Restorative Treatment Research Articles

Augmented and virtual reality in dentistry: an introduction

This report introduces the reader to the concepts and applications of augmented and virtual reality in dentistry. Virtual reality (VR) is the computer-generated three-dimensional simulation of a virtual environment accessed through a headset. Augmented reality (AR) is the superimposition of computer-generated imagery or graphics onto the real world, accessed through phones, tablets and headsets. The technology has advanced in recent years with early applications to the medical field revolving around anxiety management, teaching and surgical planning. Uses for surgical orthognathic and other restorative interventions are also in an early phase of development and adoption. CPD/Clinical Relevance: VR and AR have promising applications, but more research must be carried out to determine the technology's validity in dentistry.

Multi‐analytical characterisation of Art Déco dinanderie: Single‐point and map analysis of Jean Dunand's metal artworks

AbstractJean Dunand (1877–1942) was a European artist internationally appreciated at his time for his innovative Art Déco housewares made of hammer‐beaten copper‐based alloys, known as dinanderie. Still uncertain was the nature of the constituting materials; therefore, for the first time, three objects, namely, a bowl, a trinket bowl and a vase, were the target of a multi‐modal work of characterisation. Mobile or benchtop X‐ray fluorescence, Fourier‐transform infrared (FTIR) and Raman spectroscopies were used to adapt the analyses to the shape and size of the artefacts. Elemental analysis verified that the vase consisted of brass Cu70Zn30, whereas the bowl and the trinket bowl were made of nickel silver Cu70Zn19Ni11. The black finishing present on all the artefacts was related to tenorite by Raman spectroscopy, ascribing the patina to an intentional artist's willing and not to spontaneous tarnishing processes. Metal soaps of copper and zinc were documented as degradation products by FTIR spectroscopy. The drawings adorning the vase and the trinket bowl were identified as silver‐based, contrary to what was hypothesised by conservators (i.e., tin‐based) due to conventional Dunand's inlaying technique. Besides single‐point analysis, Raman mapping was performed in‐situ, applying for the first time a Virsa™ Raman Analyser (Renishaw) in the field of cultural heritage. The fibre‐optic‐coupled instrument allowed to comply constantly with the artefacts' geometry thanks to the modular probe and the motorised focus‐tracking stand. The synergic combination of elemental and vibrational analyses resulted successful, providing new and unique information on artist's technique in view of possible restoration interventions.

A naturalistic study of plasma lipid alterations in female patients with anorexia nervosa before and after weight restoration treatment

BackgroundPlasma lipid concentrations in patients with anorexia nervosa (AN) seem to be altered.MethodsWe conducted a naturalistic study with 75 adult female patients with AN and 26 healthy female controls (HC). We measured plasma lipid profile, sex hormones and used self-report questionnaires at admission and discharge.ResultsTotal cholesterol (median (IQR): 4.9 (1.2)) and triglycerides (TG) (1.2 (0.8)) were elevated in AN at admission (BMI 15.3 (3.4)) compared with HC (4.3 (0.7), p = 0.003 and 0.9 (0.3), p = 0.006) and remained elevated at discharge (BMI 18.9 (2.9)) after weight restoration treatment. Estradiol (0.05 (0.1)) and testosterone (0.5 (0.7)) were lower in AN compared with HC (0.3 (0.3), p = < 0.001 and 0.8 (0.5), p = 0.03) and remained low at discharge. There was no change in eating disorder symptoms. Depression symptoms decreased (33 (17) to 30.5 (19), (p = 0.007)). Regression analyses showed that illness duration was a predictor of TG, age was a predictor of total cholesterol and LDL, while educational attainment predicted LDL and TG.ConclusionLipid concentrations remained elevated following weight restoration treatment, suggesting an underlying, premorbid dysregulation in the lipid metabolism in AN that persists following weight restoration. Elevated lipid concentrations may be present prior to illness onset in AN.Level of evidence: IIIEvidence obtained from well-designed cohort or case–control analytic studies.

Prevalence and Management of Early Childhood Caries in Preschoolers

ABSTRACT Background: “Early childhood caries (ECC)” is a prevalent and serious oral health issue affecting preschool-aged children globally, with adverse effects on their overall health and well-being. Objective: This center-based research designed to investigate the prevalence and management of ECC among preschoolers within a specific setting and evaluate associated factors. Methods: A cross-sectional research design was employed, involving 300 preschoolers aged 3 to 5 years. Clinical examinations were conducted, and data on demographic characteristics, oral hygiene practices, dietary habits, and dental visits were collected through structured interviews. Statistical analysis was performed to assess ECC prevalence and examine associations between demographic/behavioral factors and ECC severity. Results: The prevalence of ECC among preschoolers was 65%, with a mean dmfs score of 4.2. Factors such as age, gender, socioeconomic status, and oral hygiene practices were associated with ECC severity. Management strategies included topical fluoride application, oral health education, and restorative treatments. Conclusion: ECC remains a significant public health concern among preschoolers. Comprehensive oral health programs targeting this population are essential to mitigate ECC burden and improve oral health outcomes. Further research is needed to address systemic barriers and disparities in ECC prevention and management.

Optimization and ranking of dental restorative composites by ENTROPY‐VIKOR and VIKOR‐MATLAB

AbstractResin‐based composites, now the most prevalent material for restorative dental treatments, are available in a multitude of types. Next‐generation composites are designed to be bio interactive, solving issues such as secondary caries and mechanical failures, thus prolonging the restoration lifespan. To facilitate the discrimination of the bio interactive composite's performance and the identification of the optimal composition, we tested the VIKOR method for multi‐criteria decision‐making analysis. This study encompassed 12 performance parameters and 5 experimental dental composites. We measured density, void content, water sorption, water solubility, polymerization shrinkage, depth of cure, degree of conversion, hardness, compressive strength, and surface roughness as performance parameters, and we tested a conventional BisGMA‐TEGDMA resin blend filled with yttria‐stabilized zirconia (20 wt.%) and tricalcium phosphate. The alignment between computational methods and MATLAB‐based calculations validated the robustness of the assessment, verifying the significance of the conclusions drawn from this comprehensive analysis. Both methods (ENTROPY‐VIKOR and VIKOR‐MATLAB) ranked TZC0 as the top composite. This research provided a comprehensive understanding of the complex relationship between material composition, performance attributes, and optimization strategies in dental restorative composites, offering valuable insights for future advancements in restorative dentistry.

Effectiveness of error-based active learning compared to conventional lecture-based method among undergraduate dental students: A randomized controlled trial.

Dental education assumes an indispensable role in adequately equipping students for a successful career in dentistry. Error-based active learning, an innovative approach in dental education, is a combination of mistake-driven learning (MDL) and case-based learning (CBL) to provide a transformative learning atmosphere for students. While active learning has gained popularity in dental education, the effectiveness of error-based active learning remains unexplored. This study aims to evaluate the effectiveness of error-based active learning among final-year dental undergraduate students in comparison with the conventional lecture-based approach. A parallel-arm single-blind randomized controlled trial was conducted in a dental institute in India from November 2022 to December 2022. A total of 74 students were randomly allocated to two groups: Group A (n = 37) received error-based active learning and group B (n = 37) received conventional lecture-based learning approach. Atraumatic restorative treatment (ART) was chosen as the topic for the study. The knowledge of students was assessed at three intervals: baseline, post-intervention, and 4 weeks after the intervention, using a self-designed and validated questionnaire with Cronbach's alpha of 0.87 and a content validity ratio of 0.84. A standard survey questionnaire was employed to evaluate students' perceptions of the teaching methods. Error-based active learning group outperformed the lecture-based group significantly in the post-intervention test (20.92 ± 1.42 vs 16.97 ± 3.06), with better knowledge retention (18.30 ± 2.02 vs 14.05 ± 4.26) and positive feedback from the students. The error-based active learning approach proved superior to the conventional lecture-based method in enhancing and retaining knowledge regarding ART.

Enamel White Spot Lesions: A Review of Etiology, Prevention, and Treatment

Enamel White Spot Lesions (EWSLs) are a common dental condition characterized by being opaque or chalky white in appearance. In this review, an overview of the etiology, prevention, and treatment techniques for EWSLs is presented. Enamel demineralization caused by bacteria in dental plaque which releases acids upon the consumption of fermentable carbohydrates causing mineral loss is thought to be the main cause of those lesions, which could be predisposed through orthodontic treatment, poor diet, inadequate oral hygiene and certain medical conditions. So, sustaining an adequate carbohydrate consumption, proper fluoride exposure and good oral hygiene are some of the practices which aid in these lesions’ prevention. Although the success or failure of treatment of EWSLs depends on patient cooperation, depth of the lesion and lesion severity, treatment of those EWSLs should begin with the most conservative approach like remineralization and if failed then more invasive microabrasion, infiltration and maybe even restoration treatment strategies can be pursued. Further research is still needed in the prevention and treatment strategies.

Sexual health in transgender and gender diverse people.

Sexual health and sexual function are critical to the wellbeing of cisgender, transgender, and gender diverse populations. To date, there has been only limited patient-focused evaluation of sexual function in transgender and gender diverse patients at several stages in their gender-affirming medical care. There remains a need to better understand the impact of gender affirming medical and surgical therapy on sexual health, and to develop evidence-based treatments to address sexual dysfunction when present. The impact of gender-affirming hormone therapy on sexual health is complex and evolves over time on treatment. Despite high incidences of complications, major genital gender-affirming surgeries such as vulvovaginoplasty and penile implant placement after phalloplasty yield high patient satisfaction. While treatments to preserve or restore erections and to improve vaginal lubrication have been trialed based upon literature in cisgender populations, there remains minimal evidence to guide medical treatment of sexual dysfunction ranging from erectile dysfunction to dyspareunia. There is a continued need for ongoing efforts to develop patient-reported outcome measures and rigorous investigation of sexual health preservation and restoration treatments in transgender and gender diverse populations.

Results of biochemical and histological studies after restoration of bone defects using cellular technologies in dental patients

Objective of the research was to find out the effectiveness of the use of osteoplastic materials based on the multipotent mesenchymal stromal cells of the adipose tissue during surgical treatment for restoration of bone defects in dental patients. The clinical material included examination of 79 patients who underwent replacement of bone defects of the alveolar processes and/or an alveolar part of the appropriate jaw by means of different osteoplastic materials and their combinations or without their application (the control group). Acid phosphatase activity in the oral fluid of patients was determined by means of the unified “end point” method. Alkaline phosphatase activity in the oral fluid was determined using a set of reagents produced by the company “Filisit-Diagnostika” (Ukraine). Oral fluid mineralization index (MI) of patients was calculated according to the ratio of enzymatic activity of alkaline phosphatase (ALP) to acid phosphatase (AP) according to the formula: MI=ALP/AP. Histological material was taken at the stage of installation of a dental implant. It was established that the use of a composition based on multipotent mesenchymal stromal cells of adipose tissue, platelet-enriched blood plasma and bone tissue substitute containing hydroxyapatite contributes to the improvement of regenerative processes in the bone tissue of the jaws, which is confirmed by a 28.68% decrease in acid phosphatase activity, an increase by 25, 97% of alkaline phosphatase activity in the oral fluid of group B patients and, accordingly, a 77.08% increase in the ratio of alkaline to acid phosphatase. According to the results of histological studies and phase-contrast microscopy, after 6-8 months of observation, in patients of group B, the areas of jaw defects were filled with newly formed bone tissue, identical to native bone, and the resulting trepanobioptas had the structure of cancellous bone with osteoblastic elements forming a chain around osteoid tissue. Having analyzed the results of biochemical and histological studies it was established that application of an osteoplastic composition based on the multipotent mesenchymal stromal cells of the adipose tissue, bone tissue substitute with hydroxyapatite and platelet-rich plasma allows restoration of bone defects of the alveolar processes and an alveolar part of the appropriate jaw in shorter terms. The method is an optimal alternative to traditional osteoplastic materials to be used in modern dental practice and dental implantation.

Deer exclusion is necessary to promote post‐fire herbaceous regeneration in the understorey of a Mediterranean forest

The frequency of severe wildfires is on the rise in the Mediterranean Basin as a result of climate change and land abandonment. Recurrent wildfires may retard or impede ecosystem recovery, frequently requiring the implementation of restoration practices. In that context, a post‐fire deer exclusion experiment was conducted in a Mediterranean mixed forest ecosystem with high population densities of deer species (Fallow deer and Red deer). A deer exclusion area was established as a form of restoration intervention to promote post‐fire vegetation recovery. We surveyed plant species during the second and third springs after fire in both deer‐excluded and deer‐allowed areas in order to detect changes in the community. We analyzed the plant species composition, species diversity, and structure of herbaceous and woody plant communities. We also compared the frequency of annual and perennial herb species, functional groups, and post‐fire plant regeneration strategies. The main differences were due to differences between springs rather than of deer‐excluded and deer‐allowed plots. Deer consumed both woody and herbaceous species, favoring the assemblage of herbaceous over woody species. Deer favored the establishment of annual forbs, including unpalatable and/or exotic species, while limiting the abundance of graminoids. Observed deer impacts could have been magnified during the second spring by a drought. Our study demonstrates that deer exclusion can be an effective restoration practice for promoting post‐fire herbaceous regeneration in forests with significant densities of wild ungulates, although seasonal effects may override restoration practice effects.

Patterns and factors associated with dental service utilization among insured people: a data mining approach

BackgroundInsurance databases contain valuable information related to the use of dental services. This data is instrumental in decision-making processes, enhancing risk assessment, and predicting outcomes. The objective of this study was to identify patterns and factors influencing the utilization of dental services among complementary insured individuals, employing a data mining methodology.MethodsA secondary data analysis was conducted using a dental insurance dataset from Iran in 2022. The Cross-Industry Standard Process for Data Mining (CRISP-DM) was employed as a data mining approach for knowledge extraction from the database. The utilization of dental services was the outcome of interest, and independent variables were chosen based on the available information in the insurance dataset. Dental services were categorized into nine groups: diagnostic, preventive, periodontal, restorative, endodontic, prosthetic, implant, extraction/surgical, and orthodontic procedures. The independent variables included age, gender, family size, insurance history, franchise, insurance limit, and policyholder. A multinomial logistic regression model was utilized to investigate the factors associated with dental care utilization. All analyses were conducted using RapidMiner Version 2020.ResultsThe analysis encompassed a total of 654,418 records, corresponding to 118,268 insured individuals. Predominantly, restorative treatments were the most utilized services, accounting for approximately 38% of all services, followed by diagnostic (18.35%) and endodontic (13.3%) care. Individuals aged between 36 and 60 years had the highest rate of utilization for any dental services. Additionally, families comprising three to four members, individuals with a one-year insurance history, people contracted with a 20% franchise, individuals with a high insurance limit, and insured individuals with a small policyholder, exhibited the highest rate of service usage compared to their counterparts. The regression model revealed that all independent variables were significantly associated with the use of dental services. However, the patterns of association varied among different service categories.ConclusionsRestorative treatments emerged as the most frequently used dental services among insured individuals, followed by diagnostic and endodontic procedures. The pattern of service utilization was influenced by the characteristics of the insured individuals and attributes related to their insurance.

Colorimetric Evaluation of a Reintegration via Spectral Imaging-Case Study: Nasrid Tiling Panel from the Alhambra of Granada (Spain).

Color reintegration is a restoration treatment that involves applying paint or colored plaster to an object of cultural heritage to facilitate its perception and understanding. This study examines the impact of lighting on the visual appearance of one such restored piece: a tiled skirting panel from the Nasrid period (1238-1492), permanently on display at the Museum of the Alhambra (Spain). Spectral images in the range of 380-1080 nm were obtained using a hyperspectral image scanner. CIELAB and CIEDE2000 color coordinates at each pixel were computed assuming the CIE 1931 standard colorimetric observer and considering ten relevant illuminants proposed by the International Commission on Illumination (CIE): D65 plus nine white LEDs. Four main hues (blue, green, yellow, and black) can be distinguished in the original and reintegrated areas. For each hue, mean color difference from the mean (MCDM), CIEDE2000 average distances, volumes, and overlapping volumes were computed in the CIELAB space by comparing the original and the reintegrated zones. The study reveals noticeable average color differences between the original and reintegrated areas within tiles: 6.0 and 4.7 CIEDE2000 units for the yellow and blue tiles (with MCDM values of 3.7 and 4.5 and 5.8 and 7.2, respectively), and 16.6 and 17.8 CIEDE2000 units for the black and green tiles (with MCDM values of 13.2 and 12.2 and 10.9 and 11.3, respectively). The overlapping volume of CIELAB clouds of points corresponding to the original and reintegrated areas ranges from 35% to 50%, indicating that these areas would be perceived as different by observers with normal color vision for all four tiles. However, average color differences between the original and reintegrated areas changed with the tested illuminants by less than 2.6 CIEDE2000 units. Our current methodology provides useful quantitative results for evaluation of the color appearance of a reintegrated area under different light sources, helping curators and museum professionals to choose optimal lighting.

High Anticholinergic Burden and Dental Caries: Findings from Northern Finland Birth Cohort 1966.

Anticholinergic drugs propose a threat for oral health by causing dry mouth. The aim of this cross-sectional study was to investigate whether a high anticholinergic burden was associated with the presence of initial caries lesions, manifested caries lesions, dental fillings, or tooth loss among 46-y-old people. The study population consisted of 1,906 participants from the Northern Finland Birth Cohort 1966 who underwent an oral health examination in 2012-2013. Socioeconomic and medical data were collected from questionnaires, medical records, and national registers. Nine previously published anticholinergic scales were combined and used to measure the high anticholinergic burden from the participants' medication data. Cariological status was determined according to the International Caries Detection and Assessment System, and the number of missing teeth (excluding third molars) was used as an indicator for tooth loss. The decayed, missing, and filled surfaces index was used to depict caries experience. Negative binominal regression models were used to estimate prevalence rate ratios (PRRs) and confidence intervals (CIs). Fourteen percent of the participants (n = 276) used at least 1 anticholinergic drug and about 3% had a high anticholinergic burden (n = 61). After adjusting for confounding factors, participants with a high anticholinergic burden had a higher likelihood of having manifested carious lesions needing restorative treatment (PRR, 1.60; CI, 1.11-2.29) and more missing teeth (PRR, 1.59; CI, 1.13-2.24) when compared to participants without any or with a lower anticholinergic burden. High anticholinergic burden was associated with a present caries experience and with tooth loss among the general middle-aged population. The findings of this study suggest that middle-aged patients with a high anticholinergic burden may have a heightened risk of dental caries. These patients may benefit from targeted caries preventive regimes.

Discrimination of natural and synthetic forms of azurite: An innovative approach based on high-resolution terahertz continuous wave (THz-CW) spectroscopy for Cultural Heritage

It is not always possible to discriminate natural and synthetic forms of pigments in a non-invasive way. In this work, we demonstrate that THz spectroscopy allows for this selective discrimination of chemically related compounds. In the presented results, we show the spectral characterization of the following copper carbonates: natural azurite and two of its synthetic forms, bice blue and blue verditer. In particular, the physical properties of the two synthetic forms were characterized for the first time in the terahertz spectral range by exploiting a high-resolution coherent terahertz Continuous Wave (THz-CW) spectrometer. The findings reveal distinct absorption spectra for the three chemically related pigments, showing specific fingerprints that can be used to discriminate the natural compound from the synthetic forms.In fact, we show that by THz-CW it was possible to discriminate those pure components in binary mixtures and quantify the single components contribution.This identification is of great interest to assist in dating artworks or evidence restoration and retouching treatments. The results demonstrate that THz-CW spectroscopy can pave the way to an innovative approach to the Cultural Heritage field.

Dynamics of tree stems and biomass in old‐growth and secondary forests along gradients in liana dominance, elevation and soil

Abstract Lianas, or woody vines, are key components of many tropical forests and can have substantial impacts on the dynamics and functioning of these important ecosystems. Their competition with trees for resources, in particular light, can hamper the recovery of forests from disturbances. Yet, it is unclear how forest disturbance interacts with liana–tree ratio (LTR), topography and soil properties to shape tree dynamics and the trajectories of forest succession. Using temporal data from the Kilombero Valley and the Udzungwa Mountains of Tanzania, we demonstrate how the dynamics of tree stems and biomass vary between secondary and old‐growth forests with changes in the dominance of lianas and environmental gradients. Greater tree recruitment and mortality in secondary forests compared with old‐growth forests suggested rapid regeneration processes and faster turnover. However, no significant differences were found in the net annual changes in the number or biomass of trees between secondary and old‐growth forests. Our findings also showed that higher LTRs were positively associated with stem mortality but also with tree biomass growth, indicating a nuanced ecological role of lianas in forest ecosystems, which warrants further investigation to fully understand the causal factors at play. Net changes in tree stem numbers decreased significantly with elevation, implying climatic constraints on forest regeneration at higher elevations. Soil cation exchange capacity and organic carbon were found to significantly influence tree stem recruitment and net change in abundance, although their effects on biomass remained unclear. Synthesis: Our findings indicate that the recovery of tropical forests from disturbance in terms of the number and biomass of tree stems may be predictable along environmental gradients. These insights have the potential to broaden our capacity to develop more nuanced strategies that identify when and where tropical forests may require restoration interventions, with a focus on structural recovery.

Medical Voluntarism and Orthopaedic Advancements: Lancashire and the Disabled Ex-Servicemen of the First World War.

This article explores the fundamental role of Lancashire's medical voluntarism in providing restorative orthopaedic treatments to the region's First World War, disabled ex-servicemen and assisting in their return to society. It offers a case study of orthopaedic treatments and schemes of rehabilitation provided at Grangethorpe Hospital, Rusholme, between 1914 and 1918. Forming a regional comparison to existing histories of First World War disabled ex-servicemen, which focus primarily on the interwar period, this article traces continuities in pioneering medicine and examples of Lancashire-based medical individuals and institutions. In doing so, this article demonstrates how the region's response to disablement during the Industrial Revolution underpinned the construction of charities and the advancement of orthopaedic treatments required to provide rehabilitative care during the First World War. Moreover, this paper situates Lancashire and its commitment to medical voluntarism and the reconstruction of disabled ex-servicemen as a key site in the UK's history of voluntarism.

Influence of crown-lengthening surgery on teeth rehabilitated with ceramic single crowns: A 12-month prospective clinical study

ObjectiveTo compare the clinical periodontal parameters of teeth restored with a single ceramic crown, with and without crown lengthening procedure. MethodsThis prospective, longitudinal, controlled, and single-blinded clinical trial involved 22 patients with a total of forty-one teeth with ceramic crowns. The teeth were divided into two groups: test (n = 21), comprising teeth rehabilitated post crown-lengthening surgery, and control (n = 20), comprising teeth rehabilitated without crown-lengthening surgery. Plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing (BoP), and clinical attachment level (CAL) were compared between groups (surgically treated and non-surgically treated) and within each group for each type of site (treated -tt; adjacent – ad; and nonadjacent - nad). Additionally, gingival phenotype (GP), gingival recession (GR), and keratinized tissue width (KTW) were also assessed post- restoration. Statistical analyses used a significance level set at 5 %. ResultsPI, GI, and BoP were reduced, but no statistically significant differences were observed within each group or between groups for most follow-up periods. CAL of the TT sites was consistently higher in the test group, and PD was also higher in the test group (p < 0.05), except at T3. adPD, nadPD, adCAL, and nadCAL demonstrated no significant differences between groups and periods. A significant association was identified between GP and the occurrence of GR, with the thick-flat phenotype demonstrating less association with GR, regardless of whether crown lengthening was performed or not. ConclusionCrown-lengthening surgery in rehabilitated teeth does not significantly affect PI and GI after 12 months. Although crown-lengthening surgery affected PD and CAL in TT sites, it did not affect adjacent and non-adjacent sites. Clinical relevanceThese findings emphasize the importance of considering individual patient factors and the potential impact on periodontal tissues when planning crown-lengthening surgery. Clinicians must have a comprehensive understanding of the dynamics of the periodontal tissues involved in restorative treatments to optimize the procedure, increase success rates, and minimize potential complications.

Atraumatic Restorative Treatment: An Overview and Update

Atraumatic Restorative Treatment: An Overview and Update

Occlusal veneer restoration treatment outcomes of cracked tooth syndrome: A 22.4-month follow-up study.

The aims of this clinical study were to investigate success rate, vital pulp survival rate, tooth survival rate and patient-reported masticatory ability by evaluating the pain symptoms and signs of the cracked teeth as well as Index of Eating Difficulty (IED) and Oral Health Impact Profile-14 (OHIP-14) questionnaire after cracked teeth were restored with occlusal veneers. 27 cracked teeth of 24 patients with cold and/or biting pains without spontaneous/nocturnal pains were recruited in this study. The cracked teeth were restored with occlusal veneers fabricated by lithium disilicate ceramic. Cold test and biting test were used to evaluate pain signs. IED and OHIP-14 questionnaire were used to evaluate masticatory ability. FDI criteria was used to evaluate restorations. The paired Wilcoxon test was used to analyze significant differences of detection rate of pain signs, OHIP scores and IED grade before and after restorations. Kaplan-Meier survival curve was used to describe the success rate, vital pulp survival rate, and tooth survival rate. 27 cracked teeth were restored with occlusal veneers with average of 22.4-month follow-up. Two cracked teeth had pulpitis and pain signs of the other cracked teeth completely disappeared. OHIP total scores were significantly reduced after treatment. Scores of 'pain', 'occlusal discomfort', 'uncomfortable to eat', 'diet unsatisfactory' and 'interrupted meals' reduced significantly after treatment. After treatment, IED grades of 25 vital teeth were significantly lower than those before treatment. FDI scores of 25 restorations except for 2 teeth with pulpitis were no greater than 2. The 12months accumulated pulp survival rate of the cracked teeth was 92.6%. The 12months accumulated tooth survival rate was 100%. The success rate at the latest recall was 92.6%. Occlusal veneer restorations with success rate of 92.6% and the same pulp survival rate might be an effective restoration for treating the cracked teeth. The occlusal veneer restorations might be an option for treating the cracked teeth when cracks only involve enamel and dentin, not dental pulp.

In-Vitro Evaluation of Shear Bond Strength of Glass Ionomer Cement to Primary Teeth Dentin Pretreated with Silver Diamine Fluoride and Sodium Fluoride Varnish

Aim: To evaluate and compare the shear bond strength (SBS) of glass ionomer cement (GIC) to primary teeth dentin pretreated with silver diamine fluoride (SDF) and sodium fluoride (NaF) varnish. Materials and Methods: A total of 50 non carious human primary molars were used in this study. The teeth were prepared to expose a flat dentin surface, ensuring comparability across samples. The samples were then randomly divided into two groups. Group I: The dentin surface of the primary teeth was pretreated with 38% SDF. Group II: The dentin surface of the primary teeth was pretreated with 5% NaF varnish. Following pretreatment, all samples were restored using GIC. The SBS was evaluated using a universal testing machine, which measures the force required to detach the GIC from the dentin surface. Results: The study found that the mean SBS of Group I (SDF 38%) was significantly higher at 10.11 ± 2.34 MPa compared to Group II (NaF 5%), which had a mean SBS of 6.34 ± 2.56 MPa. This represented a mean difference of 3.77 MPa in favor of the SDF pretreatment group. Conclusion: The primary teeth dentin pretreated with 38% SDF demonstrated a significant increase in SBS to GIC compared to the teeth pretreated with 5% NaF varnish. This suggests that SDF not only acts as a caries-preventive agent but also enhances the bond strength of restorative materials adhered to dentin surfaces. Clinical Significance: The findings hold considerable clinical significance, especially for pediatric dentistry. The use of SDF as a dentin pretreatment can improve the adhesion of GIC to the dentin of primary teeth. This is particularly beneficial given the minimally invasive nature of the procedure, making it an optimal choice for young patients who may find conventional dental procedures distressing. In summary, this study supports the use of SDF over NaF varnish for pretreating primary teeth dentin before GIC restoration, due to the superior bond strength observed. Implementing this can improve the longevity and effectiveness of restorative treatments in primary teeth, offering a viable, simple method that aligns well with pediatric dental care standards.