Restorative Dental Procedures Research Articles

Green Synthesis, Characterization, and Evaluation of the Antimicrobial Properties and Compressive Strength of Hydroxyapatite Nanoparticle-Incorporated Glass Ionomer Cement.

Background Glass ionomer cement (GIC) plays a vital role in dental restorative procedures, serving purposes such as filling, luting, and adhesion. However, its inadequate mechanical properties pose challenges, especially in areas experiencing significant stress. To overcome this limitation, nanohydroxyapatite (nHA), known for its bioactive phosphate content, is added to the GIC at specific concentrations to improve its properties. Aim We aim to evaluate the antimicrobial property and compressive strength of green-mediated nHA-incorporated GIC. Material and methods Green synthesis of hydroxyapatite nanoparticles was prepared using Moringa oleifera extract in a solvent form and eggshell waste served as the calcium source. These nHApowders were then integrated into the GICat varying concentrations (3%, 5%, and 10%) designated as Group I, Group II, and Group III, respectively, while Group IV (control) consisted of conventional GIC. Specimens were fabricated and subjected to chemical structure analysis through Fourier transform infrared spectroscopy (FTIR), energy dispersive X-ray (EDX), and scanning electron microscopy (SEM). The antimicrobial activity and compressive strength of all groups were investigated. The antimicrobial activity against Streptococcus mutans and Lactobacillus was evaluated through the minimum inhibitory concentration (MIC) test, while compressive strength was evaluated by measuring the maximum force endured by the specimen before fracturing. Data analysis utilized IBM SPSS Statistics software, employing repeated measures ANOVA to determine mean MIC values and compressive strength, with Tukey's posthoc test for pairwise comparisons. Results The results of the study showed that the antimicrobial efficacy of nHA GIC improved with increasing weight percent (% wt) of the additive, exhibiting significantly enhanced activity against Streptococcus mutans and Lactobacillus compared to the control group (Group IV) with statistical significance (p < 0.05). Moreover, the compressive strength exhibited notable enhancements in the modified groups, including Group I (172.55 ± 0.76), Group II (178.16 ± 0.760), and Group III (182.45 ± 0.950), when compared to the control (162.46 ± 1.606), with statistically significant differences (p < 0.05). Conclusion The study demonstrates that the incorporation of green-mediated nHA-containing GIC results in superior antimicrobial efficacy and compressive strength compared to the control group (Group IV). In particular, the highest concentration of nHA-modified GIC (10%) exhibited the most favorable antimicrobial properties along with increased strength. Therefore, utilizing green-mediated nHA in the GIC shows promise as an effective restorative material. Future investigations should delve into the molecular chemistry and bonding mechanisms to further explore its potential.

Comparative Evaluation of the Effectiveness of Innovative Periorbital Eye Massager and Virtual Reality Eyeglasses for Reducing Dental Anxiety during Dental Restorative Procedures in Children.

Many behavior management techniques are employed to reduce the anxiety associated with dental procedures in children. One of the most commonly used methods comprises audiovisual distraction using virtual reality (VR) eyeglasses. In this study, an innovative device, a periorbital eye massager (PEM), is compared with VR to evaluate dental anxiety in children. in this study, 22 children were divided into two groups, that is, group I consisting of PEM and group II consisting of VR. The participants were instructed to wear the device and then subjected to dental restorative procedures. After completion of the procedure, anxiety was measured using a validated questionnaire by the children and by using the modified behavior pain scale by the second investigator. Also, physiological parameters like heart rate and oxygen saturation were evaluated before and after a dental procedure. The results were statistically insignificant for group I and group II when a validated questionnaire and modified behavior pain scale were used to measure the dental anxiety of children. Also, the data also shows no significant difference in heart rate and oxygen saturation between the two groups. The innovative PEM can also be used as an effective behavior management tool in managing dental anxiety in children, as there was no statistically significant difference between PEM and VR. As a pediatric dentist, the methods for administering a patient present a novel challenge because behavior management varies from patient to patient. As a result, the prospects for augmenting various techniques of behavior therapy for pediatric patients are limitless. Gala UP, Kalaskar R. Comparative Evaluation of the Effectiveness of Innovative Periorbital Eye Massager and Virtual Reality Eyeglasses for Reducing Dental Anxiety during Dental Restorative Procedures in Children. Int J Clin Pediatr Dent 2024;17(1):48-53.

Longevity of dental restorations in Sjogren’s disease patients using electronic dental and health record data

BackgroundDecreased salivary secretion is not only a risk factor for carious lesions in Sjögren’s disease (SD) but also an indicator of deterioration of teeth with every restorative replacement. This study determined the longevity of direct dental restorations placed in patients with SD using matched electronic dental record (EDR) and electronic health record (EHR) data.MethodsWe conducted a retrospective cohort study using EDR and EHR data of Indiana University School of Dentistry patients who have a SD diagnosis in their EHR. Treatment history of patients during 15 years with SD (cases) and their matched controls with at least one direct dental restoration were retrieved from the EDR. Descriptive statistics summarized the study population characteristics. Cox regression models with random effects analyzed differences between cases and controls for time to direct restoration failure. Further the model explored the effect of covariates such as age, sex, race, dental insurance, medical insurance, medical diagnosis, medication use, preventive dental visits per year, and the number of tooth surfaces on time to restoration failure.ResultsAt least one completed direct restoration was present for 102 cases and 42 controls resulting in a cohort of 144 patients’ EDR and EHR data. The cases were distributed as 21 positives, 57 negatives, and 24 uncertain cases based on clinical findings. The average age was 56, about 93% were females, 54% were White, 74% had no dental insurance, 61% had public medical insurance, < 1 preventive dental visit per year, 94% used medications and 93% had a medical diagnosis that potentially causes dry mouth within the overall study cohort. About 529 direct dental restorations were present in cases with SD and 140 restorations in corresponding controls. Hazard ratios of 2.99 (1.48–6.03; p = 0.002) and 3.30 (1.49–7.31, p-value: 0.003) showed significantly decreased time to restoration failure among cases and positive for SD cases compared to controls, respectively. Except for the number of tooth surfaces, no other covariates had a significant influence on the survival time.ConclusionConsidering the rapid failure of dental restorations, appropriate post-treatment assessment, management, and evaluation should be implemented while planning restorative dental procedures among cases with SD. Since survival time is decreased with an increase in the number of surfaces, guidelines for restorative procedures should be formulated specifically for patients with SD.

Radiographic Assessment of 121 Glass Fiber Post Procedures in 32 Patients Aged 21-60 Years Performed by 6th-Year Dental Students During the 2022-2023 Academic Year at the College of Dentistry, Jazan University, Saudi Arabia.

BACKGROUND The restoration of endodontically treated teeth (ETT) and severely damaged teeth has been a concern of clinicians. Glass Fiber Post (GFPs) combine the strength of carbon fiber posts with the esthetic appearance of glass to resemble natural dentin during dental restoration procedures. This radiographical study assessed the GFP carried out by students enrolled in the Clinical Comprehensive Course at the College of Dentistry, Jazan University. MATERIAL AND METHODS A total of 32 patients treated by 18 6th-year dental students with 121 GFPs were assessed in this cross-sectional radiographic study. The assessment covered tooth type, arch, post-to-root width, length of post in relation to the crown and root lengths, amount of remaining gutta percha (GP), and gap between GP and post. Data were analyzed using SPSS, and associations between variables were determined using the chi-square test. RESULTS Maxillary teeth were the most frequently restored with posts (88.4%) with most being (58.7%) anterior teeth, and 50.4% of posts had widths that were one-third that of the root. The percentage of posts was twice (71.1%) or equal to (26.4%) the crown length, whereas two-thirds of the tested GFPs were >5 mm of the remaining GP. Significant differences were observed in location and position of teeth with post width, post length in relation to crown or root length, and amount of remaining GP, with P values of 0.018, 0.000, and 0.001, respectively. CONCLUSIONS The assessed radiographs revealed that the performance of sixth year students in accomplishment GFP radiographically was satisfactory and within the values recommended in the literature.

Effects of Plasma Treatment on the Strength of Bonding to Ceramic Surfaces in Orthodontics-A Comprehensive Review.

Over the past several decades, orthodontic treatment has been increasingly sought out by adults, many of whom have undergone restorative dental procedures that cover enamel. Because the characteristics of restorative materials differ from those of enamel, typical bonding techniques do not yield excellent restoration-bracket bonding strengths. Plasma treatment is an emerging surface treatment that could potentially improve bonding properties. The purpose of this paper is to evaluate currently available studies assessing the effect of plasma treatment on the shear bond strength (SBS) and failure mode of resin cement/composite on the surface of ceramic materials. PubMed and Google Scholar databases were searched for relevant studies, which were categorized by restorative material and plasma treatment types that were evaluated. It was determined that cold atmospheric plasma (CAP) treatment using helium and H2O gas was effective at raising the SBS of feldspathic porcelain to a bonding agent, while CAP treatment using helium gas might also be a potential treatment method for zirconia and other types of ceramics. More importantly, CAP treatment using helium has the potential for being carried out chairside due to its non-toxicity, low temperature, and short treatment time. However, because all the studies were conducted in vitro and not tested in an orthodontic setting, further research must be conducted to ascertain the effectiveness of specific plasma treatments in comparison to current orthodontic bonding treatments in vivo.

Effect of audio and virtual reality distraction on the dental anxiety of children with mild intellectual disability.

Intellectual disability, is a neurodevelopmental disorder that typically manifests early in childhood and consists of both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. It can be categorized into mild, moderate, severe, and profound based on its severity. Cognitive impairment may be observed predominantly in children with intellectual disabilities. Marked deficits in areas of learning, planning, communication, social participation, and personal independence in children with mild intellectual disabilities make behavior guidance and communication a challenge during dental treatments. The aim was to evaluate and compare the use of two different distraction tools, audio, and virtual reality (VR) on the dental anxiety of children with mild intellectual disability during dental treatment. Twenty children diagnosed with mild intellectual disability were equally divided into two groups. A cross-over study design consisting of two appointments 1 month apart was employed. In the first appointment, audio and VR distractions were provided to participants in Groups 1 and 2, respectively, and the distraction tools provided to the participants were interchanged in the second appointment. A trained observer recorded physiological parameters (pulse rate and oxygen saturation) and observational parameters (Venham's anxiety rating scale) during both appointments at three-time intervals. Statistical intra-group and inter-group comparison analyses were performed using Friedman's and Mann-Whitney U tests. A decrease in pulse, increase in oxygen saturation levels, and a decrease in Venham's Anxiety Rating Scores (statistically significant p<.05 / highly significant p<.01) was observed on introducing the distraction techniques in Groups 1 and 2 in both appointments. A statistically non-significant difference (p>.05) in physiological and observational parameters was observed between Groups 1 and 2 in both appointments. Audio and VR distraction techniques can be employed for behavior guidance in children with mild intellectual disability during restorative dental procedures.

A Study of the Peculiarities of the Formation of a Hybrid Interface Based on Polydopamine between Dental Tissues and Dental Composites, Using IR and Raman Microspectroscopy, at the Submicron Level.

The creation of buffer (hybrid) layers that provide improved adhesion to two heterogeneous materials is a promising and high-priority research area in the field of dental materials science. In our work, using FTIR and Raman microspectroscopy at the submicron level in a system of dental composites/intact dental enamel, we assessed the molecular features of formation and chemically visualized the hybrid interface formed on the basis of a nature-like adhesive, polydopamine (PDA). It is shown that a homogeneous bioinspired PDA-hybrid interface with an increased content of O-Ca-O bonds can be created using traditional methods of dental tissue pretreatment (diamond micro drilling, acid etching), as well as the subsequent alkalinization procedure and the developed synthesis technology. The development of the proposed technology for accelerated deposition of PDA-hybrid layers, as well as the creation of self-assembled biomimetic nanocomposites with antibacterial properties, may in the future find clinical application for minimally invasive dental restoration procedures.

Isolation Systems and its Effectiveness in Oral and Maxillofacial Surgery: A Systematic Review.

The success of restoration processes depends on the efficient control of moisture and microorganisms. Dental restorative procedures frequently use rubber dams as an isolation technique. There is still room for evidence-based discussion over how rubber dam use affects the durability and caliber of dental restorations. In this review, the effects of rubber dam isolation vs alternative isolation techniques for dental restorative procedures are compared. An extensive online search in the various databanks of the EMBASE, Medline, Pubmed, and Scopus was conducted. The keywords searched were "isolation, oral surgery, dental surgery, retractors, rubber dam, and methods of isolation." The studies selected were longitudinal research design and randomized trials. To ascertain the risk of bias, meta-analysis was carried out. The outcome was measured as the successful restoration at the end of follow-up period representing the thorough isolation. A total of 1342 people were involved in six studies from across the world that were carried out between 2010 and 2015. High bias risk existed in all the studies. Five investigations compared the rubber dam vs cotton rolls. Due to discrepancies in the data supplied, one study was omitted from the analysis. Three of the four trials that were still running showed restored survival rates with all having a follow-up of at least six months. The survival of the restored composite teeth for six months in rubber dam isolation with odds ratio of 2.29, 1.38, and 1.00 at the end of six months, one year and one and half year respectively. However, the evidence was very low and speculative. The isolation was seen effective in the primary teeth specifically for the proximal lesions. None of the included studies discussed side effects or provided information on the treatment's upfront costs. The application of rubber dams in dental techniques may result in successful outcome compared to cotton rolls, according to some low-certainty evidence revealed in this research. Other times, the evidence is really ambiguous. It is necessary to conduct additional, high-quality studies investigating how rubber dam use affects various restorative procedures.

Teeth Reconstruction Using Artificial Intelligence: Trends, Perspectives, and Prospects

Background Artificial intelligence (AI) applications in dental restorative procedures have significantly developed over recent years. However, there is a lack of documentation regarding the types of AI used in tooth reconstruction.Types of Studies Reviewed Studies using AI in tooth reconstruction were electronically searched over three databases PubMed, Cochrane library, and Google Scholar. The relevancy of theme tooth reconstruction was prioritized in searching. Only original research was included without the restriction of publication time or any filters.Results A total of 18 studies were included in this review: 5 reported programmable AI systems based on mathematical models such as statistical estimation, 9 studies used biogeneric tooth libraries, and 4 presented the deep learning models.Practical Implications AI has gained significant progress over the past two decades as a powerful tool for automated tooth reconstruction. However, further studies are required to compare different forms of AIs and to assess their clinical performance in the reconstruction of occlusal surfaces.

Heat generated during dental treatments affecting intrapulpal temperature: a review

IntroductionHeat is generated and transferred to the dentine-pulp complex during various dental procedures, such as from friction during cavity preparations, exothermic reactions during the polymerisation of restorative materials and when polishing restorations. For in vitro studies, detrimental effects are possible when intra-pulpal temperature increases by more than 5.5°C (that is, the intra-pulpal temperature exceeds 42.4°C). This excessive heat transfer results in inflammation and necrosis of the pulp. Despite numerous studies stating the importance of heat transfer and control during dental procedures, there are limited studies that have quantified the significance. Past studies incorporated an experimental setup where a thermocouple is placed inside the pulp of an extracted human tooth and connected to an electronic digital thermometer.MethodsThis review identified the opportunity for future research and develop both the understanding of various influencing factors on heat generation and the different sensor systems to measure the intrapulpal temperature.ConclusionVarious steps of dental restorative procedures have the potential to generate considerable amounts of heat which can permanently damage the pulp, leading to pulp necrosis, discoloration of the tooth and eventually tooth loss. Thus, measures should be undertaken to limit pulp irritation and injury during procedures. This review highlighted the gap for future research and a need for an experimental setup which can simulate pulp blood flow, temperature, intraoral temperature and intraoral humidity to accurately simulate the intraoral conditions and record temperature changes during various dental procedures.

Principles and concepts of occlusion in restorative dentistry

The importance of occlusion to practicing dentists is immense as it plays a key role in the success or failure of restorative procedures. This article attempts to demystify and present an overview of the complex topic of occlusion and its principles which are important for the success of restorative procedures. The article discusses the principles of occlusion as these apply to restorative dentistry. It provides a guide as to what is required to optimize the occlusion for restorative treatment outcomes, including conformative and reorganized approaches. Occlusion and its effect on the temporomandibular joint are also presented. The topic is clinically relevant as it will help the practitioners to understand the key concepts of occlusion and help improve the outcome of their restorative dental procedures.

Evaluation of the success of distraction through virtual reality using the Child Drawing Hospital Scale

Aim: The aim of this study was to compare the effect of three-dimensional audio-visual distraction on reducing dental anxiety and pain perception in children with tell-show-do technique. Methods: 52 children aged 6-11 years were randomly divided into two groups (n=26). During restorative dental treatment, distraction was given to the study group by letting them watch cartoons with 3D virtual reality (VR) glasses, while tell-show-do technique was used in the control group. The anxiety levels of the children in both groups after dental treatment were measured with the Child Drawing: Hospital Scale (CD:H) and the Children`s Fear Survey Schedule-Dental Subscale (CFSS-DS). Pulse rate measurements were made with pulse oximetry before, during and after the dental procedures. In addition, perception of pain was evaluated with the Wong-Baker FACES Pain Rating Scale. Results: There was no statistically significant difference between the study and control groups in terms of anxiety levels, CFSS-DS scores, CD:H scores and pulse rate (P&gt;0.05). Also, there was no statistically significant difference between the groups in terms of Wong Baker scores (P&gt;0.05). Conclusions: Watching cartoons with 3D VR glasses did not show any superiority over tell-show-do technique in reducing anxiety and pain levels in children during dental restorative procedures. Keywords: Anxiety; Child Behavior; Drawing; Pain Perception; Virtual Reality

Effects of Dental Operating Microscope on Anxiety, Behaviour, and Treatment duration among Children in the 5-7 Year Age Group undergoing dental restorative procedures: A Randomised Clinical Trial

Introduction: Fear of the unknown causes anxiety in paediatric patients. The use of tell-show-do, along with audiovisual distraction, promotes positive behaviour and reduces anxiety. The use of a Dental Operating Microscope (DOM) as a visual distraction aid provides better cooperation in paediatric patients. Aim: To evaluate the effects of a DOM on anxiety, behaviour, and treatment time during a restorative procedure in paediatric dental patients. Materials and Methods: The present study was a parallel-arm, randomised clinical trial conducted at IGIDS, Puducherry, India, in 2022, over a period of four months. Healthy five to sevenyear-old children on their first dental visit were selected (n=90) and divided into two groups using simple randomisation. Group A: Restoration of teeth without a DOM, and group B: Restoration of teeth using a DOM. Anxiety and behaviour were measured as soon as the child entered the operatory (T1), after tell-show-do for the procedure (T2), after cavity preparation (T3), and after completion of the restoration (T4). Caries removal efficacy and treatment duration were also assessed. The data obtained were statistically analysed using the Chi-square test and independent sample t-test (p&lt;0.05). Results: Out of the 90 children who participated in the study, 47 (52%) were girls, and 43 (47%) were boys. There was a decrease in anxiety and improved patient behaviour during cavity preparation (T3) and after completion of restoration (T4) in group B (p&lt;0.001). The operator also reported higher visual (71.10%) and tactile (95.60%) scores in caries removal, with a shorter treatment duration in groups where DOM was used (p&lt;0.001). Conclusion: The use of DOM reduced anxiety levels and improved the compliance of children during dental procedures. Operator ergonomics and the quality of treatment could be enhanced by recommending DOM in regular paediatric dental practice.

How does indirect air-cooling influence pulp chamber temperature in different volume teeth and absence/presence of resin-based composite during light curing?

BackgroundLight-curing of materials during restorative dental procedures poses a risk for pulp tissue overheating. Therefore, the aim of this study was to investigate the effect of indirect air-cooling on pulp chamber temperatures during light-curing of varying volume teeth and absence/presence of resin-based composite (RBC) at different exposure time.MethodsThe volume of 11 human teeth was measured by micro computed tomograph. An experimental rig controlled the thermal environment of the teeth and a thermocouple inserted retrograde into the root canal measured temperature changes. Pulp chamber temperature was measured with and without air-cooling on teeth without and with RBC at 15 s, 30 s and 60 s intervals. Generalized estimating equations were used for statistical analysis.ResultsThe temperature increase with air-cooling (versus no air-cooling) was lower in teeth despite absence/presence of RBC (β = − 4.26, 95%CI − 5.33 and β = − 4.47, 95%CI − 5.60, respectively). With air-cooling, the temperature increase in teeth with RBC was lower compared to teeth without RBC (β = − 0.42, 95%CI -0.79; − 0.05). Higher teeth volume resulted in lower temperature increase with air-cooling than without air-cooling (β = − 0.04, 95%CI -0.07; − 0.01 and β = − 0.17, 95%CI -0.30; − 0.05, respectively).ConclusionsAir-cooling resulted in lower pulp chamber temperature increase. Using air-cooling, the temperature increase was lower in teeth with RBC compared to teeth without RBC. Lower volume teeth resulted in higher temperature increase, thus they seemed to benefit more from air-cooling compared to higher volume teeth. Air-cooling could be an effective tool in controlling pulp temperature increase during light-curing, especially when the tooth volume is small.

Adjunctive therapies for in vitro carious lesions: Antimicrobial activity, activation of dentin metalloproteinases and effects on dental pulp cells

BackgroundAdjunctive therapies used before dental restorative procedures may encourage carious tissue removal. Beyond promising antimicrobial properties, treatments could positively modulate the dentin-pulp complex while not interfering with restoration survival. Herein, we evaluated a set of substances and their effects on carious lesions and the underlying dentin or pulp cells. MethodsArtificial caries lesions were developed in bovine teeth cavities immersed in Streptococcus mutans and Lactobacillus casei co-cultures. The cavities were treated according to the following groups: Phosphate Buffer Saline (PBS), Chlorhexidine (CHX), Papacárie® (Papain gel), Ozone (O3), and antimicrobial Photodynamic Therapy (aPDT). After treatments, samples were cultivated to count isolated microbial colonies. The zymography assay evaluated the activity of dentin metalloproteinases (MMP-2 and MMP-9). Cell viability was indirectly assessed on human dental pulp cells after 24, 72, or 120 h, whereas the odontodifferentiation potential was evaluated after ten days of cell culture. ResultsCHX and aPDT led to around 1 log bacterial load reduction. PBS, CHX, and aPDT showed the eventual expression of MMP-2 and MMP-9. Cell viability was reduced (< 30%) after 120 h for all groups compared to the control. CHX, O3, and aPDT induced greater odontodifferentiation (≈ 20% higher) than PBS and papain gel. ConclusionAdjunctive therapies presented little or no biological significance in reducing bacterial load in artificial carious lesions. Although the activation of endogenous metalloproteinases may represent a possible concern for adhesive restorations, some of these treatments may have a positive role in dental pulp tissue repair.

Rural-Urban Differences in Use of Dental Services and Procedures Among Medicare Beneficiaries in 2018.

Medicare beneficiaries in rural areas may face challenges in access to dental care. This study assessed rural-urban differences in the use of dental services and dental procedures by Medicare beneficiaries. We obtained data from the 2018 Medicare Current Beneficiary Survey cost and use files. Outcome variables examined in this study were (1) dental visits (yes/no), whether the Medicare beneficiary had ≥1 dental visit in the past year, and (2) dental procedures-preventive (yes/no), restorative (yes/no), and surgical procedures (yes/no)-whether the beneficiary had the procedure in a dental visit. The independent variable was the beneficiary's residence (rural vs urban). We used multiple logistic regression to analyze data and accounted for the survey design of the Medicare Current Beneficiary Survey. The analytic sample included 7377 respondents aged ≥65 years. Approximately 57.0% (95% CI, 54.9%-59.0%) and 46.4% (95% CI, 41.6%-51.2%) of Medicare beneficiaries in urban and rural communities in the United States had a dental visit in 2018, respectively. Rural beneficiaries were significantly less likely than their urban counterparts to have preventive procedures (adjusted odds ratio = 0.51; 95% CI, 0.36-0.72) but significantly more likely to have restorative procedures (adjusted odds ratio = 1.30; 95% CI, 1.05-1.62). We found significant disparities in use of dental services by Medicare beneficiaries in rural communities. When Medicare beneficiaries in rural areas used dental care, they were less likely than beneficiaries in urban areas to have preventive procedures but more likely to have restorative procedures, suggesting a greater burden of oral health needs among them. Policy research is needed to identify models that can incentivize prevention and improve access to dental care for Medicare beneficiaries in rural communities.

Microstructure and Mechanical Behavior of Modern Universal-Chromatic and Bulk-Fill Resin-Based Composites Developed to Simplify Dental Restorative Procedures.

One of the recent trends in the development of resin-based composites (RBCs) focuses on universal coloring to avoid time-consuming color matching and RBC layering for a clinically appropriate esthetic impact. We evaluated an experimental material for posterior restorations combining universal coloring with the possibility of bulk-fill placement. Clinically established materials were analyzed as a reference, including a bulk-fill and a universal chromatic RBC. Microstructural features were described using scanning electron microscopy and related to macroscopic and microscopic mechanical behavior. Standards to be met before market launch were supplemented by fractography, Weibull analysis, and aging behavior assessment. Quasi-static and viscoelastic behavior were evaluated on a microscopic scale, incorporating a large number of parameters and increasingly aggressive immersion media. All materials complied with the standard requirements even after aging. The latter had little impact on the measured parameters, except for strength. Strength, modulus of elasticity, and hardness parameters on the one hand and damping behavior on the other were mutually exclusive. Despite considerable differences in the microstructure and type of filler, an increased filler amount remained critical for better mechanical properties. The lower proportion of inorganic fillers was directly transferred to the elastic modulus values, which, in turn, restricts the experimental material in its clinical applications to smaller occlusal fillings.

Release of monomers in dental wastewater during treatment. A comparative in vitro and in vivo study based on Fabric phase Sorptive extraction

The main objective of this research was to detect monomers that are released during dental restorative procedures related to the oral cavity and then discharged into the environment through the drainage of the dental unit. This study involves the collection of wastewater from the spray system of a high-speed dental handpiece before it winds up in the central drain after the grinding of resin composite materials. The study was executed in two phases: an in vitro experiment and an in-vivo experiment. Three representative dental materials were used; a resin composite for direct restorations, a core-build up material, and a computer-aided designand computer-aided manufacturing (CAD/CAM) material. On both occasions, the water from the spray-system of the handpiece during the milling of the specimens was extracted using water suction and analysed by high-pressure liquid chromatography (HPLC) and verified with HPLC-PDA after Fabric Phase Sorptive Extracttion. In the first phase, triethylene glycol dimethacrylate (TEGDMA) was detected in the wastewater samples of all the materials tested whereas bisphenol-A (BPA) was not detected. Urethane dimethacrylate was released only from the CAD/CAM material (0.66 ± 0.14 ng/μL) while BisGMA was not detected. In the second phase the core build-up material released an amount of BPA (0.42 ± 0.14 ng/μL) while after 7 days, the amount of BPA increased (0.97 ± 0.07 ng/μL). The resin composite indicated for direct restoration material released the highest amount of TEGDMA (p < 0.001).The contamination of the environment by dental procedures is possible because monomers are released from different dental restorative materials and are detected in the wastewater of dental units.

Recent developments in bioactive pulp capping materials (direct and indirect)

The field of dentistry is rapidly shifting its focus toward biologically active restorative materials. Bioactive materials are those capable of inducing and promoting the regeneration of the damaged tissue and remineralizing demineralized dentinal structure as a vital dental pulp is necessary for the long-term healthy survival of a tooth. Vital pulp therapy intends to protect and prevail the vitality of pulp tissue which gets compromised when subjected to mutilating factors like dental caries, trauma, and operative or restorative procedures. During the therapy, the said bioactive material initially forms a non-irritant protective bridge over the vital pulp and later stimulates the pulpal odontoblasts to produce a reparative dentinal barrier which later forms a barrier and protects the underlying pulp’s vitality. The vitality of a tooth needs to be intact protected because the consensus reports that endodontically treated teeth, particularly molars, reportedly have a reduced survival probability than the vital teeth. [1] These factual arguments lead to the development of biologically active restorative materials. This review article intends to provide a review of the modern products introduced in the category of bioactive restorative materials.

Advances in Dental Technologies Aids Patients in Improving Quality of Life

Once in a while, new innovations emerge in the world of restorative dentistry. The emergence of new bonding agents, dental liners and bases, and adaptive capabilities of components offer new opportunities. Dental liner materials have improved tremendously over the last few years. They are applied in a thin layer to seal the walls of the cavity or minimize the influx of bacteria following restorative procedures. On the other hand, dental bases are applied in thick layers and support a restorative material during the placement as well as function. The dental liners and bases are widely used to improve the outcome of dental caries treatment and several dental restoration procedures. Apart from this, dental technology has improved a lot over the last few years and will continue to advance the field and benefit patients and healthcare professionals alike. While Covid-19 presented various uncertainties during the pandemic, it is safe to say that the pandemic increased patient awareness about safety measures and sanitation, which will boost the demand for dental technologies. Here are some of the dental technologies which will be a big hit in the coming years.