Healthy Dental Tissues Research Articles

A clinical approach for no prep direct composite veneers with opaquer/ tint to reshape a smile: a case report

Dental aesthetic has a profound influence on both self-esteem and social interactions. Patients desire changes in their smiles, while dentists aim for the preservation of dental and adjacent structures, as well as durability. In this context, no-prep resin veneers emerge as a potential solution, as they allow for the preservation of the maximum amount of healthy dental structure, pulp integrity, and dental strength. Nevertheless, treating darkened substrates poses a challenge, and conservative options like composite resins have gained recognition as restorative materials due to their aesthetic qualities and ability to preserve healthy dental tissue. A protocol can help dentists, especially by describing the stages of making direct no-prep veneers, achieving better clinical success. This article presents a clinical step-by-step guide approach to fabricating light-cured composite prepless veneers, using opaque and tints to mask dark backgrounds, and preserving the dental substrate in a patient with multiple restorations, changes in color, and shape. Light-cured composite prepless veneers comply with the principles of biomimetics and offer advantages such as conservation of dental structures, versatility, one-session preparation, cost, mechanical properties, and excellent aesthetics, however, skill with this technique is required.

Minimally invasive caries treatment

The development of minimally invasive caries treatment has dramatically changed dentistry. Instead of traditional, often invasive methods that resulted in significant loss of healthy dental tissue, this approach focuses on preserving the vitality of the pulp and minimizing tissue loss by delaying and scaling back restorative treatments. This involves the use of modern methods, with selective caries removal with or without indirect (pulp) capping being the norm for treating extensive lesions. The philosophy of minimal intervention goes beyond treatment choices to include a holistic approach from diagnosis to follow-up care, emphasizing personalized care based on risk profiles. This paradigm shift has greatly improved the standard of care, but continued attention to the risks of overdiagnosis and overtreatment is necessary to ensure optimal oral health.

The fracture resistance of pulpotomized primary molars restored with zirconia crowns, lithium disilicate or resin based ceramic endocrowns.

Endocrown in pediatric dentistry was rooted in the fundamental principles of preserving healthy dental tissues, leveraging contemporary adhesive methodologies. This research aimed on assessing and comparing the fracture resistance of pulpotomized primary molars when rehabilitated with zirconia crowns and two distinct types of endocrowns, namely E-Max and Brilliant Crios. The study involved thirty, anonymized, freshly extracted second primary molars that underwent pulpotomy. These teeth were then evenly divided into three groups, each consisting of ten specimens: the zirconia crown, the E-Max endocrown, and the Brilliant Crios endocrown groups. Post-pulpotomy, the teeth were prepared for their respective restorations. Subsequent to this preparation, the zirconia crowns, E-Max endocrowns, and Brilliant Crios endocrowns were secured. To evaluate the fracture resistance using a computer-controlled testing machine (Instron), a progressively increasing load was applied to each group until fracture occurred. The gathered data were then analyzed for outliers and subjected to normality testing using the Shapiro-Wilk and/or Kolmogorov-Smirnov tests, with a significance threshold set at 0.05. There was no statistically significant difference in fracture resistance of pulpotomized primary molars among lithium disilicate (E-Max) group (mean=1367.59N), Brilliant Crios group (mean=1349.73N) and zirconia group (mean=1240.82N). Endocrowns can be considered a promising restoration for pulpotomized primary molars.

Influence of Cavity Designs on Fracture Resistance: Analysis of the Role of Different Access Techniques to the Endodontic Cavity in the Onset of Fractures: Narrative Review.

In recent years, new endodontic access techniques have been proposed with the aim of preserving as much dental tissue as possible for subsequent prosthetic rehabilitation. It has indeed been demonstrated that the success of this therapy is essential and dependent on the proper execution of endodontic cavity access. The main objective is to provide a comprehensive and up-to-date overview of the new access techniques in endodontics in order to guide clinical practice toward a more precise and qualitative approach. As of today, there is still no universally standardized and recognized taxonomy for the different access cavity designs described in the literature. It has been observed that there are various nomenclatures in the literature. The cavity access designs described mainly in the literature can be categorized into six groups: Traditional Access Cavity (TradAC), Conservative Access Cavity (ConsAC), Ultra-Conservative Access Cavity (UltraAC), Truss Access Cavity (TrussAC), Caries-Guided Access Cavity (CariesAC), and Restoration-Guided Access Cavity (RestoAC). The drafting of this narrative review followed the indications of the SANRA (Scale for the Assessment of Narrative Review Articles). A search for scientific articles was conducted on the PubMed and SCOPUS databases, using the following search query: ((truss) OR (conservative) OR (ninja) OR (traditional)) AND access AND endodontic. The initial search yielded a total of 941 articles. After removing duplicates using EndNote X8 software, the number of articles decreased to 785. By applying the inclusion and exclusion criteria, a total of 64 articles were obtained. Among these, 20 articles were finally selected for the purposes of this review, 11 literature reviews and 9 ex-vivo studies. Studies on fracture resistance have yielded heterogeneous results. For anterior teeth, studies do not find a significant relationship between different endodontic access cavities and fracture resistance. However, in the posterior sector, there is more discrepancy and many positive results for minimally invasive access cavities seem to relate to molars. Therefore, it can be concluded that the evidence supporting the influence of endodontic preparations on dental fracture resistance is still limited. Research on new endodontic access techniques holds significant clinical relevance in contemporary endodontics. The evolution of dental technologies, including cone beam computed tomography (CBCT) and computer-guided cavity preparation, has ushered in the era of minimally invasive endodontics. This shift aims to enhance the precision and quality of endodontic treatments while preserving maximum healthy dental tissue for subsequent prosthetic rehabilitation. The success of endodontic therapy is closely tied to the proper execution of access to the endodontium, influencing all phases of endodontic treatment and playing a role in determining fracture resistance for subsequent rehabilitation phases. The dichotomy between traditional and minimally invasive approaches has spurred clinical investigations. Specifically, within the scientific community, doubts have been raised about the potential limitations of minimally invasive access cavities. Concerns include their impact on canal orifice localization and raise questions about their influence on the overall success of endodontic treatment. This review holds clinical significance as it sheds light on the evolving landscape of endodontic access techniques, analyzing the anatomical trajectory, carefully examines the transition to minimally invasive approaches, and critically assesses existing scientific evidence and concerns surrounding these developments, contributing to an informed decision-making process in clinical practice.

Evaluation of the therapeutic performance of ICON infiltration resin in the treatment of White Spot Lesions in esthetic dental areas. Clinical Report.

Abstract White spot lesions, pathologically characterized by enamel demineralization, present a significant challenge in dentistry. Notably, intervention at the white spot stage is crucial to impede further lesion progression. Recent advances studies have demonstrated the effectiveness of flowable resin infiltration as a minimally invasive alternative to traditional treatment modalities. This technique allows for the concurrent treatment of multiple lesions in a single appointment, circumventing the necessity for local anesthesia or extensive cavity preparation. Clinically, this method has shown consistent stability, evidenced by maintained enamel integrity, enhanced rigidity, and preservation of adjacent healthy dental tissues. Additionally, the aesthetic outcomes of this approach are noteworthy, with a gradual diminution of lesion visibility over time. The present case report elucidates the long-term clinical outcomes and the efficaciousness of the Icon kit in the targeted management of specific white spot lesion pathologies.

Development of a zinc chloride-based chemo-mechanical system for potential minimally invasive dental caries removal system

Background/purposeThe chemo-mechanical caries-removal technique is known to offer advantages of selective dentin caries treatment while leaving healthy dental tissues intact. However, current sodium hypochlorite based reagents usually excessively damage dentin collagen. Therefore, the purpose of this study was to develop a novel chemo-mechanical caries-removal system to preserve the collagen network for subsequent prosthetic restorations. Materials and methodsThe calfskin-derived collagen was chosen as a model system to investigate the dissolution behavior of collagen under different operating conditions of chemical-ultrasonic treatment systems. The molecular weight, triple-helix structure, the morphology, and functional group of collagen after treatment were investigated. ResultsVarious concentrations of sodium hypochlorite or zinc chloride together with ultrasonic machinery were chosen to investigate. The outcomes of circular dichroism (CD) spectra demonstrated stability of the triple-helix structure after treatment of a zinc chloride solution. In addition, two apparent bands at molecular weights (MWs) of 130 and 121 kDa evidenced the stability of collagen network. The positive 222 nm and 195 nm negative CD absorption band indicated the existence of a triple-helix structure for type I collagen. The preservation of the morphology and functional group of the collagen network on the etched dentin surface were investigated by in vitro dentin decalcification model. ConclusionUnlike NaOCl, the 5 wt% zinc chloride solution combined with ultra-sonication showed dissolution rather than denature as well as degradation of the dentin collagen network. Additional in vivo evaluations are needed to verify its usefulness in clinical applications.

Research progress and application prospect of stem cells in inflamed dental tissues on periodontal bone regeneration

Tissue engineering has become a research hotspot regarding periodontal bone regeneration in recent years. Generally, stem cells used in periodontal tissue engineering are derived from healthy dental tissues, while restricted due to the strict indication of tooth extraction and limited sources. Stem cells in inflamed dental tissues mainly derive from inflamed pulp, periapical and periodontal tissues. Stem cells in inflamed dental tissues are abundant and retain most of the basic characteristics of stem cell compared with the ones derived from healthy dental tissues, which can be a promising source of stem cells for periodontal bone regeneration. In this review, we summarize the current application and prospect of stem cells in inflamed dental tissues on periodontal bone regeneration, and then discuss their feasibility as seed cells, in order to provide a reference for future research and clinical application of stem cells in inflamed dental tissues.

Amelogenin and alkaline phosphatase expression in ameloblast after saltwater fish consumption in pregnant mice (Mus musculus)

Background: The intricate process of tooth formation during embryonic development ensures sufficient nutrition for the growth of healthy dental tissues. Amelogenin and alkaline phosphatase (ALP) are serine proteinases secreted by the ameloblast during the transition and maturation phases of the amelogenesis process. Consumption of saltwater fish is predicted to increase the expression of amelogenin and ALP in ameloblast cells during tooth formation. Only now have the function of each gene, tooth-forming cells, and the proteins they produce in the biomolecular amelogenesis of tooth enamel, which began during prenatal development, been clarified. Purpose: This study aims to determine how saltwater fish powder affects the ability of mother mice to increase the expression of amelogenin and ALP in cell ameloblast. Methods: Using a completely randomized design, this study was experimental and aimed to examine the effects of sardine (Sardinella fimbriata), splendid ponyfish (Leiognathus splendens), and tuna (Euthynnus affinis) powder. As samples, twenty-four female mice (Mus musculus) were used. Two groups of mice were created: group 1 (2.14 mg/0.5 ml) and the control group. The expression of amelogenin and ALP was determined using immunohistochemistry (IHC) and t-test (p0.05). Results: Expression of ameloblast was significantly different between the treatment and control groups (p0.05). Conclusion: The consumption of saltwater fish reduces the amelogenin and ALP expressions of mouse fetal ameloblast cells during tooth development in vivo.

Behaviour of flexible/elastic materials under quasi-static force

Elasticity and stress absorption are present in many different materials in our daily life. Understanding how materials behave under pressure (whether that is constant or dynamic), and how and when they deform can be fundamental in terms of their success or longevity. Elastic behaviour is present in many different forms in different materials, e.g.: meats or other food. Interestingly, elasticity is also a major issue in the oral cavity, when talking about healthy dental tissues, such as dentin or even special dental restorative materials. The article focuses on the general mechanical behaviour of elastic and viscoelastic materials and measurements performed on them.

MILK CONSUMPTION AFFECTS THE EXPRESSION OF AMELOGENIN IN AMELOBLAST CELLS DURING AMELOGNESIS (IN VIVO ANALYSIS OF PREGNANT MICE)

Background: Tooth development during embryonic period is complex process that needs enough nutrition for the formation of healthy dental tissue. Amelogenin are proteins that are secreted by ameloblast in the secretory stage that are importants in the crystal formation and the regulation of email thickness. Milk consumption during pregnancy can increase the expression of amelogenin of ameloblas cell in the tooth development process. This research aims to determine the impact of milk during pregnancy against the expression of amelogenin protein of ameloblast cell in the amelogenesis.Method: This is a true experimental laboratories research using post test only control group design. A total of 12 pregnant female mice (Mus Musculus L.) are used and divided into 2 groups, control group (given sterile aquades) and treatment group (given pregnancy milk). The measurements of amelogenin expression are done in 18th day of pregnancy period. Data were analyzed using Independent sampel of T-test analysis.Result: The result of this study showed that the average amounts of amelogenin expression in the treatment group are lower than the control group. Independent sampel t-test showed that there are significant difference in the amount of amelogenin expression between the control and treatment group (P>0,05)Conclusion: The milk consumption during pregnancy influenced the amelogenin expression of ameloblast cell in the mice fetus’s amelogenesis.

Minimally Invasive Dentistry: Step by Step of an Anterior Adhesive Bridge

Fixed Partial Dentures (PPF/FPD) bonded with resin cement are viable alternatives based on the fundamentals of Minimally Invasive Dentistry (MIO). The conservative concept of preserving healthy dental tissue allows planning a minimally invasive restorative approach. Nowadays, remain uncertain how to replace teeth in patients with edentulous spaces that are not suitable for implant placement or with limited economic factors. The current ceramic systems provide greater bond strength to the substrate while offering an optimal aesthetic result. Clinical and laboratory investigations demonstrate the adequate long-term clinical performance of fixed partial dentures bonded with resin cement. The present clinical case will be approached in an even more conservative way, without the unnecessary removal of healthy dental tissue, replacing a tooth with a unitary fixed partial prosthesis in a patient not suitable for the placement of endosseous implants.

FACTORS OF CARIES DEVELOPMENT AND WAYS TO REDUCE THEI IMPACT IN SCHOOL CHILDREN

Topic relevance. Dental diseases in children, particularly dental caries, are still requiring approaches and methods of their effective prevention and treatment. Analysis of caries rates in 7 – 9 year children has revealed a probable increase in the prevalence and intensity of caries in permanent teeth over the past 20 years.
 The aim of the study. Epidemiological studies indicate that the intensity of dental caries among children and adolescents in Ukraine varies from 2 to 5.8 depending on the region of residence. We conducted dental clinical-laboratory examination and performed a questionnaire survey of 223 schoolchildren and their parents in order to determine the main factors of caries occurrence and possibility to influence them.
 Materials and methods. The statistical significance of the differences between the results obtained for different data groups with normal distribution was determined using Student's t-test. The correlation coefficient was considered significant when the error probability was p<0.05.
 Results and discussion. The results of the study revealed the greatest increase in the prevalence and intensity of caries in permanent teeth in 7-8 year old children (by 17.3% and 2.4 times respectively) and in 910 year old children (by 21.5% and 2.5 times, respectively). The course of caries in children aged from 7 to 12 occurs against the background of the decrease of pH value and microcrystallization of the oral liquid and is caused by the lowering teeth resistance to caries that is supported by the results of the enamel acid resistance test. In order to reduce the prevalence and intensity of dental caries in children, there is an urgent need to elaborate a proper approach to preventive measures aimed at enhancing the resistance of hard dental tissues. The developed scheme of preventive activities with children is based on regular dental checkups, fostering skills of proper tooth brushing and oral care, providing basic information about caries development and health consequences when it left untreated, options of caries treatment and the basics of good nutrition.
 Conclusion. Taking control of caries factors will contribute to the strengthening healthy dental tissues and creating favourable conditions for healthy functioning of teeth that will result in the strengthening of oral and general health in children. The application of the elaborated schemes of prognostic assessment of cariesogenic situation and caries prevention measures for children and their parents will reduce the dental caries rates.

THE EVALUATION OF CURRENT RESEARCH ON THE STRENGTH OF DENTAL RESTORATIVE COMPOSITE MATERIALS

The aim of the study: to analyze the sources of scientific and metric information on the state of research on the strength of dental composites for tooth restoration.
 It has been determined that the range of composite materials available on the dental market is very wide. They differ significantly in chemical, mechanical, physical, and biological characteristics, operating properties, techniques of their usage. All this requires special training to use the composites effectively and to get high quality restoration results. The optimal choice of material and suitable technique taking into account a particular clinical situation can increase the durability of restorations and prevent the development of complications that largely depends on the strength characteristics of composites.
 At present, the problem of selecting and creating the perfect filling material has not been completely solved that is confirmed by the large number of new developments in materials science. At the same time, composite polymers are gaining ground in dental practice. The new concept of adhesive preparation of dental tissues before inserting filling material and improving the properties of the composite materials themselves contribute to the maximum preservation of healthy dental tissues, increase the aesthetics, durability and functionality of dental restorations.
 It has been determined that the mechanical strength characteristics of composite materials play a significant role in the longevity/durability of restorations depending on different chewing force and occlusal loading. It is important to investigate factors, which may cause the destruction of dental composites during the functional loading.
 The physical and mechanical properties of dental composites are impacted by a number of factors, including the type of polymer matrix, the amount of material takes, size and distribution of the filler, the state of the bond between the filler and the matrix, the degree of polymerization. The choice of a material also depends on a number of characteristics in terms of the combination of main components. Since the material parameters set by the material manufacturers can not be changes, the deep understanding of its properties will help to choose the best material in each clinical situation.
 The main physical properties of dental composites include compressive and tensile strength, modulus of elasticity, coefficient of thermal expansion, wear resistance, polymerization shrinkage, X-ray contrast, density and thixotropy, optical effects (transparency, fluorescence, etc.).
 The AE method based on the registration of elastic waves arising from the formation, change and destruction of the structure of various materials, is currently the most effective for studying the processes and stages of development of material defects. It enables in detecting initial changes in the material structure, the initial location of defects, the direction of their spreading and determining the maximum strength of the material. The advantages of this method include the ability to obtain information about the destruction in the early stages, its high accuracy and sensitivitys.
 The AE method is commonly used to study the resistance to destruction of various composite materials, the study of the tooth / composite interface, the analysis of polymerization stresses and the degree of shrinkage.

Examination of caries‐affected dentin and composite‐resin interface after different caries removal methods: A scanning electron microscope study

To evaluate the caries-affected dentin and composite-resin interface with scanning electron microscopy (SEM) after different caries removal methods in human molars. Twelve with extensive approximal caries lesions that did not reach the pulp and five caries-free molars (control group [CG]) were used. Carious teeth were divided into four experimental groups: Atraumatic Restorative Treatment (ART), Rotary Instrument (RI), Photo-Ablation, and Papain-Based Enzymatic Gel (Brix 3000®, Brix, Brazil). Class II slot cavities were prepared with RI in the CG. Then all caries removed teeth and control groups were restored (All-Bond Universal, BISCO, USA; Clearfil MajestyES-2, Kuraray, Japan). Specimens were prepared for SEM examinations. Hybrid layer (HL) thicknesses were measured using ImageJ programme. Gap measurements were performed with micro-CT. Data were analyzed with ANOVA and posthoc Dunnett's t-tests (p <.05). The highest HL thickness was found in Photo-Ablation Group, and a statistically significant difference was observed among the control and experimental groups (p < .05). The lowest HL thickness was measured in the Enzymatic Gel Group. In terms of internal gap formation, CG showed statistically significant differences compared to the other groups (p < .05). The highest internal gap was observed in RI Group, while the lowest gap was observed in CG. According to SEM, a uniform HL and resin tags were seen in the CG. Smear layer, irregular HL, and gap formation were observed in ART Group. In RI Group, nonuniform HL formation and resin tags were observed. In Photo-Ablation Group, a uniform HL without smear layer and internal gap was observed. In the Enzymatic Gel Group, both opened dentinal tubules, and melting-like formations were observed on the dentin surface. Especially melting-like formations were observed in peritubular dentin. It can be concluded that all caries removal methods except rotary instrumentation were conservative methods, which preserve more healthy dental tissues. RESEARCH HIGHLIGHTS: Among the caries removal procedures, the photo-ablation caries removal method stands out with the highest hybrid layer (HL) thickness and the lowest internal gap formation. Despite having the lowest HL thickness, the enzymatic gel method can be advantageous for patients requesting an alternative caries removal instead of a rotary instrument.

THE EFFECT OF PREGNANCY MILK ON THE EXPRESSION OF KALLIKREIN RELATED PEPTIDASE-4 (KLK-4) AND COLLAGEN TYPE 1 (Coll-1) IN AMELOGENESIS

Background: Tooth development during embryonic period is a complex process and requires adequate nutrients for the formation of healthy dental tissues. Kallikrein-related peptidase-4 (KLK-4) and collagen type 1 (Coll-1) are serine proteinases secreted by ameloblast during the transition and maturation stages of the amelogenesis processes, functioning to degrade the protein matrixes, so that the enamel can reach its final hardness. Pregnancy milk contains various nutrients expected to increase the KLK-4 expression of ameloblast cells in tooth development processes Purpose: This study aimed at determining the influence of pregnancy milk on the KLK-4 and collagen type 1 (Coll-1) expression of ameloblast cells in the tooth development processes.study Method The research subjects comprised of 10 pregnant female mice (Mus Musculus L.) that were divided into: control group (given sterile aquadest) and treatment group (given pregnancy milk + sterile aquadest) for 18 days followed by the collection of the tooth germ. The specimens were then stained using Imunnohistochemistry to see the KLK-4 and Coll-1 expressions. The data were analyzed using a pathway analysis. Result: The average KLK-4 and Coll-1 expression in the treatment group were higher than those in the control group. Based the pathway analysis, there were direct correlation of Pregnancy milk with Coll-1 expression and that with KLK-4 and Coll-1 expression as well as indirect correlation of pregnancy milk with KLK-4 expression. Conclusion: Pregnancy milk influences the Kallikrein-related peptidase-4 (KLK-4) and Coll-1 expression of ameloblast cells in the tooth development of the mice’s fetusesKeywords: Coll-1 pregnancy milk, Kallikrein-related peptidase-4 (KLK-4), Tooth development

PENGARUH SUSU IBU HAMIL TERHADAP EKSPRESI KALLIKREIN-RELATED PEPTIDASE-4 (KLK-4) PADA SEL AMELOBLAS DALAM TUMBUH KEMBANG GIGI

Background: Tooth development during the embryonic period is a complex process that needs enough nutrition for the formation of healthy dental tissue. Kallikrein-related peptidase-4 (KLK-4) is a serine proteinase secreted by ameloblast during transition and maturation stages in the amelogenesis process which functions to degrade protein matrices so enamel could reach the final hardness. Pregnancy milk contains various nutrients that can increase KLK-4 expression of ameloblast cells in the tooth development. This study aims to determine the impact of pregnancy milk against the KLK-4 expression of ameloblast cell in the tooth development process. Method: 12 pregnant female mice (Mus Musculus L.) divided into control group (given sterile aquadest) and treatment group (given pregnancy milk + sterile aquadest) for 18 days then the tooth germ was taken. Samples were stained to see the KLK-4 expression. Data were analyzed using an Independent sample t-test. Result: Our study showed that the average amounts of KLK-4 expression in the treatment group are higher than the control group. Based on the Independent sample t-test statistic methods, there is a significant difference with the value of p=0,017. Conclusion: The pregnancy milk could influence the Kallikrein-related peptidase-4 (KLK-4) expression of ameloblast cell in the mice fetus’s tooth development.

Functional Rehabilitation with an Onlay Ceramic Adhesive Restoration: Case Report

The objective of this article was to analyze the indications for the proper selection of Onlay adhesive ceramic restorations, providing a step-by-step clinical protocol. Biomechanical principles based on morphological considerations and geometric terms must be present for the careful preparation of Onlay-type cavities. Concepts about cavitary preparations are discussed under essential conditions in the preservation of healthy dental tissue, without compromising the functional and aesthetic results over time. The author's suggestion is to respect and follow in a timely manner each of the steps applied in this restorative clinical protocol, to improve the final outcome of the restoration.

REPARAÇÃO EM RESINA COMPOSTA: REVISÃO SISTEMÁTICA

Introdução: A substituição total de restaurações de resina composta é uma das técnicas mais utilizadas por cirurgiões dentistas quando estas restaurações apresentam alguma falha. Essa técnica amplia o preparo cavitário, removendo tecido dentário sadio, podendo gerar danos pulpares. A reparação de resina composta substitui parcialmente a restauração preservando estrutura dental e o substrato remanescente de resina composta. Objetivo: Realizar uma revisão sistemática por meio de estudos que descrevessem a eficácia clínica e laboratorial da reparação em restaurações de resina composta defeituosas. Método: Como base para a pesquisa, foram acessados os bancos de dados PubMed, Scopus, BVS e SciELO, os descritores selecionados através do DesC e MeSH foram, Resinas compostas, Desgaste de restauração dentária, Falha de restauração dentária, Reparação de restauração dentária. Resultados: Foram incluídos todos os artigos que abordassem sobre a técnica de reparação. Conclusão: Existem poucas evidências cientificas que mostrem o sucesso e vantagens desse método sobre a substituição total, porém os estudos analisados já apresentam bons resultados.

Reattachment of an Incompletely Fractured Anterior Tooth by a Conservative Approach

The major objectives of restoration dentistry are to restore teeth in a way that allies conservation of healthy dental tissue, esthetics, function, and durability. The ideal would be to attain restorations that are as strong as the natural teeth, which seems unnoticeable even to dentists and more demanding patients.3 Thus, in many clinical situations, the best option for fractured anterior teeth is reattachment of the tooth fragment because of the following reasons: • It reinstates the natural shape, contour, surface texture, and occlusal alignment. • Original color and brightness of the tooth are maintained. • Incisal edge of the tooth fragment wears at a similar rate to the adjacent teeth, whereas a composite restoration will likely wear more rapidly. • Less chair-side time is required so the reattachment is much more economical. Attachment of a tooth fragment can be achieved with good esthetic and functional results, even in more complex situations where pulp and/or the biologic width are involved.4-10 With the evolution of adhesive systems, offering excellent bonding to dentin,11,12 reattachment of dental fragment has been a noninvasive treatment offering good results,4,5,7,13-17 even when performed under challenging conditions.9 Bevels, chamfers, grooves, and undercuts apparently make no difference in the prognosis.9,18

Evaluation of the Efficacy of Caries Removal Using Polymer Bur, Stainless Steel Bur, Carisolv, Papacarie - An Invitro Comparative Study.

Dental caries continues to affect a significant portion of the world population and treatment of the decay is associated with pain by many patients. Intervention and application of rotary instruments for treatment of carious lesions has often resulted in considerable removal of tooth structure. Chemo-mechanical method, a minimal invasive technique for caries removal was developed to overcome these shortcomings. This innovative method seems to be efficient in removing infected dentine without altering the healthy dental tissue or harming the adjacent oral mucosa. To evaluate the efficacy and efficiency of Caries removal Using Polymer Bur, Stainless Steel Bur, Carisolv and Papacarie. A total of 120 sectioned specimens were obtained from 60 extracted teeth. Each tooth was sectioned mesiodistally in the center of the carious lesion so that two halves (buccal and lingual or palatal) having equal sized carious lesions are compared. The sectioned specimens were subdivided into four groups (Polymer Bur, Stainless Steel Bur, Carisolv, Papacarie) allotting 30 specimens to each for caries excavation. One-way ANOVA, Chi-square test analysis was done for comparison between groups which showed significant results with Stainless Steel Bur excavation taking less mean time when compared to other agents and Polymer Bur showed more amount of bacterial remnants after excavation whereas Carisolv and Papacarie were efficient with less dentinal tubule destruction and bacterial remnants after excavation. Further inter comparison between groups was done using Paired t-test and Fischer's Exact-test. The Mean time taken by Stainless Steel Bur excavation was found to be less and caused more amount of dentinal tubule destruction when compared to Polymer Bur, Carisolv and Papacarie. Chemo-mechanical methods found to be more efficient with lesser amount of bacterial remnants and dentinal tubule destruction after caries excavation when compared to conventional methods.