Operative dentistry最新文献

Objective: The aim of this bibliometric analysis was to investigate the prevalence of bibliometric parameters related to clinical trials with bulk-fill resin composites according to financial assistance over time.

Methods: Five electronic databases were accessed (PubMed/MEDLINE, Embase, The Cochrane Library, Virtual Health Library, and Scopus) and seven bibliometric parameters related to geographic origin, year, impact factor, and publication details related to bulk-fill resin composite restorations and their clinical performance were considered. The prevalence ratio was applied using Poisson multiple regression analysis (α=0.05) to assess the association between funding and associated bibliometric parameters.

Results: In total, 59 clinical trials that analyzed the clinical performance of restorations with bulk-fill resin composites were published between 2014 and 2023 and were evaluated bibliometrically; 40.7% (n=24) of the studies reported financial assistance. Financing was associated with bibliometric parameters related to the consistency of the materials, specifically with studies involving sculptable and flowable composites funded more frequently (p<0.001) than studies evaluating only sculptable consistency. Studies that analyzed class I and II cavities showed greater financial assistance (p=0.028) compared to class I cavities, and financing increased as the journal's impact factor increased (p=0.013).

Conclusions: Financial assistance of clinical trials evaluating bulk-fill resin composite restorations was associated with material consistency, tooth cavity design, and journal impact factor bibliometric parameters.

Purpose: This study compared four CAD/CAM lithium disilicate-reinforced glass ceramic systems (IPS e.max CAD, Rosetta SM CAD, T-lithium CAD, and IRIS CAD) regarding their crystalline and microstructural characteristics, thermal properties, mechanical strength, and bonding to a resin cement.

Methods and materials: The crystalline and morphological characteristics of the ceramic microstructure were investigated by X-ray diffraction (XRD) and scanning electron microscopy (SEM), thermal behavior was assessed via differential thermal analysis (DTA). Mechanical properties were evaluated using a biaxial flexural strength test, and bonding to a resin cement was measured with a microshear strength test at distinct storage times. Data were evaluated using analysis of variance and Tukey HSD tests (α = 0.05).

Results: High peak positions corresponding to standard lithium metasilicate and lithium disilicate with similar intensities were observed for all ceramics in the XRD analysis. SEM morphological analysis showed differences in crystal characteristics among the ceramics after HF etching. The DTA thermograms showed a crystallization process ranging from 812-872°C among the different ceramic systems. The IRIS system showed the lowest flexural strength values, while bond strengths to resin cement remained comparable among materials, regardless of storage time.

Conclusions: Most lithium disilicate ceramic systems demonstrated acceptable characteristics in the tests performed, except for IRIS, which showed shortcomings in crystal morphology and mechanical strength, along with inconsistent thermal behavior. These findings underscore the importance of careful material selection to ensure durable dental restorations.

Objective: To present a clinical case featuring a posterior cantilevered single-retainer all-ceramic resin-bonded fixed dental prosthesis (PC-RBFDP) with 12 years of follow-up. This FDP was used to restore a missing premolar using a single-retainer canine abutment. The aim was also to draw clinical recommendations based on current data and experience.

Methods: To address the present case, the missing premolar was replaced with a stratified 3Y-TZP zirconia PC-RBFDP fabricated from a conventional impression using CAD-CAM technology. The prosthesis was bonded using a resin luting cement containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP), and the patient was reevaluated semi-annually. Insights obtained from this case, along with advancements in scientific understanding based on current data, are further explored.

Results: This clinical case, which occurred 12 years ago, was successful. Building on the insights gained from this case and subsequent ones, modifications to the preparation geometry have been implemented, informed by the in vitro biomechanical findings presented herein. Furthermore, a step-by-step clinical procedure is suggested, drawing from experience with other cases and the current literature on PC-RBFDPs.

Conclusions: With a necessity of caution due to the limited evidence supporting this therapy, this clinical case shows promising results in the use of ceramic RBFDPs in the posterior region, providing an alternative to implants in contraindicated patients. The comprehensive approach shown in the step-by-step clinical case and the manuscript, including indication assessment, selection of bonding materials, ceramic choice, and preparation geometry, utilizes, to the best of our ability, the most current information and technology available. Continued research is needed to further validate this treatment modality.

This study evaluated the microleakage in zirconia crowns cemented with bioactive vs resin cements at two margin locations: cementum/dentin deep margin and composite-elevated margins. Standardized mesial box cavities were prepared in 30 molar teeth, with proximal cavosurface margins placed 1 mm below the cemento-enamel junction (CEJ) and restored with resin composite. The teeth were prepared for zirconia crowns, with mesial margins on the composite and distal margins on tooth structure 1 mm below the CEJ. Following digitization and zirconia crown fabrication, the specimens were randomly allocated into five groups based on the type of cement used: one multistep adhesive resin, one self-adhesive resin, one bioactive hybrid ionic resin, and two bioceramic cements. Microleakage was evaluated by measuring the percentage of dye penetration depth at the interfaces, with data analyzed using two-way ANOVA. The results revealed a significant interaction between cement type and margin location, with elevated margins exhibiting less leakage than deep ones across all cement types (p≤0.001). However, the effect of margin location on microleakage varied depending on the cement type, with variations in microleakage scores at each margin location ranging from statistically nonsignificant (p>0.05) to statistically significant (p≤0.05). Adhesive resin and hybrid bioactive cements significantly outperformed others in reducing microleakage at both margin interfaces.

The patient underwent combined orthodonticorthognathic surgical treatment due to her skeletal Class III malocclusion. In the first phase, orthodontic decompensation was performed with maxillary and mandibular fixed appliances. The maxillary first premolars were extracted; the created space was closed by anterior retraction. The posterior anchorage was reinforced with interradicular temporary anchorage devices. In the second phase, a digital surgical treatment plan was made with intra- and extraoral simulation (including occlusion and profile). During the orthognathic surgery, a bilateral sagittal split osteotomy with mandibular setback was combined with maxillary movements, using 3D-printed surgical splints. In the third phase, the orthodontic treatment continued to finish and settle the occlusion. Spaces were created between the upper incisors for ceramic veneers to gain proper overjet and occlusion. The last phase was prosthetic and esthetic rehabilitation. During the planning, a 2Dand 3D-smile design was created and presented to the patient as a mock-up. After digital impression and design, four E-max veneers were milled and cemented using dual cement to finish the workflow. Retention splints were created to preserve the new status as a final step.