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.

Fiber-reinforced composites (FRCs) are recognized for enhancing the fracture resistance of structurally compromised teeth. However, the optimal orientation and placement of fibers in direct resin composite restorations remain under debate. This study aimed to evaluate the fracture resistance of maxillary premolars with mesio-occluso-distal (MOD) cavities restored using polyethylene fibers with different placement techniques, compared to conventional incremental composite restoration. Methods: Sixty intact maxillary premolars were randomly assigned to six groups (n = 10). Group 1: intact teeth (positive control); Group 2: MOD cavity without restoration (negative control); Group 3: MOD cavity restored with nanohybrid composite using the incremental technique; Group 4: polyethylene fiber placed on the pulpal floor; Group 5: fiber placed circumferentially along cavity walls (wall-papering technique); Group 6: fiber placed buccolingually in an occlusal groove (occlusal splinting). Fracture resistance was assessed using a universal testing machine. Failure mode was also analyzed. Results: Group 6 (occlusal splinting) exhibited the highest fracture resistance (1137.72 ± 316.20 N), significantly exceeding Group 3 (546.93 ± 59.89 N) and other fiber-reinforced groups (p < 0.05). Failure mode analysis revealed no significant differences between the fiber-reinforced groups and the intact teeth. Group 6 also had the highest percentage of restorable fractures (90%). Conclusions: Incorporating polyethylene fibers, especially through occlusal splinting, significantly improves fracture resistance in MOD-restored maxillary premolars. This technique may offer a promising alternative to conventional composite restorations in structurally weakened posterior teeth.

Temporomandibular disorder (TMD) is a group of clinical troubles and is considered one of the major causes of non-dental pain. TMD is characterized by a wide range of signs and symptoms associated with TMJ and other related structures that negatively affect the Quality of life (QoL). This study investigated the public knowledge about TMD among people living in the Kingdom of Saudi Arabia's main cities and provinces. An electronic survey was designed, containing 16 questions in Arabic and Eng

Objectives: Trauma to maxillary incisors is frequent, and requires timely, conservative management for optimal prognosis. This in vitro study evaluated the fracture resistance (FR) and orthodontic bracket bond strength (BS) of incisors following incisal fragment reattachment using various restorative techniques. Materials and Methods: Two independent tests—FR testing (Newtons) and BS testing (megapascals)—were conducted. Eighty intact human maxillary central incisors (n = 40/test), standardized in size and shape using a digital caliper (Mitutoyo, ±0.01 mm), were embedded in acrylic resin and numbered. An uncomplicated crown fracture was induced in 64 teeth (n = 32/test), and the teeth were randomly assigned (simple randomization using Excel’s RAND function) to five groups (n = 8/group/test): (1) intact teeth (negative control, NC); (2) nanohybrid composite buildup using Filtek Z250 and Single Bond 2 (positive control, CB); (3) fragment reattachment using flowable composite (Filtek Supreme, FL); (4) reattachment with a palatal veneer using a nanohybrid composite (PV); and (5) reattachment reinforced with a polyethylene fiber band (Ribbond Inc., RB). In BS testing groups, stainless steel orthodontic brackets (PINNACLE) were bonded using Transbond XT, centered over the fracture line. Light curing was performed using an LED unit (Mini LED Standard, Acteon, 1250 mW/cm², 20 s/bond, 40 s/composite, 2 mm curing tip distance). Specimens were stored in distilled water at room temperature for 24 h before reattachment. FR and BS were evaluated using a universal testing machine (Instron) until failure. Failure modes were analyzed, and data were statistically evaluated using one-way ANOVA, Tukey’s post hoc test, and Pearson’s correlation analysis. Results: Significant differences were observed among groups for both FR and BS (p < 0.05). The NC group exhibited the highest FR (514.4 N) and BS (17.6 MPa). The RB group recorded the second-highest FR (324.6), followed by the PV (234.6), CB (224.9), and FL (203.7) groups. The CB group demonstrated the second-best BS (16.6), followed by the RB (15.2), FL (13.4), and PV (6.5) groups. FR and BS were negatively correlated. Mixed failures predominated in the reattachment groups, except for the PV group, which showed mainly adhesive failures. In BS testing, mixed failures dominated in the NC and CB groups, while adhesive failures predominated in the PV and FL groups. Conclusions: Ribbond reinforcement improves the mechanical performance of reattached incisal fragments, and composite buildup may provide more reliable bracket bonding than fragment reattachment. Clinical Relevance: In cases where biomimetic, minimally invasive reattachment is indicated, Ribbond fiber reinforcement appears to offer a reliable restorative solution.