Background: Mesio–occluso–distal (MOD) cavity preparations are often fragile due to the amount of tooth and carious structure removed. MOD cavities can often fracture if left unsupported. Aim: The study investigated the maximum fracture load of mesi–occluso–distal cavities restored using direct composite resin restorations with various reinforcement techniques. Method: Seventy-two freshly extracted, intact human posterior teeth were disinfected, checked, and prepared according to predetermined standards for mesio–occluso–distal cavity design (MOD). The teeth were assigned randomly into six groups. The first group was the control group restored conventionally with a nanohybrid composite resin (Group I). The other five groups were restored with a nanohybrid composite resin reinforced with different techniques: the ACTIVA BioACTIVE-Restorative and -Liner as a dentin substitute and layered with a nanohybrid composite (Group II); the everX Posterior composite resin layered with a nanohybrid composite (Group III); polyethylene fibers called “Ribbond” placed on both axial walls and the floor of the cavity, and layered with a nanohybrid composite (Group IV); polyethylene fibers placed on both axial walls and the floor of the cavity, and layered with the ACTIVA BioACTIVE-Restorative and -Liner as a dentin substitute and nanohybrid composite (Group V); and polyethylene fibers placed on both axial walls and the floor of the cavity and layered with the everX posterior composite resin and nanohybrid composite (Group VI). All teeth were subjected to thermocycling to simulate the oral environment. The maximum load was measured using a universal testing machine. Results: The highest maximum load was exhibited by Group III with the everX posterior composite resin, followed by Group IV, Group VI, Group I, Group II, and Group V. A statistically significant difference was demonstrated between groups (p = 0.0023). When adjusting for multiple comparisons, there were statistical differences specific to comparisons between Group III versus I, Group III versus II, Group IV versus II, and Group V versus III. Conclusions: Within the limitations of the current study, it can be concluded that a higher maximum load resistance can be achieved (statistically significant) when reinforcing nanohybrid composite resin MOD restorations with everX Posterior.

Introduction: The recently developed single-shade composite resin (using the concept of structural coloring) is a promising option to eliminate the process and subjectivity of shade selection. However, current evidence of its performance is still insufficient. This study aimed to evaluate the color matching, color stability, and refractive index (RI) of single-shade restorations compared with conventional composite resin. Methods: This in vitro study was conducted on 48 extracted maxillary premolars. The teeth were sorted into three tooth shade groups (B2, A3, and A3.5). Each group included two subgroups based on the materials used: Omnichroma (OM; Tokuyama Dental, Tokyo, Japan) and Filtek Z350 (FT; 3M ESPE, St. Paul, MN, USA). Buccal and lingual Class V round cavities were prepared and restored according to the randomly assigned subgroups, with the test single-shade material (OM) on one surface and the matching conventional control material (FT) of the proper shade on the other surface of each tooth. Color matching was evaluated by visual assessment and a spectrophotometer. All specimens were distributed into four staining groups and immersed in various staining beverages (black coffee, Arabic coffee, Coca-Cola, and distilled water) for four weeks. Color changes were assessed using a spectrophotometer. Four groups of disc-shaped specimens (single-shade, B2, A3, and A3.5) were fabricated to evaluate the RI using a refractometer. Statistical analyses were performed to compare the materials. Results: The mean value of the color difference (ΔE) of single-shade restorations was significantly higher than that of paired conventional restorations in all shade groups. The highest mean ΔE was in subgroup A3.5-OM (8.84 ± 2.39) and showed significantly less color matching than other OM subgroups (p=0.009). The visual assessment showed comparable and acceptable color matching in all subgroups except A3.5-OM (p=0.006). There was a significant color change after the staining test within and across staining groups, but the color change was comparable between the OM and FT subgroups. The RI of single-shade material was significantly higher than conventional material (p<0.05). Conclusion: The color matching of single-shade restorations was affected by tooth shade. Its color stability was influenced by various staining substances but was similar to conventional restorations.

Objectives. The level of evidence (LOE) of Saudi dental research from 2000 to 2020 was evaluated, and factors associated with the LOE were determined. Methods. This study was a systematic review. PubMed, Web of Science, and Medline databases were utilized to retrieve available dental articles published in English between January 2000 and May 2020. The inclusion criteria consisted of clinical studies conducted in Saudi Arabia with at least one Saudi dental affiliation. The retrieved eligible articles were evaluated independently by two reviewers using a modified Oxford LOE scale. The LOE of the studies was compared between the last two decades. Results. Of the 7237 articles identified, 1557 articles met the inclusion criteria. Approximately 78 of the published articles reported Level IV evidence. A higher trend toward Level I, II, and III publications has occurred in recent years (i.e., 20102020). However, no statistically significant difference existed in LOE proportions between the two decades. The presence of international collaboration and high journals impact factor was significantly associated with a higher LOE. Conclusion. Most published dental research studies were low LOE studies (i.e., Level IV). National and international collaboration is highly encouraged as this is a factor, according to our findings, that would be a positive addition toward publishing dental research of a higher LOE in Saudi Arabia.

To identify the models and levels of integration of the undergraduate dental curriculum in Umm Al-Qura University in KSA. This comprehensive evaluation and analysis of the current dental curriculum will facilitate better planning for curriculum reform, thus improving the quality of dental education. All courses were evaluated by three reviewers who independently checked the most recent course specifications forms (2021) to extract data relating to course descriptions and contents. A model of integration was identified for each course (using a modified Harden's integration ladder). Courses and their relative weighting (by credit hours) were mapped to the level of integration by years, departments, course classification, and educational methods. The overall pattern of curriculum integration was then determined. All courses exhibited some level of integration to varying degrees throughout years and across departments. The most frequently used model is the nested model of integration. The overall pattern of curriculum integration is low to moderate. Highly integrated courses are only taught during the second and final years and are managed by the Departments of Basic Oral Sciences and Restorative Dentistry. Clinical courses represent 44.3% of the curriculum although only 26.6% of clinical courses have a high level of integration. Problem-based learning/case-based learning (PBL/CBL) and clinical training strategies are mostly applied in moderately to highly integrated courses, although PBL/CBL is the least used educational method throughout the curriculum. All courses exhibited some level of integration with an overall low to moderate pattern. More collaborative planning and working between departments are recommended to increase the level of integration of courses throughout different academic years. In addition, modern educational strategies such as PBL/CBL and blended learning should be implemented more in our dental curriculum.

Introduction: The treatment of choice for posterior teeth is full-coverage crowns, but these materials should not be color-affected by external factors such as tobacco use. This laboratory study aimed to evaluate the mean color change (ΔE*) values of lithium aluminum disilicate (LAD) full...