were divided into two equal groups and filled with the conventional and bulk-fill composite. Four regions were considered to simulate carious lesions (two regions in enamel and two regions in dentin). In each group, half of the regions in the dentin and half in the enamel were randomly selected for secondary caries simulation and filled with a wax-plaster combination while the remaining regions stayed intact. Bitewing imaging was done using the PSP digital sensor. Five examiners reviewed the images, and lesions were recorded. Caries diagnosis indicators and paired-sample t-test were used for statistical analysis. The reproducibility and accuracy of the examiners' responses were evaluated using the kappa and agreement coefficient (α=0.05). The sensitivity, specificity, and accuracy of diagnosing secondary carious lesions in enamel were significantly better under conventional than bulk-fill composite. Similarly, the sensitivity and accuracy of diagnosing secondary caries in dentin were significantly higher under conventional composite than bulk-fill composite (p<0.05). No significant differences were found in the agreement and kappa coefficient between conventional and bulk-fill composites in the enamel and dentin (p>0.05). The diagnostic accuracy of carious lesions was higher under conventional composite than bulk-fill composite. However, the location of the secondary was ineffective in caries diagnosis.

Impact of Access Cavity Design on Fracture Resistance of Endodontically Treated Maxillary First Premolar: In Vitro.

This study was designed to investigate the impact of access cavity designs on fracture resistance of endodontically treated maxillary first premolars. The study sample consisted of 72 intact maxillary first premolars, randomly divided into six groups (n = 12). A standardized proximal cavity preparation was prepared for all samples using standard bur. Groups I: control group with only standard proximal cavity and no endodontic access, group II: Truss access cavity, group III: Separated access to buccal and palatal canals without removal of dentine in between, group IV: Access to buccal and palatal canals with removal of dentine in between, group V: Traditional access cavity, group VI: Mesio-occlusal-distal cavity (MOD). For groups I and VI, only composite restoration was used to restore the proximal cavity, while for groups II- V, the access was prepared and endodontic treatment was performed on all teeth, then composite restoration was placed. The root canals were instrumented using nickel-titanium files, irrigated with sodium hypochlorite, and filled with AH plus sealer and gutta-percha using warm vertical condensation. All samples were then placed in an acrylic mold and underwent thermal aging for 10,000 cycles between 5 and 55°C. The samples were fixed in a universal testing machine with the long axis of the roots positioned at 20° to a load applied at a crosshead speed of 1 mm/min using a stainless steel semi-spherical indenter (Ø = 3 mm) until fracture occurred to determine the fracture resistance force in Newton. The normality test (Shapiro-Wilk) showed that data are normally distributed. Group II exhibited the highest mean fracture resistance, and group VI was the least likely to resist the fracture. No statistically significant differences between tested groups (p-value = 0.237). The MOD group showed a more unfavorable mode of fracture compared to other groups. No significant difference in fracture resistance between conservative and traditional access cavities. The missing marginal ridges, such as in MOD cavities played an important role in decreasing the fracture resistance of endodontically treated teeth.

Assessing the impact of dental restorative materials on fibroblast cells: an immunohistochemical and ELISA analysis.

In this study, our aim was to investigate the effects of restorative materials such as composite, compomer and high viscosity glass ionomer, which are frequently used in dentistry, on L929 fibroblast cells by evaluating the oxidative stress parameters, pro- and anti-inflammatory cytokines, and apoptosis markers. L929 fibroblast cells were cultured, and dental filling materials were applied in two doses (50 and 100 µl). Immunohistochemical staining was performed for experimental groups with Anti-Bax and Anti-Caspase 9 antibodies. Then, ELISA technique was used to detect the level of TNF-alpha, TGF-beta, IL-1-beta, IL-6, IL-10, LPO and CAT. In the light of the data, the examined dental filling materials were effective on increasing the TGF-beta, IL-10, LPO and CAT levels, and decreasing the TNF-alpha, IL-1-beta, and IL-6 levels. The histological micrographs were also support the issues. When the levels of H-score in Caspase 9 labeled micrographs were evaluated, the mean of the control group was lower than the mean of the experimental groups. Biocompatibility varies according to the content of the material, the amount of residual monomer, and its solubility. Although all the experimental groups have cytotoxic effects, the least effect is seen in the Omnichroma group.

Clinical evaluation of posterior restorations over wet and dry dentin using an etch-and-rinse adhesive: A 36-month randomized clinical trial.

OBJECTIVES: To evaluate the clinical performance of posterior restorations over wet and dry dentin with an etch-and-rinse adhesive after 36 months of clinical service. METHODS: Forty-five participants were recruited, each one had at least two posterior teeth that needed restoration. Ninety restorations were placed on Class I or Class II cavities. For the restoration protocol, a simplified etch-and-rinse adhesive (Adper Single Bond 2) was applied over wet (WD) or dry dentin (DD) and later restored with a bulk-fill composite (Filtek Bulk Fill) under rubber dam isolation. Each restoration was evaluated using the World Dental Federation (FDI) criteria after 6, 12, and 36 months of clinical service, regarding the following principal restoration characteristics: postoperative sensitivity, marginal discoloration, marginal adaptation, fracture of material and retention, and recurrence of caries. Kruskal Wallis analysis of variance rank (α = 0.05) and Kaplan-Meier survival analysis were used for statistical analysis. RESULTS: After 36 months of clinical evaluation, no significant difference between groups was observed in each FDI criterion (p > 0.05). Twenty restorations (WD=10, DD=10) showed minor marginal staining, and twenty-two restorations (WD=11, DD=11) presented small marginal adaptation defects (p > 0.05). Four restorations were lost (WD = 2, DD = 2) and the fracture rates (95% confidence interval) were 94.9% for each one, without significant difference between wet and dry dentin (p > 0.05). SIGNIFICANCE: The degree of dentin moisture does not seem to affect the clinical performance of a simplified etch-and-rinse adhesive in posterior restorations when the adhesive is applied vigorously over the dentine surface.