States Public Health Service Criteria Research Articles

Evaluation of Giomer Using Eighth Generation Bonding Agent and Resin-Modified Glass Ionomer Cement Restoration in Non-Carious Cervical Lesions.

Non-carious cervical lesions (NCCL) raise a considerable restorative challenge for the dentist in bonding, as adhesion is not as strong and predictable as enamel bonding. A critical factor for restorative success is the selection of restorative material. Clinicians have tried many restorative materials and techniques to obtain the best performance. The aim of the present study was to evaluate and compare the clinical outcome of a Giomer and Resin modified glass ionomer cement (RMGIC) restoration in NCCL using united states public health service (USPHS) criteria at baseline, 3, 6 and 12 months. Patients from age 25 - 50 years having non-carious cervical lesions on both the sides and requiring restorations were screened. 20 patients were selected and further divided into 2 groups using simple random sampling technique. Group A- Beautifil II restoration using G-Premio bond (n = 10) and Group B- Ketac N100 restoration (n = 10). Restorations were done according to manufacturer's instructions and consequently evaluated at baseline, 3, 6 and 12 months using the USPHS criteria for marginal discolouration, marginal integrity, surface texture, colour match, gross fracture and post-operative sensitivity. Giomer restorations showed better results than RMGIC. There was decrease in alpha ratings in both the study groups i.e., Giomer and RMGIC from 6 to 12 months. The overall findings suggest that both Giomer and RMGIC gave satisfactory clinical results when used to restore non-carious cervical lesions. Both the materials can successfully be used since there was no statistically significant difference in the clinical outcome.

Survival and success of veneered zirconia crowns.

The aim of the present study was to evaluate the long-term clinical survival and success rate of veneered zirconia crowns with a modified anatomical framework design after 10 years in function. In total, 36 zirconia crowns were fabricated for 28 patients. An anatomically modified framework design was developed. Crowns were inserted between 2008 and 2009. A follow-up of 19 patients with 28 crowns was conducted in 2020 to document mechanical and biologic parameters. Additionally, a modified version of the pink esthetic score (PES) was documented. Patient satisfaction was assessed using United States Public Health Service (USPHS) criteria. The success and survival rates were calculated using the Kaplan-Meier analysis. After more than 10 years of clinical service, the survival rate of the zirconia crowns was 92.9%. Biologic complications occurred in 12% of the examined crowns, whereas technical complications occurred in 54%. Mostly, chippings (50%) and insufficient marginal gaps (50%) were observed. Most crowns were positively evaluated for more than one technical complication. Periodontal conditions with probing depths of up to 3 mm were comparable with measured values before crown delivery (73% to 75%). Most of the crowns had modified PES values of 10 or higher. Patient satisfaction was high. The modified framework design led to a high survival rate of the crowns but a relatively low success rate. High patient satisfaction and inconspicuous periodontal conditions were demonstrated. Biologic complications occurred far less frequently than technical complications.

A 32-month evaluation of lithium disilicate cantilever resin-bonded fixed dental prostheses to replace a missing maxillary incisor

The absence of a tooth in the esthetic zone can cause emotional and social distress. The use of minimally invasive and visually pleasing lithium disilicate resin-bonded fixed dental prostheses (RBFDPs) may be a suitable option for replacing a missing maxillary incisor. However, the available literature on lithium disilicate cantilever RBFDPs is limited. This retrospective multicenter study assessed the survival and success rates of lithium disilicate anterior cantilever RBFDPs with an average follow-up period of 3 years up to 9 years. RBFDPs delivered by 3 operators were clinically assessed for survival using a modified United States Public Health Service criteria list. The incidence density was determined for each criterion and operator. The standard error and 95% confidence interval were calculated for each incidence density difference (α=.05 for all analyses). A total of 108 RBFDPs were evaluated after a mean period of 32.45 months, ranging from 14 days to 111 months. None of the restorations exhibited failure, carious lesions, or fractures during the follow-up period. The primary reasons for reduced success rates were inflammation of the surrounding soft tissues and discoloration, with incidence densities of 0.074 and 0.057 per year, respectively. Significant differences were observed among RBFDPs from different operators for criteria that included adaptation, color match, marginal adaptation, polishability, surface staining, gingival health, and antagonist wear. Cantilever lithium disilicate RBFDPs appear to be suitable for short-term restoration. RBFDPs exhibited visible changes after short-term follow-up. However, these changes did not result in failure.

The Effect of Ground and Unground Enamel on the Clinical Performance of Direct Composite Build-up After Orthodontic Treatment: Five Years of Follow-up.

To assess the clinical performance of restorations with ground and unground enamel for diastema closure. Twenty-four patients attended and received two to ten composite build-ups for diastema closure. The restorations were performed separately by grinding and not grinding the enamel on the proximal surfaces on symmetric teeth. A nanofill direct composite (Filtek Ultimate Universal Restorative System, 3M ESPE, St Paul, MN, USA) was used with a three-step etch-and-rinse adhesive (Scotchbond Multi-Purpose, 3M ESPE) for restorations. Restorations were evaluated according to the modified United States Public Health Service (USPHS) criteria at baseline and 1-, 2-, 3-, 4-, and 5-year recalls. The cumulative success rate of direct composite build-up with ground and unground enamel was 100% and 88.7%, respectively. Six restorations with unground enamel failed due to fracture. No significant difference was found between the restorations with ground enamel and unground enamel with regard to the evaluation criteria. The 5-year success rates of restorations with ground and unground enamel were excellent. The success rate of restorations with ground enamel was higher than that of restorations with unground enamel. Fracture was the reason for failure in the restorations with unground enamel.

Clinical performance of monolithic polymer-infiltrated ceramic and lithium disilicate posterior crowns: A controlled, randomized, and double-blind clinical trial

The success rate of monolithic polymer-infiltrated ceramic posterior crowns after 1 year is unclear. The purpose of this controlled, randomized, and double-blind clinical trial was to evaluate the performance of posterior complete crowns in polymer-infiltrated and lithium disilicate ceramics and to assess the impact of oral rehabilitation on esthetic satisfaction, quality of life, and periodontal health. A total of 33 crowns were provided in 18 participants allocated to 2 groups: Control (Lithium disilicate-IPS e.max CAD; Ivoclar AG) and Experimental (Polymer-infiltrated ceramic-Vita Enamic; Vita Zahnfabrik). The crowns were evaluated before treatment (T0) and after 1 (T1), 6 (T2), and 12 (T3) months by using modified United States Public Health Service (USPHS) criteria, visual analog scales (VASs), oral impacts on daily performances (OIDP), and periodontal parameters. Survival analysis was performed by using Kaplan-Meier followed by the log-rank test (α=.05). The OIDP and USPHS data were analyzed descriptively while VASs for esthetic satisfaction and periodontal parameters were statistically evaluated by using the Mann-Whitney Friedman, and Wilcoxon post hoc tests. For 18 participants with a mean age of 47.2 years, 19 crowns were manufactured in lithium disilicate and 14 in polymer-infiltrated ceramic. The Kaplan-Meier test revealed similar survival rates of 92.5% for polymer-infiltrated ceramic and 94.7% for lithium disilicate (P>.05). The analysis of periodontal parameters revealed a significant increase in the bleeding on probing (BOP) for polymer-infiltrated ceramics (P=.032) but for lithium disilicate, it was not significant (P=.387). Survival rates between the evaluated materials were not significantly different, with acceptable clinical performance after 1 year of follow-up.

Two-year clinical evaluation of Class I composite resin restorations using three adhesive systems: A double-blind randomized clinical trial

Aim: The purpose of this randomized split-mouth clinical study was to assess the effect of three adhesive systems on the 2-year clinical success of Class I composite resin restorations. Methodology: In the treatment of the Class I carious lesions of 20 participants aged 18–24 years with at least three similar carious lesions, three adhesives—Clearfil SE Bond (CSE; Kuraray, Osaka, Japan), Single Bond 2 (SB2; 3M ESPE, St. Paul, MN, USA), and Tri-S Bond (TSB; Kuraray, Osaka, Japan)—and a Filtek Z550 nanohybrid composite resin (3M ESPE, St. Paul, MN, USA) were cured. The baseline and 2-year results of the restorations were assessed according to the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. The chi-square test was used to analyze the data obtained. Results: There was no loss of restoration in any group at 2 years. No significant differences were observed in any criteria (marginal staining, fracture retention, secondary caries, and postoperative sensitivity) evaluated except marginal adaptation, in accordance with FDI and USPHS criteria (p > 0.05). At 2 years, SB2 showed the best marginal adaptation, followed by CSE and TBS. There was a statistically significant difference between SB2 and TSB (p ˂ 0.05). Conclusion: All three adhesive systems can be used successfully in the restoration of Class I carious lesions. How to cite this article: Çakır Kılınç NN, Demirbuğa S. Two-year clinical evaluation of Class I composite resin restorations using three adhesive systems: A double-blind randomized clinical trial. Int Dent Res 2023;13(2):67-74. https://doi.org/10.5577/idr.2023.vol13.no2.4 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Evaluation of Abfraction Lesions Restored with Three Dental Materials: A Comparative Study.

Abfraction lesions are manifested as damage to hard tissues in the cervical area of dental crowns. The study aimed to assess the direct restoration of abfraction lesions according to the modified United States Public Health Service (USPHS) criteria for 24 months. The restorations were accomplished with Fuji Bulk-GC, Omnichroma Flow-Tokuyama, and Beautifil® II-Shofu dental materials, and the therapy was or was not associated with wearing thermoformed mouthguards. From the 53 selected and analyzed patients (n = 53), 28 patients (with restorations of abfraction lesions) belonged to the 1st group and 25 patients (with 105 restorations, who also wore mouthguards) belonged to the 2nd group. Blind determination assessments were effectuated at baseline and after 2, 6, 12, 18, and 24 months. Results showed that, regardless of the rating score, there are no significant statistical differences in the evaluation criteria between the two groups of patients Conclusions: For each material, the scores of USPHS criterion presented good clinical performances after 24 months, with no significant statistical differences between the fillings and the applied therapy in the two groups of patients.

Total Rehabilitation Using Adhesive Dental Restorations in Patients with Severe Tooth Wear: A 5-Year Retrospective Case Series Study.

Currently, there is little clinical evidence to support the medium- and long-term survival and clinical performance of ultraconservative approaches using adhesive restorations in full-mouth restorations. The aim of this case series study was to evaluate the medium-term clinical performance of anterior and posterior adhesive restorations applied with direct and indirect techniques using resin composites and glass-ceramic-based materials. The inclusion criteria were an esthetic problem as the main reason for consultation and severe generalized wear of grade 2 to 4 according to the Tooth Wear Evaluation System (TWES 2.0). In addition, at each follow-up appointment, patients were required to submit a clinical-parameter-monitoring record according to the modified United States Public Health Service (USPHS) criteria. Eight patients with severe tooth wear were treated through full rehabilitation in a private dental clinic in Spain by a single operator (AFC). A total of 212 restorations were performed, which were distributed as follows: 66 occlusal veneers, 26 palatal veneers and 120 vestibular veneers. No signs of marginal microleakage or postoperative sensitivity were observed in any occlusal, vestibular and/or palatal restoration after the follow-up period. The estimated survival rate of the 212 restorations was 90.1% over 60 months of observation, with a survival time of 57.6 months. Only 21 restorations had complications, which were mostly resolved with a direct composite resin. The dichotomous variables of the restoration type (posterior veneer, anterior veneer) and the type of restored tooth (anterior, posterior) were the risk predictors with statistically significant influences (p < 0.005) on the survival of the restorations. According to the results of this study, there is a significantly higher risk of restorative complications in posterior teeth compared to anterior teeth. Also, it can be concluded that the indication of adhesive anterior and posterior restorations is justified in the total oral rehabilitation of patients with severe multifactorial tooth wear, as they are associated with a low risk of failure.

Clinical performance comparison between lithium disilicate and hybrid resin nano-ceramic CAD/CAM onlay restorations: a two-year randomized clinical split-mouth study

A total of 20 lithium disilicate glass–ceramics (IPS e.max CAD, Ivoclar Vivadent) and 20 resin nano-ceramic (Voco Grandio Blocks) onlay restorations were performed in 20 patients using a split-mouth design to compare the two-year clinical performance of lithium disilicate and resin nano-ceramic onlay restorations. Both restorations were evaluated at baseline, one-year, and two-year clinical follow-ups based on the modified United States Public Health Service (USPHS) criteria. Chi-square and Fisher’s exact tests showed no statistically significant difference between Voco Grandio and IPS e.max ceramic restorations for all evaluated parameters during the different follow-up periods (p > 0.05). Cochrane’s and MC-Nemar’s tests indicated statistically significant differences regarding color match within the Voco Grandio group. They also indicated statistically significant differences in marginal discoloration, marginal adaptation, surface texture, and postoperative hypersensitivity within both ceramic material groups (p < 0.05). Kaplan–Meier curve indicated that the survival rate of both ceramic materials was 90%. After two years of clinical service, IPS e.max CAD and Voco Grandio onlay restorations exhibited similar clinical performance.

Ceramic anterior veneer restorations in periodontally compromised patients: A retrospective study.

Successful periodontal therapy can lead to poor esthetic results, especially in the anterior region, for which there are treatment options such as direct composite or indirect veneer restorations. Until now, there are no data describing the long-term results of veneer restorations in periodontally treated patients. The aim of this retrospective study was to evaluate the outcome of anterior porcelain veneer restorations in periodontally compromised and noncompromised patients. Periodontally healthy and periodontally compromised patients, who had received anterior veneer restorations at least 5years ago, were invited to a follow-up examination. Groups were divided according to their periodontal diagnosis (periodontally healthy, stage I/II, stage III/IV). Tooth loss, veneer loss, biologic parameters, and complication rates were examined. Also, veneers were evaluated according to modified United States Public Health Service criteria. A total of 68 patients with 312 veneers were examined with a mean follow-up time of 8years. Veneered teeth in patients with periodontitis stage III/IV showed no difference regarding tooth-specific, overall, and functional veneer survival when compared to periodontally healthy patients (Kaplan-Meier analyses). In Cox regression analysis, follow-up time had an impact on complications and veneer loss, whereas periodontal diagnosis showed no significant influence on the survival of restorations. Comparative tests showed that patients with severe periodontitis at baseline have slightly lower veneer survival rates after 8years and slightly higher complication rates after 13years. Long-term results and complication rates of veneer restorations in periodontally compromised patients are comparable to periodontally healthy patients over a mean follow-up of 8years.

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

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

Effect of different adhesive systems on dental defects and sensitivity to teeth in composite resin restoration: a systematic review and meta-analysis.

This meta-analysis aimed to elucidate the effects of various acid etching patterns on the sensitivity of teeth and their clinical effectiveness following composite resin repair. PubMed, Cochrane Library, Web of Science, and Embase databases were searched for relevant studies on the postoperative sensitivity (POS) of composite resin restorations after using different bonding systems. The retrieval was from the inception of the databases to August 13, 2022, with no filter of written language. Literature screening was conducted by two independent researchers. The Cochrane risk-of-bias assessment tool was adopted for quality evaluation, and Stata 15.0 for analysis. Twenty-five randomized controlled trials were included in the present study. Following resin composite restoration, 1309 restorations were bonded by self-etching (SE) adhesives, whereas 1271 restorations were bonded by total-etching (TE) adhesives. The meta-analyses showed that there is no evidence to prove the SE and TE will affect POS at present when measured using the modified United States Public Health Service (USPHS) criteria [RR = 1.00 (95% CI: 0.96, 1.04)], the World Dental Federation (FDI) [RR = 1.06 (95% CI: 0.98, 1.15)], or the visual analog scale (VAS) [SMD = 0.02 (95% CI: -0.15, 0.20)] scales. At a certain follow-up time, TE adhesives provide better outcomes in terms of color match, marginal staining, and marginal adaptation. In other words, TE adhesives have better esthetic results. The type of bonding technique (ER and SE) does not affect the risk and degree of POS in class I/II and class V restorations. Further research is required to verify whether these findings apply to different forms of composite resin restorations. Besides the fact that TE barely increase postoperative sensitivity, it also yields superior cosmetic results.

Clinical performance of some resin-based materials in restoring non-carious cervical lesions

Objectives. The objective of the study was to investigate the clinical performance of two different resin-based materials 6 months after their placement in dental non-carious cervical lesions (NCCL). This study also aimed to evaluate the effects of the materials on periodontal tissues in terms of clinical changes of several periodontal parameters. Material and methods. NCCLs characteristics (localization, morphology, dimensions) were preoperatively recorded. The clinical behavior of the restorations based on the modified United States Public Health Service (USPHS) criteria and periodontal parameters (plaque index, bleeding index, probing depth, and attachment loss) were assessed at baseline and after 1, 3 and 6 months. Results. No significant modifications were recorded for the modified USPHS criteria 6 months after the placement of NCCL restorations excepting postoperative hypersensitivity which was associated with 4 restorations after 6 months. Significant improvements of plaque and bleeding indices were recorded, while no significant modifications were noted for the other periodontal parameters. Conclusions. Considering the clinical success related to the good clinical behavior and the positive effect of the restorations on the periodontal status, the experimental conventional composites and giomers could be considered as a good therapeutic option for the restoration of NCCLs.

Clinical effectiveness of alkasite versus nanofilled resin composite in the restoration of occlusal carious lesions in permanent molar teeth of children: a randomized clinical trial

PurposeTo evaluate and compare the clinical effectiveness of alkasite with nanofilled resin composite restorations for occlusal caries lesions in permanent molar teeth of children, at one-year follow-up.MethodsIn this randomized controlled clinical trial with parallel design, 38 children aged 7–13 years with occlusal caries lesions on 59 first permanent molars were randomly allocated into two groups, Group 1: Filtek™ Z350XT (nanocomposite) and Group 2: Cention N® (alkasite resin composite). The restorations were evaluated at one year using the United States Public Health Service (USPHS) criteria. Data were analyzed using Chi-square or Fisher’s exact test.ResultsAll restorations had either Alpha or Bravo scores at one-year follow-up. In Group 1, all restorations scored Alpha, while one restoration each (3.6%) in Group 2 scored Bravo for fracture and marginal adaptation. All restorations in both groups scored Alpha for retention, secondary caries, and post-operative sensitivity. For anatomic form, all restorations in Group 1 scored Alpha, while three (10.7%) restorations in Group 2 had Bravo scores. For marginal discolouration, three restorations in both groups scored Bravo (11.5% and 10.7%, respectively). For surface roughness, one restoration (3.8%) in Group 1 and three restorations in Group 2 (10.7%) scored Bravo. The comparative results between the two groups for all the variables in the USPHS criteria were not statistically significantly different.ConclusionsThe performances of the nanofilled composite and alkasite were clinically acceptable and comparable. Alkasite can be an alternative material for the restoration of occlusal caries lesions in permanent molars of children.Clinical trial registrationThe clinical trial was registered at Clinical Trials Registry—India (CTRI Reg no: CTRI/2020/12/029830 Dated: 15/12/2020).

Porcelain Veneers in Vital vs. Non-Vital Teeth: A Retrospective Clinical Evaluation.

Nowadays, the ceramic veneer approach can be considered more predictable than direct composite veneer. To date, there is a lack of studies comparing the clinical performance of anterior veneers cemented on vital teeth (VT) and non-vital teeth (NVT). This longitudinal clinical study investigated the performance of ceramic veneers in VT or anterior NVT. A total of 55 patients were evaluated in the study. Two groups were defined based on the vitality status of the teeth (93 teeth-vital and 61 teeth-non-vital). The United States Public Health Service (USPHS) criteria were used to assess the clinical status. The data were evaluated statistically with the Mann-Whitney U test. All restorations were considered acceptable, and only one veneer in VT failed for the criteria of secondary caries. There were no statistically significant differences in any of the criteria evaluated (p ≤ 0.671). The ceramic veneers evaluated showed a satisfactory clinical performance both in VT and NVT.

12 Month's Assessment Of Clinical Efficacy Of Resin Modified Glass Ionomer Cement And Flowable Composites In Restoration Of Non-Carious Cervical Lesions, A Randomized Clinical Trial.

The objective of this study was to compare the clinical efficacy of Resin modified glass ionomer cement and Flowable composite in terms of retention, marginal adaptation and surface texture using United States Public Health Service criteria in non-carious cervical lesions measured over a period of one year. A Randomized Clinical Trial is conducted with Informed consent on 60 patients who are randomly allocated into 2 groups with at least 2 Non Carious Cervical Lesions in each. Group 1 is used for Flowable Composite while group 2 is used for resin modified glass ionomer cement. A recall is maintained to draw conclusions between two materials in terms of occurrence of marginal adaptation, retention and surface texture, to show which material is superior to other. Out of 30 restorations in 12 months follow up, only 19 found to be present in flowable composite group while in resin modified glass ionomer cement group, 28 are retained. Regarding margin integrity, Group 1 showed 21 intact margins whereas 23 margins were intact in group 2, while 18 and 25 showed smooth surface in flowable composite and Resin modified glass ionomer cement group respectively, on exploration. It can be concluded from our study that Resin modified glass ionomer cement is superior to Flowable composite in terms of retention (p=0.005) and surface texture (p=0.045) in restoration of non carious cervical lesion.

One Year Clinical Evaluation Of Translucent Zirconia Crowns In Dental Esthetic Zone With Biologically Oriented Preparation Technique Versus Conventional Preparation (RCT)

Statement of the problem: Tooth preparation with horizontal finish line requires removal of reasonable amount of tooth structure at the cervical area which affects the remaining tooth structure at this area. Therefore, more conservative preparation design such as biologically oriented preparation technique (BOPT) might be needed to save tooth structure at the cervical area. The Purpose: To Evaluate the effect of Conventional preparation design (horizontal), and Biologically Oriented Preparation Technique (BOPT), on Marginal adaptation, fracture and gingival inflammation score of the translucent zirconia crown in dental esthetic zone. Methodology:, 44 monolithic translucent zirconia single crowns were fabricated inn dental esthetic zone . The patients were separated randomly into two groups. Group1: (horizontal preparation design) Group2: BOPT. After final cementation. The Modified United States Public Health Service (MUSPH) criteria for restoration clinical evaluations were used to assess marginal adaption. Gingival inflammation was assessed using gingival inflammation index. Evaluation of the restoration was at intervals of three, six, nine, and twelve months. Results: Comparison between two groups at different intervals regarding marginal adaptation, fracture and gingival inflammation score revealed statistically insignificant difference. Conclusions: Within limitations of the present one year follow up randomized clinical trial, the following conclusions could be drawn: 1.The conventional and BOPT preparation designs both clinically accepted to provide successful dental restoration The lower gingival inflammation score of the restored teeth with the conventional preparation design compared to that of the BOPT, may not be conclusive as regard the study time frame, indicating that increasing the follow-up period might alter the present finding. Clinical implications: Beyond of all the prosthodontic preparation techniques, knowledge of B.O.P.T. (Biological Oriented Preparation Technique) allows us to achieve predictable and consistent results in terms of periodontal health and gingiva architecture surrounding ceramic restoration. Nevertheless, long term studies are necessary to ensure the benefits of this techniques.

Clinical evaluation of complete digital workflow ceramic overlays in treatment of children with molar incisor hypomineralization

Pediatric dentists frequently encounter challenges in management of first permanent molars with molar incisor hypomineralization (MIH). They are found to have posteruptive breakdowns, active growth phase, inconclusive occlusal contacts, and wide pulp chambers with prominent pulp horns. The previous led to poor compliance, defective anesthesia, and restoration adhesion problems.ObjectivesEvaluate clinically indirect lithium disilicate glass–ceramic overlay versus indirect composite resin overlay using complete digital workflow in treatment of permanent molars with MIH in children.Patients and methodsThis split mouth randomized clinical trial compared full digital workflow lithium disilicate glass–ceramic overlay in comparison with the same workflow indirect computer aided design-computer aided manufacturing resin overlay in treatment of MIH molars in 12 children aged between 8 and 13 years with total of 24 first permanent molars into two groups. These MIH vital molars fell in the array of index 2 and 4 upon which the entire carious and hypomineralized enamel was removed with uniform reduction with final shoulder margin on sound enamel to receive the overlays.ResultsBoth groups were assessed according to United States Public Health Services criteria of evaluation on 3 months interval for 9 months where the lithium disilicate glass ceramic overlay group showed 100% cumulative survival rate with consistent retention and anatomic form results as well as complete absence of pain and hypersensitivity at 9 months. No significant difference between both groups except for the anatomic form in which significant difference was found in favor of the lithium disilicate glass–ceramic group.ConclusionOverlays serve as esthetic, conservative and long-term treatment option with digital dentistry incorporation in every aspect of dentistry nowadays to provide accurate and quick delivery of the restorations with both groups behaved in a clinically acceptable performance.

The clinical success of ART restorations and Hall technique in primary molars: a randomized 18-month follow-up study.

The aim of the study was to evaluate the clinical and radiographic success of the Hall technique (HT) and atraumatic restorative treatment (ART) restorations using high-viscosity glass-ionomer cement for the management of occlusal carious lesions in primary molars. This randomized clinical study observed 40 children (aged 5-6 years). For each child, one tooth was treated with HT and one with ART. The primary outcome measures for HT restorations were successful, minor, and major failure rates. Clinical evaluations of ART restorations were performed according to the modified United States Public Health Service criteria during 18-month follow-up. McNemar test was used for statistical analysis. Thirty of 40 (75%) participants returned for 18 months of follow-up. In the clinical evaluations of teeth that were treated with HT, the patients did not have complaints of pain or other symptoms, all crowns remained in the oral cavity, the gums were healthy, and the teeth were functional in all evaluations. At the end of the 18-month follow-up, the surface texture and marginal integrity criteria of ART restorations were recorded as 26.7% and 33.3%, respectively. In the radiographic evaluation of 30 patients treated with ART and HT, all restorations were considered successful. The 18-month clinical and radiographic results after treatments applied to single-surface cavities in anxious children showed that both treatment methods were successful.

Clinical performance of two onlay designs for molars after root canal treatment.

To evaluate the clinical performance of two proposed onlay designs. Molars with occlusal and/or mesial/distal defects after root canal treatment were classified by design into three groups. Onlays without shoulders were the control group (Group C, n = 50). The designed onlays were Group O (n = 50) and the designed mesio-occlusal/disto-occlusal onlays were Group MO/DO (n = 80). All onlays had an occlusal thickness of approximately 1.5-2.0 mm, and the designed onlays had a shoulder depth and width of approximately 1 mm. In Groups C and O, the box-shaped retention was 1.5 mm in depth. The proximal box was connected with a dovetail retention in Group MO/DO. Patients were examined every 6 months and followed for 36 months. Restorations were evaluated by using the modified United States Public Health Service Criteria. Statistical analysis was performed by using Kaplan-Meier analysis, the chi-square test, and Fisher's exact test. No tooth fracture, debonding, secondary caries, or gingivitis was observed in any group. Groups O and MO/DO had satisfactory survival and success rates, and there was no significant difference in performance characteristics among the three groups (P > 0.05). The two proposed onlay designs were effective in protecting molars.