Composite Resin Restorations Research Articles

Evaluation of Fracture Resistance of Root Canal Treated Teeth Restored with Different Types of Post-Endodontic Restorations: An In Vitro Study

Background Clinicians often face issues in restoring teeth with extensive root canals using various restorative methods. For clinical success these methods of restoration must be evaluated.Methods A randomized controlled trial was conducted on sixty extracted intact maxillary premolars. The prmolars were collected and equally divided into six groups. Except for G1 all the other groups were treated endodontically G2 MOD preparation without restoration G3 MOD preparation with resin composite restoration G4 MOD preparation with resin composite restoration amp restored with porcelain fused metal crown G5 MOD preparation restored with glass fiber horizontal post and resin composite and G6 MOD preparation restored with Polyethylene fiber mesh. The specimens were loaded in a micro universal testing machine until the fracture occurred. Failure loads were then statistically analyzed. The mode of failure was determined by visual inspection.Results Composite resin restorations reinforced with a fiberglass horizontal post and polyethylene mesh significantly increased fracture resistance of endodontically treated premolar teeth with MOD cavity. Conclusion Fiberglass horizontal post can be used as an alternative for post endodontic restoration in endodontically treated teeth with MOD cavities.

Clinical performance of various bonding agents in noncarious cervical defects.

Four bonding agents and a composite restorative resin were evaluated in patients having noncarious cervical defects. This clinical trial was conducted in patients having at least 4 noncarious cervical defects in posterior teeth evaluating the clinical effectiveness in relation to retention, discoloration at margins, and postoperative sensitivity of 5th, 6th, 7th, and 8th generations of bonding agents over a period of baseline, 3, 6, 12, and 24 months. Data were recorded and put into statistical analysis using Chi-square tests. At 24 months, retention rate was found out to be 92.6% for the 7th generation which was better than 5th (66.7%) and 6th (70.4%) generation whereas significant marginal discoloration was seen at 6 months follow-up in which 5th generation showed maximum results. However, all the four generations have an equal score of postoperative sensitivity at all the time intervals. The 7th generation adhesives performed better than other generations in terms of retention. Changes in marginal discoloration were detected at 6 months with maximum score in 5th generation adhesives.

An In Vitro Comparative Evaluation of Fracture Strength of Composite Resin and Activa Kids Bioactive Restorative for Use in Strip Crowns

Background Advanced stages of early childhood caries requires complex measures such as strip crowns for the anterior teeth and stainless steel crowns for the posterior teeth. Composite resin is the traditional material of choice for use in strip crowns. ACTIVA KIDS Bio ACTIVE-RESTORATIVE is the first bioactive composite with pedo shade delivering all the chemical properties of glass-ionomer cement and physical properties of composite resins.Aim The aim of this study was to compare the fracture strengths of composite resin and ACTIVA KIDS BioActive Restorative Pulpdent USA when used with a strip crown for restoring primary anterior teeth.Methodology Twenty exfoliated non-carious human maxillary primary central and lateral incisors were selected for the study to receive strip crowns and the dimensions were standardized for all the samples. In Group I Composite resin Te-Encom Plus Ivoclar vivadent and in Group II ACTIVA Kids BioActive Restorative Pulpdent USA were used to fill the strip crowns respectively after etching and application of bonding agent. After light curing the samples strip crowns were then removed assessed for fracture strength under Universal testing machine. Fracture strength of both the groups was statistically analyzed and recorded using student ldquotrdquo test.Results The minimum to maximum force obtained was 235.08ndash682.71 N for Group 1 which when compared to Group II 167.57ndash449.29 N was higher. However fracture strength between both the groups p .062 showed no significant difference statistically. Deformation at break percentage has shown significant difference between both the groups p.004 which was higher for Group I 1.34 when compared to Group II 0.68.Conclusion The fracture strength of experimental group restored with ACTIVA Kids Bioactive Restorative was comparable with composite resin when used as a core material inside the strip crown for anterior restorations. ACTIVA Kids Bioactive Restorative can be a better material of choice compared to traditional composite resins because of its excellent chemical and physical properties. The data also showed the fracture strength of ACTIVA Kids Bioactive Restorative to be comparable to composite resins.

Activity-based Costing of Common Caries Treatments Among Paediatric Patients

Background: Activity-based costing (ABC) is a micro-costing method. Despite being an accurate tool for cost calculation, ABC system is rarely applied in the dental fraternity as it is complex to be conducted. Data gathered through ABC is beneficial in bridging the gap between policy makers who emphasise on cost saving and the practitioners who emphasise on quality of treatment. Aim: To conduct an ABC of common treatments for caries management among paediatric patients at Hospital Canselor Tuanku Muhriz (HCTM), Malaysia. Methods: ABC was conducted through a clinical pathway to lay out the routine activities of dental caries management among paediatric patients, and to gather information about the equipment, instruments and consumables used, personnel involved, and the time spent for each procedure. Then, these resources were assigned into different categories namely equipment more than RM 500.00, instruments less than RM 500.00, consumables and staff salary. Finally, cost drivers were determined by calculating the amount of resources used and the time spent. Results: Based on the clinical pathway conducted, there were 10 common treatments for caries management for paediatric patients. The common treatments involved were fissure sealant, glass ionomer cement (GIC) restoration for primary teeth, composite resin (CR) restoration for primary teeth, CR restoration for permanent teeth, strip crown restoration, stainless steel crown (SSC) restoration, pulpotomy, pulpectomy, extraction and scaling. The price range of treatment ranged from RM 60.00 to RM 450.00. Pulpotomy had the highest cost, whereas extraction of teeth had the lowest cost. Conclusion: Study on costing is important to reduce the gap between the demand in dental treatment and the limited resources available to perform the treatment. ABC is deemed to be appropriate to be used in this study as dental treatments are largely procedure-based and this costing method produces a a more precise and transparent data. The outcome of this data provides a tool for other hospitals to be used as a standardised approach for treating these patients and subsequently improve the quality of dental care given.

Effect of novel biomodification strategies on bonding to pulp chamber dentin - An In Vitro study.

Adhesion to dentin remains a tough challenge due to its heterogeneous composition, complex histologic structure and high tubular content, warranting the need to investigate methods to improve the bond strength of the commonly used access restorative materials to pulp chamber dentin. To evaluate the effect of dentin biomodification using 6.5% grape seed extract and a 980 nm diode LASER on the shear bond strength of resin-based bonded restoration to pulp chamber dentin. Access cavities were prepared in 42 extracted human maxillary premolars, which were then sectioned in a buccolingual direction. The samples were serially immersed in 5.25% NaOCl for 40 minutes and 17% EDTA for 3 minutes and allocated into three groups: the control group, the group pre-treated with 6.5% grape seed extract (GSE) and the group pre-treated with a 980 nm diode light amplification by stimulated emission of radiation (LASER). All the samples were restored with resin composites and subjected to shear bond strength testing using a universal testing machine. Statistical analysis was done using SPSS version 23 software. The mean shear bond strength was highest in the group pre-treated with GSE, followed by that pre-treated with diode LASER and finally in the control group. Dentin biomodification using both chemical and physical agents such as grape seed extract and diode LASER was shown to improve the shear bond strength of resin composite endodontic access restorations to the pulp chamber dentin.

Impact of access cavities on root canal preparation, restorative protocol quality, and fracture resistance of teeth.

The survival of endodontically treated teeth depends on the remaining tooth structure. The aim of this study was to evaluate the impact of different access cavities on root canal preparation, restorative protocol, and fracture resistance of endodontically treated teeth. Fifty-six mandibular molars were divided into control (n=8) and experimental (n=16) groups according to access cavity: Traditional, Conservative, and Truss; and redistributed (n=8) according to instrumentation protocols: Reciproc Blue and R-motion. After, teeth were scanned in micro-CT and then filled and redistributed according to composite resin restoration (n=8): Filtek One BulkFill and Filtek Z350. A new micro-CT scan was performed to analyze the restorative material. Then, samples were submitted to fracture resistance testing and the failure pattern was determined. Data were analyzed using paired T-test, ANOVA, Tukey, and chi-square tests (α=0.05). In Truss, R-Motion promoted less transportation in different thirds of root canals. Higher percentages of voids (5.05%) and filling material (11.7%) were observed in Truss. Fracture resistance values were higher for the control group, followed by Truss, Conservative, and Traditional. The predominant failure pattern was type-II. In Truss, reciprocating instruments with smaller taper showed less canal transportation. Also, Truss provided higher values of fracture resistance, although it presented a higher percentage of voids and remaining filling material. Thus, in Truss, reciprocating files with smaller taper showed less canal transportation, and these cavities provided higher values of fracture resistance, although it presented a higher percentage of voids and remaining filling material.

Surface roughness and microhardness evaluation of composite resin restorations subjected to three different polishing systems immediately and after 24 h: An in vitro study.

Finishing and polishing of composite resin restorations can be considered two different procedures or two steps of a single procedure. During the finishing procedure, contours are corrected while margins and irregularities are smoothened. The polishing procedures result in the production of a smooth and lustrous finish. Consensus regarding the correct timing for initiating the steps of finishing and polishing after the curing of the composite resins is divided. Some authors support immediate finishing and polishing while other authors support delaying the finishing and polishing procedures. The aim of this study is to evaluate the surface roughness and microhardness of composite resin restoration subjected to finishing and three different polishing systems immediately and after 24 h. Eighty composite resin samples were prepared. A Teflon mold was made which was customized for this study having dimensions of 10-mm diameter and 2-mm depth. For the first group of specimens, Group I (n = 20) the composite resin surface was covered with Mylar Strips which acted as control. The other specimens (n = 60) were prepared without the use of a Mylar strip, followed by curing. For all the samples, curing was done with a light-emitting diode for 40 s each. Eighty light-cured samples were divided equally into 4 groups, each group containing 20 samples (n = 20). Out of the 20 samples, in the second, third, and fourth groups, (Kenda C. G. I., Shofu Super-snap X-Treme, and Eve Diacomp Plus Twist) 10 samples were finished and polished immediately after curing and the other 10 samples were finished and polished after 24 h of curing. The samples in Groups II, III, and IV were subjected to finishing by a 12-fluted tungsten carbide bur and were polished according to the respective manufacturer's instructions. The samples were then subjected to quantitative analysis of surface roughness by a noncontact three-dimensional optical profilometer (Bruker GT-Q; Ettlingen, Germany) and qualitative analysis of surface roughness by a scanning electron microscope (Zeiss EVO 18 Special Edition; Carl-Zeiss-Strasse; Oberkochen Germany) at ×10,000 magnification. The samples were also subjected to Vickers microhardness measurement using a microhardness tester (Leica VMHT 001; Walter UHL GmbH, Germany) under 100 g load over 10 s. A. For surface roughness: The samples cured under Mylar strips gave the least surface roughness values (0.25 ± 0.032). Immediate finishing and polishing procedures led to statistically less surface roughness than when finishing and polishing procedures were performed after a delay of 24 h for all polishing systems used B. For microhardness: The samples cured under Mylar strips gave the least microhardness values (57.1 ± 2.03). Delayed finishing and polishing increased microhardness values in all finishing and polishing systems used. Different polishing systems did not have any significant effect on the microhardness values in immediate and delayed finishing and polishing groups.

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.

Influence of filler types on wear and surface hardness of composite resin restorations.

Wear and surface hardness of resin composites are of relevance from the clinical standpoint. With the incorporation of novel filler system, more studies need to be performed to investigate newly marketed resin composites. The objective of this study was to investigate the abrasive wear and surface hardness of dental restorative with different filler types. Nanohybrid filled Harmonize (HM) and Tetric N-Ceram (TNC), microhybrid filled Filtek Z250 (Z250), nanofilled Filtek Z350 (Z350) were included in the study. Twelve cylindrical resin composites specimens with 10 mm in diameter and 6 mm in thickness were prepared for abrasive wear test. Eight hundred cycles under 17 kg load were conducted for final wear by CW3-1 wear machine. The specimen was cleaned with an ultrasonic unit for 3 min followed with drying procedure. After measurement of weight loss and the density of specimens, the specimens were kept for measurement of surface hardness. Surface hardness was measured using a micro-hardness tester with a Vickers diamond indenter after polishing. Three specimens of each material were observed by scanning electron microscopy (SEM) after the abrasion to evaluate the morphology of the surface. Data were analyzed using one-way analysis of variance (ANOVA), followed by Tukey HSD test (α = .05). Z250 performed the least volume wear loss (41.1 ± 2.1 mm3), as well as the hardest value (102.7 ± 2.9 HV). There was no significant difference with the volume wear loss (p = 1.000) and surface hardness (p = 0.874) of HM and TNC. SEM images of nanohybrid filled HM and TNC represented smoother surface compared with other types of resin composites. Microhybrid Z250 showed the highest wear resistance and surface hardness, nanofilled and nanohybrid resin composites may still face the insufficient of wear and surface hardness quality.

Stress distribution of endodontically treated mandibular molars with varying amounts of tooth structure restored with direct composite resin with or without cuspal coverage: A 3D finite element analysis.

Decision-making regarding whether cuspal coverage is required or not for the restoration of root canal-treated posterior teeth is still a matter of challenge for the dentist. Four models of endodontically treated mandibular molars with mesio-occlusal (MO) cavity were designed and simulated with direct composite resin restorations. Group 1A - cavity width <½ the intercuspal distance restored without cuspal coverage, Group 1B - same as Group 1A but with cuspal coverage, Group 2A - MO cavity width >½ but <2/3rd the intercuspal distance restored without cuspal coverage, and Group 2B - same as Group 2A but with cuspal coverage. The models received occlusal load to simulate a mastication load. Static finite element analysis (FEA) was adopted for predicting the stress distribution generated in the restored tooth by the loading condition. FEA of the models have shown that the variations in stress values were significant in bulk-fill material compared to enamel and other structures. Comparing the maximum and minimum principal stress values in the overall region demonstrated that 2A was safer, whereas 2B was found to be the worst case. The results indicate that restoration of endodontically treated mandibular molar with loss of one marginal ridge with composite resin without cuspal coverage revealed minimal internal stress values and showed the best performance overall.

The Impact of Saliva and Oral Microbiome on Restorative Dental Materials

Saliva and the oral microbiome play critical roles in the performance and longevity of dental restorative materials. Saliva's buffering capacity, pH regulation, and remineralization impact the durability and stability of materials. Variations in saliva composition among individuals can influence wear resistance and surface degradation of these materials. This review explores the intricate relationship between saliva, the oral microbiome, and restorative dental materials, emphasizing their mutual influences and the implications for dental practice. The oral microbiome, consisting of diverse microorganisms, further complicates this interaction. Bacterial adhesion, biofilm formation, and microbial metabolism significantly affect the integrity of restorative materials. For example, the degradation of composite resins by oral bacteria and their acidic byproducts can compromise the mechanical properties of these materials. Clinical manifestations of these interactions include deterioration of composite resin restorations, biofilm formation, and corrosion of amalgam restorations. Recognizing these manifestations is crucial for dentists to implement timely interventions and personalized management strategies. Regular monitoring and timely intervention, coupled with advancements in biomaterials, are key to enhancing the durability and effectiveness of restorative dental treatments.

Do different adhesives influence the color stability and fluorescence of composite restorations after aging?

This study aimed to evaluate the influence of dental adhesive color on the chromatic stability and fluorescence intensity of composite resin restorations of different thicknesses. Ninety bovine enamel samples were obtained and restored with resin composite varying thicknesses of restorative material and enamel (1.0 mm enamel and 1.0 mm composite; 1.5 mm enamel and 0.5 mm composite; 0.5 mm enamel and 1.5 mm composite). The restorations were made of composite resin (Opallis E-bleach H) using different types of dental adhesives: Ambar, Ambar APS, and Single Bond Universal (n=10). The samples were subjected to color measurement tests in a spectrophotometer using CIEDE2000 and fluorescence intensity measurements before and after aging in a red wine coloring solution. Data were subjected to analysis of variance (ANOVA) and Tukey's test (α = 0.05). There were no statistically significant changes in color stability or fluorescence intensity for restorations made of different materials or thicknesses (p>0.05). Single Bond Universal showed greater color stability at 0.5 mm thickness (ΔE00 = 4.4 ± 1.6) compared to other thicknesses of the same material (p=0.003), as well as a greater difference in fluorescence intensity after aging at 1.5 mm thickness (-414.9 ± 103.8) compared to other materials (p=0.0002). Overall, it was concluded that the different adhesive systems did not influence the color stability and fluorescence of restorations of different thicknesses.

Marginal integrity of composite resin restoration in class I cavities prepared by hydro-abrasion

Aim To evaluate and compare the marginal integrity of composite resin restorations made by two different preparation techniques: conventional drill and hydro-abrasion. Materials and methods Forty extracted human premolars with simple occlusal caries were used. The teeth were fixed with sticky wax to the base of plastic cylinder. The cylinder was filled with self-curing acrylic resin so that only root was embedded within the self-curing acrylic resin. The teeth were randomly divided into two main groups (n = 20) according to the preparation technique. Group I: class I cavity preparation was done by the conventional drill method using a #245 Carbide bur and contra angle high-speed hand piece with water coolant. Cavity design was restricted to remove caries with no undercuts, and no beveling. Group II: class I cavity preparation was done by Aquacut Quattro air hydro-abrasion unit which uses a gamma irradiated aluminum oxide particle as abrasives (29 μm), cutting fluid and a hand piece of 0.6 mm diameter tip. The preparation in both groups was restored by the same composite resin (Grandio) and adhesive systems (Futurabond U) following the manufacturer's instructions. All specimens were thermocycled. Impressions for each tooth was made using a polyvinyl Siloxane material. The impressions were then poured with epoxy resin. These replicas were examined under scanning electron microscope. Scanning electron microscope photographs of tested samples were used for the gap evaluation. Results It was found that, group I recorded higher mean value of marginal gap length (157.57 ± 35.15 μm) than group II that recorded (69.55 ± 20.02 μm). Also, group I recorded higher mean value of marginal gap length ratio (10.72 ± 2.47) than group II that recorded (7.44 ± 2.69). Conclusion Conventional drilling technique was faster than the hydro-abrasion technique for cavity preparation. Hydro-abrasion technique showed more marginal adaptation than conventional drilling technique.

Nature-mimicking layering with composite resins through a bio-inspired analysis: 25 years of the polychromatic technique.

For decades, the dental community has discussed which materials would be the ideal substitutes for lost tooth structure. Initially, the biomimetic approach advocated that feldspathic ceramics would be the material of choice for enamel. However, given the complexity of obtaining excellent dental technicians and the financial cost, are composite resins a suitable replacement? The optical properties with opalescence and fluorescence effects, as well as this material's high fracture toughness, indicate it as a long-lasting restorative material. However, because this material depends on the operator's expertise, knowledge of layering techniques and the selection of each material for the different layers is required. Thus, knowledge of the polychromatic technique through a bioinspired approach is necessary to obtain results of life-like restorations. This article aims to review the polychromatic layering technique (PLT), considering the optical and mechanical properties of dentin and enamel and correlating these properties with current composite resins to guide clinicians in selecting the most suitable restoratives for their clinical challenges. The polychromatic layering technique is revisited, cross-referencing the properties of dentin and enamel with current composite resin restoratives and their biomimetic properties. The effectiveness and predictability of the PLT are corroborated in clinical cases of varying degrees of difficulty requiring different layering strategies. After the bio-inspired analysis, using nature as a model to be understood and followed, it is possible to note how the polychromatic technique remains current and viable in mimicking nature, providing esthetic and natural results in the layering of composite resins. Composite resins effectively replicate the optical and mechanical characteristics of natural dentin and enamel through the bioinspired approach presented by the polychromatic layering technique.

The Effect of Food-Simulating Liquids on Surface Features of Single-Shade Universal Composites: An In Vitro Study.

This study aimed to investigate the microhardness, surface roughness, and field emission scanning electron microscopes (FE-SEM) images of three different single-shade composites (Essentia Universal, Omnichroma, and Vittra APS Unique) in food simulation liquids such as ethanol, citric acid, and distilled water. Three single-shade universal composites were selected for this study. For each composite resin group, 92 samples (5-mm diameter and 2-mm depth) were prepared in plexiglass molds (N = 276). Then, samples were separated into four groups randomly consisting of 23 samples each (10 for hardness, 10 for roughness, and 3 for FE-SEM analysis). Three groups were immersed in food-simulating liquids (FSL)-citric acid (0.02N), distilled water, and 75% ethanol stored in a glass at 37°C for the next 7 days to simulate a wet oral environment. Control samples were stored in an opaque-light-proof box at room temperature. After the conditioning period, roughness and microhardness were measured, and FE-SEM analysis was performed. For statistical analysis, the two-way analysis of variance and Tukey honestly significant difference tests were used to evaluate roughness and microhardness (P < 0.05). There was a statistically significant difference between the composites in terms of roughness and hardness averages (P = 0.001; P < 0.05). Omnichroma showed the most surface changes in ethanol storage, whereas Vittra Unique showed the most surface changes in citric acid storage such as Essentia. FSL that mimic various oral environments affect single-shade universal resin composite restorations.

Effect of Polydopamine on Bonding Characteristics of Mineral Trioxide Aggregate to Resin Composite.

The success of vital pulp therapy is crucial to preserve the integrity of the teeth and to enable an uninterrupted root formation in a young permanent tooth. This warrants placement of an intact permanent seal immediately in contact with the pulp capping material. Mineral trioxide aggregate (MTA) sets by hydration and deters placement of an immediate permanent resin composite restoration over it. The aim of this in vitro study is to evaluate the wettability, surface morphology and shear bond strength (SBS) of polydopamine (PDA)-pretreated MTA to resin composite (RC). The contact angle (CA) and morphological changes caused by self-etch (SE) adhesive on untreated and PDA-pretreated MTA was analyzed using contact angle meter and scanning electron microscope (SEM) respectively. To evaluate SBS, 144 MTA samples were prepared using a custom-made mold of 5 mm diameter and 3 mm height. The samples were randomly divided into two groups of 72 samples each based on whether their surface was pretreated with PDA or not. Under each group, nano-hybrid RC restoration was done either immediately or after a delay of 3 h, 24 h and 96 h. SBS of the MTA/resin composite assembly was tested in a universal testing machine. CA values were analyzed using One-way analysis of variance and Games-Howell Post Hoc test. Mann-Whitney test and Friedman post-hoc Dunn test were used to analyze SBS values. SE adhesive made a significantly lesser mean CA with PDA-pretreated MTA (27.20°+-2.28) compared to untreated MTA (34.22°+-1.45, p<0.05). SEM micrographs showed that while etching with SE primer eroded the surface characteristics, PDA coating minimized the erosive effect of the acidic primer and preserved the original crystalline plate-like structure of MTA. At all tested time intervals, PDA pretreatment significantly increased the SBS of MTA to RC, compared to untreated control. Immediate bond strength of PDA pretreated MTA (26.30+-7.60 MPa) was equivalent to the SBS value achieved at 96 h with untreated MTA (27.82+-2.96 MPa). Within the limitations of this in vitro study, it can be concluded that PDA pretreatment of MTA surface improved its wettability, prevented loss of surface integrity following etching and increased the SBS of RC to MTA. (EEJ-2022-11-144).

Biological evaluation of Partial caries removal in class II resin composite restorations with two different clinical endpoints of excavation: A 12-month clinical study

Biological evaluation of Partial caries removal in class II resin composite restorations with two different clinical endpoints of excavation: A 12-month clinical study

A practical, predictable, and reliable method to select shades for direct resin composite restorations.

This article describes a practical, predictable, and reliable method to select shades for direct composite restorations using custom shade guides made of resin composite at hand using a process of elimination CLINICAL CONSIDERATIONS: Esthetics in direct resin composite restorations depends on the clinician's ability to reproduce the shape and shade of natural teeth, thus appropriate shade selection is a must. This method presented in this article simplifies the process of shade selection for direct resin composite restorations. The use of custom shades tabs made of commecially available resin composites, its arrangment and a process of elimination of tabs during shade selection allows the practitioner to obtain the best possible resin composite shade available for every case. The use of custom shade guide tabs and an elimination protocol facilitates and expedites the process of shade selection for direct resin composites CLINICAL SIGNIFICANCE: The article presents a practical, predictable, and reliable method to select shades for direct resin composite restorations for daily practice.

Evaluation of microleakage patterns, micromorphological and elemental analysis of tooth/restoration interface of four class V self-adhesive resin composite restorations

Evaluation of microleakage patterns, micromorphological and elemental analysis of tooth/restoration interface of four class V self-adhesive resin composite restorations

Effect of different beverages on surface roughness of resin composite restorations

Effect of different beverages on surface roughness of resin composite restorations