Direct Composite Restorations Research Articles

Awareness of possible complications associated with direct composite restorations: A multinational survey among dentists from 13 countries with meta-analysis

ObjectivesResin-based composites (RBCs) evolved into favoured materials for teeth restorations, marking a significant change in dental practice. Despite many advantages, RBCs exhibit various limitations in their physical and chemical properties. Therefore, we assessed the dentists' awareness of possible complications after direct composite restorations and their opinions about this material. MethodsThe online questionnaire was created in English in May 2023. A 16-item survey was dedicated to general dentists and specialists. The first section included four questions related to demographic characteristics. The second section comprised twelve questions and focused on awareness of potential side effects of composite restorations, the most crucial advantages and disadvantages of composite resins, and the frequency of experienced clinical complications after the application of composite materials. ResultsA total of 1830 dentists from 13 countries took part in the survey. Dentists most often declared awareness of low adhesion to the dentine (77.5 %) and, most rarely, solubility in oral fluids (42.6 %). Aesthetics was identified as the main advantage of composite fillings (79 %), followed by the possibility of repair (59 %) and adhesion to enamel (57 %). Polymerisation shrinkage was a major disadvantage for most countries (70 % overall). Analysing the declared potential clinical complications for all countries, statistically significant findings were obtained for marginal discolouration (OR=2.982, 95 % CI: 1.321–6.730, p-value=0.009) and borderline significance for secondary caries (OR=1.814, 95 % CI: 0.964–3.415, p-value=0.065). ConclusionsDentists value aesthetics and repairability but are aware of shrinkage and experience discolouration. The issue of toxicity and solubility seems to be the least known to dentists.Clinical significance: Dentists should use RBCs with critical caution due to possible side effects. Despite the undoubted aesthetics of direct composite restorations, it is necessary to remember potential clinical complications such as marginal discolouration or secondary caries.

Full-mouth rehabilitation in a patient with multiple caries: A case report

Background: Full-mouth rehabilitation of multiple caries can improve the quality of life. The selection of appropriate restorations on caries and teeth that have undergone post-endodontic treatment is critical to treatment success and enhances the quality of life. Purpose: This case report presents a full-mouth rehabilitation of a patient with multiple caries. Case: A 30-year-old man complained of multiple caries and pain in the posterior mandibular tooth, especially when eating and drinking (cold and hot), which interfered with his activities. The clinical examination found caries in teeth 16, 22, 24, 25, 26, 27, 36, 37, and 38 and a retained root of tooth 46. The percussion and biting tests were negative, while the sensibility test was positive. Case Management: Severe caries found in tooth 37 was managed with endodontic treatment and an indirect onlay restoration with lithium disilicate-based material. The retained tooth of 46 was extracted and restored with a partial denture. The other teeth, 16, 22, 24, 25, 26, 27, 36, 37, and 38, were treated by direct composite restoration. Holistic treatment was performed on all the problem teeth to support oral hygiene and was followed by dental health education. Conclusion: Full-mouth rehabilitation is essential for oral hygiene and can improve the quality of life. Education on maintaining oral hygiene is a must for protecting oral health.

The Evaluation of the Cervical Marginal Sealing of Direct vs. Indirect Composite Resin Restorations in MOD Cavities.

The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities. MOD preparations were performed on 30 extracted teeth. The mesial cervical margin of each tooth was relocated using a flow composite resin (Enamel Plus HRi Flow, Micerium, Avegno, GE, Italy), then the samples were divided into three groups. In group A, the cavities were directly restored using a nanohybrid composite resin (Miris 2 Coltène Whaledent, Altstaetten, Switzerland) and a universal adhesive (ScotchBond Universal, 3M ESPE, St. Paul, MN, USA) by the etch-and-rinse strategy, for group B, the restoration procedure was similar but the self-etch strategy was used, and the samples in group C were filled using the inlay technique. Each sample was stored for 48 h in a 2% methylene blue solution, then it was cut in a mesio-distal direction using a Struers Secotom 50 device (Cleveland, OH, USA). The marginal sealing and adhesive interface were assessed for each sample at the cervical margin by optical microscopy (OM) and scanning electron microscopy (SEM). One-way ANOVA and Bonferroni post-hoc tests were used with a significance level of 0.05. Significant differences were recorded within groups A and C, between mesial and distal margins (p = 0.02 in group A and p = 0.043 in group C). The marginal sealing is more effective in MOD inlay restoration compared to direct restorations. Relocation of the cervical margin with flow composite resin and the use of different adhesive strategies do not improve the marginal sealing.

Treatment of wedge-shaped lateral incisors with direct composite veneer restorations: two case presentations

Wedge-shaped lateral incisors are teeth associated with dental anomalies, often encountered in maxillary teeth, characterized by being smaller than normal and having cylindrical or pointed shapes. For achieving an aesthetic appearance in treatment, ceramic or composite restorations are commonly preferred. However, ceramic restorations are not recommended as the primary choice for treating wedge-shaped lateral teeth due to their tendency to cause more substance loss in dental tissues, higher costs, and challenging repairs compared to composite restorations. In cases where patients presented with bilateral wedge-shaped lateral incisors seeking aesthetic improvements, various treatment options were explained to them, and after evaluating their preferences, the decision was made to use direct resin composite restorations for aesthetic enhancement. The color of the teeth was determined, and an appropriate composite resin was selected. Following the completion of the restorations, finishing and polishing procedures were applied. The purpose of presenting these two cases is to demonstrate the use of direct composite veneer restorations in achieving aesthetic treatment.

Comparative Evaluation of Marginal Leakage of Various Bevel Designs Using Direct Composite Restoration in Fractured Anterior Teeth: An In Vitro Study.

Background and objective Resin-based restorative materials are the backbone of modern restorative dentistry. But in spite of being an excellent material, there are many shortcomings with direct resin restorative materials such as polymerization shrinkage and microleakage that complicate the rate of clinical success. Hence, the aim of the present study is to compare the microleakage caused by composite restorations usingtwo different bevels, primary and zigzag bevels, while restoring fractured anterior teeth. Materials and methodology Thirty non-carious maxillary central incisors were split into two divisions wherein Group I received the primary bevel and Group II received the zigzag bevel. After receiving the bevel, the samples are restored with direct filling composite material (Neo Spectra ST, Dentsply Sirona, Charlotte, NC, USA). The restored samples underwent thermocycling (Holmarc, Kochi, India) and were assessed for microleakage under a stereomicroscope (Leica M205, Wetzlar, Germany).For the statistical analysis, IBM SPSS Statistics for Windows, V. 23.0 (IBM Corp., Armonk, NY) was used. Descriptive statistics were expressed in mean and standard deviation. Analytical statistics including the independent Student t-test was used to assess the difference derived from both groups at p<0.05. The normality of the data was assessed using the Shapiro-Wilk test. Results In the primary bevel, 53.3% of the samples showed first-degree microleakage, and 46.7% showed second-degree microleakage, respectively, and in samples restored using the zigzag bevel, 66.7% of the samples had no microleakage, and 33.3%of the samples had first-degree microleakage. The independent t-test revealed that the microleakage of the zigzag bevel showed a significantdifference, being superior to the primary bevel at p<0.01. Conclusion Acknowledging the limitations of the study conducted, both bevel designs had a certain degree of microleakage when restored with composite material in anterior fractured teeth. However, the zigzag bevel produced significantly lesser microleakage as compared to the primary bevel restorations.

Management of midline diastema using the direct composite resin technique - A case report

Diastema or space between the anterior teeth is a common aesthetic complaint of patients. Direct composite resins in midline diastema cases allow dentists to have complete control in formation of natural smiles. This case report describes midline diastema closure with esthetic composite layering technique. A 25-year-old male patient reported to the clinic, with a complaint of spacing in the upper front tooth region of the jaw. The direct aesthetic composite laminate veneer was considered as the treatment of choice for the build-up of both maxillary central incisors as a more conservative, inexpensive, aesthetic, and quicker option. A2 &amp; A3 shades were selected; prepared tooth surface was etched for 15 seconds using 37% phosphoric acid, rinsed with water for 20 seconds, and air dried with slight air pressure. Bonding agent was applied (Adper single Bond, 3M ESPE, USA) and cured for 20 seconds using (Vivadent Blue phase) curing light. The labial surface of the restoration was flattened using red banded knife-edge tip diamond bur. The natural look of the restored teeth was achieved after finishing and polishing. At six-month and one-year recalls the general outlook of the maxillary anterior teeth was considered natural and aesthetical. Clinically, both restorations have no fractures and also the restoration margins on both maxillary central incisors demonstrated no discolorations. By taking this into consideration and according to the positive results, an experienced dentist with proper case selection, using an appropriate technique and modern materials, can perform highly aesthetic and durable direct composite resin restorations that can satisfy patients as under the conditions of the case presented.

Clinical performance of short fiber reinforced composite and glass hybrid on hypomineralized molars: A 36-month randomized split-mouth study

ObjectivesThis study aimed to assess the clinical performance outcome at 36 months of molars with molar incisor hypomineralization and carious lesions, treated with two different restorative approaches following selective caries removal. MethodsThe children aged 6 to 12 years (18 female, 13 male) included in the study had at least two carious permanent first molars diagnosed with molar incisor hypomineralization. Sixty-two molars were restored in a split-mouth design. In all subjects, selective caries removal was performed so that caries was completely removed from the cavosurface walls and only soft dentin was left above the pulp chamber. Short fiber reinforced composite (SFRC; EverX Flow™) covered by micro-hybrid composite (G-Aenial® posterior composite) and Glass Hybrid (GH; Equia Forte® HT) were used as restorative materials. The restorations were evaluated according to modified United States Public Health Service (USPHS) criteria at baseline, 6, 12, 18, 24, and 36 month follow-ups. ResultsDuring the 36-month follow-up, eight GH and four SFRC restorations failed. The clinical success of both restorations decreased statistically over time (p < 0.001 for both). When variables such as restoration type, sex, age, tooth type, and time were included in the model, the risk of failure of the restorations of the left lower first molar was statistically significantly higher than that of the left upper first molar (p < 0.002). ConclusionDirect composite restorations with SFRC and GH restorations perform similar clinical success with selective caries removal in the management of permanent molars affected by molar incisor hypomineralization. Clinical significanceSFRC or GH restorations with similar clinical success might be preferred for the management of MIH-affected molars.

Composite Restoration Design Effect During Curing and Chewing.

The purpose of this work is to observe the effect of the cavity design of the direct composite restoration on a real case of the patient's tooth structures after applying his mandibular kinematics with finite element analysis. Four complex maxillomandibular models of teeth 17 and 47 were constructed from the patient's cone-beam acquisition and the patient's kinematic data recorded with Modjaw® were added. Different shapes and sizes of mesio-occluso-distal (M.O.D.) composite restorations were simulated, including the polymerization shrinkage of this material. Finite element analyses were used to observe the Von Mises stresses occurring during polymerization and mastication. The stresses were observed at the cavity margin and the amplitude of the stresses was higher when the enamel volume was lower. The reduction in occlusal enamel volume with the open-angle vestibular and palatal walls resulted in a greater increase in stresses observed on the structures. The occlusal enamel is the area that bears the maximum masticatory stress, the loss of this enamel volume generates a much greater concentration of stress on the underlying structures. It is important to preserve as much enamel tissue as possible when designing a cavity for a direct composite restoration.

A Minimally Invasive Esthetic Approach for Teeth with Molar Incisor Hypomineralization: a Clinical Case Report

Molar incisor hypomineralization (MIH) is a qualitative defect of enamel, clinically characterized by white or yellow/brownish demarcated opacities that affect permanent molars, often associated with permanent incisors. The etiology is multifactorial, including systemic and genetic/epigenetic factors. Defects of anterior teeth can negatively impact children since they might present lower self-esteem and socialization problems. Purpose: To describe a minimally invasive treatment for anterior teeth affected by molar incisor hypomineralization, performed with direct composite resin restoration and a universal adhesive system. Case Report: An 8-year-old patient sought dental care with complaints about her dental appearance, reporting suffering from school bullying. She presented a white-yellowish opacity on the maxillary right central incisor. After a clinical examination, she was diagnosed with molar incisor hypomineralization. To improve dental esthetics, a direct composite resin restoration was proposed. The enamel surface was prepared and etched with 35% phosphoric acid etchant solution for 15 seconds before applying the universal adhesive system. Two different shades of the composite were used for layering the material to disguise the defect without extensive removal of the dental structure. The result was satisfactory as it was possible to mask the opacity, reestablish enamel thickness, and improve the patient's quality of life. Conclusion: Conservative restorations comprising a universal adhesive system seem to bring desirable esthetic results for anterior teeth with molar incisor hypomineralization.

Delayed vs. immediate placement of restorative materials over Biodentine and RetroMTA: a micro-shear bond strength study

BackgroundThe aim of the present study was to investigate the micro-shear bond strength (µSBS) of various restorative materials applied on two different fast-setting calcium silicate-based materials and to evaluate the effect of restoration time on µSBS.MethodsA total of 180 acrylic blocks with a cavity in the center were randomly divided into 2 main groups according to the capping material to be used (Biodentine or RetroMTA). The specimens were also randomly divided into 3 groups according to the restoration time (3 min, 12 min, 24 h). After the specified waiting periods, glass hybrid material (EQUIA Forte HT), resin composite (Filtek Z550) and light-cured calcium silicate material (Theracal LC) were placed on the specimens with tygon tubes. The specimens were kept for 24 h and then subjected to µSBS test. Statistical analysis was performed by 3-way ANOVA followed by Tukey test for pairwise comparisons (α = 0.05).ResultsThere is a statistically significant difference (p < 0.05) between the µSBS values obtained by applying resin composite on RetroMTA after different setting times (24 h > 12 min > 3 min). The µSBS obtained for the Biodentine-resin composite at the end of the 3 min setting time is significantly lower (p < 0.05) than the µSBS values at 12 min and 24 h. For both calcium silicate cements, at the end of all time periods, the µSBS obtained when resin composite was applied at the end was higher than the other materials (p < 0.05).ConclusionsFor Biodentine-resin composite bonding, the manufacturer’s recommendation of 12 min can be considered an appropriate time, whereas for RetroMTA-resin composite bonding, the µSBS increased as the waiting time increased. Regardless of the waiting time, it is recommended to prefer direct composite resin restoration over Biodentine and RetroMTA.

Multidisciplinary Treatment: Follow-Up of Dental Autotransplantation for 10 Years.

The objective is to present a clinical case of dental autotransplantation managed with surgery, orthodontics, endodontics, periodontics, and aesthetic rehabilitation. A 10-year-old boy sought treatment after avulsion of the maxillary left central incisor, which was not reimplanted. Based on anamnesis, clinical examination, and complementary examinations, agenesis of the maxillary and mandibular second premolars except the mandibular right second premolar was observed. After a multidisciplinary planning, the space in the maxillary left central incisor region was opened to receive the transplanted mandibular right second premolar. The receptor site was created in a single surgical procedure. Pulp necrosis was noted in the transplanted tooth, which was treated endodontically, and the agenesis spaces were closed using fixed orthodontic appliances. After removing the appliance, gingivectomy with osteotomy was performed in the maxillary right central incisor and the transplanted tooth regions to harmonize the height and shape of the gingival contour. Next, aesthetic readjustment was performed with tooth whitening, using office and home techniques, followed by microabrasion of the vestibular surface of the maxillary right central incisor. Direct composite resin restorations were placed in the maxillary incisors, and the teeth were rehabilitated using incisal and palatal guides. A multidisciplinary approach is essential for reestablishing the function and aesthetics of complex cases involving dental autotransplantation.

Advances in Preventive and Therapeutic Approaches for Dental Erosion: A Systematic Review.

The databases PubMed, Scopus, and Web of Science were used for a thorough search. Studies on the prevention and treatment of dental erosion that were conducted in English and used in vitro were among the inclusion criteria. The search turned up 391 papers in total, with 34 of those publications matching the requirements for inclusion. Varnishes, toothpastes, and solutions containing fluoride and other substances were used as preventive measures. Dental erosion is a significant issue, and taking preventative steps is crucial to lessening the disease's spread and its effects. Interventions based on fluoride seem to be successful at halting erosion and encouraging remineralization. To effectively address severe tooth erosion, therapeutic methods, including composite restorations, prosthetic crowns, and veneers, are available. Dental erosion causes aesthetic and functional issues that are best addressed with less invasive treatments like direct composite restorations. To improve and broaden the range of available treatments for this common dental issue, additional research and development are required.

Comparing fracture resistance on bovine incisors restored by tooth fragment reattachment versus direct composite restoration techniques.

Anterior teeth are prone to traumatic dental injuries (TDIs). Although a number of techniques ranging from original tooth fragment reattachment (TFR) to direct composite restoration (DCR) can be used to restore uncomplicated crown fractures, there is no consensus on which method is best. The purpose of this study was to investigate the fracture resistance of bovine incisors restored by two different techniques (TFR and DCR) in three different fracture models. Sixty extracted bovine lower incisors were randomly divided into three groups (n = 20). Angle, oblique, or transverse sections of all the teeth in a group were prepared by using a disk. The cut surfaces were scanned, and the cross-sectional areas (CSA) of the enamel and dentin were measured. Half the teeth in each group were restored by DCR (n = 10) and the other half by TFR (n = 10). The forces required to fracture the restored teeth were then measured using a Universal testing machine, and the fracture modes were analyzed (cohesive, adhesive, or mixed). No statistically significant differences between the TFR and DCR restorations were detected for total and enamel CSAs in any of the restoration shapes (p > .067). The fracture forces required to break DCT angle and transverse restorations were significantly greater than for the corresponding shapes restored with TFR (p < .033). However, the difference in the forces needed to fracture oblique section restorations by DCR or TFR was not statistically significant (p = .239), despite a similar trend (143.4 ± 51 N and 120.9 ± 25 N, respectively). This study revealed that a greater force is required to fracture teeth restored by the DCT than by the TFR technique, especially for a transverse section. This demonstrates that restoring a fractured tooth provides a superior outcome compared to reattaching the fractured fragment.

Frequency of Direct Composite Restorations to Anterior Teeth After Orthodontic Treatment: A Retrospective Study

Frequency of Direct Composite Restorations to Anterior Teeth After Orthodontic Treatment: A Retrospective Study

[Deep Margin Elevations, clinical considerations].

Subgingival restorations are problematic due to reduced visibility at the preparation margins, humidity (saliva, crevicular fluid and/or blood), problems with taking impressions (digital or analogue) and problems with the application of a rubber dam. Solutions, such as the use of a surgical microscope, retraction cord and Teflon tape, are available. Since modern dentistry largely relies upon adhesive techniques with hydrophobic materials, these require a clean and dry working area. One solution is to place the preparation margin supragingivally. This can be done in three ways: a local build-up using a direct composite restoration, a surgical clinical crown lengthening or an extrusion (orthodontic or surgical). Since in practice only a small part is usually located subgingivally, placing a direct composite restoration is often sufficient. The term Deep Margin Elevation is generally used in the international English-language literature for this approach. If the area located subgingivally is larger, then techniques like crown lengthening and extrusion might be better.

Evaluation of the proximal contact tightness in class II resin composite restorations using different contact forming instruments: a 1-year randomized controlled clinical trial

BackgroundProper proximal contact in direct composite restorations is crucial for periodontal health. Over a one-year period, this study was conducted to assess successive biological changes in proximal contact tightness PCT in class II direct composite restorations and the adjacent teeth by applying sectional matrix system along with different contact forming instruments.Methods72 direct compound class II composite restorations were performed in patients aged 18–40 years and divided into 4 groups: Group I (n = 18): proximal contact was restored with Palodent plus sectional matrix system, Group II (n = 18): Trimax as contact forming instrument, Group III (n = 18): Perform as contact forming instrument and Group IV (n = 18): Contact pro as contact forming instrument. All contact forming instruments were used along with Palodent plus matrix system. PCT was measured using a digital force gauge before (T0), immediate post operative (T1) and at 3 (T2), 6 (T3), 9 (T4), and 12 months (T5) after restorative treatment. Using One-Way ANOVA, Tukey’s post hoc test, and Bonferroni correction, PCT values were compared between groups before and after the intervention restoration. Meanwhile, for comparisons within groups, a paired t-test was conducted (p ≤ 0.05).ResultsContact forming instruments combined with Palodent plus sectional matrix system achieved better PCT. Trimax led to a statistically considerable tighter proximal contacts than the other groups (p < 0.05). No statistically significant difference was found in PCT between Contact pro-2, Perform and Palodent plus sectional matrix system. By means of multivariate analysis, the PCT between both T0 and T1 were increased (p < 0.001) and then it decreased till T5.ConclusionsThe use of transparent contact forming instruments achieved greater PCT compared to Palodent sectional matrix system alone that gradually decreased throughout 12 months and reached the PCT between the natural teeth. Using Trimax system provided the tightest proximal contacts. Additionally, digital force gauge was confirmed as an inclusive and accurate method to quantify PCT.Trial registrationClinicalTrials.gov NCT05749640: 24/5/2022.

ASPECTS OF ASSESSING AESTHETIC PARAMETERS IN PATIENTS

Main goal. To study the state of the maxillofacial system in patients with defects in the hard tissues of the teeth and dentition for the presence of aesthetic problems and the prevalence of aesthetic treatment methods with indirect restorations.&#x0D; Matherials and methods. To study the state of the maxillofacial system , we have created the “Map of determining the level of aesthetics” , which includes an analysis of the shape and colour of the teeth , the condition of the gums , the presence of restorations , the state of occlusal relationships and oral hygiene. 230 people aged 18-45 were examined, intraoral scanning and model scanning were used. General clinical examination methods were carried out, radiological methods were used. In order to evaluate metal-free restorations, clinical evaluation methods according to USPHS criteria (Ryge) were applied.&#x0D; Research results. During the examination of patients, we found that 72.0% of the subjects were not satisfied with their aesthetic appearance. The reasons for this are the discrepancy between the color and shape of predominantly direct restorations, changes in tooth position, and different levels of gingival attachment. We found that in a significant part of patients, fixed metal-ceramic or metal-acrylic fixed structures and direct composite restorations for a period of 3 years or more prevailed, which led to the development of an inflammatory process in the marginal periodontal tissues and gingival bleeding. Significant causes of aesthetic dissatisfaction in the examined patients were changes in the color and shape of teeth or restorations in 67.2% of the examined patients, changes in the position of teeth in 35.6%, and unequal level of gingival attachment of the anterior teeth in 18.4%. In addition, the reasons for the aesthetic dissatisfaction of patients were the inappropriate shape of the cutting edge, the condition of the gums and oral hygiene, direct and indirect restorations. Based on the data obtained, we proposed the Aesthetics Index, which takes into account a set of factors: tooth color, tooth shape, tooth position, level of gingival attachment, shape of the cutting edge, gum condition, condition of direct restorations, condition of indirect restorations, state of oral hygiene, frequency of visits to the dentist. When examining patients according to 10 criteria, a high level (41-50 points) of aesthetics was found in 16.8%, and an average level (31-40 points) in 56.8%. It should be noted that a low level of aesthetic satisfaction (up to 30 points) was found in 26.4% of patients during subjective and confirmed by objective examination.&#x0D; Conclusions. We have proposed the Aesthetic Index, which takes into account the main aesthetic parameters and the state of the hard tissues of teeth and restorations. This index is accessible and simple, and can be used by dentists in their practice. The obtained results indicate that only 16.8% of patients have aesthetic restorations that fully meet the requirements, and 26.4% have a low level of patient aesthetic satisfaction. The main reasons for this are changes in the color, shape, position of the teeth and the level of gum attachment.

Advanced Dental Rehabilitation in Case of Severe Tooth Wear Caused by Gastroesophageal Reflux Disease and Bruxism During COVID-19 Pandemia: A Case Report

Stomatological manifestations of psychosomatic diseases can be associated, culminating in advanced oral alterations. These psychosomatic changes have also increased during the COVID-19 pandemic. In this perspective, parafunctional habits, such as bruxism and clenching, and gastro-oesophageal reflux disease can develop major dental destruction. Thus, various types of treatment are required in the rehabilitation of these patients. The purpose of this article is to present the case of a patient who developed severe tooth wear due to the association between gastro-oesophageal reflux disease and bruxism, during the COVID-19 pandemic. The patient was treated with a bite raising, direct composite restorations and removable prostheses.

Dental erosion in restorative dentistry

Over time, teeth undergo both physical and chemical changes that result in the wearing down and thinning of dental hard tissues. These changes include various forms of damage, including abrasion, attrition, abfraction, and erosion. Among these, dental erosion caused by acids has emerged as a significant concern in the field of dentistry. While the incidence of tooth decay has decreased, dental erosion has become more prevalent, largely due to shifts in dietary habits. Detecting erosion at an early stage is crucial because the process is irreversible. The diagnosis involves a thorough examination of the teeth to identify specific erosion characteristics. Both external and internal factors contribute to the occurrence of erosion, and even children are susceptible to it. Implementing preventive measures, such as educating patients, providing dietary advice, and employing fluoride therapy, plays a vital role in managing erosion. Treatment approaches vary depending on the severity of the erosion and may include techniques ranging from sealing and direct composite restorations to more extensive reconstructions involving ceramic restorations. It is important to emphasize that adequate preventive measures and regular follow-up are crucial for achieving long-term success in managing erosion.

Restoration of a Vital Tooth With Extensive Crown Destruction Using Glass Fiber and Polyethylene Fiber-reinforced Composite Resin: A Clinical Case.

Conservative restorative dentistry has been evolving in the last 25 years, focusing mainly on the development of direct restorative materials. Resin-based composites remain an excellent conservative alternative for restoration of teeth with extensive caries lesions. Over time, several strategies have been proposed to improve the mechanical properties of these composites so that they can adequately withstand masticatory forces. Glass fiber-reinforced resin-based composites and their use in situations where there is great loss of tooth structure have gained popularity due to their favorable mechanical properties. Combined techniques with polyethylene fibers can further enhance their clinical performance. This study presents a brief review of their most important qualities and potential use in direct restorative procedures. In addition, a clinical case is described where a vital tooth with extensive coronal destruction was restored using polyethylene fibers embedded in glass fiber-reinforced flowable resin under resin-based composite. The reinforcement of both the remaining tooth structure and the restoration with fibers is a valid treatment option since the network structure formed by the fiber reinforcement can increase the longevity of the direct composite restorations. There are few reports in the literature describing the use of a combined technique using polyethylene fibers embedded in glass fiber-reinforced flowable resin under resin-based composite. Thus, clinical follow-up of this case is required.