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OBJECTIVES: Interventions during pregnancy and early childhood have been shown to impact dental health. Thus, Antenatal Care and Dental Care collaborated in an intervention called Health Counselling in Dental Care (HCDC). HCDC was offered free of charge to first-time expectant parents and was aimed at reducing the frequency of dental caries in children and their parents. However, the intervention reached less than 50% of the parents. The aim of this study was to explore facilitators of, barriers to, and suggestions for increased participation in HCDC.

METHODS: Data was collected through semi-structured, face-to-face interviews with expectant parents. Participants were purposively sampled based on having been invited to HCDC and to achieve a variation in socio-demographics. Interviews were audio recorded, transcribed verbatim, and analysed using conventional qualitative content analysis.

RESULTS: In total, 16 interviews were conducted (10 women, 6 men). Six categories representing three facilitators and three barriers for participation emerged. The facilitators were the midwife's crucial role for disseminating information about HCDC and motivating participation, that the parents perceived HCDC as valuable for themselves and their offspring, and a desire for new or more knowledge. The barriers included a shortage of information regarding the counselling, a perceived lack of value for the parents and offspring, and the timing of the counselling during pregnancy.

CONCLUSIONS: The midwives were crucial in providing information and motivation for HCDC participation. To increase attendance, sufficient information regarding the benefits of counselling is required, and the timing needs to be flexible and family-centred.

OBJECTIVE: The objective of this randomized controlled prospective clinical trial was to evaluate the short time clinical behaviour of an altered resin modified glass-ionomer cement (RMGIC), which is claimed to possess bioactivity, in posterior restorations and to compare it intraindividually with a nanofilled resin composite.

METHODS: Totally 78 pairs Class II and 4 pairs Class I restorations were placed in 29 female and 38 male participants with a mean age of 58.3 years (range 37-86). Each patient received at random at least one pair of, as similar as possible, Class II or Class I restorations. In the first cavity of each pair, the modified flowable RMGIC (ACTIVA Bioactive; AB) was placed after phosphoric acid etching of the cavity and without adhesive, according to the instructions of the manufacturer. In the other cavity a well established nanofilled resin composite (CeramX; RC) with a single step self-etch adhesive (Xeno Select) was placed. The restorations were evaluated using slightly modified USPHS criteria at baseline, 6 and 12 months. Caries risk and parafunctional habits of the participants were estimated.

RESULTS: 158 restorations, 8 Class I and 150 Class II, were evaluated at the one year recalls. At baseline two failed restorations were observed (2AB), at 6 months six failures (5AB, 1RC) and at 12 months another thirteen failed restorations were observed (12AB, 1RC). This resulted in annual failure rates of 24.1% for the AB and 2.5% for RC (p<0.0001). The main reasons for failure for AB were lost restorations (5), postoperative symptoms (4) and secondary caries (3). Do to the unacceptable very high one-year failure frequency, the clinical study was stopped and no further evaluation will be performed.

SIGNIFICANCE: The use of the AB restorative in Class II cavities, applied as instructed by the manufacturer after a short phosphoric acid pretreatment but without adhesive system, resulted in a non-acceptable very high failure frequency after a one year period. Further studies should be conducted using a bonding agent.

Objectives: Adhesion and marginal adaptation of a claimed bioactive restorative material (ACTIVA BioACTIVE Restorative) to human teeth were compared with those of a resin-modified glass ionomer cement (Fuji II LC) and a control resin composite (Ceram X Mono).

Material and Methods: Shear bond strength and marginal adaptation to enamel and dentine were assessed after no pretreatment of the hard tissues or after etching with phosphoric acid (ACTIVA BioACTIVE Restorative and Ceram X Mono) or polyacrylic acid (Fuji II LC). For ACTIVA BioACTIVE Restorative, the effect of applying a self-etch adhesive (Xeno Select, Dentsply Sirona) was also investigated. Data were analyzed using non-parametric tests (α = 0.05).

Results: Bond strength and marginal adaptation in enamel and dentine were significantly different among the investigated materials (p<.05). Due to loss of restorations, it was not possible to measure bond strength of ACTIVA BioACTIVE Restorative if no pretreatment was performed or if dentine was etched; however, use of the self-etch adhesive resulted in similar bond strength as Ceram X Mono. Etching improved adhesion of Fuji II LC to enamel and dentine. Regarding marginal adaptation, ACTIVA BioACTIVE Restorative showed the highest wall-to-wall contraction to enamel in all pretreatment groups and the overall highest wall-to-wall contraction to dentine after etching. Due to loss of restorations, no marginal assessment was possible on cavities with margins in dentine when no pretreatment was used. The use of a self-etch adhesive with ACTIVA BioACTIVE Restorative resulted in similar adaptation to dentine compared to the other materials.

Conclusion: The self-adhesive property of ACTIVA BioACTIVE Restorative is nonexistent.

Kompositte plastmaterialer og adhæsivteknik har gjort det muligt at restaurere frakturerede fortænder med minimal risiko for pul-pale og parodontale komplikationer hos både børn og voksne. Behandlingen kan udføres umiddelbart efter traumet, hvis skaden ikke involverer parodontium eller knogle. Klasse IV fyldninger har kortere holdbarhed end fuldkeramiske – og metalkeramikkroner. Holdbarheden er blevet forbedret med nyere materialer og adhæ-siver. En plastopbygning af en fraktureret tand er mere konservativ for både tandsubstans, pulpa og det omgivende blødtvæv end en krone. Taget i betragtning, at det kan være nødvendigt at omlægge plastfyldningen 2–3 gange for at have samme holdbarhed som en krone, vil de økonomiske konsekvenser for patienten være de samme for begge behandlinger. Heller ikke kroner holder evigt, de må som følge af caries, fraktur af keramik, manglende retention eller af æstetiske grunde også omlægges eller repareres over tid. Klinikere søger ofte efter et mirakelmateriale, men slutresultatet er oftest forbundet med klinikerens håndelag og viden. Alle trin i den restorative procedure er vigtige for en holdbar og æstetisk restaurering.

Resin composites and adhesive techniques offer a conservative restoration of crown-fractured teeth with a minimal risk of pulpal and periodontal complications in both children and adults. The restoration can be performed immediately after injury if there is no associated periodontal or supporting bone injury. Class IV resin restorations have a shorter longevity than full ceramic and porcelain fused to metal crowns. The durability of restorations with newer materials and bonding systems has improved. A composite build-up of a fractured tooth is more conservative to the hard tooth-structures, the pulp and the surrounding soft tissue than a crown. Considering that the resin composite build up may need replacement 2–3 times in order to equal the durability of a crown, the economic consequences for the patients over time may be the same for both treatments. However, crowns are also replaced or repaired over the years due to caries, fracture of ceramic, lack of retention or for esthetic reasons. Clinicians often look for a miracle material, but the final result is linked to the clinician's manual skills and knowledge. All steps in the direct restorative procedure are mandatory for a lasting and aesthetic restoration.

This randomized study evaluated a flowable resin composite bulk-fill technique in posterior restorations and compared it intraindividually with a conventional 2-mm resin composite layering technique over a 6-yr follow-up period. Thirty-eight pairs of Class II restorations and 15 pairs of Class I restorations were placed in 38 adults. In all cavities a single-step self-etch adhesive (Xeno V) was applied. In the first cavity of each pair, the flowable resin composite (SDR) was placed, in bulk increments of up to 4 mm. The occlusal part was completed with a layer of nanohybrid resin composite (Ceram X mono). In the second cavity of each pair, the hybrid resin composite was placed in 2-mm increments. The restorations were evaluated using slightly modified US Public Health Service (USPHS) criteria at baseline and then annually for a time period of 6 yr. After 6 yr, 72 Class II restorations and 26 Class I restorations could be evaluated. Six failed Class II molar restorations, three in each group, were observed, resulting in a success rate of 93.9% for all restorations and an annual failure rate (AFR) of 1.0% for both groups. The AFR for Class II and Class I restorations in both groups was 1.4% and 0%, respectively. The main reason for failure was resin composite fracture.

OBJECTIVE: The objective of this randomized controlled prospective trial was to evaluate the durability of a low shrinkage and TEGDMA/HEMA-free resin composite system in posterior restorations in a 6-year follow up.

METHODS: 139 Class II restorations were placed in 67 patients with a mean age of 53 years (range 29-82). Each participant received at random two, as similar as possible, Class II restorations. In the first cavity of each pair the TEGDMA/HEMA-free resin composite system was placed with its 3-step etch-and-rinse adhesive (cmf-els). In the second cavity a 1-step HEMA-free self-etch adhesive was used (AdheSe One F). The restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 6 years. Caries risk and parafunctional habits of the participants were estimated.

RESULTS: Three molar teeth showed mild post-operative sensitivity during 3 weeks for temperature changes and occlusal forces. After 6 years, 134 Class II restorations were evaluated. Twenty-one restorations, 8 cmf-els (11.4%) and 13 ASE-els (20%) failed during the 6 years (p<0.0001). The annual failure rates were 1.9% and 3.3%, respectively. The main reasons for failure were fracture followed by recurrent caries. Most fractures and all caries lesions were found in high risk participants.

SIGNIFICANCE: The Class II resin composite restorations performed with the new TEGDMA/HEMA-free low shrinkage resin composite system showed good durability over six years.

Purpose: To evaluate in a randomized clinical evaluation the 3-year clinical durability of a one-step universal adhesive and compare it intraindividually with a 2-step self-etch adhesive in Class II restorations.

Materials and Methods: Each of 57 participants (mean age 58.3 years) received at least two extended Class II restorations that were as similar as possible. The cavities in each of the 60 individual pairs of cavities were randomly distributed to the 1-step universal adhesive (All-Bond Universal: AU) and the control 2-step self-etch adhesive (Optibond XTR: OX). A low shrinkage composite (Aelite LS) was used for all restorations, which were evaluated using slightly modified USPHS criteria at baseline and 1, 2, and 3 years.

Results: 114 Class II restorations were evaluated at three years. Eight restorations, 3 AU and 5 OX, failed during the follow-up, resulting in 94.7% (AU) and 91.2% (OX) success rates (p > 0.05). Annual failure rates were 1.8% and 2.9%, respectively. The main reason for failure was composite fracture.

Conclusion: Class II composite restorations placed with a 1-step universal adhesive showed good short-term efficacy.

Aim of the study was to determine the effect of an alcohol-free chlorhexidine mouth rinse and an essential oils containing mouth rinse on pro-inflammatory cytokine levels in gingival crevicular fluid in participa nts who continue to perform their regula r mechanical oral hygiene regimes and normal dietary practice.

Twenty adult volunteers (mean age: 59 yea rs) participated in the double-blind randomised controlled cross-over study. Three mouth rinses were used during 16-day periods as an adjuncti­ ve to regular mecha nical oral hygiene:a solution with alcohol-free chlorhexidine (CHX; Paroex®), a solution with essentialoils (EO; Listerine®), and water (negative control). The mouth rinse periods were separated by 3-month washout periods.

At days o (baseline) and 17 (end) of each mouth rinse period, gingiva lcrevicular fluid (GCF)

was collected at different tooth sites and analyzed with ELISA technique for IL-1a,IL-115 and IL-ira leveIs.

No significant correlations between clinical parameters (QHI and GI) and cytokine concentra­ tions were observed, regardless of mouth rinse regimen.The generalized linear modeIs revealed that none of the mouth rinses had a statistically significant impact on IL-1 concentrations in GCF. Large inter-individual variations were observed for the levels of IL-1a, IL-115 and IL-1ra. Also the changes in concentrations between day o and day 17 for the mouthrinses showed Iarge intra-individual  variations.

It can  be concluded that  neither the alcohol-free  chlorhexidine  nor the  mouth  rinse contain­ ing essential oils reduced the levels of IL-ia, IL-115 and IL-ira in GCF

OBJECTIVE: To evaluate in a randomized controlled study the 5-year clinical durability of a flowable resin composite bulk-fill technique in Class I and Class II restorations.

MATERIAL AND METHODS: 38 pairs Class I and 62 pairs Class II restorations were placed in 44 male and 42 female (mean age 52.4 years). Each patient received at least two, as similar as possible, extended Class I or Class II restorations. In all cavities, a 1-step self-etch adhesive (Xeno V+) was applied. Randomized, one of the cavities of each pair received the flowable bulk-filled resin composite (SDR), in increments up to 4mm as needed to fill the cavity 2mm short of the occlusal cavosurface. The occlusal part was completed with the nano-hybrid resin composite (Ceram X mono+). In the other cavity, the resin composite-only (Ceram X mono+) was placed in 2mm increments. The restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 5 years. Caries risk and bruxing habits of the participants were estimated.

RESULTS: No post-operative sensitivity was reported. At 5-year 183, 68 Class I and 115 Class II, restorations were evaluated. Ten restorations failed (5.5%), all Class II, 4 SDR-CeramX mono+ and 6 CeramX mono+-only restorations. The main reasons for failure were tooth fracture (6) and secondary caries (4). The annual failure rate (AFR) for all restorations (Class I and II) was for the bulk-filled-1.1% and for the resin composite-only restorations 1.3% (p=0.12). For the Class II restorations, the AFR was 1.4% and 2.1%, respectively.

CONCLUSION: The stress decreasing flowable bulk-fill resin composite technique showed good durability during the 5-year follow-up.

CLINICAL SIGNIFICANCE: The use of a 4mm incremental technique with the flowable bulk-fill resin composite showed during the 5-year follow up slightly better, but not statistical significant, durability compared to the conventional 2mm layering technique in posterior resin composite restorations.