Replacement Of Restorations Research Articles

ТЕРАПЕВТИЧЕСКИЕ СПОСОБЫ ЛЕЧЕНИЯ ДИСКОЛОРИТА ЗУБОВ

The problem of discoloration of teeth, especially accompanied by increased sensitivity, does not lose its relevance in modern dentistry. Despite the presence in the arsenal of dentists of a significant number of means and methods for solving this problem, it does not go away, but, on the contrary, is overgrown with new complaints. In this work, we analyzed the frequency to analyze the frequency of choice of therapeutic methods for treating discoloration of teeth by patients of dental clinics. A questionnaire was developed for a dentist on the patient's choice of a therapeutic method for eliminating dental discoloration and a survey of 30 dentists (10 - therapists, 10 - orthopedists and 10 - general dentists) was conducted for 2019 and 6 months of 2020. It was found that during this period, 184 out of 331 patients who applied to dental clinics with this problem used therapeutic methods for eliminating tooth discoloration: tooth enamel coating with varnish ("Colordent" + adhesive "Single Bond") was carried out in 16.6% of patients, clinical bleaching of enamel in 32.6% of patients with tooth discoloration, intracoronal bleaching followed by direct restoration (replacement of existing fillings with new ones) in 53.8%. The analysis showed that therapeutic methods for eliminating discoloration of teeth predominate slightly, 55%. Of course, in choosing this direction, the doctor is guided by the clinical situation, IROPZ, taking into account the wishes of the patient and his capabilities. However, it seems necessary to develop and test new, gentle and resistant to mechanical stress methods for eliminating discoloration of economy-class teeth with the possibility of solving the problem of increased tooth sensitivity.

Teaching of the repair of defective composite restorations in Middle Eastern and North African Dental Schools

ObjectivesTo evaluate the status of teaching of repair of defective resin-based composite restorations in dental schools in the Middle Eastern and North African (MENA) countries. MethodsA validated 14-item questionnaire was mailed to the directors of the operative/restorative dentistry department in 40 MENA dental schools. Data were collected on teaching, including whether the repair of resin-based composite restorations was part of the dental school curriculum; the rationale behind the teaching; how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability and expected longevity of the repair procedure. ResultsThirty-two schools responded to the survey (response rate of 80%). Twenty-two (69%) schools reported the teaching of resin-based composite repairs as an alternative to the replacement of restorations. Of the schools not teaching repairs, 80% indicated that they plan to include this topic in the curriculum within the next five years. Most schools taught theoretical and practical aspects of repair at a clinical level only. Two-thirds of schools reported tooth substance preservation being the main reason for teaching repair techniques. The main indications for repair treatment were marginal defects (59%), followed by partial loss of restoration (56%). Most schools that performed repairs reported high patient acceptability. Considerable variation was noted in relation to expected longevity of resin- based composite repairs. ConclusionsThe repair of defective resin-based composite restorations is actively taught within most of the surveyed schools. Advantages of repair, compared to replacement include minimum intervention, preservation of tooth structure, and savings of time and cost. Clinical significanceThe decision between replacing or repairing a defective resin-based composite restoration in the MENA region tends to be based on clinicians’ subjective experience and judgement. However, to further enhance the teaching of resin-based composite repair standardised guidelines need to be developed based on existing evidence.

The Level of Knowledge Among Dentists and Dental Students in Saudi Arabia Regarding Repair versus Replacement of Composite Restorations

The Level of Knowledge Among Dentists and Dental Students in Saudi Arabia Regarding Repair versus Replacement of Composite Restorations

Knowledge, Attitude, and Practice of Resin Composite Repair among Libyan Practitioners

Aim: To examine the contemporary knowledge, attitude and practice of resin composite repair procedures among dental clinicians in Benghazi – Libya.
 Methods: A survey questionnaire, which consisted of twenty questions, was designed and distributed electronically to 270 graduated dentists in Benghazi - Libya. The questions sought information in relation to the knowledge, attitude and practice of the repair procedures for defective resin composite restorations.
 Results: The survey response rate was 94%. The findings of the study showed that 143 (56.3%) of the participants were taught about resin composite repair during undergraduate, postgraduate studies, or from other sources. The respondents indicated that the most common indication for composite repair was secondary caries (24.8%) followed by fracture of restoration (18.5%), partial loss of restoration (18.1%), discoloration (17.3%), defective margin, and defective contour (9.1%). Moreover 71% of the participants performed composite repair in dental clinics. The study results revealed that the majority of the dentists (72%) considered the repaired composite restoration as a permanent filling. Most of the participants (43.3% strongly agreed, 43.7% agreed) in Benghazi believed teaching of composite repair technique should be included in the academic curriculum. In conclusion, resin composite repair is a well-established procedure among Libyan practitioners in Benghazi, which is considered a legitimate alternative to total restoration replacement.

Дверной портал крымских ханов эпохи итальянского Возрождения: визуальная культура в Крыму в раннее Новое время

The article is a translation from English of the scientific work of the Turkish historian Nikole Kançal Ferrari: “An Italian Renaissance Gate for the Khan: Visual culture in Early Modern Crimea”. The article deals with the issue of foundation and identification of the author of the Iron Door (Demir Kapu) project in Backchisarai. The article also considers the question of the original location and date of installation of the project. This is rather difficult task due to the intensive restoration works and replacement of many decayed decorative components of the portal. The accurate analysis of the original appearance of the monument is almost impossible. In this regard, the analysis and research of the other sources is carried out except for the gates of the Topkapi Palace in Istanbul and the surviving inscriptions of the Crimean Khanate.

English

With increased dental awareness, there has been a growing trend in patients who are opting for teeth retention, so post-endodontic restorations play a significant role in dictating restoration longevity. However, till date restoration of root canal treated teeth is still controversial. Root canal treated teeth often suffer from extensive loss of tooth structure because of access cavity preparation, caries removal, replacement of restoration and trauma.1 Traditionally the restorative material of choice for an endodontically treated molar would be post and core followed by metal / ceramic crowns. However, studies have shown that these intra-canal posts may increase risk, of undermining the residual tooth structure, root perforation and catastrophic failures.2 With adhesive strategies, there has been a paradigm shift towards post-less restorations and utilisation of pulp chamber as an extension, thus integrating the crown and core as a single unit or monobloc. 2,3 This was the concept of the endocrown technique. 3 Bindle and Mormann first, delineated the use of porcelain adhesive endodontic crowns.4 Endocrowns are more practical, conservative, aesthetic, simple to fabricate, economical, less time consuming and allows favourable distribution of masticatory stresses. Most studies on endocrowns showed comparable or somewhat superior results to other conventional treatments for endodontically treated teeth (ETT). However, the available literature is based largely on the use of ceramic endocrowns. 2-4 It was observed that data pertaining to endocrown fabrication with other indirect restorative materials is still limited, and the choice is still unclear.Indirect composites show enhanced mechanical properties, creation of ideal contacts and contours, favourable wear, aesthetics and can serve as an economical alternative to ceramics.5 Hence, this paper attempts to present a case report of functional and aesthetic rehabilitation of an endodontically treated molar with an endocrown restoration utilising indirect composite (SR Adoro System).

Vertical Bite Rehabilitation of Severely Worn Dentitions with Direct Composite Restorations: Clinical Performance up to 11 Years.

Our aim was to evaluate the clinical performance of direct composite restorations placed in patients with severely worn dentitions at an increased vertical dimension of occlusion, after up to 11 years. One hundred and sixty-four teeth in 13 patients with severely worn dentitions had been reconstructed with either microhybrid (first cohort; n = 59) or nanofilled (second cohort; n = 105) composite restorations at increased vertical dimension of occlusion using a wax-up-based template-aided placement technique. From the dental records, information about repair and replacement of restorations was obtained. Patients were clinically examined after a mean follow-up time of 10.7 years (first cohort) or 5.2 years (second cohort) using United States Public Health Service (USPHS) criteria. Subjective patient satisfaction was also recorded using visual analogue scales (VAS). The overall quality of the restorations was good with predominantly ‘Alpha’ and ‘Bravo’ scores, respectively. Nanofilled composite showed less surface degradation and better margin qualities than microhybrid composite. Of the 59 restored teeth in the first cohort, 13 restorations showed unfavorable events after 10.7 years, of which ten could be repaired. In the second cohort, 23 of 105 restorations showed unfavorable events, which could all be repaired. VAS scores revealed high patient satisfaction with the treatment approach. In conclusion, direct composite restorations placed at an increased vertical dimension of occlusion show good clinical long-term performance in patients with severe tooth wear.

Patch test of dental materials in Oral Lichen Planus with considering the role of saliva

Lichen planus is the most common skin disease that affects the oral mucosa. Oral Lichen Planus is a T-cell-mediated autoimmune disorder. In the current study, for the first time, an oral cavity condition in skin patch tests with adding saliva is simulated. In addition, the patch results are compared with healthy subjects. Forty-one OLP patients and 63 healthy subjects were enrolled in the study. All participants were provided with patch tests, including allergens, in combination with saliva in chambers. Allergens from the European baseline (standard) series selected according to the most prevalent positive results in the previous study were applied. Positive results of Mercury and Cobalt tests were significantly higher in the case group. In this study, the differentiation of patients with lichen planus and lichenoid was identified according to the Van der Meij & Van der Waal criteria. The patch test was conducted for healthy individuals as well. The most important of all was the use of patients' saliva in the patch test, done for the first time in this field. In the case of OLP, a patch test can help identify positive reactions to dental materials; thus, the replacement of dental restorations may be needed.

DENTISTRY IN THE POST COVID-19 WORLD

With the advent and widespread use of vaccines against the COVID-19 virus, the world finally seems ready to begin its journey into the post COVID era. Like the rest of the world, dentistry had also grind to a halt. Aerosols, a routine byproduct of our work had now morphed into a carrier of a potentially fatal disease, for both patients and dentists alike. All the focus during this pandemic was on limiting aerosol generation and its expulsion from the dental offices so that they can stay open to provide services to the community and also sustain the families and households attached to these practices.Like the previous pandemics, which served as stepping stones towards better infection control practices, the COVID-19 pandemic actually served as a validation of the Centre for Disease Control (CDC) and Health Technical Memorandum (HTM) 105 guidelines in helping to protect dentists from this disease. One large scale survey conducted by the American Dental Association on 2400 dentists found that less than 1% were afflicted by the virus. Those afflicted had actually contracted the disease from family members, and not their practices. This shows that while following the minimum standards was protective, there is a need of moving towards the best practice standards to maintain and increase the quality of dental care.This pandemic has also served as catalyst for the growth of teledentistry, online conferences and webinars. There is now renewed focus on how to limit our dependence on handpieces and bringing back hand instruments for caries and calculus removal. Replacement of restorations is now old news, and more attention is being paid to its repair. All this is being done to reduce aerosol production and exposure as it will take up to a year or more to ensure worldwide vaccination. Hence the threat of a virus mutation and a potential fourth wave are risks still at large. Therefore, some of these changes are temporary and some might become permanent. All these lessons must be kept in mind and regularly refreshed as we learn to practice dentistry in this new world.

Negligible therapeutic impact, false-positives, overdiagnosis and lead-time are the reasons why radiographs bring more harm than benefits in the caries diagnosis of preschool children

BackgroundTo evaluate the clinical course and interventions required during two years of follow-up of dental surfaces of deciduous molars diagnosed, and consequently treated, by two different strategies: diagnosis made by clinical examination alone or associated with radiographs.MethodsThis is a secondary analysis of a two-arm randomized clinical trial with parallel groups related to the diagnostic strategy for caries detection in preschool children. 216 children (3–6 years old) were followed-up for two years. All dental surfaces were diagnosed by visual inspection and later, through radiographic assessment. Baseline treatment was made in accordance with the results obtained by visual inspection performed alone or combined with radiographic method, considering the allocated group. Dental surfaces with no restoration needs, or those restored at the beginning of the study were followed-up for two years. The treatment decision was made according to the allocated group. The outcome was the occurrence of failure (a new caries lesion or a restoration replacement) during the follow-up.Results4383 proximal and occlusal surfaces of deciduous molars in 216 preschool children were diagnosed and treated according to the abovementioned diagnostic strategies and followed-up for 24 months. The assessment of radiographs made change the initial decision reached by visual inspection in about 30% of the surfaces when all types of interventions were considered. However, most disagreements occurred for initial lesions, where radiographs tended to underestimate them. Discordances between methods occurred in less than 5% of all surfaces when considered lesions requiring operative treatment. For discrepancy cases, the placed interventions guided by following the radiographic results did not present less failures against those made following only visual inspection. As a matter of fact, the use of radiographs in the diagnostic strategy for caries detection in children brought more harms than benefits due to the occurrence of false-positives, overdiagnosis and lead-time bias.ConclusionsSimultaneous association of visual inspection and radiographic assessment for caries detection in preschool children causes more harms than benefits, and therefore, visual inspection should be conducted alone in the regular clinical practice.Trial registration Clinicaltrials.gov platform: NCT02078453, registered on 5th March 2014.

Defective restoration repair or replacement: An American Dental Association Clinical Evaluators Panel survey

BackgroundClinicians often encounter defective restorations and are faced with the difficult decision of whether to repair the existing restoration or replace it. MethodsAn electronic survey on repairing or replacing defective restorations was developed to assess how clinicians are making these decisions and the technical aspects considered when making a repair. E-mails containing the survey link were sent to the American Dental Association Clinical Evaluators (ACE) Panel on August 14, 2019, and the survey remained open for 2 weeks. Nonrespondents were sent reminders 1 week after deployment. ResultsApproximately 4 of every 5 respondents repair defective restorations. The top 3 conditions for making these repairs were noncarious marginal defects (87%), partial loss or fracture of the restoration (79%), and crown margin repair due to carious lesions (73%). Among respondents who repair defective restorations, almost all repair direct resin composite (98%), whereas approximately one-third do not repair the other restorative materials (that is, amalgam, glass ionomer, and fractured indirect all-ceramic crowns). Resin composite is used most often to repair resin direct composite restorations, and likewise, glass ionomer is used most often to repair glass ionomer restorations. Only 54% of respondents use amalgam to repair amalgam restorations. Surface treatments varied among the 3 available restorations types. ConclusionsMany dentists are actively making restoration repairs, but choosing clinical scenarios to make these repairs is material dependent. Practical ImplicationsThe repair of defective restorations is an acceptable and more conservative alternative than restoration replacement, and its success depends on proper case selection, material, and technique.

Knowledge about composite restorations repair vs replacement- a survey among a subpopulation of saudi dental students

Objectives: the purpose of this study was to evaluate the knowledge among dental students at King Khalid University, Jazan University, and Najran University in the kingdom of Saudi Arabia about when to repair or replace defective direct composite restoration. Materials and Methods: A questionnaire-based survey was formulated, pursuing the information about management (repair/replacement) of defective composite restorations and distributed among 200 dental students of three universities in the southern region of the kingdom of Saudi Arabia.The data were collected with the help of an online questionnaire. Data entry and the analysis were done using the statistical software package SPSS version 20.0. It was presented using descriptive statistics in the form of frequencies and percentages for qualitative variables, and range means and standard deviations for age, quantitative variable. Analytic statistics ere done using Chi-Square tests (x2) to test the significant difference between categorical variables. The level of significance, the p-value was 0.01 (p < 0.01). Results: The decision to choose between composite repair or replacement was influenced by whether this topic was taught to them at various undergraduate levels during Bachelor of Dental Surgery. The reason associated with the decision to repair defective composite restorations, 76% reported as cost-effective followed by Increased longevity (71%), the permanent filling (70%), patient’s preference for repair (65%), and least time consuming (50%). 67% participants preferred significantly (p<0.001) repair due to secondary caries in the previously restored tooth with composite, followed by the small surface defect in a composite restoration (65%), risk of pulpal damage significantly (p<0.001) in a defective composite restoration (62.5%) and more invasive and destructive treatment option (35%). More than half of respondents 123 (61.5%) reported that they were not taught about composite repair during the Bachelor of Dental Surgery. Conclusion: It is suggested with the help of our study that didactic and clinical training components regarding composite repair should be seriously included in the teaching curriculum of dental institutions as it is in the best interest of the patient. Dental students should be provided with clinical training on this topic so that they can follow proper decision-making protocols available during repair or replacement of defective resin composite restorations. Other researches in the future can be carried out for refining the guidelines and techniques utilized for composite repair. KEYWORDS Composite restoration; Discoloration; Polymerization shrinkage; Secondary caries.

Association of age and gender of patients who underwent amalgam restoration in mandibular premolars with class 1 dental caries

The presence of dental caries is the main reason for the placement and replacement of restorations. Maintaining restorations to a satisfactory clinical condition is a big challenge for the practitioners. The aim of the study is to associate the age and gender of the patients who underwent amalgam restorations in mandibular premolars with class 1 dental caries. This was a descriptive study, where all the patients data were collected by reviewing patients records and analysing the data of 86000 patients reported from June 2019 to March 2020 to the Department of conservative dentistry and endodontics, Private Dental college and hospitals, Chennai. Data was collected and tabulated, statistical analysis was done by SPSS – IBM. In this study, we observed that there is a significant difference between the age, gender and tooth number of patients who underwent amalgam restoration in mandibular premolar with class 1 dental caries. Amalgam restoration has served the profession well, and it is very useful in restorative dentistry. Thus the use of amalgam can be continued as a material of choice if esthetics is not a concern.

Minimal Invasive Dentistry: Literature Review

Minimally invasive procedures are the new paradigm in health care. Everything from heart bypasses to gall bladder, surgeries are being performed with these dynamic new techniques. Dentistry is joining this exciting revolution as well. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralisation and minimal intervention for the placement and replacement of restorations. Minimally invasive dentistry reaches the treatment objective using the least invasive surgical approach, with the removal of the minimal amount of healthy tissues. This paper reviews in brief the concept of minimal intervention in dentistry.

Influence of different clinical criteria on the decision to replace restorations in primary teeth

ObjectivesThis cross-sectional study is nested in a randomized clinical trial. It was designed to evaluate the influence of using two different clinical criteria to assess caries lesion around restorations on the decision to replace restorations in primary posterior teeth. Variables that might influence this decision were also considered. MethodsOne trained and calibrated examiner assessed 550 restorations of 160 children (3–10 years old). Children were randomized to have their restorations evaluated and subsequently treated according to World Dental Federation (FDI) or Caries Associated with Restorations and Sealants (CARS) criteria. After reaching the treatment decision, the same examiner performed another evaluation using the other criteria. Spearman’s correlation coefficients and 95 % confidence intervals (95 %CI) between the scores obtained with both criteria and respective treatment decisions were calculated. Poisson multilevel regression analysis were performed between the exploratory variables related to children, restored tooth and restoration assessment; the outcome variables were decisions related to restoration replacement, any operative intervention and presence of secondary caries. ResultsThe strongest correlation observed between the methods was for recurrence of caries. A total of 94 restorations (17.1 %) were indicated for replacement with FDI criteria and 30 (5.5 %) were indicated for replacement with CARS. Besides the diagnostic method used, number of decayed teeth and restorations with two and three restored surfaces were associated with the decision of replacement and presence of recurrent caries lesions. ConclusionsThe decision to replace posterior restorations in primary teeth is influenced by the criteria used for the restorations assessment and also by the children's caries experience and multisurface restorations. The restoration material did not influence the decision of restorations replacement. Clinical significanceThe decision to replace posterior restoration in primary teeth is strongly related to the evaluation method and not only by patients' risk factors.

Synthesis of an anti-cariogenic experimental dental composite containing novel drug-decorated copper particles

Secondary caries is one of the most major cause for re-placement of dental composite restorations. Targeting the survival of cariogenic bacteria residing on the restoration surface may reduce this problem. The present study aims to evaluate the antibacterial potential as well as assess the physical and chemical properties of experimental dental composites containing novel drug-decorated copper particles (DDCP) as adjunct antibacterial filler particles. These were incorporated at concentrations of 0%, 0.5%, 0.10%, 0.20%, and 0.25% (w/w) into experimental composite consisting of methacrylate monomers and silanized silica fillers. RESULTS: Direct contact test revealed that the anti-cariogenic potential of experimental composites was more than the control groups. The cell viability assay showed no toxic effect on MC3T3-E1 cell lines in the MTT assay. The microhardness of experimental composites increased as the percentage of DDCP increased, however, the degree of cure was increased only up till the concentration of 0.20%. The release kinetics of the composites reveals that even after 28days there was a steady and slow release of copper particles signifying the sustained anti-cariogenic effect. CONCLUSION: The experimental composites have good anti-cariogenic potential, which was sustained for one month without any deleterious effect on the physical and chemical properties of resin dental composites.

A Questionnaire-Based Survey Assessment of Iraqi Dentists Using Repair Versus Replacement of Defective Composite Restoration

Tooth restoration one of the most common procedures in dental practice. The replacement of the entire restoration leads to loss of tooth structure and increase risk of pulp injury; replacement is also time consuming and costly. According to the minimally invasive approach when minimal defects, repair is the better choice than the total replacement of the restoration. This study aims to evaluate repair rating versus replacement treatment procedure for defective composite fillings among Iraqi dentists. Material and methodology: A questionnaire survey were designed and distributed to 184 post-graduate dentists in Iraq. The inquiry pertained general information; including their clinical experience in years, their preference in terms of direct composite restoration, repair or replacement of old restorations, whether they taught the indications for repair, and the selection type of composite for repair. Result of 200 questioner’s disrepute, 184 questionnaires were completed and collected. The data revealed that the respondents with 1-5, 6-15 and16-25 years of experience were 62 (33.7%), 75 (40.8%), and 47(25.5%) of total respondents, respectively. The total 174 dentists (94.6%) prefer using tooth-colored restorations and 10 (5.4%) dislike this approach. Result clearly indicate that most of the dentists choose replacement for any fractured or discolored restorations. The data showed that 59.2% of dentist are not familiar with repair, and 40.8% dentists are familiar. The result revealed that 82.1% the dentists were not trained on repair during their undergraduate study. Generally, they had no ideal standard to replace or repair depending on their clinical experience. Therefore, clear criteria and guidelines for replacing and repairing should be developed and followed in post-graduate courses.

Quality of Information Regarding Repair Restorations on Dentist Websites: Systematic Search and Analysis.

BackgroundRepairing instead of replacing partially defective dental restorations represents a minimally invasive treatment concept, and repairs are associated with advantages over complete restoration replacement. To participate in the shared decision-making process when facing partially defective restorations, patients need to be aware of the indications, limitations, and advantages or disadvantages of repairs. Patients are increasingly using the internet to gain health information like this online.ObjectiveWe aimed to assess the quality of German-speaking dentist websites on repairs of partially defective restorations.MethodsThree electronic search engines were used to identify German-speaking websites of dental practices mentioning repairs. Regarding information on repairs, websites were assessed for (1) technical and functional aspects, (2) comprehensiveness of information, and (3) generic quality and risk of bias. Domains 1 and 3 were scored using validated tools (LIDA and DISCERN). Comprehensiveness was assessed using a criterion checklist related to evidence, advantages and disadvantages, restorations and defects suitable for repairs, and information regarding technical implementation. Generalized linear modeling was used to assess the impact of practice-specific parameters (practice location, practice setting, dental society membership, and year of examination or license to practice dentistry) on the quality of information. An overall quality score was calculated by averaging the quality scores of all three domains and used as primary outcome parameter. Quality scores of all three domains were also assessed individually and used as secondary outcomes.ResultsFifty websites were included. The median score of quality of information was 23.2% (interquartile range [IQR] 21.7%-26.2%). Technical and functional aspects (55.2% [IQR 51.7%-58.6%]) showed significantly higher quality than comprehensiveness of information (8.3% [IQR 8.3%-16.7%]) and generic quality and risk of bias (3.6% [IQR 0.0%-7.1%]; P<.001/Wilcoxon). Quality scores were not related to practice-specific parameters (P>.05/generalized linear modeling).ConclusionsThe quality of German-speaking dentist websites on repairs was limited. Despite sufficient technical and functional quality, the provided information was neither comprehensive nor trustworthy. There is great need to improve the quality of information to fully and reliably inform patients, thereby allowing shared decision making.

Type and time of first re-intervention of posterior restorations – 13-year scenario at the public dental service

Objectives: We investigated the first re-interventions of two- and three-surface direct restorations on posterior teeth, specifically noting the type and time of the first re-intervention.Materials and methods: In 2002, altogether 5542 posterior two- and three-surface composite and amalgam restorations were done for 3051 patients aged 25–30 years at Helsinki City Public Dental Service (PDS). Based on electronic patient records, we analysed all restorations (n = 2445) having re-intervention during a 13-year follow-up. We recorded the type of tooth, restoration size, and type of first re-intervention. The time to re-intervention was the interval between the date of the placement of restoration at the year 2002 and its first re-intervention.Results: Restorative treatment was the most common (77.9%) first re-intervention, followed by endodontics (11.5%), extractions (5.2%), and other (5.4%). Males, more frequently than females, had extraction or endodontics as first re-intervention. The average time to re-intervention was 5.7 years (SD 3.8; median 5.2). Both median and mean times were shortest for cases involving endodontics or extractions.Conclusions: For the majority of two- and three-surface posterior restorations, the first re-intervention is restorative (replacement or repair of restoration). The shortest time to re-intervention is for restorations that have endodontics or extraction as the first re-intervention.

Cerium Dioxide Particles to Tune Radiopacity of Dental Adhesives: Microstructural and Physico-Chemical Evaluation.

The insufficient radiopacity of dental adhesives applied under composite restorations makes the radiographic diagnosis of recurrent caries challenging. Consequently, the misdiagnosis may lead to unnecessary replacement of restorations. The aims of this study were to formulate experimental dental adhesives containing cerium dioxide (CeO2) and investigate the effects of different loadings of CeO2 on their radiopacity and degree of conversion for the first time. CeO2 was characterized by X-ray diffraction analysis, Fourier transforms infrared spectroscopy, and laser diffraction for particle size analysis. Experimental dental adhesives were formulated with CeO2 as the inorganic filler with loadings ranging from 0.36 to 5.76 vol.%. The unfilled adhesive was used as a control. The studied adhesives were evaluated for dispersion of CeO2 in the polymerized samples, degree of conversion, and radiopacity. CeO2 presented a monoclinic crystalline phase, peaks related to Ce-O bonding, and an average particle size of around 16 µm. CeO2 was dispersed in the adhesive, and the addition of these particles increased the adhesives’ radiopacity (p < 0.05). There was a significant decrease in the degree of conversion with CeO2 loadings higher than 1.44 vol.%. However, all materials showed a similar degree of conversion in comparison to commercially available adhesives. CeO2 particles were investigated for the first time as a promising compound to improve the radiopacity of the dental adhesives.