A Critical Review on the Factors Affecting the Bond Strength of Direct Restorative Material Alternatives to Amalgam

This article comprehensively reviews the performance of simplified direct restorative materials that have the potential to be an alternative to amalgam. Following an understanding of the material structures and clinical performances, this review provides an analysis of the bonding mechanisms and influential factors on the bond strength. These factors include substrate-related variations, involving primary vs. permanent dentin, sound- vs. caries-affected/demineralized dentin comparisons and surface-related factors and pretreatments. Special attention is given to the factors changing the substrate surface, such as different contaminants, remedy methods after contamination and different conditioning methods related to the materials. Variations in sample preparation and bond strength test parameters are also evaluated for the analysis of the outcomes. This review aims to provide an overview of the factors involved in the application procedure of direct restorations together with in vitro testing variations to guide the selection of suitable materials by understanding strengths and shortcomings.

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

OBJECTIVE

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.

MATERIALS AND METHODS

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).

RESULTS

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).

CONCLUSION

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.

CLINICAL SIGNIFICANCE

Glass-hybrid materials presented a lower performance in terms of color match or retention when compared to a sculptable bulk-fill composite resin.

Expert consensus on dental caries management

Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.

Repair Bond Strength of High-viscosity Glass-ionomer Cements Using Resin Composite Bonded with Light- and Self-cured Adhesive Systems

CLINICAL RELEVANCE

High-viscosity glass-ionomer cements (HVGICs) used with atraumatic restorative treatment can be repaired with light- or self-cured adhesive systems; however, the repair bond strength of two-step, self-etching and one-step adhesives in the light-cure mode surpass one-step self-cure adhesives. Working on a feasible self-cure approach in the absence of such in rural areas as well as in war zones is of prime importance.

SUMMARY

Performance of Adhesives and Restorative Materials After Selective Removal of Carious Lesions: Restorative Materials with Anticaries Properties

Selective carious tissue-removal strategies require specific considerations in selection of restorative materials. A tight marginal seal placed over hard dentin and sound enamel is essential. For selective removal of carious tissue with permanent restoration, bioactive materials, such as high-viscosity glass-ionomer cement (HV-GIC) or calcium silicates, may be preferred over caries-affected firm or leathery dentin to improve remineralization. HV-GICs have the best clinical evidence of caries-arresting effect and demonstrate sufficient longevity as long-term provisional restorations that can later be used in open or closed sandwich restorations. As with any material, oral health maintenance remains important for long-term survival of restorations.