Adhesive dentistry and endodontics: materials, clinical strategies and procedures for restoration of access cavities: a review

The complexity of restorative dentistry has increased greatly in recent years, with the myriad of products used in "adhesive dentistry." So too has the "simple" matter of restoring access cavities after completion of endodontic treatment. This review discusses current methods of "bonding" to tooth structure, ceramic materials, and metals, with emphasis on those aspects that are important to endodontics. Specific materials, procedures and major decision making elements are discussed, as well as how to avoid problems in compatibility between endodontic and restorative materials.     

Perforation repairs.

Management of instrument perforations in the periodontal ligament space during endodontic or restorative procedures is an ongoing problem in dentistry. The introduction of microscopes, new instruments and materials has resulted in more controllable and predictable surgical and nonsurgical outcomes. This paper discusses some of the newer techniques and materials used to manage perforations effectively.     

A review of contemporary impression materials and techniques

The contemporary restorative dentist has a host of impression materials available for making impressions in fixed prosthodontics,implant dentistry, and operative dentistry. With proper material selection and manipulation, accurate impressions can be obtained for fabrication of tooth- and implant-supported restorations. This article outlines the ideal properties of impression materials and explains the importance of critical manipulative variables. Available impression materials are analyzed relative to these variables, and several "specialized" impression techniques are described. Special attention is paid to polyvinyl siloxane impression materials because they have become the most widely used impression material in restorative dentistry.     

Mechanisms of N-acetyl cysteine-mediated protection from 2-hydroxyethyl methacrylate-induced apoptosis

Resin-based materials are now commonly used in dentistry in restorative materials as well as in endodontic sealers. These materials have been shown to be cytotoxic. The mechanisms by which resin-based materials mediate their adverse effects have not been completely elucidated. Here we show that 2-hydroxyethyl methacrylate (HEMA) induces apoptotic cell death in oral keratinocytes and immune cells through the intrinsic cell death pathway. Functional loss and cell death induced by HEMA was significantly inhibited in the presence of N-acetyl cysteine (NAC) treatment. In addition, HEMA induced a decrease in mitochondrial membrane potential, and an increase in cleaved caspases was potently inhibited in the presence of NAC treatment. Overall, the results reported in this article indicate that NAC is an effective chemoprotectant that can safely be used to protect the pulp and the surrounding tissues from adverse effects of dental restorative and endodontic materials.     

Ultrasonics in endodontics: a review of the literature

During the past few decades endodontic treatment has benefited from the development of new techniques and equipment, which have improved outcome and predictability. Important attributes such as the operating microscope and ultrasonics (US) have found indispensable applications in a number of dental procedures in periodontology, to a much lesser extent in restorative dentistry, while being very prominently used in endodontics. US in endodontics has enhanced the quality of treatment and represents an important adjunct in the treatment of difficult cases. Since its introduction, US has become increasingly more useful in applications such as gaining access to canal openings, cleaning and shaping, obturation of root canals, removal of intracanal materials and obstructions, and endodontic surgery. This comprehensive review of the literature aims at presenting the numerous uses of US in clinical endodontics and emphasizes the broad applications in a modern-day endodontic practice.     

Monoblocks in root canals: a hypothetical or a tangible goal

The term monoblock has become familiar in the endodontic literature with recent interest in the application of dentin adhesive technology to endodontics. Endodontic monoblocks have generated controversial discussions among academicians and clinicians as to whether they are able to improve the quality of seal in root fillings and to strengthen roots. This review attempts to provide a broader meaning to the term monoblock and to see how this definition may be applied to the materials that have been used in the past and present for rehabilitation of the root canal space. The potential of currently available bondable materials to achieve mechanically homogeneous units with root dentin is then discussed in relation to the classical concept in which the term monoblock was first employed in restorative dentistry and subsequently in endodontics.     

Perspectives for the use of silver nanoparticles in dental practice

Nanotechnology has been used for medical applications in several forms, including dental practice with the development of silver nanoparticles (Ag NPs) as a useful tool. The aim of this review was to identify the properties and appliances of Ag NPs in dental practice. Silver compounds and NPs have already been used as dental restorative material, endodontic retrofill cements, dental implants and caries inhibitory solution. Despite the effectiveness that Ag NPs has shown in dental practice, Ag NPs remain a controversial area of research with respect to their toxicity in biological and ecological systems. Therefore any application of Ag NPs in dentistry requires more studies. In order to avoid the toxicity of these materials Ag NPs can be temporarily used in dentistry.     

Utilization of multiple restorative materials in full-mouth rehabilitation: a clinical report

Many different restorative materials are currently available for use in modern dentistry. Clinicians and dental technicians should be able to choose the most suitable materials for each patient based on research, anecdotal evidence, clinical experience, as well as patient's expectations and desires. The purpose of this article is to share the challenges presented in full-mouth rehabilitation and to describe the considerations in selecting three different restorative materials to achieve a successful restoration in terms of biomechanics, function, and esthetics.

CLINICAL SIGNIFICANCE

Interdisciplinary treatment planning, knowledge of available restorative materials, sequencing treatment modalities, and adequate communication between all parties involved are key to a successful treatment outcome when pursuing full-mouth restorative rehabilitation.     

Adhesive dentistry and endodontics. Part 2: bonding in the root canal system-the promise and the problems: a review

One of the recent trends in endodontics has been the development of bonded obturating materials, in an effort to provide a more effective seal coronally and apically. Materials utilizing dentin adhesive technology have been borrowed from restorative dentistry and adapted to obturating materials. This review discusses the obstacles to effective bonding in the root canal system, the progress that has been made, and possible strategies for improved materials in the future. Much of the literature reviewed and many of the principles discussed are taken from the restorative dentistry literature and applied to the unique environment of the root canal system.     

Enhancing your practice with the magnifying video scope

The MVS (such as the Explorer and the MagnaVu) allows the dentist and team to provide quality dentistry in a more comfortable position, for longer periods of time. This is especially important for complex surgical and extensive restorative/aesthetic cases. The procedures that would be enhanced via the MVS include: diagnostic, preventative care, restorative, periodontal, endodontic, orthodontic, implant, and laser dentistry.     

数字化口腔修复（4）-直接数字化制造

虽然口腔CAD／CAM方法依然是切削系统中的主流,但是加法制造技术也能更有效、更经济地为口腔医学提供可摘义齿支架和颅面重建的个性化固定装置。伴随更多的个性化材料的发展,修复体制造业将发生由传统的金属和陶瓷向着生物适合性的高强度聚合体、陶瓷和共熔合金方向转变。直接数字化制造将定义口腔医学的未来。数字化扫描、虚拟设计和数字化制造的进步将对传统的牙体预备,印模方法、义齿加工产生冲击。数字化的口腔技工室将经历由传统工匠向懂计算机的技师方向转变,并伴随着更先进的材料的应用,而获得高产量和高质量的回报。虽然,我们还不能够抛弃过去曾经应用于口腔医学中的常规原理,但是现在,口腔界的同仁们将为了患者去挑战和拥抱数字化口腔修复的新技术。     

Dental materials in pediatric dentistry.

Dental materials for the restorative armamentarium in pediatric dental care continue to improve in esthetics and function. This review describes the application of some contemporary materials and concepts. Fluoride-releasing glass ionomers are appropriate for use as luting cements and as liners and bases. The glass ionomer cements have minimal solubility in oral fluids and possess the capability of inhibiting secondary caries. Amalgam and composite resin are effective for class II restorations, although amalgam placement is considerably less time consuming and less technique sensitive. Composite resins, particularly more highly filled resins, are appropriate for anterior restorative care. The use of ceramic glass inserts may provide strength and decrease restorative time for composite resin restorations in the future. When planning treatment for pediatric dental patients, each patient and restorative material to be used should be evaluated on an individual basis, in order to provide appropriate care within each material's limitations. Pediatric restorative dentistry involves the use of many materials. As materials improve in durability, strength, esthetics, and anticariogenic properties, the concepts of contemporary pediatric restorative dentistry change. Certainly, the traditional principles of restorative dentistry remain practical and significant in the practice of dentistry. Although these traditional concepts are extremely relevant, newer materials allow for modifications to be made during treatment planning in restorative dentistry. This review presents some newer materials and concepts and their applications in current pediatric restorative dentistry.     

Considerations About Esthetics of Composite Resin Restorations

There is a tendency to use composite resins as a universal restorative material because of the esthetics of the finished restoration. The author discusses the meaning of "esthetics" in restorative dentistry and details the clinical procedures to improve the esthetic performance of the materials. Indications for the materials are set for initial, isolated lesions in the dentition of patients who are well motivated to good standards of oral hygiene. Only then can composite resin materials be accepted as universal restorative esthetic materials, both in the front and lateral segments of the mouth.     

Retention of teeth versus extraction and implant placement: treatment preferences of dental faculty and dental students

The purpose of this study was to determine the treatment preferences amongst dental faculty and dental students for either retention of teeth by endodontic and restorative treatment or extraction and implant placement. A survey of 134 general dentistry faculty and 253 senior (fourth-year) dental students was conducted in a university college of dentistry. Participants completed a survey consisting of questions for which one of two choices could be selected. For questions describing specific clinical situations, dental faculty and dental students more frequently selected endodontic and restorative treatment over extraction and implant placement. However, dental students selected implants more frequently than dental faculty, and more recent graduates on the dental faculty selected implants more frequently than less recent graduates on the dental faculty. In addition, there was an increase in the selection of implants, for all participant groups, as the prosthetic and endodontic complexities of the clinical situations increased. Participants were more likely to select endodontics rather than implants for medically compromised patients, and an implant was overwhelmingly selected over a fixed bridge for the replacement of a single tooth unit. In conclusion, the findings of this study indicate that retention of teeth is preferred, but there may be an increased preference toward implants in the future.     

Biomechanics of the intact, prepared and restored tooth: some clinical implications

The practice of restorative dentistry has changed for many and varied reasons. They include changes in the epidemiology of dental caries due to fluoridation, and availability of new equipment and techniques for cavity preparation and new or improved restorative materials. Changes driven by these 'new' materials frequently do not provide the benefits anticipated. In the context of this paper, it is argued that, regardless of restorative materials and techniques, the biomechanics of intact, prepared and restored teeth must be understood to attain a satisfactory clinical outcome.     

Modern restorative dentistry: a new approach

An analysis of the role of restorative dentistry within oral health care shows that it has broadened its scope over its long history. It started with the replacement of lost teeth and, later, lesions and structural defects of tooth tissue were treated. Progress has been achieved through the development of new materials and procedures, specifically those that ensure microscopic and/or chemical adhesion and those that allow for the removal of infection tissue and its restoration, while protecting the remaining healthy structure of the tooth. Teeth can also be protected even before the initiation of an infected lesion by sealing morphologic features such as pits and fissures. All of these procedures are components of modern restorative dentistry which now contributes to the disappearance of the totally edentulous patient. Dentistry has the responsibility of helping in the generation of sufficient social and economic resource to make this modern restorative dentistry available to the community as a whole.     

Soft-tissue management using an Er,Cr:YSGG laser during restorative procedures

Effective management of gingival tissues in restorative dentistry poses a challenge to practitioners. Many methods and materials are available to dental professionals to manage tissue. This article will demonstrate the use of an Er,Cr:YSGG laser as an effective, minimally invasive technology to manage soft tissue during restorative procedures.     

Microleakage between endodontic temporary restorative materials placed at different times.

Occlusal endodontic access preparations are occasionally made in teeth without removing the original restoration. However, microleakage between restorative materials that are placed at different times has not been extensively studied. Therefore, our objective was to compare microleakage at three areas: between an access opening restorative material and the cavity wall; between an additional material placed later to patch a secondary opening in the first restorative material and the original restorative material itself; and between the secondarily placed material and the cavity wall. Standard endodontic access preparations were made in 120 noncarious, nonrestored crowns of extracted human molars. These teeth were divided into six experimental groups. Another four molars were controls. The endodontic access cavities were restored with either IRM or amalgam as the primary restorative material. After 14 days, half of the primary restorations was removed, and this defect was filled with a secondary restorative material: IRM, Caviton, or a double seal of Caviton and IRM. Microleakage was measured linearly as the extent of basic fuchsin dye penetration under a stereomicroscope after thermal cycling (5 degrees and 55 degrees C for 100 cycles) and tooth sectioning. Wilcoxon signed-rank test was used for statistical analysis. Results indicated significantly less microleakage between primary and secondary restorative materials placed at different times than microleakage between primary temporary restorative materials and the access cavity wall, regardless of the type of primary restorative material used (IRM or amalgam).     

Iatrogenesis in the treatment of dental caries.

Traditional restorative dental treatment has many shortcomings and has not been shown to be an effective method for managing caries. In spite of this, many dentists continue to be powered by an aggressive restorative approach which, in the light of changing "rules" of operative dentistry, must now be seen as inappropriate and as a form of iatrogenesis. Many things have changed in recent years, including: the prevalence of caries; understanding of the science of the caries process; a fuller appreciation of the problems inherent in restoring teeth; cavity design; restorative materials; and the demands of patients. Dental practice needs to change very dramatically if iatrogenesis is truly to be reduced to a minimum and dentistry is to provide the sort of preventive-based care the modern consumer is increasingly realising makes most sense.     

Comparison of apical leakage in teeth obturated with a polyamide varnish or zinc oxide and eugenol cement using lateral condensation.

The sealing ability of copal varnish has been investigated when used as an adjunct in restorative procedures, retrofilling procedures, and dontic obturation procedures. Barrier, a polyamide-type polymer cavity varnish, has been compared with copal varnishes in restorative dentistry. This investigation compared the apical sealing properties of a zinc oxide and eugenol sealer (Roth) with a polyamide varnish (Barrier). Twenty-four teeth were instrumented and divided into two groups, one obturated with gutta-percha and Roth sealer and one with gutta-percha and Barrier, using submersion in methylene blue dye to demonstrate apical leakage. Roth sealer exhibited less dye penetration than Barrier when used as an endodontic sealant (p < 0.02).