Survival Rate Of Restorations Research Articles

Biodentine™ as a temporary filling in deep carious lesions in permanent teeth: a prospective observational 33-month follow-up study.

The study aimed to evaluate temporary fillings using Biodentine™ in asymptomatic deep carious lesions after 12, 24, and 36months in school children from the remote village of Kerung, Nepal. From November 2018 to November 2019, 91 temporary fillings were placed using Biodentine™ (a hydraulic calcium silicate cement) in permanent molars with deep carious lesions of schoolchildren in the remote district of Kerung, Nepal. These restorations were performed after selective caries removal in a non-dental setting with hand instruments and cotton roll isolation, as electric motors and saliva ejection systems were unavailable. In total, 78 single-surface and 13 multi-surface fillings were placed. Clinical and radiographic follow-up periods encompassed 12, 21, and 33months, respectively. After 12months, all single-surface fillings (100%) survived, whilst all multi-surface fillings were partially or entirely lost. The survival rate of single-surface restorations after 21 and 33months was 67.6% and 50%, respectively. Radiographically, no pathology was observed. This study showed that Biodentine could be used in deep carious lesions as a temporary filling in single-surface lesions for at least up to 1year and in a substantial number of cases for up to 21 and 33months.

Clinical outcomes of tooth- and implant-supported restorations performed in a university-based undergraduate program after 13-15 years.

To assess the clinical concept of patient treatment with fixed tooth- and implant-supported restorations in a university-based undergraduate program after 13 - 15 years. Thirty patients (mean age 56 years) who had received multiple tooth- and implant-supported restorations were recalled after 13-15 years. The clinical assessment comprised of biological and technical parameters as well as patient satisfaction. Data were analyzed descriptively and the 13-15-year survival rates for tooth- and implant-supported single crowns and fixed dental prostheses were calculated. The survival rate of tooth-supported restorations amounted to 88.3% (single crowns) and 69.6% (fixed dental prostheses); in implants it reached 100% for all types of reconstructions. Overall, 92.4% of all reconstructions were free of technical complications. The most common technical complication was chipping of the veneering ceramic (tooth-supported restorations: 5.5%; implant-supported restorations: 13-15.9%) regardless of the material used. At teeth, increased probing depth ≥5mm was the most frequent biological complication (22.8%), followed by endodontic complications of root-canal treated teeth (14%) and loss of vitality at abutment teeth (8.2%). Peri-implantitis was diagnosed in 10.2% of implants. Results of this study indicate that the clinical concept implemented in the undergraduate program and performed by undergraduate students works well. The clinical outcomes are similar to those reported in the literature. In general, the majority of biological complications occurrs in reconstructed teeth, whereas implant-supported restorations are more prone to technical complications.

Single crown vs. composite for glass fiber post-retained restorations: An 8-year randomized clinical trial

ObjectivesThis study aimed to compare the success and survival rates of metal-ceramic crowns and composite resin restorations applied in root filled teeth that received a glass fiber post. MethodsA prospective, randomized controlled trial, with equivalent parallel groups was designed. Eighty-two teeth were randomly allocated to the metal-ceramic or composite resin groups. Multivariate Cox regression analysis with shared frailty for patients and Kaplan-Meier curves were performed using success and survival rates (p<0.05). ResultsSeventy-five post-retained restorations (34 metal-ceramic crowns and 41 composite restorations) in 62 patients were analyzed. The median follow-up was 8.1 years [IQR 4.0–9.9]. Twenty-seven failures were observed. Twenty-two failures (81.5 %) were observed in the composite resin group, of which six (27.3 %) were not repairable. Five failures (18.5 %) were observed in the metal-ceramic crown group, of which three (66.6 %) were non-repairable. The cumulative success rate at 8 years was 85.0 % for crowns (AFR=1.31 %) and 43.2 % for composite resins (AFR=6.58 %), while the survival rate was 93.8 % for crowns (AFR=0.52 %) and 97.6 % for composite resins (AFR=0.20 %). Considering the success rates, adjusted multivariate Cox regression showed that composite resin had a Hazard Ratio of 5.07 (95 %CI, 1.99–12.89) greater than the metal-ceramic crown. No significant difference in the failure risk was observed when the survival rates were considered (HR=0.38, 95 %CI (0.10 – 1.44), p = 0.156). Co-variables did not affect the success and survival rates (p>0.05). ConclusionsMetal-ceramic crowns showed a higher success rate than composite restorations. The survival rates were similar, but composite restorations presented a higher need for repairs. Clinical SignificancePost-retained composite restorations may need more reinterventions during the lifecycle, although more preservation of sound tooth structure is expected with a large restoration of resin post-and-core. These aspects have to be discussed with the patient for decision-making planning.

Partial glass-ceramic posterior restorations with margins beyond or above the cemento-enamel junction: An observational retrospective clinical study.

This observational retrospective clinical study aimed to investigate the survival and success rates of partial indirect lithium disilicate restorations with margins extending above or beyond the cementoenamel junction (CEJ). The study included patients who underwent partial indirect lithium disilicate restorations with immediate dentin sealing (IDS) between January 2008 and October 2018. All the restorations were placed in a single general dental practice following a standardized protocol. The impact of various predictive variables on the survival rates was assessed. Moreover, modified United States Public Health Service (USPHS) criteria were used to evaluate the survival quality. Totally 1146 partial indirect lithium disilicate restorations in 260 patients were evaluated over an average period of 7.5 years. The cumulative survival and success rates were 97.3% and 95.3%, respectively. Margins extending beyond the cemento-enamel junction did not increase the risk of success or survival failure (P > 0.05). Patients with a high risk of caries, male sex, or non-vital teeth had a significantly higher risk of restoration failure (P < 0.05). Restorations with longer clinical service times exhibited marginally lower clinical quality (P < 0.001). Partial indirect glass-ceramic restorations demonstrated survival and success rates of 97.3% and 95.3%, respectively, over an extended period. However, a higher risk of restoration failure existed in patients with a high caries risk for (pre)molars that had undergone endodontic treatment and in males. In terms of the risk of success or survival failure, comparable results were obtained for the positions of the restoration margin in relation to the cemento-enamel junction.

Clinical Performance of Two CAD/CAM Fabricated Ceramic Restorations with Different Designs for MIH Rehabilitation: A Randomized Controlled Trial

Background: Molars affected with severe molar incisor hypomineralisation (MIH) require extensive restorations, which do not last for a long time and often require treatment in the form of onlays or full coverage restorations. Objective: A randomized clinical trial evaluated the clinical performance of two CAD/CAM fabricated ceramic restorations, Vita Suprinity (VS) and Vita Enamic (VE), with different preparation designs, occlusal veneer and endocrown, for rehabilitation of the first permanent molar affected by MIH. Materials and Methods: The study was registered with NCT05434884 clinical trial ID with 68 patients ranging from 8 to 13 years old, who attended the dental clinic of Al-Azhar University, Girls Branch, and suffering from a severe form of molar incisor hypomineralization. The patients were divided equally into two groups, group I, i.e., occlusal veneer (OV) group, and group II, i.e., endocrown (EN) group, according to different preparation designs related to different severity levels of first permanent molars’ hypomineralization (moderate and severe); each group was subdivided equally and randomly into two subgroups, subgroup A, i.e., Vita Suprinity (VS), and subgroup B, i.e., Vita Enamic (VE), according to the material used for fabrication of the restoration. The survival and success rates of restorations were assessed using the clinical United States Public Health Service (USPHS) criteria at 1 week, and 3, 6, 12, and 18 months' recall times after cementation, and statistical analysis was performed. Results: There was no statistically significant difference between groups and subgroups in terms of all evaluation parameters during the whole observational period. Conclusion: Based on observations, occlusal veneer and endocrown designs fabricated from CAD/CAM VS and VE showed similar clinical success in the rehabilitation of first permanent molars with severe MIH over 18 months of evaluation.

Systematic review and network meta-analysis of restorative therapy and adhesive strategies in root caries lesions

AimThis systematic review and network meta-analysis (NMA) aimed to establish a clinically relevant hierarchy of the different adhesive and/or restorative approaches to restore cavitated root caries lesions through the synthesis of available evidence. Materials and methodsA systematic search was conducted in Medline/Web of Science/Embase/ Cochrane Library/Scopus/grey literature. RCTs investigating ≥2 restorative strategies (restorative /adhesive materials) for root caries lesions in adult patients were included. Risk of bias within studies was assessed (Cochrane_RoB-2) and the primary outcome was survival rate of restorations at different follow-up times (6-/12-/24-months). Network meta-analyses were conducted using a random effects model stratified by follow-up times. I2-statistics assessed the ratio of true to total variance in the observed effects. All available combinations of adhesives (1-SE: one-step self-etch; 2–3ER: two-/three-step etch-and-rinse) and restorative materials (conventional composite (CC) as well as conventional and resin-modified glass ionomer cements (GIC, RMGIC)) were included. Risk of bias across studies and confidence in NMA (CINeMA) were assessed. Results547 studies were identified and nine were eligible for the NMA. In total, 1263 root caries lesions have been restored in 473 patients in the included clinical trials. Patients involved were either healthy (n = 6 trials), living in nursing homes (n = 1 trial) or received head-and-neck radiotherapy (n = 2 trials). There was statistically weak evidence to favour either of material/material combination regarding the survival rate. A tendency for higher survival rate (24-months) was observed for 2–3ER/CC (OR24mths 2.65; 95%CI=1.45/4.84) as well as RMGIC (OR24mths 2.05; 95%CI=1.17/3.61) compared to GIC. These findings were though not statistically significant and confidence of the NMA was low. ConclusionAn evidence-based choice of restorative strategy for managing cavitated root caries lesions is currently impossible. There is a clear need for more standardised, well-designed RCTs evaluating the retention rate of root caries restoration approaches.

Survival Rates of Glass versus Hybrid Ceramics in Partial Prosthetic Restorations: A Scoping Review with Emphasis on Adhesive Protocols.

As dental practices and methodologies evolve, the emergence of novel materials adds complexity to clinical choices. While glass ceramics, particularly those based on lithium disilicate and leucite-reinforced variants, have been extensively researched and are well regarded for their attributes, hybrid ceramics remain relatively recent area of research that is less investigated. This review aims to evaluate the durability of glass and hybrid ceramics while assessing the role of various adhesive techniques on restoration longevity. Using a comprehensive search of PubMed and EMBASE, 84 articles from the past decade were found. Only eleven met the set criteria for analysis. The results underscore the urgent need for the extended monitoring of partial prosthetic restorations. The existing literature has significant gaps, hindering the attainment of dependable insights about these materials' long-term performance. For a clearer understanding of how different ceramic systems affect restoration survival rates, rigorous research involving more participants and uniform outcome documentation is vital.

Retrospective clinical study on the performance and aesthetic outcome of pressed lithium disilicate restorations in posterior teeth up to 8.3 years

ObjectivesEvaluation of cumulative survival and complication rate of monolithic lithium disilicate inlays and partial crowns performed by supervised undergraduate students up to 8.3 years of clinical service.Materials and methodsIn this retrospective clinical study 143 lithium disilicate posterior restorations (IPS e.max Press) were examined according to the FDI criteria. A standardised questionnaire was used to determine patient satisfaction. The aesthetic outcome was evaluated by dentists and dental technicians using intraoral photographs. Data were descriptively analysed. Cumulative survival and success rates were calculated using Kaplan–Meier estimation.ResultsThe cumulative survival rate of lithium disilicate restorations was 97.5% after a mean service time of 5.9 years and 95.0% after 8.3 years. The cumulative success rate decreased from 94.4% after 5.9 years to 30.7% after 8.3 years. Repairs were required for 7 restorations (4.9%), and 5 (3.5%) were classified as failures. The results of the questionnaire indicate a high level of patient satisfaction. The subjective aesthetics were assessed more critically by dental technicians compared to dentists.ConclusionLithium disilicate posterior restorations survived successfully up to 8.3 years when carried out by undergraduate students.Clinical relevancePressed lithium disilicate glass ceramic inlays and partial crowns are reliable treatment options in posterior teeth.

Non-retentive adhesive restorations

With the advent of adhesive dentistry, tooth preparation can be minimally invasive. An optimal adhesion to the dental tissues is a requirement. Rubberdam isolation, using a gold standard adhesive and bonding to freshly prepared dentin are all factors that improve the adhesion to tooth tissue. For non-retentive restorations, indirect composite and glass-ceramic materials are suitable. To date, several studies have shown a high survival rate of indirect adhesive restorations. The adage "if you can isolate the tooth, you can preserve it" may guide the choice of starting an adhesive procedure.

Clinical performance of single implant prostheses restored using titanium base abutments: A systematic review and meta-analysis.

The aim of this review was to evaluate the survival rates of restorations utilizing titanium base abutments (TBA) for restoring single-unit implant prostheses. This review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The focus question was: In patients who require the restoration of a single dental implant utilizing a titanium base abutment, what are the determining factors and outcomes relating to implant prosthesis prognosis and survival? A comprehensive search of databases (PubMed, EMBASE, and Cochrane Library) was conducted on 16 April 2023 and updated on 5 May 2023. Randomized clinical trials (RCT), retrospective studies and prospective studies, reporting on the use of TBA for single implant prostheses, were reviewed. A Cochrane collaboration risk of bias assessment analysis was performed for randomized clinical studies, and the Newcastle-Ottawa Scale tool was applied for non-randomized studies. A meta-analysis was performed on clinical trials reporting on survival rates of both TBA and other abutments. Other clinical studies, reporting on TBA only, were included for descriptive statistics. The search provided 1159 titles after duplicates were removed. Six RCTs were included to perform a meta-analysis and compare the survival of the TBA to other abutments [OR 0.74; 95% CI: 0.21-2.63, heterogeneity; I2 0%; p = .99]. Twenty-three prospective and retrospective studies fulfilled the criteria and were included in the meta-analysis after 12 months of function. A total of 857 single implant-supported prostheses fabricated with a TBA were included. TBA abutments have an estimate 98.6% survival rate after 1 year in function (95% CI: 97.9%-99.4%). The mean follow-up period was 31.2 ± 16.9 months. Single implant prosthesis restored with titanium base abutments showed favourable short-term survival rates.

Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment.

This study evaluated the short-term clinical and microbiological performance of resin-modified glass ionomer cement (RM-GIC) cement containing chlorhexidine (CHX) for atraumatic restorative treatment (ART) in primary teeth. The clinical trial was conducted in 36 children that received ART in primary molars either with GIC (group I, n = 18) or GIC containing 1.25% CHX (group II, n = 18). The survival rate of restorations was checked 7 days, 3, and 6 months after their application when saliva and biofilm were collected for microbiological assessment of mutans streptococci (MS) counts. Data were analyzed using the Kruskal-Wallis/Mann-Whitney U tests for clinical analysis and microbiological evaluations (p < 0.05). The survival rate of restorations was similar comparing groups I with II. Microbiological analysis showed a significant reduction in MS levels 7 days after the treatment in both saliva and biofilm of children treated with RM-GIC containing CHX (group II); however, MS counts at 3 and 6 months did not differ from the initial counts. A total of 1.25% CHX improved the microbiological properties of GIC in the short term without impairing the clinical performance of ART restorations. Glass ionomer cement (GIC) containing CHX could be an alternative in ART procedures with the objective of promoting an additional antimicrobial effect, which is interesting for children with high counts of MS during the initial phase of adaptation to dental treatment. da Silva ME, de Sena MD, Colombo NH, et al. Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment. Int J Clin Pediatr Dent 2023;16(S-1):S27-S32.

Longevity of dental amalgam

Objective: To carry out an integrative literature review collecting findings on the longevity of dental amalgam, comparing them with composite resin. Methods: The PubMed, Virtual Health Library (VHL) and LILACS databases were used to search for scientific articles. For the literature search, the following keywords were applied: Amalgam, Dental Restorations, Survival, Longevity, Failure. All descriptors were combined with each other using the Boolean operator “AND” and following the description of the MeSH/DeCs terms. After applying the eligibility criteria, nine articles were selected. Results: Several properties influence the longevity of amalgam restorations, with survival and failure rates of amalgam restorations varying across studies, with disagreements over the superiority of composite resin or dental amalgam. The main cause of failures in restorations is secondary caries and, in some cases, only repair with amalgam in restorations appears as a solution instead of the complete replacement of the material. Final considerations: Knowing that amalgam is still present in the clinical practice of some professionals, as well as in the oral cavity of a large portion of the population, the replacement or repair of these restorations must be evaluated individually, without the bias of toxicity or release of mercury by the material.

Clinical survival of No-prep indirect composite laminate veneers: a 7-year prospective case series study

BackgroundThe no preparation technique which is a reversible form of treatment characterized by the absence of tooth tissue preparation and preserves the soft tissue architecture while preserving all natural tooth structures is indicated in cases where the tooth structure allows material to be added. The aim of this study is to evaluate the clinical performance and survival rates of indirect composite laminate veneers with no preparation after 7 years.Materials and methodsA total of 80 indirect composite veneers were placed on maxillary anterior teeth in 35 patients (n = 80). Diastema (n = 64), wedge tooth anomalies (n = 9) and re-shaping (n = 7) were the main indications for veneer treatments. All laminate veneers were fabricated with an indirect microhybrid composite material (Gradia, GC Dental). No tooth preparation was performed. Light-cured resin cement (Choice 2, Bisco) was used to lute the veneers. Composite veneers were evaluated using Modified United States Public Health Service criteria. Survival rates of the veneers were calculated using Kaplan-Meier statistics. The data containing the results of the USPHS criteria at baseline, 2 years and 7 years was statistically analyzed using Wilcoxon Signed Rank test at the 0.05 level of significance.ResultsThe overall survival rate was 91.3%. After 7 years, 7 absolute failures including 4 debonding (marginal adaptation, score 4) and 3 fractures (fracture of restoration, score 3) were noted. Color match was scored as 1 (n = 34) and 2 (n = 15). Slightly rough surfaces (41 of 73 laminates) and slight marginal discoloration (15 of 73 laminates) were noted. The overall scores after 84 months were significantly higher than the baseline scores for the marginal adaptation (p = 0.008), color match (p = 0.000), marginal discoloration (p = 0.000), surface roughness (p = 0.000), and fracture of restoration (p = 0.001) criteria.ConclusionsIn this study, indirect composite veneers without any preparation on maxillary anterior teeth showed acceptable performance in terms of both survival rate and quality of restorations. This procedure offers a predictable and successful treatment that ensures maximum preservation of the intact tooth.

To Assess the Adequacy of Antimicrobial Sealing gel and O-ring at the Implant-Abutment Interface to Prevent the Microleakage - An in Vitro Study

Background: Although, there are numerous treatment options, periimplantitis remains a problem in implantology that has yet to be adequately handled. Microleakage, which promotes peri-implantitis by reinfecting the implant interior areas with microbes, is one element to consider. Purpose: To evaluate the adequacy of antimicrobial sealing gel (Gapseal) and O-ring in preventing the bacterial infiltration of staphylococcus aureus into the internal surface of the implant-abutment interface. Materials and Methods: One hundred twenty samples were divided into three groups (n=40) based on different sealing materials: group I (unsealed); group II (Gapseal); group III (O-ring).To ensure sterility, one implant from each group was incubated at random. The remaining implant and abutment assemblies were attached and incubated in a nutrient solution containing staphylococcus aureus for the next 24 hours. After incubation, samples were decontaminated by immersing them in a 2 percent sodium hypochlorite solution for 30 minutes followed by normal saline for 5 minutes. The assemblies were disassembled and placed in the test tubes containing sterile nutrient solution; the test tubes were agitated to ensure that nutrient solution appropriately contact the inner surfaces of implant abutment assemblies. This bacterial suspension was injected onto Nutrient agar plates and incubated for 24 hours. The resultant colonies that appear on the agar plate were counted with naked eyes. Results: Statistical analysis was performed using Kruskal-Wallis analysis of variance and Mann-Whitney U test. On average, the number of bacterial colonies was the minimum (= 4.4) in Group-II, followed by that (= 19.1) in Group-III and the maximum (= 29.2) in Group-I. Conclusion: The application of Gapseal at the implant-abutment interface reduces microbial leakage and possibly increases the survival rate of implant-assisted restorations.

Aesthetic Rehabilitation of Anterior Fractured Teeth with Partial Veneer: A Case Report

A variety of approaches can be employed to restore dentinal enamel fracture such as reattachment of the tooth fragment, direct composite restorations and indirect veneers. Thus, ceramic partial veneers or ceramic fragments are the most suitable option due to the increasing interest in minimally invasive dentistry and their superior optical behavior. They are considered as an innovative ultra-conservative approach that covers only the fractured part of the tooth surface without any preparation. Clinical protocol was however delicate. Bonding procedures must be highly respected and sectional veneer must be positioned carefully and checked regularly.Nowadays, Ceramic partial veneers are becoming a more popular approach but there are still concerns about the fracture strength and the survival rate of such restorations. This following report discusses the case of a patient presenting a fractured incisor that was rehabilitated using a ceramic partial veneer.

Ceramic Crowns and Sleep Bruxism: First Results from a Randomized Trial.

Background: This randomized clinical trial was conducted to assess whether sleep bruxism (SB) is associated with an increased rate of technical complications (ceramic defects) in lithium disilicate (LiDi) or zirconia (Z) molar single crowns (SCs). Methods: Adult patients were classified as affected or unaffected by SB based on structured questionnaires, clinical signs, and overnight portable electromyography (BruxOff) and block randomized into four groups according to SB status and crown material (LiDi or Z): LiDi-SB (n = 29), LiDi-no SB (n = 24), Z-SB (n = 23), and Z-no SB (n = 27). Differences in technical complications (main outcome) and survival and success rates (secondary outcomes) one year after crown cementation were assessed using Fisher’s exact test with significance level α = 0.05. Results: No technical complications occurred. Restoration survival rates were 100% in the LiDi-SB and LiDi-no SB groups, 95.7% in the Z-SB group, and 96.3% in the Z-no SB group (p > 0.999). Success rates were 96.6% in the LiDi-SB group, 95.8% in the LiDi-no SB group (p > 0.999), 91.3% in the Z-SB group, and 96.3% in the Z-no SB group (p ≥ 0.588). Conclusions: With a limited observation time and sample size, no effect of SB on technical complication, survival, and success rates of molar LiDi and Z SCs was detected.

Survival Rate of Atraumatic Restorative Treatment Restorations in Primary Posterior Teeth in Children with High Risk of Caries in the Republic of Kosovo-1-Year Follow-up.

Atraumatic restorative treatment (ART) may be beneficial for disadvantaged populations with no or limited access to dental services. This study aimed to evaluate the survival rate of single-surface ART restorations in primary posterior teeth in children with high caries risk. This study was conducted in six rural areas of the Republic of Kosovo, and 100 children aged 3 to 8 years participated in the study. Information was obtained from each parent/guardian regarding their children, such as sociodemographic characteristics, general health, dental history, dietary habits, oral hygiene, and fluoride exposure. The reduced Cariogram was used to estimate the risk of caries in the participants based on the seven factors specified in the program, and all the provided information were collected and entered in a computer program of the Cariogram. A pediatric dentist, accompanied by two assistants, performed 100 ART restorations in school settings using high-viscosity glass-ionomer cement (Fuji IX) following the nine steps of the ART procedure. The restorations were evaluated at 3, 6, 9, and 12 months using the ART restoration criteria. Percentages, mean value, standard deviation, mean interquartile range, and difference test between arithmetic mean values were used to analyze the research results. Review of the average of reduced Cariogram showed that the majority of children, 72%, were at high risk of developing caries, with only 28% having a good chance of avoiding caries in the future. A total of 77% of the children in the study had never visited dentists before due to poor economic conditions and the lack of dentists in the area. The success rates of ART restorations performed in single-surface cavities in primary teeth were very encouraging, with more than 97% success rates after a 1-year follow-up period. Our results demonstrate that ART is efficient, affordable, and practical for the treatment of single-surface cavities in primary posterior teeth. Owing to its low price and atraumatic nature, ART can potentially help disadvantaged children in Kosovo access dental care.

Two-year retrospective evaluation of monoshade universal composites in direct veneer and diastema closure restorations.

The aim of this retrospective evaluation was to assess the short-term outcome of two monoshade universal resin composites with high chameleon effect in anterior direct veneer and diastema closure restorations, and to investigate the possible reasons for failure. Patients subjected to veneer and diastema closure restorations with two monoshade universal resin composites (Essentia Universal Shade; EU, GC Corp., and Omnichroma; OC, Tokuyama) operated between January 2018 and March 2019 were selected for the present retrospective evaluation. A total of 159 composite restorations (78 veneers and 81 diastema closure restorations) performed by a single operator in 44 patients (mean age: 33.6) were included in the study. Two blinded and calibrated examiners performed 1- and 2-year assessments of the restorations with respect to FDI criteria, using medical/clinical history and dental photography records. Data were analyzed using Pearson Chi-square with Continuity Correction, Fisher's Exact tests, and Cox regression (a < 0.05). The cumulative overall survival rates of EU and OC restorations were 94.6% (97.3% for the first year) and 88.6% (95.3% for the first year), respectively, with no significant difference from each other (p=0.316). The cumulative overall survival rates of direct veneer and diastema closure restoration types were 90.2% (95.1% for the first year) and 92.4% (97.4% for the first year), respectively, with no significant difference (p=0.559). The reasons for failure were evaluated as fracture of the restoration, failure in esthetic anatomical form, and color mismatch. All the failed direct veneer restorations were due to fractures (FDI score of 5.4), whereas 5 of 6 failed diastema closure restorations were due to color mismatch (FDI score of 3.4). Regarding the composite materials, there were no significant differences between the success rates of the restoration types (p=0.442 for EU, p=1.000 for OC). With respect to the restoration types, there were also no significant differences between the success rates of the resin-based composites (p=1.000 for direct veneer restorations and p=0.228 for the diastema closure restorations). In addition, no significant difference was observed between male and female patients regarding the acceptable and unacceptable scores (p=1.000). The 2-year clinical performance of the two monoshade universal composites in anterior veneer and diastema closure restorations were both considered successful and similar. Despite the lack of shade selection, both monoshade universal composites presented a successful color match. However, the diastema closure restorations might be more prone to color mismatch compared to the veneers over time, while veneer restorations presented more fractures than the diastema closure restorations. Monoshade universal composites presented successful short-term clinical outcomes regarding both function and esthetics in anterior direct veneer and diastema closure restorations.

Assessment of Salivary Mutans Streptococci Counts to Atraumatic Restorative Treatment Among Children: A Randomised Controlled Trial.

Introduction Besides the survival rate of restorations, the effect of atraumatic restorative treatment (ART) on bacterial count is also important. After ART restoration, the bacterial count drops due to the fluoride's antibacterial activity and hence it can decrease the chances of further decay. The present studyassessed salivary mutans streptococci counts for six months of evaluations subsequent to ARTamong 12-15-year-old children attending schools in Piparia village, Vadodara district. Methods ART was performed on 32 children and followed up after six months to evaluate the success rate of ART. Saliva collection and microbial analysis were performed five times from every participant, before ART restoration placement, seven days, 30 days (one month), 90 days (three months) and 180 days (six months) post-restoration. Results At baseline, the mean colony forming units (CFU) was 48.30 ± 46.58, which reduced to 32.64 ± 30.40 at one week, which showed a 32% reduction in colony counts. This further reduced to 18.60 ± 20.81 at one month, marking a further 43% reduction in colony counts. This again reduced to 13.63 ± 18.04 at three months, which showed a 27% reduction in colony counts. CFU came to 16.23 ± 23.34 at six months, which showed a 19% increase in colony counts. Comparison of baseline mean CFU (48.30 ± 46.58) to six months mean CFU of streptococcus mutans (SM) (16.23 ± 23.34) showed a 66% reduction in colony counts. A statistically significant difference was found between numerous intervals of time of CFU of streptococcus mutans. Conclusion The findings reveal that ART is a clinical treatment that can be used to treat caries in young children, and it helped significantly reduce Streptococcus Mutans levels in saliva.

Retrospective 1- to 8-Year Follow-Up Study of Complete Oral Rehabilitation Using Monolithic Zirconia Restorations with Increased Vertical Dimension of Occlusion in Patients with Bruxism.

Aim: The aim of this paper is to perform a retrospective assessment of the clinical performance of the complete oral rehabilitation of patients with bruxism treated with implants and teeth-supported veneered and non-veneered monolithic zirconia restorations with increased occlusal vertical dimension. Methods: In this retrospective follow-up study, 16 bruxer patients, mean age 59.5 ± 14.9 years, were treated with 152 veneered and 229 non-veneered monolithic zirconia and followed for a mean of 58.8 ± 18.8 months (range 1–8 years). The patients were examined clinically and radiographically, annually. Clinical data were extracted from the medical records. In the recall appointments, modified California Dental Association (CDA) criteria were used to evaluate the restorations. Implant and restoration survival and success rates were recorded and analyzed. Results: The cumulative survival rates of implants and restorations were 97.7% and 97.6%, respectively. Nine restorations were replaced: three due to horizontal tooth fractures, two because of implant failure and four had secondary caries. A total of 43 biologic and technical complications were recorded. In the veneered group, the predominant complication was minor veneer chipping (16.4%), which required polishing only (grade 1). In the non-veneered group, the main complication was open proximal contacts between the implant restorations and adjacent teeth (14.5%). Conclusions: The survival rates of restorations and implants in patients with bruxism are excellent, even though veneered zirconia restoration exhibited a high rate of minor veneer chipping, which required polishing only. The biologic complication of fractured single-tooth abutment may occur.