Journal of Dental Medicine

Background and Aims: Endocrown is a type of monoblock restoration using the pulp chamber and remaining coronal tooth structure for retention. Advancements in adhesive techniques have breathed fresh spirit into endocrown. Nowadays, there are two approaches for endocrown: conventional approach and  biomimetic approach. This study aimed to review data on the steps and clinical and philosophical points of using these approaches to help dentists’ selection and performance.
Materials and Methods: The review was conducted by reviewing the articles available in PubMed, Scopus, and Google Scholar databases from 1995 to 2022. The keywords used were; Crown, Endodontically-treated teeth, Light-curing of dental adhesive, Onlay, and Post-Core.  
Results: After removing duplicates, titles/abstracts were reviewed. Animal studies, studies without available full text or non-English language studies were excluded from the study. Then, the full texts of the remaining 59 articles were evaluated and 49 articles were eligible for the present study. The articles included clinical trials, in vitro, systematic reviews, and case reports.
Conclusion: Endocrown is a successful alternative to crown, especially in molar teeth. Regardless of the conventional or biomimetic approach, this treatment has a more favorable fracture pattern while preserving the remaining tooth tissue as much as possible.

Background and Aims: The bond strength of direct composite restoration to the caries affected dentin is a challenging issue. Preparation of dentin with an antibacterial agent is a method for creating durable bonded restorations. The aim of this study was to investigate the effect of curcumin photosensitizer on the bond strength of a universal adhesive to the caries-affected dentin (CAD).
Materials and Methods: In this experimental in vitro study, forty-four decayed human molar teeth were selected. After removing the surface enamel and dentin by a water-cooled saw, the decayed mid-coronal dentin was stained with a caries detection solution. The green and soft infected dentin was removed and CAD and hard and healthy surrounding dentin were left. Then, the remaining dentin surfaces were treated by 600 grit silicon carbide papers and polished. The specimens were divided into two groups (n=22): dentin pretreatment group by curcumin and control with no dentin pretreatment group by curcumin.  Each group was divided into two subgroups based on the method of application of All-Bond Universal adhesive (Bisco, USA) (etch and rinseand self-etching methods). After placing the Aelite All Purpose Body (Bisco, USA) composite, all  specimens  were placed in a universal testing machine for microshear bond strength (µSBS) test. The failure mode of the isolated surfaces was evaluated under a stereomicroscope. Two-way ANOVA analysis was used for statistical analysis.
Results: Based on the obtained results, intervention with the adhesive application method and surface pretreatment with curcumin had no significant effect on the bond strength. Also, there was no significant difference in the bond strength of the curcumin group in both etch and rinse and self-etching methods (SE=56.3±27.11 MPa; ER=52.4±84.11 MPa) (P=0.847). In the curcumin-free group, there was no significant difference between the two different adhesive application methods (P=0.187).
Conclusion: The results obtained in the present study showed that the pretreatment of dentin affected by caries with light-sensitive curcumin and also use of a universal adhesive by either self-etching or self-etchinf methodshad no influence on the microshear bond strength of the composite restoration.

Background and Aims: The development and regular use of adhesive systems has started to revolutionize many aspects of restorative and preventive dentistry. The success of adhesive restorations highly depends on correct application of them. Therefore, the present study was conducted with the aim of determining the knowledge of dentists in Rafsanjan city (Iran) in choosing correct dental adhesive systems in 2023.
Materials and Methods: In this cross-sectional descriptive study, all dentists working in Rafsanjan city were included. The data was collected by a valid and reliable electronic questionnaire, which included two parts of demographic information (gender, age, place of work and year of graduation) and the 12 multiple-choice questions aimed to assess respondents' knowledge regarding the selection of dental adhesive materials in combination with self-cure or dual-cure composites, anterior and posterior composite restorations, fiber posts, fissure sealants, primary teeth, anterior composite veneers, ceramic laminates, and non-carious cervical lesions. The scoring of this questionnaire was as follows: 0 to 3 correct answers = Low level of knowledge; 4 to 6 correct answers = Moderate level of knowledge; 7 to 9 correct answers = Good level of knowledge; 10 to 12 correct answers = Very good level of knowledge.  The four answer choices included "etch-and-rinse (three-step)", "etch-and-rinse (two-step)", "self-etch (two-step)", and "self-etch (all-in-one bottle)". Then data were analyzed by parametric tests (ANOVA, t-test, and Pearson). The significant level was considered as P<0.05.
Results: Out of 91 dentists in Rafsanjan, 79 (86.8%) participated in the study, of which 35 (46.3%) were men. The average work experience was 3.49±3.96 years for men and 2.98±3.73 years for women. The average knowledge score was 4.38±2.16 out of 12 (4.29±2.23 in men and 4.45±2.12 in women). The results showed that there was no significant relationship between the knowledge score and the gender, age, work experience, and workplace (P>0.05).
Conclusion: According to the results which indicated the insufficient knowledge of dentists in  choosing correct dental adhesive systems, it is suggested to pay more attention on teaching in this field at the dental schools. For graduate dentists, new and practical information about the choice of adhesive systems should be provided by continuous education programs.

Background and Aims: Repairing existing composite restorations, rather than replacing them entirely, is regarded as a conservative and tissue-preserving approach in restorative dentistry. However, achieving a durable bond between the aged and newly applied composite resin remains a significant clinical challenge. This study aimed to compare the shear bond strength of repaired composite restorations using three different adhesive systems.
Materials and Methods: In this in vitro study, which conducted at the Faculty of Dentistry, Urmia University of Medical Sciences, 60 disk-shaped composite specimens were fabricated with standard dimensions. After undergoing artificial aging (storage in distilled water for 6 months), their surfaces were roughened mechanically using a diamond bur. The specimens were randomly divided into three groups (n=20) and repaired using fifth-generation (Adper Single Bond), seventh-generation (OptiBond All-In-One), and universal (Single Bond Universal) adhesives, followed by the application of new composite. All  specimens were subjected to thermocycling, and the shear bond strength was measured using a universal testing machine. Fracture patterns of the samples were also examined using a stereomicroscope to determine the modes of failure. Data were analyzed using one-way ANOVA and Chi-square tests in SPSS at a significance level of 0.05.
Results: The mean shear bond strengths were 15.22 ± 4.47 MPa for Adper Single Bond, 14.05 ± 4.66 MPa for OptiBond All-In-One, and 13.44 ± 4.68 MPa for Single Bond Universal. No statistically significant differences were found among the groups (P=0.468). Fracture pattern distribution was also not significantly different (P=0.453), with predominantly cohesive or mixed failures observed across all groups. No adhesive failures were observed.
Conclusion: Under standardized surface preparation, none of the tested adhesive systems demonstrated a statistically significant advantage in the shear bond strength between the aged and new composite. Therefore, the choice of adhesive in composite repair procedures can be guided by practical considerations such as product availability, ease of application, and dentist preference.