Contemporary operative caries management:consensus recommendations on minimally invasive caries removal

The International Caries Consensus Collaboration (ICCC) presented recommendations on terminology, on carious tissue removal and on managing cavitated carious lesions. It identified 'dental caries' as the name of the disease that dentists should manage, and the importance of controlling the activity of existing cavitated lesions to preserve hard tissues, maintain pulp sensibility and retain functional teeth in the long term. The ICCC recommended the level of hardness (soft, leathery, firm, and hard dentine) as the criterion for determining the clinical consequences of the disease and defined new strategies for carious tissue removal: 1) Selective removal of carious tissue - including selective removal to soft dentine and selective removal to firm dentine; 2) stepwise removal - including stage 1, selective removal to soft dentine, and stage 2, selective removal to firm dentine 6 to 12 months later; and 3) non-selective removal to hard dentine - formerly known as complete caries removal (a traditional approach no longer recommended). Adoption of these terms will facilitate improved understanding and communication among researchers, within dental educators and the wider clinical dentistry community. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal or control first. Only when cavitated carious dentine lesions are either non-cleansable or can no longer be sealed, are restorative interventions indicated. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralised tissues close to the pulp do not need to be removed. The evidence and, therefore these recommendations, supports minimally invasive carious lesion management, delaying entry to, and slowing down, the destructive restorative cycle by preserving tooth tissue, maintaining pulp sensibility and retaining the functional tooth-restoration complex long-term

Fiber-reinforced dental composites in beam testing

OBJECTIVES: The purpose of this study was to systematically review current literature on in vitro tests of fiber-reinforced composite (FRC) beams, with regard to studies that followed criteria described in an International Standard. The reported reinforcing effects of various fibers on the flexural strength and elastic modulus of composite resin beams were analyzed. SOURCES: Original, peer reviewed papers, selected using Medline from 1950 to 2007, on in vitro testing of FRC beams in comparison to non-reinforced composite beams. Also information from conference abstracts (IADR) was included. DATA: With the keywords (fiber or fibre) and (resin or composite) and (fixed partial denture or FPD), the literature search revealed 1427 titles. Using this strategy a broad view of the clinical and non-clinical literature on fiber-reinforced FPDs was obtained. Restricting to three-point bending tests, 7 articles and 1 abstract (out of 126) were included. Finally, the data of 363 composite beams were analyzed. The differences in mean flexural strength and/or modulus between reinforced and unreinforced beams were set out in a forest plot. Meta-regression analyses were performed (single and multiple regression models). CONCLUSIONS: Under specific conditions we have been able to show that fibers do reinforce resin composite beams. The flexural modulus not always seems to increase with polyethylene-reinforcement, even when fibers are located at the tensile side. Besides, fiber architecture (woven vs. unidirectional) seems to be more important than the type of fiber for flexural strength and flexural modulus

Conservative interproximal box-only polyacid modified composite restorations in primary molars, twelve-month clinical results.

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Three-dimensional video analysis of forearm rotation before and after combined pronator teres rerouting and flexor carpi ulnaris tendon transfer surgery in patients with cerebral palsy.

The effect of combined pronator teres rerouting and flexor carpi ulnaris transfer on forearm rotation was prospectively studied by comparison of pre- and postoperative three-dimensional analysis of forearm range of motion in ten patients with cerebral palsy. One year postoperatively, surgery had improved maximal supination of the forearm in all patients by an average of 63 degrees, but there was also a mean loss of 40 degrees pronation. Forearm range of motion increased by a mean of 23 degrees. The centre of the range of motion on average shifted 52 degrees in the direction of supination. Based on these results of objective forearm range of motion analysis, we conclude that the common combination of pronator teres rerouting and flexor carpi ulnaris transfer in patients with cerebral palsy effectively facilitates active supination but impairs active pronation