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.

Introduction: This study aimed to assess the current awareness and practices of resin composite light curing of general dental practitioners (GDPs) in Saudi Arabia and to set several evidence-based recommendations to improve the quality of the outcome of concern. Methods: An online questionnaire was created. Two hundred and fifty email invitations were sent to GDPs appointed in general governmental hospitals in five main cities in Saudi Arabia to join the survey voluntarily and anonymously. The survey consisted of 24 questions classified into the following domains: 1-Demographic criteria 2- frequency and technical aspects of resin composites application 3- criteria of the currently used light curing units and curing light. Descriptive statistics and chi-square test were used to analyse the obtained responses. Results: One hundred and fifty-six responses were received. A significant number of GDPs are significantly satisfied with the quality of their light curing, not aware of the thermal hazards of light curing, and do not check power output of their LCUs (light curing units) (P<0.05). An insignificant number of respondents use eye shields for eye protection during light curing. Conclusion: There was no uniform light curing protocol followed by respondent GDPs. GDPs in Saudi Arabia should improve their knowledge and clinical skills of light-curing resin composite.

This study evaluated the effectiveness of atmospheric pressure plasma jet (APPJ) treatment on the surface characteristics and bond strength of zirconia and lithium disilicate ceramics for CAD-on restorations. A total of 70 cylindrical-shaped specimens of lithium disilicate and 70 disc-shaped specimens of Y-TZP zirconia were machined, thermally processed, surface-treated, and then resin-bonded. The specimens were grouped according to the following surface treatments: no surface treatment, sandblasting, plasma, sandblasting followed by plasma, sandblasting followed by universal adhesive, plasma followed by universal adhesive, and sandblasting and plasma treatment followed by universal adhesive. The treated surfaces were subjected to a wettability assessment via contact angle measurement and a topography assessment using scanning electron microscopy (SEM). The cemented assembly was subjected to shear bond strength testing with a universal testing machine, and the results were imported to SPSS 23.0 for statistical analysis. The results show that APPJ treatment induced a significantly low contact angle for both ceramics with no surface alteration upon scanning. Moreover, APPJ treatment produced a bonded assembly with a shear bond strength comparable to sandblasting. In conclusion, APPJ treatment should be considered an efficient surface treatment with a non-destructive nature that surpasses sandblasting with the provision of a high shear bond strength between CAD-on ceramics.

This in vitro study assessed the effect of different primers on the shear bond strength (SBS) and adhesive remnant index (ARI) of orthodontic brackets bonded to reinforced polyetheretherketone (PEEK) substrate. A total of 40 specimens were randomly distributed to two groups based on the primer used for orthodontic bonding: group 1 (control)—Transbond XT adhesive with Visio.link primer and group 2 (test)—orthodontic adhesive (Transbond XT) with traditional orthodontic primer. After bonding, specimens were thermocycled followed by SBS testing and ARI scoring of debonded specimens. Data were analyzed using the unpaired independent t-test and the Chi-square test. Group 1 specimens showed significantly higher SBS values (21.38 ± 1.48 MPa) compared to group 2 specimens (18.63 ± 1.29 MPa) (p < 0.0001). Adhesive remnant index scores showed no significant variations in bond failure modes and distributions between groups. The SBS obtained by the tested primers exceeded the clinically recommended value. Consequently, there is a comparable clinical application for both tested primers in orthodontic bonding, especially the traditional orthodontic primer, where the availability of Visio.link in clinical practice is not ensured.

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.