Mouthguards were used to protect boxers from lip lacerations and other soft tissue injuries in the late 19th century. Now they are used various parts of dental treatment, which are sports protective aid, bleaching tray, orthodontic retainer, implant insertion guide tray, splint and so on.

Repeated dislodgement of Class V restoration due to habitual clenching stress should be restored with stress control. Mouthguard can be used as stress relief device.

This case describes methods that can relieve occlusal force to teeth by using mouthguard.

Satisfactory results can be obtained by using mouthguard for retention of repeated dislodgement Class V restorations.

If patients suffered from repeated restorations of Class V due to clenching, mouthguard can be used additional device to relieve the occlusal stress in conservative dentistry.

The purpose of this study was to compare the microleakage of low and high viscosity flowable resins in class V cavities applied with 1-step adhesives.

Forty class V cavities were prepared on the cervices of buccal and lingual surfaces of extracted molar teeth and divided into four groups (n=8). Cavities were restored with AQ Bond Plus/Metafil Flo α, G-Bond/UniFil LoFlo Plus (Low flow groups), AQ Bond Plus/Metafil Flo and G-Bond/UniFil Flow (High flow group), respectively.

Specimens were immersed in a 2% methylene blue solution for 24 hours, and bisected longitudinally. They were observed microleakages at the enamel and dentinal margins.

In conclusion, the low viscosity flowable resins showed lower marginal microleakage than do the high viscosity flowable resins in class V cavities.

The aim of this study was to examine that thick dentin bonding agent application or low modulus composite restoration could reduce stresses on dentin bonding agent layer.

A mandibular first premolar with abfraction lesion was modeled by finite element method. The lesion was restored by different composite resins with variable dentin bonding agent thickness (50µm, 100µm, 150µm). 170N of occlusal loading was applied buccally or lingually. Von Mises stress on dentin bonding agent layer were measured.

When thickness of dentin bonding agent was increased von Mises stresses at dentin bonding agent were decreased in both composites. Lower elastic modulus composite restoration showed decreased von Mises stresses. On root dentin margin more stresses were generated than enamel margin.

For occlusal stress relief at dentin boning agent layer to applicate thick dentin bonding agent or to choose low elastic modulus composite is recommended.

The purpose of this study was to investigate the distribution of tensile stress of canal obturated maxillary second premolar with access cavity and notch-shaped class V cavity restored with composite resin using a 3D finite element analysis.

The tested groups were classified as 8 situations by only access cavity or access cavity with notch-shaped class VS cavity (S or N), loading condition (L1 or L2), and with or without glass ionomer cement base (R1 or R2). A static load of 500 N was applied at buccal and palatal cusps. Notch-shaped cavity and access cavity were filled microhybrid composite resin (Z100) with or without GIC base (Fuji II LC). The tensile stresses presented in the buccal cervical area, palatal cervical area and occlusal surface were analyzed using ANSYS.

Tensile stress distributions were similar regardless of base. When the load was applied on the buccal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth with class V cavity were slightly higher than that of the tooth without class V cavity. When the load was applied the palatal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth without class V cavity were slightly higher than that of the tooth with class V cavity.

This study was to investigate the influence of composite resins with different elastic modulus, cavity modification and occlusal loading condition on the stress distribution of restored notch-shaped noncarious cervical lesion using 3-dimensional (3D) finite element (FE) analysis.

The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity and a modified cavity with a rounded apex were modeled. Unmodified and modified cavities were filled with hybrid or flowable resin. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress.

The results were as follows:

In the unrestored cavity, the stresses were highly concentrated at mesial CEJ and lesion apex and the peak stress was observed at the mesial point angle under both loading conditions.

The purpose of this study was to compare the marginal microleakage of different 2-step adhesive systems in Class V cavities prepared with different diamond points.

Forty Class V cavities were prepared with two different (coarse or fine) diamond points on cervical third of extracted molars. The occlusal and gingival margin of cavities was located in enamel and dentin, respectively. They were divided into one of four equal groups (n = 10) and ; Group 1-prepared with coarse diamond point (EX-41), restored with Single Bond and Z 250, Group 2-prepared with fine diamond piont (TF-21F), restored with Single Bond and Z 250, Group 3-prepared with coarse diamond point (EX-41), restored with Clearfil SE Bond and Clearfil AP-X, Group 4-prepared with fine diamond point (TF-21F), restored with Clearfil SE Bond and Clearfil AP-X.

Specimens were thermocycled, immersed in a 2% methylene blue solution for 24 hours, and bisected longitudinally. They were observed leakages at enamel and dentinal margins. Data were analyzed using Mann-Whitney and Wilcoxon signed ranked test.

In this study, marginal microleakage of Single Bond was not affected by type of diamond points. But Clearfil SE Bond showed higher marginal microleakage at both enamel and dentinal margin when Class V cavity was prepared with coarse diamond point.

The purpose of this study was to estimate the relation between techniques used for microleakage from dye penetration and for marginal adaptation from SEM evaluation of the restoration.

Using high speed #330 bur, class V cavities (4 × 3 × 1.5 mm around CEJ) were prepared on the buccal surface of 20 extracted human molars. Six dimples as reference points for SEM and dye penetration evaluation were made with 1/2 round bur. Cavity was bulk filled with microhybrid composite resin (Esthet X) and all-in-one adhesive (Xeno III). Teeth were stored in saline solution for one day, after then, they were finished and polished using Sof-Lex system.

Fifty percent silver nitrate dye solution was used for the evaluation of microleakage and resin replica was used for marginal adaptation. All of these were done after 1000 times thermocycling between 5 and 55℃.

Vertical sections were made through three dimples of restoration to obtain samples for the evaluation of dye penetration and inner marginal adaptation. Outer adaptational estimation was done with an intact restoration before sectioning. Dye penetration was determined in three degrees and percentage of outer and inner leaky margin was estimated from SEM image.

The data were analysed statistically: Spearman's rho test were used to check relationships between two methods.

The result were as follows:

There were significant relationships between degree of dye penetration and inner and outer marginal adaptations each (p < 0.01).

Within the results of this study, relationship between the percentage of marginal adaptation and microleakage shows significant relationship. However, inner and outer marginal adaptation did not show any significant relationship mutually.

The purpose of this study is to evaluate prospectively the effect of different bonding systems and retention grooves on the clinical performance of resin restorations in non-carious cervical lesions (NCCLs). Thirty-nine healthy adults who had at least 2 NCCLs in their premolar areas were included in this study. One hundred and fifty teeth were equally assigned to six groups: (A) Scotchbond Multi-Purpose (SBMP, 3M ESPE, St. Paul, MN, USA, 4th generation bonding system) without retention grooves; (B) SBMP with retention grooves; (C) BC Plus (Vericom Co., Anyang, Gyeonggido, Korea, 5th generation bonding system) without retention grooves; (D) BC Plus with retention grooves; (E) Adper Prompt (3M ESPE, Seefeld, Germany, 6th generation bonding system) without retention grooves; (F) Adper Prompt with retention grooves. All cavities were filled with a hybrid composite resin, Denfil (Vericom Co., Anyang, Gyeonggido, Korea) by one operator. Restorations were evaluated at baseline and at 6-month recall, according to the modified USPHS (United States Public Health Service) criteria. Additionally, clinical photographs were taken and epoxy resin replicas were made for SEM evaluation. At 6-month recall, there were some differences in the number of alpha ratings among the experimental groups. But, despite the differences in the number of alpha ratings, there was no significant difference among the 3 adhesive systems (p > 0.05). There was also no significant difference between the groups with or without mechanical retention (p > 0.05). Follow-ups for longer periods than 6 months are needed to verify the clinical performance of different bonding systems and retention grooves.

The purpose of this study was to compare the ability of three resin surface sealants to prevent microleakage in Class V composite resin restorations. Forty Class V cavities with the occlusal margin in enamel and gingival margin in dentin were prepared on the buccal surfaces of sound extracted molars, and restored with composite resin. Restorations were randomly assigned into one of four equal groups (n = 10): a control group, without resin sealing, and three experimental groups in which margins were sealed with Fortify Plus, Biscover and Permaseal, respectively. Specimens were thermocycled, immersed in a 2% methylene blue solution for 4 hours, sectioned longitudinally, and observed the leakage at the occlusal and gingival margins. The result was analyzed using Kruskal-Wallis test, Mann-Whitney test and Wilcoxon signed rank test.

In conclusion, the ability to reduce microleakage at occlusal margins was similar in all of three sealants. However at gingival margin, it depended on the type of used resin surface sealant. At gingival margin, control and Fortify Plus group showed statistically higher microleakage than PermaSeal group, and Fortify Plus group also showed higher microleakage than BisCover group (p < 0.05).

The purpose of this study was to analyze the stress distribution aspect of unrestored and restored combined shape (wedge shape occlusally and saucer shape gingivally) class V cavity, which found frequently in clinical cases.

A maxillary second premolar restored with a combined shape class V composite restorations were modeled using the three dimensional finite element method. Static occlusal load of 170 N was applied on lingual incline of buccal cusp at the angle of 45° with the longitudinal axis of the tooth. And three dimensional finite element analysis was taken by ANSYS (Version 6.0, Swanson Analysis System Co., Houston, U.S.A) program which represent the stress distribution on unrestored and restored cavity wall and margin.

The conclusions were as follows.

Compared to the unrestored cavity, Von Mises stress at the cementoenamel junction and line angle of the cavity base were reduced and in restored cavity.

The purpose of this study was to compare the effect on marginal leakage of a resin surface sealant (Biscover) applied before or after polymerization of composite resin to unsealed composite restorations. Thirty Class V cavities with the occlusal margin in enamel and cervical margin in dentin or cementum were prepared on the buccal surfaces of sound extracted molars and restored with a microfilled light-cured composite resin (Micronew). Restorations were randomly assigned into one of three equal groups (n = 10): a control group - no surface sealing, group 1 - applied Biscover after polymerization of the composite resin, and group 2 - applied Biscover before polymerization of the composite resin. Specimens were thermocycled, immersed in a 2% methylene blue solution for 4 hours, sectioned longitudinally, and analyzed for leakage at the occlusal and gingival margins. The results of this study were as follows;

1. In sealed group, group 2 showed higher microleakage than group 1 at both occlusal and gingival margins, but there was no significant difference between two groups (p > 0.05).

2. Unsealed control group showed a little higher microleakage than sealed group at occlusal margins, and a little higher or similar microleakage than sealed group at gingival margins (p > 0.05).

3. Control group and group 2 showed significantly less microleakage at the occlusal margins, but group 1 showed no significantly difference between microleakage at the occlusal and gingival margins.

This study evaluated the marginal microleakage of five single step adhesives. Class V cavity preparations with occlusal margins in enamel and gingival margins in dentin were prepared on both buccal and lingual surfaces of extracted human molar teeth. Prepared teeth were randomly divided into five groups and restored using one of the single step adhesives and composite resins: Prompt L-Pop/Filtek Z-250 (Group 1), AQ Bond/Metafil CX (Group 2), One-Up Bond F/Palfique Toughwell (Group 3), Futurabond/Admira (Group 4), Xeno III/Spectrum TPH (Group 5).

The restored teeth were thermocycled. Microleakage was assessed by dye penetration using 2% methylene blue dye solution. The teeth were bisected buccolingually and evaluated for microleakage under steromicroscope. The data were statistically analysed by Kruskal-Wallis test and Mann-Whitney tests.

The results of this study were as follows;

Microleakage of enamel margins in group 3 was statistically higher than that in groups 1, 2, 4, 5 (p < 0.05).

In conclusion, Prompt L-Pop showed the least leakage at enamel margin, and AQ Bond showed at dentin margin in this study. Marginal miroleakage in dentin was higher than that in enamel.