Five-year survival of class II restorations with and without base bulk-fill composite: a retrospective cohort study.

OBJECTIVE: This study aimed to determine the survival of class II composite restorations in premolars and molars with and without base bulk-fill composite in general dental practice. MATERIALS AND METHODS: We collected data from the electronic patient files of the Public Dental Services in the City of Oulu, Finland. The timespan of data collection was from August 15th, 2002, to August 9th, 2018. The data consisted of class II composite restorations both with and without base bulk-fill composite. We compared the survival of these restorations using Kaplan-Meier survival curves, the log-rank test, survival rates, and the Wilcoxon signed ranks test. RESULTS: We observed 297 restorations in 96 patients. The five-year survival rates for restorations with and without base bulk-fill composite were comparable in premolars (77.5% and 77.4%, respectively) but different in molars (69.9% and 57.8%, respectively, p = 0.069). In molars, the restorations with base bulk-fill composite exhibited a higher survival rate in 14 patients, whereas in 11 patients the restorations without base bulk-fill composites exhibited a higher survival rate. In 24 patients the survival rates were similar for restorations with and without the base bulk-fill composite (p = 0.246). CONCLUSIONS: The restorations with and without base bulk-fill composite had similar longevity. CLINICAL RELEVANCE: Base bulk-fill composites are safe to use in general practice due to their similar survival rates compared to conventional composites.

Masking ability of gingiva-colored resin-based composites over different tooth-colored substrates.

The purpose of the study was to investigate the influence of different tooth-colored substrates and restoration thicknesses on the final color of gingiva-colored resin-based composites (GCRBCs). Five different shades of GCRBCs [light pink (LP), dark pink (DP), orange (Or), brown (Br), and purple (P)] were used to prepare disc-shaped specimens with 2 different thicknesses: 1.0 mm, and 2.0 mm. GCRBC discs (n = 5) were placed over 3 different tooth-colored substrates (ND1, ND5, and ND9) and color parameters were assessed using a spectroradiometer. Color differences (∆E*ab and ∆E00) were calculated using CIELab and CIEDE2000 formulas and compared to 50:50% perceptibility (PT: ∆E*ab = 1.7, ΔE00 = 1.1) and acceptability (AT: ∆E*ab = 3.7, ΔE00 = 2.8) visual thresholds. Color variation data were statistically analyzed using two-way ANOVAs followed by Bonferroni's post hoc tests (a = 05). The ∆E*ab and ΔE00 values of GCRBCs placed over ND9 substrates were significantly higher in the LP-1.0 mm and Or-1.0 mm groups that presented values above AT (p< .001).Regardless of the substrate color and GCRBC thickness applied, ∆E*ab and ΔE00 values below AT were recorded in the gingival color groups of P. Substrate color significantly affected the color differences in the gingival color groups of LP, DP, and Or with a restoration thickness of 1.0 mm (p < .05). Gingival color, restoration thickness, and substrate color influenced the color differences of GCRBCs. When the gingival color was a lighter gingival color, rather than dark purple, the masking ability was decreased, especially with a restoration thickness of 1.0 mm.

Effect of shade and thickness on the microhardness of resin-based composite specimens at different points considering curing light beam's inhomogeneity.

BACKGROUND: Recent studies have reported the inhomogeneity in the light emitted by dental light-curing units (LCUs). It is essential to understand how this uneven light distribution affects the physical properties of resin-based composites (RBCs) at various points across their surfaces. This study aimed to evaluate the effect of LCU beam's inhomogeneity on the microhardness of RBCs with different shades and thicknesses. METHODS: Four body (A1B, A2B, A3B, and A4B), one dentin (A3D), and one enamel shade (A3E) of RBC (Filtek Z350 XT) were examined. The specimens were fabricated in four thicknesses (1, 2, 3, and 4 mm) and subjected to a 40-second light-curing. Vickers microhardness testing was performed at the center point, and 3 mm left and right from the center at the bottom surface of each sample. The LCU beam profile was characterized using a beam profiler, while irradiance after specimen passage was measured using a spectrometer. One-way analysis of variance (ANOVA) and Tukey's post-hoc tests were used to analyze the effects of shades and thicknesses on irradiance and microhardness, respectively. One-way repeated-measures ANOVA was used to compare the microhardness across different points. Pearson's correlation analysis examined the relationship between irradiance and microhardness. RESULTS: The beam profile of LCU revealed inhomogeneous light distribution. Light irradiance was decreased with both the increase in thickness and darker shade of the specimens (p < 0.05). Microhardness was found to decline with an increase in sample thickness (p < 0.05), and was consistently higher at the center point compared to the periphery, particularly in thicker (3 and 4 mm) and darker shades (A3B, A4B, and A3D). A positive correlation was found between the irradiance and microhardness across all evaluated points (p < 0.05). CONCLUSIONS: Inhomogeneous light emission from LCU significantly influences the microhardness of RBC samples, depending on the thicknesses and shades. The findings underline the importance of considering LCU beam inhomogeneity in clinical settings to ensure optimal polymerization of RBC.

Restoration with a posterior CAD/CAM onlay after failure of a direct resin-based composite restoration: a case report.

A conservative approach to restoration assists in preserving the remaining tooth structure of extensively destroyed vital teeth. This case report describes a single-appointment chairside technique for placement of ceramic restorations in posterior teeth. A patient presented for treatment of her mandibular right first molar, which had a fractured resin-based composite restoration. Due to the presence of vital pulp, extent of the restoration, and presence of caries in the tooth, the following treatment plan was proposed: placement of a lithium disilicate glass-ceramic onlay fabricated with a computer-aided design/computer-aided manufacturing workflow. After the dentist removed the restoration and performed selective caries removal, structural analysis guided the reduction of the buccal cusps. Immediate dentin sealing was performed with a 2-step self-etching adhesive system, and a 1-mm-thick layer of flowable resin-based composite was placed as a resin coating. A digital impression was obtained, the onlay restoration was designed, and a lithium disilicate block was milled and subsequently crystallized. When the onlay was completed, the tooth preparation was sandblasted, selectively etched, and coated with a universal adhesive. The intaglio surface of the onlay was cleaned and primed, the onlay was bonded with dual-cure resin cement, and occlusal adjustments were completed. Follow-up examinations at 1 and 4 months revealed the clinical success of the case. From start to finish, it takes approximately 2.5 hours to produce a single-appointment chairside restoration. The technique used in this case offers a fast-paced workflow that is comfortable and practical for the patient and provides a predictable clinical outcome without the need for a temporary restoration.

Influence of radiant exposure and material shade on the degree of conversion and microhardness of a resin-based composite.

This in vitro study evaluated the influence of radiant exposure and material shade on the degree of conversion (DC) and microhardness of a resin-based composite (RBC). Sixty-four RBC specimens in shades A1E (enamel) and A4D (dentin) were light cured at a calibrated exitance of 1000 mW/cm2 for 5, 10, 15, or 20 seconds, resulting in radiant exposure levels of 5, 10, 15, or 20 J/cm2. The DC was determined using Fourier-transform infrared spectroscopy (n = 3 per shade per exposure level). The Knoop hardness number (KHN) was measured on the top and bottom surfaces of each specimen (n = 5 per shade per exposure level). Data were analyzed using 2- and 3-way analyses of variance and post hoc Tukey tests (α = 0.05). The RBC shade did not affect the DC (P = 0.860), and the lowest DC values were achieved with an exposure level of 5 J/cm2 (P < 0.001). The shade did not affect the KHN on the top surface, but the radiant exposure level did, with the application of 5 J/cm2 resulting in significantly lower values (P < 0.05). For the bottom surface, shade A1E showed significantly higher KHN values than A4D (P < 0.001). An increase in the radiant exposure led to increased DC and KHN for both shades of RBC until reaching a saturation point of 10 J/cm2 for A1E and the top surface of A4D. The darker and more opaque shade was not adequately polymerized at a 2-mm depth, even when the highest radiant exposure level was applied.

In-vitro pulpal temperature increases when photo-curing bulk-fill resin-based composites using laser or light-emitting diode light curing units.

OBJECTIVE: To evaluate the in vitro pulpal temperature rise (ΔT) within the pulp chamber when low- and high-viscosity bulk-fill resin composites are photo-cured using laser or contemporary light curing units (LCUs). MATERIALS AND METHODS: The light output from five LCUs was measured. Non-retentive Class I and V cavities were prepared in one upper molar. Two T-type thermocouples were inserted into the pulp chamber. After the PT values reached 32°C under simulated pulp flow (0.026 mL/min), both cavities were restored with: Filtek One Bulk Fill (3 M), Filtek Bulk Fill Flow (3 M), Tetric PowerFill (Ivoclar Vivadent), or Tetric PowerFlow (Ivoclar Vivadent). The tooth was exposed as follows: Monet Laser (1 and 3 s), PowerCure (3 and 20 s), PinkWave (3 and 20 s), Valo X (5 and 20 s) and SmartLite Pro (20 s). The ΔT data were subjected to one-way ANOVA followed by Scheffe's post hoc test. RESULTS: Monet 1 s (1.9 J) and PinkWave 20 s (30.1 J) delivered the least and the highest amount of energy, respectively. Valo X and PinkWave used for 20 s produced the highest ΔT values (3.4-4.1°C). Monet 1 s, PinkWave 3 s, PowerCure 3 s (except FB-Flow) and Monet 3 s for FB-One and TP-Fill produced the lowest ΔT values (0.9-1.7°C). No significant differences were found among composites. CONCLUSIONS: Short 1- to 3-s exposures produced acceptable temperature rises, regardless of the composite. CLINICAL SIGNIFICANCE: The energy delivered to the tooth by the LCUs affects the temperature rise inside the pulp. The short 1-3 s exposure times used in this study delivered the least amount of energy and produced a lower temperature rise. However, the RBC may not have received sufficient energy to be adequately photo-cured.

Considerations about Cytotoxicity of Resin-Based Composite Dental Materials: A Systematic Review.

The dental material industry is rapidly developing resin-based composites (RBCs), which find widespread use in a variety of clinical settings. As such, their biocompatibility has gained increasing interest. This literature review presents a summary of research into the cytotoxicity of methacrylate-based composites published from 2017 to 2023. Subject to analysis were 14 in vitro studies on human and murine cell lines. Cytotoxicity in the included studies was measured via MTT assay, LDH assay, and WST-1 assay. The QUIN Risk of Bias Tool was performed to validate the included studies. Included studies (based entirely on the results of in vitro studies) provide evidence of dose- and time-dependent cytotoxicity of dental resin-based composites. Oxidative stress and the depletion of cellular glutathione (GSH) were suggested as reasons for cytotoxicity. Induction of apoptosis by RBCs was indicated. While composites remain the golden standard of dental restorative materials, their potential cytotoxicity cannot be ignored due to direct long-term exposure. Further in vitro investigations and clinical trials are required to understand the molecular mechanism of cytotoxicity and produce novel materials with improved safety profiles.

Color stability and degree of conversion of gingiva-colored resin-based composites.

OBJECTIVES: To evaluate gingiva-colored resin-based composites' (GCRBC) color stability and degree of conversion (DC%). METHODS: Eight discs (8 × 1 mm) of 20 shades of GCRBC were prepared. Color coordinates were measured against a gray background with a calibrated spectroradiometer, CIE D65 illuminant and the CIE 45°/0° geometry at baseline and after 30 days of storage in distilled water, coffee, and red wine. Color differences ( ∆ E 00 ) between final and baseline conditions were calculated. An ATR-FTIR spectrometer with a diamond tip was used to calculate DC%. The results were analyzed statistically using ANOVA and Tukey post-hoc test. The level of significance was p < 0.05. RESULTS: DC% and color stability correlated with each other and with the GCRBC brand. DC% ranged between 43% and 96%, highest values correspond to flowable composites. All composites have experienced color changes after immersion in water, wine and coffee. However, the magnitude of the color change has varied widely depending on the immersion medium and the GCRBC. Color changes generated by the wine were, globally, greater than those induced by coffee (p < 0.001) and above the acceptability thresholds. CONCLUSIONS: The DC% of GCRBCs is sufficient to achieve adequate biocompatibility and physicomechanical properties, but the high susceptibility to staining could compromise aesthetic long-term results. CLINICAL SIGNIFICANCE: The degree of conversion and the color stability of gingiva-colored resin-based composites correlated with each other. All composites have experienced color changes after immersion in water, wine and coffee. Color changes generated by wine were, globally, greater than those induced by coffee and above the acceptability thresholds that could compromise aesthetic long-term results.

Evaluation of the Selected Mechanical and Aesthetic Properties of Experimental Resin Dental Composites Containing 1-phenyl-1,2 Propanedione or Phenylbis(2,4,6-trimethylbenzoyl)-phosphine Oxide as a Photoinitiator.

The goal of this study was to compare the mechanical properties of experimental resin dental composites containing a conventional photoinitiating system (camphorquinone CQ and 2-(dimethylami-no)ethyl methacrylate (DMAEMA)) to a photoinitiator system containing 1-phenyl-1,2 propanedione (PPD) with 2-(dimethylami-no)ethyl methacrylate) or acting alone phenylbis(2,4,6-trimethylbenzoyl)-phosphine oxide (BAPO). The manually produced composites consisted of an organic matrix: bis-GMA (60 wt. %), TEGDMA (40 wt. %), and silanized silica filler (45 wt. %). The composites contained 0.4/0.8 wt. %, 0.8/1.6 wt. %, and 1/2 wt. % of PPD/DMAEMA and another group included 0.25, 0.5, or 1 wt. % of BAPO. Vickers hardness, microhardness (in the nanoindentation test), diametral tensile strength, and flexural strength were assessed, and CIE L* a* b* colorimetric analysis was conducted for each composite produced. The highest average Vickers hardness values were obtained for the composite containing 1 wt. % BAPO (43.73 ± 3.52 HV). There was no statistical difference in the results of diametral tensile strength for the experimental composites tested. The results of 3-point bending tests were the highest for composites containing CQ (77.3 ± 8.84 MPa). Despite the higher hardness of experimental composites including PPD or BAPO, compared with composites with CQ, the overall results indicate that the composite with CQ still represents a better solution when used as a photoinitiator system. Moreover, the composites containing PPD and DMAEMA are not promising in terms of color or mechanical properties, especially as they require significantly longer irradiation times.

Effects of nanohybrid flowable resin-based composites on fibroblast viability using different light-curing units.

PURPOSE: To investigate the in vitro cytotoxic effects of Bis-GMA-containing and Bis-GMA-free flowable resin-based composites (RBCs) on primary human gingival fibroblast cells (hGFc) using direct and indirect curing methods and three different light-curing units (LCUs). MATERIALS AND METHODS: Cells were isolated and cultured in vitro in 24-well plates. The plates were divided into treatment (cells with RBC), control (cells only), and blank (media only) groups. In the treatment groups, two types of nanohybrid flowable RBCs were used: Bis-GMA-free and Bis-GMA groups. Each treatment group was subdivided according to the curing method, i.e., direct curing (RBC was injected into the wells and cured directly on the attached cells) and indirect curing (the samples were pre-cured outside of the well plate and then added to the well plate with cells). To vary the LCU, the subgroups were further divided into three groups: multiple-emission peak light-emitting diode, single-emission peak light-emitting diode, and quartz-tungsten-halogen units. Curing was conducted for 20 seconds. The hGFc cytotoxicity was evaluated via 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay after 24, 48, and 72 hours of culturing. RESULTS: The MTT assay results showed that both RBCs were significantly cytotoxic toward hGFc compared to the control group (p < 0.0001). The Bis-GMA group was significantly more cytotoxic to the cells compared to the Bis-GMA-free group. In addition, the curing method and time interval affected cell viability regardless of the LCU used. CONCLUSION: The Bis-GMA flowable RBC and direct curing method had the highest cytotoxic effects on hGFc regardless of the LCU used. Careful selection of flowable RBCs and proper curing techniques are required to decrease the cytotoxic effects on hGFc and improve the clinical handling of oral tissues.

A quantitative assessment of silicone and PTFE-based stamp techniques for restoring occlusal anatomy using resin-based composites.

OBJECTIVES: Publications on stamp techniques for placing resin-based composite (RBC) restorations consist mainly of case studies. Furthermore, comparative studies are rare and no longer relevant to the materials tested today. Thus, two general techniques were investigated in this study. MATERIALS AND METHODS: Standardized occlusion class I cavities were prepared in twenty-eight extracted caries-free wisdom teeth with unimpaired occlusal surfaces and restored with the RBC material Grandio®. Light curing of the final layer was performed either after removal of the stamp isolated with PTFE tape or by leaving a stamp made of transparent polysiloxane in place. CEREC scans of the RBC restorations placed (follow-up) were superimposed on scans of the unimpaired occlusal surface (baseline) and quantitatively analyzed with the software OraCheck with regard to volume change and gain or loss of layer thickness in six sectional planes. RESULTS: Assessing the excess material, there was no difference (p = 0.31) between the silicone technique (0.26 mm ± 0.02) and the PTFE technique (0.22 mm ± 0.02 mm). Nevertheless, the loss of tooth substance was significantly greater (p < 0.001) with the silicone technique (-0.29 mm ± 0.02 mm) than with the PTFE technique (-0.15 mm ± 0.02 mm). CONCLUSIONS: With the PTFE stamp technique, less healthy tooth structure was removed during the finishing procedure and the stamp was more dimensionally stable. CLINICAL RELEVANCE: The study shows the advantages and disadvantages of the investigated stamp techniques and helps the practitioner to choose an appropriate technique.

Can TPO as Photoinitiator Replace "Golden Mean" Camphorquinone and Tertiary Amines in Dental Composites? Testing Experimental Composites Containing Different Concentration of Diphenyl(2,4,6-trimethylbenzoyl)phosphine Oxide.

The aim of this research was to compare the biomechanical properties of experimental composites containing a classic photoinitiating system (camphorquinone and 2-(dimethylami-no)ethyl methacrylate) or diphenyl(2,4,6-trimethylbenzoyl)phosphine oxide (TPO) as a photoinitiator. The produced light-cured composites consisted of an organic matrix-Bis-GMA (60 wt.%), TEGDMA (40 wt.%) and silanized silica filler (45 wt.%). Composites contained 0.27; 0.5; 0.75 or 1 wt.% TPO. Vickers hardness, microhardness (in the nanoindentation test), diametral tensile strength, resistance to three-point bending and the CIE L* a* b* colorimetric analysis was performed with each composite produced. The highest average Vickers hardness values were obtained for the composite containing 1 wt.% TPO (43.18 ± 1.7HV). The diametral tensile strength remains on regardless of the type and amount of photoinitiator statistically the same level, except for the composite containing 0.5 wt.% TPO for which DTS = 22.70 ± 4.7 MPa and is the lowest recorded value. The highest average diametral tensile strength was obtained for the composite containing 0.75 wt.% TPO (29.73 ± 4.8 MPa). The highest modulus of elasticity characterized the composite containing 0.75 wt.% TPO (5383.33 ± 1067.1 MPa). Composite containing 0.75 wt.% TPO has optimal results in terms of Vickers hardness, diametral tensile strength, flexural strength and modulus of elasticity. Moreover, these results are better than the parameters characterizing the composite containing the CQ/DMAEMA system. In terms of an aesthetic composite containing 0.75 wt.%. TPO is less yellow in color than the composite containing CQ/DMAEMA. This conclusion was objectively confirmed by test CIE L* a* b*.

Wear behavior of current computer-aided design and computer-aided manufacturing composites and reinforced high performance polymers: An in vitro study.

OBJECTIVE: To analyze the wear rate of computer-aided design and computer-aided manufacturing (CAD/CAM) composites, polyetheretherketones and glass ceramics. MATERIAL AND METHODS: Our study groups were prepared from two different resin-based composites (Brillant Crios, Cerasmart), a glass ceramic (IPS Emax CAD) and reinforced polyetheretherketone (BioHPP) material (n = 10). Premolar teeth were used as antagonists. The specimens, which were subjected to two body wear tests (240,000 cycles, 1.2 Hz, 50N) in the chewing simulator, were scanned with a 3D laser scanner both before and after the wear test. Volume loss and wear depth were determined by means of the obtained images software program. The wear pattern was examined by scanning electron microscopy. Kruskal Wallis test served for analyzing. RESULTS: The least volume loss and wear depth were seen in the polyetheretherketone material (0.06 ± 0.04 mm3 , 0.02 ± 0.01 mm), while the maximum volume loss was seen in the groups containing resin-based composite. (p = 0.05). The volume loss value in glass ceramics is between CAD/CAM composites and polyetheretherketone. CONCLUSION: The behavior of polyetheretherketone against enamel was different from glass ceramics and composite materials in terms of the amount of wear. CLINICAL SIGNIFICANCE: Polyetheretheketone can be considered as an alternative to other chairside materials in terms of wear resistance.

The effects of amalgam contamination and different surface modifications on microleakage of dentin bonded to bulk fill composite when using different adhesive protocols.

BACKGROUND: To evaluate the effect of amalgam contamination, different surface treatments, and adhesive protocols on dentin microleakage to bulk-fill composite resin material. METHODS: Forty teeth were fixed in (polyvinyl siloxane) PVS molds, and the Class II cavities were placed on mesial and distal aspects. Thirty teeth were restored by amalgam and thermocycled to 10,000 cycles (5 and 55 °C, 30-s dwell time). The rest were restored with Filtek one Bulk Fill composite without amalgam predecessor. Samples were divided into: G1 (dentin pretreated with 2% chlorhexidine gluconate), G2 (0.5 mm of dentin was removed), G3 (no surface modification), and G4 (control, where composite was bonded to sound dentin without amalgam predecessor.). Single Bond Universal Adhesive system was used to bond the composite material, by using the etch-and-rinse protocol in the mesial cavity preparation and self-etch protocol in the distal. Specimens underwent thermocycling for 5000 cycles, then embedded in silver nitrate and sectioned for stereomicroscope examination. Descriptive statistics, Mann-Whitney U test, and Kruskal-Wallis test were used to analyze the results at p < 0.05. RESULTS: The highest microleakage score values (4.00) were found in the G2, and G4 in etch-and-rinse protocol. While the lowest scores were found in G2 when using self-etching protocol (1.5). Lower microleakage values were associated with the chlorhexidine treatment group for both adhesive protocols. No significant differences were found between amalgam contaminated and non-contaminated groups. CONCLUSIONS: Amalgam contamination did not affect microleakage. Self-etching adhesive protocol significantly reduced microleakage for all groups irrespective of the surface treatment. Chlorhexidine pretreatment improved microleakage for both adhesive protocols but had no significant effect.

Twenty-Four-Month Clinical Comparison of Two Bulk-Fill and a Microhybrid Composite Restorations in Class II Cavities.

OBJECTIVES: The aim of this study was to evaluate the clinical performance of two bulk-fill composite resins in Class II cavities for up to twenty-four months. MATERIALS AND METHODS: In total 75 Class II restorations were made in 25 patients using two nanohybrid bulk-fill resin composites and a microhybrid composite. The restorations were evaluated at baseline and at 6, 12, and 24 months, using U.S. Public Health Service (USPHS) criteria. The restoration groups were compared using the Pearson chi-square test, and the Cochran Q-test was used to compare the changes across different time points within restorative materials (p⟨0.05). RESULTS: Two patients who did not attend the appointments were excluded from the study, so 23 patients were evaluated with a 92% recall rate; at the end of the two-year follow-up, 66 restorations were evaluated. Three restorations underwent endodontic treatment and were deemed failures. The overall success rate was 96%. There were statistically significant differences between the three restorative resins in terms of color match parameter (p⟨0.05). No differences were observed between the restorative resins in terms of other criteria (p⟩0.05). CONCLUSIONS: During the two-year follow-up period, the three composite resins showed similar clinical performance except for the color match parameter.

Effects of mouthwashes on color stability and surface roughness of three different resin-based composites.

OBJECTIVE: The aim of this study is to evaluate the effects of different types of mouthwashes (Klorhexidin, Curasept ADS 205, Meridol, Listerine Cool Citrus) on the surface roughness and color changes of a microhybrid (Point 4), a bulk fill (SonicFill), and a nanohybrid (Nova Compo-N) resin-based composite (RBC). MATERIALS AND METHODS: Disk-shaped specimens were prepared from tested RBCs and divided into four subgroups which immersed in four different types of mouthwashes. The specimens were subjected to immersion cycles in the mouthwashes and artificial saliva (n = 8). Each cycle consisted of complete immersion in a mouthwash for 21 min and afterwards in saliva for 12 h at 37°C, and this cycle was repeated 8 times. The surface roughness was evaluated using a profilometer and coloration was evaluated using a spectrophotometer before and after immersion time. One-way analysis of variance (ANOVA) for the evaluation of surface roughness data was performed, and interrelation between groups was identified with the Sheffe's multiple comparison test. RESULTS: There were no significant differences between the Ra values of the RBCs before and after immersion in mouthwashes (P > 0.05). There were significant differences between ΔE value of the SF and NCN groups before and after immersion time (P < 0.05). CONCLUSION: Mouthwashes contribute to oral health, especially in patients at high risk of caries. However, in such patients, patient-specific recommendations should be made when using mouthwashes due to the large number of composite fillings.

Longevity of posterior composite and compomer restorations in children placed under different types of anesthesia: a retrospective 5-year study.

OBJECTIVES: The aims of this study were (i) to assess cumulative survival rates of class II resin-based composite and compomer restorations in primary molars with a 5-year observation period and (ii) to analyze the influence of different types of anesthesia and different localizations of the restorations in the teeth. METHODS: Patient charts of a private practice for pediatric dentistry were screened for class II resin-based composite (Spectrum TPH3) and compomer (Dyract Posterior; both Dentsply DeTrey) restorations in primary molars with a 5-year observation period used with Adper Prompt L-Pop (3M-ESPE). One restoration per patient (age ≤ 6 years at placement) was randomly selected. RESULTS: Two hundred sixty restorations were included (43% resin-based composites, 57% compomers). After 5 years, cumulative survival rates were 43% for resin-based composite and 49% for compomer restorations with no statistically significant differences. There was a tendency for higher survival rates for restorations placed under N2O inhalation sedation or general anesthesia. Distal-occlusal compomer restorations showed significantly lower survival rates (p = 0.003) as compared to mesial-occlusal compomer restorations. CONCLUSION: Within the limitations of the study, we conclude that type of restorative material as well as the type of anesthesia do not influence restoration survival rates, although restorations placed in patients receiving N2O inhalation sedation or general anesthesia tend to perform better as compared with patients receiving no anesthesia or only local infiltration. CLINICAL RELEVANCE: Resin-based composite and compomer restorations show similar survival rates of more than 43% (annual failure rates less than 11.5%) after 5 years for restoration of primary molars.

Effect of cavity lining on the restoration of root surface carious lesions: a split-mouth, 5-year randomized controlled clinical trial.

OBJECTIVE: To compare the clinical performance of cavities with no lining and lining with resin-modified glass ionomer (RMGIC) for the treatment of root surface carious lesions. MATERIALS AND METHODS: The study included 39 patients (mean age, 39.6 years) who visited the university hospital for the treatment of at least 2 root surface carious lesions. After caries removal, the depth, length, and height of the cavities were measured. Using a paired-tooth design and simple randomization technique, the cavities were assigned to one of two groups that were either unlined or lined with RMGIC (Glass Liner II). All cavities were restored with a nanohybrid resin-based composite (Clearfil Majesty Esthetic). One hundred restorations (50 lined, 50 unlined) were placed. Two examiners other than the operator blindly evaluated the restorations at the follow-ups according to the modified Havemann criteria for marginal adaptation, anatomic form, marginal staining, caries in the adjacent tooth structure, caries at the cavosurface margin, and tooth sensitivity. Chi-square, Fisher's exact, Mann-Whitney U, and Cochran Q tests were used for the analysis (p < 0.05). RESULTS: At the 5-year follow-up, 12 restorations were failed. However, there was no significant difference between the marginal adaptation and marginal staining of the materials (p = 0.526 and p = 0.893, respectively). Four caries lesions were detected in the adjacent tooth structure and at the cavosurface margin at the 5-year assessment. CONCLUSION: There was no significant difference in the clinical performance of the lined and unlined restorations. CLINICAL RELEVANCE: The clinical performance of both unlined and RMGIC-lined cavities at the 5-year post-restoration assessment was acceptable. TRIAL REGISTRATION: NCT03802539.

Clinical evaluation of a low-shrinkage resin composite in endodontically treated premolars: 3-year follow-up.

OBJECTIVES: This study compared the 3-year clinical performance of a low-shrinkage silorane-based composite material with that of a methacrylate-based composite material in the restoration of endodontically treated premolar teeth. MATERIALS AND METHODS: A total of 70 patients requiring a Class II composite-resin restoration of a premolar tooth following root-canal treatment participated in the study. Cavities were restored with either a silorane-based restorative (Filtek Silorane + Silorane System Adhesive) or a methacrylate-based restorative (Filtek Z250 + Clearfil SE Bond) system applied according to the manufacturer's instructions. Restorations were evaluated by two blinded observers at five different time intervals (baseline; 6 months; 1, 2, and 3 years) according to modified USPHS criteria. Pearson's chi-square tests were used to examine differences in the clinical performance of the materials (retention, color match, marginal discoloration, secondary caries, anatomical form, marginal adaptation, and surface roughness), and Friedman and Wilcoxon tests were used to compare changes between baseline and each recall time, with a level of 0.05 considered statistically significant. RESULTS: After 3 years, no statistically significant differences in clinical performance were observed between the two materials (p > 0.05). Intra-system comparisons revealed a statistically significant deterioration in color match, marginal discoloration, anatomical form, marginal adaptation, and surface roughness scores after 3 years for both systems. Although the difference was not significant at 3 years of follow-up, the level of deterioration in marginal adaptation and surface roughness was greater for the Filtek Silorane restoration than for the Filtek Z250 restoration at the 1 year follow-up (p > 0.05). CONCLUSION: Restorations of both materials were clinically acceptable after 3 years. The Filtek Silorane system did not appear to offer any clinical advantages over the methacrylate-based system when used in the restoration of Class II cavities in endodontically treated premolars. CLINICAL RELEVANCE: The restoration of endodontically treated premolars with minor or moderate loss of tooth structure can be directly performed either with silorane or methacrylate-based composite resins.

Influence of Dental Prosthesis and Restorative Materials Interface on Oral Biofilms.

Oral biofilms attach onto both teeth surfaces and dental material surfaces in oral cavities. In the meantime, oral biofilms are not only the pathogenesis of dental caries and periodontitis, but also secondary caries and peri-implantitis, which would lead to the failure of clinical treatments. The material surfaces exposed to oral conditions can influence pellicle coating, initial bacterial adhesion, and biofilm formation, due to their specific physical and chemical characteristics. To define the effect of physical and chemical characteristics of dental prosthesis and restorative material on oral biofilms, we discuss resin-based composites, glass ionomer cements, amalgams, dental alloys, ceramic, and dental implant material surface properties. In conclusion, each particular chemical composition (organic matrix, inorganic filler, fluoride, and various metallic ions) can enhance or inhibit biofilm formation. Irregular topography and rough surfaces provide favorable interface for bacterial colonization, protecting bacteria against shear forces during their initial reversible binding and biofilm formation. Moreover, the surface free energy, hydrophobicity, and surface-coating techniques, also have a significant influence on oral biofilms. However, controversies still exist in the current research for the different methods and models applied. In addition, more in situ studies are needed to clarify the role and mechanism of each surface parameter on oral biofilm development.