Wiley-Online-Library: Journal of Esthetic and Restorative Dentistry: Table of Contents

Clinical Performance of Bulk‐Fill Versus Incremental Composite Placement Approaches in Vital Posterior Teeth: A 24 Months Randomized Controlled Trial

Mohammed Abd El Ghany Mohammed, Ahmed Saad Naser, Dina Abozaid — Wed, 10 Jun 2026 22:45:00 -0700

ABSTRACT

Background

Composite resin placement technique may influence marginal integrity, polymerization stress distribution, and long-term clinical performance of posterior restorations. This randomized controlled clinical trial evaluated the 24-month clinical performance of four different placement techniques in Class I posterior composite restorations.

Methods

Fifty patients aged 20–35 years presenting with four occlusal carious lesions each were enrolled, resulting in 200 restorations. Cavities (4–5 mm depth) were prepared according to caries extension. Restorations were randomly allocated into four equal groups (n = 50) according to placement technique: stamp technique, snowplow technique, modified incremental “pizza” technique, and bulk-fill technique. All materials were applied following manufacturers' instructions. Clinical evaluation was performed at baseline and after 6, 12, and 24 months using FDI criteria. Functional (fracture/retention, marginal adaptation), esthetic (marginal staining, anatomical form), and biological (postoperative sensitivity, secondary caries) properties were assessed by two calibrated evaluators. Statistical analysis was performed at a significance level of α = 0.05.

Results

Thirty-eight patients with a total of 152 restorations were evaluated at the end of the 24 months in line with FDI at the end of the study with 76% recall rates. No statistically significant differences were observed among groups regarding fracture/retention or secondary caries (p > 0.05). Marginal adaptation and marginal staining demonstrated minor deterioration over time across all groups, with statistically significant intergroup differences found (p < 0.05). Postoperative sensitivity was minimal and transient in all groups with no significant difference (p = 0.181).

Conclusions

Clinical Significance

Surface roughness of restorative materials is influenced by polishing protocols, material type, and exposure to staining beverages. Appropriate polishing procedures result in smoother surfaces; however, surface degradation occurs following exposure to commonly consumed beverages such as coffee and red wine. These findings highlight the importance of selecting effective polishing systems and considering the long-term effects of dietary habits when using 3D-printed and CAD/CAM restorative materials.

Issue Information

Wed, 03 Jun 2026 00:32:16 -0700

Journal of Esthetic and Restorative Dentistry, Volume 38, Issue 7, Page 1261-1264, July 2026.

Three‐Second Short Dentin Etching: Systematic Review of In Vitro Evidence in Adhesive Dentistry

Wed, 03 Jun 2026 00:32:16 -0700

ABSTRACT

Background

Short dentin etching, or selective dentin etching (SDE) for 3 s, has emerged as a potential strategy to enhance the bond strength of adhesive systems while preserving dentin integrity. This systematic review aimed to evaluate whether a 3-s SDE protocol improves bond strength and interface durability compared to other adhesive strategies, such as conventional etch-and-rinse or self-etch protocols, with or without variations in etching time or application method.

Methods

A systematic search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines across PubMed, Scopus, Scielo, Embase, and ISI Web of Science, with no restrictions on publication year. Studies included human or bovine dentin as the substrate, employed SDE for 3 s before adhesive placement, and compared bond strength outcomes using conventional etching protocols. The outcome of interest was bond strength. Two independent reviewers screened and extracted data.

Results

Nine in vitro studies met the inclusion criteria. Evidence suggests that 3-s SDE improves immediate bond strength and, in some cases, long-term durability of universal adhesives by preserving hydroxyapatite and preventing over-demineralization of dentin. Excessive etching time (≥ 15 s) was associated with thicker, poorly infiltrated hybrid layers prone to hydrolytic degradation. The effect of SDE varied with adhesive type, presence of 2-hydroxyethyl methacrylate (HEMA), application method (with or without rubbing), solvent content, and hybrid layer composition, highlighting the importance of both material selection and etching technique.

Conclusions

SDE for 3 s enhances bonding performance and may increase the longevity of adhesive restorations. Clinicians should consider adhesive type, etchant viscosity, and substrate variability when applying this protocol. Future studies should explore standardized clinical protocols and long-term outcomes in vivo.

Minimally Invasive Treatments for Dental Fluorosis: A Network Meta‐Analysis of Esthetic Masking Efficacy

Wed, 03 Jun 2026 00:32:16 -0700

ABSTRACT

Background

Dental fluorosis produces enamel opacities and discolorations that compromise esthetics and often require minimally invasive treatments. Although several modalities are available including microabrasion, bleaching, resin infiltration, and remineralization, their comparative performance remains unclear.

Objective

To evaluate and rank the esthetic masking efficacy of minimally invasive treatments for dental fluorosis using a network meta-analysis.

Methods

A systematic review and network meta-analysis were conducted in accordance with PRISMA-NMA. Seven controlled clinical studies (13 interventions; 555 participants) met eligibility criteria. Random-effects network models were performed in R and independently replicated in MetaInsight. Treatment rankings were generated with SUCRA/P-scores, and certainty of evidence was assessed using CINeMA.

Results

Multimodal protocols combining microabrasion with in-office bleaching achieved the highest esthetic performance across immediate, three-month, and 6-month evaluations. Microabrasion + in-office bleaching (MAB + IOB) ranked first (highest SUCRA probability) and produced the largest ΔE improvements, followed by MAB + IOB + CPP-ACP and MAB + RI. Resin infiltration alone showed consistent, clinically meaningful effects and emerged as the most effective standalone technique. In contrast, microabrasion alone, CPP-ACP, and sodium hypochlorite demonstrated modest or unstable changes. Cross-platform triangulation between R and MetaInsight produced fully concordant effect estimates and identical treatment hierarchies. CINeMA indicated no major incoherence and moderate confidence for most comparisons.

Conclusion

Combined minimally invasive strategies, particularly MAB + IOB, with or without CPP-ACP, provide the greatest and most durable esthetic masking of fluorosis-related discoloration. Resin infiltration remains the strongest single-modality option. Remineralization and oxidizing agents alone show limited effectiveness. These findings establish a clinically relevant hierarchy to guide conservative management of dental fluorosis.

Clinical Significance

Sequential multimodal protocols integrating surface modification, bleaching, and resin-based refractive adjustment maximize esthetic outcomes while preserving enamel, supporting their use as first-line approaches for mild-to-moderate fluorosis.

Trial Registration

PROSPERO; registration number CRD420251234096

Clinical Performance of Ormocer‐Based Versus Conventional Methacrylate‐Based Resin Composites in Posterior Restorations: A Systematic Review and Network Meta‐Analysis

Wed, 03 Jun 2026 00:32:16 -0700

ABSTRACT

Objectives

This systematic review and network meta-analysis aimed to compare and rank the clinical performance of ormocer-based resin composites versus conventional resin-based composites in posterior Class I and II restorations.

Materials and Methods

Electronic searches were conducted in PubMed, Web of Science, Cochrane Library, Embase, and Scopus up to October 2025. Randomized controlled and prospective clinical trials evaluating ormocer-based versus conventional resin composites with at least 6-month follow-ups were included. Primary outcomes were marginal adaptation, retention, and fracture, assessed using USPHS or FDI criteria. A random-effects NMA was performed using the netmeta package (R), calculating risk ratios and P-scores across 6-, 12-, 24-, and 36-month intervals. Risk of bias was assessed with RoB 2, and certainty of evidence through CINeMA.

Results

Twelve trials (2006–2024; 1158 restorations) met eligibility. Across all time points, ormocer-based materials including hybrid and bulk-fill variants showed no statistically significant differences versus conventional methacrylate composites for marginal adaptation, retention, or fracture (RR = 1.0 with 95% CIs spanning unity). Treatment rankings based on p-scores were closely clustered (≈0.3–0.6), indicating probabilistic equivalence. Most studies showed a low overall risk of bias; the CINeMA appraisal supported moderate confidence in the main contrasts.

Conclusions

Across 6–36 months, ormocer-based composites (including hybrid and bulk-fill formulations) showed no statistically significant differences versus conventional methacrylate-based composites for marginal adaptation, retention, or fracture, and treatment rankings were closely clustered, indicating probabilistic equivalence rather than superiority. The certainty of evidence was overall moderate, primarily limited by imprecision and reduced network density at longer follow-ups.

Clinical Significance

The Impact of Dentin Primers on Collagen Secondary Structure: An Infrared Spectroscopic Analysis Using Amide III Deconvolution

Konstantinos Anastasiadis, Oikonomou Michael — Wed, 03 Jun 2026 00:32:16 -0700

ABSTRACT

Objective

To investigate how dentin primers with different compositions and etching strategies affect collagen secondary structures in human dentin.

Materials and Methods

Diagnostic Accuracy of Dentin Sclerosis by Optical Coherence Tomography and the North Carolina Index in Noncarious Cervical Lesions

Wed, 03 Jun 2026 00:32:16 -0700

ABSTRACT

Objective

Clinical Significance

Conclusions

Ivocolor and MiYO Color were not affected in a clinically relevant way by the ceramic substrate and adequately maintained their color and gloss. MiYO Structure exhibited similar results, except for color retention on LD and gloss retention on 5% 5Y-MZ.

Clinical Significance

Several universal stain and glaze systems generally perform equally well on various ceramic substrates but could be significantly affected in as little as 5 years of brushing with a whitening dentifrice depending on the substrate and system used.

Influence of Different Multilayer Zirconia Materials on the In Vitro Load‐Bearing Capacity of Resin‐Bonded Fixed Partial Dentures in the Posterior Region

Sat, 16 May 2026 03:39:44 -0700

ABSTRACT

Objective

Comparison of the load-bearing capacity and failure pattern of posterior resin-bonded fixed partial dentures (RBFPDs) differing in retainer design, zirconia material, and vertical nesting position.

Materials and Methods

Achieving physiologic proximal contact is essential for complete crown seating and long-term periodontal health. Improper adjustment can result in tight or open contacts, leading to incomplete seating, marginal discrepancies, food impaction, and discomfort. This study evaluated the seating accuracy of posterior single-unit porcelain fused to metal (PFM) crowns after proximal contact adjustment using different contact-indicating methods.

Clinical Considerations

In this prospective randomized clinical study, 124 patients requiring posterior single-unit PFM crowns were randomly allocated into four groups (n = 31 each): Artifol (8 μm), articulating paper (40 μm), Arti-Spot (3 μm), and visual acuity alone. Proximal contacts were adjusted during laboratory procedures according to the assigned method. At clinical try-in, seating was considered “perfect” if no further proximal adjustment was required. Intraoral periapical radiographs confirmed crown seating. Data were analyzed using Fisher's exact tests (p < 0.05).

Conclusion

A significant association was observed between adjustment method and crown seating (p = 0.000). Arti-Spot demonstrated the highest number of perfectly seated crowns (29/31), whereas visual assessment showed the poorest results. Thin contact-indicating materials demonstrated more consistent outcomes in immediate chairside proximal contact assessment compared to other methods.

Influence of Superimposition Strategies and Landmark Distribution on the Full‐Arch Trueness of Orthodontic Digital Models

Thu, 07 May 2026 23:07:23 -0700

ABSTRACT

Objective

Clinical Evaluation of Zirconia Occlusal Veneer Fixed Partial Denture: A New Design for Posterior Resin‐Bonded Fixed Partial Dentures (RBFPDs)

Tue, 05 May 2026 22:57:33 -0700

ABSTRACT

Purpose

To evaluate the clinical performance of zirconia occlusal veneer fixed partial dentures (FPDs).

Materials and Methods

Forty occlusal veneer FPDs (n = 10) replacing first molars were fabricated using two preparation designs (D1 and D2) and two types of zirconia: second-generation traditional zirconia (3Y-TZP) and third-generation translucent zirconia (5Y-PSZ). Design D1 involved a 1 mm occlusal reduction of the abutments, a 1 mm circumferential occlusal shoulder, and axial wall preparation of the surfaces adjacent to the missing molar, limited between the buccal and lingual line angles. The adjacent preparation in the design D2 was extended to the lingual midpoint and included an axial groove on each abutment. After resin cementation, patient and specialist satisfaction with esthetic appearance was recorded. Clinical data on fracture, debonding, and recurrent caries were collected at 1, 6, 12, and 18 months.

Results

No cases of debonding or recurrent caries were observed. Two occlusal veneer FPDs in Group D1/5Y experienced complete fractures at 4 and 17 months, respectively. Only one FPD in Group D2/5Y developed a crack at the first-month follow-up. Statistical analysis showed no significant differences among the groups in fracture resistance or esthetic satisfaction.

Conclusion

Occlusal veneer fixed partial dentures made of second-generation zirconia provide an effective alternative to conventional treatments for replacing first molars or second premolars, particularly when adjacent abutments are intact and the patient maintains good oral hygiene.

Objective Measurement of Tooth Color Using Spectrophotometry and ICDAS: Quantifying CIELAB Color Changes Across Caries Severity

Farah Rashid, James Dudley — Tue, 05 May 2026 22:55:21 -0700

ABSTRACT

Objective

The International Caries Detection and Assessment System (ICDAS) is widely used for early caries detection but relies on visual interpretation. Although spectrophotometry objectively quantifies tooth color, variation across ICDAS categories and its relationship with lesion severity remain unclear. The present in vitro study therefore characterized spectrophotometric measurements across ICDAS categories, evaluated their association with severity, and quantified differences across categories.

Materials and Methods

Three hundred unrestored extracted posterior teeth were classified as ICDAS 0–4 by a calibrated examiner. CIELAB values were obtained with a Spectrophotometer at five standardized sites per tooth under controlled lighting and aggregated to tooth-level. Differences across categories were analyzed using ANOVA/Kruskal-Wallis with correlation and regression analysis. Color differences (ΔE00) were calculated relative to the ICDAS 0 (reference) and interpreted using published perceptibility and acceptability thresholds.

Results

Color parameters differed significantly across ICDAS categories (p < 0.001). ΔE00 increased from ICDAS 2, exceeding reported perceptibility and acceptability thresholds. With increasing severity, L* decreased while a* and b* increased with significant monotonic associations for all color parameters (ρ = −0.58 to 0.62; p < 0.001).

Conclusions

Statistically significant differences in spectrophotometric color measurements were observed across caries severity categories, with progressive reductions in lightness and corresponding increases in red and yellow chromatic components. Overall color differences were greater in higher severity categories and exceeded perceptibility and acceptability thresholds from moderate lesion stages onward.

Clinical Significance

Spectrophotometric color assessment provides an objective framework for quantifying enamel changes associated with caries progression. Color differences exceeding established perceptibility and acceptability thresholds indicate clinically appreciable changes beyond early lesion stages, supporting the use of color-based metrics as an adjunct to conventional visual assessment.

Effects of Polishing, Resin Coating, and Glaze Coating on the Surface Properties of a 3D‐Printed Splint Resin

İzim Türker Kader, Ecem Karacan, Berru Kursoğlu, Pınar Kursoğlu — Tue, 05 May 2026 22:51:50 -0700

ABSTRACT

Objective

Two‐Dimensional Accuracy of Provisional Laminate Veneers Designed Using Two Digital Smile Design Platforms and Fabricated by Additive and Subtractive Manufacturing

Murat Feriz, Zeliha Şanıvar Abbasgholizadeh, Yılmaz Umut Aslan, Yasemin Özkan — Sun, 03 May 2026 23:27:20 -0700

To evaluate the impact of lithium disilicate cantilever resin-bonded fixed dental prostheses (RBFDPs) on oral health-related quality of life (OHRQoL), patient satisfaction, and esthetic outcomes in patients with a missing maxillary incisor.

Materials and Methods

In this prospective observational study prostheses were placed in patients with a missing maxillary incisor. Gingival grafts were performed for localized alveolar ridge defects. OHRQoL, patient satisfaction, and pink and white esthetics (PES/WES) were assessed pre-treatment (T0), 1 week post-treatment (T1), and most recent follow-up (T2). PES were stratified by graft status. Subgroup analyses were performed, including RBFDP configuration. Three observers assessed esthetics independently, and interobserver reliability was calculated using the Intraclass Correlation Coefficient (α = 0.05). Changes in OHRQoL, patient satisfaction, and esthetics across the three time points were analyzed using the Friedman's test (α = 0.05) with post hoc pairwise comparisons conducted using Wilcoxon signed-rank tests (α = 0.0167).

Results

Thirty-five patients were followed for a mean of 43 months. Median OHRQoL scores decreased from 30.0 to 16.0, with greatest improvements in psychological well-being. Patient satisfaction increased from 1.0 to 5.0 on a 0–5 scale. PES/WES improved from 3.3 to 15.7 on a 0–20 scale, with white esthetics showing the largest gains. Gingival grafts further improved PES. When stratified by RBFDP configuration, OHRQoL scores were lowest for the contact-point design. Interobserver reliability was moderate to good.

Conclusions

Lithium disilicate cantilever RBFDPs significantly improved OHRQoL, patient satisfaction, and objectively determined esthetics, with stable effects over time.

Clinical and Prosthetic Outcomes of Titanium Zirconium Versus PEEK Composite Maxillary Fixed Prostheses Opposing Distal Extension Partial Dentures: Comparative Clinical Study

Mon, 20 Apr 2026 23:23:57 -0700

ABSTRACT

Objectives

Titanium and zirconia are commonly used materials for implant frameworks. The selection of prosthetic material influences the load-bearing capacity of fixed dental prostheses and plays a critical role in the longevity of implant-supported fixed dental prostheses (ISFDPs) by affecting stress transmission during the chewing cycle.

Purpose

To evaluate clinical results, prosthetic results, and patient satisfaction associated with fixed prostheses fabricated from polyetheretherketone and titanium–zirconia, supported by six maxillary implants and opposed by mandibular distal extension removable partial dentures.

Materials and Methods

Thirty patients with an edentulous maxilla and mandibular distal-extension ridges received six implants in the maxillary regions of 12, 14, 16, 22, 24, and 26, with lengths of 10–14 mm and diameters of 3.6–4.5 mm. Patients were randomly classified into two equal groups: (G1) PEEK composite frameworks, and (G2) titanium–zirconia frameworks. Plaque score, gingival score, pocket depth, implant mobility, and vertical bone loss (VBL) were assessed at the time of fixed complete-arch implant prosthesis placement (T0), and at six (T6) and twelve (T12) months after delivery. Patient satisfaction (VAS) and prosthetic complications were evaluated after 1 year.

Results

G2 showed significantly higher plaque scores, pocket depth, and VBL than G1 at 6 and 12 months. G2 revealed a significantly higher patient satisfaction with maxillary prostheses compared to natural teeth and appearance than G1. Compared to G2, G1 showed noticeably greater patient satisfaction with relation to cleaning and ease of chewing than G2. G2 revealed a significantly higher incidence of prosthetic complications regarding veneer fracture or separation and prosthetic screw loosening than G1.

Conclusions

Results

The workflow achieved consistent multimodal alignment of hard- and soft-tissue structures, eliminating the need for analog facebow transfer or mechanical mounting. The intraoral mock-up reproduced the virtual design, confirming the clinical transferability of esthetic and functional parameters.

Conclusions

This workflow integrates virtual planning with clinical validation, thereby improving diagnostic precision, esthetic predictability, and interdisciplinary communication in prosthodontic rehabilitation.

Clinical Relevance

This approach provides a reproducible option for virtual patient construction, enabling immediate chairside validation and supporting more predictable clinical decision-making in esthetic and occlusal rehabilitation.

A 10‐Step Digital Workflow for Immediate Implant Placement and Loading in Terminal Dentition Patients

Fri, 03 Apr 2026 00:02:31 -0700

ABSTRACT

Objective

To present a step-by-step approach for formulating the preoperative prosthetic design and rehabilitating patients with terminal dentition through immediate implant placement and loading using a singular design.

Clinical Considerations

The proposed workflow begins with the acquisition of critical and complementary digital data, which are then registered to create a virtual patient representation. A two-dimensional smile design is subsequently converted into a three-dimensional (3D) design to determine the type of full-arch prosthesis. By utilizing the 3D models obtained from cone-beam computer-tomography data segmentation and fusing them with intraoral scan data, the prosthesis final design (singular) is established considering post-extraction soft tissue changes. Then implant planning is performed along with the selection of the necessary abutments and components. Subsequently, the provisional prosthesis is designed, and a stackable guide system is created to enable immediate implant placement and loading, leading to undisturbed soft tissue healing in accordance with the final design, which is particularly critical in FP1 restorations to preserve the existing gingival zeniths and papilla architecture.

Conclusions

The proposed 10-step digital workflow provides a systematic framework for selecting a singular design for full-arch implant-supported prostheses in patients with terminal dentition, by integrating current technological advancements and a remodeling prediction algorithm. Immediate implant placement and loading are guided by a facially driven prosthetic design and thorough implant planning, facilitating soft tissue healing according to the final design and ensuring outcomes that satisfy both function and esthetics.

Clinical Significance

By implementing the presented 10-step approach for rehabilitating patients with terminal dentition, a comprehensive treatment plan can be developed through systematic analysis of the acquired digital data and executed in accordance with fundamental prosthodontic and surgical principles.

Analyzing the Stability of White Spot Lesions Treated Using CPP‐ACP Coupled With Universal Adhesive Resin Against an Acidic Erosion Challenge

Neven S. Aref, Jana A. Almutairi — Thu, 02 Apr 2026 02:49:15 -0700

ABSTRACT

Objective

The management of white spot lesions (WSLs) remains challenging due to frequent exposure to acidic conditions in the oral environment. This in vitro study evaluated the surface properties of WSLs treated by casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) combined with a universal adhesive resin for the management of WSLs after subsequent exposure to an acidic beverage.

Materials and Methods

Sixty-four extracted human molars were sectioned to obtain 128 specimens, of which 96 were artificially demineralized to create WSLs. Specimens were randomly allocated into eight groups: sound enamel (control); sound enamel exposed to an acidic beverage; demineralized enamel; demineralized enamel exposed to an acidic beverage; ICON resin–treated WSLs; ICON resin–treated WSLs exposed to an acidic beverage; CPP-ACP followed by universal adhesive resin–treated WSLs; and CPP-ACP followed by universal adhesive resin–treated WSLs exposed to an acidic beverage. Surface microhardness, surface roughness, and color change were evaluated. Qualitative surface morphology was assessed using scanning electron microscopy. Data were analyzed using one-way ANOVA followed by Tukey's post hoc test (α = 0.05).

Results

CPP-ACP followed by universal adhesive resin–treated WSLs showed higher surface microhardness values than ICON resin–treated WSLs before and after acidic exposure (p ≤ 0.05). However, CPP-ACP followed by universal adhesive resin-treated WSLs exhibited significantly lower surface roughness values after acidic exposure compared with ICON resin-treated lesions (p ≤ 0.05). Both treatments produced lower color change values than untreated WSLs. Following repeated acidic challenges, CPP-ACP combined with a universal adhesive resin demonstrated lower ΔE values than ICON resin–treated WSLs (p ≤ 0.05).

Conclusion

Within the limitations of this in vitro study, the findings suggest that the combination of CPP-ACP with a universal adhesive resin was associated with more favorable surface-related properties of treated WSLs under acidic challenge conditions.

Clinical Significance

The combined use of CPP-ACP and a universal adhesive resin may contribute to improved surface integrity and esthetic appearance of white spot lesions under acidic challenge conditions; however, clinical validation is required before routine clinical application.

Efficacy of Surface Sealant on Clinical Performance of Composite Resin Restorations: A Systematic Review

Thu, 02 Apr 2026 02:26:23 -0700

ABSTRACT

Objective

To evaluate and compare the translucency of 3D-printed zirconia materials: 3Y tetragonal zirconia polycrystal (3Y-TZP) and 5Y partially stabilized zirconia (5Y-PSZ).

Material and Methods

3D-printed 5Y-PSZ and 3Y-TZP materials fabricated using digital light processing (DLP) were investigated. In addition, three zirconia materials made for the milling approach were examined: one 3Y-TZP and two 5Y-PSZ variants. For translucency measurements, samples with a square base of 100 mm² and five different thicknesses ranging from 0.25 to 1.25 mm (±50 μm tolerance) were produced (n ≥ 5/subgroup). The L*a*b* color coordinates were measured using an experimental setup consisting of a spectroradiometer, an integrating sphere, and a 35-W tungsten lamp. The translucency parameter was calculated using the color difference between white and black backgrounds. The microstructure and grain size were analyzed using scanning electron microscopy.

Results

Translucency increased with a decrease in thickness, across all materials. Milled materials exhibited higher translucency than 3D-printed counterparts with equivalent yttria content. The 3D-printed 5Y-PSZ and milled 3Y-TZP materials displayed comparable translucencies. Microstructural analysis revealed discrete microporosities in the 3D-printed materials.

Conclusions

Despite microstructural differences and defects reducing the translucency of 3D-printed zirconia compared to their milled counterparts, 3D-printed 5Y-PSZ demonstrates sufficient optical properties for monolithic restorations in posterior regions.

Evaluating the Efficiency and Tooth Sensitivity of a Novel Whitening Strip: A Randomized, Double‐Blind Controlled Trial

Rui‐xin Chen, Yu‐jie Lan, Li Guo, Xin‐yi Zhang, De‐qin Yang — Mon, 08 Dec 2025 12:15:22 -0800

ABSTRACT

Objective

This randomized controlled clinical trial was to evaluate the tooth whitening efficacy and tooth sensitivity of a novel whitening strips with 3% hydrogen peroxide and 1.5% potassium nitrate.

Materials and Methods

Ninety six participants were randomly assigned into two groups: an experimental group using LESENING Whitening Strips with 3% hydrogen peroxide and 1.5% potassium nitrate (n = 41), and the control group using Crest 3D Whitestrips only with 3% hydrogen peroxide (n = 41). Participants attached whitening strips to the teeth' buccal surface for 30 min once daily at home for 28 days continuously. Tooth sensitivity was evaluated using the Schiff score. Tooth color and color change were assessed using a spectrophotometer (CIELAB coordinates L*, a*, b*, ΔE*_ab, and dental whiteness index ΔWI_D) and shade guides (Vita Classical ΔSGU and Vita Bleachedguide ΔSGU), with measurements made at baseline and after 7, 14, 21, and 28 days' use. Levene test, repeated measures ANOVA, post hoc Tukey tests, the Kruskal–Wallis test and the Bonferroni correction method were used for data analysis (α = 5%).

Results

In color differences (ΔE*_ab) and whiteness index (ΔWI_D) analysis, a change of ΔE*_ab ≥ 1.2 or ΔWI_D ≥ 0.72 was considered visually perceptible. Both groups showed clinically significant tooth whitening after 7 days and notable ΔE*_ab and increases in ΔWI_D were observed in both groups (p < 0.05). After 14 days, both groups showed increased brightness (ΔL*) and reduced yellowness (Δb*) (p < 0.05). After 28 days, there was no discernible tooth sensitivity in the experimental group, while there was some obvious tooth sensitivity in the control group. Both groups showed a significant change in tooth color compared to the baseline but there were no significant differences between the two groups.

Conclusion

LESENING whitening strips with 3% hydrogen peroxide and 1.5% potassium nitrate were esthetically effective. Moreover, the LESENING group showed lower tooth sensitivity change than the Crest group.

Clinical Relevance

The use of LESENING whitening strips with 3% hydrogen peroxide and 1.5% potassium nitrate for at-home dental whitening could reduce the risk of dentin hypersensitivity without compromising whitening efficacy.

Trial Registration: ISRCTN registry number: ISRCTN30027746

Digital Dynamic Occlusal Analysis and Equilibration for Salvage of Compromised Full‐Arch Prostheses

Xiangnan Wu, Wen Yang, Meirui Ma, Yaxiong Yin, Yuanyuan Ma — Fri, 05 Dec 2025 00:00:00 -0800

ABSTRACT

Objective

To establish a digitally integrated protocol for managing failed full-arch occlusal rehabilitations through dynamic jaw tracking, virtual occlusal analysis, and computer-guided equilibration.

Clinical Considerations

A virtual patient model was reconstructed using multimodal three-dimensional datasets including cone-beam computed tomography, intraoral scans, photographs and jaw motion records. Dynamic occlusal simulations identified premature contact asymmetry, and digital occlusal equilibration evaluated the discrepancy between the initial occlusion and centric relation occlusion. Guided by these findings, intraoral equilibration and computer-aided design/manufacturing (CAD/CAM) transitional restorations were implemented, followed by definitive restorations, eliminating conventional articulator mounting and manual analysis.

Conclusions

The reintervention protocol for compromised full-arch occlusal rehabilitation achieved biomechanical stability and esthetic harmony via a digital workflow.

Clinical Significance

Digital occlusal analysis and equilibration combined with staged CAD/CAM workflows addresses complex rehabilitation failures by synchronizing functional demands with esthetic parameters, reducing clinical adjustments compared to analog methods. The biologic adaptation phase proved critical for patients with preexisting occlusal dysfunction.