Dental Restorations Research Articles

Assessments and Investigation of Process Parameter Impacts on Surface Roughness, Microstructure, Tensile Strength, and Porosity of 3Dprinted Polyetherether Ketone (PEEK) Materials:

Additive manufacturing (AM) is emerging as a competitive technology with promising applications across various sectors, including biomedical, automotive, construction, and dental implants. This study investigates the influence of key process parameters on the surface roughness, microstructure, tensile strength, and porosity of Polyether Ether Ketone (PEEK), a high-performance thermoplastic used in dental prosthetics. Traditionally, metals and ceramics have been the standard for dental restorations, but advancements in computer-aided design (CAD) and computer-aided manufacturing (CAM) have improved accuracy, particularly for implant-supported prostheses. However, conventional methods like CAD-milling face challenges such as material waste and tool wear. AM techniques, such as fused deposition modeling (FDM), offer a solution by constructing objects layer by layer, minimizing waste. This research explores the effects of nozzle temperature on the mechanical properties of 3D-printed PEEK, emphasizing its role in optimizing performance and minimizing issues like porosity. Key factors like surface roughness and microstructure are highlighted as critical to the biocompatibility and longevity of dental restorations. The study identifies the optimal nozzle temperature range for PEEK 380-440°C, noting that deviations from this range lead to compromised mechanical properties. Overall, the findings provide valuable insights into optimizing the AM process for PEEK in dental applications and suggest that further biological and chemical studies are necessary to fully realize the material's potential in replacing traditional dental restoration materials.

Glass Ionomer Modified with Bacterial Cellulose Nanocrystals. An In Vitro Analysis Assessing Shear Bond Strength and Microleakage Scores in Deciduous Dentition

The aim of this study was to evaluate the shear bond strength (SBS) and microleakage of bacterial cellulose nanocrystals (BCNCs) incorporated into conventional glass ionomer cement (CGIC) when bonded to deciduous dentin. Sixty primary first and second molars with class I cavitated dentinal lesions were preserved and randomly allocated into two groups based on the technique used for caries removal. Group 1 utilized the conventional approach for caries removal, while Group 2 used Carie Care™ for caries removal. Each of these groups was further divided into two subgroups based on the type of restoration received. Microleakage and failure mode assessments were performed using a stereomicroscope, while SBS testing was conducted using a universal testing machine. The SBS and microleakage scores were analyzed using one-way analysis of variance (ANOVA) and Tukey post hoc test with a significance level of p=0.05. Specimens from Group 1A (conventional approach+CGIC) presented the highest scores of marginal leakage, while Group 1B (conventional approach+BCNCs-modified CGIC) demonstrated the lowest values of microleakage. Additionally, samples from Group 2B (Carie Care™+BCNCs-modified CGIC) revealed the highest bond integrity scores. The incorporation of BCNCs into CGIC had a positive impact on both shear bond strength and marginal leakage when bonded to the dentin substrate. This modification improved the performance of the glass ionomer cement, enhancing its applicability in dental restorations.

Biomechanical assessment of zirconia-calcium silicate-silver composite dental crowns: A 3D finite element analysis study

Optimal dental health significantly contributes to an individual’s physical and psychological well-being, with an increasing focus on esthetics and functionality in dental restoration procedures. This research explores the use of zirconia ceramic materials combined with calcium silicate and silver compositions as an alternative for dental crown applications. The study employs 3D finite element analysis to assess stress distribution on full crowns with composites under axial and oblique loads, aiming to understand biomechanical aspects and identify fracture resistance and failure modes. The materials include zirconia-calcium silicate-silver composites with varying volume fractions (Zr 74 to 29%, Ca2SiO4 68 to 25%, and Ag 3 to1%). Results show stress concentration at the crown intaglio surface, influenced by the material’s elastic modulus. Specifically, the C14 composite crown with Young’s modulus 90.82 GPa exhibits lower stress levels for crown 10.9 MPa at axial load and 12.77 MPa at oblique load, making it a potentially recommended choice. These findings suggest the potential of designed biomaterials, emphasizing the importance of material selection in enhancing the longevity and resilience of dental crowns. Also, the study enhances understanding of biomechanical aspects in dental crown restorations, contributing valuable insights for clinical applications.

Thermomechanical aging effects on vertical marginal gap and fracture resistance: a comparative study of Bioflx and traditional pediatric crowns

BackgroundVarious types of crowns are used for full-coverage restoration of primary teeth affected by caries, developmental defects, or after pulp therapy. Prefabricated Stainless Steel and Zirconia crowns are commonly utilized. Bioflx crowns, which blend the properties of Stainless Steel and Zirconia, provide a flexible and aesthetically pleasing alternative.AimThis study aimed to evaluate the vertical marginal gap and fracture resistance of Bioflx pediatric crowns compared to Zirconia and Stainless Steel crowns following thermomechanical aging.MethodsThis in-vitro study was conducted using mandibular second primary crowns of three different materials (n = 30). Crowns were divided into three groups; Zirconia crowns group (n = 10, Nu Smile, USA), Bioflx crowns group (n = 10, Nu Smile, USA) and Stainless Steel crowns group (n = 10, Nu Smile, USA). The crowns were cemented onto standardized acrylic resin dies and subjected to thermomechanical aging. Vertical marginal gap measurements were obtained using a USB digital microscope with an integrated camera, while fracture resistance was assessed with a universal testing machine. Data were analyzed for outliers and tested for normality using the Shapiro-Wilk or Kolmogorov-Smirnov tests, with statistical significance set at 0.05.ResultsSignificant differences were observed in the vertical marginal gaps among the groups after cementation and thermomechanical aging (P = 0.013 and P = 0.001, respectively). Zirconia crowns exhibited the largest average marginal gap, followed by Bioflx and Stainless Steel crowns. Stainless steel crowns demonstrated the highest fracture resistance, followed by Bioflx crowns, while Zirconia crowns showed the lowest.ConclusionsBioflx crowns exhibit the largest vertical marginal gap but show greater fracture resistance compared to Zirconia crowns, although they are still less resistant than Stainless Steel crowns after undergoing thermomechanical aging.

Adhesive restorations in primary dentition: A retrospective analysis of survival rate and associated factors.

Several clinical and individual factors may play a role in the survival rate of dental restorations, such as characteristics related to the child's age and oral hygiene, and factors associated with the tooth, such as the type of material and number of surfaces to be restored. To analyse the survival rate of adhesive restorations on primary teeth and factors associated with restoration survival. The study included dental records of children aged 3-12 years having received adhesive restorations on primary teeth at a Brazilian dental school between 2009 and 2019. A Kaplan-Meier survival curve was used to plot survival rates using the log-rank test. A multivariate Cox regression model was run to identify individual and dental factors associated with restoration failure. The sample comprised 269 restored teeth in 111 children. Survival curves were similar for all materials (p = .20) and types of isolation (p = .05). The annual failure rate was 3.60% for glass ionomer cement, 1.23% for resin-modified glass ionomer cement and 0.40% for composite resin. The following variables were associated with more failures: Class II restoration compared with Class I (HR = 1.96; 95%CI: 1.28-2.99, p < .001), proportion of decayed teeth (HR = 11.89; 95%CI: 2.80-50.57, p < .001) and child's age (HR = 1.17; 95%CI: 1.06-1.29, p < .001). The different materials and types of isolation had similar survival rates. Children with more decayed teeth have an increased risk of restoration failure.

MMP Inhibition, Marginal Integrity and Cytotoxicity of Zinc-Releasing GIC

ObjectivesThe degradation of the restorative-dentin interface due to endogenous dentin enzymes, such as matrix metalloproteinases (MMPs), is a significant issue that accelerates the deterioration of the dentin matrix and leads to the failure of restorative treatments. Caredyne Restore (CR), a novel glass ionomer cement (GIC) with zinc ions in its formulation, represents the latest effort to mitigate this issue. This investigation aimed to evaluate the MMPs inhibitory effect, marginal integrity, and cytotoxicity of CR compared to a conventional GIC, Fuji IX (FIX). MethodsThe inhibitory effect of CR on MMPs activity was evaluated using in-situ zymography to visualize the endogenous gelatinolytic activity in the GIC-dentin interface. Additionally, CR's sealing properties were investigated using dye-assisted confocal laser microscopy (CLSM) to assess marginal leakage across the GIC-dentin interface. Both in-situ zymography and CLSM observations were conducted 1 day and seven days after pH cycling. Finally, the cytotoxicity of the GIC eluates was examined on rat dental pulp cells (RPC-C2A). Assay measurements were performed after 24 and 48 h of incubation with test solutions prepared using various GIC eluate concentrations. ResultsThe MMPs activity of the CR specimens was significantly lower than that of FIX specimens after seven days of pH cycling. Signs of marginal leakage were also lower in the CR specimens. Comparison of CR and FIX eluates at the same concentration showed no significant difference in terms of biocompatibility. ConclusionsCaredyne restore is capable of inhibiting endogenous enzyme activity and improving sealing properties, while maintaining sufficient biocompatibility. Clinical SignificanceZinc ions released from Caredyne Restore offer a safe way to improve the quality of dental restorations and promote minimally invasive treatment, especially in lesions where the dentin matrix is susceptible to enzymatic degradation and recurrent caries.

Bibliometric analysis of the current status and trends in dental applications of glass fiber-reinforced composites from 1998 to 2022.

Over the last few years, considerable attention has been devoted to glass fiber-reinforced composites (GFRCs) in the field of dentistry. Glass fiber-reinforced composites are useful in prosthodontics, endodontics, restorative dentistry, orthodontics, and periodontics. This study considered various aspects related to GFRCs to assess the publications and citations on the subject from 1998 to 2022.A bibliometric method of analysis was adopted to conduct the study. The relevant papers published within the established time frame were identified. A document-type filter was applied to retrieve only those results that were peer-reviewed. The most influential authors, journals, institutions, and countries were identified, as indicated by the number of citations, as well as the most frequently used keywords.The findings of the bibliometric analysis revealed that the first article on GFRCs in the context of dentistry was published in 1998. The greatest number of papers on this subject was published in 2011 (n = 51), while the number of citations reached its peak in 2008 (n = 1,546). The University of Turku in Finland published the greatest number of articles, whereas Brazil was the most prolific country, producing the highest number of publications on dental fiber. Researchers from Brazil, Italy and Germany mainly collaborated with researchers from other countries, including the USA and Finland. The analysis revealed that publications of multiple authors were more likely to be cited.Significant advancements have been made in the field of GFRCs, as demonstrated by an increased collaboration amongst different countries, organizations and investigators, which enhanced the development and progression of research related to GFRCs.

Biomimetic Capabilities of Lithium Disilicate Glass-Ceramic Restorations on Posterior Teeth: Evaluation of the Long-Term Survival Rate—A 10-Year Follow-Up

In contemporary dental practice, clinicians have a variety of materials and options for restoring single teeth compromised by carious or non-carious diseases. According to studies and new concepts in biomimetic restorative dentistry, indirect ceramic restorations will play an increasingly important role in daily practice. We follow up and evaluate clinically three times over a 10-year period on eighty-six indirect restorations (n = 86) of lithium disilicate e.Max Press (Ivoclar, Schaan, Liechtenstein) in 32 patients. Restorations are evaluated in the 2nd, 5th, and 10th years after the fixation. Four of the restorations studied (n = 86) had to be replaced at year 5 follow-up because of fracture (failure rate: 4.65%; Kaplan–Maier). There are no restorations with bulky, cohesive fractures. Lithium disilicate ceramic restorations provide a good treatment alternative for a 5- to 10-year period of observation, and they can be successfully applied in dental practice in 91.73% to 98.84% of cases. Advancements in digital dentistry, including the use of intraoral scanners and CAD/CAM technology, are set to further refine the precision and efficiency of indirect restorations for distal teeth, enabling quicker turnaround times and improved fit. Additionally, ongoing developments in biomaterials promise to enhance the durability and biocompatibility of these restorations, potentially leading to better long-term success rates and patient satisfaction. The goal of this clinical study was to look at how well biomimetic ceramic overlays and onlays made of lithium disilicate held onto teeth with a IV-generation adhesive system for 10 years. The study also looked at how well the edges of the teeth adjusted and how strong the teeth were overall.

Characterization of 3D printed composite for final dental restorations.

This study evaluated the mechanical, optical, microstructural, surface, and adhesive behavior of a 3D printing resin comparing it with a machinable resin composite. Specimens of different sizes and shapes were either printed (Vitality, Smart Dent) or machinable (Grandio Blocs, Voco GmbH) resin composites with similar composition were prepared. Surface and mechanical characterization were performed with Knoop hardness, flexural strength (three-point-bending), and elastic modulus tests. The wear of the tested materials was evaluated against steatite antagonists. The optical properties stability (color change, ΔE00, and translucency, TP00) were observed after staining in red wine. In addition, the bond strength of the resin composites to two resin cement protocols were investigated with microshear bond strength tests at baseline and after thermocycling. Scanning electron microscope (SEM) coupled with Energy-Dispersive X-ray Spectroscopy (EDS) was used for microstructural and chemical characterization. Statistical analyses were performed with t- and ANOVA tests. Hardness values (132.76 (16.32) KH- Machinable and 35.87 (2.78) KH - Printed), flexural strength (172.17 (26.99) MPa - Machinable and 88.69 (8.39) MPa - Printed), color and translucency change (1.86 (0.31)/0.06 - Machinable and 3.73 (0.36)/9,16- Printed), and wear depth (24.97mm (3.60)- Machinable and 7.16mm (2.84) - Printed) were statistically different. Average Regarding bond strength, mean values (MPa) for non-aged and aged groups were respectively 21.76 (6.64) / 31.9 (12.66) for Bifix cement (Voco GmbH, Cuxhaven, Germany) and 26.75 (5.14) / 24.36 (6.85) for Variolink cement (Ivoclar Vivadent, Schaan, Liechtenstein) in Printed and 17.79 (3.89) / 9.01 (3.36) ) for Bifix cement and 22.09 (6.55) / 11.01 (3.77) for Variolink cement in Machinable materials. The material and aging factors did affect bond strength but the cement factor did not (p = 0.202). No statistical differences were observed for mean roughness (Ra) between materials. The better dispersion and larger size of the inorganic particles in the Machinable resin were contrasted with the clustered smaller particles of printed resin, under SEM. The mechanical properties and color stability of the machinable resin were superior to those of the printed resin, probably due to the greater amount and dispersion of inorganic particles in the Mach resin, but bond strength after aging was stronger and more stable in the printed resin. 3D-printed resin composites with similar compositions to machinable resin composites do not necessarily exhibit the same properties, which can impact clinical performance. Understanding these differences can assist manufacturers in improving their materials and help clinicians distinguish between materials appropriate for provisional and final restorations.

Design and Development of Infiltration Resins: From Based Monomer Structure to Resin Properties.

The resin infiltration technology concept is one of the most widely used minimally invasive restorative techniques in restorative dentistry with the most outstanding therapeutic effect, and it is also one of the key research directions in restorative dentistry. "Infiltration resin" is the specialty restorative material for the technology, which is the key factor to success. The specialized restorative material is commonly known as "infiltrant/infiltration resins" "resins infiltrant" "infiltrant" or "resins," which will be consistently referred to as "infiltration resins" throughout the article.-The paper aims to provide a comprehensive overview of infiltration resins by introducing the development of their therapeutic mechanisms, basic components, current challenges, and future trends, Based on existing literature, we analyze and compare how changes in the base monomer's structure and ratio affect the effectiveness of infiltration resins, from the material's structure-effective relationship. After compiling the information, the existing solution strategies have been listed to offer substantial support and guidance for future research endeavors.

Exploration and innovative application of digital technology in pediatric dentistry

Pediatric dentistry treats patients aged 0-18 years, encompassing the characteristics of general dentistry. The clinical techniques are closely related to restorative dentistry, endodontics, orthodontics, and maxillofacial surgery, while also possessing unique aspects. It particularly focuses on the growth and development patterns of children's dentition and maxillofacial structures. Currently, digital technology has deeply integrated with various clinical disciplines of dentistry, and pediatric dentistry has made significant progress with pediatric-specific digital applications. On one hand, the introduction of mature digital technologies is enabling the digital transformation of pediatric dental treatment models; on the other hand, there is innovative development of new digital technologies tailored to the specific needs of pediatric dental care, filling gaps in the field. Based on years of research in digital technology for pediatric dentistry, our team details the current innovative applications and scientific explorations in this area from these two perspectives. Additionally, we anticipate the potential expansion of digital technologies not yet applied in pediatric dentistry, providing a reference for clinical scholars in the field to conduct exploratory research.

Research on the method of digital technology assisted direct resin composite restoration for deep distal caries in mandibular second molars

Objective: To explore the digital design and fabrication technology of personalized restorative matrix for dental filling, and to explore the feasibility of direct resin restoration for deep caries lesions in distal neck of mandibular second molar. Methods: For patients with deep caries lesions in the distal neck of the mandibular second molar who visited the Department of Cariology and Endodontology of Peking University School and Hospital of Stomatology from September 2023 to April 2024, after preparing the cavity and gingival retractor, a three-dimensional intraoral scanner was used to obtain three-dimensional data of the patient's dentition. In the dental restoration computer-aided design software, the inlay function was used to generate the restored tooth morphology. The edge range of the personalized restorative matrix was drawn on the restored model by three-dimensional reverse engineering software to achieve edge sealing effect. The selected edge range data was processed with distal shelling to generate a digital model of a personalized restorative matrix with a thickness of 0.5 mm. A metal three-dimensional printer was used to fabricate the titanium alloy restorative matrix, and its application was completed in 10 clinical cases. The marginal adaptation and retention stability of the personalized restorative matrix were evaluated under a dental microscope, and forming effect evaluation was performed through immediate postoperative periapical radiographs. Results: The preliminary clinical application of the personalized restorative matrix fabricated using digital technology revealed that, in the treatment of 10 affected teeth, rubber dam isolation was successfully ensured, resulting in clinically effective direct resin composite restorations with optimal marginal adaptation and reasonable contours. Immediate postoperative periapical radiographs showed good convexity of the filling body, with no overhangs found. Both marginal adaptation and retention stability met the requirements of clinical treatment. Conclusions: The personalized restorative matrix designed in this study can solve the clinical problems of moisture separation and resin forming in the treatment of deep caries lesions in distal neck of the mandibular second molar, and can achieve stable and reliable adhesive restoration effects.

Knowledge, attitude, and practice of dental patients toward dental defects and dental fillings in Jinan, Shandong Province, China: a mediation analysis

BackgroundDental filling is a prevalent method for treating dental defects. This study aimed to investigate the knowledge, attitude, and practice (KAP) toward dental defects and dental fillings among dental patients in Jinan, Shandong Province, China.MethodsThis cross-sectional study was conducted at the main campus and several branch campuses of Jinan Stomatological Hospital, and community locations within Jinan city between October 2023, and January 2024. Spearman correlation analysis and mediation analysis were used to assess the associations and interrelationships between KAP scores.ResultsIn this study, 2529 dental patients participated, with 69.1% being females. Of these, 1711 had no dental defects, 551 had defects and fillings, and 267 had defects without fillings. Their median knowledge, attitude, and practice (Questions 1–6) scores were 8.00 [5.00, 12.00] (possible range: 0–18), 27.00 [26.00, 29.00] (possible range: 10–50), and 19.00 [15.00, 24.00] (possible range: 9–45), respectively. Mediation analysis revealed that in patients without dental defects, knowledge had a direct effect on attitude (β = -0.983, 95% CI: -0.999, -0.966, P < 0.001). Additionally, attitude had a direct effect on practice (β = -0.797, 95% CI: -1.490, -0.103, P = 0.024), while knowledge had an indirect effect on practice through attitude (β = 0.783, 95% CI: 0.096, 1.470, P = 0.026). In patients with dental defects who had undergone dental fillings, significant direct effects were observed between knowledge and attitude (β = -0.736, 95% CI: -0.821, -0.650, P < 0.001), knowledge and practice (β = 0.396, 95% CI: 0.214, 0.577, P < 0.001), and attitude and practice (β = -0.499, 95% CI: -0.683, -0.315, P < 0.001). Moreover, knowledge had an indirect effect on practice (β = 0.367, 95 CI: 0.221, 0.513, P < 0.001). In patients with dental defects but without any fillings, direct effects were found between knowledge and attitude (β = -0.929, 95% CI: -1.028, -0.829, P < 0.001).ConclusionsDental patients had inadequate knowledge, attitude, and practices concerning dental defects and fillings. It is recommended that clinical interventions should focus on enhancing patient education and promoting positive engagement in dental care practices.

Biocompatibility and performance of new generation dental composites

Dental composites have undergone significant advancements in recent years, with new-generation materials being developed to improve both biocompatibility and mechanical performance. These innovations have led to the increased use of dental composites in restorative dentistry, particularly in both anterior and posterior restorations. Biocompatibility remains a key concern, as the release of unreacted monomers, such as bisphenol A glycidyl methacrylate (Bis-GMA), can cause local tissue irritation or systemic effects. Modern composites aim to reduce these risks by incorporating alternative resin systems and advanced photo initiators. Nanotechnology has further enhanced the performance of these materials by improving mechanical strength and wear resistance, but questions about the safety of nanoparticles and their long-term biological effects continue to be explored. In addition to biocompatibility, the mechanical properties of new-generation composites have been significantly optimized. The introduction of bulk-fill composites allows for deeper polymerization and faster placement, reducing clinical procedure times while maintaining high mechanical integrity. Polymerization shrinkage, a common issue in traditional composites, has been minimized in newer formulations, reducing the risk of marginal gaps and microleakage. The effectiveness of different light-curing units, such as light-emitting diode (LED) versus halogen lights, plays a crucial role in achieving optimal polymerization depth, especially in posterior restorations where light penetration can be limited. Long-term clinical outcomes depend on several factors, including material choice, placement technique, and patient adherence to oral hygiene. Despite the improvements in composite materials, the longevity of restorations still faces challenges such as wear, fracture, and degradation over time. Continued research into the safety, effectiveness, and clinical performance of new-generation composites is essential to ensuring patient safety and enhancing the durability of restorations in the future. These advancements promise to address many of the limitations seen in earlier dental materials while offering superior performance and patient satisfaction.

EVOLUTION OF DENTIN ADHESIVES: LITERATURE REVIEW

The aesthetic demand has culminated in the improvement of restorative dentistry through new products, such as dentin adhesives, so commonly used in current restorative procedures. The quality of the bond between the restorative material and the dental substrate is essential for the longevity of the treatment; therefore, dentin adhesives with different compositions are commercialized, aiming to achieve ideal adhesion. The present study aimed to review the literature on the evolution of dentin adhesives, since research can bring to light innovations that overcome the limitations of contemporary adhesive systems. This article shows the evolution of dentin adhesive agents, their effectiveness and clinical relevance. Knowing new dentin adhesives, techniques and necessary care before and during the application of the chosen adhesive contributes to increasing the durability of adhesive restorations, in order to ensure satisfactory results in the bond between the resin and the dental substrate, avoiding the repetitive restorative cycle.

Advancing Diabetic Dental Restorations: A Comparative Analysis of Alveolar Bone Loss in Class II Composite Resin Versus Amalgam Fillings.

Introduction This study evaluated the impact of Class II composite resin and amalgam restorations on alveolar bone loss in diabetic patients, a population more susceptible to periodontal complications. The main objective was to determine whether the choice of restorative material impacts periodontal health, providing insights to optimize dental care for this high-risk group. Materials and methods This observational, comparative. cross-sectional study included 64 diabetic patients, divided into two groups based on their Class II restorations. Group 1 had 32 patients with composite resin restorations, while Group 2 comprised 32 patients with amalgam restorations. Both groups were matched for age and diabetes duration to ensure comparability. Periodontal health, specifically alveolar bone loss, was assessed through clinical and radiographic evaluations. The study analyzed the impact of the two materials on alveolar bone levels. Results Data from 64 diabetic patients (32 in Group 1 and 32 in Group 2) were statistically analyzed using PASW Statistics for Windows, Version 18.0 (Released 2009; SPSS Inc., Chicago, United States). Three statistical tests, descriptive statistics, two-sample t-test, and analysis of covariance (ANCOVA), were used. The results showed significant differences between the two groups, with composite resin restorations linked to greater alveolar bone loss. Conclusion The choice of restorative material significantly influences periodontal health in diabetic patients. Composite resin restorations were associated with a higher risk of alveolar bone loss and periodontal disease, emphasizing the need for careful material selection and regular periodontal monitoring in diabetic patients.

Comparing Military and Civilian Dentists' Treatment Planning Decisions: A Pilot Study.

Clinical decision-making varies among dentists. However, the literature is limited and narrow in scope regarding the variation between public and private sector dentists. Because both types of dentists' decisions can directly influence military dental readiness, it is important to understand the potential differences in diagnosis, treatment planning, and the delivery of care. The purpose of this pilot study was to compare treatment planning recommendations between civilian and military providers. Patient-level data from the 2018 Recruit Surveillance, a stratified, cross-sectional study of 1,208 randomly selected U.S. Air Force recruits, were used to evaluate treatment planning outcomes for the 2 provider groups (2 civilians; seven military providers). Treatment planning outcomes included type of noninvasive, operative, and oral surgery treatment recommended, temporomandibular disorder referrals, and orthodontic referrals. Patient demographic variables included age, gender, education, race/ethnicity, and military component ("status"). Data were examined both at the tooth level and patient level for statistical significance. Multivariate analyses were performed with statistically significant variables included in each final model for patient-level data. Data were analyzed with logistic regression and Poisson regression (alpha = 0.05). Bivariate logistic regression analyses were performed for tooth-level data. Significant differences were found between military and civilian dentists' treatment planning decisions (P < .05) for both patient-level and tooth-level data. Adjusted for significant bivariate predictors of patient demographics at the patient level, civilian dentists were more likely to refer patients for orthodontic treatment, prescribe remineralization for sound tooth surfaces, incipient caries, and carious teeth, and prescribe direct restorations for teeth with 3 to 5 carious surfaces instead of single crowns compared to military dentists. Additionally, civilian dentists were less likely to prescribe sealants for sound tooth surfaces or carious teeth. No statistically significant difference in treatment planning outcomes was observed between civilian and military dentists for sealants for incipient caries, single crowns, or extraction of third molars. At the tooth level, civilian dentists were more likely to prescribe remineralization for sound tooth surfaces, remineralization instead of sealants for carious surfaces, and extraction of third molars. No statistically significant differences were noted between civilian and military providers for recommending sealant or remineralization for teeth with incipient caries or prescribing a single crown versus placing a direct restoration on posterior teeth with 3 to 5 carious surfaces. Significant differences in treatment planning outcomes between civilian and military providers exist. Civilian providers are more likely to refer patients for orthodontic treatment and prescribe remineralization, direct restorations instead of single crowns, and third molar extractions, while military providers are more likely to prescribe sealants for sound tooth surfaces or carious teeth. Therefore, comparisons of treatment planning outcomes between civilian and military providers warrant further research.

Heterotopically differentiated PDLSCs-laden 3D bioprinting scaffolds for concurrent oral hard and soft tissue regeneration

Following dental extraction, the alveolar bone and gingival tissues could undergo varying degrees of resorption, affecting subsequent implant integration and aesthetic outcomes. Adequate volume of both hard and soft tissues is essential for optimal results. Three-dimensional (3D) bioprinting technology offers the advantages of biomimicry, personalization, and precise spatial distribution, which are pivotal for enhancing the success and esthetics of dental restorations. In this study, we fabricated a construct with a natural transition and varying material concentrations by 3D bioprinting, comprising an upper layer of Collagen/Alginate/periodontal ligament stem cells (PDLSCs) and a lower layer of Collagen/nano-hydroxyapatite (nHA)/Alginate/PDLSCs. Characterization of the physicochemical properties revealed that the incorporation of nHA significantly enhanced the mechanical properties of both the bioink and the construct. Flow cytometry analysis confirmed the stemness of PDLSCs. Scanning electron microscopy (SEM) revealed that the construct possesses satisfactory pore density and a natural transition at the stratification point. The construct displayed good cell viability and proliferation, with the cellular movement observed at the stratification interface after bioprinting. Differentiation staining and quantitative reverse transcription-polymerase chain reaction (RT-qPCR) results demonstrated that PDLSCs within the 3D construct are capable of both osteogenic and fibroblastic differentiations. Ectopic transplantation in mice confirmed the biocompatibility of the construct. A rat tooth extraction model validated the construct's effectiveness in the integrated regeneration of both hard and soft tissues in alveolar ridge preservation (ARP). In conclusion, this personalized, concentration-varied 3D construct exhibits excellent biocompatibility and tissue preservation effects, holding significant potential for clinical application. &amp;nbsp;

The Influence of Ionizing Radiation on Fluoride Release from Restorative Dental Materials: A Comparative In Vitro Study

The Influence of Ionizing Radiation on Fluoride Release from Restorative Dental Materials: A Comparative In Vitro Study

Evolution of the Guided Direct Composite Resin Technique in Restorative Dentistry: A Systematic Review.

This systematic review aims to understand the limitations and benefits of the guided direct restorative technique, to optimize the final outcomes, considering the evolution from analog to digital, including planning, the diversification of guides, and the different resins employed. A search was conducted in the electronic databases PubMed, Cochrane, and through manual searches, initiated in May 2023 and updated in April 2024. The following search strategy was used: ((injectable composite resin) OR (direct pressed composite)) OR (3D-guided), utilizing the PICO framework. Initially, 739 articles were retrieved. After applying inclusion and exclusion criteria, 33 studies were considered suitable for data extraction, including 12 in vitro studies and 21 case reports or technique descriptions. The articles focused on comparisons of techniques, flowable, heated, and conventional resins, as well as various technique reports with variations in guides, materials, and planning, potentially aiding clinicians in more effective and safer execution of this restorative technique. The utilization of digital workflows presents greater solutions to the challenges of the guided direct restorative technique. Understanding the properties of the resins used is crucial for the results and should be chosen according to the patient's needs. A guided direct restorative procedure can deliver previously planned dental treatment based on individualized planning. This method ensures greater reproducibility in aesthetics and occlusion, resulting in superior quality work for the patient.