Restoration Of Posterior Teeth Research Articles

Comparative Evaluation of Microleakage in Posterior Primary Tooth Restorations

Comparative Evaluation of Microleakage in Posterior Primary Tooth Restorations

Comparative Evaluation of Microleakage in Posterior Primary Tooth Restorations

Comparative Evaluation of Microleakage in Posterior Primary Tooth Restorations

Clinical, radiographic and biochemical assessment of proximal cavities restored with composite resin using incremental vs. bulk packing techniques: One-year randomized clinical trial

BackgroundBulk-fill resin composites may suffer from recurrent caries around compound proximal restorations in posterior teeth, especially at the proximo-gingival interface.Over 12 months, will the bulk fill technique affect the caries recurrence rate at gingival margins when compared to the conventional incremental packing technique? How early will the first clinical, radiographical, and biochemical evidence of caries recurrence occur?MethodsAfter randomization, in 30 patients with two compound (OM or OD) supragingival lesions, one tooth was restored using the bulk fill technique on one side (group 1) (n = 15). In contrast, the other tooth on the other side was restored utilizing the incremental layering technique (group 2) (n = 15). Both teeth received restorative material (X-tra fil, Voco, Cuxhaven, Germany). The FDI criteria were used to evaluate restorations. As for the periodontal assessment, the gingival index, plaque index, papillary bleeding scoring index and periodontal pocket depth were evaluated. The gingival crevicular fluid (GCF) specimens were gathered, and MMP-9 was extracted and quantitated by ELISA. A customized radiographic template was designed, and 3D printed digital bitewing radiographs were taken. Assessments were done clinically, radiographically and biochemically at baseline (1 week) and after 3, 6 and 12 months. Data was statistically analyzed.ResultsThe null hypothesis was accepted clinically; no statistically significant differences appeared between bulk and incrementally filled posterior restorations. As for the radiographic assessment, the null hypothesis was accepted except for increased periodontal ligament width at 3 months. The null hypothesis for the biochemical evaluation was rejected as there were significant changes in levels of MMP-9 at different testing times.Conclusions1. With similar results but less sensitivity and significant time saving, the bulk fill technique can be considered an efficient alternative to the incremental fill technique in restoring proximal cavities. 2. Early evidence of caries recurrence can be correlated to an increase in the MMP-9 level in gingival crevicular fluid, followed by an increase in radiographic periodontal ligament width measurement.Trial registrationAn ethical approval from the Research Ethics Committee at the Faculty of Dentistry, October 6 University, (Approval No. RECO6U/5-2022). The study was registered at the Pan African Clinical Trials Registry on 24/07/2023 with an identification number (PACTR202307573531455).

The effect of adding pineapple leaf microfibers (Ananas comosus L. Merr) to packable composite resin on flexural strength

Composite resin is a restorative material often used for the aesthetic restoration of anterior and posterior teeth. Packable composite resin is indicated for posterior teeth because its resistance to pressure can reduce the problem of loss of contact. Flexural strength is a combination of compressive stress and tensile stress on the restoration of the teeth in the anterior and posterior areas while functioning in the oral cavity. A restorative material that cannot withstand the flexural force continuously can cause fractures. The addition of microfiber is capable of increasing the strength and mechanical properties, including the flexural strength of packable composite resin. This study aims to determine the influence of the addition of discontinuous microfiber on the flexural strength of packable composite resin. This type of research is a true experimental laboratory study with a post-test only control group design. The study used a total of 16 packable composite samples, divided into two groups: the control group without added discontinuous microfiber from pineapple leaf and the treatment group with the addition of discontinuous microfiber from pineapple leaf.

Interdisciplinary Delphi study by PROSEC North America: Recommendations on single indirect restorations made from ceramic and nonmetallic biomaterials for posterior teeth.

This article puts forward consensus recommendations from PROSEC North America regarding single indirect restorations made from ceramic and nonmetallic biomaterials in posterior teeth. The consensus process involved a multidisciplinary panel and three consensus workshops. A systematic literature review was conducted across five databases to gather evidence. The recommendations, informed by findings from systematic reviews and formulated based on a two-phase e-Delphi survey, emphasize a comprehensive treatment strategy that includes noninvasive measures alongside restorative interventions for managing dental caries and tooth wear. The recommendations advocate for selecting between direct and indirect restorations on a case-by-case basis, favoring inlays and onlays over crowns to align with minimally invasive dentistry principles. The recommendations highlight the critical role of selecting restorative biomaterials based on clinical performance, esthetic properties, and adherence to manufacturer guidelines. They emphasize the importance of precision in restorative procedures, including tooth preparation, impression taking, contamination control, and luting. Regular follow-up and maintenance tailored to individual patient needs are crucial for the longevity of ceramic and nonmetallic restorations. These PROSEC recommendations provide a framework for dental practitioners to deliver high-quality restorative care, advocating for personalized treatment planning and minimally invasive approaches to optimize oral health outcomes. The PROSEC North America recommendations highlight the importance of minimally invasive techniques in posterior tooth restorations using ceramic and non-metallic biomaterials. These principles prioritize tooth structure conservation and personalized treatment planning, essential for enhancing clinical outcomes and long-term oral health.

5-Year clinical performance of ceramic onlay and overlay restorations luted with light-cured composite resin

ObjectivesThis prospective clinical trial evaluated the clinical performance of ceramic partial coverage indirect adhesive restorations (PCIARs) in posterior teeth luted with a light-cured composite resin. MethodsFrom April 2016 to January 2017, a total of 60 patients (27 males, 33 females; mean age: 42.2 ± 10.86 years old) received 83 glass-ceramic PCIARs (26 onlay, 57 overlay) made of IPS Emax CAD (Ivoclar Vivadent). All restorations were luted with a light-cured composite resin (Filtek Z250, 3 M ESPE) by two operators. Two independent calibrated examiners blinded to the operators performing the treatment evaluated the restorations at baseline, 1-year, and 5-year following FDI World Dental Federation criteria including esthetic, functional, and biological properties. Data were analyzed with the Friedman test and the Wilcoxon sign test (p < 0.05). ResultsNone of the restorations failed due to fracture or retention loss. One restoration was clinically unsatisfactory because of secondary caries. Marginal staining (p:0.000), marginal adaptation (p:0.018) showed significant differences between 1-year and 5-year recall. ConclusionsThe PCIARs demonstrated excellent clinical performance at 1-year period. The degradation parameters appeared as minor staining and minor irregularities after 5-year, without any affect on the clinical performance. Clinical SignificanceOur findings provide evidence that the clinical performance of PCIARs luted with a light-cured composite resin was clinically acceptable after a five-year evaluation period. Due to secondary caries, only one restoration was considered clinically unsatisfactory. ClinicalTrials registration number: NCT04838483

Fracture Resistance of Direct versus Indirect Restorations on Posterior Teeth: A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis was to compare static compression forces between direct composite resin restorations and indirect restorations for posterior teeth. All studies comparing mechanical properties of direct versus indirect restorations of posterior teeth were included from 2007 up to February 2024. A meta-analysis was conducted for static compression fracture resistance. Medline, Central, and Embase databases were screened. Twenty-four articles were included in the qualitative synthesis, and sixteen studies were finally included in the quantitative synthesis. There was no difference in terms of fracture resistance between direct and indirect restorations for posterior teeth (p = 0.16 for direct and indirect composite resin restorations and p = 0.87 for direct composite resin restorations and indirect ceramic restorations). Also, sub-group analysis with or without cusp coverage in each group revealed no discernable difference. Based on this study, it can be concluded that the choice between direct and indirect restoration approaches may not significantly impact fracture resistance outcomes. There was no statically significant difference between direct and indirect restorations for posterior teeth in all cases of restorations with or without cusp coverage and no matter the used materials. However, to better evaluate these materials, further studies are warranted.

In Vitro Evaluation of Mechanical, Surface, and Optical Properties of Restorative Materials Applied with Different Techniques.

(1) Background: currently, the advantages of bulk-fill resin composite and high-viscosity glass ionomer materials have increased their use in dentistry; accordingly, their mechanical, surface, and optical properties have become more important. This study aimed to evaluate the mechanical, surface, and optical properties of three different restorative materials (a high-viscosity bulk-fill resin composite (TNC), a flowable bulk-fill resin composite (EBF), and a high-viscosity glass ionomer (FIX)) after application using different techniques (control, heat application, and ultrasonic activation). (2) Methods: specimens were prepared to assess the color stability and surface roughness (n = 12). The specimens were immersed in two different solutions for 14 days. For the compressive strength test, specimens were prepared using a Teflon mold (n = 12). (3) Results: among the specimens applied according to the manufacturer's instructions and immersed in distilled water, it was observed that the surface roughness values of FIX on the 7th day were statistically significantly higher than the other materials (p < 0.05). The compressive strength values of EBF applied using ultrasonic activation were significantly lower than those of EBF applied using the other techniques (p < 0.05). (4) Conclusions: coffee can negatively affect the color stability of restorative materials, but discoloration may vary depending on differences in the content of the material. All materials evaluated in this study exhibited clinically acceptable surface roughness values. It can be concluded that flowable bulk-fill resin composite is the most durable material in terms of compressive strength, so it can be used in the restoration of posterior teeth, especially those exposed to intensive stress.

Comparison of clinical efficacy of CAD CAM Endocrowns made of feldspathic ceramic, zirconia lithium silicate, and lithium disilicate: A two-year mixed cohort study

ObjectiveEndocrowns can be fabricated from various materials as a treatment option for endodontically treated teeth. This mixed cohort study aimed to demonstrate the clinical efficacy of Endocrowns made of feldspathic, zirconia lithium silicate, and lithium disilicate ceramics using a chairside CAD/CAM system. MethodsThe present study compared the clinical outcomes of 141 Endocrown restorations in posterior teeth of 85 patients in a two-year follow-up. The efficacy of restorations was evaluated in three aspects: esthetics, biological response, and function, with the aid of the FDI guideline, and presented as descriptive analyses. Additionally, the data were analyzed using Chi-square and Spearman correlation tests. The significance level was set at p = 0.05. ResultsThe study findings revealed that the type of restorations (feldspathic ceramic, zirconia lithium silicate, and lithium disilicate) (p > 0.05) and underlying teeth (molars and premolars) (p > 0.05) play no part in restorations’ failure. Caries' recurrence is primarily responsible for the failure of the endocrowns. Secondary caries and radiolucency were observed in four teeth (2.83 %). The clinical efficacy of 126 restorations (89.36 %) fell into the category of “clinically excellent” and “clinically good.” Ten restorations (7.09 %) were classified as “clinically sufficient/satisfactory,” and only five restorations (3.54 %) needed replacement due to having “clinically unsatisfactory” and “clinically poor” quality. ConclusionsEndocrowns showed a high success rate and durability in the short term, therefore can be considered a safe choice for restoring endodontically treated teeth. It is worth noting that caries were the most common reason for the failure of the restorations. Clinical significanceEndocrowns made of different ceramics have been proven reliable restorations for endodontically treated molars and premolars.

Evaluation of Knowledge and Attitude of Yazd Dental Students in Connection with the Training of Posterior Teeth Restoration with Composite in 2023

Introduction: Today, composite resins are a suitable choice for tooth restoration, which in relation to posterior teeth, the most important limitations are marginal leakage, secondary decay, poor load bearing capacity, high wear and inability to restore contact. The durability of posterior restorations especially class II restorations is less compared to amalgam restorations. This has been affected by various factors such as polymerization shrinkage, thermal expansion coefficient and abrasion resistance that limits the durability of the posterior composite. Methods: The present study was a cross-sectional descriptive study, which 68 final year dental students of School of Dentistry of Shahid Sadoughi University of Medical Sciences in Yazd City were selected by census and their attitude and awareness were studied using a valid and reliable questionnaire containing demographic characteristics and attitude as well as awareness questions. All the data were analyzed in SPSS 16 statistical software. Likert scale was used to measure awareness and attitude. Results: In the present study, among the 68 final year dental students, 37 students (54.4%) were male 31 students (45/6%) were female the mean and standard deviation of the age of the participants was 25.12 ± 2.3 years. In this study, the mean and standard deviation of total attitude score of final year dental students was equal to 22.80 ± 6.74 and the total attitude score of final year dental students based on Likert Scale was lower than the average. Most of the students reported the quality of posterior composite training to meet practical needs as poor. Conclusion: Based on the results, the awareness and attitude of final year dental students in relation to posterior composite restoration training was less than average and weak, respectively. There was no significant difference was observed between the knowledge and attitude scores with the gender and age.

Longevity of composite restorations in posterior teeth placed by dental students: a 12-year retrospective study.

To evaluate the longevity of resin composite restorations placed in posterior teeth by dental students, using data from electronic records from 2008 to 2019. Demographic (gender and age) and clinical variables (dental group, position in dental arch, and the number of restored surfaces) were evaluated. The 5-year follow-up was assessed according to the day the restoration was placed. Kaplan-Meier curves were generated to calculate the annual failure rate. Data were analyzed by Chi-Square, Kruskal-Wallis, and Mann-Whitney tests (α = 0.05). In total, 3.883 records relative to return periodicity were analyzed. The final sample consisted of 900 restorations from 479 patients. The majority were females, aged between 31 and 60. In total, 256 failures were reported (success rate = 78%), showing an annual failure rate of 2.05%. The main reasons for failures were restoration replacement (55.5%), endodontics (21.9%), prosthetics (14.5%) and extraction (8.2%). There was a higher risk of failure in restorations involving three or more surfaces (p = 0.000) and in patients over 60 years (p < 0.001). In females (p = 0.030), molars (p = 0.044), and maxillary teeth (p = 0.038) failed in a shorter time. Resin composite restorations placed in permanent posterior teeth by dental students had high survival rates. The main reason for failure was the replacement of restorations. The age group and the number of restored surfaces significantly affected the success of the restorations. The electronic health records over 12 years showed that 78% of the resin restorations in posterior teeth placed by dental students were successful for a minimum of five years.

Comparing modified USPHS and FDI criteria for the assessment of glass ionomer restorations in primary molars utilising clinical and photographic evaluation.

To compare the applicability of modified US Public Health Service (USPHS) and FDI criteria for evaluating glass ionomer cement (GIC) restorations in primary posterior teeth through digital image analysis. This comparative analytic study was conducted at the Children's Dental Clinic RSKGM FKG UI, involving 40 GIC restorations on lower first primary molars in children aged 4-9years. After cleaning, the restorations were assessed clinically using modified USPHS and FDI criteria before taking digital images, then the collected images were re-evaluated using both sets of criteria, and the clinical assessment results were compared to the digital image assessment results. Statistical analysis revealed significant differences between the clinical evaluation of GIC restorations in primary teeth and their corresponding digital photographs when using the modified USPHS criteria, and although the use of FDI criteria yielded different results, these differences were not statistically significant. The assessment of GIC restorations through digital images aligns more closely with clinical assessments using the FDI criteria compared to the modified USPHS criteria.

Dental Metal Matrix Composites: The Effects of the Addition of Titanium Nanoparticle Particles on Dental Amalgam.

Dental amalgams have been used by dentists for the restoration of posterior human teeth. However, there have been concerns about the release of mercury from amalgams into the oral cavity. The objective of the present research is to study the effect of titanium (Ti) nanoparticles on the microstructural mechanism of the release of mercury vapor in two commonly used brands of dental amalgam (the Dispersalloy: 11.8% Cu; the Sybralloy: 33% Cu). Ti powder was added to both the Dispersalloy and the Sybralloy in increments of 10 mg up to 80 mg. The addition of Ti powder to both brands of dental amalgam has been found to result in a considerable decrease in Hg vapor release. The decrease in the Hg vapor release due to Ti addition has been explained by the formation of strong Hg-Ti covalent bonds, which reduce the availability of Hg atoms for evaporation. The Ti atoms in excess of the solubility limit of Ti in Hg reside in the grain boundaries, which also reduces the evaporation of Hg from the amalgam. The binding of Hg with Ti via a strong covalent bond also results in a significant improvement in mechanical properties such as Vickers hardness.

Antibacterial Agents for Composite Resin Restorative Materials: Current Knowledge and Future Prospects.

Resin composites became the material of choice for direct restorations in anterior and posterior teeth. Despite the revolutionary improvement in the material, restoration failure is still a major drawback due to the material's inherent negative properties, including a lack of antibacterial effects. Therefore, many attempts have been made to incorporate antibacterial agents into resin composite materials to improve their antimicrobial properties and prevent secondary caries formation. Multiple laboratory studies have been conducted using different antibacterial agents, such as quaternary ammonium compounds, methacryloyloxydodecylpyridinium bromide, magnesium oxide nanoparticles, chlorhexidine, and chitosan. This review provides a glance at the current status of these materials and the research directions needed in the future.

Current trends in placing posterior composite restorations: Perspectives from Palestinian general dentists: A questionnair study.

The success of composite restorations relies on material selection and practitioner-related factors that shape the overall outcome. This study explores the practices of Palestinian general dental practitioners in placing posterior composites, examining the impact of work sector, experience, and gender on their choices. The study was conducted as an online cross-sectional questionnaire and involved 351 participants, with a response rate of 69.8%. The survey comprised 18 closed-ended questions covering demographics, material selection, and composite placement in special cases, techniques, and factors influencing the choices. Statistical analyses included descriptive statistics, chi-squared tests, and Fisher's exact tests. Composite was the predominant choice for small-size (83.7%) and large-size posterior cavities (60.4%). Practitioners commonly opted for composite restorations in cases involving occlusal parafunctional activity (60%), poor oral hygiene (78%), and subgingival cavities (72.2%). Only 19.6% and 5.3% reported occlusal and gingival beveling, respectively. Rubber dams for isolation stood at 30%, one-step self-etch adhesives at 44.9%, and the oblique layering technique at 51%. Light-emitting diode curing units were popular (97.55%), but monitoring output with a radiometer was infrequent (93.5%). Tofflemire metal matrix usage was 46.1%, whereas a sectional matrix system was employed by 29.8%. A 2 mm layer exposure to light curing for 20 s was reported by 62%, and 27.75% utilized additional light-curing postmatrix band removal. The study highlights the need for Palestinian dental professionals to update their clinical approaches in placing composite restorations in posterior teeth. Gender, work sector, and experience influence practitioners' choices, emphasizing the importance of tailored continuing education programs for improving clinical practices.

Mechanical Performance of Extensive Restorations Made with Short Fiber-Reinforced Composites without Coverage: A Systematic Review of In Vitro Studies.

In recent years, composite resin materials have been the most frequently used materials for direct restorations of posterior teeth. These materials have some clinically relevant limitations due to their lack of fracture toughness, especially when used in larger cavities with high volume factors or when utilized as direct or indirect overlays or crown restorations. Recently, short-fiber-reinforced composite materials have been used in bi-structure restorations as a dentine substituting material due to their superior mechanical properties; however, there is no scientific consensus as to whether they can be used as full restorations. The aim of our review was to examine the available literature and gather scientific evidence on this matter. Two independent authors performed a thorough literature search using PubMed and ScienceDirect up until December 2023. This study followed the PRISMA guidelines, and the risk of bias was assessed using the QUIN tool. The authors selected in vitro studies that used short-fiber-reinforced composite materials as complete restorations, with a conventional composite material as a comparison group. Out of 2079 potentially relevant articles, 16 met our inclusion criteria. All of the included studies reported that the usage of short-fiber-reinforced composites improved the restoration's load-bearing capacity. Fifteen of the included publications examined the fracture pattern, and thirteen of them reported a more favorable fracture outcome for the short-fiber-reinforced group. Only one article reported a more favorable fracture pattern for the control group; however, the difference between groups was not significant. Within the limitations of this review, the evidence suggests that short-fiber-reinforced composites can be used effectively as complete restorations to reinforce structurally compromised teeth.

Evaluating the Effect of NanoFilled Composite Restorations on the Wear Resistance of Posterior Teeth: An RCT

ABSTRACT Background: Dental restorations play a crucial role in preserving the structural integrity and function of posterior teeth. However, wear resistance remains a significant concern for these restorations Materials and Methods: In this RCT, 120 participants with posterior tooth restoration needs were randomly assigned to two groups. Group A received conventional composite restorations, while Group B received NanoFilled Composite restorations. The restorations were placed according to standardized protocols. Wear resistance was assessed using a custom-designed chewing simulator, and the material wear was quantified using a profilometer. Patient-reported outcomes and clinical evaluations were also recorded at regular intervals over a 24-month follow-up period. Results: The wear resistance of the NanoFilled Composite restorations (Group B) was significantly higher than that of the conventional composite restorations (Group A) after 24 months of follow-up (P &lt; 0.05). Profilometer measurements revealed that Group B had an average wear depth of 0.15 mm, while Group A had an average wear depth of 0.25 mm. Patient-reported outcomes indicated higher satisfaction and comfort in Group B. Clinical evaluations also demonstrated that Group B restorations had better retention and marginal integrity Conclusion: This RCT demonstrates that NanoFilled Composite restorations exhibit superior wear resistance compared to conventional composite restorations when used in posterior teeth.

Clinical performance of a glass-hybrid system in comparison with a resin composite in two-surface class II restorations: a 5-year randomised multi-centre study

ObjectiveTo evaluate the 5-year clinical performance of a glass hybrid restorative system and a nano-hybrid resin composite in moderate to large two-surface class II cavities.Materials and methodsThis study was carried out by dental schools in Zagreb, Croatia; Izmir, Turkey; Belgrade, Serbia; and Milan, Italy. A total of 180 patients requiring two class-II two-surface restorations in the molars of the same jaw were recruited. The teeth were randomly restored with either a nano-hybrid resin composite (Tetric EvoCeram, Ivoclar Vivadent) or a glass-hybrid material (EQUIA Forte, GC). During the 5-year follow-up, two calibrated evaluators at each centre scored the restorations annually using the FDI-2 scoring system. The survival rates were calculated using the Kaplan–Meier method and compared using non-parametric matched pair tests (p < 0.05).ResultsThere were no statistically significant differences between the overall survival and success rates of the two types of restorations (p>0.05). The success rates (FDI-2 scores 1–3) for EQUIA Forte were 81.9% (average annual failure rate: 3.9%) and 90.7% for Tetric EvoCeram (average annual failure rate: 1.9%). The survival rates (FDI-2 scores 1–4) for EQUIA Forte and Tetric EvoCeram were 94.5% and 94.4%, respectively, with an average annual failure rate of 1.1%.ConclusionsIn terms of success and survival rates, both the glass-hybrid restorative system and the nano-hybrid resin composite have been shown to perform satisfactorily.Clinical relevanceThe results of this study indicate that EQUIA Forte can be one of the therapeutic options for moderate to large two-surface class II restorations of posterior teeth.

In Vitro Evaluation of Mechanical Properties of Cention N and Its Comparison with Resin Modified Glass Ionomer Cement (RMGIC) Restorative Material as Used in Primary Teeth.

22 specimens prepared with Cention and RMGIC were embedded in primary teeth mounted in acrylic for analysing shear bond strength. Shear bond strength was analysed using a universal testing machine. The modes of failure in samples were observed under a stereomicroscope and scanning electron microscope. 22 customised samples of Cention N and RMGIC were prepared and categorised as group A and group B, respectively. The flexural and compressive strengths of these samples were evaluated using a universal testing machine. The shear bond strength of RMGIC was higher than that of Cention N, whereas the compressive and flexural strengths of Cention N were significantly higher than those of RMGIC. The modes of failure were predominantly adhesive followed by mixed failures. The results of this study suggest that Cention N demonstrated superior mechanical properties compared with RMGIC and can therefore be recommended for restorations in primary posterior teeth. Cention N being a smart, esthetic, self-cured, or dual-cured material with better mechanical properties offers a wide range of applicability in primary teeth.

Resin inlays as an aesthetic alternative to conventional restorations in posterior teeth. Case study

The systematized professional experience was developed from the analysis of a case treated based on resin inlays as an aesthetic alternative to conventional restorations in posterior teeth. The description of the design and care protocol prior to the attention of the ethics committee is of relevant importance. The objective was to expose the use of composite resin under indirect technique as an alternative to the structural involvement of posterior teeth in a patient treated at the postgraduate clinic of the San Gregorio University of Portoviejo, Manabí, Ecuador. Dies were used as a basis for making the inlays using the incremental technique. To obtain the model, the arch of the selected teeth was impressed with alginate, followed by casting in light silicone for the prepared portion of the tooth and in type III stone plaster for the rest. The cementation process in the oral cavity is carried out with dual resin cement. After analyzing the information collected, an encouraging conclusion is reached that supports the viability and predictability of composite resins indirectly in clinical settings. This, of course, provided that there is a deep knowledge of the advantages and limitations inherent to the various materials involved. Likewise, it is positioned as a reasonable alternative for cases of considerably affected teeth, which, in some instances, could have been considered for more extensive treatments, such as crowns, which involves the removal of remaining dental tissue that could possibly have been preserved