OBJECTIVE: To compare the interfacial fracture toughness (IFT) with or without aging, of four different classes of CAD-CAM ceramic and composite materials bonded with self-adhesive resin cement to titanium alloy characteristic of implant abutments.
METHODS: High translucent zirconia (Katana; KAT), lithium disilicate-based glass-ceramic (IPS. emax.CAD; EMX), polymer-infiltrated ceramic network material (PICN) (Vita Enamic; ENA), and dispersed filler composite (Cerasmart 270; CER) were cut into equilateral triangular prisms and bonded to titanium prisms with identical dimensions using Panavia SA Cement Universal. The surfaces were pretreated following the manufacturers\' recommendations and developed interfacial area ratio (Sdr) of the pretreated surfaces was measured. IFT was determined using the Notchless Triangular Prism test in a water bath at 36 °C before and after thermocycling (10,000 cycles) (n = 40 samples/material).
RESULTS: IFT of the materials ranged from 0.80 ± 0.25 to 1.10 ± 0.21 MPa.m1/2 before thermocycling and from 0.71 ± 0.24 to 1.02 ± 0.25 MPa.m1/2 after thermocycling. There was a statistical difference between IFT of CER and the two top performers in each scenario: KAT and EMX before aging, and KAT and ENA after aging. Thermocycling significantly decreased IFT of EMX. The Weibull modulus of IFT was similar for all materials and remained so after thermocycling. Sdr measurements revealed that ENA (7.60)>Ti (4.97)>CER (2.85)>KAT (1.09)=EMX (0.96).
CONCLUSIONS: Dispersed filler CAD-CAM composite showed lower performance than the other materials. Aging only affected IFT of Li-Si glass-ceramic, whereas zirconia and PICN performed equally well, probably due to their chemical bonding potential and surface roughness respectively.

UNASSIGNED: Total knee arthroplasty (TKA) with a highly congruent condylar-stabilized (CS) articulation may be advantageous due to increased stability versus cruciate-retaining (CR) designs, while mitigating the limitations of a posterior-stabilized construct. The aim was to assess ten-year implant survival and functional outcomes of a cemented single-radius TKA with a CS insert, performed without posterior cruciate ligament sacrifice.
UNASSIGNED: This retrospective cohort study included consecutive patients undergoing TKA at a specialist centre in the UK between November 2010 and December 2012. Data were collected using a bespoke electronic database and cross-referenced with national arthroplasty audit data, with variables including: preoperative characteristics, intraoperative factors, complications, and mortality status. Patient-reported outcome measures (PROMs) were collected by a specialist research team at ten years post-surgery. There were 536 TKAs, of which 308/536 (57.5%) were in female patients. The mean age was 69.0 years (95% CI 45.0 to 88.0), the mean BMI was 32.2 kg/m2 (95% CI 18.9 to 50.2), and 387/536 (72.2%) survived to ten years. There were four revisions (0.7%): two deep infections (requiring debridement and implant retention), one aseptic loosening, and one haemosiderosis.
UNASSIGNED: Kaplan-Meier analysis demonstrated no difference in implant survival according to sex, age, or obesity status. Ten-year PROMs were available for 196/387 (50.6%) surviving patients and were excellent: mean Oxford Knee Score 34.4 (95% CI 32.7 to 36.1); mean Forgotten Joint Score (FJS) 51.2 (95% CI 16.1 to 86.3); mean EuroQol five-dimension five-level questionnaire score 69.9 (95% CI 46.8 to 93.0); 141/196 (71.9%) achieved the 22-point FJS patient-acceptable symptom state (PASS); and 156/196 (79.6%) were \"very satisfied or satisfied\".
UNASSIGNED: This is the only large study reporting ten-year implant survival and functional outcomes of TKA using a cemented single-radius design and with a CS tibial bearing construct. The findings of excellent implant survival, safety, and functional outcomes indicate that this combination is a safe and effective option in routine TKA. Further investigation of this single-radius design TKA with CS tibial bearings with well-matched patient study groups will allow further insight into the performance of these implants.

OBJECTIVE: This prospective clinical trial evaluated the clinical performance of ceramic partial coverage indirect adhesive restorations (PCIARs) in posterior teeth luted with a light-cured composite resin.
METHODS: From April 2016 to January 2017, a total of 60 patients (27 males, 33 females; mean age: 42.2 ± 10.86 years old) received 83 glass-ceramic PCIARs (26 onlay, 57 overlay) made of IPS Emax CAD (Ivoclar Vivadent). All restorations were luted with a light-cured composite resin (Filtek Z250, 3 M ESPE) by two operators. Two independent calibrated examiners blinded to the operators performing the treatment evaluated the restorations at baseline, 1-year, and 5-year following FDI World Dental Federation criteria including esthetic, functional, and biological properties. Data were analyzed with the Friedman test and the Wilcoxon sign test (p < 0.05).
RESULTS: None of the restorations failed due to fracture or retention loss. One restoration was clinically unsatisfactory because of secondary caries. Marginal staining (p:0.000), marginal adaptation (p:0.018) showed significant differences between 1-year and 5-year recall.
CONCLUSIONS: The PCIARs demonstrated excellent clinical performance at 1-year period. The degradation parameters appeared as minor staining and minor irregularities after 5-year, without any affect on the clinical performance.
CONCLUSIONS: Our findings provide evidence that the clinical performance of PCIARs luted with a light-cured composite resin was clinically acceptable after a five-year evaluation period. Due to secondary caries, only one restoration was considered clinically unsatisfactory.
BACKGROUND: NCT04838483.

OBJECTIVE: This study aimed to assess the seating accuracy of resin composite CAD/CAM overlay restorations, employing various preparation designs and luting materials (pre-heated composite (HC) or resin cement (RC)).
METHODS: A human molar\'s STL file was utilized to create 100 3D-printed resin tooth replicas, randomly distributed into 5 groups (n = 20) based on finishing line preparation designs: 1) Rounded shoulder above the dental equator - DE (SA); 2) Chamfer above the DE (CA); 3) Butt joint above the DE (BJ); 4) Rounded shoulder below the DE (SB); 5) Chamfer below the DE (CB). Digital impressions were acquired for all replicas, and restorations milled using Tetric CAD (Ivoclar Vivadent). The restorations were luted with HC (Tetric Prime, Ivoclar Vivadent) or RC (RelyX Universal, 3 M). Seating accuracy was evaluated through digital scans during try-in without any luting agent and post-cementation using a 3D analysis software (Geomagic wrap, 3D Systems). Data were statistically analyzed using Two-Way ANOVA (p < 0.05).
RESULTS: The type of luting material (RC vs HC), preparation design, and their interactions significantly impacted 3D seating of the restorations (p < 0.001). HC exhibited higer volumetric increase than RC. BJ and CA designs consistently demonstrated superior seating accuracy, irrespective of the luting material used.
CONCLUSIONS: The utilization of pre-heated composite resin could negatively influence the seating of overlay restorations, probably due to its higher viscosity when compared to the resin cement. However, when HC is selected as luting agent, preparation designs lacking internal angles are recommended for enhancing the precision of overlays seating.

OBJECTIVE: To evaluate three temporary luting cements in terms of their restoration loss rates, biological interactions, esthetic properties, and handling characteristics.
METHODS: 75 adults requiring fixed prosthodontics voluntarily participated in a single-blind, randomized controlled trial. After preparation, temporary restorations were luted with a randomly selected temporary luting cement (either Provicol QM Plus (PQP), Bifix Temp (BT), or Provicol QM Aesthetic (PQA)). Clinical examinations were performed one to two weeks after cementation. The following criteria were evaluated: tooth vitality, percussion, hypersensitivity, gingival bleeding, odor formation, esthetics, cement handling, removability, cleanability, and retention loss. Antagonistic teeth served as controls. Statistical analysis was performed using the paired t-test, one-way ANOVA, Pearson\'s chi-square and Fisher\'s exact test, where appropriate.
RESULTS: The overall loss rate of temporary restorations was 16.0%, showing no cement-specific differences. Postoperative hypersensitivity occurred in 8% of cases regardless of cement type. Esthetic impairment was reported by 31% of the PQP-fixed restorations, compared with 4.0% and 4.2% of the BT and PQA-bonded restorations. Cement application was reported to be easy in 100% of cases, excess removal in 88-96%, depending on the cement used.
CONCLUSIONS: The choice of luting material affects the esthetic appearance of a temporary restoration and should be considered, particularly in restorations in esthetically demanding areas. No significant differences between the cements were identified regarding biocompatibility, handling, and loss rate.
CONCLUSIONS: Translucent cements can help to reduce color interferences, resulting in a more appealing appearance of the temporary restoration.

Adhesion of zirconia is difficult; thus, etching agents using several different methods are being developed. We investigated the effects of surface treatment with commercially available etching agents on the bond strength between zirconia and resin cement and compared them with those achieved using air abrasion alone. We used 100 zirconia blocks, of which 20 blocks remained untreated, 20 blocks were sandblasted, and 60 blocks were acid-etched using three different zirconia-etching systems: Zircos-E etching (strong-acid etching), smart etching (acid etching after air abrasion), and cloud etching (acid etching under a hot stream). Each group was subjected to a bonding procedure with dual-polymerized resin cement, and then 50 specimens were thermocycled. The shear bond strengths between the resin cement and zirconia before and after the thermocycling were evaluated. We observed that in the groups that did not undergo thermocycling, specimens surface-treated with solution did not show a significant increase in shear bond strength compared to the sandblasted specimens (p > 0.05). Among the thermocycled groups, the smart-etched specimens showed the highest shear bond strength. In the short term, various etching agents did not show a significant increase in bond strength compared to sandblasting alone, but in the long term, smart etching showed stability in bond strength (p < 0.05).

UNASSIGNED: Cemented hemiarthroplasty is an effective form of treatment for most patients with an intracapsular fracture of the hip. However, it remains unclear whether there are subgroups of patients who may benefit from the alternative operation of a modern uncemented hemiarthroplasty - the aim of this study was to investigate this issue. Knowledge about the heterogeneity of treatment effects is important for surgeons in order to target operations towards specific subgroups who would benefit the most.
UNASSIGNED: We used causal forest analysis to compare subgroup- and individual-level treatment effects between cemented and modern uncemented hemiarthroplasty in patients aged > 60 years with an intracapsular fracture of the hip, using data from the World Hip Trauma Evaluation 5 (WHiTE 5) multicentre randomized clinical trial. EuroQol five-dimension index scores were used to measure health-related quality of life at one, four, and 12 months postoperatively.
UNASSIGNED: Our analysis revealed a complex landscape of responses to the use of a cemented hemiarthroplasty in the 12 months after surgery. There was heterogeneity of effects with regard to baseline characteristics, including age, pre-injury health status, and lifestyle factors such as alcohol consumption. This heterogeneity was greater at the one-month mark than at subsequent follow-up timepoints, with particular regard to subgroups based on age. However, for all subgroups, the effect estimates for quality of life lay within the confidence intervals derived from the analysis of all patients.
UNASSIGNED: The use of a cemented hemiarthroplasty is expected to increase health-related quality of life compared with modern uncemented hemiarthroplasty for all subgroups of patients aged > 60 years with a displaced intracapsular fracture of the hip.

Patients are always looking for conservative, esthetic, and long-lasting dental restorations, and the technique used directly influences the longevity of the treatment. The location of the restoration in the mouth and the extent of the decay influence the treatment choice. The larger the dimensions of the cavity preparation, the greater the difficulties in restoring the tooth using direct techniques. The semidirect technique, when indicated, can achieve satisfactory results. It is a relatively easy procedure, consisting of tooth preparation to receive an indirect restoration, fabrication of an alginate impression, fabrication of the composite resin restoration on a flexible cast, cementation, removal of excess cement, and occlusal adjustment. The aim of this case report is to present a viable alternative to direct and indirect restorations for posterior teeth with extensive decay. The article describes the extraoral semidirect technique for fabricating a composite resin restoration, highlighting its indications and discussing advantages and disadvantages.

OBJECTIVE: The aim of the study is measuring the magnitude and determining the method of finger pressure exerted by doctors on ceramic veneers during their fixation.
METHODS: A simulation model was designed in order to measure the volume of finger pressure. Veneers were produced for 2 central incisors. Doctors alternately placed veneers on the model and applied pressure on them for 20 seconds simulating the clinical stage of cementing. The operator recorded the maximum readings of the scales and entered the result on the research protocol. In addition, it was recorded which finger the doctor exerts on the veneer during its cementing to ensure a tight fit: thumb or index finger.
RESULTS: The values obtained during cementation of 54% doctors ranged up to 1 kg, 27% of doctors from 1 to 2 kg and only 19% more than 2 kg. 80% of doctors applied the main pressure on the veneer using their thumb, while the pressure force was 1.4 kg. For those doctors who pressed the veneer to the tooth with their index finger, the impact value was 0.8 kg.
CONCLUSIONS: The finger pressure on the veneer during cementation applied by dentists varies, the average pressure on the veneers was about 1.5 kg. The amount of pressure on cement during laboratory tests of cements for fixing veneers differs from clinical values many times. The development of a veneers fixation protocol, taking into account the conducted research, will ensure a reliable and accurate fit of the veneer at the stage of its cementing.
UNASSIGNED: Измерение величины и определение способа пальцевого давления, оказываемого врачами на керамические виниры во время их фиксации.
UNASSIGNED: Для измерения величины пальцевого давления была спроектирована симуляционная модель. На 2 центральных резца были изготовлены виниры. Врачи поочередно устанавливали виниры на модель и в течение 20 с на них оказывали давление, имитируя клинический этап цементирования. Оператор регистрировал максимальные показания весов и заносил полученный результат в протокол исследования. Кроме того, фиксировали, каким именно пальцем врач оказывает воздействие на винир во время его цементирования для обеспечения плотной посадки: большим или указательным.
UNASSIGNED: Установлено, что 54% врачей во время цементирования оказывают давление на винир до 1 кг, 27% врачей — от 1 до 2 кг, и только 19% врачей — более 2 кг; 80% врачей оказывали основное давление на винир, используя большой палец, при этом сила прижимного давления составила 1,4 кг. У врачей, которые прижимали винир к зубу указательным пальцем, величина воздействия была 0,8 кг.
UNASSIGNED: Пальцевое давление на винир во время его цементирования у разных врачей имеет существенные различия, в среднем давление на виниры составило около 1,5 кг. Давление на цемент во время лабораторных испытаний цементов для фиксации виниров отличается от клинических величин многократно. Разработка протокола фиксации виниров с учетом поведенных исследований обеспечит надежную и точную посадку винира на этапе его цементирования.

A technique is outlined for utilising a polymeric composite reinforced with glass fibres in a three-dimensional mesh as a post-core in aesthetic cases. The clinical procedure involves obtaining an impression of the root canal space, scanning the definitive cast, and milling a fibre-reinforced composite post-core. Subsequently, the intra-radicular post-core is cemented using an adhesive resin cement. The use of custom-made computer-aided design-computer-aided manufacturing (CAD-CAM) fibre-reinforced composite post-core facilitates repairability, provides better adaptation to the root canal space, avoids uneven cement thickness, ensures chemical adhesion to resin cement, and promotes favourable aesthetics when combined with all-ceramic crowns.