Restorations In Primary Teeth Research Articles

In Vitro Comparison of Fracture Resistance of Severely Damaged Primary Anterior Teeth Restored with Different Post and Core Systems.

This study aimed to compare the fracture resistance (FR) of severely damaged primary anterior teeth restored with five different post and core systems. This in vitro, experimental study evaluated 60 extracted primary maxillary central incisors. The teeth were horizontally sectioned at 1 mm above their cementoenamel junction (CEJ), underwent pulpectomy, and their root canals were filled with Metapex paste. After post space preparation and sealing of root fillings with light-cure glass ionomer (1 mm thickness), the teeth were randomly assigned to five groups (n = 12) of (1) glass fiber post and everX composite (reinforced with short fibers), (2) glass fiber post and bulk-fill composite, (3) everX composite post and core, (4) bulk-fill composite post and core, and (5) Filtek conventional composite post and core. The teeth underwent 5,000 thermal cycles between 5°C and 55°C, and their FR was measured in a universal testing machine (0.5 mm/min, 148°). The mode of failure was also determined. Data were analyzed by ANOVA and Tukey's test at 0.05 level of significance. The FR was the highest in fiber post and everX composite, and the lowest in Z250 conventional composite post and core group (P < 0.001). The FR of fiber post and everX composite group was significantly higher than that of everX composite post and core (P = 0.04), bulk-fill composite post and core (P = 0.001), and Z250 composite post and core (P < 0.001) groups. The frequency of repairable fractures was the highest in glass fiber post plus everX composite (91.66%) and the lowest in Filtek conventional post and core group (66.66%) (P > 0.05). Within the limitations of this in vitro study, the results showed that restoration of severely damaged primary maxillary central incisors with glass fiber post and everX composite reinforced with short fibers enhanced their FR, and increased the chance of reparability in case of restoration fracture. This technique may be recommended for the restoration of primary anterior teeth since it is simple and saves time.

Prevalence and mean number of teeth with amalgam and nonamalgam restorations, United States, 2015 through 2018

BackgroundAmalgam has been used for more than 150 years as a safe and reliable restorative material. The authors described the occurrence of amalgam and nonamalgam restorations in the United States in primary and permanent teeth across age groups and according to sociodemographic characteristics. MethodsThe authors used clinical examination data from the National Health and Nutrition Examination Survey 2015-2018 for participants 2 years and older (n = 17,040). The authors estimated the prevalence and mean number of amalgam and nonamalgam restorations in primary and permanent teeth according to age groups (2-5 years, 6-11 years, 12-15 years, 16-19 years, 20-39 years, 40-59 years, 60-79 years, and ≥ 80 years), race and ethnicity, federal poverty guideline, education, and pregnancy status. ResultsThe prevalence of amalgam restorations ranged from 4% through 69%. Overall, amalgam restorations were more prevalent in children and adolescents from racial and ethnic minority groups and families at lower poverty levels and with lower education. The mean number of teeth with nonamalgam restorations was higher than those with amalgam restorations in primary teeth of children aged 6 through 11 years, permanent teeth of those 12 through 15 years and 20 through 39 years, and women aged 20 through 49 years, regardless of pregnancy status. The mean number of amalgam restorations was higher than that for nonamalgam restorations in older age groups. ConclusionsNonamalgam restorations were the most common in the primary teeth of children older than 5 years and in the permanent teeth of adults younger than 40 years. Amalgam restorations were more common in older adults. Amalgam and nonamalgam restorations were equally common in children younger than 5 years. Practical ImplicationsThe study findings suggest a shift from amalgam to alternative restorative materials in the United States.

Evaluation of Self-Adhesive Composite Restorations Bond on Primary Canines: An In Vitro Study.

Background and purpose The aesthetic requirements for the restoration of the primary anterior teeth of both the child and his parents increased recently, especially with the presence of materials with good mechanical properties capable of giving a good aesthetic shape. However, the challenge remains in the possibility of applying these materials to primary teeth, where the child's cooperation and ability to keep their mouth open during the completion of the restoration is an important challenge for the dentist. Therefore, this study aimed to evaluate the bonding of self-adhesive composite by studying the microleakage in primary canines. Materials and methods The studied sample consisted of 60 extracted primary canines that were divided into three equal groups (n=20) according to the type of restoration: group 1 (experimental) - self-adhesive composite alone, group 2 (experimental) - self-adhesive composite with selective enamel etching, and group 3 (control) - conventional composite with the self-etching bond and selective enamel etching. A Class V cavity was prepared at the cementoenamel junction, 2 mm deep and 1 mm in diameter. In this way, the gingival wall is dentine, while the incisal wall is enamel-dentine. Restorations were placed according to the group to which the tooth belongs. After that, all teeth were subjected to 500 cycles of thermocycling. Then, a methylene blue dye microleakage test was performed, and longitudinal sections of the teeth were made and studied under x20 magnification using a stereo microscope. Results In the gingival wall, the scores of microleakage in the conventional composite group after selective etching were lower than those of the self-adhesive composite groups, with a statistically significant difference. While in the incisal wall, there were no statistically significant differences in the frequencies of the scores of microleakage between the three groups. Conclusions Within the limitations of this study, the conventional composite bonded better to enameland dentine than self-adhesive composite resin applied alone or after selective enamel etching. The bonding of the self-adhesive composite was lower than that of the conventional composite, and it is not recommended to use it in Class V restorations of primary anterior teeth.

Microleakage and Marginal Integrity of Surface-Coated and Laser-Pretreated Class V Composite Restorations in Primary Teeth.

Introduction: Despite the advanced formulations of resin composites, microleakage is still among the commonest causes of clinical failure of these restorations. We evaluated the effect of surface coating and laser pretreatment on the microleakage of Class V resin composite restorations in primary teeth. Methods: Sixty extracted primary molar teeth having intact lingual or facial surfaces were randomly allocated into the control, G-Coat Plus surface coating, and erbium-doped yttrium aluminum garnet (Er:YAG) laser pretreatment groups. Class V cavities were provided with the coronal and gingival margins in the dentin and enamel, respectively. Restoration of the cavities was done with Z250 resin composite and they were thermocycled, followed by immersing in 2% basic Fuchsin dye for 24 hrs. Samples underwent sectioning occlusogingivally and the microleakage was assessed under a stereomicroscope (40×). Statistical analysis was done via SPSS and Kruskal-Wallis test (α=0.05). Results: The control and G-Coat plus groups were significantly different regarding the microleakage (P<0.001), and G-Coat Plus and laser pretreatment groups (P<0.001) at both gingival and occlusal margins. However, it showed no significant difference between the laser and the control group on the enamel (P=0.063) and dentin margins (P=0.757). Microleakage at the gingival margins was significantly greater compared to the occlusal margins in the control and laser groups (P<0.001), but not in the G-Coat Plus group (P=0.051). Conclusion: G-Coat plus coating significantly reduced microleakage at dentin and enamel margins of Class V composite restorations in primary teeth, in comparison with other groups of the study. Also, dentin margins showed more significant amounts of microleakage versus enamel margins in all groups, except for the G-Coat Plus group.

Clinical evaluation and parental and child satisfaction with restoration of primary teeth using zirconia and stainless steel crowns: A randomised clinical study

Introduction: Full-coronal restoration is the choice of treatment for restoring pulpally treated tooth or tooth with multiple surface involvement. In paediatric dentistry, semi-permanent stainless steel crowns (SSCs) are considered gold standard, but with increasing need of aesthetics, zirconia crowns have started gaining importance. Hence, this study was conducted to evaluate the clinical performance of SSCs and zirconia crowns and to compare the child satisfaction and parental ratings of impact of treatment using these preformed crowns. Materials and Methodology: This study was a part of randomised controlled trial performed on 60 children of 4–8 years old. The primary molars were cemented with either SSCs or zirconia crowns and were evaluated clinically at baseline, 6-month and 12-month follow-up for crown retention, crown fracture, gingival and debris index, wear, marginal integrity and recurrent caries. The trials also evaluated parental satisfaction and child satisfaction based on five-point Likert scale at the end of 12-month follow-up. The data were analysed using Chi-square test for categorical data and independent sample t-test for quantitative data. Results: Both the crowns were 100% retentive at 12-month follow-up. Fair debris score and mild gingivitis were reported in 3% with SSC at 6–12 months. One zirconia crown fractured at 12 months. Fifty-four per cent of parents in zirconia and 57% in SSC stated that the crowns improved masticatory function. Children reported a mean Likert score of 3.0 for SSC and 4.89 for zirconia which was highly significant. Conclusion: Both the crowns increased the overall health of crowned tooth and were fully retentive for the studied duration. However, zirconia crowns were more gingival friendly and had an edge over SSC in terms of aesthetics.

Exploration and preliminary clinical investigation of an adhesive approach for primary tooth restoration.

The current study aims to investigate a suitable adhesive for primary tooth enamel. Shear bond strength (SBS) of primary teeth and the length of resin protrusion were analyzed using one-way ANOVA with Bonferroni multiple comparison tests after etching with 35% H 3PO 4. SBS and marginal microleakage tests were conducted with Single Bond Universal (SBU)/Single Bond 2 (SB2) adhesives with or without pre-etching using a nonparametric Kruskal-Wallis test. Clinical investigations were performed to validate the adhesive for primary teeth restoration using Chi-square tests. Results showed that the SBS and length of resin protrusion increased significantly with the etching time. Teeth in the SBU with 35% H 3PO 4 pre-etching groups had higher bond strength and lower marginal microleakage than those in the SB2 groups. Mixed fractures were more common in the 35% H 3PO 4 etched 30 s + SB2/SBU groups. Clinical investigations showed significant differences between the two groups in cumulative retention rates at the 6-, 12- and 18-month follow-up evaluations, as well as in marginal adaptation, discoloration, and secondary caries at the 12- and 18-month follow-up assessments. Together, pre-etching primary teeth enamel for 30 s before SBU treatment improved clinical composite resin restoration, which can provide a suitable approach for restoration of primary teeth.

Survival of Glass Ionomer Restorations in Primary Molar Teeth in a Tertiary Hospital in Chitwan

Introduction: Glass ionomer cement (GIC) is frequently used as a restorative material in dentistry and has been known for its anti-carious property, biocompatibility and good marginal adaptation. The study aims to evaluate the survival of GIC restorations on primary molar teeth of dental patients attending College of Medical Sciences, Chitwan. Methods: A retrospective longitudinal study was conducted among the patients who were treated with, at least one GIC restoration (GC Fuji II/GC Fuji IX GP) in their primary molars during the past three years. Data were collected to assess the demographic variables like gender, economic status and mother’s education; restoration-related variables like no of surfaces involved, type of material used, location of the restoration in oral cavity, and age of restoration and; outcome related variable i.e. survival of restoration (survived / failed). United States Public Health Service (USPHS) criteria was used to determine survival. Data analysis was done using software SPSS version 17. Chi-square tests were carried out to find out the association between dependent and independent variables. Significance level was set at p&lt;0.05. Results: The 1-3 years cumulative survival rate of the GIC restoration in primary molars was found to be 74.5%. The survival rates for 1 year, 2 years and 3 years were found to be 93.5%, 78.6% and 62.5% respectively. There was no significant association between the survival of the restoration and location of the tooth in oral cavity and sociodemographic indicators like gender, age, economic status and mother’s education. However, statistically significant association was found between survival of restoration and type of restorative material, number of surfaces involved and age of restoration. Type VIII GIC had a higher survival rate (85.7%) compared to Type II GIC (68.2%), and single-surface restorations had a higher survival rate (84.9%) compared to two-surface restorations (52.3%). Conclusion: Our findings suggest that GIC can be used for restoring primary molars, particularly as single-surface restorative material. It also suggests that Type VIII GIC can more effective in restoring the primary molars as compared to the conventional Type II GIC.

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.

Bond strength of conventional versus modified methods for Class IV restorations in primary incisors: An in vitro study.

Background. Aesthetic restorations of severely decayed anterior primary teeth are challenging due to the small size of the teeth and the large pulp chambers. Therefore, this study evaluated and compared the tensile and shear bond strengths of conventional versus modified methods (slot technique) of Cl IV restorations in primary incisors. Methods. A total of 120 extracted intact maxillary primary central and lateral incisors were divided into two groups. In group A, conventional Cl IV cavities were prepared. In group B, after conventional cavity preparation, four and three incisal slots were prepared on the incisal edges of the central and lateral incisors, respectively. All the teeth were restored using composite resin, and then the tensile and shear bond strengths were evaluated. Results. A statistically significant increase in the tensile bond strength of restorations was recorded in the modified technique compared to the conventional method (P=0.001). Although an increase in the shear bond strengths was found in the modified method, the value did not reach a statistically significant level (P=0.158). The most frequent fracture type was adhesive in the conventional group and cohesive in the modified group, considering the tensile and shear bond strength tests. In both groups, the highest average tensile bond strength was recorded in teeth with the cohesive fracture in dentin, and the lowest average was seen in the adhesive type. Conclusions. Incisal slots could increase the tensile bond strengths of Cl IV composite resin restorations in primary teeth.

Esthetic restoration of mutilated primary anterior teeth using ribbond – Report of two cases

Early childhood caries is one of the most common and severe oral health problems among the children. It is associated with aesthetic and functional problems that can interfere in the personality and behavioural development of the child. Severe ECC in children leads to extensive breakdown of the tooth structure requiring placement of a intracanal post or retainer before restoration of the tooth. The present case series describes two cases of 4 and 5 year old children with severely decayed maxillary anterior teeth that were restored using Ribbond as a post material followed by resin-composite strip crowns.

Clinical Effectiveness of Restorative Materials for the Restoration of Carious Primary Teeth: An Umbrella Review.

Since untreated dental caries remain a worldwide burden, this umbrella review aimed to assess the quality of evidence on the clinical effectiveness of different restorative materials for the treatment of carious primary teeth. A literature search in electronic bibliographic databases was performed to find systematic reviews with at least two-arm comparisons between restorative materials and a follow-up period ≥12 months. Reviews retrieved were screened; those eligible were selected, and the degree of overlap was calculated using the ‘corrected covered area’ (CCA). Data were extracted and the risk of bias was assessed using the ROBIS tool. Fourteen systematic reviews with a moderate overlap (6% CCA) were included. All materials studied performed similarly and were equally efficient for the restoration of carious primary teeth. Amalgam and resin composite had the lowest mean failure rate at 24 months while high-viscosity and metal-reinforced glass ionomer cements had the highest. At 36 months, high-viscosity glass ionomer cements showed the highest failure rate with compomer showing the lowest. Most reviews had an unclear risk of bias. Within the limitations of the review, all materials have acceptable mean failure rates and could be recommended for the restoration of carious primary teeth.

Clinical Accuracy of Two Different Criteria for the Detection of Caries Lesions around Restorations in Primary Teeth

This is a delayed-type cross-sectional prospective accuracy study nested in a randomized clinical trial. The aim was to investigate the diagnostic accuracy of two visual criteria for caries lesions detection around restorations in primary teeth: the International Dental Federation (FDI) criteria, considering adaptation, staining, and the presence of caries, and the Caries Associated with Restorations and Sealants (CARS) system. For this, one examiner made the diagnosis and subsequent treatment decision using visual assessment in 163 children (3–10 years old) with both FDI and CARS criteria. The order of criteria used was defined by randomization. The reference standard was composed of two approaches: (1) the presence of carious tissue after restoration removal and (2) the presence of caries lesions after 6 and 12 months of follow-up. Sensitivity, specificity, and accuracy parameters were calculated at the dentin threshold. Poisson multilevel regression analyses were performed to evaluate the association of the diagnostic methods and other explanatory variables with the outcomes. Of the 651 restorations included, 480 were evaluated by the reference standard methods and were analyzed. The CARS system presented higher accuracy (0.721) than those obtained with FDI recurrence of caries (0.702), FDI marginal adaptation (0.700), and FDI marginal staining criteria (0.681). The FDI marginal staining showed the study’s lowest sensitivity (0.280) and accuracy (0.681) values. The specificity values of FDI recurrence of caries and FDI marginal adaptation were lower than the CARS system. Restorations assessed after the follow-up period resulted in lower sensitivity but higher specificity than those replaced after initial evaluation. In conclusion, the CARS system is more accurate in detecting caries around restorations in primary teeth than the FDI system, in general. However, the FDI recurrence of caries and FDI marginal adaptation present similar performance to the CARS system when the dentin threshold is considered. On the other hand, marginal staining is not an accurate parameter to evaluate caries around restorations.

Kap survey on stainless steel crowns among undergraduates

Introduction: Stainless steel crowns (SSC) are an important restorative armamentarium in paediatric dentistry. They are cemented with a biocompatible luting agent and are adapted to individual teeth. An appropriate cementing agent for SSCs is conventional glass ionomer cement. For the restoration of primary teeth, these crowns offer an outstanding alternative to other restorative materials. Aim: The main aim of this survey is to analyse the knowledge, attitude and practice on stainless steel crowns among undergraduates. Materials and method: Self-administrated questionnaire was designed based on the knowledge, attitude and practice of stainless steel crowns. The questionnaire contained 14 questions which were shared through Google forms link. The study population included undergraduates belonging to the 18 – 25 age group. The statistics done using SPSS software, chi square test was done to check the association and a p value of 0.05 was said to be statistically significant. The survey has been completed in the month of February 2021. Results: 53% think extensively decayed teeth are the major indication for stainless steel crown, 34% think as a preventive restoration and 13% think severe cases of bruxism.

New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial.

BackgroundThe clinical performance of new restorative materials must be evaluated before recommending its use in primary teeth.AimThis randomized clinical trial evaluated the survival rates of restorations in single and occluso-proximal cavities of primary teeth performed with a new dual-cure resin-based material in comparison with a resin-modified glass ionomer cement after 12 months of follow-up.Materials and methodsA total of 107 restorations were placed in 27 children by one experienced pediatric dentist. Two materials were tested: Vitremer and a dual-cure resin-based material with (CentionN+Adh) and without (Cention N-Adh) adhesive system application. Two calibrated and blinded examiners evaluated the restorations at 3, 6, and 12-month. The longevity of the restorations was analyzed using Kaplan-Meier survival curves and Log-rank test (α = 5%).ResultsThe overall survival rates after 12-month were 81.9% for Vitremer, 70.4% for Cention N+Adh, and 66.7% for Cention N-Adh, which had the poorer performance (HR = 0.54; 95% CI= 0.31-0.95; p = 0.031). When considering the type of the cavities, the difference was significant only for occluso-proximal cavities when Cention N-Adh was used (HR = 0.46; CI = 0.26-0.81; p = 0.008).ConclusionAll evaluated materials are suitable for restoring occlusal cavities after selective caries removal. However, Cention N needs to be used with adhesive in occluso-proximal cavities.Clinical significanceCention-N can be used for deciduous teeth restorations, with similar longevity rates as resin modified glass ionomer cements.Trial registration number RBR-9nqszrHow to cite this articleda Cunha CM, Wambier LM, Paris Matos TD, et al. New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial. Int J Clin Pediatr Dent 2022;15(1):38-46.

Fracture strength of preformed zirconia crown and new custom-made zirconia crown for the restoration of deciduous molars: in vitro study.

Preformed metal crown (PMC) were considered as the best method of restoring primary molars. In recent years, dentistry has seen the emergence of esthetic full-coverage restorative alternatives that gave better results but their ability to manipulate the size, shape, and fit is very limited. The milled zirconia crown is a new alternative for the restoration of deciduous teeth, but the mechanical properties of these restorations need to be tested. To assess and compare the force required to fracture on two posterior pedodontics crowns: a prefabricated Zirconia crowns (PZC) (NuSmile Zr Zirconia®) and a new custom-made zirconia crown (also called Zirkid©) on a freshly extracted deciduous molars. Thirty freshly extracted deciduous molars were selected and were randomized into two groups: (1) molars prepared to receive the PZC and (2) molars prepared to receive the milled zirconia crowns. All pediatric crowns were cemented with glass ionomer and the samples were placed in the thermocycling machine for thermal aging of 1000 cycles. Mechanical compression forces were applied using the Universal Testing Machine until fracture of the crowns. The force required to fracture were evaluated. Since variable was normally distributed with Kolmogorov-Smirnov test, Student t test was used for statistical comparison. This study showed that the mean fracture force was significantly elevated with zirconia crowns made with Zirkid© (2888.6 ± 1060.2N) compared to NuSmile Zr crowns (646.5 ± 223.9N) (p value < 0.001). Considering the limitations of the present in vitro study, further in vitro and in vivo studies are required to support the use of Zirkid© in primary molar teeth restorations and to assess others mechanical properties.

Gamut of tooth coloured opportunities to reinstate the paediatric smile: A review

Early Childhood Caries has been acknowledged as a root of severe decay in children at a global level. Most frequently we see involvement of upper incisors followed by the molars. This disturbs the phonetics and most importantly the aesthetics of the child. Over the years, there have been plenteous studies concerning the restoration of primary teeth. As the technology advanced, the level of parental satisfaction with the conventional stainless-steel crowns lowered, this made the Paediatric dentists to search for an aesthetic restoration for the decayed primary tooth. Treatment of decayed anterior teeth can be done by a variety of techniques which includes Strip crowns, Polycarbonate crowns, Cheng crowns, acrylic crowns, Zirconia crowns and the most recent is Figaro crowns. The advent of such advanced techniques and materials helps in creating beautiful restorations which help children to improve their self-image as the child aesthetics is the guide to the adult aesthetics. This article gives an overview of few of the aesthetic options for rehabilitation of ECC cases.

Prevalence of unsatisfactory dental restorations in posterior primary teeth and associated factors.

The aim of this study was to investigate the prevalence of unsatisfactory dental restorations on posterior primary teeth and associated factors in school children aged six to ten years. A cross-sectional study was conducted with children randomly selected from public schools in a small Brazilian town. Questionnaires were sent to the guardians addressing socioeconomic and behavioral aspects of the child. Oral examinations were performed at the schools to determine the quality of dental restorations, visible biofilm, and presence of moderate/extensive untreated caries (scores 3-6 ICDAS). This examination was performed by two previously trained and calibrated examiners. Associations were tested using multilevel logistic regression. Among the 400 children evaluated, 98 had restorations (217 teeth). The prevalence of unsatisfactory restorations was 34.6%. Restorations in amalgam were less likely to fail compared to those in glass ionomer cement (OR = 0.11; 95%CI: 0.02-0.49; p = 0.005). Children with moderate/extensive untreated caries were more likely to have unsatisfactory restorations (OR = 6.79; 95%CI: 2.20-20.93; p = 0.001). Children with a visible plaque index ≥ 20% were also more likely to have unsatisfactory restorations (OR = 2.28 95%CI: 1.05-4.92; p = 0.036). The prevalence of unsatisfactory restorations was high. The occurrence of this outcome was associated with restorative material, presence of caries, and visible plaque.

Does selective caries removal in combination with antimicrobial photodynamic therapy affect the clinical performance of adhesive restorations of primary or permanent teeth? A systematic review with meta-analysis.

to answer the following question: Does the SCR technique in combination with aPDT affect the clinical performance of adhesive restorations in deep carious lesions of primary or permanent teeth? a systematic review was conducted. Five databases, supplemented by trial registers, google scholar, manual search, personal communications, and grey literature were investigated. Randomized clinical trials were included. Two independent reviewers selected the studies, extracted qualitatively the data, and evaluated the risk of bias (using Cochrane Collaboration's tool and Robot Reviewer program). The certainty of the evidence was accessed based on The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. A meta-analysis of comparable data was performed with RevMan software 5.3. A total of 39 articles and 3 studies were found. The final selection included 3 articles with a total of 82 participants. No studies were found on permanent teeth. The studies presented low risk of bias. Considering the treatment in the experimental (SCR + aPDT) or control groups (SCR), no difference on clinical performance of adhesive restorations in deep caries of primary teeth was observed after 6 months (p = 0.78; CI -0.01 (-0.09, 0.07)) or 12 months (p =0.75; CI -0.02 (-0.12, 0.08)). All outcomes presented moderate certainty of evidence mainly due to the small sample size that downgrade the GRADE scores. based on moderate certainty of the evidence, the clinical use of aPDT as an adjuvant of SCR has potential indication for treatment in deep caries of primary teeth. However, studies with more follow up and on permanent teeth are missing with the necessity for further research.

Evaluation of the microbial, cytotoxic and physico-chemical properties of the stainless steel crowns used in pediatric dentistry

Preformed stainless steel crowns are used in pediatric dentistry to obtain full crown restoration of primary molar teeth. They are consider the best restoration in terms of durability and effectiveness. The purpose of this study is to evaluate microbial, cytological and physio-chemical properties to determine whereas stainless steel crown are biocompatible, safe for surrounding tissue and helpful in avoiding micro-organisms influence on the tooth tissue. Based on the results, it was determined that stainless steel crowns used in pediatric dentistry represent no cytotoxic risk to the surrounding tissues, have a low probability of developing hypersensitivity to the coronal material and also that their biological properties make them suitable to use in pediatric dentistry for the reconstruction of damaged primary molar tissue.

Physical properties and wear behavior of CAD/CAM resin composite blocks containing S-PRG filler for restoring primary molar teeth

ObjectivesThis study aimed to develop computer-aided design/computer-aided manufacturing (CAD/CAM) resin composite blocks (RCBs) containing surface pre-reacted glass-ionomer (S-PRG) filler for primary molar teeth and evaluate their physical properties and wear resistance. MethodsExperimental CAD/CAM RCBs containing S-PRG filler for primary molar teeth (EB), a commercial CAD/CAM RCB (HC), two resin composites for primary teeth (BKP and BKZ) and one for permanent teeth (BⅡ) were used. Hardness tests, three-point bending tests, fracture toughness tests, and water absorption tests were conducted. Wear tests were conducted for these materials and stainless steel crowns (SSCs). ResultsThe Vickers hardness of EB was lower than that of HC (p < 0.05), and there was no significant difference among BKZ, BKP, and BⅡ (p > 0.05). After 1 week of water immersion, EB and HC showed greater flexural strength than the other materials (p < 0.05). EB showed greater fracture toughness than the other materials (p < 0.05). The water absorption of EB was lower than that of HC, BKZ, and BKP (p < 0.05), and greater than that of BⅡ (p < 0.05). Antagonist wear was significantly smaller in EB than in HC and BⅡ (p < 0.05), and significantly greater than in BKZ (p < 0.05). Antagonist wear could not be measured in SSC because of excessive wear that was out of range of the surface roughness tester. SignificanceThe CAD/CAM RCBs containing S-PRG filler for primary molar teeth developed in this study demonstrated adequate physical properties and wear performance, suggesting that they are suitable for restoration of primary molar teeth and could function in place of SSCs.