This case report introduces a straightforward, noninvasive approach for the esthetic rehabilitation of malformed anterior teeth in adolescents using direct composite restorations. The universal composite resin restorations are applied within a transparent 3-dimensionally printed rigid-resin index, which is individually customized from a digital wax-up. Compared to other methods, this technique streamlines the restoration process, significantly reducing chairside time while enhancing the predictability, accuracy, and patient acceptance of the aesthetic outcome.
This study aimed to evaluate the clinical performance of an alkasite restorative material in molars that had undergone root canal treatment.
The research was registered in Brazilian Registry of Clinical Trials. The randomized clinical trial involved 33 patients, each with at least 1 mandibular molar requiring restoration after receiving endodontic treatment. Patients were randomly assigned to receive either bulk-fill resin composite (Tetric N Ceram Bulk Fill, Ivoclar Vivadent) or the alkasite restorative material (Cention N, Ivoclar Vivadent). Upon completion of the restorations, 3 calibrated professionals utilized the United States Public Health Service criteria to assess various factors, including retention, secondary caries, marginal adaptation, restoration color, marginal pigmentation, and anatomical form. Evaluations were conducted at intervals of 7 days, 6 months, and 17 months. Additionally, the assessment encompassed the presence of radiolucent lines adjacent to the restoration, material deficiencies or excess, contact points, and caries recurrence. The data underwent analysis using the Friedman and Mann-Whitney tests (α = 0.05).
After 17 months, the results revealed that the alkasite restorative material exhibited greater wear of anatomical shape compared to the bulk-fill resin composite (
The alkasite restorative material (Cention N) emerges as a viable option for restoring endodontically treated teeth, displaying clinically acceptable alterations after a 17-month evaluation period.
Brazilian Registry of Clinical Trials (ReBEC) Identifier:
This study aimed to evaluate the surrounding and underlying shades’ effect on the color adjustment potential (CAP) of a single-shade composite used in a thin layer.
Cylinder specimens (1.0 mm thick) were built with the Vittra APS Unique composite, surrounded (dual specimens) or not (simple specimens) by a control composite (shade A1, A2, or A3). Simple specimens were also built only with the control composites. Each specimen’s color was measured against white and black backgrounds or the simple control specimens with a spectrophotometer (CIELAB system). The whiteness index for dentistry (WID) and translucency parameters (TP00) were calculated for simple specimens. Differences (ΔE00) in color between the simple/dual specimens and the controls were calculated. The CAP was calculated based on the ratios between data from simple and dual specimens.
The Vittra APS Unique composite showed higher WID and TP00 values than the controls. The highest values of ΔE00 were observed among simple specimens. The color measurements of Vittra APS Unique (simple or dual) against the control specimens presented the lowest color differences. Only surrounding the single-shade composite with a shaded composite barely impacted the ΔE00. The highest CAP values were obtained using a shaded composite under simple or dual specimens.
The CAP of Vittra APS Unique was strongly affected by the underlying shade, while surrounding this composite with a shaded one barely affected its color adjustment.
This study aimed to evaluate the effect of improper positioning single-peak and multi-peak lights on color change, microhardness of bottom and top, and surface topography of bulk fill and incremental composites after artificial aging for 1 year.
Bulk fill and incremental composites were cured using multi-peak and single-peak light-emitting diode (LED) following 4 clinical conditions: (1) optimal condition (no angulation or tip displacement), (2) tip-displacement (2 mm), (3) slight tip angulation (α = 20°) and (4) moderate tip angulation (α = 35°). After 1-year of water aging, the specimens were analyzed for color changes (ΔE), Vickers hardness, surface topography (Ra, Rt, and Rv), and scanning electron microscopy.
For samples cured by single-peak LED, the improper positioning significantly increases the color change compared to the optimal position regardless of the type of composite (
The bulk fill composite presented greater resistance to wear, higher color stability, and better microhardness than the incremental composite when subjected to improper curing. The multi-peak LED improves curing under improper conditions compared to single-peak LED. Prevention of errors when curing composites requires the attention of all personnel involved in the patient's care once the clinical relevance of the appropriate polymerization reflects on reliable long-term outcomes.
This study aimed to assess the presence of pulp stones through an examination of cone beam computed tomography images and correlate their prevalence with age, sex, dental arch and side, tooth type, and restoration type and depth.
Cone beam computed tomography images obtained from 673 patients and archival data on 11,494 teeth were evaluated. The associations of pulp stones with age, sex, dental arch and side, tooth type, and restoration type and depth were noted. All the measurements were subjected to a χ2 test and one sample χ2 test (
In the study group, 163 (24.2%) patients and 379 (3.3%) teeth had at least one pulp stone. The pulp stone frequency in those aged 30–39 years was significantly greater than in those aged 18–29 and ≥ 60 years, and the frequency was higher in females than in males (
Maxillary molar teeth, medium-depth restorations, individuals aged 30–39 years and females had a greater percentage of pulp stones.
To evaluate the polymerization efficiency of a matrix-modified bulk-fill composite, and compare it to a conventional composite which has a similar filler system. The degree of conversion (DC%) and monomer elution were measured over different storage periods. Additionally, fillers' content was examined.
Cylindrical specimens were prepared, in bulk and incrementally, from Filtek Bulk Fill (B) and Filtek Supreme XTE (S) composites using a Teflon mold, for each test (
There was no significant difference in DC% over different storage periods between B-bulk and S-incremental. Higher monomer elution was detected significantly from S than B. The elution quantity and rate varied significantly over storage periods and between different monomers. SEM images showed differences in fillers' sizes and agglomeration between both materials.
Matrix-modified bulk-fill composites could be packed and cured in bulk with polymerization efficiency similar to conventional composites.
This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.
The aim of this study was to investigate the microshear bond strength (μSBS) of different universal adhesive systems applied to hybrid computer-aided design/computer-aided manufacturing (CAD-CAM) restorative materials repaired with a composite resin.
Four types of CAD-CAM hybrid block materials—Lava Ultimate (LA), Vita Enamic (VE), CeraSmart (CS), and Shofu Block HC (SH)—were used in this study, in combination with the following four adhesive protocols: 1) control: porcelain primer + total etch adhesive (CO), 2) Single Bond Universal (SB), 3) All Bond Universal (AB), and 4) Clearfil Universal Bond (CU). The μSBS of the composite resin (Clearfil Majesty Esthetic) was measured and the data were analyzed using two-way analysis of variance and the Tukey test, with the level of significance set at
The CAD-CAM block type and block-adhesive combination had significant effects on the bond strength values (
The μSBS values were affected by hybrid block type. All tested universal adhesive treatments can be used as an alternative to the control treatment for repair, except the AB system on VE blocks (the VE/AB group). The μSBS values showed variation across different adhesive treatments on different hybrid CAD-CAM block types.
The restoration of endodontic tooth is always a challenge for the clinician, not only due to excessive loss of tooth structure but also invasion of the biological width due to large decayed lesions. In this paper, the 7 most common clinical scenarios in molars with class II lesions ever deeper were examined. This includes both the type of restoration (direct or indirect) and the management of the cavity margin, such as the need for deep margin elevation (DME) or crown lengthening. It is necessary to have the DME when the healthy tooth remnant is in the sulcus or at the epithelium level. For caries that reaches the connective tissue or the bone crest, crown lengthening is required. Endocrowns are a good treatment option in the endodontically treated tooth when the loss of structure is advanced.
To determine the retentive strength and failure mode of undercut composite post, glass fiber post and polyethylene fiber post luted with flowable composite resin and resin-cement.
Coronal parts of 120 primary canine teeth were sectioned and specimens were treated endodontically. The teeth were randomly divided into 6 groups (
There were statistically significant differences between groups (
Although the composite post with undercutting showed the greatest resistance to dislodgement, fiber posts cemented with flowable composite resin provided acceptable results in terms of retentive strength and fracture mode.