El material restaurador ideal en la era de la odontología de invasión mínima. Rescatando al oro directo / The ideal restorative material at the minimal invasive dentistry era. Rescuing direct gold

Los logros de los avances obtenidos en el manejo actual de la caries han dado la oportunidad a los odontólogos de detectar lesiones de caries en sus estadios incipientes. A pesar de la existencia de una gran variedad de materiales restauradores directos disponibles en el mercado actual y que pueden utilizarse para restaurar lesiones pequeñas de caries, el material que tiene más posibilidades de éxito para este tipo de lesiones es sin duda alguna el oro cohesivo, también conocido como oro directo (AU)

The goals obtained with the current management of dental caries has given the dentists the opportunity to detect incipient caries lesions in early stages. Although, the current existence of a great variety of direct restorative materials available in the market to restore small caries lesions, the material that may show better success for these type of lesions, is without any doubt: the gold foil or direct gold (AU)

Materiales bioactivos para restauraciones directas en dientes posteriores / Bioactive materials for direct restorations in posterior teeth

Se trata de paciente femenino de 22 años de edad, en quien se realizó una restauración en un molar siguiendo la filosofía de mínima intervención desde el diagnóstico hasta la obturación con un material bioactivo. Los objetivos del tratamiento fueron devolver la funcionalidad y estética de dicho molar, pero sobre todo brindar una protección a largo plazo mediante la liberación y recarga de iones de calcio, fosfato y flúor proporcionado por el material bioactivo (AU)

t is about a female patient of twenty-two years, in which a restoration was made in a molar following the philosophy of minimal intervention from diagnosis to filling with a bioactive material. The objectives of the treatment were to restore the functionality and aesthetics, but mainly to provide long-term protection through the release and recharge of calcium, phosphate and fluoride ions provided by the bioactive material used (AU)

Anatomical post: a simple and safe alternative

Objective: To describe a clinical case that called for an anatomical post to be made to support and retain an indirect restoration in the anterior tooth. Case report: A 72-year-old female patient came to the office complaining that the crown of tooth 22 had come loose. A clinical and radiographic examination of element 22 was performed, and showed a very broad root canal, total displacement of the cast metal crown-core set, and satisfactory endodontic treatment. The restorative planning for this patient included the making of an anatomical post from Exacto # 2 fiberglass post (Angelus, Brazil), and refilling it with Bulk One composite resin (3M, USA), using self-adhesive resin cement U200 (3M, USA). The reconstruction of the coronary portion of the post was also performed with the same composite resin (Bulk One 3M, USA). The preparation for full crown and temporary restoration was performed in the same session, using self-curing acrylic resin. The all-ceramic crown was molded and cemented in subsequent sessions. Conclusion: The use of anatomical posts with composite resin represents a technically viable alternative for rehabilitating endodontically treated teeth with wide root canals, in cases where conventional prefabricated fiber posts cannot be adapted easily. The advantages that stand out are that these posts can be applied easily, at low cost, and in a single session.

Objetivo: Descrever um caso clínico de confecção do pino anatômico para suporte e retenção de restauração indireta em dente anterior. Relato do Caso: Paciente feminina, 72 anos, compareceu ao consultório queixando-se que a coroa do dente 22 havia "soltado". Realizou-se exame clínico e radiográfico do elemento 22, que apresentou conduto radicular bastante amplo, deslocamento total do conjunto núcleo/coroa e tratamento endodôntico satisfatório. O planejamento restaurador para essa paciente incluiu a confecção de pino anatômico, com pino de fibra de vidro Exato #2(Angelus, Brasil) reembasado com resina composta Bulk One (3M, EUA), utilizando o cimento resinoso autoadesivo U200 (3M, EUA). Foi realizada a reconstrução da porção coronária do pino também com resina composta do tipo Bulk. Realizou-se, na mesma sessão de atendimento, o preparo para coroa total e restauração provisória utilizando dente de estoque e resinaacrílica autopolimerizável. Em sessões seguintes foi realizada a moldagem e cimentação da coroa total em cerâmica pura. Conclusão: A utilização de pinos anatômicos com resina composta representa uma alternativa tecnicamente viável, de fácil aplicabilidade, com baixo custo e em única sessão, para reabilitação de dentes tratados endodonticamente com conduto radicular onde os pinos em fibra pré-fabricados convencionais não apresentam boa adaptação.

Superficial effects of different finishing and polishing systems on the surface roughness and color change of resin-based CAD/CAM Blocks / Efectos superficiales de diferentes sistemas de acabado y pulido en la rugosidad superficial y el cambio de color de los bloques de Resina CAD/CAM

ABSTRACT: CAD/CAM blocks are widely used in dental restorations around the world. This study aimed to investigate the effects of different polishing and finishing systems on surface roughness and color change of resin-based CAD/CAM blocks. In this study, material samples of 2×7×12mm were prepared. In three different experimental groups, surface polishing was carried out with one-step, two-step and multi-step polishing systems. The samples in one subgroup of each experimental group were polished with the diamond paste. Once the initial roughness and color values of the samples were measured using a profilometer and a spectrophotometer, the samples were immersed in coffee. Surface roughness and color change (ΔE00) results were statistically analyzed using two-way variance analysis (ANOVA). Finishing and polishing systems created significantly different levels of surface roughness on the hybrid ceramic block (Vita Enamic) but not on the composites block (Brilliant Crios, Grandio Blocs). While the two-step and multi-step finishing and polishing systems produced the lowest color change on hybrid ceramic blocks, one-step and two-step systems achieved this on composite blocks (p<0.05). In all test groups, the supplementary polishing performed after regular polishing procedures helped us reduce the surface roughness and color change on CAD/CAM blocks. The findings obtained in this study suggest that one and two-step polishing systems are more suitable for resin-based composite CAD/CAM blocks; for hybrid ceramic CAD/CAM blocks, on the other hand, two and multi-step finishing and polishing systems seem to be more efficient concerning lower surface roughness and resistance to color changes.

RESUMEN: Los bloques CAD/CAM son ampliamente utilizados en las restauraciones dentales, alrededor del mundo. El objetivo de este estudio es investigar los efectos de diferentes sistemas de pulido y acabado sobre la rugosidad de la superficie y el cambio de color de los bloques CAD/CAM de resina. En este estudio se prepararon muestras de material de 2×7×12mm. El pulido de la superficie se llevó a cabo en tres grupos experimentales con sistemas de pulido de un paso, de dos pasos y de varios pasos. Las muestras de un subgrupo de cada grupo experimental se pulieron con la pasta de diamante. Una vez medidos los valores iniciales de rugosidad y color de las muestras mediante un perfilómetro y un espectrofotómetro, las muestras se sumergieron en café. Los resultados de la rugosidad superficial y el cambio de color (ΔE00) se analizaron estadísticamente mediante un análisis de varianza de dos vías (ANOVA). Los sistemas de acabado y pulido crearon niveles de rugosidad superficial significativamente diferentes en el bloque cerámica híbrida (Vita Enamic) pero no en el bloque de composites (Brilliant Crios, Grandio Blocs). Mientras que los sistemas de acabado y pulido de dos y varios pasos produjeron el menor cambio de color en los bloques de cerámica híbrida, los sistemas de un paso y dos pasos lo consiguieron en los bloques de composite (p<0,05). En todos los grupos de prueba, el pulido suplementario realizado después de los procedimientos de pulido regulares nos ayudó a reducir la rugosidad de la superficie y el cambio de color en los bloques CAD/CAM. Los hallazgos obtenidos en este estudio sugieren que los sistemas de pulido de uno y dos pasos son más adecuados para los bloques CAD/CAM de resina; en cambio, para los bloques CAD/CAM de cerámica híbrida, los sistemas de acabado y pulido de dos y varios pasos parecen ser más eficientes en lo que respecta a la menor rugosidad de la superficie y la resistencia a los cambios de color.

Resistance fracture of minimally prepared endocrowns made by three types of restorative materials: a 3D finite element analysis.

A thin endocrown restoration was often applied in endodontically treated teeth with vertical bite height loss or inadequate clinical crown length. A model of mandibular molars made by endocrown restoration with 1 mm thickness and 2 mm depth of pulp chamber was constructed and imported into FEA ANSYS v18.0 software. The three CAD/CAM materials, feldspathic (Mark2), lithium disilicate (EMAX), and lava ultimate (LU), were assigned, and the five load indenters were loaded on the full occlusal (FO), occlusal center (OC), central fossa (CF), buccal groove (BG), and mesiobuccal cusp (MC) of restoration in the model. The MinPS and MaxPS of the thin endocrown were significantly higher than those of tooth tissue in five types of loads except for the LU endocrown loaded in the FO group. The smaller the contact surface of the load was, the higher MaxPS and MinPS were. MaxPS and MinPS of the MC were the highest, followed by the BG and CF in the restoration. In the stress distribution of tooth tissue, MaxPS in the LU endocrown accumulated at the external edge of enamel and was significantly higher than MaxPS in Mark2 and EMAX endocrown concentrated on the chamber wall of dentin under OC, CF and BG loads. Within the limitations of this FEA study, the LU endocrown transferred more stress to tooth tissue than Mark2 and EMAX, and the maximum principal stress on endocrown restoration and tooth tissue at the mesiobuccal cusp load was higher than that at the central fossa and buccal groove load.

Calcium hydroxyapatite nanoparticles as a reinforcement filler in dental resin nanocomposite.

The current study focuses on the fabrication of calcium hydroxyapatite (Ca10(PO4)6(OH)2) (HA) in a nanorange having whiskers- and cubic-shaped uniform particle morphology. The synthesized HA particles hold a promising feature as reinforcement fillers in dental acrylic resin composite. They increase the efficacy of reinforcement by length and aspect ratio, uniformity, and monodispersity. Therefore, the acrylic resin was reinforced with the as-synthesized monodispersed HA filler particles (0.2-1 Wt%). The presence of filler particles in the composite had a noticeable effect on the tribological and mechanical properties of the dental material. The morphological effect of HA particles on these properties was also investigated, revealing that cubic-shaped particles showed better results than whiskers. The as-fabricated composite (0.4 Wt%) of the cubic-shaped filler particles showed maximum hardness and improved antiwear/antifriction properties. Particle loading played its part in determining the optimum condition, whereas particle size also influenced the reinforcement efficiency. The current study revealed that particle morphology, particle size, uniformity, etc., of HA fillers, greatly influenced the tribological and mechanical properties of the acrylic resin-based nanocomposite. Improvement in the tribological properties of HA particle-reinforced acrylic resin composites (HA-acrylic resin) followed the trend as AR < CmC < WC < CC.

Biomimetic mineralisation systems for in situ enamel restoration inspired by amelogenesis.

Caries and dental erosion are common oral diseases. Traditional treatments involve the mechanical removal of decay and filling but these methods are not suitable for cases involving large-scale enamel erosion, such as hypoplasia. To develop a noninvasive treatment, promoting remineralisation in the early stage of caries is of considerable clinical significance. Therefore, biomimetic mineralisation is an ideal approach for restoring enamel. Biomimetic mineralisation forms a new mineral layer that is tightly attached to the surface of the enamel. This review details the state-of-art achievements on the application of amelogenin and non-amelogenin, amorphous calcium phosphate, ions flow and other techniques in the biomimetic mineralisation of enamel. The ultimate goal of this review was to shed light on the requirements for enamel biomineralisation. Hence, herein, we summarise two strategies of biological minimisation systems for in situ enamel restoration inspired by amelogenesis that have been developed in recent years and compare their advantages and disadvantages.

Water jet as a novel technique for enamel drilling ex vivo.

To investigate the usage of a water jet for enamel drilling ex vivo, 210 individual extracted molars without lesions or fillings were collected. Then, the specimens were drilled by a water jet or a high-speed dental drill. The cavities of 50 teeth were reconstructed digitally by micro-computed tomography (micro-CT) to measure the height and width. The cavities of 10 teeth were longitudinally incised and their surfaces were observed by scanning electronic microscopy (SEM). After the cavities were filled, 50 fillings were vertically incised. The bonding interface between tooth and filling was observed by SEM. 50 teeth with fillings were stained in 0.1% rhodamine B solution, and then the dye penetration between tooth and filling was observed under the stereomicroscope and confocal laser scanning microscopy (CLSM). The bonding strength between enamel and filling of 50 teeth was simulated and predicted with finite element analysis (FEA). At 140-150 MPa and for 2-3 s, cavities were made with a depth of approximately 764 µm in each tooth. SEM showed the cavity surface in the water jet group had a more irregular concave and convex structure than that in the high-speed dental drill group. There was a trend that the microleakage and bonding width was smaller in the water jet group than in the high-speed dental drill group. FEA indicated that the stress on the resin surface was greater than on the enamel surface in the water jet group. Compared with the tooth drilled by a high-speed dental drill, the tooth drilled by a water jet gained better retention of the filling material and suffered less bonding strength on the enamel surface. Water jet drilling is effective for enamel drilling.

Accuracy of cone-beam CT in detecting vertical root fractures in teeth with post-endodontic restorations: an in vitro study

The aim of this study was to evaluate the accuracy of cone-beam CT (CBCT) for the detection of artificially created vertical root fractures (VRF) in extracted teeth restored with metallic (MP) and fiberglass (FGP) posts. After root canal obturation, 60 extracted human premolars were scanned by using the highest-resolution settings of a CBCT unit. Theprepared roots were randomly divided into three groups: group C (control group): non-restored and non-endodontically treated teeth (n = 20); group MP (n = 20); group FGP (n = 20). In all groups, 10 teeth were artificially fractured. Two external and independent observers blindly recorded the presence or absence of VRF. Sensitivity, specificity, accuracy, intra-and interobserver agreement were calculated. Kappa value for inter-and intraobserver agreement was 0.82 and 0.84 respectively, demonstrating goodagreement. The highest values for sensitivity (0.80 -0.90), specificity (1.00) and accuracy (0.90 -0.95) were found in the control group. The teeth with FGP restoration presented the lowest sensitivity (0.30 -0.50) and accuracy (0.60 -0.65) values. Both examiners had a good performance in the diagnosis of fractures in teeth with MP, with accuracy ranging between 0.85 -0.90. The presence of MP did not influence accuracy; however, the presence of FGP reduced the diagnostic capacity of CBCT.

Filtración marginal y contracción en la polimerización en nuevas resinas Bulk Fill: una revisión de la literatura / Marginal leakage and polymerization shrinkage in new Bulk Fill resins: a review of the literature

A pesar de los avances e innovaciones de los materiales dentales, la microfiltración marginal y la contracción durante la polimerización continúan siendo una de las causas principales del fracaso de los tratamientos en odontología restauradora. Un sellado marginal correcto será posible cuando las fuerzas de adhesión superen las fuerzas generadas por la contracción de polimerización y las fuerzas generadas por los cambios dimensionales térmicos posteriores a la polimerización, por lo que investigaciones previas demostraron que estas limitaciones pueden ser superadas con el uso de resinas Bulk Fill como material de relleno de cavidades extensas y profundas de dientes posteriores. Estas resinas. de relleno masivo, están recibiendo atención, principalmente porque se pueden colocar, a diferencia de las resinas convencionales, en incrementos de 4 mm sin afectar la contracción de la polimerización, la adaptación de la cavidad o el grado de conversión. El objetivo de la presente revisión bibliográfica es describir la contracción de polimerización y la consecuente filtración marginal que sufren las resinas compuestas para el sector posterior Bulk Fill con base de datos de la literatura (AU)

Despite advances and innovations in dental materials, marginal microfiltration and shrinkage during polymerization continue to be one of the main causes of treatment failure in Restorative Dentistry. A correct marginal seal will be possible when the adhesion forces exceed the forces generated by polymerization contraction and the forces generated by post-polymerization thermal dimensional changes, for which previous research has shown that these limitations can be overcome with the use of Bulk Fill resins as filling material for large and deep posterior tooth cavities, these massive filling resins are receiving attention mainly because they can be placed, unlike conventional resins, in 4 mm increments without affecting polymerization shrinkage. , cavity adaptation or degree of conversion. The objective of the present bibliographic review is to describe the polymerization contraction and consequent marginal filtration suffered by Composite Resins for the Bulk Fill posterior sector with a literature database (AU)

Effect of Direct and Indirect Materials on Stress Distribution in Class II MOD Restorations: A 3D-Finite Element Analysis Study.

The aim of this study is to investigate the stress distributions of different restoration options for class II mesio-occluso-distal (MOD) cavities. A class II MOD cavity with proximal box gingival floor 1 mm below cementoenamel junction was designed in a mandibular first molar tooth model. 3D finite-element analysis (FEA) and 3D-CAD modelling were used to examine the occlusal stresses distributed to the remaining buccal enamel (RBE), remaining lingual enamel (RLE), adhesive surfaces, and restorative materials by direct and indirect materials resulting from a 600 N of static occlusal load stimulating foodstuff. von Mises (VM) and maximum principal (Pmax) stresses were evaluated for two CAD/CAM materials and three direct materials. CAD/CAM materials exerted less stress than the direct restorative materials. Significant von Mises and Pmax stress value differences were seen among all restoration models on RBE. Reducing RLE and including it into the cavity would be a more effective option for this model in this scenario. As VM and Pmax stresses of PIHC CAD/CAM material for RBE and dentin were significantly lower than other tested materials, it may be the choice of material for indirect MOD restorations.

High bonding strength between zirconia and composite resin based on combined surface treatment for dental restorations.

Zirconia is the preferred material for dental restorations; however, dental restorations are usually affected by zirconia fractures due to chipping and delamination of the veneer ceramic. One effective solution for repairing chemically inert zirconia frameworks is to strongly chemically bond them with the composite resin via surface modification. Thus, the bonding strength between the zirconia and composite resin determines the performance of dental restoration. Herein, we investigate the shear bond strength between zirconia ceramic and two ceramic repair systems before and after thermal cycling based on different surface pretreatments, including air-abrasion and a novel silane coupling agent. When treated with combined sandblasting, novel silane and 10-methacryloyloxydecyl hydrogen phosphate act as a bonding agent for the zirconia surface, and the maximum shear bond strength achieves 27.5 MPa, as measured by a universal testing machine through the average of 16 separate measurements. The results show that the combined treatment resists the interface damage caused by expansion and contraction during thermal cycling. The long-term bond durability is due to the micro-mechanical bond force formed by resin and ceramic, and the chemical bonds of Zr-O-Si at the interface. Results indicate that selective pretreating the surface results in high bond strength between the zirconia and the composite resin, which is meaningful to optimize dental restoration.

Cervicofacial and mediastinal emphysema following minor dental procedure: a case report and review of the literature.

BACKGROUND: Subcutaneous cervical emphysema is a clinical sign associated with many conditions, including laryngotracheal trauma, pneumothorax and necrotizing deep tissue infections. CASE PRESENTATION: We discuss a case of a 76-year-old man presenting with extensive cervical emphysema a few hours after a minor dental filling procedure. The CT-scan revealed a significant amount of air within the cervical and mediastinal spaces, reaching lobar bronchi. Vitals were within normal values Bloodwork demonstrated an elevation of creatinine kinase (3718; normal < 150) and mild leukocytosis (WBC = 11.6). We decided to proceed to an urgent cervical exploration to exclude necrotizing fasciitis. This revealed air but no tissue necrosis nor abnormal fluid. The patient improved clinically and was discharged two days later with oral antibiotics. Although cervicofacial subcutaneous emphysema following dental procedures has been reported, it is usually less extensive and involving more invasive procedures using air-driven handpieces. CONCLUSION: As an otolaryngologist confronted with extensive subcutaneous emphysema following a potential entry route for an aggressive infection, given the seriousness of this diagnosis, the decision of whether or not to perform a diagnostic surgical exploration should remain.

Harnessing biomolecules for bioinspired dental biomaterials.

Dental clinicians have relied for centuries on traditional dental materials (polymers, ceramics, metals, and composites) to restore oral health and function to patients. Clinical outcomes for many crucial dental therapies remain poor despite many decades of intense research on these materials. Recent attention has been paid to biomolecules as a chassis for engineered preventive, restorative, and regenerative approaches in dentistry. Indeed, biomolecules represent a uniquely versatile and precise tool to enable the design and development of bioinspired multifunctional dental materials to spur advancements in dentistry. In this review, we survey the range of biomolecules that have been used across dental biomaterials. Our particular focus is on the key biological activity imparted by each biomolecule toward prevention of dental and oral diseases as well as restoration of oral health. Additional emphasis is placed on the structure-function relationships between biomolecules and their biological activity, the unique challenges of each clinical condition, limitations of conventional therapies, and the advantages of each class of biomolecule for said challenge. Biomaterials for bone regeneration are not reviewed as numerous existing reviews on the topic have been recently published. We conclude our narrative review with an outlook on the future of biomolecules in dental biomaterials and potential avenues of innovation for biomaterial-based patient oral care.

Five year evaluation of the complications observed in porcelain fused to metal (PFM) crowns placed at a university hospital.

OBJECTIVE: To determine the frequency of complications in crowns cemented over a 5-year period in a tertiary care hospital and also to report the survival of these crowns. METHODS: The retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from March 2017 to March 2018 and comprised porcelain fused-to-metal crowns placed on the anterior or posterior teeth that were fabricated at the institutional laboratory and were placed in institutional dental clinics in the preceding 5 years. Porcelain-fused to-metal The crowns were clinically and radio-graphically evaluated in a duration of two months for presence/absence of complications. Factors associated with the failure of the crowns, their survival and the impact of covariates, like gender, flossing and bruxism, on the survival time were determined. Data was analysed using SPSS 22. RESULTS: There were 150 crowns related to 107 patients who had a mean age of 45.0±11.4 years. The most common complication observed was open proximal contacts 9(6%) followed by de-cementation 8(5.3%), porcelain chipping 9(6%) and abutment fracture 2(1.3%). The 5-year survival rate of the crowns was 127(84.7%). The mean follow-up time was 57.2±1.0 months. Overall, year-wise survival of PFM crowns for one year till five years was 147 (98%), 144 (96%), 135 (90%), 130 (86%) and 119 (79%) respectively. CONCLUSIONS: The porcelain-fused-to-metal crowns had a high 5-year survival rate. Open proximal contacts represented the most common complication.

Effect of light irradiation condition on gap formation under polymeric dental restoration; OCT study.

OBJECTIVE: To investigate the effect of two light-curing systems; quartz tungsten-halogen (QTH) and light-emitting diode (LED), and irradiation time on interfacial gap formation of dental composite resin restorations bonded with an adhesive resin using optical coherence tomography (OCT). MATERIALS AND METHODS: Forty cavities were prepared in extracted human molar teeth and divided into four groups (n=10) based on the type of light curing system QTH (LITEX 680A) and LED (Demi Plus) and curing duration (10 s or 40 s). A single-step self-etching dental adhesive (Tetric® N-Bond; Ivoclar Vivadent AG, Schaan, FL, Liechtenstein) was applied and polymerized with QTH for 10 s (QTH-10), or for 40 s (QTH-40). Similarly, the adhesive in LED-10 and LED-40 groups was polymerized with an LED for 10 s or 40 s, respectively. Then, all specimens were restored with Filtek™ Z350 XT flowable composite (3M ESPE AG, St. Paul, MN, USA) and immersed in ammoniacal silver-nitrate contrasting solution. Cross-sectional images were recorded at every 250µm using cross-polarization OCT system (CP-OCT; IVS-300, Santec, Komaki, Aichi, Japan). Image analysis to quantify the percentage of gap at resin-dentin interface was performed using a custom plugin for ImageJ software. RESULTS: Data analysis using one-way ANOVA showed a significant difference in mean gap percentage between the four test groups (p<0.0001). Mean gap percentage values were 75.8%, 53.2%, 9.9% and 5.6%. The highest for LED-10 followed by LED-40 (p <0.05). QTH-40 revealed a slightly better adaptation compared with QTH-10, but the difference between them was not significant (p <0.05). CONCLUSION: CP-OCT with a contrast agent is a useful non-invasive imaging tool for dental composite resin materials. QTH showed better results than LED under the experimental conditions. When using an LED light-curing unit, prolonged irradiation improved interfacial adaptation of dental composite bonded with a self-etching adhesive.

Evaluation of mechanical properties of new elastomer material applicable for dental 3D printer.

PURPOSE: Digital technology has advanced and changed clinical dentistry. The utility of various thermoplastic materials for 3D dental printing has not been thoroughly explored. The aim of this study was to evaluate mechanical properties of a new thermoplastic elastomer material applicable for a dental 3D printer. MATERIAL & METHOD: Three thermoplastic elastomers: ABS, PLA and an acrylic block copolymer (KUR) and a dental self-curing resin (PMMA) were used in this study. Physical properties were evaluated by measuring water sorption (WS), dimensional accuracy (DA), ultimate tensile strength (UTS) and shear bond strength (SBS) to PMMA. For WS and DA, specimens were measured by weight and length, respectively after desiccation and immersion in 37 °C distilled water for 1 day, 1 week and 1 month. For UTS, the specimens were prepared according to ISO 527-2-5A and loaded to test the UTS at a crosshead speed of 5 mm/min after storage in 37 °C distilled water for 24 h and 1 month. For SBS, MMA self-curing resin was filled in a Teflon ring which was mounted onto polished specimens to make the adhesive area. The prepared specimens were tested for SBS after storage in 37 °C distilled water for 24 h and 37 °C distilled water for 24 h followed by 10000 times thermal cycling. The data were analyzed by repeated measures ANOVA, two-way ANOVA and t-test with Bonferroni correction at 95% confidence level. RESULT: The WS value of PMMA was significantly higher than those of the other materials after 1 day (p < 0.05), while the WS values of KUR were significantly higher than those of the other materials after 1 week and 1 month (p < 0.05). The DA values were influenced by water storage periods except for KUR. There were no significant differences among ABS, PLA and PMMA in SBS before thermal cycling (p > 0.05). The SBS of KUR was the lowest among the materials before thermal cycling (p < 0.05). However, there was no significant difference between PMMA and KUR after thermal cycling (p > 0.05). CONCLUSION: The acrylic block copolymer demonstrated acceptable physical properties, suggesting the potential to be a material to make provisional restorations for a dental 3D printer.

The motivational effect of multicolored dental restoration on dental behavior of first preliminary school children.

Objectives: To assess the motivational effect of multi-colored restoration on the anxiety level of pediatric patients at thedental clinic and its motivational effect on their oral hygiene status. Material and methods: A total of 30 participants. Results: Both groups revealed reduction in the anxiety level and improvement in their behavior at the dental office but did not reach significance. Plaque index showed a significant reduction per group and a near significance as compared between test groups. Conclusions: The use of the multicolored restoration could provide a potential advantage to improve the oral health status of children and might aid in enhancing their behavior at dental clinic particularly younger age groups.

Preformed pediatric zirconia crown versus preformed pediatric metal crown: study protocol for a randomized clinical trial.

BACKGROUND: Guidelines in pediatric restorative dentistry recommend the use of preformed pediatric stainless steel crowns (SSCs) in cases of severe tooth decay of at least two surfaces. This clinically effective and safe restorative option is frequently refused by parents for esthetic reasons; they prefer conventional restorations using esthetic filling materials (composites, glass ionomer) if lesion severity limited to two surfaces permits. Recently, manufacturers have proposed esthetic preformed pediatric zirconia crowns (ZCs) but these have been assessed in only two randomized clinical trials (RCT) with follow-ups of 6 and 12 months. Only one of these RCTs was carried out on primary molars to test ZCs (NuSmile ZR) without a groove in its inner surface. The primary objective of this proposed RCT is to assess the effectiveness of ZCs compared with SSCs. Our hypothesis is that the effectiveness of ZCs will be equivalent to that of SSCs. METHODS: In this split-mouth, 2-year RCT, pairs of primary molars in 101 child participants will be randomized and restored with SSCs (ESPE, 3M) and ZCs (EZCrowns, Sprig Oral Health Technologies) characterized by grooves on their inner surface. Primary molars will first be allocated to SSCs, and 1 to 2 weeks later the other primary molar of the same pair will be restored by ZC. The primary outcome is the success defined by the "absence of major clinical and radiographic failure" (e.g., pain, pulp infection, dental abscess or periradicular pathology visible on radiographs). The secondary outcomes include the retention and fracture rates, the gingival condition, the wear of the antagonist of the treated teeth, as well as both parental and child satisfaction. DISCUSSION: This study will investigate two types of preformed pediatric crowns for the management of severe decay on primary molars. The results may help practitioners choose the better therapeutic option and to explain to parents the advantages and disadvantages of these two therapies. TRIAL REGISTRATION: NCT03296709 . Registered on  27 September 2017.

The influence of restorative material and glass fiber posts on fracture strength of endodontically treated premolars after extensive structure loss.

OBJECTIVE: The aim of this in vitro study was to investigate the fracture strength and cuspal deflection of endodontically treated premolars restored using different composite resins along with or without fiber post application. MATERIALS AND METHOD: Eighty intact premolars were randomly divided into eight groups (n = 10); CO group: intact teeth (control), OPR group: mesio-occlusal-distal-palatal (MODP) preparation (OPR) + endodontic treatment (ET), TC group: MODP preparation + ET + Tetric N-Ceram, TB group: MODP preparation + ET + Tetric EvoCeram Bulk Fill, SO group: MODP preparation + ET + SonicFill 2, TC-P group: MODP preparation + ET + Hahnenkratt glass fiber post + Tetric N-Ceram, TB-P group: MODP preparation + ET + Hahnenkratt glass fiber + Tetric EvoCeram Bulk Fill, and SO-P Group: MODP preparation + ET + Hahnenkratt glass fiber post + SonicFill 2. After thermocycling, specimens were subjected to a compressive load until fracture. Data were analyzed using analysis of variance and Tukey tests (P < 0.05). RESULTS: The mean fracture strength of groups which received post treatment showed similar fracture strength values [TC-P (931.6 ± 97.9), TB-P (882.0 ± 59.7), SO-P (862.0 ± 143.0) (P > 0.05)] and was significantly higher than OPR (530.6 ± 41.7), TC (841.2 ± 93.1), TB (774.5 ± 101.8), and SO (735.0 ± 178.01) groups (P < 0.05). No significant difference was detected among groups considering cuspal deflection (P > 0.05). The fiber post insertion resulted in more unfavorable fractures. CONCLUSION: Endodontically treated teeth restored with fiber post and bulk-fill or conventional composite resins demonstrated fracture strength values similar to intact teeth.