Postoperative Sensitivity Research Articles

Is dentin biomodification with collagen cross-linking agents effective for improving dentin adhesion? A systematic review and meta-analysis.

ObjectivesThe aim of this investigation was to evaluate the effectiveness of collagen cross-linking agents (CCLAs) used in combination with the adhesive technique in restorative procedures.Materials and MethodsIn this systematic review, the authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. An electronic search was performed using PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and DOSS, up to October 2020. The gray literature was also researched. Only randomized clinical trials were selected.ResultsThe selection process yielded 3 studies from the 838 retrieved. The addition of CCLAs in the retention of restorations increased the number of events. The postoperative sensitivity scores and marginal adaptation scores showed no significant difference between the CCLA and control groups, and the marginal pigmentation scores showed a significant increase in the CCLA group. There were no caries events in any group throughout the evaluation period.ConclusionsThis systematic review showed that there is no clinical efficacy to justify the use of CCLAs in the protocols performed.

Microabrasion plus resin infiltration in masking white spot lesions.

Enamel opacities or white spot lesion is a result of enamel demineralization due to cariogenic activity or fluorosis, or enamel hypo-plastic/hypo-mineralized, which are an esthetic concern. A recent evidence base of dentistry has been focused on the Minimal Invasive Dental (MID) approach for treating such lesions. The aim of the study is to evaluate the esthetic improvement of white spots lesion using microabrasion and resin infiltration in upper permanent incisors, immediately and up to six months follow-up. For the present case with enamel opacities, the minimal invasive therapy resin infiltration was chosen, preceded by microabrasion technique, to improve the teeth aesthetic appearance of the affected teeth. An excellent improvement in 11 and 21 teeth esthetic. However, we still found good outcome in the enamel surfaces after six months follow-up, which became hard to detect, except in the near inspection. The patient was delighted with the well-defined enhancement in his esthetics smile and was mentioned no postoperative sensitivity immediately or in the recall evaluation. The resin infiltration showed significant teeth esthetic improvement immediately and good follow-up outcome for six months, preceded by microabrasion. More high-quality and long-term clinical studies are needed to verify durability and factors that may affect treatment quality.

Success of Veneers with Indirect Resin Composite

Objective: To evaluate the success of veneers fabricated with indirect resin composite (Ceramage). Method: This Descriptive Case Series was completed at de’ Montmorency college of dentistry/Punjab Dental Hospital, Lahore over the period of 6 months from Jul 2018 to Jan 2019. Patients fulfilling the inclusion criteria of the study were selected. After the informed consent, pre-operative radiographs of the teeth to be veneered were taken to rule out any caries activity or periapical pathology. A total of 60 veneers were fabricated with indirect resin composite. Patients were followed up with 6 months interval and restorations were evaluated for complications like dislodgment, chipping, fracture, sensitivity and bleeding from gums. Results: Out of total of 60 veneers 50 were successful and 10 were unsuccessful. only 4 showed slight postoperative sensitivity,4 showed moderate postoperative sensitivity and 2 showed severe postoperative sensitivity.out of total 5 showed minor crack lines,3 showed minor chipping (1/4 of the restoration) and 2 showed moderate chipping (1/2 of restoration). Success rate of veneers fabricated with indirect resin composite (Ceramage) was 83.3%. Conclusions: The indirect veneers have undergone considerable improvement and refinement over the past few decades and have now matured into a predictable restorative concept in terms of longevity, periodontal response and patient satisfaction. The design of the restoration should take the material properties into account in order to enhance the clinical performance. Key words: Indirect Resin Composite, Veneers, Smile makeover

Theracal lc: A boon to dentistry

TheraCal LC, the focus of this article, is a material that creates a new category of resin-modified calcium silicates (RMCS). It is a light-cured, resin-based, and highly radiopaque liner designed to release calcium to promote hard-tissue formation, and is indicated for use under direct restorative materials as a replacement to calcium hydroxide and other calcium silicate-based materials, glass ionomers, eugenol-based sedative materials, and pulp capping restoratives. TheraCal LC exhibits several properties to help maintain ideal hard-tissue health and to reduce the incidence of postoperative sensitivity. This article is aimed to review the composition, method of application, setting reaction, properties and uses of TheraCal LC. TheraCal LC is interesting and promising product, which have the potential of creating major contributions to maintaining pulp vitality.

Comparative evaluation of different adhesive strategies of a universal adhesive in class II bulk-fill restorations: A 48-month randomized controlled trial

ObjectivesTo compare the clinical performance of the universal adhesive used in etch-and-rinse (ER) and self-etch (SE) adhesive strategies for 48-month in class II bulk-fill restorations. MethodsA total of 84 class II bulk-fill resin composite (Tetric EvoCeram Bulk Fill) restorations were placed in 35 participants by one operator using the universal adhesive's (Adhese Universal VivaPen) etch-and-rinse or self-etch mode randomly. The restorations were evaluated by two calibrated examiners at baseline and after 6-, 12-, 24-, 36- and 48-month using modified USPHS criteria. The comparison of the two adhesive strategies for each evaluation criteria was performed with the chi-square test. The baseline scores were compared with those at the recalls using the Friedman and Cochran's Q-test (p < .05). ResultsAt 48-month, 74 restorations were evaluated in 30 participants (recall rate: 85.7%). Marginal discoloration was statistically more frequent in SE approach (p < .05), whereas no significant difference was observed between the two strategies in terms of marginal adaptation (p > .05). There were statistically significant differences between the baseline and 48-month recall in the SE group in terms of marginal adaptation and discoloration (p < .05). In ER group, significant differences were found between baseline and 48-month only for marginal adaptation (p < .05). None of the restorations showed post-operative sensitivity. Secondary caries was observed in one restoration from SE group. ConclusionsThe tested bulk-fill restorative exhibited better clinical performance only in terms of marginal discoloration when the universal adhesive was used with ER strategy. Clinical relevanceThough ER approach of the tested universal adhesive appears to be advantageous in terms of marginal discoloration, both adhesive strategies had similar impact on the clinical success of bulk-fill resin restorations.

Postoperative sensitivity in posterior resin composite restorations with prior application of a glutaraldehyde-based desensitizing solution: A randomized clinical trial

ObjectivesTo evaluate the effect of a glutaraldehyde-based desensitizer on the postoperative sensitivity (POS) in posterior resin composite restorations up to 12 months using a universal adhesive (Tetric N-Bond Universal) with selective enamel etching (SE) or an etch-and-rinse (ER) strategy. MethodsClass I and class II resin composite restorations (n = 220) at least 3 mm deep were inserted in 55 subjects. The universal adhesive was applied using the SE (self-etch strategy on dentin with selective enamel etching) or the ER strategy, with or without prior application of a glutaraldehyde-based desensitizer (Gluma Desensitizer – GL) to form groups SEGL and ERGL. A bulk-fill resin composite (Tetric NCeram Bulk Fill) was used for all restorations. Spontaneous POS was assessed 7 days after the restorative procedure using the Visual Analog Scale (VAS) and the Numeric Rating Scale (NRS). After 7, 14, and 30 days of completing each restoration, the subjects were reassessed to evaluate POS caused by stimulation with an air blast, horizontal and vertical percussion. In addition, marginal discoloration, marginal adaptation, fracture, and recurrence of caries were evaluated using the FDI (World Dental Federation) criteria after 7 days and at 12 months. ResultsNo significant spontaneous or stimuli-induced POS was observed when restorations with or without GL were compared (p>0.05). A higher risk of spontaneous POS was observed within 7 days (40.0%; 95% CI 28.1 to 53.1), without statistically significant differences among groups. None of the participants reported POS at 12 months, however five restorations were considered clinically unsatisfactory (p > 0.05). ConclusionsThe previous application of GL did not significantly reduce spontaneous or stimuli-induced POS in posterior resin composite restorations at any time, regardless of the adhesive strategy used. Clinical significanceThe use of a glutaraldehyde-based desensitizing agent did not generate lower incidence of postoperative sensitivity in resin composite posterior restorations.

Does immediate dentin sealing influence postoperative sensitivity in teeth restored with indirect restorations? A systematic review and meta-analysis.

ObjectiveThis study comprehensively reviewed clinical trials that investigated the effect of immediate dentin sealing (IDS) technique on postoperative sensitivity (POS) and clinical performance of indirect restorations.Materials and methodsThe systematic review was conducted according to the preferred reporting items for systematic reviews and meta‐analyses statement, and was guided by the PICOS strategy. Clinical trials in which adult patients received at least one indirect restoration cemented with IDS approach and one restoration cemented following the delayed dentin sealing (DDS) were considered.ResultsFollowing title screening and full‐text reading, four studies met the inclusion criteria and were included for qualitative synthesis, while two studies were selected for quantitative synthesis. According to Risk of bias‐2 tool, two studies were classified as “some concerns” for the outcome POS. No statistically significant differences were found between teeth restored with indirect restorations using the IDS and DDS approach for POS (p > 0.05), neither at the baseline (very low certainty of evidence according to GRADE) nor after 2 years of follow‐up (low certainty of evidence according to GRADE).ConclusionThere is low‐certainty evidence that IDS does not reduce POS in teeth restored with indirect restorations.Clinical significanceThere is no clinical evidence to favor IDS over DDS when restoring teeth with indirect restorations.

Short-term effect of adhesive system on clinical performance of bulk fill composite

Aim: Although bulk fill composites have been widely used as restorative material, there is no consensus regarding the best clinical protocol in terms of composite technique and adhesive system. Therefore, this clinical trial evaluated the clinical performance of bulk fill composites for class I restorations under different protocols. Methods: A randomized clinical trial including 155 class I restorations was conducted using different adhesive systems: conventional technique (phosphoric acid + conventional three-step adhesive system) (Group 1, 2 and 3); or self-etching adhesive system (Groups 4, 5 and 6). Control groups 1 and 4 were restored with conventional composite; groups 2 and 5 with low viscosity bulk fill and conventional composite as occlusal coverage; groups 3 and 6 with high viscosity bulk fill. The FDI criteria was used for clinical evaluation at baseline and after 6 months. Results: All groups showed good clinical performance. At baseline, the adhesive system did not affect postoperative hypersensitivity. After 6 months, group 5 showed a significant reduction in color and translucency; group 6 a reduction in terms of anatomical form and for postoperative sensitivity and an improvement in patient satisfaction (p&lt;0.05). Considering the same restorative technique, the use of the self-etching adhesive system showed a significant decrease in color and translucency (p&lt;0.05). Conclusion: All groups showed favorable clinical performance, and promising results were found for the conventional adhesive system and high viscosity bulk fill protocol.

Risk of Postoperative Sensitivity and Pulpal Complications in Respect of: Amount of Reduction, Temporization, Cement Type

Fixed partial dentures (FPDs) made of metal ceramic are a popular treatment option for missing teeth. Studies have shown that posterior abutments of FPDs had a higher pulp survival rate than anterior abutments. Postoperative sensitivity following the cementation of a fixed prosthesis is a frequent symptom, especially when the abutments include important pulp. Dentinal hypersensitivity affects between 4 and 74 percent of people. Females are found to have a somewhat greater DH incidence than males. While DH can affect individuals of any age, there have been several theories on what causes abutment sensitivity after tooth preparation and cementation. In this review we included some of it. Also, we discussed methods of management of postoperative sensitivity and Management of fractured abutment screw.

An 18-month clinical evaluation of prolonged polymerization of a universal adhesive in non-carious cervical lesions: A double-blind randomized clinical trial

ObjectiveThis study aimed to evaluate the effect of prolonging polymerization time on the 18 months clinical performance of a universal adhesive system used as etch-and-rinse (ER) and self-etch (SE). Methods140 restorations were randomly placed in 35 subjects according to the following groups: ER10 (light-curing for 10 s); ER40 (light-curing for 40 s); SE10 (light-curing for 10 s) and; SE40 (light-curing for 40 s/1200 mW/cm2). A resin composite was placed incrementally. The restorations were evaluated at baseline and after 18 months by using the FDI criteria. The following outcomes were evaluated: marginal staining, marginal adaptation, spontaneous post-operative sensitivity and recurrence of caries. The differences among the groups were calculated using Friedman repeated measures analysis of variance rank (α = 0.05). ResultsAfter 18 months the retention/fracture rates were 88.9% (95%CI 74.1–95.6%) for ER10, 94.3% (95%CI 91.4–98.5%) for ER40, 77.2% (95%CI 60.1–87.9) for SE10 and 97.2% (95%CI 85.5–99.9%) for SE40. A significant difference was detected in the retention rate when SE10 was compared to the SE40 (p = 0.01). Also, ER40 showed a significant improvement of the marginal adaptation when compared to ER10 (p = 0.01). SignificanceThis is the first study that demonstrates an improvement in the clinical performance of universal adhesive systems in non-carious cervical lesions when prolonged light-cured was applied.

Clinical Evaluation of Glass-Lonomer Cement and Giomer for the Management of Cervical Caries

Background: Giomer is a unique class of restorative material has been introduced as the true hybridization of Glass Ionomer (GI) and composite resin and has the distinguishing feature of a stable surface pre-reacted glass ionomer. Glass Ionomer Cements (GIC) are also unique restorative materials with many uses in clinical practice and provide for caries-protective fluoride releasing at the margins of restorations, as well as their ability to have the fluoride within their chemical matrix recharged by outside exposure to other fluoride-containing materials. The present study aim at clinically evaluate the comparison between the glass Ionomer cement and Giomer for the management of cervical caries.&#x0D; Materials and methods: The study was a cross sectional comparative study which was carried out from 01 December 2018 to 31 November 2019 in the Department of Conservative Dentistry and Endodontics, Bangladesh Dental College, Dhanmondi, Dhaka. Total number of cases was 80. The patients were divided into two groups, half of the patient (Group-1) was treated with Glass Ionomer cement and half of the patient (Group-2) was treated with Giomer restoration. The post-operative sensitivity discoloration, dislodgement of filling material and secondary caries formation were recorded. All the patients were assigned and the data were analyzed statistically by SPSS version 21. p-value &lt; 0.05 was taken as significant.&#x0D; Results: The study reveals 60% of the study population was within 41 to 50 years of age group (Group-1) and 62.5% were 51 to 60 years (Group-2) 45% in (Group-1) and 10% in (Group-2) had history of post filling sensitivity, 12% in (Group-1) and 5% in (Group-2) had discoloration after restoration, 2.5% had history of dislodgement of the filling in (Group-1), no history of dislodgement of the filling in (Group-2), 2.5% had history of secondary caries formation in (Group-1) and no history of Secondary caries formation in (Group-2).&#x0D; Conclusion: Patients were more approachable for Giomer restoration than Glass ionomer for the management of cervical caries over a period of 12 month.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 60-64

Ten tips for avoiding post-operative sensitivity with posterior composite restorations

Patients increasingly seek tooth-coloured restorations in their posterior dentition, and with the anticipated decline in the use of amalgam as a result of the Minamata Agreement, this will increase. However, the incidence of post-operative sensitivity has been variously assessed as being between 0% and 51%, therefore information on its avoidance is essential. This article reviews the reasons for such sensitivity by examining the potential materials' factors, plus clinical aspects, such as the configuration factor and bonding to tooth substance. CPD/Clinical Relevance: There is a significant incidence of post-operative sensitivity after placement of a posterior composite restoration, so information on how to avoid this may be of value.

Survival of Hybrid Laminate Veneers using two different tooth preparation techniques: Randomized Clinical Trial.

The aim of this study was to evaluate the survival of laminate veneers constructed using a recent polymer-infiltrated ceramic network material following the aesthetic pre-evaluative temporary (APT) technique of tooth preparation in comparison to traditional technique. Six patients received 54 laminate veneers. They were divided into two equal groups (n=27) according to the technique of tooth preparation: group T: traditional technique and group A: aesthetic pre-evaluative temporary technique. VITA ENAMIC material was used for CAD/CAM construction of laminate veneers. Cementation was performed using a light cured resin cement. The laminate veneers were evaluated at baseline, after 3, 6 and 12 months according to the modified United States Public Health Service (USPHS) criteriea. The data was collected, tabulated and statistically analyzed. Secondary caries, endodontic complications, cracks and loss of retention were not noted in any laminate veneer. Extensive fractures were not detected in both study groups through the study period. There was a statistically significant decrease of color match criteria between the two groups at the 6 and 12 months recalls. Based on this study, both preparation techniques resulted in successful clinical performance. After 12 months, all the veneers in both groups showed no post-operative sensitivity and all patients were highly satisfied regarding their veneers. However, there was a deterioration in color match criteria through the study period in both study groups.

Оценка зрительных функций и сумеречного зрения у пациентов после имплантации различных видов ИОЛ

Purpose. To compare NCOSIS in the distance, at an average distance and near, twilight vision and sensitivity to blinding in patients after implantation of various IOL models. Materials and methods. Сataract phacoemulsification was performed in 60 patients, Hoya iSert 250 IOL was implanted in Group I, Lentis Comfort IOL was implanted in Group II, Acrysof IQ PanOptix IOL was implanted in Group III. In the postoperative period, twilight vision and sensitivity to bright light were evaluated. Results. The threshold value with a contrast level of 1: 23 and 1: 5 without illumination was achieved in patients of all the studied groups in 100% of cases; with a contrast of 1:2 in 90% of cases in patients of group I, in 80% of cases-in patients of group II and III; with a contrast of 1:2.7 in 60% of groups I and II, in 50% in patients of group III. The threshold value with a contrast level of 1:23 was achieved in patients of all the studied groups in 100% of cases, with a contrast of 1:5 in 100% of cases in patients of groups I and III, in patients of group II in 80% of cases; with a contrast of 1:2.7 with illumination in 80% of patients of group I and 60% of patients of groups II and III; with a contrast of 1:2 and illumination in 50% of patients of group I, 40% of group II and 20% of patients of group III of the study. Conclusion. Under mesopic conditions with high contrast indicators, all three types of IOLs show equally high results of visual quality. In light conditions, monofocal IOL allows you to get a higher quality of vision in low contrast conditions, at high and medium levels, IOL indicators do not differ statistically significantly, with a significantly larger range of vision in bifocal and multifocal IOLs. Key words: cataract phacoemulsification, intraocular lenses, twilight vision.

Effect of bleaching gel volume on color change and postoperative sensitivity: a randomized clinical study.

Although bleaching therapy is considered a dose-dependent treatment, the effect of the volume of product used is yet to be studied. This study thus aimed to evaluate the influence of bleaching gel volume on chromatic alteration and postoperative sensitivity. Thirty patients were selected and allocated into three groups; the lower canines were analyzed according to the volume of gel used: GI-0.025mL, GII-0.05mL, and GIII-0.10mL. Chromatic alteration analysis was performed using a portable digital spectrophotometer by calculating the ΔE, ΔE00, ΔL*, Δa*, and Δb* values and the whiteness index (WID). Spontaneous sensitivity was assessed using a questionnaire, and sensitivity was stimulated by thermo-sensory analysis. Analyses were conducted in five stages: baseline, after 1st, 2nd, and 3rd bleaching sessions, and 14days after the end. Data were analyzed using the two-way ANOVA test with repeated measures and Tukey's post hoc test (p < 0.05). It was observed that ΔE, ΔE00, and ΔL* were similar between groups at the end of the bleaching therapy; and the values of Δa*, Δb*, and WID were higher in the GIII group. For sensitivity, it was found that the GI was the one with the lowest values; o GII intermediate values; while the GIII group presents the highest values of spontaneous and stimulated sensitivity. Gel volume influenced the response to bleaching and significantly influenced the spontaneous sensitivity and cold stimulus. The amount of bleaching gel used during therapy is key to both the response to color change and postoperative sensitivity.

Erbium-doped: yttrium-aluminum-garnet (Er:YAG) versus scaling and root planing for the treatment of periodontal disease: A single-blinded split-mouth randomized clinical trial.

This randomized, controlled clinical trial aimed to compare the differences in periodontal clinical outcomes, duration of the procedure, and patient's experience between conventional scaling and root planing and erbium-doped: yttrium-aluminum-garnet (Er:YAG) in the treatment of generalized moderate to severe chronic periodontitis or generalized Stages II or III, and Grade B periodontitis based on the Centers for Disease Control (CDC), American Academy of Periodontology (AAP), and European Federation of Periodontology (EFP) definitions. Thirty subjects were initially recruited. In a split-mouth fashion, right and left sides were randomly allocated into two treatment arms: conventional scaling and root planing (C-SRP) versus laser-assisted scaling and root planing (L-SRP). A blinded examiner recorded clinical measurements at baseline and 3 months. Duration of the procedure was also recorded for each visit, and the patient's experience was assessed with a questionnaire at baseline, 1, and 3 months. The final sample consisted of 26 subjects. Both treatments resulted in overall improvement, but no significant differences were found between modalities for clinical attachment gain or probing depth reduction. The duration of the procedure was approximately half for L-SRP, and postoperative sensitivity was greater in C-SRP. The low-energy protocol with Er:YAG (50 mJ) used for the non-surgical treatment of moderate-severe chronic or Stage II-III, Grade B periodontitis performed in this study population was a treatment modality that yielded similar clinical improvements when compared to conventional scaling and root planing.

Microleakage Evaluation in Class V Cavities Restored with Five Different Resin Composites: In vitro Dye Leakage Study.

PurposeRestorative materials and techniques have improved the clinical success of a variety of restorative procedures. Despite these new improvements, microleakage remains one of the leading causes of restoration failure and may lead to postoperative sensitivity, enamel microcracks, marginal staining, discoloration, recurrent caries, and deformation of teeth. This study evaluated microleakages of five recent resin composites in class V cavities.Materials and MethodsStandardized class V cavities were prepared on the labial surfaces of one hundred extracted intact and noncarious human permanent premolar teeth. The cavities were divided into five groups (n=20) according to the resin composite material. Groups: A1, A2, A3, A4 and A5 were restored with Omnichroma, Spectrum, Mosaic, Tetric N-Ceram and Harmonize, respectively. The teeth were stained with methylene blue and then sectioned, and the extent of dye penetration was examined under a stereomicroscope and scanning electron microscope (SEM) to evaluate microleakage. One-way ANOVA test was used to statistically analyze the data. Statistical Package for Social Sciences Computer Software (SPSS) version 15.0 was used.ResultsDye penetration was observed at the tooth-restoration interface in all the studied samples, with varying degrees of penetration. At the cervical margins of the cavities, no statistically significant difference in the microleakage scores was observed (P=0.16). At the cavity floor, no statistically significant difference in microleakage scores was observed (P=0.74). Omnichroma resin composite had the highest microleakage results.ConclusionNanohybrid resin composites showed less microleakage than other resin composites. Among all the groups, Omnichroma showed the highest microleakage at the cavity floor and at the cervical areas.Clinical SignificanceIn light of our findings, nanohybrid resin composites appear to be capable of reducing microleakage, and the results reported herein must be verified by additional clinical trials.

Neurotic personality trait as a predictor in the\xa0prognosis of composite restorations: A 24-month clinical follow up\xa0study

The role of personality traits in modulating the incidence and progression of medical disease conditions are well documented, however, there is a paucity of information for its effects on dental health conditions and specifically on the prognosis of restorative dental materials. This study aims to evaluate the clinical performance of Micro-hybrid and Nano-ceramic composite restorations among patients with different personality traits. A total of 323 patients, indicated to receive operative treatment at a University Dental College Hospital, were invited to participate in this study. Consenting patients were requested to complete the Big Five Inventory (BFI-44 Item) personality questionnaire and were evaluated by a psychiatrist for categorizing the participants based on their personality traits. Out of the recruited patients, 124 patients falling in to the dominant trait of Agreeableness (n = 62) and Neuroticism (n = 62) were included in the study for further investigation. Next, patients from the Agreeableness (Group A) and the Neuroticism personality trait group (Group N) were randomly divided into two subgroups each—sub group Am (n = 44) and Nm (n = 48) for Micro-hybrid composite restorations and Sub group An (n = 42) and Nn (n = 47) for Nano-ceramic composite restorations. Two trained and calibrated dentists prepared the cavities according to previously published methodology. The restorations were evaluated at baseline (immediately after restoration), 6-months, 12-months and 24-months intervals by two blinded independent dental professionals for anatomical form, secondary caries, color match, retention, marginal adaptation, surface texture, marginal discoloration and post-operative sensitivity. There is no statistically significant difference noted in various parameters of restoration performance between Micro-hybrid composite and Nano-ceramic composite compared among ‘agreeableness’ personality group and among ‘neuroticism’ personality group after controlling the personality trait factor. Higher ‘Neuroticism’ individuals had higher restoration deterioration in color matching and surface texture when compared to higher ‘Agreeableness’ trait individuals. Regression analysis showed no effect of gender or cavity size on the outcome of results. Assessment of personality traits may serve as a useful tool during treatment planning which would aid clinicians in choosing suitable restorative dental material and prosthesis design according to individual patient’s physiological and functional needs, thereby overall improving the quality of treatment provided.

What is the clinical evidence of Bulk Fill resins performance of in primary and permanent teeth? a systematic review and meta-analysis

With the increasing acceptance of the clinical use of bulk-fill resins, it is necessary to investigate the in vivo performance of these restorative materials. In this perspective, this systematic review to evaluate the clinical performance of Bulk-fill resins in restorations of vital, primary and permanent posterior teeth. PubMed, Cochrane, Scopus, LILACS, BBO and Capes publications search base were searched without restriction regarding the year of publication or language of the article. The inclusion criteria were clinical trials that evaluated the efficacy of resins composed of bulk-fill compared to the incremental technique. For the selection of articles and data extraction, two calibrated evaluators evaluated abstracts and complete articles. A total of 1443 abstracts were identified, of which 14 articles were included in the review. Of these, 01 was classified with a high level of evidence; 08 were moderate and 05 with a low level of evidence. The studies presented an average follow-up of the restorations of 35.1 months. A large part of the studies (75%) demonstrated that the occurrence of postoperative sensitivity. The high failure rate was more prevalent in class II restorations. The marginal adaptation/color change was material dependent and the occurrence of secondary caries in bulk-fill resin restorations was not significant concerning conventional resins in most studies. In the short term, the satisfactory clinical performance of bulk-fill resins used in primary and permanent restorations, with clinical outcomes and results equivalent to conventional composite resins were observed.

Does a preoperative cone beam CT reduce complication rates in the surgical removal of complex lower third molars? A retrospective study including 486 cases

BackroundThis study was designed to analyse the value of preoperative Cone Beam CTs (CBCT) prior to the surgical removal of complex lower third molars. Furthermore, the aim was to assess injuries to the inferior alveolar nerve (IAN) bundle and postoperative neurological disorders depending on the position of the lower third molar and the inferior alveolar nerve bundle.MethodsIn this retrospective examination preoperative Cone Beam CTs and Orthopantomographs (OPT) of 324 patients were analysed concerning the location of the lower third molars in relation to the mandible and the inferior alveolar nerve bundle. Surgery protocols of all patients who underwent the surgical removal of at least one complex lower third molar were analysed concerning patient data, length of surgery, intraoperative haemorrhage, intraoperative exposure of the inferior alveolar nerve bundle, postoperative swelling and postoperative neurological disorders. The data was then compared to data from international studies.ResultsIn all 324 patients a permanent neurological damage was not found. Temporary neurological damage was recorded in 13 cases (2.6%). A caudal nerve position with no measurable distance to the root of the lower third molar was associated with the highest risk of a temporal neurological damage. A vestibular touching nerve route also correlated with postoperative sensitivity impairment. If a mesioangulation (Winter) or a Pell and Gregory Type IIIC appears in the OPT, risk of neurological damage is at its highest.ConclusionsThree-dimensional radiographic imaging, in our patient group, does not significantly affect the risk for complications during the surgical removal of complex lower third molars. Therefore, it should only be utilized for risk assessment, especially in cases of symptom-free lower third molars.A preoperative orthopantomogram still can be accepted as standard for radiographic imaging.An intraoperative exposure of the IAN bundle does not necessarily predict simultaneous neurological damage. Exposure of the IAN bundle is no indication for a discontinuation of the surgery.