World Dental Federation Criteria Research Articles

The role of visual aids in the clinical success of posterior restorations: Randomized controlled clinical trial

ObjectiveThis clinical study aimed to assess the impact of utilizing loupes and dental operating microscopes (DOM) with varying magnifications on the success of class II direct composite restorations. MethodsA total of 130 class II, moderately deep caries teeth from 85 patients were randomly assigned to four groups: naked eye, ×3 loupe, ×5 loupe, and ×8.5 DOM. Cavities were restored with or without magnification. The restorations were evaluated according to World Dental Federation criteria at 1, 6, and 12-month intervals by previously calibrated evaluators. Cochran's Q test was used to compare paired scores across three or more time points within groups, while the Friedman test was employed to compare scores at three or more time points. Multiple comparisons were adjusted using the Bonferroni correction. The significance level was set at p < 0.05. ResultsStatistical analysis revealed no significant differences among the groups at the 1-, 6-, and 12-month follow-up periods (p > 0.05). Although not statistically significant, the magnified groups exhibited higher scores in aesthetic anatomical form, proximal form, postoperative sensitivity, periodontal response, and adjacent mucosalcriteria compared to the naked eye group. ConclusionAlthough no statistically significant difference was observed at the 12-month follow-up between restorations performed with and without magnification, the groups using magnification showed higher scores.

Clinical performance of different composite materials in class II cavities bonded with universal adhesives.

To assess the clinical performance of two composite materials with two universal adhesives and a two-step self-etch adhesive on class II restorations for 18 months. Two hundred and fifty-two class II cavities were bonded with G-Premio Bond, Single Bond Universal, and Clearfil SE Bond 2. A nanohybrid composite (Filtek Z550 Universal) or a microhybrid composite (G-aenial Posterior) was used to fill the bonded cavities. World Dental Federation criteria were used to evaluate the restorations at 1 week, 6, and 18 months. Statistical analysis was performed using Friedman and Fisher's exact tests (α = 0.05). Retention loss and fracture were not observed in any restorations during the 18 months. The adhesives used showed no significant differences for all criteria examined (p > 0.05) regardless of composite material. After an 18-month follow-up, seven G-aenial Posterior and three Filtek Z550 Universal restorations presented slight marginal discrepancies, with no significant differences (p = 0.246). At 1 week, Filtek Z550 Universal (9.5%) led to significantly higher postoperative sensitivity compared with G-aenial Posterior (0.8%) (p = 0.001). Universal adhesives showed similar clinical performance to Clearfil SE Bond 2. The restorations with Filtek Z550 Universal had a relatively higher risk of postoperative sensitivity. Universal adhesives were clinically successful for 18 months. At 1 week, the type of composite material used significantly affected the occurrence of postoperative sensitivity.

5-Year clinical performance of ceramic onlay and overlay restorations luted with light-cured composite resin

ObjectivesThis prospective clinical trial evaluated the clinical performance of ceramic partial coverage indirect adhesive restorations (PCIARs) in posterior teeth luted with a light-cured composite resin. MethodsFrom April 2016 to January 2017, a total of 60 patients (27 males, 33 females; mean age: 42.2 ± 10.86 years old) received 83 glass-ceramic PCIARs (26 onlay, 57 overlay) made of IPS Emax CAD (Ivoclar Vivadent). All restorations were luted with a light-cured composite resin (Filtek Z250, 3 M ESPE) by two operators. Two independent calibrated examiners blinded to the operators performing the treatment evaluated the restorations at baseline, 1-year, and 5-year following FDI World Dental Federation criteria including esthetic, functional, and biological properties. Data were analyzed with the Friedman test and the Wilcoxon sign test (p < 0.05). ResultsNone of the restorations failed due to fracture or retention loss. One restoration was clinically unsatisfactory because of secondary caries. Marginal staining (p:0.000), marginal adaptation (p:0.018) showed significant differences between 1-year and 5-year recall. ConclusionsThe PCIARs demonstrated excellent clinical performance at 1-year period. The degradation parameters appeared as minor staining and minor irregularities after 5-year, without any affect on the clinical performance. Clinical SignificanceOur findings provide evidence that the clinical performance of PCIARs luted with a light-cured composite resin was clinically acceptable after a five-year evaluation period. Due to secondary caries, only one restoration was considered clinically unsatisfactory. ClinicalTrials registration number: NCT04838483

Clinical comparison of high-viscosity glass-hybrid systems with a sculptable bulk-fill composite resin in different cavity types.

This randomized, double-blind clinical investigation assessed the performance of two high-viscosity glass-ionomer systems and a bulk-fill composite in different cavity types. In 146 participants, 360 (class I, II, and V) cavities were restored using three different materials (Equia Forte HT, Chemfill Rock, and SonicFill 2) with equal allocation. Using modified World Dental Federation criteria, restorations were assessed after 1 week, 6 months, and 18 months by an experienced examiner. Statistical analysis was conducted using Fisher's exact and Wilcoxon signed rank tests (α = 0.05). After 18 months, 267 restorations were assessed in 116 participants. After 18 months, 5 Equia Forte HT restorations failed due to debonding and fracture. Only one loss was observed in the Chemfill Rock restorations. Equia Forte HT exhibited significantly lower retention than SonicFill 2 after 18 months (p = 0.019), irrespective of cavity type. At 1 week, 3 Class I restorations with SF showed postoperative sensitivity. The type of cavity did not affect the performance of the restorative materials used (p > 0.05). Equia Forte HT and Chemfill Rock presented similar clinical performance regardless of color match. Equia Forte HT showed a lower performance compared to SonicFill 2. Glass-hybrid materials presented a lower performance in terms of color match or retention when compared to a sculptable bulk-fill composite resin.

Repair protocols for indirect monolithic restorations: a literature review.

Despite the advancements in indirect monolithic restorations, technical complications may occur during function. To overcome this issues, intraoral repair using resin composite is a practical and low-cost procedure, being able to increase the restoration's longevity. This review aimed to evaluate the need for repair and suggest a standardized repair protocol to the main indirect restorative materials. For this, studies were surveyed from PubMed with no language or date restriction, to investigate the scientific evidence of indirect monolithic restoration repair with direct resin composite. A classification to guide clinical decisions was made based on the FDI World Dental Federation criteria about defective indirect restorations considering esthetic and functional standards, along with the patient's view, to decide when polishing, repairing or replacing a defective restoration. Based on 38 surveyed studies, different resin composite intraoral repair protocols, that included mechanical and chemical aspects, were defined depending on the substrate considering resin-based, glass-ceramic or zirconia restorations. The presented criteria and protocols were developed to guide the clinician's decision-making process regarding defective indirect monolithic restorations, prolonging longevity and increasing clinical success.

Clinical performance of non-carious cervical lesions restored with using self-etch mode of adhesives according to the FDI criteria.

The purpose of this study was to evaluate the 18-month retrospective study of self-etch adhesive (Prime&Bond One Select) and self-etch mode of universal adhesives (Single Bond Universal, Gluma Bond Universal) applied to non-carious cervical lesions according to the World Dental Federation criteria. Thirty patients without any systemic disease, good oral hygiene, having at least 20 teeth and six non-carious cervical lesions treated using a self-etch mode of adhesives operated between January and March 2017. Accordingly, 335 restorations were evaluated according to the World Dental Federation criteria at 3, 6, 12 and 18 months. Pillai's Trace test was used to determine the interaction of criteria with time and adhesive systems. IBM SPSS Statistics 21.0 program was used in the analysis. Value of P < 0.05 was accepted as a criterion for statistical significance. At the end of 18 months, participation was 100%. There was a statistically significant difference P < 0.05 between Prime&Bond One Select and Single Bond Universal, Prime&Bond One Select and Gluma Bond Universal in the 18-month period. In terms of marginal staining, fracture of material and retention, recurrence of caries, erosion and abfraction, tooth integrity criteria at the end of the 18 months, Prime&Bond One Select performed clinically very good, Single Bond Universal and Gluma Bond Universal performed clinically good according to World Dental Federation criteria. Marginal adaptation criteria, Prime&Bond One Select, Single Bond Universal and Gluma Bond Universal performed clinically good. Retention loss rate was found to be the lowest in Prime&Bond One Select and the highest in Gluma Bond Universal. Accordingly, 18-month evaluation of all adhesives used in the study showed clinically acceptable results in all of the World Dental Federation criteria.

Clinical outcome of CAD/CAM overlays of MIH affected young permanent molars

BackgroundRestoration of first permanent molars with MIH is considered a challenge for dentists because the enamel has less flexibility and hardness with increased porosity and organic content. Materials and methodsThe current study was a randomized control trial in which fifty-two first permanent molars were distributed equally into two groups (Z) teeth that received zirconia overlays and (EC) teeth that received IPS e.max CAD overlays. Clinical assessments were carried out at baseline, 6, and 12 months using modified FDI World Dental Federation criteria. ResultsAfter the observational period of one year, all restorations were still in function with no significant differences in the esthetic, functional, and biological performance of overlays fabricated with zirconia and IPS e.max CAD except one case have been fractured in the group (EC) and three cases have been de-bonding in the group (Z). ConclusionsUsing monolithic zirconia and IPS e.max CAD overlays could be a viable selection for restoring MIH-affected posterior teeth. In further studies, it is advisable to assess the restoration that combines strength with adhesive properties like zirconia-reinforced lithium silicate glass ceramic restoration.

Evaluation of the marginal adaptation and gingival status of full-crown restorations using an intraoral camera

ObjectiveThe purpose of this study was to compare the usefulness of intraoral photographs, acquired with a household intraoral camera operating in conventional, calibrated, and polarized modes, with clinical examinations for assessing the marginal adaptation and gingival status of full-crown restorations.MethodsClinical examinations were performed by a prosthodontist who classified the marginal adaptation of full-crown restorations according to FDI World Dental Federation criteria, and a periodontal expert who classified gingival status according to the Modified Gingival Index (MGI). The margins and gingival status of the conventional, calibration, and polarization groups of full-crown restorations were independently assessed by three evaluators who obtained photographs using an intraoral camera. Cases where at least two of three assessors were in agreement were analyzed using Cohen’s kappa coefficient and the chi-square test, and the sensitivity and specificity were calculated.ResultsThe conventional, calibration, and polarization groups differed significantly in marginal and gingival status of full-crown restorations. In the calibration group, there was good agreement between the camera-based and oral clinical examinations in terms of the gingival status of full-crown restorations (kappa = 0.945), with 100% sensitivity and 91.67% specificity; this was also the case in the polarization group with respect to the margins of full-crown restorations (kappa = 0.917, sensitivity = 97.22%, specificity = 94.44%).ConclusionsAn intraoral camera with black and white calibrated images is useful to assess the gingival status of full-crown restorations. Polarization mode can be used to assess the marginal adaptation of full-crown restorations. The camera is a feasible and valid diagnostic aid.

Retrospective Long-Term Clinical Outcome of Feldspathic Ceramic Veneers.

The purpose of this study was to evaluate the clinical outcome of feldspathic ceramic laminate veneers over a 7-year period using minimally invasive techniques, such as vertical preparation (without prosthetic finish line), or no preparation (no-prep). A total of 170 feldspathic ceramic veneers were cemented in the anterior region, including 70 maxillary and 100 mandibular veneers, after special conditioning of the teeth and restorations. The veneers were evaluated using the FDI World Dental Federation criteria evaluation kit after recalling all the patients between February and June 2021. In total, 14 feldspathic veneers failed and were replaced with lithium disilicate because of core fracture, and 10 cases of chipping occurred on the ceramic surface and were polished. The overall survival rate was 91.77% for up to 7 years of function, with a failure rate of 8.23%. In this retrospective survival analysis, the failures, including the fracture of veneers and dental hard tissue, occurred both in prep and no-prep teeth. No failures were observed in veneers with a maximum thickness of 0.5 mm compared to those with a maximum thickness of 1 mm, 1.5 mm, 2 mm, and 2.5 mm.

36-Month Randomized Clinical Trial Evaluation of Preheated and Room Temperature Resin Composite.

This study evaluated the effect of preheating resin composites (RCs) on the clinical performance of class I restorations during a 36-month period using a split-mouth, double-blinded randomized design. A total of 35 patients were selected. Every patient received one pair of class I nanofilled resin composite (RC, Filtek Z350 XT) posterior restorations (n=70). One side of the mouth received preheated composites; on the other side, the composite was placed in a nonheated state following the manufacturer's instructions. These restorations were evaluated at 1-week (baseline), 12-months, 24-months, and 36-months using the FDI World Dental Federation criteria. The statistical analyses were also performed using the Wilcoxon and Friedman tests with the level of significance set at 0.05. After 36 months, 33 patients attended the recall visits, and 66 restorations were evaluated. The Friedman and Wilcoxon signed-rank tests revealed insignificant differences between both groups (p>0.05) for all FDI parameters. However, a significant difference was detected for staining as a criterion at 36 months (p=0.01). Moreover, a significant difference in the staining was detected when the baseline and 36 months were compared in the nonheated RC group (p=0.001). For esthetic, functional, and biological properties, the nonheated composite exhibited 93.9%, 100%, and 100% of the clinically accepted scores, respectively, and the preheated group presented 100% for all properties. Four restorations had postoperative sensitivity at baseline for nonheated (11.4%) and five for preheated (14.2%), but the postoperative sensitivity scores were considered highly acceptable at 12-, 24-, and 36-months. After 36 months, preheated nanofilled RCs showed an acceptable clinical performance similar to that of the nonheated ones in class I restorations, but with better resistance to marginal staining.

Computer‐aided design and computer‐aided manufacturing indirect versus direct composite restorations: A randomized clinical trial

This study compared the clinical performance of large indirect restorations (IRs) versus direct restorations (DRs) in posterior teeth. Thirty subjects received two class II restorations (n=60), one fabricated from a precured composite block (Grandio Blocs, VOCO) for the indirect technique (IT) and the other with light-cured composite (GrandioSO, VOCO) for the direct technique (DT). For IT, the restoration was created using the computer-aided design and computer-aided manufacturer (CAD/CAM) system. For DT, the material was applied light-cured by using a layering technique. All restorations were evaluated by using the World Dental Federation criteria. Twenty-three subjects attended the 2-year recall, and 46 restorations were evaluated. No significant differences were detected between the techniques for most parameters analyzed (p > 0.05). For "color match" at 7 days and 6 months, better results were observed for the DT. In relation to the overall scores, all restorations were esthetically acceptable after 2 years, while 93.3% of DT and 90% of IT showed acceptable function. For biological scores, 96.67% of DRs and 100% of IRs was acceptable after 24 months. Considering all properties, the success rates were 93.3% for DRs and 90% for IRs. After 2 years, both restorations presented similar and good clinical behavior for all the properties analyzed. Light-cured direct posterior composite restorations may perform similarly to indirect composite restorations made with precured CAD/CAM composite blocks up to 2 years.

6-month clinical performance of a universal adhesive on non-carious cervical lesions: self-etch and etch-and-rinse techniques

Objectives: The purpose of this study was to evaluate the 6-month clinical performance of Adhese Universal applied with two different application strategies (self-etch vs. etch-andrinse technique) when restoring non-carious cervical lesions. Methods: Twenty-six patients participated in this study. Restorations of 117 non-carious cervical lesions were assigned to 2 groups: 1) Adhese Universal in the etch-and-rinse mode (n=59) and 2) Adhese Universal in the self-etch mode (n=58). The same resin composite (Tetric EvoCeram) was used for all restorations. The restorations were evaluated at baseline and at 6 months, using the World Dental Federation criteria. The results were analyzed statistically by the McNemar test (α=0.05 and power of 80%) to compare the differences between baseline and 6 months and a generalized estimating equation to compare the differences between the 2 techniques. Results: No differences were found in restoration performance between the baseline and the end of the 6-month period in the self-etch mode (marginal coloring: p=0.1366; fractures/retention: p=1.000; marginal adaptation: p=1.000; hypersensitivity: p=0.4795; recurrence of caries: p=1.000). On the other hand, in the etch-and-rinse mode, for both fractures/retention (p=0.0028) and marginal adaptation (p=0.0016), significant differences were found. Significant differences were also detected between groups at 6 months for fractures/retention and marginal adaptation (p&lt;0.01). Nine restorations were lost at 6 months in the etch-and-rinse group. Conclusions: The tested universal adhesive obtained better results in the self-etch technique than in the etch-and-rinse technique, both on fractures/retention and marginal adaptation.

Clinical Performance of Posterior Inlay-Retained and Wing-Retained Monolithic Zirconia Resin-Bonded Fixed Partial Dentures: Stage One Results of a Randomized Controlled Trial.

To prospectively compare the clinical performance of posterior inlay-retained and wing-retained monolithic zirconia fixed partial dentures (FPDs). After simple randomization, 30 participants received either one inlay-retained (n = 15; mean age: 56.38 ± 12.70 years; 10 men [66.7%]) or one wing-retained (n = 15; mean age: 45.90 ±13.24 years; 7 men [46.7%]) FPD. The restorations, which predominantly replaced first molars, were fabricated from translucent, 3mol% yttria-stabilized zirconia and attached with self-etching resin cement. Restorations and abutment teeth were clinically followed up for complications one week and 3, 6, and 12 months after cementation. Plaque and gingival scores, probing pocket depths, and attachment levels were recorded for the abutment and contralateral reference teeth both before treatment and during follow-up examinations. The restorations were also assessed in accordance with FDI World Dental Federation criteria. Statistical analyses were conducted with R (α = 0.05). An adaptive, 2-stage study design based on the incidence of failure-free survival in the groups after 12 months (stage 1) was implemented. Predefined decision rules were used to determine whether further recruitment (stage 2) would enable the detection of a statistically significant difference between the restoration designs with sufficient power. During 12 months, only one wing retainer debonded which required removal of the FPD. Failure-free survival was thus 93.3% for wing-retained and 100% for inlay-retained FPDs (log-rank test, p = 0.317). Moderate aftercare resulted in intervention-free rates of 78.8% and 86.7% for inlay-retained and wing-retained restorations, respectively (log-rank test, p = 0.605). Based on FDI World Dental Federation criteria, all restorations were acceptable at the 12-month follow-up (Fisher-Boschloo test, p = 0.161). Plaque, gingival, and periodontal scores remained practically unchanged from before treatment to the 12-month follow-up. Recruitment was stopped after stage 1 because, based on the small difference in the incidence of failure-free survival in the groups, it was accepted that it would not be possible to recruit the necessary number of participants to show a statistically significant difference between the retainer designs. Both inlay-retained and wing-retained monolithic zirconia resin-bonded FPDs performed well for the 12-month, short-term follow-up period.

A New Dual-cure Universal Simplified Adhesive: 18-month Randomized Multicenter Clinical Trial.

Non-carious cervical lesion restorations using a dual-cure universal adhesive in self-etch and etch-and-rinse mode showed satisfactory clinical performance after 18 months. Objectives: The objective of this multicenter, double-blind, split-mouth randomized clinical trial was to evaluate the clinical performance of a new dual-cure universal adhesive system (Futurabond U, Voco GmBH) when applied using different strategies over a period of 18 months.Methods and Materials: Fifty patients participated in this study. Two hundred non-carious cervical lesions were restored using the adhesive Futurabond U according to four adhesive strategies (n=50 per group): only self-etch (SEE), selective enamel etching + self-etch (SET), etch-and-rinse with dry dentin (ERDry), and etch-and-rinse with wet dentin (ERWet). After the adhesive application, cavities were restored using Admira Fusion composite resin. These restorations were evaluated according to FDI World Dental Federation criteria for the following characteristics: retention/fracture, marginal adaptation, marginal staining, postoperative sensitivity, and caries recurrence.Results: After 18 months, only four patients (12 months: one patient, n=4 restorations; and 18 months: three patients, n=12 restorations) were not evaluated. Fourteen restorations were lost after 18 months of clinical evaluation (four for SEE, three for SET, three for ERDry, and four for ERWet). The retention rates for 18 months (95% confidence interval) were 92% (81%-97%) for SEE, 94% (83%-97%) for SET, 94% (83%-97%) for ERDry, and 92% (81%-97%) for ERWet (p>0.05). Thirty-eight restorations were considered to have minor discrepancies in marginal adaptation at the 18-month recall (13 for SEE, 13 for SET, six for ERDry, and six for ERWet; p>0.05). Fourteen restorations were detected as a minor marginal discoloration at the 18-month recall (six for SEE, six for SET, one for ERDry, and one for ERWet; p>0.05). However, all were considered clinically acceptable. No restorations showed postoperative sensitivity or caries recurrence at the time.Conclusion: The clinical performance of the Futurabond U did not depend on the bonding strategy used, and it was considered reliable after 18 months of clinical evaluation, although more marginal discrepancy was observed in the self-etch group.

How Do the Etching Mode and Thermomechanical Loading Influence the Marginal Integrity of Universal Adhesives?

This study evaluated the effect of etching mode and thermomechanical loading on universal adhesives. Two universal adhesives, Peak Universal and Adhese Universal, were used in two etching modes as the experimental groups: Peak Universal etch-and-rinse (PER), Peak Universal self-etch (PSE), Adhese Universal etch-and-rinse (AER), and Adhese Universal self-etch (ASE). Two adhesives considered gold standards were used as control groups: OptiBond FL (OER) was used as a control group for the etch-and-rinse (ER) mode, and Clearfil SE Bond (CSE) was used as a control group for the self-etch (SE) mode. Standardized class V cavities were created on the buccal and lingual surface in 30 extracted caries-free human third molars. Each adhesive and resin composite was applied according to the manufacturer's instructions. The specimens were subjected to thermomechanical loading (TML) immediately after the fillings were placed. Before and after TML, replicas and photographs of the fillings were performed and evaluated quantitatively and qualitatively. The Mann-Whitney U-test or Kruskal-Wallis test was used for quantitative analyses, and Fisher exact test was used for qualitative analysis. Adhese Universal achieved a significantly higher percentage of continuous margin in the enamel than Peak Universal for the two types of etching both before and after TML (except for the SE group after TML). In dentin, the greatest percentage of continuous margin was achieved for Adhese Universal in the ER group (100%) before TML and for both universal adhesives in the SE groups (61%) after TML. For both etching modes and both time points, Adhese Universal had a greater percentage of continuous margin than Peak Universal for the whole margin. For the ER approach, significant differences were observed both before and after TML, and for the SE approach, significant differences were observed before TML. TML did not cause a significant decrease in the percentage of continuous margin in the enamel, but the results were the opposite in dentin. A qualitative assessment using World Dental Federation criteria did not show statistically significant differences between the groups. Scanning electron microscope assessment of marginal integrity showed that the evaluated factors such as etching mode and TML significantly influenced the marginal integrity of the universal adhesives. The replica method shows that laboratory and clinical assessment methods complement each other and give a broader view of marginal integrity.

The one-step no-prep approach for full-mouth rehabilitation of worn dentition using PICN CAD-CAM restorations: 2-yr results of a prospective clinical study

ObjectivesTo prospectively evaluate the One-step No-prep treatment of full mouth-worn dentition, a minimally invasive and multidisciplinary approach using PICN CAD-CAM composite restorations without provisional phase. MethodsSeven patients (n = 192 restorations) with severe tooth wear were included. Patient data were recorded, and an occlusal analysis and a tissue-guided wax-up were realized. After replacement of old fillings, no-prep Vita Enamic restorations (posterior restorations and palatal veneers) were bonded within 24 h. Direct composites were performed to mask the buccal joint on anterior teeth. Maxillo-facial physiotherapy was performed. Restorations were evaluated following World Dental Federation criteria. Treatment influence on Oral-Health-Impact-Profile-49 (OHIP-49) score was assessed. ResultsTooth wear etiology was related to soft drink consumption and bruxism. Mean VDO increase was 5.09 ± 0.85 mm on the incisal pin. The mean restoration thickness on molars was 0.55 ± 0.21 mm, and the lowest was 0.11 mm. 2-year survival rate of restorations was 100 % and success rate was 93.5 %, with 11 minor chippings and one debonding. A significant improvement of the global OHIP-49 score was observed. ConclusionsIn this clinical study on high risk patients, PICN restorations, applied in a minimally invasive way, showed high survival and success rates after two years, while minor chipping of very thin occlusal borders constituted the most frequent complication. Moreover, the patient acceptance was good according to OHIP-49 in this multidisciplinary approach. Clinical significanceThe use of PICNs allows the development of no prep and simple treatment protocols of worn dentition. The absence of provisionals did not engender any problem, on the basis of the realization of an occlusal analysis, the support of a maxillo-facial physiotherapist, and the use of an easy-to-adjust restorative material.

Bonding Performance of Simplified Adhesive Systems in Noncarious Cervical Lesions at 2-year Follow-up: A Double-blind Randomized Clinical Trial

This study aimed to evaluate the bonding performance of a universal adhesive used according to self-etching or etch-and-rinse protocols in noncarious cervical lesions (NCCLs) and to compare the two protocols with their respective gold standard techniques. This randomized, double-blind clinical study enrolled 34 participants who met the inclusion criteria, 29 of whom returned after two years. They received 152 restorations bonded with one of the three adhesives (Scotchbond Universal Adhesive, Adper Single Bond 2, or Clearfil SE Bond) and one of the two bonding techniques tested. The NCCLs were restored with nanocomposite resin (Filtek Supreme). Final contours were done with a fine diamond rotary instrument and polished with rubber points. The restorations were evaluated using the FDI World Dental Federation criteria at baseline (seven days after the restoration procedure), 6, 12, and 24 months. Descriptive statistics, Kruskal-Wallis, Friedman analysis of variance, and least significant difference tests were performed. No statistically significant differences were found in esthetics or the functional and biological evaluated criteria among the adhesive systems and techniques. The Scotchbond Universal system behaved similarly to the conventional etch-and-rinse or self-etching systems in all the adhesion strategies in the evaluated periods.

A Randomized Double-blind Clinical Trial of Dentin Surface Treatments for Composite Restorations in Noncarious Cervical Lesions: A 36-month Evaluation.

This randomized, double-blind clinical trial aimed to evaluate the influence of different dentin surface treatments in noncarious cervical lesions (NCCLs). Twenty-nine patients participated in this study. One hundred sixty-five NCCLs were selected and randomly assigned to three groups: G0 (control group) with phosphoric acid etching for 15 seconds; G1: phosphoric acid etching for 30 seconds; and G2: ultrasound probe applied for 30 seconds on the dentin surface. Class V composite resin restorations were performed (Z350, 3M ESPE, St Paul, MN, USA). The restorations were evaluated at baseline and at six, 12, 24, and 36 months according to the World Dental Federation criteria. Survival curves were obtained using the Kaplan-Meier method and the log-rank test. Comparisons between groups and times were performed using the McNemar and Chi-square tests (α =0.05). The presence of failures due to retention was statistically different among the groups ( p=0.012), and G0 and G2 showed better clinical performance than did G1. Sensitivity decreased over time in all groups. Marginal discoloration, postoperative sensitivity, and marginal adaptation were not different among the groups ( p>0.05). The studied dentin surface treatments showed similar clinical performance to the conventional technique at 36 months in terms of marginal discoloration, marginal adaptation, and postoperative sensitivity. In contrast, increased acid-etching time resulted in a higher risk of failure due to retention over time in composite Class V restorations.

An in vivo study on the clinical efficacy of resin infiltration technique on treatment of white spot lesions

The caries infiltration technique was introduced with the aim of filling the intercrystalline spaces with a low-viscosity resin, to arrest lesions and treat the esthetic problem of white spot lesions. This study was designed to evaluate the effect and clinical efficacy of resin infiltration technique on masking of enamel white spot lesions compared to an ordinary adhesive system. Methods: A total number of 20 patients having 120 not cavitated anterior teeth with white spot lesions were subjected to this study. After scaling, polishing and oral hygiene measures, the six maxillary anterior teeth were isolated with rubber dam. The teeth were divided into two groups, the first group (central incisor, lateral incisor and canine on right side of patient) was treated with hydrochloric acid (Icon-Etch) then ethanol (Icon-Dry) followed with application of resin (Icon-Infiltrant), while the second group: (central incisor, lateral incisor and canine on left side of the same patient) was treated with phosphoric acid (N-Etch) and adhesive (ExciTE F).Durability of used resins were clinically assessed by six of the FDI World Dental Federation criteria which were selected to be suitable for the current study (Surface luster, Surface Staining, Postoperative hyper-sensitivity, Recurrence of caries, Adjacent mucosa, and Patient’s view), Each property has five grades from excellent to poor. Results: Both of treated groups showed improved surface luster, decreased postoperative hypersensitivity, diminished recurrent caries and increased patient satisfaction. Icon resin infiltration was more durable than Excite F adhesive after one year follow up. Both groups showed no initial surface staining, but with timesurface stainingbeing more with icon infiltrated group. Both materials have no effect on adjacent mucosa at different aging times. Conclusions: Icon resin infiltration is an effective treatment for deminiralized white spot lesions but with frequent repolishing to overcome surface staining for long lasting esthetic outcome. Excite F adhesive can be used only for short time sealing of enamel surface to improve the esthetics of white spot lesions and control of caries progression.

A Randomized, Controlled, Split-mouth Trial Evaluating the Clinical Performance of High-viscosity Glass-ionomer Restorations in Noncarious Cervical Lesions: Two-year Results.

To compare the two-year clinical performance of high-viscosity glass ionomer (Hv-GIC) restorations in noncarious cervical lesions with nanohybrid composite restorations applied with a three-step etch-and-rinse adhesive (E&Ra/nanoC). One hundred thirty-four noncarious cervical lesions were included and assigned to two groups according to the split-mouth design. The cervical lesions in the experimental group were restored with an Hv-GIC (Equia, GC), while a nanohybrid composite (G-aenial, GC) with a three-step etch-and-rinse adhesive (Optibond FL, Kerr) was applied as the control. All tested restorative materials were used according to the manufacturers' instructions. Clinical evaluation was performed after one week, six months, one year, and two years using World Dental Federation criteria. Data were analyzed using Friedman's ANOVA and Mann-Whitney U-tests (α = 0.05). After two years, Hv-GIC restorations had a retention rate of 91% in comparison to 100% for E&Ra/nanoC restorations. Significant differences existed between the two restorative materials solely with respect to the retention parameter after two years (p = 0.008). The two-year clinical performance of Hv-GIC was clinically acceptable. However, the retention of E&Ra/nanoC restorations was significantly better than that of Hv-GIC restorations after two years.