Composite resin is universally used for posterior teeth restorations. Fibers have been suggested for the mechanical improvement of the restorations. This study assessed the fracture resistance of class II fiber-reinforced composite restorations and compared it with the fracture resistance of three control groups: (1) healthy teeth, (2) non-fiber-reinforced restorations and (3) unrestored cavities. A search was performed using PubMed, Web of Science and Google Scholar from 15 May to 12 June 2023. Only in vitro studies from the last 10 years were included for this systematic analysis. This study was registered in the PROSPERO database, it followed PRISMA guidelines and the risk of bias was assessed using the QUIN tool. Fracture resistance median values, in Newtons (N), were calculated for the experimental and control groups (95% confidence interval). For pairwise comparison, nonparametric tests (p < 0.05) were applied. Twenty-four in vitro studies met the inclusion criteria. The fracture resistance of the experimental group was 976.0 N and differed (p < 0.05) from all controls. The experimental group showed lower values of fracture resistance than healthy teeth (1459.9 N; p = 0.048) but higher values than non-fiber-reinforced restorations (771.0 N; p = 0.008) and unrestored cavities (386.6 N; p < 0.001). In vitro systematic outcomes evidenced that glass and/or polyethylene fibers improved the fracture resistance of composite restorations.

Adhesive resins with guided application protocols have been developed with the main goal of reducing the number of clinical steps. Universal Adhesives (UA) can be applied with both Self-Etch (SE) or Etch-and-Rinse (ER) adhesion strategies. This review aims to evaluate the bond strength of UA, applied to dental tissues, by a systematic bibliometric review of in vitro studies. The research question, through the PICO model, aimed to assess the current knowledge of the immediate and long-term bond strength of UA, applied with a direct restorative technique. PubMed and ScienceDirect database searches focused on the bond resistance of UA applied with the ER and SE strategies. Studies assessing shear bond strength and microtensile bond strength, in both enamel and dentin, were included. From 1109 screened articles, 12 fulfilled the inclusion criteria. The bond strength of UA to enamel showed better results with the ER approach, while the adhesion strategy did not significantly affect the bond strength of UA to dentin. Evidence from in vitro studies has tended to suggest that the use of the SE adhesion approach seems to be a better choice to improve the bond strength to the dentin. The selective enamel etching is advisable when applied with the SE adhesion approach to optimize the UA bond strength to the enamel.

Amorphous calcium phosphate (ACP) is a well-established bioceramic material known to promote the remineralization of dental hard tissues. White spot lesions (WSLs) represent the initial stage of enamel demineralization and are frequently observed in patients with fixed orthodontic appliances or inadequate oral hygiene. Although recommendations for remineralizing agents include both the prevention of lesion progression and the stimulation of tissue remineralization, the clinical efficacy of ACP-based materials remains under debate. This systematic review, registered in the PROSPERO database (CRD42024540595), aims to evaluate the clinical efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-based products in the remineralization of WSLs and to compare these outcomes with those achieved using non-bioceramic approaches. Inclusion criteria comprised randomized clinical trials, prospective cohort studies, and pilot studies conducted on human subjects with WSLs affecting permanent teeth. Studies involving artificial WSLs or non-cariogenic enamel lesions were excluded. The quality of the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Fourteen articles met the inclusion criteria and were analyzed. The main findings indicate that CPP-ACP is clinically effective in promoting the remineralization of WSLs, although the results were inconsistent across studies. Comparisons with placebo and resin infiltration treatments revealed greater efficacy for CPP-ACP. The combination of CPP-ACP with fluoride appeared to further enhance the remineralizing effect on WSLs. Additional standardized clinical studies with longer follow-up periods are warranted to confirm these outcomes.

Dental rehabilitation with implants is a clinical reality in clinical practice. The Interproximal Contact Loss (ICL) between implant-supported prostheses adjacent to natural teeth is a relatively common occurrence. This systematic review and meta-analysis aims to evaluate the possible clinical effects of the periodontium regarding the ICL between teeth and implanted-supported prostheses. We also identified the main ICL assessment tools described in the literature. This study was registered on the PROSPERO (CRD42023446235), was based on the PICO strategy, and followed the PRISMA guidelines. An electronic search was carried out in the PubMed, B-on, Google Scholar, and Web of Science databases without setting a time limit for publications. Only systematic reviews and comparative clinical trials were included and analyzed. Nineteen publications were eligible for meta-analysis, with thirteen retrospective and six prospective clinical trials. A total of 2047 patients and 7319 prostheses in function were evaluated, and ICL was found in 51% with a confidence interval of 0.40 to 0.61. As ICL assessment tools, dental floss was used in 65%, matrices were used in 30%, and X-ray images were used in 5% of cases. The clinical follow-up ranged from 1 to 21 years, with 50% between 1 and 3 years, 25% between 3 and 10 years, and 25% between 10 and 21 years. ICL was found to occur more frequently in the mandible. No statistically significant difference existed between the anterior (55%) and posterior (47%) oral regions. On the mesial surface, ICL ranged from 13% to 81.4%, possibly due to the different follow-up periods and the diversity of methods used in the assessment. No differences were found for ICL between single or multiple implanted-supported prostheses. Food impaction was the most common effect of ICL and was more prevalent on the implant-supported prosthesis’s mesial surface in the mandible’s posterior region. There was evidence of peri-implant mucositis but without progression to peri-implantitis, and the form of retention or the number of elements was not relevant.

The management of deep subgingival carious lesions presents significant challenges for achieving durable adhesive restorations due to limited access, moisture control, and proximity to periodontal tissues. Two main approaches are currently adopted to manage these cases: Deep Margin Elevation (DME) and Surgical Crown Lengthening (SCL). This systematic review (PROSPERO registration CRD420250654262) aimed to compare the performance and survival of restorations placed following DME versus SCL in teeth with deep subgingival margins. A comprehensive literature search was conducted in PubMed, B-ON, and the Cochrane Library for studies published between 2014 and 2025. Following PRISMA guidelines, six studies were included. Methodological quality and risk of bias were assessed using ROBINS-I, RoB 2, and the CARE guidelines. The available evidence indicates that both DME and SCL provide satisfactory periodontal stability, high restoration survival rates, and a low incidence of recurrent caries. DME emerged as a minimally invasive strategy that facilitates adhesive procedures by relocating deep margins to more accessible positions, potentially improving marginal integrity while preserving tooth structure and gingival architecture, particularly in patients with a thick gingival biotype. The choice between DME and SCL should be individualized. Further long-term clinical studies are required to clarify their impact on adhesive interface durability in subgingival environments.

Background/Objectives: To assess and compare the knowledge of and attitudes toward erosive tooth wear (ETW) among university students at the Portuguese University Fernando Pessoa (UFP). Methods: Cross-sectional, prospective pilot study approved by the UFP-Ethics Committee for a bilingual (English and Portuguese) online self-administered questionnaire displayed to all UFP students of the 2023–2024 academic year. Two groups were recruited, dental students (DSs) and non-medical students (NMSs), based on a convenience sample of 344 students. Participants voluntarily answered demographic questions, 15 true/false/do not know questions between knowledge of ETW, and 10 positive statements to score the attitude toward ETW based on a 5-point Likert scale. Differences in scores for DSs and NMSs groups by non-parametric tests and the correlation between knowledge of and attitudes by the Pearson coefficient were considered significant for p < 0.05. Results: A total of 251 (72.9%) students participated, but only 245 (71.2%) fulfilled the survey. The knowledge and attitude scores of the DSs (Md = 12.0; IQR 11.0–13.0 and Md = 43.0; IQR 40.0–48.0) were higher (p < 0.001; p = 0.019) than those of NMSs (Md = 8.0; IQR 6.0–10.0 and Md = 41.0; IQR 38.0–46.0). The attitudes score showed similar (p > 0.05) results for gender, age, nationality, and curricular year. Moderate level of knowledge was higher (p < 0.001) for DSs (Md = 12.0, IQR 11.0–12.0) than for NMSs (Md = 10.0, IQR 9.0–10.0) students. DSs and NMSs revealed differences in attitude level distribution (p < 0.001). Conclusions: This survey highlighted the need for knowledge on ETW among NMSs, but especially the high need for measures to promote more positive attitudes toward ETW among all university students, DSs, and NMSs. It provided valuable insights into the demographic characteristics, response rate, knowledge, and attitude scores of ETW with the implementation of multicenter designs applied to similar populations being important for future research.