The “Pre-Finishing” Approach in Direct Anterior Restorations. A Case Series

n esthetic restorations of anterior teeth the clinician has to manage several aspects in order to have a predictable outcome. A deep knowledge of the anatomy as well as the adhesive procedures and the optical properties of resin-based composites are mandatory to achieve esthetic results. Contemporary restorative materials present either several shades and different translucency properties and therefore they are able to mimic teeth’s optical behavior thus providing a natural aspect to anterior restorations. The wrong thickness of different composite layers may provide unpleasant results such as low value (grayish) restorations that often requires reintervention. A precise step-by-step procedure is therefore mandatory to provide the proper shade at the correct place. There is therefore the need of some corrections and adjustments during the layer procedure in order to avoid errors in shade positioning that could affect final result. The authors present a case series (six clinical cases) treated with the proposed technique with up to five years follow-up

Color Stability of Resin Cements after Water Aging

The color stability of resin cements plays a key role in the achievement of esthetically-pleasant restorations. Resin luting materials can be mainly divided into two main classes: adhesive (relying on previous application of adhesive systems) or self-adhesive (also known as one-step cements). The different chemical compositions determine their physio-mechanical characteristics which, in turns, influence their color stability. To evaluate the color variations of different dual-cured resin cements after water aging, 80 disc-shaped specimens (15 mm in diameter and 1.2 mm thick) were obtained from the following resin cements (n = 10): (1) Maxcem Elite Universal, MCU (Kerr); (2) RelyX Universal, RXU (3M); (3) Calibra Ceram, CAL (Dentsply); (4) Multilink, MUL (Ivoclar-Vivadent); (5) Panavia V5, PAN (Kuraray); (6) Calibra Universal, CUN (Dentsply); (7) SpeedCEM Plus, SCP (Ivoclar); and (8) Panavia SA, PSA (Kuraray). After light-polymerization, the specimens were measured with a spectrophotometer and CIELab* values were recorded. The specimens were then placed in a digitally controlled thermostatic water bath at 60° for 30 days and afterwards the color measurements were repeated. Color differences were calculated for each specimen before and after water-aging procedures with ΔEab formula and the data were statistically analyzed (p < 0.05). The type of cement statistically influenced the ΔEab (p < 0.05), with MCU showing the lowest color variations (4.3 ± 0.7) whereas RXU and PSA the highest (16.9 ± 1.6 and 16.8 ± 1.2, respectively). No differences were observed between CAL, CUN and SCP (p = 0.05). Color stability is related to the chemical composition of the resinous luting materials, thus material dependent

Effect of Different Artificial Staining Procedures on the Color Stability and Translucency of a Nano-Hybrid Resin-Based Composite

Background: To evaluate the effect of different experimental staining procedures on color stability and translucency of a nano-hybrid resin-based composite (RBC). Methods: Forty-eight cylindrical-shaped specimens (10 x 2 mm) were prepared with a nano-hybrid RBC (Clearfil Majesty ES-2) and randomly divided in four groups according to the experimental staining procedure: G1) static immersion in a staining solution (coffee) (44 +/- 1 degrees C); G2) staining cycling between coffee (44 +/- 1 degrees C) and distilled water (37 +/- 1 degrees C) with an experimental staining machine based on Arduino, an Open Source hardware development platform; G3) staining cycles as in G2 + brushing with a low abrasive toothpaste (Relative Dentin Abrasion RDA = 30) (Elmex Sensitive Professional); G4) staining cycles as in G3, with brushing performed with a very strong abrasive toothpaste (RDA = 90) (Lacult Active). Color parameters were recorded at the baseline (T0) after staining procedures (T1) and repolishing (T2) using a spectrophotometer. Color change ( increment E00) and translucency (TP, CR) were evaluated. Data were statistically analyzed (p < 0.05). Results: For increment E00 after staining, Group 1 showed the highest color change and Group 3 the lowest. All groups were significantly different (p < 0.001) except for Group 2 vs. Group 4; after repolishing, Group 1 was significantly higher than Group 3 (p < 0.001), Group 2 (p < 0.001), and Group 4 (p = 0.003); Group 2 was higher than Group 3 (p < 0.001). For TP variable, after staining procedures, Group 2 was significantly higher than all other groups (p < 0.001), and Group 1 was significantly higher than Group 3 (p < 0.001) and Group 4 (p = 0.007). After repolishing, Group 4 was significantly lower than Group 3 (p = 0.008) and Group 2 (p = 0.027). Repolishing procedure significantly reduced color parameters. Conclusions: The investigated staining procedure induced significant differences in color stability and translucency. The use of a very strong abrasive toothpaste (RDA = 90) induced higher color change than a low abrasive one (RDA = 30). Repolishing procedures are able to partially reduce color change induced by artificial staining procedures

Synchronized Phasors Monitoring During the Islanding Maneuver of an Active Distribution Network

The paper describes the performances of a phasor measurement unit (PMU) prototype based on a synchrophasor estimation algorithm conceived for the monitoring of active distribution networks, as well as its experimental application during some intentional islanding and reconnection tests of an urban medium voltage power network. With respect to typical applications in transmission networks, the use of PMUs in distribution networks requires very low values of total vector error (TVE), which involves particular low values of phase errors of the synchrophasor estimates. These requirements are met by a specifically developed PMU, the characteristics and experimental characterization of which are illustrated in the paper. Three of these PMUs have been then used to monitor experimental tests carried out to assess the capability of a urban distribution network to operate autonomously when fed by a local 80 MW combined-cycle power plant. The information provided by the installed PMUs significantly facilitate the operator maneuvers and appear to be useful for the development of an improved control and management system of the active distribution network

Color Stability of Polymer-Based Composite CAD/CAM Blocks: A Systematic Review

Background: This systematic review aims to evaluate the color stability of resin composite CAD/CAM blocks (CCB) when submitted to staining solutions. Methods: A systematic search was performed on different databases (Embase, Medline, Scopus, Web of Science). Search terms were: ‘polymer infiltrated’, ‘polymer-based’, ‘resin nanoceramic’, ‘resin ceramic’, ‘hybrid composite’, ‘hybrid ceramic’, ‘composite ceramic’, ‘resin infiltrated’, ‘CAD-CAM’, ‘CAD/CAM’, ‘color stability’, ‘staining’, ‘staining susceptibility’, ‘color change’, ‘color difference’. Inclusion criteria: in vitro articles published in the English language until 18 September 2022 without initial time restriction evaluating the color stability of CCB when submitted to staining solutions. Exclusion criteria: studies investigating color change induced by smoke or whitening treatments; studies not including a clinical evaluation of the results using the thresholds for color perceptibility and acceptability. Risk of bias assessment using the QUIN tool. Findings: Out of the 378 initially retrieved articles, 19 were included in this review. They investigated 17 different CCBs and different artificial staining by liquid protocols, including coffee, red wine, tea, and cola. CCBs exceeded clinical acceptability thresholds for color shift in 18 out of 19 studies, with a significantly higher color stability than conventional hybrid resin-based composites (RBCs), and a significantly lower color stability than ceramic materials. The identified differences in CCBs in color stability can be attributed to the material’s composition, but also to the heterogeneity of staining procedures. Interpretation and clinical implication: Clinicians should be aware that, although to a lower degree when compared to RBCs used in direct or indirect procedures, CCBs undergo color changes to a higher degree in comparison to ceramic materials

Color stability of bulk-fill compared to conventional resin-based composites. A scoping review

To identify the types of available evidence in literature on color stability of BF in comparison with conventional RBCs submitted to artificial staining by colored beverag

Restauri diretti in composito: Le potenzialità di un sistema composito universale

L'evoluzione dei moderni sistemi in resina composita ha con­ sentito ai clinici di ottenere risultati sempre più performanti dal punto di vista estetico e funzionale. L'introduzione di particelle di riempitivo di diverse dimensioni ha migliorato, infatti, le prestazioni permettendo di combinare risultati estetici ottimali ed elevate caratteristiche biomecca­ niche del materiale composito e del complesso dente-restauro adesivo. Anche dal punto di vista ottico sono stati compiuti importanti progressi. Si è partiti da compositi opachi in un'unica tonalità di colore e si è arrivati, oggi, alla disponibilità di diverse colo­ razioni, opacità e traslucenze in grado di riprodurre la quasi totalità delle situazioni cliniche. L a possibilità di utilizzare un sistema composito universale permette, infatti, di affrontare praticamente tutti i quadri clinici che richiedano un trattamento adesivo diretto. Per sistema composito universale s'intende un sistema che com­ prenda: � diverse tinte (quindi diverse colorazioni, eventualmente re­ lative alla scala VITA: A, B, Ce D); � diversi cromi delle stesse tinte (quindi diversi gradi di sa- turazione, per esempio Al-A4); � masse opache; � masse altamente traslucenti; � masse smalto con diversa colorazione e diverso valore (lu- minosità). La possibilità di operare scelte di poche masse all'interno di un sistema composito completo consentirà pertanto di risol­ vere in maniera predicibile varie situazioni cliniche sia nei set­ tori anteriori sia nei settori posteriori