Objectives. To assess visually color-matching and blending-effect (BE) of a universal shade bulk-fill-resin-composite placed in resin-composite-models with different shades and cavity sizes and in natural teeth (extracted and patients’ teeth).Materials and Methods. Resin-composite-discs (10 mm × 1 mm) were prepared of universal shade composite and resin-composite of shades: A1, A2, A3, A3.5, and A4. Spectrophotometric-color-measurement was performed to calculate color-difference (ΔE) between the universal shade and shaded-resin-composites discs and determine their translucency-parameter (TP). Visual assessment was performed by seven normal-color-vision-observers to determine the color-matching between the universal shade and each shade, under Illuminant D65. Color-matching visual scoring (VS) values were expressed numerically (1–5): 1: mismatch/totally unacceptable, 2: Poor-Match/hardly acceptable, 3: Good-Match/acceptable, 4: Close-Match/small-difference, and 5: Exact-Match/no-color-difference. Occlusal cavities of different sizes were prepared in teeth-like resin-composite-models with shades A1, A2, A3, A3.5, and A4. The cavities were filled by the universal shade composite. The same scale was used to score color-matching between the fillings and composite-models. BE was calculated as difference in mean-visual-scores in models and that of discs. Extracted teeth with two different class I-cavity sizes as well as ten patients’ lower posterior molars with occlusal caries were prepared, filled by universal shade composite, and assessed similarly.Results. In models, the universal shade composite showed close matching in the different cavity sizes and surrounding shades (4≤VS<5) (BE = 0.6–2.9 in small cavities and 0.5–2.8 in large cavities). In extracted teeth, there was good-to-close color-matching (VS = 3.7–4.4 in small cavities, BE = 2.5–3.2) (VS = 3–3.5, BE = 1.8–2.3 in large cavities). In patients’ molars, the universal shade composite showed good-matching (VS = 3–3.3, BE = −0.9–2.1).Conclusions. Color-matching of universal shade resin-composite was satisfactory rather than perfect in patients’ teeth.

Clinical Relevance: Fiber inserts incorporated at the gingival floor of Class II composite restorations resulted in a significant reduction of microleakage scores as compared to restorations made without inserts. This may lead to a reduced incidence of recurrent caries.

Secondary caries is one of the main reasons for the clinical failure in dental restorations. Therefore, it is preferable for restorative materials to possess antibacterial properties, which support a longlasting restoration. The present in vitro study aimed to evaluate the effect of both the polyamidoamine (PAMAM) liquid and bioactive glass (BAG) powder added to glass ionomer cements (GICs) on their antibacterial properties. Polyamidoamine was prepared and characterized. Four groups were distinguished, as follows: GI - samples of commercially available GIC (control); GII - samples of GIC mixed with PAMAM; GIII - samples of GIC mixed with BAG; and GIV - samples of GIC mixed with PAMAM and BAG.The biofilm assessment test was conducted using a colony forming unit (CFU) count, and the ion release test was used to quantify the amount of released silica (Si), calcium (Ca), phosphorus (Ph), and sodium (Na) ions in mg/L. Thirty-six samples were prepared for each test. Furthermore, the pH of the soaking solution was measured for each sample in the ion release test. The parametric data was examined using one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test. The biofilm assessment test revealed a significant reduction in the recovered Streptococcus mutans counts in all modified groups compared to the control group (p < 0.05). Also, the ion release test demonstrated a significant increase in the release of Si and Na ions for all modified groups compared to the control group (p < 0.05). The modification of GICs with PAMAM and BAG enhances their antibacterial properties.

Zirconia is a high-strength ceramic material that expands the design and application possibilities for all-ceramic restorations and dental implants. To enhance the bonding of zirconia restorations to tooth substrates and the osseointegration of implants with the surrounding bone, the surface should be modified by surface treatment. Unfortunately, the effective treatment of sintered zirconia is difficult. Surface treatment for presintered zirconia may be less difficult; thus, the effectiveness of surface treatments of presintered zirconia was investigated herein. The zirconia specimens were randomly divided into eight groups: (1) control (untreated) and seven treated groups subjected to surface treatment (s.ttt.) in the presintered stage, followed by sintering: (2) s.ttt. 1: hydrofluoric acid (HF) gel left during sintering; (3) s.ttt. 2: HF gel washed before sintering; (4) s.ttt. 3: coated with nanosilica; (5) s.ttt. 4: coated with microsilica; (6) s.ttt. 5: coat followed by airborne-particle abrasion; (7) s.ttt. 6: coat followed by partial etching; and (8) s.ttt. 7: coat followed by total etching. The surface microstructure was examined using scanning electron microscopy (SEM) and the crystalline phase was identified using X-ray diffraction (XRD). Biaxial flexural strength was also tested. The results of SEM for s.ttt. 1 and 2 displayed irregular surfaces. S.ttt. 3 showed deeper penetration of the nanosilica into zirconia (27 µm) compared to the microsilica used in s.ttt. 4. S.ttt. 5 and 6 showed irregular coats. S.ttt. 7 showed intergranular pores. The XRD of s.ttt. 1, 2, and 3 revealed tetragonal zirconia as the control group. S.ttt. 4 and 5 showed cristobalite silica and tetragonal zirconia. S.ttt. 6 and 7 contained amorphous silica and tetragonal zirconia, while s.ttt. 7 also showed monoclinic zirconia. The highest flexural strength was for s.ttt. 4 (982.4 MPa), while the lowest was for s.ttt. 7 (386.6 MPa). There was no significant difference in the flexural strength between the control, s.ttt. 1, and 2 (846.3 MPa, 830.0 MPa, and 835 MPa, respectively). Compared to the control group, s.ttt. 3 had a lower flexural strength (634.1 MPa), while s.ttt. 5 and 6 had higher flexural strengths (863.1 MPa and 872.2 MPa, respectively). It can be concluded that the surface modification of presintered zirconia is a promising method as long as no phase transformation or deep subsurface penetration occurs.

Ceramic thickness and technicians’ manipulative variables are critical factors affecting the resultant shade of dental ceramo-metallic restorations. This study investigated the effect of the following variables on shade duplication of ceramo-metallic specimens: (a) ceramic thickness; (b) differences between several technicians (inter-technician variability); and (c) the ability of each technician to repeat the resultant shade (intra-technician variability). Ninety ceramo-metallic specimens were prepared and divided into three main groups (n = 30/gp) according to the different technicians who built up the veneering ceramic of the specimens. Each group was further subdivided into three subgroups (n = 10/subgroup) according to the thickness of the ceramic (1, 1.5, and 2 mm built over a 0.5 mm-thick metal substructure). Three different technicians were asked to follow the same protocol as regards the same ceramic batch (Shade 3M2, Vita VM13, Zahnfabrik, Germany), firing temperature, and number of firing cycles. Meanwhile, each technician followed his own protocol with regard to other ceramic manipulative variables. The duplicated shades of the specimens were investigated using the Vita Easyshade spectrophotometer by using the verify shade mode. Color difference (∆E) values were calculated between the target shade (3M2) and the duplicated shades of the specimens automatically by the Vita Easyshade spectrophotometer (Vita, Zahnfabrik, Germany). The effect of ceramic thickness and inter- and intra-technician variability on the duplication of the target shade was investigated. The results showed that the effect of ceramic thickness on the duplicated shades depended on inter-technician variability. High inter-technician variability (∆E = 2–6.4) was noticed in contrast to low intra-technician variability (∆E = 0.2–1.5). It could be concluded that proper shade-duplication of ceramo-metallic restoration was a cumulative technique intimately related to manipulative variables and ceramic thickness.