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O selamento dentinário imediato é um procedimento essencial na Odontologia, que envolve a aplicação de agentes de selamento na interface entre a dentina e o material restaurador imediatamente após a remoção da cárie e do preparo da cavidade dentária. Este processo busca selar os túbulos dentinários expostos, proporcionando proteção à polpa dentária. O presente caso foi realizado em um paciente do sexo masculino, 56 anos que se queixou de desconforto no elemento dentário 17. Após avaliação clínica e radiográfica, foi constatado uma ampla restauração desadaptada na porção mesio - oclusal do referido dente, sendo que o elemento em questão não possui tratamento endodôntico. Após planejamento e assinatura do TCLE, os seguintes passos foram realizados: remoção da lesão cariosa do dente 17, seguido da realização do levantamento marginal mesial e a realização do selamento dentinário imediato. Moldagem com silicone de adição do dente em questão e do antagonista, assim como registro da mordida. Foi confeccionada uma restauração semidireta em resina composta sob o modelo de gesso obtido. A cimentação da restauração foi feita na consulta seguinte, cumprindo os requisitos fundamentais para restaurar forma, função e estética, resultando na melhoria da qualidade de vida do paciente(AU)

Immediate dentin sealing is an essential procedure in dentistry, involving the application of sealing agents at the interface between dentin and the restorative material immediately after caries removal and cavity preparation. This process aims to seal exposed dentinal tubules, providing protection to the dental pulp. The present case involved a 56-year-old male patient who complained of discomfort in tooth number 17. After clinical and radiographic evaluation, a wide, maladapted restoration in the mesio-occlusal portion of the tooth was identified, with no endodontic treatment in the affected element. Following planning and informed consent, the following steps were taken: removal of the carious lesion from tooth number 17, followed by the execution of mesial marginal elevation and immediate dentin sealing. Silicone addition molding of the affected tooth and antagonist, along with bite registration, was performed. A semi-direct restoration in composite resin was fabricated based on the obtained gypsum model. The restoration was cemented in the subsequent appointment, meeting the essential requirements to restore form, function, and aesthetics, resulting in an improvement in the patient's quality of life(AU)

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OBJECTIVES: This study aimed to compare the success and survival rates of metal-ceramic crowns and composite resin restorations applied in root filled teeth that received a glass fiber post. METHODS: A prospective, randomized controlled trial, with equivalent parallel groups was designed. Eighty-two teeth were randomly allocated to the metal-ceramic or composite resin groups. Multivariate Cox regression analysis with shared frailty for patients and Kaplan-Meier curves were performed using success and survival rates (p<0.05). RESULTS: Seventy-five post-retained restorations (34 metal-ceramic crowns and 41 composite restorations) in 62 patients were analyzed. The median follow-up was 8.1 years [IQR 4.0-9.9]. Twenty-seven failures were observed. Twenty-two failures (81.5 %) were observed in the composite resin group, of which six (27.3 %) were not repairable. Five failures (18.5 %) were observed in the metal-ceramic crown group, of which three (66.6 %) were non-repairable. The cumulative success rate at 8 years was 85.0 % for crowns (AFR=1.31 %) and 43.2 % for composite resins (AFR=6.58 %), while the survival rate was 93.8 % for crowns (AFR=0.52 %) and 97.6 % for composite resins (AFR=0.20 %). Considering the success rates, adjusted multivariate Cox regression showed that composite resin had a Hazard Ratio of 5.07 (95 %CI, 1.99-12.89) greater than the metal-ceramic crown. No significant difference in the failure risk was observed when the survival rates were considered (HR=0.38, 95 %CI (0.10 - 1.44), p = 0.156). Co-variables did not affect the success and survival rates (p>0.05). CONCLUSIONS: Metal-ceramic crowns showed a higher success rate than composite restorations. The survival rates were similar, but composite restorations presented a higher need for repairs. CLINICAL SIGNIFICANCE: Post-retained composite restorations may need more reinterventions during the lifecycle, although more preservation of sound tooth structure is expected with a large restoration of resin post-and-core. These aspects have to be discussed with the patient for decision-making planning.

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OBJECTIVE: To summarize and evaluate critically the results of clinical trials comparing the risk of failure of restorations after chemomechanical and mechanical carious tissue removal. MATERIALS AND METHODS: The PubMed/MEDLINE, EMBASE, Scopus, LILACS, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases, and grey literature were searched to identify studies related to the research question and published up to January 2022. Two authors independently selected the studies, extracted the data, and assessed the risk of bias and the certainty of evidence. Meta-analysis was performed using a random effects model to compare the effect of chemomechanical and mechanical excavation on the outcome (restorative failure), considering the type of carious tissue removal (selective and complete) as subgroups. RESULTS: From 443 potentially eligible studies, 58 clinical studies were selected for full-text analysis, and 6 were included in the review. There was no statistically significant difference in the risk for failure of restorations performed after chemomechanical and mechanical excavation (RR: 1.26, 95% CI 0.93; 1.72, p = 0.14) either for complete (p = 0.97) or selective (p = 0.11) carious tissue removal. The heterogeneity found was null. The risk of bias was high and the certainty of evidence was low. CONCLUSION: Based on the low certainty of evidence, the risk of failure of restorations performed after chemomechanical and mechanical carious tissue removal is similar. CLINICAL RELEVANCE: Chemomechanical carious tissue removal may be performed before restoration placement, without jeopardizing the short-term longevity. Further studies are required before definitive conclusions can be drawn.

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OBJECTIVE: To investigate the influence of an intermediate layer of a flowable resin composite in class II resin composite restorations. MATERIALS AND METHODS: The authors searched MEDLINE via PubMed, Scopus, LILACS, Embase, and Web of Science electronic databases, and the ClinicalTrials.gov website to identify laboratory and clinical studies that evaluated class II cavities with resin composite restorations with or without an intermediate layer of flowable resin composite. Two authors independently selected the studies, extracted the data, and assessed the risk of bias and the quality of the evidence. Meta-analyses were performed using RevMan5.3 with fixed-effects model comparing bond strength (MPa), fracture strength (Newton), and clinical (number of failures) outcomes between restorative techniques (with or without flowable resin composite as an intermediate layer). RESULTS: From 1707 potentially eligible studies, 140 in vitro studies and 14 clinical studies were selected for full-text analysis, and 11 were included in the systematic review, being 7 in vitro and 4 clinical studies. There was no statistically significant difference between the restorative techniques considering the outcomes evaluated. The heterogeneity found was null. The risk of bias was classified as medium for in vitro studies and unclear in most clinical studies. The quality of the evidence of the clinical studies was low. CONCLUSION: The use of flowable resin composite as an intermediate layer does not improve the effectiveness of the class II restorations based on laboratory and clinical outcomes. CLINICAL RELEVANCE: Flowable resin composite as an intermediate layer may be used for class II restorations; however, this technique does not improve the effectiveness of the class II restorations.

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OBJECTIVES: The purpose of this systematic review was to compare the clinical performance of bulk-fill resin composites with conventional resin composites used for direct restorations of posterior teeth. METHODS: This review followed the PRISMA statement. This review was registered at PROSPERO (registration number CRD42016053436). A search of the scientific literature was performed by two independent reviewers using the PubMed/MEDLINE, Embase, The Cochrane Library, and Web of Science databases from commencement until January 2018. The research question was "Do bulk-fill resin composites have a clinical performance comparable to conventional resin composites in posterior restorations?" Only studies evaluating class I and II direct restorations in permanent teeth with a follow-up period of at least 1 year were included. The RevMan 5 program was used for meta-analysis, calculating the relative risk (RR) and 95% confidence interval (CI) of the dichotomous outcome (restoration failure or success). RESULTS: Ten articles were selected, comprising 941 analyzed restorations. The mean follow-up period was 33.6 months (12-72 months). No statistically significant differences in the failure rate were observed between conventional and base/flowable bulk-fill resin composites (p = 0.31; RR 1.49; 95% CI 0.69-3.25) or full-body/sculptable bulk-fill resin composites (p = 0.12; RR 1.89; 95% CI 0.84-4.24). CONCLUSIONS: The present systematic review and meta-analysis indicate similar clinical performances of bulk-fill and conventional resin composites over a follow-up period of 12 to 72 months. CLINICAL SIGNIFICANCE: Based on the results of this study, the bulk-fill resin composites could be an alternative for direct restorations in posterior teeth. However, clinical trials of longer duration are required.

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Due to the esthetic necessity required nowadays, the multidisciplinary treatment became a fundamental step in the restoration success. When the patient exhibits dental agenesis of one or more elements, he can show difficulty in social interactions. The age of the patient is a limiting factor to esthetic procedures, however, it should be evaluated as a real indicative with each case. The utilization of semi-direct restorations is a viable option due the cost, esthetic and improvement of physical and mechanical properties. The purpose of this paper is to present a case detailing the confection and cementation of anterior semi-direct restorations aimed at an anatomic reestablishment associated with integrated treatment with periodontics and orthodontics.

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The aim of this study was to evaluate thenine-year clinical performance of Class III composite restorations using two microhybrid anterior composite resins [Magic™-Vigodent/(F) and Z100™-3M ESPE/(Z)]. Material and Methods: The study was a randomized controlled trial, following the splitmouth design. Seventy restorations were placed, thirty-five for each resin composite into 35 patients. The restorations were placed by one operator according to the manufacturers’ specifications. Two independent evaluators conducted the clinical evaluation using modified USPHS criteria. After nine years, 56 restorations (28F-28Z) were evaluated. Data were analyzed using Chi-square, Exact Fisherand McNemar tests (p < 0.05). Results: Nopost operative sensitivity, secondary caries and loss of anatomic form was observed after nine-years for both composites. There were no significant differences between the two composites tested at baseline and after nine-years. Significant differen ces for Z and Frestorations between baseline and nine-year with respect to color matching and for F regarding themarginal integrity were detected. Conclusion: The clinical performance of both materials was consideredacceptable after the 9-year evaluation...

Objetivo: O objetivo deste estudo foi avaliar após nove anos a performance clínica de restaurações de classe III em resina composta, utilizando-se duas resinas microhíbridas para dentes anteriores [Magic-Vigodent/(F) e Z100-3M ESPE/(Z)]. Material e Métodos: Trata-se de um estudo clínico controlado aleatório, o qual utilizou o desenho de boca dividida.Setenta restaurações foram realizadas em trinta e cinco pacientes, sendo trinta e cinco para cada resina composta. As restaurações foram realizadas por um único operador seguindo as especificações dos fabricantes. Dois avaliadores independentes avaliaram as restaurações utilizando-se o critério USPHS modificado. Após nove anos, 56 restaurações(38F – 28Z) foram avaliadas. Os dados foram analisados por meio dos testes Qui-quadrado, Exato de Fisher e McNemar (p < 0,05). Resultados: Não foram detectados sensibilidade pós-operatória, cárie secundária e perda de forma anatômica no período analisado para ambas resinas. Não houve diferenças entre o período inicial e de nove anos para as resinas testadas, exceto para Z e F foram em relação à a cor e para a integridade do material para F. Conclusão: O comportamento clínico das duas resinas testadas foi considerado adequado após nove anos de avaliação...

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Objective: The aim of this study was to evaluate the cuspal deflection of teeth restored directly and indirectly. Material and Methods: Forty sound maxillary premolar teeth were restored with composite and different base materials. Wide mesial-occlusal-distal cavity preparations were performed, with isthmus width of one third of the distance between the cuspal tips, 3 mm occlusal and a 5 mm interproximal preparation height. The teeth were divided into 4 groups (n = 10), according to the restoration type: G1) GIC-DCR (1 mm glass ionomer cement base and direct restoration using nanoparticulate composite); G2) FL-DCR (1 mm base of flowable composite resin and direct restoration using nanoparticulate composite); G3) GIC-ICR (1 mm glass ionomer cement base and indirect restoration using nanoparticulate composite GIC base); G4) FL-ICR (1 mm base of flowable composite resin and indirect restoration using nanoparticulate composite). The specimens were submitted to compressive load of 50 N on the buccal and lingual cusps, in a universal testing machine. The lingual cusp microstrain (με) measurements were executed by strain gauges. Results: The Kruskal-Wallis (5%) test was used and showed there were no significant differences among the microstrain values for the four study groups (G1 = 1250; G2 = 1075; G3 = 1279; G4 = 937). Conclusion: It could be concluded that the restorative techniques and the bases employed did not show any influences in cuspal deflection

Objetivo: O objetivo deste trabalho foi avaliar, por meio de medidores de tensão, a deflexão cuspídea sofrida por dentes restaurados, direta e indiretamente, com resinas compostas e diferentes materiais de base. Material e Métodos: Para o preparo dos corpos-de-prova (CP) foram utilizados 28 dentes pré-molares humanos íntegros, extraídos por razões ortodônticas que tiveram suas raízes embutidas em poliuretano de densidade semelhante a do osso e suas raízes recobertas por um espaçador visando simular o espaço referente ao ligamento periodontal. Na etapa seguinte os dentes receberam preparos cavitários do tipo mésio-ocluso-distais amplos e então restaurados direta e indiretamente com resina composta e dois diferentes materiais de base/forramento, resina flow e cimento de ionômero de vidro. Para a realização das medidas de deflexão das cúspides foram utilizados extensômetros lineares elétricos colados à face lingual de cada dente e submetidos a uma carga de 50 N aplicada por uma ponta romba de diâmetro de 3,0 mm, que promoveu compressão simultânea nas vertentes triturantes das cúspides vestibular e lingual, numa máquina universal de ensaios. Resultados: Foi realizado o teste de Kruskall-Wallis (5%) de significância e não foram encontradas diferenças estatísticamente significantes entre os grupos (G1 – 1250; G2 = 1075; G3 = 1279; G4 = 937). Conclusão: Pode-se concluir que o tipo de restauração bem como o tipo de base empregados nesse estudo não alteram a deflexão cuspídea dos dentes com restaurações amplas.

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