Public Health Service Criteria Research Articles

Minimally Invasive Glass-Ceramic Restorations: Clinical and Patient-Reported Outcomes in Full-Mouth Rehabilitations.

To evaluate clinical outcomes (restoration survival, technical and biological complications), and patient-reported outcome measures (PROMs) of full mouth rehabilitation with minimally invasive glass-ceramic restorations after up to 12 years of clinical service. Twenty individuals (12 females, 8 males) received full-mouth rehabilitation with minimally invasive tooth-supported glass-ceramic restorations during the years 2009 - 2017 and agreed to participate in a follow-up visit. Full dental and periodontal examinations were completed, and the restorations were evaluated according to United States Public Health Service (USPHS) criteria. Kaplan-Meier was used for analysis of the survival time. The patients received 439 minimally invasive restorations made from lithium disilicate reinforced glass-ceramic (79.7%), feldspathic porcelain (17.5%) and leucite reinforced glass-ceramic (2.7%). Restoration design included occlusal and buccal surface partial coverage restorations (35.3%), full-contour restorations (31.2%), veneers (27.8%), onlays (4.6%) and inlays (1.1%). The mean follow-up time from restoration insertion was 4.5 years (1.5-12.4 years). Five patients lost altogether 13 restorations during the follow-up time. The estimated cumulative Kaplan-Meier 5-year survival rates were 96.6% on the restoration level and 86.4% on the patient level. Major technical complications amounted to 3% (n=13) of the restorations, including larger chippings (n=5) and loss of retention (n=7). Biological complications were observed at a rate of 4.3%. Patients were very satisfied with esthetics (VAS 9.5) and function (VAS 9.3) of the restorations. Minimally invasive full-mouth rehabilitation with glass-ceramic restorations resulted in high survival rates, few complications and a high level of patient satisfaction over a mid-term time-period. There is an increasing trend toward minimally invasive restorations, as previous studies indicate that these designs preserve healthy tooth structure, leading to fewer biological complications. The present study demonstrates that minimally invasive restorations can be reliably used in full-mouth rehabilitations.

Clinical evaluation of giomer-based injectable resin composite versus resin-modified glass ionomer in class V carious lesions over 18 months: A randomized clinical trial

Abstract Aim: This randomized clinical trial aimed to evaluate the clinical performance of giomer-based injectable resin composite (GIRC) versus resin-modified glass ionomer (RMGI) in class V carious lesions over 18 months. Participants and Methods: Thirty participants with a cervical carious lesion were recruited and allotted to two groups (n = 15); Group 1 received GIRC (Beautifil Flow Plus X F03, Shofu Dental Corporation, Kyoto, Japan), and Group 2 received RMGI (Fuji II LC, GC Corporation, Tokyo, Japan). Materials were placed according to the manufactures’ instructions. Restorations were evaluated using the modified United States Public Health Service criteria at baseline, after 6, 12, and 18 months. Data were statistically analyzed with the significance level set at (P ≤ 0.05) where categorical data as frequency, percentage, and intergroup comparisons were performed using the Chi-squared test and intragroup comparison using Cochran’s Q-test. Results: Intergroup and intragroup comparisons showed no statistically significant difference between GIRC and RMGI at different time intervals for marginal adaptation, marginal staining, surface texture, secondary caries, retention, and postoperative sensitivity. Conclusion: GIRC and RMGI showed similar clinical performance and are clinically acceptable after 18-month follow-up period.

Outcomes of surveyed monolithic CAD/CAM zirconia crowns for removable partial denture abutments: A 7-year clinical study.

This retrospective clinical study aimed to evaluate the clinical outcomes of surveyed monolithic computer-aided design and computer-aided manufacturing (CAD/CAM) zirconia crowns for abutment teeth in removable partial dentures (RPDs). Patients who received monolithic surveyed zirconia crowns were clinically examined. The crowns were examined according to the modified United States Public Health Service criteria, and Kaplan-Meier survival was determined. The effect of different variables on the survival and success rates was assessed using Cox regression analysis (α = 0.05). A total of 297 crowns of 275 patients were evaluated over a mean period of 7 years. The cumulative survival and success rates were 95.6% and 91.2%, respectively. Complications were in the form of secondary caries (n=12), minor chipping (n=9), and debonding (n=5). A higher number of failures was observed in the mandibular molars (P < 0.05). Surveyed monolithic zirconia crowns demonstrated high survival after 7 years of service. Monolithic zirconia is an excellent alternative to metal ceramic crowns for RPD abutments.

Clinical performance of different adhesion strategies in non-carious cervical lesion restorations: A four-year randomized clinical trial.

To evaluate the retention rate and other clinical criteria of four different restorative techniques for non-carious cervical lesions (NCCLs) after 4 years. This is a prospective, randomized, double-blind, and split-mouth study evaluating four different adhesion strategies in non-carious cervical lesion restorations: adhesive restorative system (Scotchbond Universal Adhesive/Filtek Z350XT) without (SBU) and with selective enamel acid-etching (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic as acid pretreatment (E-RMGIC). In total, 200 restorations were placed in 50 patients. Good health, no allergies to dental products, adequate oral hygiene were inclusion criteria. Pregnancy, active caries, use of desensitizers/fluoride, orthodontic appliances, and severe bruxism were exclusion criteria. All restorations were scored regarding retention, marginal integrity, marginal discoloration, surface texture, wear, secondary caries, anatomical form, surface staining, color match, and inflammation of gingival tissue marginal adaptation, using modified United States Public Health Service (USPHS) criteria at baseline and after 1, 2, 3 and 4 years. Kruskal-Wallis, Friedman, and Wilcoxon were used (p < 0.05). In total, 40 patients returned for the follow-up. RMGIC and E-RMGIC presented more alteration in surface texture than SBU and E-SBU. SBU had lower retention at four years than at baseline. Decreased alpha scores for marginal integrity and marginal discoloration were observed for all groups after four years when compared to baseline. Survival curves, related to retention, presented no statistical differences among groups (p = 0.315). NCCLs restored with ionomer had more reduction in surface luster than resin composite restorations. The use of selective enamel etching promoted less loss of retention for universal adhesive. The increase of initial marginal defects occurred for all types of adhesion strategies. The use of selective enamel etching cause less loss of retention for universal adhesive used in NCCL. Initial marginal defects occur for all types of adhesion strategies after four years.

Survival and complications of 3D-printed, noninvasive restorations for prosthetic rehabilitations: a 12-month preliminary observational study.

The adjustment and transfer of a stable occlusion can be a major challenge in prosthetic rehabilitations. The aim of the present study was to assess a noninvasive treatment option for complex prosthetic rehabilitations and occlusal analyses using 3D-printed restorations clinically. Eleven patients received a partial or complete rehabilitation with the aid of 3D-printed restorations (n = 171). After 12 months of clinical service, all restorations were analyzed using the United States Public Health Service (USPHS) criteria. The 12-month clinical data revealed that 3D-printed restorations showed a survival rate of 84.4%. Complications occurred mostly regarding the anatomical form (7%) or marginal integrity (6%) and were consequently rated 'Charlie' or 'Delta.' Color stability and color match of 3D-printed restorations were rated 'Alpha' in 83% and 73%, respectively, of all restorations. Marginal inflammation was rated 'Alpha' in 89% of all restorations. An excellent surface texture and no secondary caries or postoperative sensitivities (100%) were observed. 3D-printed restorations might be an alternative treatment option for initiating complex prosthetic rehabilitations. Technical complications rarely occurred. Biologic complications did not occur at all. The color stability showed promising results after 12 months of clinical service. However, the results should be interpreted with caution until long-term results with a high number of restorations are available.

3D-Printed Permanent Resin Crowns on Pre-Molar and Molar Teeth; Two-Year Results of a Prospective Clinical Study.

The aim of this prospective clinical study was to evaluate the 12 and 24-month clinical results of overlay and one-piece endodontic crown restorations applied with additively manufactured 3D printed permanent ceramic-filled resin (PCR) according to the Modified US Public Health Service (USPHS) criteria. A total of 33 indirect restorations (16 overlay, 17 endocrown) (4 premolar, 29 molar) produced using PCR (Formlabs) were applied to 30 patients by a single dentist. The restorations were evaluated according to the modified USPHS criteria at baseline (7 days), 12 and 24 months times by two independent evaluators. The study registration number is NCT05168852. In the comparisons of the dependent criteria scores, the Related Samples Cochran Q test was used, and in post-hoc paired comparisons, the Bonferroni test. The Fisher-Freeman-Halton test was applied in the comparisons of categorical variables according to the restoration type groups (α = 0.05). No statistically significant difference was determined between the evaluation criteria scores at baseline, 12 months, and 24 months for the marginal adaptation (P=0.05), retention (P=1), interproximal contact (P=0.368), color match (P=1), surface texture (P=1), and patient satisfaction (P=1). The only score criteria that showed a statistically significant difference between baseline and 24 months (P=0.001) among all other criteria was marginal discoloration. This criteria's score change was from 100% A score to 69.7% A score. In the 2-year follow-up of indirect single-tooth restorations produced with 3D-printed PCR, all restorations showed acceptable clinical performance. (≥99.5%A&#43;B score at 2 years).

CLINICAL EVALUATION OF THREE DIFFERENT SELF-ADHERING MATERIALS IN CLASS I RESTORATIONS

Introduction: Self-adhering flowable composite (Vertise Flow, Kerr, USA) simplified the long-lasting restorative procedure and opened a new chapter in conservative dentistry. This study aimed to evaluate the clinical effect of VF in comparison with resin-modified glass ionomer (Fuji II LC, GC, Japan) and glass carbomer (Glass Fill, GCP Dental, Vianen, Netherlands) in cavities of I class. Material and methods: Thirty patients with initial occlusal caries lesions were recruited in the study. For each patient, three restorations of I class were placed, one each with each examined material. All materials were applied according to the manufacturer’s instructions. The restoration was evaluated after one month and after 6 months using the modified United States Public Health Service criteria measuring (retention, postoperative sensitivity, color match, marginal adaptation, and marginal discoloration). For statistical analysis, Fisher’s test, Student’s test, Mann-Whitney, and Chi-square test were used to investigate changes in the follow-up periods. Results: After one month and after 6 months, there was no statistically significant difference between the three materials for all the parameters tested (p0.05). Conclusion: VF showed a clinical effect similar to resin-modified glass ionomer (Fuji II LC, GC, Japan) and glass carbomer (Glass Fill, GCP Dental, Vianen, Netherlands) in cavities of I class after 6- months of follow-up.

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

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

A 3-year clinical evaluation of endocrown restorations with two different materials using the computer-aided design/ computer-aided manufacture system

ObjectiveTo compare the clinical efficacy of resin nanoceramic and zirconia-reinforced lithium silicate ceramic endocrowns in the treatment of endodontically treated teeth by assessing the clinical performance of restorations fabricated using a chairside computer-aided design/computer-aided manufacturing (CAD/CAM) system. Materials and methodsNinety endocrown restorations were fabricated on endodontically treated teeth using a CAD/CAM system. Fifty-two restorations were fabricated using Lava Ultimate blocks (LU, 3 M Espe, Seefeld, Germany) and 38 restorations were fabricated using Celtra Duo blocks (CD, Dentsply Sirona, York, PA, USA). The performance of the endocrown restorations was evaluated over a 3-year period using the modified United States Public Health Service (USPHS) criteria by two calibrated evaluators. The data were analyzed using Chi-square (x2) and Fisher exact tests (p < 0.05). ResultsThe restoration survival rates in the two groups were 82.7 % (LU) and 86.8 % (CD) (p = 0.6). Twelve restorations failed (8 LU, 4 CD) due to debonding (n = 4, 2 LU, 2 CD), ceramic fracture (n = 2, 1 LU, 1 CD), tooth fracture (n = 5, 4 LU, 1 CD), and secondary caries (n = 1, 1 LU) during the follow-up period. There was no statistically significant difference between the two materials according to the modified USPHS criteria (p > 0.05). ConclusionResin nanoceramic and zirconia-reinforced lithium silicate ceramic endocrown restorations fabricated using a chairside CAD/CAM system demonstrated acceptable clinical performance in the treatment of endodontically treated teeth. Clinical SignificanceResin nanoceramic and zirconia-reinforced lithium silicate ceramics are potential alternative materials for the chairside fabrication of endodontically treated teeth.

Comparative Assessment of Compomers and Ormocers as Pit and Fissure Sealants in Permanent Molars among Children Aged 7-9 Years.

In recent years, the dental profession's focus has shifted from the therapeutic to the preventive aspect of dental caries. Pit and fissure sealants, optimal fluoridation, healthy dietary habits, and good oral hygiene have been recommended for caries prevention. Many sealant materials are available on the market. Compomers are hybrid dental materials that are modified composite resins with polyacids. The esthetic properties of traditional composite systems are combined with the fluoride-releasing and adhesive properties of glass ionomer cement (GIC). Organically modified ceramic (Ormocer) material has high abrasion resistance and better aesthetics, similar to natural teeth. To compare the sealing ability of compomer and ormocer as pit and fissure sealants in permanent mandibular first molars of 7-9-year-old children. A cross-sectional study with a split-mouth design was conducted on 88 children aged 7-9 years who attended the Department of Pediatric and Preventive Dentistry. Children were selected based on the inclusion and exclusion criteria. By tossing a coin, the placement of sealant material was selected for the right permanent first molar. Rubber dam isolation was done. The tooth surface was etched and washed. The respective sealants were applied. Sealants were cured with visible light, and occlusion was checked with articulating paper. Subsequently, the second sealant was placed in the next appointment, following the same clinical procedure in the opposite quadrant. Clinical evaluation was done at 3, 6, and 9 months for retention, marginal integrity, color match, wear, and presence of caries. The criteria were graded and rated as alpha, beta, and charlie based on modified Ryge United States Public Health Service (USPHS) criteria. All the data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) software 20.0. The retention rate of ormocer at the 9-month review interval was 88.3%. There was a statistically significant difference in retention rates between compomer and ormocer (p = 0.003). The marginal integrity and wear of ormocer at the 9-month review interval were 84.4% compared with compomer, which was statistically significant with p = 0.010 and p = 0.035, respectively. Children with the fewest caries belonged to the ormocer group (p = 0.010) compared to the compomer group. Children with ormocer as a pit and fissure sealant showed good retention, remarkable marginal integrity, absence of wear, and fewer dental caries compared to compomer sealants. Hence, ormocer-based sealants can be used in pediatric dental practice to protect children's oral hygiene and promote a healthy lifestyle. Saravanan SM, Srinivasan D, AR SE, et al. Comparative Assessment of Compomers and Ormocers as Pit and Fissure Sealants in Permanent Molars among Children Aged 7-9 Years. Int J Clin Pediatr Dent 2024;17(7):742-747.

The survival and clinical performance of anterior composite resin restorations and posterior indirect and cast restorations used to treat generalised tooth wear

Objective To evaluate the survival and clinical performance of restorative materials used in the rehabilitation of generalised severe tooth wear within a UK NHS postgraduate teaching hospital.Methods The clinical performance of 527 restorations on 20 patients with generalised severe tooth wear was reviewed after a mean period of five years. Anterior teeth were restored with direct composite resin and posterior teeth with indirect restorations. The study used the modified United States Public Health Service criteria for restoration assessment. Survival of the restorations was analysed using Kaplan-Meier survival curves, the log-rank test and the Cox proportional hazards regression analysis.Results The sample included 20 participants: 13 men and 7 women, with a median age of 51.8 years (range: 33-73 years). The median survival time for all restorations was 11.3 years when major failures were considered and 5.9 years for restorations when all types of failure were considered. A median survival time of 5.9 years for composite resin restorations and over seven years for cast restorations was found when considering all failures. Composite resin restorations commonly failed as a result of fracture, wear and marginal discolouration. Factors significantly influencing restoration survival were the material used, aetiology, incisal relationship and tooth location. The biological complications associated with this treatment regime were rare. Patient satisfaction remained generally high, with greatest dissatisfaction related to treatment time.Conclusions The use of anterior composite resin with posterior indirect restorations to treat generalised severe tooth wear is a viable treatment modality with very few major complications.

Performance of Bonded Lithium Disilicate Partial-coverage Crowns in the Restoration of Endodontically Treated Posterior Teeth: An Up to Seven-Year Retrospective Study.

To evaluate the clinical performance of adhesively bonded lithium disilicate glass-ceramic (LDG) partial-coverage crowns in restoring posterior endodontically treated teeth (ETT). A total of 121 morphologically compromised posterior ETT were restored with LDG partial-coverage crowns between October 2015 and January 2018. The restorations were fabricated in the laboratory or at the chairside. Two adhesive systems and resin cements were used to cement the restorations. Tooth and restoration survival rates were calculated. The restorations were evaluated clinically using the modified United States Public Health Service (USPHS) criteria for an observation period of 5-7 years. The Cox proportional hazards model was used to estimate relative failure risks such as tooth type, resin cements, gender, and sleep bruxism. The standard chi-squared test was used to compare the survival of different tooth types for significant differences (α=0.05). In addition, survival probability was calculated using the Kaplan-Meier algorithm. Among seven failed cases, one was a tooth fracture, and six were restoration fractures. According to the Kaplan-Meier analysis, the estimated survival rate of the teeth was 99% for seven years, while the estimated survival rate of the restorations was 94.8% for 5 years and 92.8% for 7 years. Tooth type and resin cements did not influence restoration survival rates (p>0.05), while sleep bruxism and male patients might increase the risk of failure (p<0.05). The indirect adhesively bonded LDG partial-coverage crowns of posterior ETT exhibited favorable clinical outcomes. Ceramic fracture was the most common failure pattern.

The 24 months clinical evaluation of class II bulk fill composite restorations

Background: Resin Composite materials are widely used in daily clinical dentistry because of their moderate cost compared with ceramics, easy placement, adequate esthetics, ability to bond with enamel and dentine, and physico-chemical properties. Bulkfill composite materials were introduced to reduce chairside time. These materials have properties such as optimal bond strength, decreased polymerization shrinkage, and reduced cuspal deflection. This in-vivo study compared the clinical performance of three different class II resin composite restorations. Methods: Seventy-one patients (41 females and 30 males) aged 20–43 years with at least three approximal caries were included in the present study. Two hundred twenty-three teeth with approximal caries were restored with two bulk-fill composites (Tetric-N Ceram Bulk fill [TEC], Filtek Bulk Fill [FB]) and a posterior resin composite (Gradia Direct Posterior [GDP]). Two experienced dentists clinically evaluated the restorations with a 5x magnification loupe using the modified United States Public Health Service (USPHS) criteria at baseline and at 24 months. Results: The chi-square test was performed for statistical analysis. The cumulative retention rate for all restorations at 24 months was 90.5%. Retention loss was observed for three TEC (6.1%), four FB (8.2), and seven GDP (14%) restorations. There was no statistically significant difference among the three resin composite restoration groups in color match, marginal adaptation, surface roughness, marginal discoloration, anatomical form, and secondary caries criteria (P&gt;0.05). Conclusion: Bulk-fill composite restorations in class II slot cavities have the same clinical results as traditional posterior composite restorations.

Clinical study of cervical caries treatment the effectiveness by assessing composite restorations condition

Background. Cervical caries is a fairly common teeth pathology and its treatment is carried out in complicated clinical conditions. Therefore, increasing the term of functioning of composite restorations is an urgent task. Aim. Identification of the effectiveness of a differential approach to dissection of hard dental tissues depending on the depth of enamel microcracks and implementation of professional hygiene in the treatment of cervical caries in the short- and long-term periods. Materials &amp; Methods. The study involved 50 people (average age [23.28±5.52] years) in whom cervical caries was treated in 72 teeth. All patients were divided into three equal groups based on the number of restorations according to the selected dissection technique and the chara­cteristics of professional hygiene. The dissection technique depended on the depth of the enamel microcracks in Main Group I (MG I), the dissection was carried out within the limits of clinically intact hard dental tissues in Control Group (CG) and Main Group II (MG II). The dental biofilm was removed from the vestibular surface of the teeth by the method of air-abrasive cleaning using the erythritol-based powder in MG I and MG II, the vestibular surface of the tooth was cleaned of dental deposits with a polishing paste without fluoride in CG. The quality of restorations was assessed based on the United States Public Health Service (USPHS) criteria on the day of restoration, 6 and 12 months later. The effectiveness of the prescribed treatment was identified by the dynamic indicators of the dental pulp electroexcitability and the electrical conductivity of the enamel. Results. There were no partial or completely destroyed restorations in all terms of the observation period. Composite restorations were preserved according to the criteria of "anatomical shape" and "color matching". One year later restoration defects were absent in 61 teeth (84.72%): in MG I – in 22 (91.67%), in CG – in 19 (79.17%), in MG II – in 20 (83.33%). Recurrent caries and symptoms of hypersensitivity were not identified in MG I. A slightly greater effectiveness of the treatment was noted in MG II group in comparison with CG (by 4.16%) that confirms the importance of removing the dental biofilm before restoration by the method of air-abrasive clea­ning using erythritol. Conclusions. The analysis of the state of restorations in the long-term period showed that the dissection technique and the features of professional hygiene affected their quality before restoration. The number of high-quality composite restorations was by 10.42% more on average in MG I than in the other groups. The obtained results make it possible to recommend the proposed method for using in practical dentistry. Keywords: electroodontology, electroodontometry, microcracks.

Clinical Survival of Reduced-Thickness Monolithic Lithium-Disilicate Crowns: A 3-Year Randomized Controlled Trial.

The aim of this randomized controlled trial was to see if the minimally invasive approach (reduced restoration thickness) would result in good clinical success of monolithic ceramic crowns compared to conventional layered all-ceramic crowns, and thus be an alternative to conventional tooth preparation. The ceramic that was investigated was IPS e.max lithium-disilicate ceramic produced using two different processing methods. A comparison was made between monolithic crowns with reduced thickness and standard layered crowns. Fifty-two patients, who had undergone endodontic treatment on either a premolar or molar, were randomly assigned into two groups. The teeth intended for layered crowns underwent to a 2 mm occlusal reduction with a 1 mm rounded shoulder, whereas the teeth intended for monolithic crowns underwent to a 1 mm reduction in the occlusal area with a 0.6 mm rounded shoulder. The clinical success was evaluated in eight categories using modified United States Public Health Service (USPHS) criteria. The observation period was 36 months, with control appointments every 6 months. There was no significant difference in clinical success between monolithic and conventional layered crowns after 3 years. One monolithic crown fractured while all other crowns were intact and the survival rate was 96%. All layered crowns were intact and the survival rate was 100%. The results of this study indicate that the minimally invasive approach can be a good alternative to conventional tooth preparation. IPS e.max lithium-disilicate ceramic demonstrated an exceptional three-year survival rate independently of the thickness of the material.

1-year Results of Molar Incisor Hypomineralization-affected Cases Treated with Silver Modified Atraumatic Restorative Treatment: A Retrospective Study.

Silver-modified atraumatic restorative treatment (SMART) can be an alternative method for molar incisor hypomineralization (MIH)-affected cases. The purpose of this study was to assess whether tooth location and cavity preparation affect the clinical success of MIH-affected permanent molars treated with the SMART technique. Modified United States Public Health Service criteria were utilized for the analyzes. The clinical records (3, 6, and 12 months) of 19 MIH-affected cases (6-12 years; no spontaneous pain and percussion/palpation sensitivity) treated with the SMART technique were assessed. The groups were allocated based on tooth location (mandibular-maxillary) and cavity preparation (class 1-2). The Fisher exact the Chi-squared test was utilized, and the p-value < 0.05 was accepted as statistically significant. Overall success rates were 94.7% at 3 and 6 months and 52.63% at 12 months. Clinical success did not differ statistically regarding location (p > 0.05). The class 1 cavity preparation group was found to be significantly more successful at the 12-month assessments (p = 0.033). The class of cavity preparation may affect the success of the treatment in long-term assessments. The SMART technique, especially in class 1 occlusal restorations, can be recommended as a short-term alternative to traditional treatment methods for MIH-affected cases. Bal C, Sozuoz MA, Sari MBD, et al. 1-year Results of Molar Incisor Hypomineralization-affected Cases Treated with Silver Modified Atraumatic Restorative Treatment: A Retrospective Study. Int J Clin Pediatr Dent 2024;17(6):683-689.

Long-term performance of ceramic in/-onlays vs. cast gold partial crowns – a retrospective clinical study

ObjectivesTo assess the long-term clinical performance of ceramic in-/onlays (CIOs) and cast gold partial crowns (CGPCs) in posterior teeth in terms of success, survival, complications (biological, technical) and quality.Material and methodsIn a retrospective study, a total of 325 patients were recorded after up to 24.8 years (mean 13.9 ± 3.8 years) having (pre-)molars restored with CIO (Empress I, Ivoclar Vivadent, n = 161) and CGPC (Degunorm, DeguDent, n = 164) by supervised undergraduate students. A total of 296 restorations were assessed clinically and radiologically in healthy and endodontically treated teeth using modified United States Public Health Service (USPHS) criteria. Cumulative success and survival rates of the restorations were calculated using Kaplan–Meier estimates. Biological and technical complications were recorded. Status of oral health comprising caries risk and localized periodontitis were assessed.ResultsThe cumulative success rates of CIOs were 92.1% and of CGPCs 84.2% after mean service times of 14.5 years. The annual failure rates of total service times were 0.5% in teeth restored with CIO (n = 155) and 0.7% in teeth restored with CGPC (n = 163). The cumulative survival rates of CIOs were 93.9% after a mean service time of 15.2 years and decreased to 91.7% after 23.5 years. The cumulative survival rates of CGPCs were 92.6% after a mean service time of 14.9 years and 91.8% after 23.5 years. Complications in CIOs (n = 149) were ceramic fracture (6.7%), secondary caries (4.7%), endodontic complication (2.7%) and tooth fracture (1.3%) compared to CGPCs (n = 147) with endodontic complication (8.8%), secondary caries (4.8%) and decementation (2.0%). Endodontically treated teeth restored with CIO or CGPC revealed significantly less often success compared with corresponding vital teeth (p = .02). CIOs and CGPCs revealed clinically and radiographically good and excellent qualities with 71.8% (107/149) and 68% (100/147) without any significant differences regarding type of restoration.ConclusionsBoth CIOs and CGPCs achieved high survival rates up to 24.8 years when performed by supervised undergraduate students. The longevity of the restorations may benefit from the intraoral repair of accessible defects and, in case of pulp infection or necrosis, an adequate endodontic management.Clinical relevanceCIOs and CGPCs made by supervised undergraduate students are proper restoration types in posterior teeth in the long-term. An adequate preparation design, meticulous care in the inserting technique and constant biofilm removal due to proper oral hygiene combined with professional maintenance care are substantial. The clinical long-term performance was mostly limited by ceramic fractures in CIOs and endodontic complications in CGPCs.

Evaluation of pre-heated composite resins with soft-start polymerization and conventional composite restorations in class-I carious lesions – A randomized clinical trial

BackgroundBy increasing fluidity and conversion, pre-heated composites enhance adaptability and strength, while soft-start polymerization decreases internal stresses. AimOver a period of a year, this split-mouth design, randomized controlled clinical trial (RCT) compared pre-heated composites with soft-start polymerization to conventional composites in class-I lesions, with the goal of improving restoration outcomes. Methodsand Findings: Immediately following ethical approval and registration with CTRI, 37 patients with in-formed permission who met specified inclusion and exclusion criteria for class-I lesions were chosen for enrollment. Using a 1:1 ratio, teeth were randomly assigned to Group-A (pre-heated composite with soft-start polymerization) or Group-B (traditional composite restoration). At three-time intervals, the evaluation was blinded and calibrated using Modified United States Public Health Service (USPHS) criteria: baseline, six-month, and one-year marks. Statistical analysis was performed using SPSS 21.0 and the Mann-Whitney U test for inter-group comparisons and the Friedman test for intra-group comparisons. InterpretationPre-heated composites with soft-start polymerization performed better in terms of marginal adaptation with a statistically significant difference (p = 0.019) and in terms of color match they performed better clinically (p = 0.062) at 12 months. Other variables like marginal discolouration, sec-ondary caries, anatomic form, post-operative sensitivity, surface texture and retention showed no statistically significant difference (p < 0.05). Pre-heated composites with soft-start mode performed marginally better than nanofilled composites. However, both techniques can be used to successfully restore simple class-I carious lesions.

Monolithic Zirconia Single Crowns Supported by Narrow- or Standard-Diameter Titanium-Zirconia Implants in Posterior Sites: 1-Year Results of a Randomized Controlled Trial.

To compare the prosthetic outcomes of screw-retained monolithic zirconia (Zr) single crowns supported by either narrow-diameter (3.3 mm) or standard-diameter (4.1 mm) tissue-level titanium-zirconia (TiZr) implants in posterior sites. A total of 18 participants, each with a missing molar or premolar tooth requiring an implantsupported single crown, were randomly assigned to either the test or control group. All participants received screwretained monolithic Zr single crowns supported by single tissue-level TiZr implants. Test group participants received narrow-diameter implants (3.3 mm), whereas control group participants received standard-diameter implants (4.1 mm). A modified version of the United States Public Health Service (USPHS) criteria was used to assess the prosthetic outcome across 12 parameters after 1 year of function. Data were analyzed descriptively, and statistical analysis was performed using a statistical software (SPSS, Version 28.0; IBM) with the level of significance set at P < .05. Of the 18 single crowns delivered, 16 were available for review at the 1-year follow-up, including 7 in the test group and 9 in the control group. Patient characteristics and crown site distribution were similar, with no significant differences observed between the two groups (chi-square test; P < .05). There were no crown failures, meaning a crown survival rate of 100% was achieved after 1 year. The prosthetic outcome based on USPHS criteria was comparable between the two groups with no significant differences observed (chi-square test; P < .05). There were 19 prosthetic events in total (10 in the test group and 9 in the control group), with no significant differences between the groups (chi-square test; P < .05). Loss of proximal contact was the dominant event, with a total of eight events (three in the test group and five in the control group). Patient satisfaction after 1 year was high in both treatment groups, with no significant differences detected. Screw-retained monolithic Zr single crowns supported by either narrow- or standard-diameter tissue-level TiZr implants in posterior sites have comparable prosthetic outcomes after 1 year. Long-term results from well-designed trials are still needed to validate the findings of the present study.

Clinical outcomes of self-glazed zirconia veneers produced by 3D gel deposition: a retrospective study

BackgroundSelf-glazed zirconia (SZ) restorations are made by a novel additive three-dimensional gel deposition approach, which are suitable for a straightforward completely digital workflow. SZ has recently been used as minimally invasive veneer, but its clinical outcomes have not been clarified yet. This study aimed to evaluate the preliminary clinical outcomes of SZ veneers compared with the widely used lithium disilicate glass–ceramic veneers made by either pressing (PG) or milling (MG) process.MethodsFifty-six patients treated with SZ, PG, and MG veneers by 2 specialists between June 2018 and October 2022 were identified. Patients were recalled for follow-up at least 1 year after restoration. Clinical outcomes were assessed by 2 independent evaluators according to the modified United States Public Health Service (USPHS) criteria. Overall patient satisfaction was assessed using visual analogue scale (VAS), and analyzed by one-way ANOVA. Chi-square test was applied to compare the difference in the success and survival rates among the 3 groups.ResultsA total of 51 patients restored with 45 SZ, 40 PG, and 41 MG veneers completed the study, with a patient dropout rate of 8.9%. Mean and standard deviation of follow-up period was 35.0 ± 14.7 months. All restorations performed well at baseline, except for 2 SZ veneers with mismatched color (rated Bravo). During follow-up, marginal discrepancy (rated Bravo) was found in 4 MG veneers and 1 PG veneer, and partially fractured (rated Charlie) was found in another 2 PG veneers. The survival rate of SZ, PG, and MG veneers was 100%, 95%, and 100%, with a success rate of 95.56%, 92.50%, and 90.24%, respectively, none of which were significantly different (p = 0.099 and 0.628, respectively). The mean VAS score of SZ, PG, and MG was 95.00 ± 1.57, 93.93 ± 2.40, and 94.89 ± 2.00 respectively, without significant difference (p > 0.05).ConclusionSZ veneers exhibited comparable preliminary clinical outcomes to PG and MG veneers, which could be considered as a feasible option for minimally invasive restorative treatment.