States Public Research Articles

Implementing a Comprehensive CPR Education in New York State Public High Schools: Ideas, Drawbacks, & Future Directions.

Cardiopulmonary resuscitation (CPR) is a lifesaving skill that can be employed when people experience cardiac arrest. While the benefits of CPR on survival are well known, much of the American population remains uneducated on how to perform it. There are many reasons for this, ranging from the cost of CPR courses to fear of making mistakes in emergency situations. There have been a variety of efforts across the United States that attempted to boost CPR education, one of which is education in schools. While not a federal law, many states now require some degree of CPR education to be provided to high school students. New York joined this coalition of states in September of 2014. Signed into law by then Governor Cuomo, Act 804-C helped pave the way for CPR education across many pupils in the state. While undoubtedly a step in the right direction, many elements of 804-C promote a disjointed, unequal, and sometimes insufficient CPR education across different schools and counties in the state. In this review, we will highlight some shortcomings of 804-C. We will also highlight ways in which New York State can improve upon their CPR education efforts while also acknowledging logistical and financial obstacles that our proposals might incur.

A REPULSA DA POPULAÇÃO QUANTO A CRACOLÂNDIA: O CAOS E A GERAÇÃO DE UM PROBLEMA SOCIAL

The present work aims to investigate a study on Cracolandia as a generating factor of a social problem, in view of the absence of efficient policies of State intervention. In this work there is the objective of presenting the origin and evolution of Cracolandia, as well as bringing to light the responsibility of the State of São Paulo in the face of actions to confront this social problem. To discuss the theme, bibliographic research will be adopted, with emphasis on government news from the State of São Paulo, on data provided by the State Public Secretariat and on legislation relevant to the theme. In this way, it is perceived that the scenario in question is extremely degrading, and it is a situation directly linked to the omissive and repressive action of the State, as there are no efficient public policies that can solve this problem, but only measures that repress the homeless and drug addicts who live in Cracolandia.

Marginal Degradation of Universal Adhesive Restorations in NCCLs: A Systematic Review and Meta-analysis

Purpose This systematic review aimed to answer the PICO question: do adhesive protocols used for non-carious cervical lesions (NCCLs) using a universal adhesive system influence marginal degradation, marginal staining, and retention of these restorations? The self-etching adhesive strategy and selective enamel etching were compared with the etch-and-rinse strategy as a control. Materials and Methods The study searched various databases, including PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Scopus, Embase, and grey literature, to find randomized clinical trials (RCTs) comparing self-etching (SE) or selective enamel etching (SEE) to the etch and rinse (ER) strategy. The risk of methodological bias was assessed using the Cochrane RoB 2 tool. Data were dichotomized and analyzed using RevMan v 5.3, adopting the Mantel-Haenszel method. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results Twenty RCTs were included in the meta-analysis. Results showed that using universal adhesives with the SE strategy resulted in clinical signs of marginal degradation at 12 months, 24 months, and 36 months of follow-up, and marginal staining at 24 months. The adhesive strategy did not interfere with the retention of restorative material used for NCCLs over 36 months, as assessed based on both the United States Public Health Service (USPHS) and World Dental Federation (FDI) criteria. Conclusion With moderate certainty of evidence, after 24 months of follow-up, the SE strategy results in the detection of clinical signs of marginal degradation and staining. The adhesive strategy adopted did not influence the retention rate of the restorations over 36 months of follow-up.

A 3-year clinical evaluation of endocrown restorations with two different materials using the computer-aided design/ computer-aided manufacture system

ObjectiveTo compare the clinical efficacy of resin nanoceramic and zirconia-reinforced lithium silicate ceramic endocrowns in the treatment of endodontically treated teeth by assessing the clinical performance of restorations fabricated using a chairside computer-aided design/computer-aided manufacturing (CAD/CAM) system. Materials and methodsNinety endocrown restorations were fabricated on endodontically treated teeth using a CAD/CAM system. Fifty-two restorations were fabricated using Lava Ultimate blocks (LU, 3 M Espe, Seefeld, Germany) and 38 restorations were fabricated using Celtra Duo blocks (CD, Dentsply Sirona, York, PA, USA). The performance of the endocrown restorations was evaluated over a 3-year period using the modified United States Public Health Service (USPHS) criteria by two calibrated evaluators. The data were analyzed using Chi-square (x2) and Fisher exact tests (p < 0.05). ResultsThe restoration survival rates in the two groups were 82.7 % (LU) and 86.8 % (CD) (p = 0.6). Twelve restorations failed (8 LU, 4 CD) due to debonding (n = 4, 2 LU, 2 CD), ceramic fracture (n = 2, 1 LU, 1 CD), tooth fracture (n = 5, 4 LU, 1 CD), and secondary caries (n = 1, 1 LU) during the follow-up period. There was no statistically significant difference between the two materials according to the modified USPHS criteria (p > 0.05). ConclusionResin nanoceramic and zirconia-reinforced lithium silicate ceramic endocrown restorations fabricated using a chairside CAD/CAM system demonstrated acceptable clinical performance in the treatment of endodontically treated teeth. Clinical SignificanceResin nanoceramic and zirconia-reinforced lithium silicate ceramics are potential alternative materials for the chairside fabrication of endodontically treated teeth.

Siberian modernist architect A. A. Volovik

This article presents the creative biography of architect Anatoly Afanasyevich Volovik, a seminal figure in the development of Soviet modernism in Novosibirsk. The article devotes particular attention to Volovik’s notable projects, including the State Public Scientific and Technical Library and Tolmachevo Airport. Additionally, it examines the impact of Volovik’s contributions to the advancement of architectural education and the training of young professionals. It is based on archival materials, contemporaneous testimonies, and an analysis of his legacy in the context of 20th-century architectural heritage.

Economic Community of West African States (ECOWAS) Public–Private Partnership (PPP) Strategy to Development

Economic Community of West African States (ECOWAS) Public–Private Partnership (PPP) Strategy to Development

Desjudicialização da saúde e diálogos interinstitucionais em Minas Gerais: a análise do Acordo de Cooperação Técnica para a gestão dos medicamentos Ranibizumabe e Aflibercept

Objective: to understand the judicialization of health in Brazil and analyze, from the perspective of health de-judicialization, the Technical Cooperation Agreement signed on December 2, 2021, between the State Health Departmentof Minas Gerais , the State Attorney General's Office of Minas Gerais, and the State Public Defender's Office of Minas Gerais for the management of the medications Ranibizumab and Aflibercept. Method: a narrative review of the literature on the judicialization of health and an exploratory study based on documentary analysis of the antecedents of the Technical Cooperation Agreement were carried out. Results and discussions: Self-composition and consensual resolution of conflicts by the Public Administration has broad legal support and, in the current legal and administrative scenario, is the most effective and efficient means of realizing the underlying public interest, notably the right to health, promoting its dejudicialization. This scenario points to the potential for new solutions, including the implementation of interinstitutional dialogues, such as the Technical Cooperation Agreement studied, which is expected to serve as the embryo for a permanent trend in the management of the judicialization of health within the scope of State Health Departmentof Minas Gerais. Final considerations: ahe cooperation agreement studied has great potential for the dejudicialization of actions with requests for ophthalmological medicines, in addition to others whose incorporations are proposed within it. It also promotes synergistic and convergent action by actors involved in judicialization. The perspective is that, from this milestone, these legal actions will decrease and patients will begin to be served through the United Health System administrative supply route. Submission: 03/19/24| Review: 08/16/24| Approval: 09/01/24

Teachers’ Quality and Students’ Academic Performance in Osun State Public Senior Secondary Schools, Nigeria

Effective and efficient quality of teachers improves the level of students’ academic performance. This study investigated teachers’ quality and students’ academic performance in Osun State Public Senior Secondary Schools, Nigeria. The objectives of this study were to establish the relationship between teachers’ academic qualifications; teachers’ years of teaching experience; teachers’ professional qualifications and teachers’ exposure to in-service training and students’ academic performance in Osun State Public Senior Secondary Schools. The study adopted a descriptive survey of correlational type. Three hundred respondents were used for the study. Teachers’ Quality Questionnaire” (TQQ) and Students’ Academic Performance Proforma (SAPP) were used for data collection. Five research questions were raised and answered to guide the study's conduct using descriptive statistics of frequency and percentages. Five research hypotheses were formulated and tested using inferential Pearson Product-Moment correlation statistics at 0.05 significance level. Findings showed that teachers’ quality has a positive and significant relationship with students’ academic performance in Osun State Public Secondary Schools, Nigeria. Based on the findings, it was recommended among others that; school management should ensure that teachers yet to register as professionals should be encouraged to do so. This will enable teachers to register with the Teacher Registration Council of Nigeria (TRCN) and be identified as qualified teachers also endeavours to motivate teachers to attend educational conferences to improve their teaching skills to be effective and efficient.

State Public Schools and Thermal Comfort: The Case of Eemti Monsenhor José Gerardo Ferreira Gomes in the City of Sobral (CE) – Brazil

This article aims to analyze the thermal comfort of the courtyard/cafeteria of the Monsenhor Jos&amp;eacute; Gerardo Ferreira Gomes Full-Time High School (EEMTI), from the perspective of the Disconfort Index (DI). The research was guided by the theoretical assumptions defined by Professor Carlos Augusto de Figueiredo Monteiro (2003), who defined a theoretical and methodological framework for the understanding of the urban factor, through the Urban Climate System (UCS). The aforementioned school, located on the outskirts of the city of Sobral/CE-Brazil, underwent changes in its teaching modality in 2017, changing to the full-time education system, where students remain at school all day, eating three meals. However, the building, even though it has undergone some adaptations for this new modality, is the same as when it was inaugurated in 1977. This fact, associated with the local environmental conditions of hot semarid climate, typical of the Brazilian Northeast, makes it difficult for students to accommodate and remain in outdoor spaces. The results collected and the DI analysis indicate a situation of thermal discomfort in most of the times analyzed, even though the research took place in the rainy season for the region, which presents a lot of cloudiness and milder temperature conditions.

Comparative Assessment of Compomers and Ormocers as Pit and Fissure Sealants in Permanent Molars among Children Aged 7-9 Years.

In recent years, the dental profession's focus has shifted from the therapeutic to the preventive aspect of dental caries. Pit and fissure sealants, optimal fluoridation, healthy dietary habits, and good oral hygiene have been recommended for caries prevention. Many sealant materials are available on the market. Compomers are hybrid dental materials that are modified composite resins with polyacids. The esthetic properties of traditional composite systems are combined with the fluoride-releasing and adhesive properties of glass ionomer cement (GIC). Organically modified ceramic (Ormocer) material has high abrasion resistance and better aesthetics, similar to natural teeth. To compare the sealing ability of compomer and ormocer as pit and fissure sealants in permanent mandibular first molars of 7-9-year-old children. A cross-sectional study with a split-mouth design was conducted on 88 children aged 7-9 years who attended the Department of Pediatric and Preventive Dentistry. Children were selected based on the inclusion and exclusion criteria. By tossing a coin, the placement of sealant material was selected for the right permanent first molar. Rubber dam isolation was done. The tooth surface was etched and washed. The respective sealants were applied. Sealants were cured with visible light, and occlusion was checked with articulating paper. Subsequently, the second sealant was placed in the next appointment, following the same clinical procedure in the opposite quadrant. Clinical evaluation was done at 3, 6, and 9 months for retention, marginal integrity, color match, wear, and presence of caries. The criteria were graded and rated as alpha, beta, and charlie based on modified Ryge United States Public Health Service (USPHS) criteria. All the data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) software 20.0. The retention rate of ormocer at the 9-month review interval was 88.3%. There was a statistically significant difference in retention rates between compomer and ormocer (p = 0.003). The marginal integrity and wear of ormocer at the 9-month review interval were 84.4% compared with compomer, which was statistically significant with p = 0.010 and p = 0.035, respectively. Children with the fewest caries belonged to the ormocer group (p = 0.010) compared to the compomer group. Children with ormocer as a pit and fissure sealant showed good retention, remarkable marginal integrity, absence of wear, and fewer dental caries compared to compomer sealants. Hence, ormocer-based sealants can be used in pediatric dental practice to protect children's oral hygiene and promote a healthy lifestyle. Saravanan SM, Srinivasan D, AR SE, et al. Comparative Assessment of Compomers and Ormocers as Pit and Fissure Sealants in Permanent Molars among Children Aged 7-9 Years. Int J Clin Pediatr Dent 2024;17(7):742-747.

Using Quality Improvement to Expand and Align State Public Health Long-Term Follow-up Data Collection Across Newborn Screening Conditions

Context: Despite the undeniable success of newborn screening (NBS), numerous barriers exist regarding long-term follow-up (LTFU) of children with conditions included in NBS. Furthermore, there is a focus on condition-specific follow-up with no national guidelines for standard quality measures collected by state public health LTFU programs. Program: Minnesota Department of Health (MDH) Longitudinal Follow-up for NBS. Implementation: A state public health LTFU for NBS quality improvement (QI) project was carried out with collaboration between MDH project team members and a QI Steering Team who provided clinical, public health, education, caregiver, and community perspectives and expertise to MDH. Relevant measures were selected from existing data elements, and additional measures were developed based on exchange between MDH project team and the QI Steering Team. Potential data sources were explored and prioritized. Processes for querying existing data sources such as death records were refined, new sources such as electronic health records and paper/PDF health records were established, and data collection was piloted. The Minnesota Electronic Disease Surveillance System was modified, and an electronic data form was created to promote consistent data abstraction from sources. Throughout the project, progress was evaluated and shared. At project conclusion, MDH project team and the QI Steering Team reviewed project outcomes and approaches to evolve the project into ongoing surveillance. Evaluation: Five common public health LTFU measures were determined. Overall, 77% of attempted measures were successfully collected. Primary and secondary data sources were adopted. In addition, collected data resulted in 7% of cases that were closed to further public health LTFU, often related to a move out of state. Discussion: This project established the feasibility of state public health LTFU surveillance of outcomes and health care use by collecting a common data set applicable across NBS conditions.

Science Teachers Preparedness for Artificial Intelligence in Practical Instruction Control and Delivery to Oyo State Public Secondary Schools

The dispatch of practical instructions to schools and supervisors prior to the actual conduct of the practical examination over the years has not received the same level of attention as that given to the movements of people and goods and, therefore, is prone to challenges. However, the process could be automated using artificial intelligence. Previous studies have investigated the effects of automation on the control and delivery of goods in the transport management sector, mostly in the Western world. Therefore, this study assessed science teachers’ challenges and readiness for artificial intelligence in practical instruction control and delivery systems. The study adopted ex-post facto design and used one hundred science teachers as participants. Science Teacher Readiness for Automated Practical Instruction Control and Delivery (r = 0.83) was used to collect data. The data collected were analysed descriptively. There are more male (73%) science teachers than female (27%). 84% of the respondent listed cost as one of the challenges, and 83% of the respondents indicated resistant to change and technical difficulties, ethical issue 67% and integration with existing system 65%) 64 The science teachers are moderately ready 64% while 24% are lowly ready and 12% are highly ready for the deployment of automated practical instruction control and delivery system. Artificial intelligence for science practical instruction delivery has greater benefits than the manual way of delivery; however, science teachers are ready for its deployment despite its challenges. Therefore, efforts should be geared towards overcoming the inherent challenges so that the benefits can be fully enjoyed.

The survival and clinical performance of anterior composite resin restorations and posterior indirect and cast restorations used to treat generalised tooth wear

Objective To evaluate the survival and clinical performance of restorative materials used in the rehabilitation of generalised severe tooth wear within a UK NHS postgraduate teaching hospital.Methods The clinical performance of 527 restorations on 20 patients with generalised severe tooth wear was reviewed after a mean period of five years. Anterior teeth were restored with direct composite resin and posterior teeth with indirect restorations. The study used the modified United States Public Health Service criteria for restoration assessment. Survival of the restorations was analysed using Kaplan-Meier survival curves, the log-rank test and the Cox proportional hazards regression analysis.Results The sample included 20 participants: 13 men and 7 women, with a median age of 51.8 years (range: 33-73 years). The median survival time for all restorations was 11.3 years when major failures were considered and 5.9 years for restorations when all types of failure were considered. A median survival time of 5.9 years for composite resin restorations and over seven years for cast restorations was found when considering all failures. Composite resin restorations commonly failed as a result of fracture, wear and marginal discolouration. Factors significantly influencing restoration survival were the material used, aetiology, incisal relationship and tooth location. The biological complications associated with this treatment regime were rare. Patient satisfaction remained generally high, with greatest dissatisfaction related to treatment time.Conclusions The use of anterior composite resin with posterior indirect restorations to treat generalised severe tooth wear is a viable treatment modality with very few major complications.

Color Stability of Single-Shade Resin Composites in Direct Restorations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The objective was to compare the color match and color stability behavior of single- and multi-shade resin-based composites (RBCs) used for direct restorations. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized clinical trials evaluating the shade performance of single-shade RBCs in direct restorations were included. A search of the scientific literature was performed in five databases (April 2024). The meta-analysis was performed using RevMan 5.4, calculating the risk difference (RD) and 95% confidence interval (CI) of the dichotomous outcome using a random effects model. Bias was assessed using the RoB 2.0 tool, and certainty of evidence was assessed using the GRADEpro tool. Four studies were selected, with 263 restorations analyzed. The results showed comparable performance between single-shade RBCs and multi-shade RBCs in terms of color match and color stability over 12 months. Three studies had a low risk of bias with all expected results, and one study had some concerns. The certainty of evidence for color stability was considered low for all follow-up periods due to the small number of events and sample size. According to the United States Public Health Service Evaluation (USPHS) and the World Dental Federation (FDI), there is comparable clinical color performance between single-shade and multi-shade RBCs over 12 months.

Evaluation of Sustainable Development for Low-Volume Roads in Sarawak

The national socio-economic development programme prioritises rural development, and the state of Sarawak requires many rural roads to connect existing villages to the main roads. This programme can be achieved by upgrading existing non-standard access roads or constructing new access roads. The current challenges and issues related to the sustainable development of low-volume roads (LVRs) in the Malaysian state of Sarawak were investigated in this study. The key goals of the study were to understand the challenges of sustainable development in Low Volume Roads (LVRs) in Sarawak using expert interviews as well as surveys on experienced engineers. It aimed at clarifying what LVRs are, highlighting challenges to do with designing and planning them, and also discussing pavement design aspects. The data for the research was collected through interviews with experts in state Public Work Department (PWD) and consultants with more than 15 years’ experience in road planning and construction. An online questionnaire was distributed and it targeted government agencies, consultants, contractors, with 52 respondents out of 200 possible. This helped to identify important problems associated with LVR development; it stressed that a proper knowledge of LVR design, planning difficulties and those specific concerning pavement designs is needed among professionals within Sarawak road building industry. Based on the findings, immediate need for actions was required to be taken by road agencies to investigate the development and appropriate design of LVRs also to record and gather historical data on current LVRs for further improvement.

An Assessment of Kwara State Public Library Services: Problems and Prospects

An Assessment of Kwara State Public Library Services: Problems and Prospects

The moving goalposts - tightening design goals during a sound impact study for a New York State Article VII filing

Article VII of the New York State Public Service Law has a review process for applications to site, construct, and operate large-scale electric or natural gas transmission facilities. A transmission facility developer proposed to rebuild 12 miles of an above-ground electric transmission line and an adjoining substation in southern New York. In the middle of the permitting process, one reviewing entity issued a new guidance document that outlined sound study methodologies and sound level design goals for projects filing Article VII applications. This arrived after the initial sound level impact study was finished and the Article VII application was deemed complete for the project. Epsilon Associates, Inc., the acoustical consultant, revisited the sound model and then implemented mitigation in the form of a 30-foot-tall barrier for the proposed substation upgrade to meet the more stringent limits outlined in the guidance. Although the project was ultimately approved and constructed, additional time was spent both by the consultant and the developer which also accrued additional costs for the project attributable to this new guidance.

Clinical Performance of Computer-Aided Design (CAD)/Computer-Aided Manufacturing (CAM) Resin Nanoceramic Endocrowns in Restoring Molars: An In Vivo Study.

Background It is difficult to determine the optimal method for restoring endodontically treated teeth, as several factors affect this decision. Functional requirements and the amount of remaining coronal tissue are considered the most important factors in choosing the best restoration for those teeth. Endocrown was introduced as a conservative alternative for endodontically treated and coronally damaged teeth. Aim The aim of this study is to assess the clinical performance of the nanoceramic system for molar endocrowns by evaluating color change, gingival condition, prosthesis integrity, and the presence of secondary caries. Materials and methods The sample consisted of 20 endocrowns. The teeth were prepared with at least 2 mm of wall thickness and a cavity depth of 4 mm from the occlusal surface. The final impression was taken, and the prostheses were adhered using dual-cure resin cement. It was clinically evaluated according to clinical success criteria (United States Public Health Service) in terms of color stability, gingival indexes, integrity of the restoration, and the presence of secondary caries after a week, three months, six months, and a year. The statistical study was conducted using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, NY, USA), and the results were considered statistically significant at the 95% level of significance. The Friedman test was used to study the significance of the differences in the average values of color change, plaque index, and the integrity of the prostheses during follow-up periods. Results The study showed a gradual increase in the degree of color change with follow-up periods. Furthermore, there was no significant difference in the incidence of gingival changes, the integrity of the prosthetic margins, or the occurrence of secondary caries during the follow-up periods. Conclusions Within the limitations of this study, an endocrown made of CeraSmart nanoceramic is an acceptable option for crowning decayed and endodontic-treated molars with acceptable clinical performance.

Performance of Bonded Lithium Disilicate Partial-coverage Crowns in the Restoration of Endodontically Treated Posterior Teeth: An Up to Seven-Year Retrospective Study.

To evaluate the clinical performance of adhesively bonded lithium disilicate glass-ceramic (LDG) partial-coverage crowns in restoring posterior endodontically treated teeth (ETT). A total of 121 morphologically compromised posterior ETT were restored with LDG partial-coverage crowns between October 2015 and January 2018. The restorations were fabricated in the laboratory or at the chairside. Two adhesive systems and resin cements were used to cement the restorations. Tooth and restoration survival rates were calculated. The restorations were evaluated clinically using the modified United States Public Health Service (USPHS) criteria for an observation period of 5-7 years. The Cox proportional hazards model was used to estimate relative failure risks such as tooth type, resin cements, gender, and sleep bruxism. The standard chi-squared test was used to compare the survival of different tooth types for significant differences (α=0.05). In addition, survival probability was calculated using the Kaplan-Meier algorithm. Among seven failed cases, one was a tooth fracture, and six were restoration fractures. According to the Kaplan-Meier analysis, the estimated survival rate of the teeth was 99% for seven years, while the estimated survival rate of the restorations was 94.8% for 5 years and 92.8% for 7 years. Tooth type and resin cements did not influence restoration survival rates (p>0.05), while sleep bruxism and male patients might increase the risk of failure (p<0.05). The indirect adhesively bonded LDG partial-coverage crowns of posterior ETT exhibited favorable clinical outcomes. Ceramic fracture was the most common failure pattern.

The 24 months clinical evaluation of class II bulk fill composite restorations

Background: Resin Composite materials are widely used in daily clinical dentistry because of their moderate cost compared with ceramics, easy placement, adequate esthetics, ability to bond with enamel and dentine, and physico-chemical properties. Bulkfill composite materials were introduced to reduce chairside time. These materials have properties such as optimal bond strength, decreased polymerization shrinkage, and reduced cuspal deflection. This in-vivo study compared the clinical performance of three different class II resin composite restorations. Methods: Seventy-one patients (41 females and 30 males) aged 20–43 years with at least three approximal caries were included in the present study. Two hundred twenty-three teeth with approximal caries were restored with two bulk-fill composites (Tetric-N Ceram Bulk fill [TEC], Filtek Bulk Fill [FB]) and a posterior resin composite (Gradia Direct Posterior [GDP]). Two experienced dentists clinically evaluated the restorations with a 5x magnification loupe using the modified United States Public Health Service (USPHS) criteria at baseline and at 24 months. Results: The chi-square test was performed for statistical analysis. The cumulative retention rate for all restorations at 24 months was 90.5%. Retention loss was observed for three TEC (6.1%), four FB (8.2), and seven GDP (14%) restorations. There was no statistically significant difference among the three resin composite restoration groups in color match, marginal adaptation, surface roughness, marginal discoloration, anatomical form, and secondary caries criteria (P&gt;0.05). Conclusion: Bulk-fill composite restorations in class II slot cavities have the same clinical results as traditional posterior composite restorations.