Dentistry Journal

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8 pages, 828 KiB

Open AccessArticle

Determining the Failure Rate of Direct Restorations—Chart Review versus Electronic Health Record Reports

by Priyal Patel, Utsavi Kapadia, Janhvi Vyas, Sahil Mhay and Romesh P. Nalliah

Dent. J. 2024, 12(8), 250; https://doi.org/10.3390/dj12080250 (registering DOI) - 8 Aug 2024

Viewed by 149

Abstract

Amalgam and composite restorations are used to treat minor dental issues. University of Michigan, School of Dentistry Electronic Health Record (EHR) reports show a 2.31% failure rate for amalgam and 1.14% for composite. Our study aims to determine the true failure rates through [...] Read more.

Amalgam and composite restorations are used to treat minor dental issues. University of Michigan, School of Dentistry Electronic Health Record (EHR) reports show a 2.31% failure rate for amalgam and 1.14% for composite. Our study aims to determine the true failure rates through manual EHR chart reviews. Patient data from the University of Michigan School of Dentistry were utilized—216 amalgam restorations from 2020 to 2022 and 350 composite restorations in 2021 were searched. We defined failure and retreatment as replacing a restoration with the same material and failure and alternate treatment as replacing restoration with an alternative treatment within one year. The failure rate refers to a combination of replacement with the same and alternative treatment material within one year. For Amalgam: 1.85% failed and were retreated; 7.87% failed and were received an alternate treatment. Composite: 9.71% failed and retreated; 2.86% failed and received alternate treatment. In total anterior composite: 10.5% retreated, 2.6% failed; posterior composite: 9.1% retreated, 3.0% failed. Our study revealed higher restoration failure rates than the reports extracted in the EHR. This highlights the need to foster a culture of precise documentation to align EHR reports with hand-search findings. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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17 pages, 4312 KiB

Open AccessArticle

Photon-Induced Photo-Acoustic Streaming vs. Shock Wave-Enhanced Emission Photo-Acoustic Streaming—The Effect of Three Final Irrigation Protocols on the Bond Strength of an Individually Formed Fiber Post

by Cassandra Lupita, Daliana Emanuela Bojoga, Alessandro Del Vecchio, Dan Ioan Stoia, Ion Grozav, Mariana Ioana Miron and Darinca Carmen Todea

Dent. J. 2024, 12(8), 237; https://doi.org/10.3390/dj12080237 - 26 Jul 2024

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Abstract

(1) Background: This study aimed to evaluate how laser-activated irrigation (LAI) influences the retention of a fiber post when used before an endodontic filling, as well as after post space preparation. (2) Materials and Methods: Sixty freshly extracted human incisors were selected. The [...] Read more.

(1) Background: This study aimed to evaluate how laser-activated irrigation (LAI) influences the retention of a fiber post when used before an endodontic filling, as well as after post space preparation. (2) Materials and Methods: Sixty freshly extracted human incisors were selected. The teeth were randomly assigned to three groups—CONVENTIONAL (CONV), PIPS or SWEEPS—and treated endodontically. Each group received irrigation with 1 × 5 mL EDTA (17%) and 3 × 5 mL NaOCl (5.25%). In the first group, the irrigants were not activated, while in the second and third group, LAI was adopted using PIPS and SWEEPS protocols (Lightwalker from Fotona, Ljubliana, Slovenia). After post space preparation, each group received the same irrigation protocol initially established. Sticky posts (everStick Post, GC AUSTRIA GmbH Swiss) were individually adapted to the corresponding post spaces and cemented using dual cure resin cement (Gradia Core, GC Austria GmbH Swiss). All specimens were vertically embedded into self-curing acrylate (Duracryl plus, Spofa Dent, Europe), and each was sectioned into three segments of type A and type B samples for debonding through push-out and pull-out tests. The results were statistically analyzed. (3) Results: The pull-out test showed the superiority of the SWEEPS group, with a mean fracture force of 133.0 ± 50.7 N, followed by the PIPS group, with 102 N, with a lower standard deviation of ± 34.5 N. The CONV group registered the lowest fracture force. Concerning the push-out test, the SWEEPS group showed superior shear stress in comparison to the other two groups (13.45 ± 4.29 MPa); the CONV group was inferior, with shear tension values of 8.31 ± 4.67 MPa. (4) Conclusions: It can be stated that the SWEEPS and PIPS protocols resulted in considerably higher fiber post retention than the conventional method, whereas the SWEEPS protocol was superior to the PIPS protocol. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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8 pages, 441 KiB

Open AccessArticle

Post and Core Treatment to Refit Telescopic Crown-Retained Dentures after Abutment Tooth Fracture: An Evaluation of Therapy by Retrospective Survival Analysis

by Jonas Adrian Helmut Vogler, William Abrahamian, Sarah Marie Reich, Bernd Wöstmann and Peter Rehmann

Dent. J. 2024, 12(7), 224; https://doi.org/10.3390/dj12070224 - 19 Jul 2024

Viewed by 621

Abstract

Telescopic crown-retained dentures (TCDs) are one of the most common types of prosthetic restorations for partially edentulous patients; however, post and core (PC) treatment shows the worst survival probability if the tooth is used as an abutment for the TCD. Due to extra [...] Read more.

Telescopic crown-retained dentures (TCDs) are one of the most common types of prosthetic restorations for partially edentulous patients; however, post and core (PC) treatment shows the worst survival probability if the tooth is used as an abutment for the TCD. Due to extra axial forces, abutment tooth fracture is a common cause of failure for TCDs; thus, PC treatment is often needed to refit the existing telescopic crown (TC). However, there are no clinical survival data on whether the PC treatment was used to refit the TC after abutment tooth fracture (PC2) or the PC was already fitted at the time of TCD treatment (PC1). A total of 246 patients with 399 PC treatments were retrospectively evaluated for follow-ups up to 17.33 years. The files were analysed for PC1 and PC2. Furthermore, the influence of the jaw, type of tooth, luting material, PC material, bone attachment, therapist and cause of failure was recorded. For statistical analysis, Kaplan–Meier and Cox regression analyses were conducted. PC2 showed highly significant lower survival probabilities than PC1 (p < 0.001). Moreover, the bone attachment and the age of the patient at the time of fitting the PC crown had an influence on the survival (p < 0.001). Therefore, PC2 should be carefully discussed with the patient and PC1 should be favoured in endodontically treated abutment teeth for TCDs. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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15 pages, 2691 KiB

Open AccessArticle

Influence of Cavity Lining on the 3-Year Clinical Outcome of Posterior Composite Restorations: A Randomized Controlled Clinical Trial

by Anh Duc Nguyen, Natalie Pütz, Mary Michaelis, Kerstin Bitter and Christian Ralf Gernhardt

Dent. J. 2024, 12(5), 128; https://doi.org/10.3390/dj12050128 - 7 May 2024

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Abstract

The purpose of this randomized, split-mouth-designed controlled and single-blinded clinical study was to evaluate the 3-year clinical performance of Class I and Class II resin composite restorations placed with or without cavity lining with a flowable composite. Fifty patients with treatment needs in [...] Read more.

The purpose of this randomized, split-mouth-designed controlled and single-blinded clinical study was to evaluate the 3-year clinical performance of Class I and Class II resin composite restorations placed with or without cavity lining with a flowable composite. Fifty patients with treatment needs in two premolars or molars were included. One of the teeth was restored using the nanohybrid composite (Grandio^®SO, control group), in the test group a high viscosity flowable composite was additionally applied as a first layer. In both groups, the same self-etch adhesive system was applied. Clinical evaluation after 3 years was carried out using the modified USPHS/Ryge criteria. At the 3-year follow-up the recall rate was 92%. Four restorations failed in the test group (8.7%), three due to the loss of vitality and one after fracture. The control group exhibited a cumulative success rate of 100%, while the test group achieved a success rate of 91.3%. This led to significant differences in the annual failure rate (AFR) between the two groups, with rates of 0% and 2.9% (p < 0.05; Mann–Whitney U-test). After 3 years the cumulative survival rate including all restorations was 95.7%. Statistical analysis revealed significant differences for the parameters: tooth vitality, marginal discoloration, success rate, and AFR. The other parameters exhibited no significant differences. Consequently, the nanohybrid composite demonstrated excellent performance over a 3-year period, whereas the utilization of a flowable composite for the cavity lining did not appear to exert a beneficial influence on clinical outcomes. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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14 pages, 2438 KiB

Open AccessArticle

Comparative Analysis of Endodontic ISO Size 06, 08, and 10 Stainless Steel K-Files Used for Glide Path Procedures

by Abayomi Omokeji Baruwa, Filipa Chasqueira, Sofia Arantes-Oliveira, João Caramês, Duarte Marques, Jaime Portugal and Jorge N. R. Martins

Dent. J. 2024, 12(4), 98; https://doi.org/10.3390/dj12040098 - 10 Apr 2024

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Abstract

Small-sized stainless steel hand files are conventionally employed in root canal treatment procedures for canal scouting and for glide path establishment, owing to their superior flexibility and proficiency in navigating confined spaces. Given the diversity of brands available in the market, there exists [...] Read more.

Small-sized stainless steel hand files are conventionally employed in root canal treatment procedures for canal scouting and for glide path establishment, owing to their superior flexibility and proficiency in navigating confined spaces. Given the diversity of brands available in the market, there exists potential variability in their physical characteristics, thereby influencing clinical performance. Consequently, this study aims to conduct a comparative analysis of the design, metallurgy, and mechanical characteristics among seven stainless steel hand file brands across ISO sizes 06, 08, and 10. A total of 315 new 25 mm length stainless steel hand files with apical sizes of 0.06, 0.08, and 0.10 from seven distinct brands were included in the study. A meticulous inspection of all instruments was undertaken to identify any structural deformations that might render them ineligible for the study. The design inspection involved the random selection of instruments from each group, which were examined under various microscopes, including a dental operating microscope, optical microscope, and scanning electron microscope. Furthermore, two instruments from each group underwent energy-dispersive X-ray spectroscopy analysis for elemental composition documentation. Mechanical tests were conducted to evaluate the instruments’ resistance to lateral deformation (buckling) and their microhardness. Statistical analysis was executed using the nonparametric Mood’s median test, with a predetermined significance level of 0.05. Regarding the instruments design, all files exhibited an active blade length ranging from 16 to 17 mm. However, variations were observed in the number of spirals, tip designs, and sizes, with the API K-File notably larger in sizes 0.06 and 0.08 compared to the other instruments. Despite uniform elements composition, differences in geometric features and mechanical properties were evident. Concerning buckling strength, the API K-File demonstrated superior performance across all tested sizes, while the Dentsply ReadySteel, SybronEndo, and Mani K-Files exhibited lower results (p < 0.05). In microhardness assessments, both the API and Oro K-Files displayed the lowest outcomes, with medians of 531 HVN and 532 HVN, respectively, whereas the SybronEndo K-File exhibited the highest microhardness (657 HVN). Despite similar metallurgical composition, the observed distinctions in geometric features and mechanical properties underscore the impact of the manufacturing process on the characteristics of glide path stainless steel endodontic files. These disparities may ultimately influence their clinical performance. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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12 pages, 1304 KiB

Open AccessArticle

Endodontic Outcome of Root Canal Treatment Using Different Obturation Techniques: A Clinical Study

by Alexander Winkler, Philipp Adler, Julia Ludwig, Norbert Hofmann, Sebastian Soliman, Gabriel Krastl and Ralf Krug

Dent. J. 2023, 11(8), 200; https://doi.org/10.3390/dj11080200 - 21 Aug 2023

Cited by 3 | Viewed by 5590

Abstract

Objective: To evaluate the clinical outcome of root canal treatment by obturation technique, root canal filling quality, and tooth- and patient-related variables. Methods: This clinical study investigated the endodontic outcome of 114 teeth treated between the years 2009 and 2012. Three different obturation [...] Read more.

Objective: To evaluate the clinical outcome of root canal treatment by obturation technique, root canal filling quality, and tooth- and patient-related variables. Methods: This clinical study investigated the endodontic outcome of 114 teeth treated between the years 2009 and 2012. Three different obturation methods were used: (1) adhesive obturation using the continuous wave of condensation technique with Resilon^® (CWR), (2) matching-taper single-cone technique with gutta-percha and AH Plus^® (SCGP), and (3) matching-taper single-cone technique with gutta-percha and GuttaFlow^® (SCGF). Pre- and postoperative periapical radiographs were performed to detect the presence of endodontic lesions (PAI classification) and to assess the quality of both the obturation and the restoration. Tooth- and patient-related data were collected. Results: The overall endodontic success rate was 75.4% after a mean observation period of 6.3 years. There were no significant correlations between the type or overall quality of obturation and the treatment outcome. Teeth with preoperative lesions had the highest odds ratio (factor of 4.98) for endodontic failure. Tooth- and patient-related variables had no significant effect on endodontic outcome. Conclusions: The preoperative periapical status of teeth requiring endodontic treatment was a substantial prognostic factor for endodontic outcome, whereas the type of obturation material or technique did not affect it. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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Review

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17 pages, 1271 KiB

Open AccessReview

Longevity of Anterior Composite Restorations for Localized Tooth Wear: A Scoping Review

by Sindhu Rajarajan, Neil Nathwani, Touraj Nejatian, Peter Fine and Albert Leung

Dent. J. 2023, 11(11), 255; https://doi.org/10.3390/dj11110255 - 31 Oct 2023

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Abstract

(1) Objective: This scoping review evaluates composite restorations as a treatment modality for anterior tooth surface loss and investigates the longevity of the direct and indirect composites used herein. (2) Method: The search encompassed Medline, Embase, Web of Science, the Cochrane Library, and [...] Read more.

(1) Objective: This scoping review evaluates composite restorations as a treatment modality for anterior tooth surface loss and investigates the longevity of the direct and indirect composites used herein. (2) Method: The search encompassed Medline, Embase, Web of Science, the Cochrane Library, and hand search utilizing the PICO framework. (3) Results: Eight studies were included in this review, comprising one randomized controlled trial, one retrospective, and six prospective studies. Some studies reported favorable outcomes for composite restorations in anterior teeth. Although not statistically significant, evidence supported the anterior composite as a viable short- to medium-term solution for managing tooth wear. Direct resin composites were deemed clinically and cost-effective when managing localized anterior tooth wear. However, limitations and inconsistencies in this scoping review limited definitive clinical recommendations. (4) Conclusions: Further research, including well-managed randomized controlled trials using standardized protocols and longer follow-up periods, is essential to reconfirm the long-term efficacies of anterior composite restorations when managing tooth wear. A robust research design and exacting protocols could facilitate more meaningful clinical conclusions. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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Other

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9 pages, 9859 KiB

Open AccessCase Report

Application of Bulk-Fill Composite to Simplify the Cementation of Indirect Restorations: The COMBO Technique

by Giuseppe Chiodera, Riccardo Monterubbianesi, Vincenzo Tosco, Ombretta Papini, Giovanna Orsini and Angelo Putignano

Dent. J. 2024, 12(8), 239; https://doi.org/10.3390/dj12080239 - 29 Jul 2024

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Abstract

This article proposes a technique to simplify the cementation of indirect restorations by exploiting the advantageous properties of bulk-fill composites (BFCs). The proposed technique consists of using a thin layer of a high-viscosity (HV) BFC in the interproximal margins of the preparation and [...] Read more.

This article proposes a technique to simplify the cementation of indirect restorations by exploiting the advantageous properties of bulk-fill composites (BFCs). The proposed technique consists of using a thin layer of a high-viscosity (HV) BFC in the interproximal margins of the preparation and applying low-viscosity (LV) resin luting agents (RLAs) to the rest of the prepared surface. The application of the HV BFC limits the extrusion of the LV RLAs in the interproximal area, deviating the excesses of LV RLAs only on the vestibular and lingual side. This deviation allows the management and control of the excess material in complicated interproximal spaces, simplifying the cementation procedure of indirect restorations and achieving a reliable final result in terms of removing excess in a safe and repeatable way. This technical report provides an alternative clinical approach for cementing indirect restorations using the consistency and viscosity of different RLAs. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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25 pages, 1358 KiB

Open AccessSystematic Review

Clinical Effectiveness of Ion-Releasing Restorations versus Composite Restorations in Dental Restorations: Systematic Review and Meta-Analysis

by Heber Isac Arbildo-Vega, Fredy Hugo Cruzado-Oliva, Franz Tito Coronel-Zubiate, Sara Antonieta Luján-Valencia, Joan Manuel Meza-Málaga, Rubén Aguirre-Ipenza, Adriana Echevarria-Goche, Eduardo Luján-Urviola, Tania Belú Castillo-Cornock, Katherine Serquen-Olano and Carlos Alberto Farje-Gallardo

Dent. J. 2024, 12(6), 158; https://doi.org/10.3390/dj12060158 - 24 May 2024

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Abstract

Background: To compare the clinical effectiveness of ion-releasing restorations (IRR) vs. composite resin (CR) in dental restorations. Methods: A systematic search was carried out from articles published until January 2024, in the biomedical databases: PubMed, Cochrane Library, Scielo, Scopus, Web of Science and [...] Read more.

Background: To compare the clinical effectiveness of ion-releasing restorations (IRR) vs. composite resin (CR) in dental restorations. Methods: A systematic search was carried out from articles published until January 2024, in the biomedical databases: PubMed, Cochrane Library, Scielo, Scopus, Web of Science and Google Scholar. Randomized clinical trials were included, with a follow-up time greater than or equal to 1 year, without time and language limits and which reported the clinical effect of IRR compared to CR in dental restorations. The RoB 2.0 tool was used to assess the risk of bias of the included studies and the GRADEPro GDT tool was used to assess the quality of evidence and the strength of recommendation of the results. Results: The search yielded a total of 1109 articles. After excluding those that did not meet the selection criteria, 29 articles remained for the quantitative synthesis. The analysis found no statistically significant difference when comparing the dental restorations with IRRs or CRs. Conclusion: The literature reviewed suggests that there are no differences between the IRRs and CRs in dental restorations. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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