Introduction: The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities. Material and method: MOD preparations were performed on 30 extracted teeth. The mesial cervical margin of each tooth was relocated using a flow composite resin (Enamel Plus HRi Flow, Micerium, Avegno, GE, Italy), then the samples were divided into three groups. In group A, the cavities were directly restored using a nanohybrid composite resin (Miris 2 Coltène Whaledent, Altstaetten, Switzerland) and a universal adhesive (ScotchBond Universal, 3M ESPE, St. Paul, MN, USA) by the etch-and-rinse strategy, for group B, the restoration procedure was similar but the self-etch strategy was used, and the samples in group C were filled using the inlay technique. Each sample was stored for 48 h in a 2% methylene blue solution, then it was cut in a mesio-distal direction using a Struers Secotom 50 device (Cleveland, OH, USA). The marginal sealing and adhesive interface were assessed for each sample at the cervical margin by optical microscopy (OM) and scanning electron microscopy (SEM). One-way ANOVA and Bonferroni post-hoc tests were used with a significance level of 0.05. Results: Significant differences were recorded within groups A and C, between mesial and distal margins (p = 0.02 in group A and p = 0.043 in group C). Conclusions: The marginal sealing is more effective in MOD inlay restoration compared to direct restorations. Relocation of the cervical margin with flow composite resin and the use of different adhesive strategies do not improve the marginal sealing.

Background: The aim of this study was to evaluate the influence of acidic beverages on the mechanical properties of various dental resin-based materials. Methods: A total number of 160 samples were prepared using four types of resin-based materials—Group A (n = 40): flowable composite, Group B (n = 40): heavy-flow composite, Group C (n = 40): resin-based sealant and Group D (n = 40): nano-hybrid composite. Then, the samples were distributed into four subgroups according to the submersion solution: a (n = 10): artificial saliva, b (n = 10): coffee, c (n = 10): cola and d (n = 10): red wine. The Vickers microhardness, Young’s modulus of elasticity and scratch resistance were assessed using a CETR UMT-2 tribometer. Results: The obtained results showed that 14-day submersion of the resin-based materials in coffee, cola and red wine solutions significantly (p < 0.05) decreased the microhardness values (VHN), Young’s modulus of elasticity and scratch resistance. Fourteen days of storage in coffee decreased the microhardness values of flow resin from 117.5 to 81.59 VHN (p < 0.001) whereas the values of the nanohybrid resin decreased from 125.5 to 89.4 (p < 0.001). The elasticity modulus of the heavy flow resin showed a decline from 15.57 to 10.50 GPa after 14 days’ submersion in coffee (p < 0.001), and from 21.29 to 13.10 GPa for the nanohybrid resin after immersion in cola (p < 0.001). For the scratch test, the resin-based sealant showed a significant decrease after 14 days of storage in coffee, from 0.34 to 0.02 units. Conclusions: The submersion of conventional nanohybrid, flowable, heavy-flow composite resins and resin-based sealants in coffee, cola and red wine solutions changes the mechanical properties (Young’s modulus of elasticity, Vickers microhardness and scratch resistance). The most resistant resin-based material to acid attack was the conventional nanohybrid composite resin, followed by heavy flow resin, flowable resin and resin-based sealant.

Introduction: The goal of this study was to evaluate the influence of combined artificial aging protocols on the surface roughness and Vickers microhardness of bulk-fill resin composites, compared with a nanofilled composite used as a reference. Materials and Methods: A total of 120 cylindrical specimens were prepared from three bulk-fill composites (Tetric EvoCeram Bulk Fill, Filtek One Bulk Fill, Venus Bulk Fill) and one nanofilled composite (Filtek Supreme Ultra). Specimens were allocated into three aging conditions: mechanical wear (A), mechanical wear combined with pH-cycling (B), and mechanical wear combined with thermocycling (C). Surface roughness (Ra) and Vickers microhardness (VHN) were evaluated at two time points (T1: 120,000 cycles; T2: 240,000 cycles). Non-parametric statistical tests were applied (α = 0.05). Results: Aging protocols significantly influenced both Ra and VHN (p < 0.05). Overall, higher surface roughness and lower Vickers microhardness values were observed after cumulative aging, with material-dependent variations between T1 and T2. The greatest post-aging differences were observed under combined mechanical wear and pH-cycling (subgroup B), whereas mechanical wear alone showed the lowest changes. Filtek One Bulk Fill and Filtek Supreme Ultra showed more favorable post-aging Ra and VHN values, whereas Venus Bulk Fill showed less favorable post-aging surface properties. No significant correlation was found between Ra and VHN (rho = −0.009; p = 0.958). Conclusions: Combined aging conditions significantly affected the surface roughness and Vickers microhardness of resin composites, with the greatest post-aging differences observed under acidic challenges. Bulk-fill materials exhibit variable resistance depending on composition, emphasizing the importance of material selection for long-term clinical performance. Clinical relevance: Composite restorations exposed to combined mechanical and acidic challenges may show altered surface roughness and microhardness, highlighting the need for materials with enhanced resistance in high-risk oral environments.

Background/Objectives: Caries adjacent to restorations or sealants (CARS) is among the most frequent biological causes of composite restoration failure, resulting from the interplay between the patient’s cariogenic risk and restoration-related factors such as marginal adaptation. The study aimed to investigate whether cariogenic risk modifies the effect of marginal adaptation on the occurrence of caries adjacent to posterior composite restorations (CARS), using risk-stratified univariate analysis and a clustering-adjusted approach, to identify associated clinical, socio-demographic, and local risk factors. Methods: This retrospective cross-sectional study evaluated 453 posterior direct composite resin restorations (Class I, Class II) in 88 patients at the Faculty of Dental Medicine, “Grigore T. Popa” University, Iași, Romania. CARS and marginal adaptation were assessed using FDI Criteria. Patients were classified as high or low cariogenic risk using a multifactorial institutional protocol. Univariate analysis and Generalized Estimating Equations (GEE) accounting for within-patient clustering were performed. Results: CARS prevalence was 27.9% in high cariogenic risk patients versus 3.15% in low cariogenic risk patients. Univariate analysis identified high cariogenic risk (OR = 11.904), deficient marginal adaptation (OR = 25.929–69.475), restoration age of 3–5 years (OR = 3.045), and Class II configuration (OR = 2.597) as significant risk factors. GEE analysis, adjusted for clustering of restorations within patients, confirmed high cariogenic risk (OR = 12.597) and deficient marginal adaptation (OR = 121.320) as independent correlates of CARS. A significant interaction between the two (p < 0.001) showed that marginal adaptation remained the dominant local risk factor in low cariogenic risk patients, while its association with CARS was largely attenuated in high-risk patients. Conclusions: GEE analysis confirmed high cariogenic risk and deficient marginal adaptation as independent correlates of CARS, with marginal adaptation acting as the dominant local risk factor only in low-risk patients.

Background/Objectives: Anaphylaxis is a rare occurrence in dental practice, yet when it happens, it demands swift management, as untreated cases can be fatal. The aim of this study is to evaluate the level of knowledge among dental students and residents regarding the symptoms and management of anaphylactic emergencies in dental surgery. Methods: The study involved a sample of 236 students from the 3rd and 5th years, and residents in their 1st and 2nd years of the General Dentistry programme at the Faculty of Dental Medicine in Iași, Romania. The response rate to the invitation was 85.8%. Knowledge was assessed using a self-administered questionnaire consisting of 18 questions organised into three sections, which were tested for internal consistency, yielding a Cronbach’s alpha value of 0.731. Results: Statistically significant differences in the responses provided by the three categories of participants were observed for the following items: management of patients with an allergic background (p = 0.033), factors aggravating allergic predisposition (p = 0.001), the correct dose of epinephrine (p = 0.001), secondary medication (p = 0.001), and the timing of treatment initiation (p = 0.009). Questions where answers indicated moderate to low levels of knowledge (25–50% correct answers) concerned the therapeutic approach for patients with an allergic background, the site of adrenaline administration, and secondary medication. Conclusions: Overall, it can be observed that students demonstrated a high level of knowledge in questions related to the symptomatology of anaphylaxis and the therapeutic management of allergic patients, whereas residents showed better performance in questions addressing the therapeutic management of anaphylaxis. However, significant knowledge gaps were identified across all participant categories, suggesting that there must be periodic supplementary training.

Quality management and internal audit are important components of patient safety, regulatory compliance, and service quality in dental practice. This narrative review examined the current status of quality management and internal audit in Romanian dental settings and explored challenges and future development opportunities in relation to European quality standards. A narrative review of the literature was conducted using PubMed, Scopus, Web of Science, and Google Scholar, complemented by an analysis of Romanian regulatory documents relevant to dental practice. The reviewed evidence suggests that quality management in Romanian dental services remains largely focused on regulatory compliance, particularly infection control and documentation requirements. Internal audit is rarely implemented as a structured tool for continuous quality improvement, while the lack of standardized audit frameworks and quality indicators limits objective performance evaluation. Additional challenges include variability in organizational resources, limited audit-related training, and uneven digital integration. Strengthening internal audit procedures and developing standardized quality-management frameworks may support continuous quality improvement and closer alignment with European quality standards.