Finite element analysis (FEA) is increasingly used in conservative and restorative dentistry to investigate the mechanical behavior of adhesive direct and indirect polymer-based restorations. Despite the growing number of FEA-based studies, the literature currently lacks a dedicated critical synthesis specifically addressing the methodological validity and clinical interpretability of FEA in adhesive restorative dentistry. This narrative review critically examines the current literature on the application of FEA in adhesive restorative dentistry, with particular attention to class I to class V cavities in anterior and posterior teeth restored with direct or indirect polymeric materials, including inlays, onlays, overlays, and tabletop restorations. A structured, non-systematic search of major databases was conducted, and selected studies were qualitatively appraised with emphasis on modeling assumptions, stress distribution, and clinical meaning. Unlike previous broad overviews of dental biomechanics, this review provides a clinically oriented framework for interpreting FEA findings across restorative strategies. FEA consistently identifies trends related to cavity configuration, cuspal support, restoration design, material stiffness, polymerization shrinkage, and adhesive interface behavior, helping to explain clinically observed failure patterns and supporting minimally invasive approaches. However, simplified material models, idealized bonding conditions, and static loading protocols limit prediction of long-term performance. When interpreted within these constraints and integrated with experimental and clinical evidence, FEA remains a valuable complementary tool for rational restorative decision-making.

Background: Root canal sealers may come into direct contact with periapical tissues, particularly in cases of apical extrusion, potentially influencing periapical healing and treatment outcomes. Cytotoxicity assessment represents a clinically relevant parameter when selecting endodontic sealers. However, evidence derived from in vitro studies remains heterogeneous and challenging to interpret from a clinical perspective. Therefore, the aim of this systematic review was to critically evaluate the in vitro cytotoxicity of all root canal sealers that have been commercially marketed over the years, excluding experimental materials, and to contextualize the findings in relation to clinically relevant experimental conditions. Methods: This systematic review was conducted according to PRISMA guidelines and preregistered on the Open Science Framework. PubMed, Scopus, and the Cochrane Library were searched up to 30 November 2025. In vitro studies evaluating the cytotoxicity of commercially available root canal sealers using validated cell viability or proliferation assays were included. Data extraction focused on sealer composition, setting condition, extraction protocols, exposure parameters, and cytotoxic outcomes. Due to marked methodological heterogeneity, a qualitative synthesis was performed. Results: Ninety-eight in vitro studies were included. All categories of root canal sealers demonstrated some degree of cytotoxicity, particularly when tested in freshly mixed conditions, at higher extract concentrations, or after prolonged exposure. Bioactive and calcium silicate-based sealers generally showed a more favorable cytotoxicity profile compared with conventional materials, especially after complete setting and at diluted concentrations, although cytotoxic effects were reported under specific experimental conditions. Resin-based sealers, including AH Plus, exhibited condition-dependent cytotoxicity, while zinc oxide–eugenol and glass ionomer sealers tended to display higher cytotoxic potential. Conclusions: In vitro cytotoxicity of root canal sealers varies according to material composition and experimental conditions. Bioactive sealers generally exhibit a more favorable biological profile, which may be clinically relevant in situations involving sealer extrusion or prolonged tissue contact. Standardized testing protocols and further translational studies are required to support evidence-based clinical material selection.

Resin-based dental composites are widely used in restorative dentistry; however, concerns persist regarding their potential release of Bisphenol-A (BPA), a compound with recognized endocrine-disrupting activity. This in vitro study evaluated the time-dependent release of BPA from four contemporary resin-based dental filling composites immersed in artificial saliva under different thermal conditions. Disk-shaped specimens (5.5 mm diameter and 2 mm thickness) of Estelite Sigma Quick, Clearfil Majesty ES-2, Omnichroma Flow, and Luna 2 were incubated in artificial saliva at physiological pH (6.8) at 37 °C and 44 °C. BPA concentrations were quantified after 1, 7, and 28 days using a validated UHPLC–MS/MS method. BPA release was observed for all materials except Luna 2, for which it remained below the limit of quantification (LOQ) at all time points and temperatures. Across all BPA-releasing composites, the highest concentrations were observed after 1 day of immersion, particularly at 44 °C. Estelite Sigma Quick exhibited the highest BPA release, followed by Clearfil Majesty ES-2 and Omnichroma Flow. BPA release decreased progressively over time for all materials. Statistical analysis confirmed significant effects of material type, temperature, and exposure duration on BPA release (p < 0.001). Within the limitations of this in vitro study, BPA release appears to be material-dependent and influenced by thermal conditions and immersion time. Although absolute BPA concentrations were low, these findings highlight the importance of material-specific evaluation and continued monitoring of potential sources of cumulative BPA exposure from restorative dental materials.

Root canal disinfection remains challenging due to anatomical complexity and the limitations of mechanical instrumentation. Evidence on irrigation is often fragmented and focused on isolated outcomes, limiting clinically integrated protocols. This narrative review provides a clinically oriented interpretation of contemporary irrigation and activation strategies, introducing a substrate-centered perspective emphasizing dentin modification and material interaction. A structured narrative search was conducted in PubMed, Scopus, and Web of Science up to February 2026 using keywords related to irrigants, irrigation protocols, activation techniques, and dentin–material interactions. Studies were selected based on clinical relevance, including complex anatomy, mature biofilms, and realistic irrigation sequences. Irrigation effectiveness is determined by the interplay between irrigant chemistry, fluid dynamics, and activation-mediated distribution within the root canal system, as well as by irrigation-induced dentin modifications influencing the dentin–material interface. Sodium hypochlorite and chelating agents remain central, although their performance depends on delivery and activation. Activation enhances irrigant exchange, biofilm disruption, and penetration into complex regions. Irrigation also induces physicochemical changes in dentin, affecting sealer penetration and interfacial stability. It should not only be considered a disinfection step but also a substrate-conditioning phase linking cleaning to obturation, with implications for treatment predictability and long-term outcomes.

Background: Bisphenol A (BPA) release from resin-based dental materials is a growing concern due to its potential endocrine-disrupting effects, particularly in pediatric patients. This in vitro study evaluated cumulative BPA release and elution kinetics from commonly used pediatric resin-based materials, due to the limited evidence available. Methods: Three restorative materials (Clearfil Majesty ES-2, Estelite Sigma Quick, and Stela Automix) and one orthodontic material (Transbond XT) were investigated. Eighteen disk-shaped specimens (5.5 mm in diameter and 2 mm in thickness) were prepared for each material and immersed in artificial saliva (pH 6.8) at 37 °C for 1, 7, and 28 days. BPA concentrations were quantified using liquid chromatography–tandem mass spectrometry (LC–MS/MS). BPA release kinetics were evaluated during the early (1–7 days) and late (7–28 days) release phases. Results: All investigated materials released measurable BPA concentrations, with cumulative BPA release progressively increasing up to 28 days. Clearfil Majesty ES-2 and Estelite Sigma Quick exhibited the highest cumulative BPA concentrations, whereas Stela Automix showed markedly lower values. Transbond XT also demonstrated measurable BPA release. For all materials, BPA release kinetics were significantly higher during the early phase than during the late phase (p < 0.001), indicating a non-linear release behavior over time. Conclusions: BPA release from pediatric restorative and orthodontic resin-based materials is material-dependent and characterized by progressive cumulative accumulation associated with significantly higher early-phase release rates. These findings highlight the importance of assessing the safety of resin-based materials used in pediatric dentistry.

Finite element analysis (FEA) is increasingly used in conservative and restorative den-tistry to investigate the mechanical behavior of adhesive direct and indirect poly-meric restorations, although its methodological validity and clinical relevance remain debated. This narrative review critically synthesizes evidence on FEA in adhesive re-storative dentistry, focusing on class I to class V in anterior and posterior teeth restored with direct or indirect polymeric materials, including inlays, onlays, overlays, and tabletop resto-rations. A structured, non-systematic search of major biomedical databases was per-formed, and eligible studies were qualitatively appraised with attention to modeling assumptions, stress patterns, and clinical interpretability. Overall, FEA con-sistently highlights mechanically relevant trends related to cavity configuration, cuspal support, restoration design, material stiffness, polymerization shrinkage, and adhesive interface behavior. These trends help explain clinically observed failure patterns and support minimally invasive, adhesion-driven principles. Nonetheless, simplified mate-rial be-havior, idealized bonding, and mainly static loading limit the ability of FEA to predict long-term clinical performance. When interpreted within these constraints and integrated with experimental and clinical evidence, FEA remains a valuable comple-mentary tool to understand adhesive restorations and support rational restorative deci-sion-making.