Posterior Composite Resin Research Articles

Evaluation of Proximal Contact Tightness and Contact Area of Posterior Composite Resin Restorations

The purpose of this study is to evaluate the influence of the matrix system on proximal contact tightness (PCT) of posterior composite resin restorations. Standardized class II cavities on 180 first lower molar dentiform model teeth (Frasaco GmbH, Tettnang, Germany) were prepared. Three groups were formed considering the matrix system: Group-IM: Ivory matrix (Hahnenkratt GmbH, Königsbach-Stein, Germany), Group-OM: Omni matrix (Ultradent, South Jordan, UT, USA), and Group-PM: Palodent V3 sectional matrix (Dentsply, Charlotte, NC, USA). Teeth were restored with resin composite mounted in a manikin head to simulate the clinical environment. Proximal contact tightness (PCT) was measured using a custom-made portable dental pressure meter (PDPM), and the validation of the PCT results was performed with a histogram analysis acquired from bite-wing radiography. All data were statistically analyzed by ANOVA and t-test in SPSS software (v.27.0) (p < 0.05). PM group showed statistically tighter contacts on both mesial (PCTm: 228.28 ± 59.17 N) and distal surfaces (PCTd: 254.91 ± 65.69 N) (p > 0.05). Mesial contacts were found to be significantly tighter than distal contacts among all (p < 0.05). According to the histogram results, only in the PM group, the difference between the mesial and distal areas is significant (p < 0.05). Histogram results confirmed that the tightest contact values were achieved in the PM group, followed by the OM and IM groups, respectively (p < 0.05). The use of sectional matrix systems and separation rings is more effective in creating tighter contact than conventional matrix systems. The use of anatomical wedges will help to create a more natural approximal contour and narrow contact area.

Effect of carbamide peroxide treatment on the ion release of different dental restorative materials

BackgroundTo predict the long-term performance of restorative materials in the oral environment, it is important to evaluate their resistance to chemical and mechanical degradation and to know the toxic potential of the type and amount of ions eluted from the filling material. In this study, home bleaching was applied to dental materials with different contents and it was aimed to determine the type and amount of ions released from these materials.MethodsIn this study, amalgam, posterior composite resin, anterior composite resin, bulk fill composite resin, indirect composite resin, hybrid ceramic and all-ceramic were used as restorative materials. 10 specimens of each material were prepared according to the manufacturer’s instructions. Each material group was divided into two subgroups as the bleached group and the control group. After bleaching, all specimens were stored in 1 ml of 75% ethanol/water solution. Solutions were renewed after 1, 14 and 28 days. The type and amount of ions released from the materials were determined using Inductively Coupled Plasma-Mass Spectrometer (ICP-MS). Data were analyzed using the Friedman, Wilcoxon Signed Ranks, and Mann-Whitney U tests (α = 0.05).ResultsIt was determined that the amount of ions release from the restorative materials decreased over time (p < 0.05). According to the results of the Mann-Whitney U test, there was no difference between the bleaching and control groups in most of the restorative materials (p > 0.05).ConclusionWithin the limits of this study, home bleaching system does not have a significant effect on ion release from restorative materials.

Clinical performance of posterior restorations using a universal adhesive over moist and dry dentin: A 36-month double-blind split-mouth randomized clinical trial

ObjectivesTo evaluate the influence of dentin moisture on the clinical behavior of a universal adhesive on posterior teeth after 36 months of follow-up. MethodsForty-five patients participated in this study. Following a split-mouth design, three operators placed 90 Class I/Class II restorations over moist dentin (MD) or dry (DD) (n = 45) with resin composite (Filtek Bulk Fill) and a universal adhesive used in the etch-and-rinse mode (Single Bond Universal). Each restoration was evaluated according to the FDI and USPHS criteria (postoperative sensitivity, fracture and retention, marginal staining, marginal adaptation, and recurrence of caries) at baseline and after 6-, 12-, and 36 months. For statistical analysis, Kruskal Wallis analysis of variance rank (α = 0.05) and Kaplan-Meier survival analysis were used. ResultsNo significant difference between groups was observed in each FDI criterion after 36 months of clinical evaluation (p > 0.05). The retention rates (confidence interval 95 %) were 97.37 % (86.5 - 99.5) for both MD and DD without significant difference between them (p > 0.05). Eight restorations (MD = 4; DD = 4) showed minimal marginal staining defects (p > 0.05). Two restorations were lost (MD = 1; DD = 1). Fifteen restorations (MD = 8; DD = 7) presented minor marginal discrepancies according to the FDI criteria (p > 0.05). ConclusionThe clinical performance of the universal adhesive when applied in etch-and-rinse mode was not influenced by dentin moisture in posterior bulk-fill composite restorations. Clinical significanceThe level of dentin moisture appears not to influence the clinical efficacy of a universal adhesive when applied using the etch-and-rinse technique in posterior composite resin restorations.

Comparative Evaluation of a New Tricalcium Silicate Cement With Calcium Hydroxide as Direct Pulp Capping Agents: A Clinical Study.

Background and objectives Direct pulp capping (dPC) is a therapeutic process that involves the application of a protective chemical to an exposed pulp with the intent to facilitate the restoration and preservation of its vitality and function. Despite numerous proposed solutions, researchers have yet to find a dependable, non-absorbable bioactive pulp capping substance that constantly activates cellular healing processes, consequently preserving pulpal vitality over an extended period of time. The objective of this study was to assess and contrast the efficacy of a novel tricalcium silicate cement and calcium hydroxide in preserving the long-term health of the dental pulp following dPC using clinical and radiographic observations. Materials and methods A total of 60 individuals with symptoms of reversible pulpitis associated with deep carious lesions were chosen for dPC in the study. Two groups comprising 30 patients each underwent dPC using the novel tricalcium silicate cement (experimental group) and calcium hydroxide (control group) out of the total number of patients. A thin protective covering of self-curing glass ionomer base was applied on top of the capping material. The dentist provided instant permanent restoration employing direct posterior composite resin. Follow-up examinations were conducted three, six, nine, and 12 months after the procedure, during which assessments were performed using clinical and radiographic parameters. Results The minimum age of the study group was 16, and its maximum age was 34 (22.35 ± 2.3 years). The control group consisted of 12 males and 18 females, while the Biodentine group consisted of 13 males and 17 females. The age and gender distribution were determined to have insignificant statistical differences across the groups. The pain score exhibited statistical significance at both the three-month and six-month follow-up visits (p < 0.05). The pain score at the 12-month follow-up was 0.38 ± 0.52 in the case group and 0.42 ± 0.61 in the control group (p = 0.79). The average Periapical Index (PAI) score for the Dycal and Biodentin groups after the 12-month follow-up was 1.38 ± 0.97 and 1 ± 0.3, respectively. This difference was found to be statistically significant (p = 0.044). In addition, there was a statistically significant difference in the PAI score at the three-month, six-month, and nine-month follow-ups (p < 0.01). During the entirety of the follow-up duration, one individual in the Biodentine group had tenderness upon percussion, a negative reaction for pulp vitality, pulpal changes, and a widening of the periodontal space. Statistically significant differences were observed in pulpal changes and tenderness on percussion during the nine-month and 12-month follow-up periods (p < 0.05). After 12 months, the rate of success in the group treated with Dycal was 91.3%, while the success percentage in the group treated with Biodentine was 98.55%. This difference in outcomes was determined to be statistically significant (λ2 = 5.46; p = 0.019). Conclusion The study findings indicate that Biodentine, a novel tricalcium silicate cement, outperforms calcium hydroxide in preserving pulp vitality over the long term following dPC. The Biodentine group attained an overall success rate of 98.55%, whereas the Dycal group had a success rate of 91.3% following 12 months of subsequent follow-up visits.

Factors influencing the longevity of posterior composite restorations: A dental university clinic study

ObjectivesThis retrospective study aimed to assess the performance of posterior composite resin restorations (PCRRs) and evaluate the influence of patient-specific factors on restoration outcomes. MethodsA total of 189 PCRRs were examined in 54 patients, with evaluations based on Modified USPHS criteria. Patient-specific factors were analyzed. Statistical analyses, including chi-square tests, independent samples t-tests, and ANOVA tests, were conducted. ResultsPatients aged over 50 exhibited higher DMFT averages and a higher rate of unsuccessful restorations. Despite higher DMFT scores in females, gender doesn't significantly impact restoration outcomes. Secondary caries correlated with.plaque scores, significantly affecting restoration survival. Marginal adaptation, retention deficiencies, and secondary caries were primary causes of failure. Multi-surface restorations faced higher failure risk due to elevated plaque scores. Class-V restorations showed a higher failure rate, challenging the number of surfaces and longevity correlation. ConclusionsThis study identified key factors influencing posterior composite resin restorations-(PCRRs) in patients over 50, including higher DMFT averages and more unsuccessful restorations. No significant difference was found between brushing; frequency and DMFT rates, possibly due to the absence of non-brushers. Secondary caries; correlated with elevated plaque scores, impacting restoration survival. Primary causes of; failure included marginal adaptation issues, retention deficiencies, and secondary caries, with multi-surface restorations facing a higher risk. However, tooth vitality, beverage and acidic food consumption, and oral hygiene habits did not significantly affect PCRR outcomes. Clinical significancePatient-specific factors significantly impact PCRRs' long-term performance. Dentists must tailor strategies, emphasizing regular monitoring and preventive measures for extended survival.

Attitudes regarding a warranty and the expected longevity of dental treatment amongst New Zealand dentists, dental students, and patients: a mixed methods survey

ObjectivesTo investigate and compare estimates of the longevity of dental treatment, expectations for free remedial treatment, and attitudes about formal dental warranties among dentists, students, and patients.Materials and methodsThis is a mixed-method cross-sectional questionnaire survey with convenience sampling from dentists, dental students, and patients in New Zealand. A questionnaire was distributed to New Zealand dentists (n = 28) and final-year dental students (n = 27). A separate questionnaire was provided to patients in a university dental clinic (n = 43). Mann-Whitney U, Chi-square and Pearson Correlation, and Binary logistic regression tests were used to test for differences between groups and correlations amongst variables. Qualitative data were analysed thematically.ResultsDentists believed that their posterior composite resin restorations would last longer (p = 0.014), would remediate failed crowns for longer (p = 0.002) and would provide longer crown warranties (p = 0.003) compared to students. Patients had higher expectations for restoration longevity and free remediation for failed treatment. Students were generally more willing to provide warranties. Crowns were perceived to be the most warrantable, while endodontic treatment was the least warrantable. Recall attendance, mechanical failure, and adequate oral hygiene were commonly proposed as warranty conditions for restorations and crowns. There was little consensus about complete dentures and endodontic treatment.ConclusionsThere are significant disparities between the expectations of patients and clinicians regarding treatment longevity and free remediation times. Clinicians, in general, are willing to provide free remediation within a specified time frame, except for endodontic treatment, but are hesitant to provide formal dental warranties.

The radiopacity of single-shade composite resins: A comparative evaluation.

The aim of this study was to evaluate the radiopacity of single-shade composite resins with group and multi-shade composite resins via a digital image analysis. Disc-shaped (5 mm in diameter, 2 mm in thickness) specimens were prepared with one multi-shade (Estelite Sigma Quick-ESQ), four single-shade (Omnichroma-OC, Charisma Topaz One-CTO, Vitra Unique-VU, and ZenChroma-ZC), three group-shade (G-aenial Achord-GA, Optishade-OS, and Estelite Asteria-EA), and one posterior composite resin (Estelite Posterior-EP) (n = 3). A radiographic image of all the specimens, an aluminum step-wedge, and a 2 mm thick tooth section were taken. Mean gray values (MGV) of the specimens, enamel, and dentin were calculated by ImageJ software. Composition analysis was performed with EDS, and SEM images (×10,000) were obtained. The data were analyzed with Kruskal-Wallis and Post hoc adjusted Bonferroni analysis (p = 0.05). The mean MGV of CTO, the highest of all test groups, was significantly higher than OC and dentin (p = 0.04 and p = 0.009, relatively). The lowest mean MGV was also observed in a single-shade group, OC. EDS analysis showed that the tested materials comprised various radiopaque elements. All of the single-shade and group-shade groups exceeded the MGV value of dentin, which is clinically expected from any restorative material. The radiopacity properties of various single-shade composite resins which as a category is a rising trend in esthetic dentistry were investigated. It is important for clinicians to be aware of novel materials' physical qualities including radiopacity, a daily clinical criteria for restorative materials.

Posterior composite resin restorations combined with stamping technique for increasing vertical dimension: a case report

This clinician's report addressed the crucial consideration of occlusion functionality in aesthetic and oral rehabilitation treatments, highlighting the need to restore the lost vertical dimension. The objective of the study was to evaluate the relevance of recovering the occlusal vertical dimension in aesthetic and rehabilitative treatments, and to determine the viability of composite resin restorations combined with the stamping technique as a restorative option. A comprehensive approach supported by accurate diagnosis and the application of a functional and aesthetic wax-up was proposed. The study focused on the use of posterior composite resin restorations with the stamping technique as a viable restorative alternative. The development and reliability of composite resins and their adhesive systems were highlighted, highlighting their key characteristics. The results obtained demonstrated notable longevity in the restorations, supporting a conservative approach that replicates anatomical details with precision using transparent silicone matrices. Additionally, the benefits of this technique in terms of time and cost efficiency were explored. In summary, this clinical case highlights the importance of implementing an appropriate treatment plan supported by solid clinical evidence. The use of posterior composite resin restorations with the stamping technique to raise the vertical dimension is revealed not only as an effective alternative in aesthetic terms, but also as a long-term sustainable option

Fracture Resistance of Endodontically Treated Teeth Restored With Short Fiber Reinforced Composite and a Low Viscosity Bulk Fill Composite in Class II Mesial-Occlusal-Distal Access Cavities: An Ex-vivo Study.

Background Teeth undergoing endodontic therapy are prone to structural weakening and increased risk of fractures. The absence of marginal ridges and pericervical dentin further compromises the fracture resistance. The choice of the post-endodontic coronal seal is crucial for the effectiveness of endodontic therapy. Aim and Objectives This study compared the fracture resistance and fracture modes of endodontically treated teeth (ETT) with mesial-occlusal-distal(MOD) cavities restored with two different posterior composite resins: e-glass fiber reinforced composite (FRC) (everX Posterior) and flowable bulk fill composite (SDR Flow+). Materials and Methods Sixty human maxillary first bicuspids were divided into four groups: Group PC- positive control (intact teeth), Group NC- negative control (unrestored endodontically treated teeth), Group EXP- samples restored with everX Posterior and nano-hybrid composite, and Group SDR- samples restored with SDR Flow+ and nano-hybrid composite. The NC, EXP, and Smart Dentin Replacement (SDR) samples underwent endodontic procedures and MOD cavity preparation. The samples from EXP and SDR groups were restored with composite resins as post-endodontic coronal seals. The fracture resistance was evaluated using a Universal Testing Machine (UTM), and fracture modes were examined under a dental operating microscope (DOM) at 6x magnification. Statistical tests were performed using One-way ANOVA and Tukeys' post hoc tests. Results The mean fracture resistance of the experimental groups was as follows: PC- 880.1 ± 209.3 N; NC- 238.1 ± 15.4 N; EXP- 766.1 ± 50.2 N; SDR- 540.8 ± 49.4 N. The highest fracture resistance values were observed in the PC group, whereas the NC group showed the least. The EXP group exhibited significantly higher fracture resistance than the SDR group. Adhesive failure was observed in most samples in the EXP group, whereas samples in the SDR group showed more cohesive failures. Favorable fractures were more prevalent in samples restored with EverX posterior. Conclusion The study findings suggest that everX Posterior can enhance the fracture resistance of structurally compromised ETT. Samples restored with everX Posterior showed a favorable mode of fracture, which can be restored. Applying FRCs can contribute to the longevity and success of endodontic treatment by reinforcing the weakened tooth structure and preventing fractures.

Developing procedural metrics for training in class II posterior composite resin restorations: Outcomes from an international Delphi panel

ObjectiveThe objective of this study was to develop and operationally define procedural performance metrics for the Class II posterior composite resin restoration procedure and to obtain face and content validity through a consensus meeting. MethodsA Metrics Group consisting of 4 experienced Consultants in Restorative Dentistry, an experienced member of staff from the Restorative Dentistry department in CUDSH and a senior behavioural scientist and education/training expert deconstructed the performance of the Class II posterior composite resin restoration and defined performance metrics. At a modified Delphi meeting, 20 experts in the field of Restorative Dentistry from 11 different Dental Institutions critiqued these metrics and their operational definitions before reaching consensus. ResultsInitially performance metrics consisting of 15 Phases, 45 steps, 42 errors and 34 critical errors were identified that characterize the performance of the Class II posterior resin composite procedure. During the Delphi panel these were modified and consensus was reached on 15 Phases (with a change to the initial sequence) with 46 Steps (1 added, 13 modified), 37 Errors (2 added, 1 deleted, 6 reclassified as Critical Error), and 43 Critical Errors (9 added). Consensus on the resulting metrics was obtained and face and content validity verified. ConclusionsIt is possible to develop and objectively define performance metrics that comprehensively characterize a Class II posterior composite resin restoration. It is also possible to achieve consensus on the metrics from a Delphi panel of experts and to confirm the face and content validity of those procedure metrics.

Fracture Load of Mesio–Occluso–Distal Composite Restorations Performed with Different Reinforcement Techniques: An In Vitro Study

Mesio-occluso-distal (MOD) cavity preparations are often fragile due to the amount of tooth and carious structure removed. MOD cavities can often fracture if left unsupported. The study investigated the maximum fracture load of mesi-occluso-distal cavities restored using direct composite resin restorations with various reinforcement techniques. Seventy-two freshly extracted, intact human posterior teeth were disinfected, checked, and prepared according to predetermined standards for mesio-occluso-distal cavity design (MOD). The teeth were assigned randomly into six groups. The first group was the control group restored conventionally with a nanohybrid composite resin (Group I). The other five groups were restored with a nanohybrid composite resin reinforced with different techniques: the ACTIVA BioACTIVE-Restorative and -Liner as a dentin substitute and layered with a nanohybrid composite (Group II); the everX Posterior composite resin layered with a nanohybrid composite (Group III); polyethylene fibers called "Ribbond" placed on both axial walls and the floor of the cavity, and layered with a nanohybrid composite (Group IV); polyethylene fibers placed on both axial walls and the floor of the cavity, and layered with the ACTIVA BioACTIVE-Restorative and -Liner as a dentin substitute and nanohybrid composite (Group V); and polyethylene fibers placed on both axial walls and the floor of the cavity and layered with the everX posterior composite resin and nanohybrid composite (Group VI). All teeth were subjected to thermocycling to simulate the oral environment. The maximum load was measured using a universal testing machine. The highest maximum load was exhibited by Group III with the everX posterior composite resin, followed by Group IV, Group VI, Group I, Group II, and Group V. A statistically significant difference was demonstrated between groups (p = 0.0023). When adjusting for multiple comparisons, there were statistical differences specific to comparisons between Group III versus I, Group III versus II, Group IV versus II, and Group V versus III. Within the limitations of the current study, it can be concluded that a higher maximum load resistance can be achieved (statistically significant) when reinforcing nanohybrid composite resin MOD restorations with everX Posterior.

Resin Composite Versus Amalgam Restorations Placed in United States Dental Schools.

To investigate the latest teaching policies for posterior resin composite placement versus amalgam and to determine the actual numbers of posterior resin composites versus amalgam restorations placed in American dental schools from 2008 to 2018. Emails were sent to the deans of all 66 dental schools in the United States to collect data in the forms of: 1) Questionnaire on current teaching policies of posterior composite and amalgam restorations; and 2) Data entry form to collect the actual numbers of posterior composite and amalgam restorations placed in their clinics. Descriptive statistics were used to summarize ratios of posterior restorations. Inferential analysis (chi-square test and z-test) was employed to compare posterior restoration proportions over time and within each year. Level of significance was set at 0.05. For the teaching questionnaire, the response rate was 52% (n=34). Seventy-six per cent of the responding schools reported that they assign 50% or more of their preclinical restorative teaching time towards posterior resin composite placement, while 50% of the responding schools devoted 25% or less towards amalgam teaching. Data entry response rate was 26% (n=17). In 2008, amalgam and resin composite restorations were placed almost equally. However, resin composite restorations were placed significantly more frequently from 2009 onwards in all responding schools. The results revealed a significant ongoing increasing trend in placing posterior resin composites in all responding schools over time (p<0.05). Data analysis revealed a clear trend towards an increase in posterior resin composite restoration placement and a decrease in the number of amalgam restorations. However, the time assigned for posterior resin composite teaching is not aligned with quantity of restorations placed. Review and adjustment of the time allocated for teaching and training of each material are suggested.

Susceptibility to discoloration of dental restorative materials containing dimethacrylate resin after bleaching.

The aim of this study is to compare the susceptibility to discoloration of dental restorative materials containing dimethacrylate resin after bleaching. In this study, resin-modified glass ionomer, polyacid-modified composite resin, giomer, posterior composite resin, anterior composite resin, bulk fill composite resin, flowable bulk fill composite resin, ormocer, indirect composite resin and hybrid ceramics were used as restorative material containing dimethacrylate resin. 20 samples were prepared from each material in accordance with the manufacturer's instructions. After the baseline colors are measured, the samples were randomly divided into four subgroups as office bleaching, home bleaching and a separate control group for each type bleaching method. Then, the samples were bleached and colored. Color measurements of the samples were repeated after exposure to bleaching and coloring. Then, ΔE00 and whiteness index (WID) were calculated. Data were analyzed using Paired-Samples T Test, two-way ANOVA, Repeated Measures ANOVA and Tukey post-hoc tests. Statistical significance level was taken as p < 0.05. In terms of bleaching systems, Opalescence Boost was found to cause more whitening in materials but more discoloration (p < 0.05). In terms of materials, it was found that the most susceptible materials to coloration were Clearfil Majesty Posterior, Filtek Bulk Fill Posterior Restorative, Filtek Bulk Fill Flowable and Fuji II LC, while the least susceptible materials were CAD/CAM materials (p < 0.05). The bleaching process increases the susceptibility to coloration of materials containing dimethacrylate resin.

Microleakage of two different posterior composites and a high-viscosity glass-ionomer cement: An in vitro study

Aim: Using AutoCAD, we examined the microleakage of permanent molars in Class I restorations using a conventional posterior composite resin, a bulk-fill composite resin, and a high-viscosity glass-ionomer cement (HVGIC). Methodology: In total, 33 extracted noncarious third molars were used. Class I cavities were prepared. The teeth were randomly divided into three groups of 11 teeth each, as follows: Group A (Filtek Z550), Group B (Filtek Bulk-Fill Posterior Restorative), and Group C (EQUIA Fil). All specimens were stored for 24 h at 37 °C in distilled water. The teeth were thermocycled 1,000 times between 5 ± 2°C and 55 ± 2°C prior to immersion in 0.5% basic fuchsin for 24 h. Two mesiodistal cuts of each tooth were photographed under a stereomicroscope equipped with a digital camera. The dye-infiltrated surface area was measured. Results: Statistical evaluations were performed by one-way analysis of variance [ANOVA]. One-way ANOVA showed no significant difference between the three groups in microleakage (P = 0.07). However, the lowest microleakage ratio was seen in Group C (EQUIA Fil). Similar results were obtained with all tested materials, but the lowest microleakage rate was obtained with EQUIA Fil (Group C). Conclusion: In this study, the tested materials were not completely successful in eliminating microleakage, although the lowest microleakage rate was obtained with EQUIA Fil. How to cite this article: Çelenk S, Ataş O, Ayna B, Günay A. Microleakage of two different posterior composites and a high-viscosity glass-ionomer cement: An in vitro study. Int Dent Res 2022;12(1):34-8. https://doi.org/10.5577/intdentres.2022.vol12.no1.6 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

3-Year Survival of direct composite resin restorations of permanent first molars with excessive material loss in children

Aim: The aim of this retrospective study was to determine survival rates of direct composite resin (DCR) restorations of permanent first molars (PFMs) with excessive material loss at the end of 3 years. Material and methods: Children between the ages of 7-14 whose PFMs had 3-surfaced DCR restoration were included in the study. In restorations Ionofil Molar glass ionomer cement (VOCO,Cuxhaven,Germany) as base material, Clearfil SE Bond adhesive agent and Clearfil Majesty Posterior composite resin (Kuraray Noritake Dental Inc.,Okayama,Japan.) were used. Survival rates of the restorations after 3 years were evaluated using The United States Public Health Service criteria and the presence of symptoms indicating irreversible pulp damage and the need for root canal treatment such as provoked or spontaneous pain, percussion, abscess, fistula in the related teeth were examined clinically and radiographically. Chi-square and Kruskal Wallis analyzes were used for the statistical analysis. Results: Totally 58 DCR restorations of PFMs of 34 patients who agreed to come for the control visit at the end of 3 years were examined. The survival rate of restorations was 70.69% and findings indicating irreversible pulp damage were found in 15.5% of the restorations examined. Conclusion: Survival rate of DCR restorations applied to PFMs with excessive material loss is not satisfactory after 3 years, however it is thought that DCR applications will continue in PFMs with excessive material loss thanks to the developments in adhesive systems and composite resins. Therefore, long-term randomized controlled clinical studies on this subject should be continued.

Effect of Marginal Leakage around Class II Composite Resin Restorations

The desire for improved esthetics have led to the appearance of “posterior composite resins” for occlusal restorations. Forty extracted permanent human molars and premolars of mesial or distal class II cavities were included. There was no leakage found at 58% and 89%. The lowest degree of leakage for all filling methods was found at the occlusal margin.

Comparison of Self-Etching Adhesives and Etch-and-Rinse Adhesives on the Failure Rate of Posterior Composite Resin Restorations: A Systematic Review and Meta-Analysis.

The aim of this study was to perform a systematic review with meta-analysis on the comparison of self-etching adhesives and etch-and-rinse adhesives with respect to the failure rate of posterior composite resin restorations. The study protocol was registered in PROSPERO (CRD42017078015), following PRISMA recommendations and PICO search strategy. Literature search was performed in the following databases: MEDLINE, ISI Web of Science, LILACS, SCOPUS, and Cochrane Library through July 2021. Six studies from five randomized clinical trials were included in the qualitative synthesis. The funnel plot detected important bias (all studies out of the funnel area). The meta-analysis showed a positive summary Cohen H effect size of 0.406 (95% CI: 0.100; 0.713, p = 0.009), favoring etch-and-rinse adhesives. The total number of failures (including restorations that required replacement and those that did not require replacement) were attributed to either marginal adaptation (five studies) or marginal staining (one study). A very low certainty of the evidence was obtained through GRADE analysis. In conclusion, current available evidence indicates that etch-and rinse adhesives performed better (with a low effect size) than self-etching adhesives in terms of failure rates in posterior composite restorations.

A cost-effective technique for fabricating a dentoform by using a complete digital workflow

Direct posterior composite resin restorations are a routine procedure and represent a large part of the restorative work in daily practice1; surprisingly, their complexity may be underestimated by many clinicians. This highly skill-dependent treatment requires well-defined layering protocols and practice by the dentist to make it more predictable and time-efficient,2-5 but many dentists do not invest in perfecting the procedure.6

Current and future trends in the teaching of direct posterior resin composites in Malaysian dental schools: a cross-sectional study

ObjectiveTo investigate the current and future teaching of posterior composite restorations in undergraduate curricula in Malaysian dental schools. MethodsA 24-item validated questionnaire including closed and open questions on the teaching of posterior composites was emailed to faculty members in all 13 Dental Schools in Malaysia. Responses were compiled on Excel and analysed. ResultsAll 13 dental schools responded to the survey yielding a 100 % response. All schools indicated the use of posterior composites for 2- and 3-surface cavities in premolars and molars. The didactic teaching time devoted to composites was greater than for amalgam (38 h vs 29 h). Clinically, most posterior restorations placed by students were composites (average 74.1 %, range 10 %–100 %); the remaining 25.9 % were amalgams (range, 0 %–50 %). Slot-type cavities were the preparation techniques most commonly taught (n = 11,84.6 %). The use of rubber dam for moisture control was mandatory in most schools (n = 11, 84.6 %). History of adverse reaction to composites was found to be the most common contraindication to composite placement. The phase down of teaching and use of amalgam in Malaysia is expected to occur within the next six years. ConclusionThe trend to increase the teaching of posterior composites reported for other countries is confirmed by the findings from Malaysian dental schools. Notwithstanding this trend, the use of amalgam is still taught, and future studies are required to investigate the implications of the phase down of amalgam in favour of posterior composites. Clinical significanceNotwithstanding the increase in the teaching of posterior composites there is a pressing need to update and refine clinical guidelines for the teaching of posterior composites globally.

Beyazlatma Ajanlarının Renklenmiş Rezin Kompozitlerin Yüzey Pürüzlülüğü ve Renk Değişimine Etkileri

Objective: The aim of this study was to evaluate the effects of 2 home bleaching agents [16% carbamide peroxide (CP) and 6% hydrogen peroxide (HP)] on the color change and surface roughness of discolored anterior and posterior resin composites. Material and Methods: Estelite Sigma Quick (ES) and Estelite Posterior (EP) resin composites were used in the present study. A total of 60 samples were prepared (thirty samples from each resin composite). Samples were immersed into the coffee solution throughout the 12 days. Samples were randomly divided into 3 groups, to applying 2 different bleaching agents and a control group (n=10). Bleaching agents were applied for 14 consecutive days. The color changes of the samples were measured at 3 different times, baseline (T0), after discoloration (T1) and bleaching procedures (T2). Surface roughness changes were measured at T1 and T2. Color differences were calculated using the CIEDE 2000 (ΔE00) formula. Differences were analyzed using one way, two-way analysis of variance and Tukey multiple comparison tests. Results: ΔE00 values showed significant differences after coffee immersion and bleaching applications in both resin composites (p<0.05). Immersion in coffee caused more color change in EP samples (ΔE00=12.46±0.47). Bleaching agent was a significant factor for the color recovery in ES samples (p<0.05). CP application in ES groups and HP application in EP groups increased the surface roughness (p<0.05). Conclusion: Bleaching agents used in the present study showed color recovery effect on discolored resin composites. The potential effect of bleaching agents on surface roughness and the sensitivity of the posterior resin composites to discoloration should be considered in restorative treatment.