A systematic approach to contouring and polishing anterior resin composite restorations: A checklist manifesto

Surface properties and susceptibility to staining of a resin composite after brushing with different whitening toothpastes

Objectives

This study investigated the effects of different whitening toothpaste (WT) on the surface properties and staining susceptibility of a resin composite.

Methods

Cylindrical samples were prepared with a micro-hybrid resin composite and were randomized into groups according to the toothpaste (n = 12): distilled water (DW), regular toothpaste (RT), WT with silica + pyrophosphate (WT-S/P), WT with pentaphosphate and pyrophosphate (WT-P/P), WT with hydrogen peroxide and pyrophosphate (WT-HP/P) and WT with charcoal and pyrophosphate (WT-Ch/P). The samples were brushed for 825 cycles in an automatic brushing machine, simulating 30 days of brushing. After that, an immersion in coffee (10 mL/sample) was performed for 30 minutes for 30 days. The analyses of color, surface microhardness (SMH), and surface roughness (Ra) were performed at the initial time, after brushing with toothpaste and after immersion in coffee. The ΔL*, Δa*, Δb*, ΔEab, Δand E00 values were calculated comparing after toothpaste with initial time and after coffee with after toothpaste. Data were analyzed using a mixed linear model for repeated measures (SMH), Kruskal-Wallis, Dunn, Friedman, and Nemenyi tests, with α = 0.05.

Results

For ΔL*, the WT-Ch/P group had the lowest values and differed from the other groups comparing the after toothpaste with the initial time interval (p < 0.001). The WT-Ch/P group had the lowest SMH values in after-toothpaste time (p < 0.001). In after-toothpaste time and after coffee time, the WT-S/P group had the highest Ra values and differed from the groups except the WT-Ch/P group (p < 0.001).

Conclusions

The toothpaste composition affects the surface characteristics and susceptibility to staining of the resin composite. The charcoal-based toothpaste had the worst performance for the color analyses and SMH.

Resin-Based Composites for Direct and Indirect Restorations: Clinical Applications, Recent Advances, and Future Trends

Continuous advancements in resin-based composites can make selection of the appropriate system a daunting task for the clinician. This review aims to simplify this process and clarify some new or controversial topics. Various types of composites for direct and indirect applications are discussed, including microfilled and microhybrid composites, nanocomposites, single shade, bulk fill, fiber-reinforced, high temperature/high pressure processed, CAD/CAM, and three-dimensional printable composites. Recent material advancements that lead to improved seal and toughness, degradation resistance, antimicrobial and self-healing capabilities are presented. Future directions are highlighted, such as the development of "smart" materials that are able to interact with the host environment.

The "Pre-Finishing" Approach in Direct Anterior Restorations. A Case Series

In esthetic restorations of anterior teeth the clinician has to manage several aspects in order to have a predictable outcome. A deep knowledge of the anatomy as well as the adhesive procedures and the optical properties of resin-based composites are mandatory to achieve esthetic results. Contemporary restorative materials present either several shades and different translucency properties and therefore they are able to mimic teeth’s optical behavior thus providing a natural aspect to anterior restorations. The wrong thickness of different composite layers may provide unpleasant results such as low value (grayish) restorations that often requires reintervention. A precise step-by-step procedure is therefore mandatory to provide the proper shade at the correct place. There is therefore the need of some corrections and adjustments during the layer procedure in order to avoid errors in shade positioning that could affect final result. The authors present a case series (six clinical cases) treated with the proposed technique with up to five years follow-up.