A conservative approach to restoration assists in preserving the remaining tooth structure of extensively destroyed vital teeth. This case report describes a single-appointment chairside technique for placement of ceramic restorations in posterior teeth. A patient presented for treatment of her mandibular right first molar, which had a fractured resin-based composite restoration. Due to the presence of vital pulp, extent of the restoration, and presence of caries in the tooth, the following treatment plan was proposed: placement of a lithium disilicate glass-ceramic onlay fabricated with a computer-aided design/computer-aided manufacturing workflow. After the dentist removed the restoration and performed selective caries removal, structural analysis guided the reduction of the buccal cusps. Immediate dentin sealing was performed with a 2-step self-etching adhesive system, and a 1-mm-thick layer of flowable resin-based composite was placed as a resin coating. A digital impression was obtained, the onlay restoration was designed, and a lithium disilicate block was milled and subsequently crystallized. When the onlay was completed, the tooth preparation was sandblasted, selectively etched, and coated with a universal adhesive. The intaglio surface of the onlay was cleaned and primed, the onlay was bonded with dual-cure resin cement, and occlusal adjustments were completed. Follow-up examinations at 1 and 4 months revealed the clinical success of the case. From start to finish, it takes approximately 2.5 hours to produce a single-appointment chairside restoration. The technique used in this case offers a fast-paced workflow that is comfortable and practical for the patient and provides a predictable clinical outcome without the need for a temporary restoration.

This in vitro study evaluated the influence of radiant exposure and material shade on the degree of conversion (DC) and microhardness of a resin-based composite (RBC). Sixty-four RBC specimens in shades A1E (enamel) and A4D (dentin) were light cured at a calibrated exitance of 1000 mW/cm2 for 5, 10, 15, or 20 seconds, resulting in radiant exposure levels of 5, 10, 15, or 20 J/cm2. The DC was determined using Fourier-transform infrared spectroscopy (n = 3 per shade per exposure level). The Knoop hardness number (KHN) was measured on the top and bottom surfaces of each specimen (n = 5 per shade per exposure level). Data were analyzed using 2- and 3-way analyses of variance and post hoc Tukey tests (α = 0.05). The RBC shade did not affect the DC (P = 0.860), and the lowest DC values were achieved with an exposure level of 5 J/cm2 (P < 0.001). The shade did not affect the KHN on the top surface, but the radiant exposure level did, with the application of 5 J/cm2 resulting in significantly lower values (P < 0.05). For the bottom surface, shade A1E showed significantly higher KHN values than A4D (P < 0.001). An increase in the radiant exposure led to increased DC and KHN for both shades of RBC until reaching a saturation point of 10 J/cm2 for A1E and the top surface of A4D. The darker and more opaque shade was not adequately polymerized at a 2-mm depth, even when the highest radiant exposure level was applied.

BACKGROUND: Recent studies have reported the inhomogeneity in the light emitted by dental light-curing units (LCUs). It is essential to understand how this uneven light distribution affects the physical properties of resin-based composites (RBCs) at various points across their surfaces. This study aimed to evaluate the effect of LCU beam\'s inhomogeneity on the microhardness of RBCs with different shades and thicknesses.
METHODS: Four body (A1B, A2B, A3B, and A4B), one dentin (A3D), and one enamel shade (A3E) of RBC (Filtek Z350 XT) were examined. The specimens were fabricated in four thicknesses (1, 2, 3, and 4 mm) and subjected to a 40-second light-curing. Vickers microhardness testing was performed at the center point, and 3 mm left and right from the center at the bottom surface of each sample. The LCU beam profile was characterized using a beam profiler, while irradiance after specimen passage was measured using a spectrometer. One-way analysis of variance (ANOVA) and Tukey\'s post-hoc tests were used to analyze the effects of shades and thicknesses on irradiance and microhardness, respectively. One-way repeated-measures ANOVA was used to compare the microhardness across different points. Pearson\'s correlation analysis examined the relationship between irradiance and microhardness.
RESULTS: The beam profile of LCU revealed inhomogeneous light distribution. Light irradiance was decreased with both the increase in thickness and darker shade of the specimens (p < 0.05). Microhardness was found to decline with an increase in sample thickness (p < 0.05), and was consistently higher at the center point compared to the periphery, particularly in thicker (3 and 4 mm) and darker shades (A3B, A4B, and A3D). A positive correlation was found between the irradiance and microhardness across all evaluated points (p < 0.05).
CONCLUSIONS: Inhomogeneous light emission from LCU significantly influences the microhardness of RBC samples, depending on the thicknesses and shades. The findings underline the importance of considering LCU beam inhomogeneity in clinical settings to ensure optimal polymerization of RBC.

OBJECTIVE: To evaluate the influence of the polymerization distance of monowave and polywave light curing units (LCUs) on the measured irradiance relative to the value reported by the manufacturer in relation to the physical properties of resin-based composites (RBCs).
METHODS: Four LCUs were used: one monowave and three polywave. The irradiance was measured with a digital radiometer. Depth of cure (DC) and flexural strength (FS) tests were performed according to ISO 4049:2019 at polymerization distances of 0 mm and 5 mm.
RESULTS: The irradiance of all LCUs was higher than that reported by the manufacturer (>25-64%). The irradiance of the four LCUs was reduced when polymerization was performed at between 0 to 5 mm (paired t-test, P < 0.001). The DC at 0 mm was similar in all groups but was significantly decreased at 5 mm distance (ANOVA P < 0.001). FS showed differences among the LCUs at 0 mm (ANOVA P < 0.001) and was affected by the polymerization distance. The elastic modulus was unaffected by the LCU used or the distance (ANOVA P > 0.001).
CONCLUSIONS: The LCU must be positioned as near as possible to RBCs during the polymerization process, as increased distance negatively affects the depth of cure and flexural strength.

The biaxial flexural strength of universal shade and conventional dental resin-based composites before and after alkaline degradation was investigated. Disk samples were prepared from these resin-based composites, and some of the specimens were immersed in 0.1 M NaOH solution to create deteriorated samples. The biaxial flexural strength of the samples before and after the alkaline degradation test was measured and statistically tested. The fracture surfaces after the biaxial flexural test were observed using a scanning electron microscope. The results showed that the biaxial flexural strength of the paste-type universal shade resin-based composite before alkaline degradation was significantly (19%) higher than that of the conventional type, but no difference was observed between the materials after alkaline degradation. On the other hand, the biaxial flexural strength of the flowable universal shade resin-based composites was significantly (around 35%) lower than that of the conventional composite, with or without degradation. Although, for paste-type materials, the biaxial flexural strength of universal shade resin-based composites was higher than that of conventional resin-based composites before alkaline degradation, after degradation the two materials showed similar values. For flowable materials, the biaxial flexural strength of universal shade resin-based composites was lower than that of conventional resin-based composites regardless of the presence or absence of degradation processes. These results suggest that some caution should be used when deciding whether to use flowable universal shade resin-based composite to fill a cavity.

OBJECTIVE: To evaluate the influence of the barium glass (BG) filler in 3D printing resin-based composites for restorative structures.
METHODS: Experimental 3D printing resin-based composites were formulated with UDMA 70%wt, Bis-EMA 20%wt, and TEGDMA 10%wt. Photoinitiators TPO and DFI (2%wt) were used. BG was incorporated at 40%wt and 50%wt. 0%wt BG was used as negative control and the VarseoSmile Crownplus (Bego) was used as a commercial control. Specimens were printed using a 3D printer. Subsequently, specimens were washed and submitted to post-curing with 405 nm at 60ºC for 2 × 20 min at FormCure (FormLabs). 3D printing resin-based composites were evaluated by flexural strength, degree of conversion, softening in solvent, radiopacity, and cytotoxicity against gingival fibroblasts. Data were statistically analyzed using one-way ANOVA (α = 0.05).
RESULTS: No significant differences in flexural strength were showed between BG40% (90.5 ± 5,4 MPa), BG50% (102.0 ± 11.7 MPa) and VA (105.2 ± 11.7 MPa). Addition of 40% and 50% of BG showed no influence in the degree of conversion compared to VA (p > 0.05). All groups showed softening in solvent after immersion in ethanol (p < 0.05). All groups showed more than 1mmAl of radiopacity. BG50% showed significantly higher radiopacity (2.8 ± 0.3 mmAl) than other groups (p < 0,05). Cytotoxicity evaluation showed gingival cell viability higher than 80% for all groups.
CONCLUSIONS: Addition of up to 50%wt of barium glass in experimental 3D printing resin-based composites showed promising results for long-term restorative structures.

OBJECTIVE: This study examines the effect of two light-curing protocols from a LED polywave light curing unit (LCU) on water sorption, solubility, and hygroscopic expansion of fast and conventional bulk-fill resin-based composites (RBCs) aged in distilled water for 120 d.
METHODS: Three bulk-fill RBCs materials were studied: Tetric PowerFill® (fast photo-polymerised composite) (TPF), Tetric EvoCeram bulk-fill (EVO), and GrandioSo x-tra bulk-fill (GSO) (conventional photo-polymerised composites). Specimens were prepared within a 3D-printed resin mold (8-mm diameter x 4-mm height) and light-cured from one side only with 2 modes of polywave LCU (Bluephase® PowerCure): 3 s mode and for 20 s in \"Standard\" mode. Water sorption and solubility were measured at fixed time intervals for 120 d of distilled water storage, then reconditioned to dry to measure desorption for 75 d, all at 37 ± 1 °C. Hygroscopic (volumetric) expansion was recorded at the same time intervals up to 120 d. Data were analysed through SPSS using Two-way ANOVA, One-way ANOVA, independent t-tests, and Tukey\'s post-hoc correction tests (p < 0.05).
RESULTS: TPF, when irradiated for 3 s demonstrated minimal water sorption (0.83%), solubility (1.01 μg/mm3), and least volumetric expansion (1.64%) compared to EVO and GSO. While EVO showed the highest water sorption (1.03%) and solubility (1.95 μg/mm3) at 3 s. GSO had the lowest sorption (0.67%) and (0.56%) in 3 s and 20 s protocols, respectively. Nevertheless, all the sorption and solubility data were within the ISO 4049 limits.
CONCLUSIONS: For TPF, fast (3 s) polymerisation did not increase either water sorption or solubility, compared with 20 s irradiation. However, with the two comparative bulk-fill composites, fast cure increased water sorption by 15-25% and more than doubled solubility. These findings were consistent with the lesser volumetric expansions observed for Tetric PowerFill at both the fast and standard protocols, indicating its relative stability across polymerisation protocols.

A critical examination of the literature for dental wear publications highlighted three distinct areas, clinical data, laboratory data and the simulation of the clinical situation data. The imprecision of the clinical data values from direct and indirect in vivo methods renders the clinical data compromised at best. Laboratory data showed a focus on finding a correlation between simplistic laboratory abrasive wear resistance studies and established materials science laboratory techniques, but with no actual correlation identified. Replication of the masticatory cycle in the mouth in the form of an oral wear simulator has focussed more on the wear testing devices rather than the wear quantification methods. As a result, the data acquisition variables in the x- and y-planes need to be examined to consider how they can influence the accuracy and precision of the laboratory wear measurements recorded in the dental literature. The current approach was undertaken using the teaching tool outlined in \"The First Three Questions\".

UNASSIGNED: A major drawback of resin composites is their tendency to accumulate microbial biofilms that can lead to secondary caries. The objective of this study was to compare the mechanical properties and the degree of conversion of commercial resin-based composite materials containing a contact-killing antibacterial agent, dimethylaminohexadecyl methacrylate (DMAHDM), at different concentrations, with a fluoride-releasing composite material.
UNASSIGNED: Four groups were tested: Tetric N Ceram composite material (G1), Tetric Evo Ceram (G2), and Tetric N Ceram with the addition of contact-killing antibacterial agent DMAHDM at concentrations of 3% (G3) and 5% (G4). The mechanical properties, including flexural strength, elastic modulus, and Vickers microhardness and the degree of conversion were investigated.
UNASSIGNED: Adding 3 % and 5 % DMAHDM resulted in flexural strength values that were comparable to Tetric Evo Ceram. Tetric N Ceram was comparable to the group containing 3 % DMAHDM (p > 0.05). However, it was significantly greater when compared to Tetric Evo Ceram (93.3 ± 9.4) and 5 % DMAHDM (p < 0.05). Both the elastic modulus and Vickers microhardness values of Tetric N Ceram were significantly higher than those of the other groups (p < 0.05). Furthermore, the elastic modulus of Tetric Evo Ceram showed similar results to groups with 3 % and 5 % DMAHDM. Nevertheless, the Vickers microhardness value is significantly higher when compared to 5 % DMAHDM (0.394 ± 0.021) (p < 0.05) while it was comparable to that of 3 % DMAHDM (0.484 ± 0.016) (p > 0.05). There was no statistically significant difference in the degree of conversion between the groups (p > 0.05).
UNASSIGNED: Adding 3% DMAHDM to Tetric N Ceram resulted in flexural strength values that were similar to those of Tetric N Ceram and Tetric Evo Ceram. DMAHDM did not affect the degree of conversion of Tetric N Ceram composite.

OBJECTIVE: This study investigated effects of the different emittance-mode protocols from three light curing units (LCUs): (i) a Laser (Monet); (ii) a quad-wave (PinkWave); (iii) a conventional LED (Elipar S10) on the temperature rise (ΔT) and degree of conversion (DC) when photo-curing fast or conventional bulk-fill resin-based composites (RBC). The aim was to correlate ΔT and DC, and the radiant exposure delivered to RBC specimens.
METHODS: A 3D-printed resin mold of 4 mm depth was filled with two bulk-fill RBCs: Tetric PowerFill® (fast photo-polymerised composite) (TPF) or Tetric EvoCeram® Bulk-Fill (EVO). Three LCUs were used: (i) Monet laser for 1 s and 3 s (MONET-1 s, MONET-3 s); (ii) PinkWave quad-wave used for 3 s in Boost mode (PW-3 s) and for 20 s in standard mode (PW-20 s); (iii) Elipar S10 for 5 s (S10-5 s) and for 20 s in standard mode (S10-20 s). 2-dimensional temperature maps were obtained before, during and for 60 s after the LCU had turned off using a thermal imaging camera. Thermal changes were analysed at five depths: (0, 1, 2, 3, and 4 mm from the top surface of the RBC). The maximum temperature rise (Tmax) and the mean temperature rise (ΔT) were determined. Cylindrical-shaped specimens were prepared from each material using a stainless-steel split mold (4 × 4 mm) and light-cured with the same protocols. The DC was measured for 120 s and at 1 h after LCU had turned off using Fourier Transform Infrared Spectroscopy (FTIR). Data were analysed using Three-way ANOVA, One-way ANOVA, independent t-tests, and Tukey post-hoc tests (p < 0.05).
RESULTS: Radiant exposures delivered by the various irradiation protocols were between 4.5-30.3 J/cm2. Short exposure times from MONET-1 s and PW-3 s delivered the lowest radiant exposures (4.5 and 5.2 J/cm2, respectively) and produced the lowest ΔT and DC. The longer exposure times in the standard modes of PW-20 s, S10-20 s, and MONET-3 s produced the highest Tmax, ΔT, and DC for both composites. The ΔT range among composites at different depths varied significantly (31.7-49.9 °C). DC of TPF ranged between 30-65% and in EVO between 15.3-56%. TPF had higher Tmax, ΔT for all depths and DC compared to EVO, across the LCU protocols (p < 0.05), except for PW-20 s and MONET-3 s. The coronal part of the restorations (1-2 mm) had the highest ΔT. There was a positive correlation between ΔT and DC at 4-mm depth after 120 s SIGNIFICANCE: Longer, or standard, exposure times of the LCUs delivered greater radiant exposures and had higher DC and ΔT compared to shorter or high-irradiance protocols. The fast photo-polymerised RBC had comparatively superior thermal and conversion outcomes when it received a high irradiance for a short time (1-5 s) compared to the conventional Bulk-Fill RBC.