Composite Restorations Research Articles

Comparative Analysis of Shear Bond Strength in Orthodontic Brackets Between Milled and 3D-Printed Definitive CAD/CAM Restorations

Objective: The objective of this study was to evaluate the effect of different surface treatment methods on the shear bond strength (SBS) of metal brackets bonded to two types of CAD/CAM composite restorations: milled and 3D-printed. Materials and Methods: A total of 160 flat-shaped specimens (10 × 10 × 2 mm3) were prepared from four different CAD/CAM composites; two milled (Lava Ultimate™ [LU] and Grandio™ [GR]) and two 3D-printed (Crowntec™ [CT] and C&B Permanent™ [CB]). These specimens underwent thermocycling (5000 cycles at 5–55 °C), then were categorized based on the surface treatment into four groups (n = 10): Group C (control, no surface treatment), Group HF (treated with 9.6% hydrofluoric acid), Group DB (mechanical roughening by a diamond bur), and Group SB (sandblasting using aluminum oxide). Metal brackets were bonded using Transbond XT Primer and universal adhesive, stored in artificial saliva for 24 h, then thermocycled again. Shear bond strength (SBS) was tested using a universal testing machine until bracket debonding occurred. The adhesive remnant index (ARI) was assessed using a stereomicroscope to quantify the residual adhesive following debonding. Result: Regarding material, GR and LU restorations had significantly higher SBS values compared to CT and CB, ranging from 13.90 MPa to 20.35 MPa. Regarding surface treatment, SB and HF groups showed significantly higher SBS values. The ARI scores showed different adhesive modes of failure, with higher instances of scores 0 and 1, which indicate no or minimal adhesive remaining. Conclusions: Both milled and 3D-printed materials had adequate SBS for clinical use, with milled materials showing superior results. Surface treatments like sandblasting and HF significantly improved bond strength, with adhesive failure being common.

Reabilitação estética de dente conóide: relato de caso

As aesthetics advance in modern dentistry, people's expectations of their smiles become ever higher. Microdontia or conoid tooth, which refers to teeth smaller than normal, is one of the abnormalities that causes major aesthetic complaints due to its characteristics. Conoid teeth have a prevalence of 0.6 to 9.9%, with conical upper lateral teeth affecting approximately 55,000 people, with women being more susceptible than men. Many factors must be considered when restoring anterior teeth, depending on patient expectations and dental practice. The direct composite resin technique has stood out for providing aesthetic benefits, preserving tooth structure, being performed in a single consultation, being cheaper and not requiring any laboratory process. The objective of this study was to report a clinical case of aesthetic rehabilitation in a conoid tooth in the upper left lateral incisor with composite resin restoration using the direct technique. Clinical planning is essential for choosing the technique and restorative material to be used. Despite the various techniques proposed for the treatment of conoid lateral incisors, the aesthetic reanatomization with a direct veneer of composite resin, with diagnostic waxing, used in this study, was effective and inexpensive, allowing a minimally invasive treatment and possible posterior adjustments, enabling the restoration of self-esteem and the harmony of the patient's smile.

Projeto de extensão: resgatando sorrisos

The article addresses restorative and aesthetic dentistry, highlighting the importance of adhesion of materials to mineralized dental tissues. The philosophy of minimally invasive restorative treatment is based on principles of prevention and maximum preservation, with minimal intervention in dental structures. Dental aesthetics are subjective, influenced by several factors, and despite advances in aesthetic materials, the need for clinical evaluations on the behavior of composite resin restorations is increasing. In the Brazilian context, where the provision of government dental treatment is limited, perceived need becomes an important predictor of the use of dental services. There is a significant demand for restorative dentistry procedures, often performed by undergraduate and postgraduate students. The article highlights the creation of an Orthodontics Extension Project to deal with repressed demand, although new activities are necessary. It is concluded that initiatives such as extension projects are essential to mitigate the lack of care for the population and prepare academics for clinical practices in restorative dentistry.

Treatment Modalities of Uncomplicated Crown Fracture in Anterior Maxillary Permanent Teeth: A Systematic Review.

Several treatment modalities have been used to restore crown fractures in case of uncomplicated crown fractures. Although many treatment modalities have been reported, there is no consensus on which one has the best results in terms of success and durability. This systematic review of treatment modalities in uncomplicated crown fractures aims to provide the most common and successful treatment modality for each patient's unique needs, balancing conservation, aesthetics, and long-term durability. Three electronic databases (PubMed, Scopus, and Google Scholar) were searched for articles regarding treatment modalities in uncomplicated crown fractures in anterior maxillary teeth. Following the application of the inclusion and exclusion criteria, 10 case reports, four case series, and two retrospective studies were selected for the review. These studies reported on fragment reattachment, direct composite resin, and veneers for the management of uncomplicated crown fractures. Fragment reattachment was the most preferred treatment modality, with milk, water, or sterile saline used as storage mediums. Direct composite restoration was preferred for missing or bad-shaped fragments or longevity. Veneers were given for aesthetic consideration and fracture resistance when the crown structure was majorly affected by the fracture. Fragment reattachment was favored in 63% of the articles included in the review followed by direct composite restoration in 26% of the articles. Venners were used in about 11% of the articles. Composites depicted a higher survival rate and a better outcome than fragment reattachment. Follow-up periods ranged from 1 week to 4 years, and all articles successfully re-established function and aesthetics, except for one tooth that required root canal treatment. Fragment reattachment, direct composite restoration, and veneers are successful treatment modalities in uncomplicated crown fractures of anterior teeth. The choice of treatment depends on various factors like availability of fragments, age, and financial condition of the patient. PROSPERO Registration ID: CRD42020153091.

Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-anlysis protocol.

Background Immediate Dentin Sealing (IDS) is a technique that applies an adhesive layer immediately after tooth preparation, prior to the placement of indirect restorations. This method is gaining attention due to its potential to improve the bond strength and mechanical properties of restorations, particularly in the posterior region where restorations endure significant masticatory forces. The objectif of this systematic review and meta-analysis is to evaluate the effect of IDS on the fracture strength of indirect posterior restorations. Methods Following PRISMA guidelines, a comprehensive literature search was conducted in four databases: Web of Science, Scopus, Cochrane Library, and PubMed. Inclusion criteria focused on in vitro studies involving human teeth with indirect posterior restorations, published between 2014 and 2023. Studies using IDS were compared to those using conventional methods. The risk of bias was assessed using the Cochrane Collaboration’s tool, and a meta-analysis was performed with a random-effects model. The standard mean difference and 95% confidence intervals were calculated to compare fracture strength, with I2 statistics assessing heterogeneity. Forest and funnel plots were employed to visualize results and publication bias, respectively. Discussion The results indicate that IDS generally enhances the fracture strength of indirect posterior restorations, particularly with ceramic materials like lithium disilicate. However, the effectiveness of IDS varies depending on the material and restoration type. While some studies demonstrated improved fracture resistance with IDS, others showed minimal benefit, especially with composite restorations. Additionally, IDS improved marginal adaptation and internal fit but increased the risk of severe failures, such as root fractures. Systematic review registration PROSPERO: CRD42024584545 (Registered on 08/09/2024).

PREVALENCE AND QUALITY OF RESTORATIVE STRUCTURES OF PERMANENT TEETH IN CHILDREN FROM LOWLAND AND MOUNTAINOUS AREAS OF THE TRANSCARPATHIAN REGION OVER THE COURSE OF OBSERVATION

Introduction: Treatment of invasive forms of caries involves the removal of demineralized hard tooth tissues and the restoration of anatomical integrity using various types of restorative materials. The choice and conditions of use of these materials have clear indications. However, the durability of restorative structures, even with strict adherence to the algorithm, is not always sufficient, especially among children living in areas with biogeochemical deficiencies. Objectives: The aim of this study was to analyze the prevalence of fillings made from different restorative materials in the permanent teeth of children living in lowland and mountainous geographical areas of the Transcarpathian region and to determine the percentage of defects in restorative structures over time. Methods: For the analysis, 525 medical records of dental patients (form 043) from two geographical areas of the Transcarpathian region were selected, specifically from Uzhhorod, University Dental Clinic LLC, and Rakhiv, the dental office of the Rakhiv District Hospital. The period of dental treatment covered was from 2018 to 2022. Paraclinical content analysis was performed to determine the number of direct and indirect restorative structures and to assess the occurrence of defects and their loss at 6 and 12 months post-treatment. Statistical probabilities and errors were determined using the computer program STATISTICA 6.1. Results. The rates of patient visits for the restoration of indirect restorations of permanent teeth in children living in the mountainous zone differ from those in children from the lowland zone of residence significantly after 6 months (4.0%; 2.1%; p<0.05), and not significantly after 12 months (10.0%; 10.5%; p>0.05). Comparing the incidence of defects, impaired fixation, or loss of various types of restorative structures in permanent teeth in children living in lowland and mountainous areas of the Transcarpathian region, it was found that the most common defects or loss of fillings made of glass ionomer cements occurred both after 6 and 12 months. The percentage distribution of the appearance of defects or loss of restorative structures made in the permanent teeth of children living in the mountainous zone from glass ionomer cements, light-curing composites on indirect restorations is 6 months (7.2%, 6.0%, 4.0%, p>0.05) and 12 months (16.3%, 11.1%, 10.0%, p>0.05). The differences are not significant. In the permanent teeth of children living in the low-lying area, the percentage of defects or loss of restorative structures made of glass ionomer cements, light-curing composites on indirect restorations is 6 months (6.7%, 4.4%, 2.1%, p<0.05) and 12 months (20.0%, 9.6%, 10.5%, p<0.05). The differences are significant. Conclusions: Thus, when comparing the percentage of defects in various restorative structures and their loss in the permanent teeth of children living in the lowland and mountainous areas of the Transcarpathian region, no significant differences were found. Specifically, for glass ionomer cements, the defect percentages were 6.7% and 7.2% after 6 months (p > 0.05) and 20.0% and 16.3% after 12 months (p > 0.05). For direct composite restorations, the defect percentages were 4.4% and 6.0% after 6 months (p > 0.05) and 9.6% and 11.1% after 12 months (p > 0.05). For indirect composite restorations, the defect percentages were 2.1% and 4.0% after 6 months (p > 0.05) and 10.5% and 10.0% after 12 months (p > 0.05). This indicates that the differences in the percentage of defects between the lowland and mountain zones are not statistically significant for any of the types of restorative structures during the specified periods.

Clinical and radiographic evaluation of deep occlusal carious molars treated with partial caries removal with and without using silver diamine fluoride (SDF) + Potassium iodide (KI) prior to resin composite restoration: A randomized clinical trial

Clinical and radiographic evaluation of deep occlusal carious molars treated with partial caries removal with and without using silver diamine fluoride (SDF) + Potassium iodide (KI) prior to resin composite restoration: A randomized clinical trial

Effect of an Additional Hydrophobic Adhesive Layer Application on the Clinical Performance of Class V Resin Composite Restorations: An 18-month Randomized Clinical Trial.

This study aimed to evaluate the 18-month clinical performance of two different one-step adhesives that were applied alone or with an additional hydrophobic adhesive layer to noncarious cervical lesions. One hundred sixty teeth in 31 patients were included in the study. Each patient received at least four restorations. A 2-hydroxyethylmethacrylate (HEMA)-containing one-step self-etch adhesive (Clearfil S3 Bond Plus, Kuraray Noritake, Noritake, Japan) and a HEMA-free universal adhesive (G-Premio Bond) were applied to noncarious cervical lesions with or without additional hydrophobic adhesive (Heliobond) randomly. Teeth were restored with a nanohybrid composite. Restorations were evaluated according to FDI criteria at baseline, 6-, 12-, and 18-month recalls. Data were analyzed with the Kruskal-Wallis and the Friedman analysis of variance (ANOVA) tests (α=0.05). At 18 months, recall rates were 100%, and there was no significant difference between four different adhesive applications in terms of any criteria (p>0.05). The cumulative retention rates were 92.5%, 92.5%, 97.5%, and 100% for the restorations with one-step self-etch, one-step self-etch plus hydrophobic adhesive layer, a universal adhesive, and a universal adhesive plus hydrophobic adhesive layer, respectively. An additional hydrophobic adhesive layer was found to have no significant effect on the 18-month clinical performance of two different one-step adhesive systems with and without HEMA.

Successful Regenerative Endodontic Therapy of a Dens Evaginatus Mandibular Second Premolar with an Acute Apical Abscess and Extensive Periapical Bone Loss: A Case Report.

Regenerative endodontics is a rapidly growing field within dentistry that aims to replace damaged tooth structures and cells of the pulp-dentin complex. This case report presents the successful management of an immature permanent second mandibular premolar with an acute apical abscess and extensive apical bone loss caused by a dens evaginatus. This tooth was unexpectedly treated with long-term calcium hydroxide (Ca(OH)2) that was replenished several times over 6 months. During the treatment process, this tooth became reinflamed developing a chronic apical abscess after resolution of the initial acute apical abscess, which resulted in the replacement and prolonged use of Ca(OH)2. The final regenerative procedures were completed using a bioceramic fast set putty placed directly over the blood clot and an occlusal composite restoration. At the 6-month follow-up, the patient was asymptomatic with a fully healed radiographic lesion, new periodontal ligament, and the apex closed with thickening of the mesial and distal aspects of the root. At the 15-month follow-up, the patient remained asymptomatic with continued evidence of radiographic development of the apical aspect of this tooth, displaying root end closure and thickening. This is a unique case report of the management of a complex infection process in an immature tooth with regenerative techniques with repeated and long-term use of Ca(OH)2. This novel report provides dental practitioners with a new potential protocol for the management of these immature cases with advanced periapical infections that require extensive disinfection to have successful outcomes.

ORAL FINDINGS AND CLINICAL BEHAVIOR IN PATIENT HAVING AUTOIMMUNE POLYENDOCRINOPATHY CANDIDIASIS ECTODERMAL DYSTROPHY (APECED)

Introduction: APECED (Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy) is a rare autosomal recessive disease with significant impacts on oral health, including oral candidiasis and varying degrees of enamel hypoplasia. Objective: To present the oral findings of a girl with APECED and the minimally invasive approach taken in recovery and rehabilitation, taking into account the complexity of her medical condition. Material and methods: A case of a 16-year-old girl with APECED, who visited the dental clinic due to defects of the hard dental tissues and severe dentinal hyperesthesia, is described. There was an underbite with a reduced lower facial floor and enamel hypoplasia in the coronal and middle third of the anterior teeth and first molars. Results: Through direct composite restorations and a minimally invasive approach, a good healing, functional and aesthetic result was achieved.

FeAl-LDH-modified biochar (FeAl-LDH@BC): A high-efficiency passivator for hexavalent chromium (Cr(VI)) reduction and immobilization in contaminated soil

A composite FeAl-LDH@BC obtained by successfully loading FeAl-LDH onto biochar (BC) is used to the Cr(VI)-contaminated soil remediation. The efforts of loading, initial pH, concentration and dosage are investigated. The results indicate that the immobilization process of Cr(VI) in soil could be well described by the pseudo-second-order kinetic model and maximum adsorption capacity of FeAl-LDH@BC is 42.78 mg/g at a temperature of 298 K. Additionally, The physicochemical properties of FeAl-LDH@BC are characterized by SEM, EDS, XRD, FTIR and XPS. The characterization results suggest that the immobilization mechanism involved adsorption and reduction. Cr(VI) is immobilized by adsorption to the layers of FeAl-LDH, the reduction of Cr(VI) to Cr(III) is then accomplished using Fe(II) as a reducing agent. In order to demonstrated the stability of composites for environmental restoration, the TCLP tests, dry-wet, freeze-thaw aging cycles, soil phytotoxicity tests, and microbial community are analyzed. The study shows that we provided a material for soil immobilization with high performance for the remediation of Cr(VI)-contaminated soil.

A randomized controlled clinical trial of the performance of three bioactive endodontic cements in primary molar teeth diagnosed with reversible pulpitis: 1-year follow-up study

ObjectivesThe objective of this clinical trial was to evaluate and compare the clinical and radiographic successes of three bioactive endodontic cements (BEC) including novel portland cement-based material releasing fluoride, resin-modified silicate glass cement, and pure tricalcium silicate-based cement—in the treatment of primary molars diagnosed with reversible pulpitis via indirect pulp capping. MethodsEighty-six (86) participants with previously untreated first and second primary molars were included in this study. The teeth were randomly allocated into three groups: pure tricalcium silicate-based cement, resin-modified silicate glass cement, and novel portland cement-based material releasing fluoride. Cavities were capped with the assigned cement after caries excavation using standard protocols. The teeth that underwent treatment were restored using glass ionomer cement and composite resin. Clinical and radiographic evaluations were performed at 1, 6, and 12 months. The data were analyzed using Pearson chi-square, Kruskal–Wallis H and Z test (P = 0.05). ResultsThe success rate was 88 % (n = 25) in the pure tricalcium silicate-based cement group, 88.5 % (n = 26) in the resin-modified silicate glass cement group, and 100 % (n = 25) in the novel portland cement-based material releasing fluoride group. The differences at the 1st, 6th, and 12th month follow-up visits were not statistically significant among the groups (P > 0.05). No difference was found between the integrity of the resin composite restorations overlying pure tricalcium silicate-based cement, resin-modified silicate glass cement, and novel portland cement-based material releasing fluoride according to the USPHS criteria. ConclusionsNovel portland cement-based material releasing fluoride can be considered an alternative for preserving the tooth, as it showed a high success rate in treating primary molars diagnosed with reversible pulpitis via indirect pulp capping. Clinical significanceNovel Portland cement-based material releasing fluoride could be beneficial in the treatment of primary molars diagnosed with reversible pulpitis via indirect pulp capping.

Clinical evaluation of direct composite versus zirconia resin-bonded fixed dental prostheses for a single missing anterior tooth: A short-term multicenter retrospective study

ObjectivesThis study aimed to compare the outcome of a simplified direct composite resin-bonded fixed dental prostheses without reinforcing fibers (CR-RBFDP) and resin-bonded fixed dental prostheses using zirconia (Zr-RBFDP). MethodsThe clinical records of five private practice dental clinics and one university hospital were analyzed. Failure was defined as a RBFDP that was removed or remade for any reason. Survival analyses were performed using log-rank tests. ResultsA total of 45 patients (CR-RBFDP, n = 17; Zr-RBFDP, n = 28) were followed up for 3 years. Among the CR-RBFDP cases, 1 case of framework fracture and 2 cases of discoloration occurred, whereas among the Zr-RBFDP cases, 1 case of debonding occurred. The mean duration of observation was 21.9 months. The 3-year survival rate was 92.3 % for CR-RBFDP and 91.7 % for Zr-RBFDP. Log-rank test showed no significant difference (p = 0.78). ConclusionsWithin the limitations of this short-term retrospective study, the survival rate of CR-RBFDP was not significantly different from that of Zr-RBFDP. Contrary to concerns regarding material strength, CR-RBFDP showed reliable results. This direct composite restoration has the advantages of being less invasive and being completed in a single visit. Clinical SignificanceDespite differences in material strength, CR-RBFDPs without fiber reinforcement showed reliable short-term clinical results. This direct composite restoration has the advantage of being less invasive and can be restored in a single visit.

Influence of curing mode and aging on the bonding performance of universal adhesives in coronal and root dentin

BackgroundThis study aims to evaluate the microtensile bond strength (µTBS) of different resin composite restorations bonded to mid-coronal dentin and proximal root dentin using light-cured, chemical-cured, and dual-cured adhesives immediately and after aging. Nanoleakage and degree of cure were also assessed.MethodsEighty-four molars were divided into mid-coronal dentin and proximal root dentin. Each group was further subdivided into three subgroups based on the restorative systems used, which involved the utilization of light-cured, chemical-cured, and dual-cured adhesives. Half of the specimens underwent µTBS testing after 24 h, while the other half after aging. Representative specimens were analyzed for nanoleakage. The degree of cure of the tested adhesive systems was also assessed.ResultsAging showed a significant negative effect on µTBS results and led to increased nanoleakage (p < 0.001). Furthermore, in all subgroups, the µTBS values of proximal root dentin were lower compared to mid-coronal dentin, except in the aged subgroup for the system utilizing the dual-cured adhesive. The restorative systems with chemical and dual-cured adhesives demonstrated comparable bonding properties. However, the system with the light-cured adhesive exhibited the worst bonding properties after aging when bonded to proximal root dentin and cured at a large distance (p < 0.05).ConclusionsAll tested restorative systems were negatively affected by aging, and the regional dentin had variable effects on the bonding properties. Clinicians should exercise caution when using the tested light-cured adhesive in areas where the curing distance exceeds 3 mm.

The current attitudes and practices of dentists in Australia towards composite repair: A cross-sectional survey study.

Whether to replace or repair a composite restoration is controversial and varies among clinicians. This study was designed to collect information on the attitudes and practices of Australian dentists towards composite repair. An electronic 16-item questionnaire was distributed online on Australian clinicians' dental forum with a URL address and instructions on completing the survey. The questionnaire remained accessible for 2 months. The data collected were analysed statistically using descriptive, average rank, Pearson chi-square and Kruskal-Wallis tests at α = 0.05. Repair of composite restorations was a widely accepted treatment modality among surveyed dentists. Despite this, approximately half of clinicians reported the prognosis of repaired restorations to be worse when compared to replacement. The most cited indications for repair were partial loss or fracture of the restoration, while the most common reason for repair was because this treatment modality was more conservative in terms of tooth structure removal. Most important patient factor influencing decision to repair composite restoration was caries risk of the patient (n = 50). Most significant situational factor to consider in decision whether to repair was previous (failed) attempts to repair (n = 74). The most important tooth level factor was the proximity of restoration to pulp (mean statistic rank 2.22). The most common composite surface treatment employed by participants bonding to old composite was acid etching (n = 87), and the main reason participants employed their chosen surface treatment was based on personal experience (n = 72). The repair of composite restorations was a commonly performed procedure that is well accepted but may still be viewed as an inferior treatment to replacement by many Australian dentists. Most dentists agreed on indications for repair restorations and surface conditioning techniques, but there was wide variation in opinions overall. Due to the lack of high-quality evidence regarding composite repair techniques, dentists tend to rely on personal experience to guide their clinical decisions.

Cost-effectiveness of expanding national health insurance coverage for composite resin restorations in cancer patients in South Korea

ObjectivesCancer patients often have compromised oral health, making them vulnerable to severe dental caries and restoration failures. Due to the nature of cervical or anterior caries in cancer patients, the use of adequate restorative materials is important. However, public dental insurance coverage for composite treatments varies among countries and only glass ionomer cements (GICs) are covered in all age groups in South Korea. This study examined the cost-effectiveness of expanding national health insurance coverage to include resin composite (RC) restorations as compared with GIC in cancer patients. MethodsData from cancer patients who received direct restoration using GIC were identified from the National Health Screening Cohort. The relative effect of RC compared to GIC was determined through a meta-analysis, which was then utilized in calculating corresponding transition probabilities within a multi-state model. A Markov-chain Monte Carlo microsimulation was performed to estimate useful life-years and total treatment costs at the tooth level. The incremental cost-effectiveness ratio (ICER) of RC versus GIC was calculated, considering scenarios with and without expanded national health insurance coverage. The robustness of the results was confirmed through various sensitivity analyses. ResultsBetween the two materials, RC resulted in a 0.4-year longer useful life. From a limited societal perspective, it cost $9.6 less with expanded coverage but $24.3 more without expansion, resulting in an ICER of -$25.2 and $63.9 per tooth-year, respectively. From a patient's perspective, the ICER values were -$72.7 versus $138.8 per tooth-year, respectively, translating into $200 more in savings with the expansion. Various sensitivity analyses consistently demonstrated a smaller ICER when insurance coverage was expanded. ConclusionsThe expansion of national health insurance coverage to include RC restorations for cancer patients appears to be clearly cost-effective. This emphasizes the need for further policy considerations to ensure access to dental care for cancer patients. Clinical SignificanceTimely management of dental caries is crucial for cancer patients, as untreated caries can escalate into severe oral conditions, negatively impacting treatment outcomes and increasing care costs. Expanding a national health insurance coverage for cancer patients in the treatment of early dental lesions is necessary to prevent advanced dental diseases.

Electrosurgical Adjunct for Soft Tissue Management of the Paediatric Dental Trauma Patient

The interface between dental restorations and the neighbouring soft tissue is of key significance for restorative success and longevity. Trauma-related enamel–dentine fractures are frequently present with the restorative challenge of subgingival margins and little remaining tooth structure. This report looks at two paediatric dental trauma patients with extensive crown fractures resulting in subgingival margins, which posed a poor long-term tooth survival. Electrosurgery was used before definitive composite restorations to allow for supragingival margins and access. Each patient attended the Child Dental Health Department at the University of Manchester Dental Hospital for assessment and treatment provision. CPD/Clinical Relevance: This article identifies electrosurgery as an increasingly useful adjunct to restorative management of traumatized permanent incisor teeth in paediatric patients.

Effect of Different Curing Times and Intensities on the Performance of Compound Class II Bulk-fill Resin Composite Restorations: An In-Vivo Study

Effect of Different Curing Times and Intensities on the Performance of Compound Class II Bulk-fill Resin Composite Restorations: An In-Vivo Study

The Art and Science of Anterior Composite Restoration

The Art and Science of Anterior Composite Restoration

Evaluation of Marginal Adaptation of SDR Plus, Fiber-Reinforced and Nanofilled Composites in Endodontically Treated Teeth: A Scanning Electron Microscopic Study.

Endodontically treated teeth (ETT) undergo structural changes, including a reduction in water content and loss of dentin elasticity, which can compromise their mechanical properties. One critical factor influencing the long-term prognosis of a restored ETT is the marginal adaptation of the restorative material. The present study compared the marginal adaptability of Smart Dentin Replacement (SDR) Plus, fiber-reinforced, and nanofilled composites in ETT using scanning electron microscopy (SEM). Cavities were made in 30 recently extracted maxillary premolars distributed into three experimental groups depending on the restorative material used: group 1 as SDR Plus (Dentsply Sirona, Charlotte, North Carolina, USA), group 2 as fiber-reinforced composite (EverX, GC Corp., Tokyo, Japan), and supra nanofilled composite (Estelite Sigma Quick, Tokuyama Dental Corp., Tokyo, Japan). Standardized access openings were performed, and endodontic treatment was completed in all teeth. Specific composite restoration techniques were applied according to the manufacturer's instructions. After thermocycling for 30 days, the restored teeth were sectioned and viewed using SEM (Labindia Instruments Pvt. Ltd., Maharashtra, India) to measure the width of the marginal gap. The data were analyzed using statistical software. The mean marginal gap width varied significantly among the groups. Group 1 had a lower mean marginal gap of 2.99 μm, group 2 exhibited the highest mean marginal gap of 10.24 μm, and group 3 had a mean marginal gap of 5.51 μm. Overall, group 2 consistently showed significantly larger marginal gaps than the other groups. Within the limitations of this study, SDR Plus demonstrated better marginal adaptation than fiber-reinforced and supra-nanofilled resins in the coronal restoration of ETT. Fiber-reinforced composites demonstrated the maximum marginal gap, followed by nanofilled composites. Thus, SDR Plus may be recommended as a suitable restorative material to enhance the longevity and success of endodontic treatments.