Federation Research Articles

An Overview of Dentist–Patient Communication in Quality Dental Care

Dentist–patient communication is at the core of providing quality dental care. This study aims to review the importance, challenges, strategies, and training of dentist–patient communication. The World Dental Federation (FDI) emphasizes the importance of effective communication between oral healthcare providers and patients as a critical component of high-quality care. Effective dentist–patient communication allows dentists to accurately and effectively pass on essential medical information to patients. It improves the dentist’s efficiency, boosts self-confidence, reduces occupational stress, and minimizes the risks of complaint or litigation. Moreover, it alleviates dental anxiety and fear, helps build trust between dentists and patients, addresses patients’ needs and preferences, increases patients’ adherence to improved treatment outcomes, and ultimately leads to enhanced patient satisfaction. Nonetheless, it has been widely acknowledged that dentists universally encounter the repercussions arising from suboptimal communication strategies. Time constraints, difficulties in establishing rapport, the oral-health illiteracy of the patients, the poor communication skills of the dentists, dentists’ perceptions, and language barriers often hinder dentist–patient communication. Dentists should take the patient-centered approach as a premise and acquire verbal and non-verbal communication skills to overcome these communication barriers. The patient-centered approach comprises the understanding of patients’ illness, shared decision-making, and intervention with mindfulness of the patient’s own pace. Simple, succinct, and jargon-free language should be used in verbal communication. Proper body postures and gestures are fundamental for showing positive attitudes towards patients. Communication training for dental students should involve a structured pedagogical approach that includes didactic instruction, role-playing exercises, patient interviewing, and ongoing assessments. Key components of effective communication skills training in dental education include motivational interviewing, open-ended questioning, affirmations, reflective listening, and summaries to enhance patient engagement and adherence to treatment plans.

Evaluation of Fracture Resistance of Different Bulk-Fill Restorations in Class II Cavities and Their Clinical Performance: Functional Properties Cavities and Their Clinical Performance: Functional Properties

Purpose: The objective of this investigation was to estimate the various bulk-fill restorations clinical performance and fracture resistance in class II cavities. Materials and Methods: The 30 freshly extracted human premolars fracture resistance was evaluated in the invitro portion of this study. The bulk-fill restorative materials were applied to the mesio-occluso-distal (MOD) cavities that were prepared. Teeth were divided into three groups of 30 teeth (10 for each test) corresponding to the treatment materials utilized (A). Group (A1): Self-adhesive composite (Surefil one); Group (A2): Thermoplasticized (Viscalor); Group (A3): EquiaForteTM HTfil. Specimens were examined for fracture resistance using universal testing machine. For the clinical study total 30 carious molar teeth in class II cavities were assigned into three main groups (10 for each group test) according to the treatment material using some selected World Dental Federation (FDI) criteria at different time intervals of baseline,6 months and 12months. Results: The results showed that fracture resistance and functional properties (fracture and retention) of the Thermoplasticized (viscalor) showed statistically significant highest mean value followed by Self-adhesive composite (surefil one), while the lowest mean value was recorded for EquiaforteTM HT Fil. Conclusion: Among the three groups Thermoplasticized (viscalor) appeared to be promising as a bulk-fill restorative material.

Three-unit posterior monolithic fixed dental prostheses made from high-translucent shade-graded zirconia: 3-Year results from a prospective clinical pilot study

ObjectivesTo assess the clinical performance of tooth-supported 3-unit fixed dental prostheses (FDPs) made from shade-graded monolithic 5Y-PSZ (partly stabilized zirconia) zirconia in terms of survival rate and the quality of restorations based on modified FDI criteria over three-years.Materials and methodsHigh-translucent shade-graded monolithic zirconia (Lava Esthetic, Solventum Dental Solutions) was used to manufacture maxillary or mandibular three-unit FDPs in the posterior region (N = 22) employing subtractive milling system (Amann Girrbach). All FDPs were bonded with a universal resin cement (Rely X Universal, Solventum Dental Solutions) and evaluated 4 weeks after cementation (baseline) and after 1, 2, and 3 years. The primary objective was to assess the survival and complication rates of the restorations. Furthermore, the quality of the restorations was evaluated based on selected and modified FDI (World Dental Federation) criteria, which encompass functional, aesthetic, and biological parameters. FDI criteria were analyzed using the Fisher-Freeman-Halton exact test.ResultsTwenty-one patients were examined at 1 year, 2 years, and 3 years. The survival rate was 100%. No mechanical complications were observed. A total of 3 biological complications occurred. These were successfully managed without any residual functional impairment. All FDI criteria were found to be clinically acceptable or better.ConclusionsMonolithic shade-graded zirconia FDPs demonstrated 100% survival at 3 years with a low complication rate.Clinical relevanceFixed 3-unit FDPs made of high-translucent monolithic zirconia might be a viable treatment option in the posterior region, preventing the chipping phenomenon and providing favorable aesthetics while allowing for an efficient digital workflow.

Clinical performance of an ormocer-based single-shade resin composite for the restoration of non-carious cervical lesions: 18-month randomized clinical trial.

This double-blind, split-mouth, randomized equivalence clinical trial aimed to evaluate the 18-month clinical performance of an ormocer-based single-shade resin composite compared with an ormocer-based multi-shade resin composite in non-carious cervical lesions (NCCLs). One hundred and twenty restorations were performed on NCCLs with two restorative materials (n = 60): Admira Fusion X-tra resin composite (ormocer-based single-shade), and Admira Fusion resin composite (ormocer-based multi-shade). After rubber dam isolation, a universal adhesive was applied in the selective enamel etching strategy. For both groups, restorations were inserted incrementally and light-cured. The restorations were clinically evaluated at 6, 12, and 18 months according to the updated FDI (World Dental Federation) criteria. Statistical analysis was performed using Friedman repeated measures ANOVA by rank and Mann-Whitney test for pairwise significance (α = 0.05). All restorations were evaluated after 18 months, and nine restorations were lost. Fracture of the material and retention rates (95 % confidence interval [CI]) were 93 % (84-97 CI) for the ormocer-based single-shade and 91 % (82-96 CI) for the ormocer-based multi-shade, with no statistical differences between them (p > 0.05). The absolute risk (95 % CI) was 0.8 (0.2 to 3.1). The updated FDI evaluation criteria showed equivalent results for ormocer-based single-shade and ormocer-based multi-shade after 18 months. Using an ormocer-based single-shade resin composite in NCCLs is advisable due to its convenience, ease of application, and lower cost compared to ormocer-based multi-shade composites without compromising clinical performance.

UKRAINIAN NATIONAL FACTOR IN GEORGE F. KENNAN’S STRATEGIC THINKING ON THE USSR

This article highlights G. Kennan’s strategic views on Ukraine, and his recommendations regarding the Ukrainian national factor in the U.S. strategy. These issues were studied against the background of Kennan's strategic thinking on the USSR, and development of “containment” strategy, mostly in 1946–1952. The conclusions emphasize that the ultimate goals of “containment” in Kennan’s interpretation were to make the USSR abandon expansionist foreign policy, and to change its concept of international relations by means short of war. He believed that the threat from the USSR existed as long as the totalitarian regime was in power, and advocated for gradual and peaceful changes in the USSR towards liberalization and modernization. He rejected the idea of its disintegration, and recognized the right to secede only for the Baltic republics. He did not recommend any policies, and did not support any activities to promote independence of Ukraine. But he did not object to the revival of national life of some peoples, including Ukrainians, and development views among them that would help change Soviet conduct. Kennan viewed the USSR as “Russia”, and believed that the U.S. should build its policy on cooperation with Russians. His personal sentiments, that is love for Russian people and Russian culture, also influenced his policy recommendations. For him, Ukrainians and Russians were too close ethnically, and their economic activities were tightly intertwined. Therefore, Ukraine's secession could cause a negative reaction and consequences for Russians. He predicted that sooner or later Russia would challenge an independent Ukraine, and Ukrainians would be forced to turn to the United States for military support. For these reasons, he viewed the future of Ukrainians in a federal union with Russians in the “new Russia”. Some Kennan's conclusions remain relevant today, and his strategic thinking on Russia and Ukraine continues to influence a significant number of U.S. political scientists and politicians.

Marginal Degradation of Universal Adhesive Restorations in NCCLs: A Systematic Review and Meta-analysis

Purpose This systematic review aimed to answer the PICO question: do adhesive protocols used for non-carious cervical lesions (NCCLs) using a universal adhesive system influence marginal degradation, marginal staining, and retention of these restorations? The self-etching adhesive strategy and selective enamel etching were compared with the etch-and-rinse strategy as a control. Materials and Methods The study searched various databases, including PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Scopus, Embase, and grey literature, to find randomized clinical trials (RCTs) comparing self-etching (SE) or selective enamel etching (SEE) to the etch and rinse (ER) strategy. The risk of methodological bias was assessed using the Cochrane RoB 2 tool. Data were dichotomized and analyzed using RevMan v 5.3, adopting the Mantel-Haenszel method. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results Twenty RCTs were included in the meta-analysis. Results showed that using universal adhesives with the SE strategy resulted in clinical signs of marginal degradation at 12 months, 24 months, and 36 months of follow-up, and marginal staining at 24 months. The adhesive strategy did not interfere with the retention of restorative material used for NCCLs over 36 months, as assessed based on both the United States Public Health Service (USPHS) and World Dental Federation (FDI) criteria. Conclusion With moderate certainty of evidence, after 24 months of follow-up, the SE strategy results in the detection of clinical signs of marginal degradation and staining. The adhesive strategy adopted did not influence the retention rate of the restorations over 36 months of follow-up.

Changes are good for OTPs and patients

Not for the first time, the changes opioid treatment programs (OTPs) must make to comply with new regulations have been praised by OTPs themselves. Mark Parrino, president of the American Association for the Treatment of Opioid Dependence told ADAW last week that most of the states' OTPs are already in compliance. Patti Juliana, Ph.D., who heads the federal Division of Pharmacologic Therapies at the Substance Abuse and Mental Health Services Administration, told him that 44 states are in alignment and compliance with the new rules. She meets with the State Opioid Treatment Authorities regularly. We caught up with Parrino at the COMPA Symposium in Schenectady, New York this month.

Three-year clinical performance of direct restorations using low-shrinkage Giomer vs. nano-hybrid resin composite

ObjectivesThe objective of this investigation was to compare the clinical performance of a nano-hybrid resin composite and a low-shrinkage Giomer resin composite.Material and methodsIn total, 35 pairs of restorations were performed using either low-shrinkage Giomer (Beautifil II LS, Shofu Inc.) or nano-hybrid (Clearfil Majesty Posterior) resin composite in 35 patients by two operators using the relevant adhesives, i.e., FL-Bond II (Shofu Inc.) and Clearfil SE Bond (Kuraray), with the self-etching technique according to each manufacturer's instructions. Two clinicians assessed the restorations 2 weeks (baseline); 6 months; and 1, 2, and 3 years after the restorative procedures using FDI (World Dental Federation) criteria (Scores 1–5). Data were analyzed using the marginal homogeneity and McNemar tests. The survival rate was calculated using Kaplan–Meier survival analysis and the survival of the two groups was compared with the log-rank test (p = 0.05).ResultsThe mean observation period was 37.7 ± 6.8 months. All restorations completed their 3-year follow-up. The criteria were mainly rated with high (1 or 2) scores for quality in both groups. Only one restoration in the low-shrinkage Giomer resin composite group was accepted as a failure at the 2-year recall due to retention loss.ConclusionAt the 3-year follow-up, the performance of the restorations using the Giomer and the nano-hybrid resin composite were similar and clinically acceptable.Clinical relevanceThe low-shrinkage Giomer resin composite exhibited a similar clinical performance to the nano-hybrid resin composite after 3 years in service with both materials displaying minor surface deteriorations at the 3-year recall.Clinical Trial Registrationhttps://clinicaltrials.gov, identifier: NCT02823769.

The Charcoal Iron Industry and Pennsylvania Forestry

ABSTRACT Pennsylvania was a pioneer in the forestry conservation movement, as one of the earliest states to develop forestry legislation, a forestry commission, state forestry reservations, and a forestry association. There are well-known early forestry leaders, like Gifford Pinchot, first chief of the US Forest Service, and Joseph T. Rothrock, the father of Pennsylvania forestry. However, much of the early foundation of the forestry movement in the state is not readily recognized. Bernhard Fernow, third chief of the federal Division of Forestry, had Pennsylvania roots. John Birkinbine, a founder and president of the Pennsylvania Forestry Association (for nearly a quarter-century), quietly provided much of the leadership for the early forestry movement. Surprisingly, Pennsylvania’s charcoal iron industry had connections to all four of these forestry leaders. Charcoal production in the state is sometimes associated with forest devastation, but a deeper look shows it is more closely associated with forest conservation.

What Can Postliberals and Evangelicals Learn from Each Other? Merciful Substitution in George Hunsinger's Philippians and Historic Reformed Theology

This article brings George Hunsinger's treatment of substitutionary atonement in his Philippians into dialogue with John Owen and B. B. Warfield as representatives of historic Reformed theology. The aim of the article is to reassert the primacy of expiation over propitiation in evangelical theology by considering Hunsinger's proposal to replace the term “penal substitution” with what he calls a “merciful substitution.” He accepts the notion of propitiation when it is defined as the removal of God's wrath predicated upon the removal of sin (expiation), but rejects the distorted understanding of propitiation according to which God is a God of wrath first and only subsequently a God of mercy. For Hunsinger, expiatory sacrifice is the means provided by God's mercy so as to reconcile us to God. Similarly, for Owen and Warfield, expiation is accomplished by Christ's substitutionary sacrifice in which the believer's sin and guilt are translated to him through mystical and federal union. While it is unlikely that evangelicals would make “merciful substitution” a normative expression of the atonement, Hunsinger's caveats against the excessively forensic and nominalistic connotations of the term “penal substitution” are worth the consideration of evangelicals who share his passion for the dogmatic norma normata that regulates our understandings of the biblical texts.

Comparison of Unitary Vs. Federal Political Systems (with an Emphasis on the Appropriateness of Federal Political System and Its Potential Advantages for Afghanistan)

Comparison of Unitary Vs. Federal Political Systems (with an Emphasis on the Appropriateness of Federal Political System and Its Potential Advantages for Afghanistan)

Is use of flowable resin composite an option for occluso-proximal restorations in primary teeth? A fracture strength analysis.

Use of flowable resin composites for ocluso-proximal restorations in primary molars could improve cervical adaptation, and reduce the failure risk. To investigate the fracture strength of occluso-proximal restorations in primary teeth using different flowable resin composites (as an intermediate layer or entire cavity) and a conventional resin composite (incremental technique). Two standardized occluso-proximal cavities were prepared on mesial and distal surfaces of 50 sound primary molars. The teeth were randomly assigned into five groups (n = 10): 2 mm Filtek Bulk Fill Flow + Z350 XT; 4 mm Filtek Bulk Fill Flow; 2 mm Z350 XT Flow + Z350 XT; 4 mm Z350 XT Flow; and Z350 XT inserted by incremental technique. All restored teeth were subjected to cariogenic challenge and then submitted to fracture strength test. The failure pattern of each specimen was categorized as reparable or irreparable/need for replacement based on the World Dental Federation (FDI) criteria. Fracture strength means were submitted to one-way ANOVA and Tukey's post hoc tests. Failure pattern was analyzed descriptively. There was no statistically significant difference on fracture strength among groups (p = .48). A similar distribution of reparable (35%-40%) and irreparable (60%-65%) failures was observed among groups. Based on a laboratorial setting, the use of different flowable resin composites (as an intermediate layer or entire cavity) may be an option to restore occluso-proximal cavities in primary molars.

Evaluating the Success of Preformed Resin Bonded Composite Strip Crowns for the Primary Central Incisor in Restoring Carious Primary Canine Teeth: A Retrospective Analysis.

Background Restoration of primary canine teeth in pediatric dentistry requires a balance of functional, biological, and esthetic factors. Stainless steel crowns, while effective for posterior restorations, often have patient acceptance issues due to esthetic limitations. Resin-bonded composite strip crowns have gained traction for anterior restorations due to their superior esthetic qualities and repairability. However, their long-term performance in primary canines characterized by unique morphological and functional demands has not been thoroughly evaluated. This study investigates the efficacy of resin-bonded incisor strip crowns in primary canines over three years, assessing their functional durability, biological integrity, and esthetic performance to provide a comprehensive evaluation of their long-term success in this application. Methods This retrospective observational study, conducted from September 2023 to December 2023 at the Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India, received ethical approval from the Institutional Human Ethical Committee (IHEC/SDC/PEDO-2103/23/131). Dental records from January 2020 to December 2020 were reviewed by two investigators to identify children aged six years or younger who had undergone pulpectomy in primary canine teeth and were restored with resin-bonded incisor strip crowns. Exclusions included records with missing contact details or post-treatment radiographs. The purpose was to ensure a three-year review period when contacting patients in 2023. Eligible parents were contacted by phone, informed about the study, and invited for a review. Informed consent was obtained in person. Children with exfoliated primary canines and those whose parents did not sign the consent form were excluded. The restored crowns were evaluated using World Dental Federation (FDI) criteria across functional, biological, and esthetic domains by two calibrated examiners. Statistical analysis was conducted using IBMSPSSStatistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York, United States), with categorical variables expressed as n (%), inter-examiner reliability assessed by Cohen's kappa, and chi-square test used for goodness of fit, setting significance at 95%. Results Of the 92 primary canines restored with resin-bonded incisor strip crowns, 60 children were evaluated. The retention rate at the three-year follow-up was 50 (83.3%). Functional evaluation revealed that 48 (80%) of crowns maintained surface texture, 42 (70%) preserved form and contour, and 52 (86.6%) demonstrated acceptable occlusion and wear. Biologically, 55 (91.7%) of the crowns had no secondary caries, and 56 (93.4%) had no dental hard tissue defects at the margin. Esthetically, 48 (80%) of crowns retained surface texture, 46 (76.6%) had a satisfactory color match, and 45 (71.6%) exhibited minimal marginal staining. Statistical analysis confirmed significant results for all functional and esthetic parameters (p < 0.05). Conclusion The technique of placing incisor strip crowns in the place of primary canines can be recommended considering its maintenance of functional, biological, and esthetic properties.

Color Stability of Single-Shade Resin Composites in Direct Restorations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The objective was to compare the color match and color stability behavior of single- and multi-shade resin-based composites (RBCs) used for direct restorations. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized clinical trials evaluating the shade performance of single-shade RBCs in direct restorations were included. A search of the scientific literature was performed in five databases (April 2024). The meta-analysis was performed using RevMan 5.4, calculating the risk difference (RD) and 95% confidence interval (CI) of the dichotomous outcome using a random effects model. Bias was assessed using the RoB 2.0 tool, and certainty of evidence was assessed using the GRADEpro tool. Four studies were selected, with 263 restorations analyzed. The results showed comparable performance between single-shade RBCs and multi-shade RBCs in terms of color match and color stability over 12 months. Three studies had a low risk of bias with all expected results, and one study had some concerns. The certainty of evidence for color stability was considered low for all follow-up periods due to the small number of events and sample size. According to the United States Public Health Service Evaluation (USPHS) and the World Dental Federation (FDI), there is comparable clinical color performance between single-shade and multi-shade RBCs over 12 months.

Comparison of Two Clinical Approaches FDI Vs Cars Visual Criteria for Secondary Caries Evaluation in Permanent Posterior Teeth

Background: Secondary caries arise at the contact of a natural tooth and a prosthetic repair. The present investigation employed two clinical methodologies, namely Caries associated with restoration or sealants (CARS) and the International Dental Federation (FDI), to evaluate and manage secondary caries in permanent posterior teeth. Objective: The goal of this research is to compare the diagnostic efficacy of FDI and CARS visual criteria for assessing secondary caries in permanent posterior teeth, to identify the more reliable and effective clinical approach for improved treatment planning and patient outcomes. Method: This was conducted at the School of Dentistry Pakistan institute of medical sciences Islamabad, after approval from the ethical committee. The sample size is 160 patients. In this study, two clinical criteria being assessed included one representing the FDI system which includes the marginal staining, marginal adaptation, and caries’ recurrence, while another one was Caries associated with restoration or sealants (CARS) based on ICCMS (International Caries Classification and Management System) for evaluation and treatment of secondary caries. Results: A total 650 restorations were assessed, with a mean age of 30.83 years (SD±2.68). While comparing, there was a strong correlation to the presence of caries lesions (Rho=0.64), and for Marginal adaptation, it was (Rho= -0.45), which depicts a weak inverse correlation. There was a moderate correlation between the two criteria (Rho=0.64,) The majority of CARS visual criteria decisions recommended no treatment in comparison to FDI criteria Conclusion: It is concluded that the FDI system is a more aggressive approach, suggesting a higher number of restoration replacements than the CARS which is less invasive. As a result, the method used to assess secondary caries may result in more or less invasive suggestions for treatment.

Restorations performance after selective caries removal to soft dentine: 18-month follow-up of a controlled clinical trial

ObjectiveThis randomized controlled clinical trial aimed to evaluate the clinical performance of composite resin restorations placed after selective caries removal to soft dentin (SCRSD) or stepwise excavation (SW) over an 18-month period. MethodsInclusion criteria were patients with permanent molars and/or premolars presenting deep caries lesions (≥50 % of the dentin thickness). Teeth were submitted to SCRSD (n = 76) or SW (n = 76). Evaluations were performed based on FDI (World Dental Federation) criterion. Survival analysis was performed to estimate the survival of restorations and its association with clinical variables and socio-demographic characteristics (adjusted Weibull regression model). The study was registered on Registro Brasileiro de Ensaios Clínicos (ReBEC 65ntbc). ResultsThe follow-up period ranged from 6 to 18 months (mean ± SD 16.3 ± 3.4 months). Patients' ages ranged from 9 to 55 years (mean ± SD 29 ± 10.5 years). A total of 135 teeth (SCRSD = 72; SW = 63) from 101 patients were evaluated. There were 4 failures in the SCRSD group (2 loss of restoration in need of replacement and 2 marginal fractures in need of repair) and 2 in the SW group (fracture in need of repair). The association between explanatory variables and restoration failure showed similar success rates for SW (99.4 %) and SCRSD (97.9 %) (p = 0.16). Patients presenting gingivitis (≥20 % of sites with gingival bleeding) had 8.50 times more risk for failure than those with <20 % of bleeding sites (p = 0.03). ConclusionThis study showed that placing a composite resin restoration over soft dentin (after SCRSD) did not affect its clinical performance after 18 months. Clinical significanceSCRSD is a feasible treatment option for the management of deep caries lesions in permanent teeth as it preserves tooth vitality and tooth structure without compromising restoration longevity.

Diagnostic Strategies for Restorations Management: A 70-Month RCT

We aimed to evaluate the impact of 2 visual diagnostic strategies for assessing secondary caries and managing permanent posterior restorations on long-term survival. We conducted a diagnostic cluster-randomized clinical trial with 2 parallel groups using different diagnostic strategies: (C+AS) based on caries assessment, marginal adaptation, and marginal staining aspects of the FDI (World Dental Federation) criteria and (C) based on caries assessment using the Caries Associated with Restorations or Sealants (CARS) criteria described by the International Caries Detection and Assessment System (ICDAS). The treatment for the restoration was conducted based on the decision made following the allocated diagnostic strategy. The restorations were then clinically reevaluated for up to 71 mo. The primary outcome was restoration failure (including tooth-level failure: pain, endodontic treatment, and extraction). Cox regression analyses with shared frailty were conducted in the intention-to-treat population, and hazard ratios (HRs) and 95% confidence intervals (95% CIs) were derived. We included 727 restorations from 185 participants and reassessed 502 (69.1%) restorations during follow-up. The evaluations occurred between 6 and 71 mo. At baseline, C led to almost 4 times fewer interventions compared with the C+AS strategy. A total of 371 restorations were assessed in the C group, from which 31 (8.4%) were repaired or replaced. In contrast, the C+AS group had 356 restorations assessed, from which 113 (31.7%) were repaired or replaced. During follow-up, 34 (9.2%) failures were detected in the restorations allocated to the C group and 30 (8.4%) allocated to the C+AS group in the intention-to-treat population, with no significant difference between the groups (HR = 0.83; 95% CI = 0.51 to 1.38; P = 0.435, C+AS as reference). In conclusion, a diagnostic strategy focusing on marginal defects results in more initial interventions but does not improve longevity over the caries-focused strategy, suggesting the need for more conservative approaches.

Bulk-Fill Ormocer versus Methacrylate-Based Resin Composite Restorative Systems: The Effect of Flowable Lining on Two-Year Clinical Performance in Class II Cavities

Abstract Objective The aim of this study was to assess and compare the impact of bulk-fill flowable resin composite liners (BFFL) on the 2-year clinical performance of bulk-fill ormocer (BORC) in comparison to methacrylate-based resin composites (BMRC) in Class II cavities. Materials and Methods Thirty participants, each aged between 18 and 30 years, were included in the study, each presenting four class II cavities. A total of 120 restorations were placed, with participants randomly assigned to one of four restorative systems through a blind drawing: Admira Fusion X-Tra (AFX) alone, AFX after lining with Admira Fusion Xtra-Base (AFB), X-Tra Fill (XF) for complete cavity filling, and XF after lining with Xtra-Base (XB). The universal adhesive system (Futura U bond Voco, Germany) was consistently applied for all restoration techniques using selective enamel etching. A single operator, following the manufacturer's instructions for each material, performed all restorations, and finishing/polishing occurred immediately after placement. Clinical evaluation, based on World Dental Federation (FDI) criteria, was conducted by two blinded examiners at baseline (7 days) and at 6, 12, and 24 months postoperatively. Results The chi-squared test was used to compare the four applied restorative systems within each follow-up period, while the marginal homogeneity test was employed to assess changes over time. No statistically significant differences were observed among the four restorative systems at any evaluation period. Conclusions After 2 years, the clinical performance of BFFL or complete bulk-fill technique remained similar, regardless of the material composition.

Application of Modern Technology in Minimal Invasive Dentistry - A Narrative Review

Preserving human anatomy and physiology is the ultimate goal of all health-related endeavours.The conservation of healthy tooth structure is the goal of minimal-intervention dentistry. The concept of "minimum/minimal intervention dental care" first appeared in the early 1980s. From its origins in general medicine, the minimum intervention philosophy in dentistry was created, focusing patient-oriented oral and dental care to prevent and treat oral disorders and maintaining over all oral health. A more conservative approach to tooth preparation and restoration in operative dentistry is called minimally invasive restorative dentistry. This terminology is relatively new. It comprises prompt identification prior to the onset of cavitation, sealing fissures and pits in uninfected areas, fluoride administration, minimum surgical repair of carious lesions, caries risk evaluation, and patient education regarding self-care. A wide range of methods are used, from initial identification of any demineralized tooth structure to evaluation and therapy, including air abrasion, laser cavity preparation, chemo-mechanical caries removal, and hand instrumentation. Adopting the current advanced method requires sufficient knowledge. The trio that comprises tissue histology, dental biomaterials science and professional patient care and management of materials are considered by the "golden triangle" of minimally invasive treatment options for dental caries in order to enable the successful application of minimally invasive dentistry in all patients. The term "minimal intervention dentistry" (MID) was first used in the early 2000s in a policy statement. Maintaining the greatest amount of healthy tooth structure and keeping teeth functional for life are the goals of MID. This approach is endorsed by the World Dental Federation (FDI) as the modern approach to dental caries management

A global survey of national oral health policies and its coverage for young children.

There is no accessible information on countries with oral health policies. The purpose of this study was to identify World Dental Federation (FDI) member countries with oral health policies and their scope and extent of coverage of oral health care for young children. This international survey recruited chief dental officers, oral health advisors to national ministries of health, and other key informants of the 158 FDI member countries between December 2020 and December 2021. The survey tool was administered online to the study participants. Key questions explored the following outcome measures: countries with oral health policies; the thrusts of the oral health policies; policy thrusts targeting young children; and dental care plans as a component of a universal health care plan. Descriptive statistics were conducted to determine the number of countries with any of the study outcome measures and coverage per country. Sixty (38%) of the 158 FDI member-countries responded to the survey. Forty-eight (55.2%) of the 60 countries had a national oral health policy document or position statement on oral health; 54 (62.1%) countries had plans on universal health care, and 42 (48.3%) included dental care within their universal health care plan. The most common policy thrusts addressing the oral health needs of children were the promotion of oral hygiene (71.7%), provision of fluoride products for children (53.3%), collaboration with primary care providers (35%), and prenatal oral health education (50%). There were differences in the scope of oral health care coverage and the coverage for young children between continents as well as between countries. Europe had many countries with children-friendly oral health policy coverage. About half of the surveyed countries had a national oral health policy. There were variations in the scope of oral health care coverage, particularly for young children, both between continents and among individual countries. These findings underscore the importance of understanding the landscape of oral health policies globally. Such insights can help inform targeted interventions to enhance oral health policies, thereby contributing to improved oral health outcomes on a global level.