This review addresses the rationale of recurrent and/or residual caries associated with resin composite restorations alongside current strategies and evidence-based recommendations to arrest residual caries and restrain recurrent caries. The PubMed and MEDLINE databases were searched for composite-associated recurrent/residual caries focusing on predisposing factors related to materials and operator’s skills; patient-related factors were out of scope. Recurrent caries and fractures are the main reasons for the failure of resin composites. Recurrent and residual caries are evaluated differently with no exact distinguishment, especially for wall lesions. Recurrent caries correlates to patient factors, the operator’s skills of cavity preparation, and material selection and insertion. Material-related factors are significant. Strong evidence validates the minimally invasive management of deep caries, with concerns regarding residual infected dentin. Promising technologies promote resin composites with antibacterial and remineralizing potentials. Insertion techniques influence adaptation, marginal seal, and proximal contact tightness. A reliable diagnostic method for recurrent or residual caries is urgently required. Ongoing endeavors cannot eliminate recurrent caries or precisely validate residual caries. The operator’s responsibility to precisely diagnose original caries and remaining tooth structure, consider oral environmental conditions, accurately prepare cavities, and select and apply restorative materials are integral aspects. Recurrent caries around composites requires a triad of attention where the operator’s skills are cornerstones.

Objectives: This review article aims to describe some of the roles of Matrix metalloproteinases (MMPs) in enamel, dentine, dental caries, hybrid layer degradation, pulp and periodontal tissues, throwing light on their current inhibitors. The article addresses the potential of MMPs to serve as biomarkers with diagnostic and therapeutic value. Design: The sections of this review discuss MMPs’ involvement in developmental, remodeling, degradational and turnover aspects of dental and periodontal tissues as well as their signals in the pathogenesis, progress of different lesions and wound healing of these tissues. The literature was searched for original research articles, review articles and theses. The literature search was conducted in PubMed and MEDLINE for articles published in the last 20 years. Results: 119 published papers, two textbooks and two doctoral theses were selected for preparing the current review. Conclusions: MMPs are significant proteases, of evident contribution in dental and periapical tissue development, health and disease processes, with promising potential for use as diagnostic and prognostic disease biomarkers. Continuing understanding of their role in pathogenesis and progress of different dental, periapical and periodontal lesions, as well as in dentine-pulp wound healing could be a keystone to future diagnostic and therapeutic regimens.

Objective. The aim of this study was to evaluate the current clinical practice of general dentists in Saudi Arabia in restoring class II cavities using direct resin composites and to set evidence‐based practice recommendations of concern. Methods. An online survey formed of 20 questions and classified into four domains was developed. 500 dentists in 5 Saudi provinces were invited to join the survey anonymously and voluntarily using poster announcements and e‐mail invitations. Descriptive statistics were used to analyze participants’ responses. Results. 343 responses were received. Dentists in Saudi Arabia vary in their clinical practices and techniques of insertion of resin composite in class II cavities. 67% of participants use cotton rolls for isolating the field while 32% use rubber dam isolation. 33% and 28% of respondents use circumferential matrix (Tofflemire) and AutoMatrix, respectively. Fracture, followed by recurrent caries and open proximal contacts, was the received main reason of failure of class II direct resin composite restorations. Conclusion. Diversity of class II resin composite practices exists among dentists in Saudi Arabia. For ensuring optimum quality outcomes and high standards of restorative dentistry healthcare, several dentists in Saudi Arabia need to reconsider their clinical practice and modify their clinical procedures of direct class II resin composites. Several evidence‐based practice guidelines are recommended to dentists in this article to improve their practice and enhance the clinical reliability and longevity of class II direct resin composite restorations.

Little is known about factors influencing the bond strength of additively manufactured materials in dentistry. The impact of diverse pretreatment strategies on the bond strength of 3-dimensionally (3D) printed composite resins indicated for definitive cementation to dentin has scarcely been investigated. The aim of this study was to evaluate the adhesive bond strength of two 3D printed definitive fixed restoration materials to dentin by using different pretreatment protocols. Composite resin rods (2×2×10 mm, n=20/group) were 3D printed with 3Delta Crown and saremco print CROWNTEC. Half of the rods were airborne-particle abraded (APA), the other half of the rods were untreated. All rods were chemically conditioned with 1 of 3 adhesives (Adhese Universal, Heliobond, Monobond Plus). Dentin rods (2×2×5 mm) were cut from bovine teeth, pretreated with Adhese Universal, and bonded to the composite resin rods with Variolink Esthetic LC. The specimens were thermocycled (10 000 cycles) before testing for tensile bond strength (TBS) and the assessment of the failure mode. Surface roughness (SR) and degree of conversion (DC) were examined with laser scanning microscopy and Raman spectroscopy. Data were statistically analyzed with 1-, 2-, and 3-way analyses of variance (ANOVAs) and Weibull analysis (α=.05). TBS values ranged from 6.57 to 10.58 MPa, without significant differences among the groups (P>.05). All groups demonstrated a comparable Weibull modulus and predominant adhesive failure. SR increased significantly (P<.05) upon APA, and the DC ranged from 70.1% to 71.9%. Regardless of the 3D printable material, SR was increased by APA, and the DC was around 70%. Different mechanical and chemical pretreatments appear to exert relatively little influence on TBS.