Glass ionomer cement (GIC) is a self-adhesive dental restorative material composed of a polyacrylic acid liquid and fluoro-aluminosilicate glass powder. It is commonly used for cementation during dental restoration. This study aimed to systematically review the existing literature regarding the clinical performance of GIC in load-bearing dental restorations. A comprehensive literature search was conducted in EBSCO, PubMed, Embrace, and Cochrane databases. Only randomized controlled trials (RCTs) were included in the search, and a broad search technique was used, where inclusion and exclusion criteria were applied. After a thorough evaluation, 12 RCTs were extensively reviewed, and whether GIC is suitable for load-bearing restorations was determined. Significant variations in staining surface or margin, color match, translucency, esthetic anatomical form, retention, material fracture, marginal adaptation, surface luster, occlusal contour, wear, and approximal anatomical form indicated the unsuitability of GIC. By contrast, significance differences in patient view and periodontal response indicated that GIC is suitable. No significant differences in postoperative sensitivity, recurrence of caries, or tooth integrity were observed. Nevertheless, the results of the review demonstrated that the clinical performance of GIC is comparable to that of traditional restorative materials with regard to the parameters analyzed. GIC is a suitable restorative material for load-bearing restorations regarding surface margin, esthetic anatomical form, material retention and fracture, marginal adaptation, occlusal contour, wear, and approximal anatomical form. It reduces other parameters, such as postoperative sensitivity, recurrence of caries, and tooth integrity.

Preserving dental pulp vitality is a key goal in minimally invasive dentistry. Conventional materials such as calcium hydroxide and mineral trioxide aggregate (MTA) are effective but limited in bioactivity and mechanical strength. This systematic review evaluated the biological efficacy of chitosan-based nanoparticles and biomaterials for pulp capping and regeneration. Following PRISMA 2020 guidelines, electronic searches were conducted across five databases up to April 2025. Controlled in vitro and animal studies using chitosan-based nanoparticles, hydrogels, or composite scaffolds were included. Risk of bias was assessed using SYRCLE (animal) and ToxRTool (in vitro), and certainty of evidence was rated via the GRADE-Preclinical framework. Due to methodological heterogeneity, data were synthesized using direction-of-effect coding and visualized through Albatross and heatmap plots. Sixteen studies met the criteria, consistently demonstrating enhanced cell viability, mineralization, and upregulation of odontogenic and angiogenic markers (BMP-2, TGF-β₁, VEGF, DSPP) compared with MTA or calcium hydroxide. Animal models confirmed improved angiogenesis, reparative dentin formation, and pulp vitality preservation. Despite uniformly positive biological outcomes, the overall certainty was rated Low to Very Low owing to small samples and unclear randomization. Chitosan-based biomaterials show promising regenerative potential, warranting well-designed preclinical and clinical studies for translational validation.

Comparative Analysis of Calcium and Hydroxyl Ion Release from Pulp Dressing Materials in Pulpotomized Premolars - Article abstract #945089

Rationale: This case series addresses the management of dental fluorosis, a condition caused by excessive fluoride intake during tooth development. The 3 patients in this report, all from the same family, exhibited varying degrees of dental fluorosis, impacting both aesthetics and function. Treatments ranged from conservative approaches like bleaching and macro-abrasion to more extensive restorative options like veneers and crowns, aiming to improve dental appearance and oral health. Patient concerns: All 3 patients were concerned with the discoloration and aesthetic issues caused by dental fluorosis. Each expressed a desire to improve their smile and address any functional impacts on their teeth. Diagnoses: The patients were diagnosed with dental fluorosis of varying severity. Diagnosis was made based on clinical examination, history of fluoride intake, and radiographs. The condition was classified using the Thylstrup and Fejerskov index, which assesses the extent of fluorosis based on enamel opacity, pitting, and discoloration. Interventions: Case 1 (moderate fluorosis): The patient underwent home bleaching, composite restorations, and the application of laminate veneers after gingivectomy. Case 2 (moderate-to-severe fluorosis): The patient had several teeth extracted due to failed endodontic treatment, followed by the placement of lithium disilicate crowns and a zirconia bridge. Case 3 (mild fluorosis): This patient received in-office and at-home bleaching, followed by macro-abrasion and resin infiltration to improve the appearance of white spots. Outcomes: Each treatment successfully addressed the functional and aesthetic concerns of the patients. The use of bleaching, veneers, crowns, and resin infiltration significantly improved their smiles. All patients reported satisfaction with the results, achieving a more natural tooth appearance and improved confidence in their dental health. Lessons: This case series highlights the importance of a multi-modal, individualized approach to managing dental fluorosis. By tailoring treatment to the severity of the condition, aesthetic and functional improvements were consistently achieved across different fluorosis severities. Dental fluorosis management should prioritize minimally invasive options while maintaining a focus on long-term aesthetic and functional restoration.