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This review aims to comprehensively explore calcium-enriched mixture (CEM) cement as a crucial biomaterial in dentistry/endodontics. With its growing clinical relevance, there is a need to evaluate its composition, chemical/physical/biological properties, clinical applications, and future perspectives to provide clinicians/researchers with a detailed understanding of its potential in endodontic procedures. Through systematic analysis of available evidence, we assess the advantages/limitations of CEM cement, offering valuable insights for informed decision-making in dental/endodontic practice. Our findings highlight the commendable chemical/physical properties of CEM cement, including handling characteristics, alkalinity, color stability, bioactivity, biocompatibility, sealing ability, and antimicrobial properties. Importantly, CEM cement has shown the potential in promoting regenerative processes, such as dentinogenesis and cementogenesis. It has demonstrated successful outcomes in various clinical applications, including vital pulp therapy techniques, endodontic surgery, open apices management, root resorption/perforation repair, and as an orifice/root canal obturation material. The efficacy and reliability of CEM cement in diverse clinical scenarios underscore its effectiveness in endodontic practice. However, we emphasize the need for well-designed clinical trials with long-term follow-up to further substantiate the full potential of CEM cement. This review serves as a robust reference for researchers/practitioners, offering an in-depth exploration of CEM cement and its multifaceted roles in contemporary dentistry/endodontics.

ObjectivesTo perform a review on the influence of preheating and/or heating of resinous and ionomeric materials on their physical and mechanical properties and to discuss the benefits and methods of preheating/heating that have been used.Material and methodsA search was performed in the Pubmed, Scopus, Scielo, and gray literature databases. In vitro studies published from 1980 until now were searched using the descriptors “composite resins OR glass ionomer cements OR resin cements OR adhesives AND heating OR preheating.” Data extraction and quality of work evaluation were performed by two independent evaluators.ResultsAt the end of reading the search titles and abstracts, 74 articles were selected. Preheating of composite resins reduces viscosity, facilitates adaptation to cavity preparation walls, increases the degree of conversion, and decreases the polymerization shrinkage. Preheating of resin cements improves strength, adhesion, and degree of conversion. Dental adhesives showed good results such as higher bond strength to dentin. However, unlike resinous materials, ionomeric materials have an increase in viscosity upon heating.ConclusionsPreheating improves the mechanical and physical properties. However, there is a lack of clinical studies to confirm the advantages of preheating technique.Clinical relevancePreheating of dental restorative materials is a simple, safe, and successful technique. In order to achieve good results, agility and training are necessary so the material would not lose heat until the restorative procedure. Also, care is necessary to avoid bubbles and formation of gaps, which compromises the best restoration performance.

Objectives To evaluate three temporary luting cements in terms of their restoration loss rates, biological interactions, esthetic properties, and handling characteristics. Materials and methods 75 adults requiring fixed prosthodontics voluntarily participated in a single-blind, randomized controlled trial. After preparation, temporary restorations were luted with a randomly selected temporary luting cement (either Provicol QM Plus (PQP), Bifix Temp (BT), or Provicol QM Aesthetic (PQA)). Clinical examinations were performed one to two weeks after cementation. The following criteria were evaluated: tooth vitality, percussion, hypersensitivity, gingival bleeding, odor formation, esthetics, cement handling, removability, cleanability, and retention loss. Antagonistic teeth served as controls. Statistical analysis was performed using the paired t-test, one-way ANOVA, Pearson’s chi-square and Fisher’s exact test, where appropriate. Results The overall loss rate of temporary restorations was 16.0%, showing no cement-specific differences. Postoperative hypersensitivity occurred in 8% of cases regardless of cement type. Esthetic impairment was reported by 31% of the PQP-fixed restorations, compared with 4.0% and 4.2% of the BT and PQA-bonded restorations. Cement application was reported to be easy in 100% of cases, excess removal in 88–96%, depending on the cement used. Conclusions The choice of luting material affects the esthetic appearance of a temporary restoration and should be considered, particularly in restorations in esthetically demanding areas. No significant differences between the cements were identified regarding biocompatibility, handling, and loss rate. Clinical relevance Translucent cements can help to reduce color interferences, resulting in a more appealing appearance of the temporary restoration.

Background The color stability and translucency of dental restorations are influenced by several factors, including the type of cement used, the chemical composition of the materials, and their thickness. This study aims to assess the color stability and translucency of various adhesive systems and CAD/CAM materials after exposure to UV aging. Methods A total of 140 specimens were prepared using five different CAD/CAM materials: CEREC (CE), Cerasmart (CS), Vita Enamic (VE), Lava Ultimate (LU), and Grandio (GR), with thicknesses of 0.5 mm and 1 mm. The specimens were randomly divided into two cementation techniques: Dual Cure (DC) and Light Cure (LC). The relative translucency parameter (RTP) was measured initially and after UV aging using the RTP 00 formula, and (∆RTP) was calculated. The specimens’ color change (∆E 00 ) was determined using the CIEDE2000 formula. Statistical analysis was conducted using Three-Way ANOVA with a significance level of 0.05. Result CE exhibited the least color change (∆E 00 ), while LU displayed the highest ∆E 00 across all parameters. There was no significant difference between the DC and LC cementation techniques, except for CS, CE, and VE at a thickness of 0.5 mm, and for CS and CE at 1 mm. Most color changes observed in the groups, were out of clinically acceptable ranges, except for the CE group with a thickness of 1 mm and DC cementation technique. The lowest ∆RTP was noted in specimens with a thickness of 1 mm and DC cementation across all groups. Conclusion The material structure had the most significant impact on ∆E 00 , while thickness significantly affected the ∆RTP. The cementation technique had the least influence on ∆E 00 and no effect on ∆RTP. New-generation cement materials, whether Light Cure or Dual Cure, showed similar effects on ∆RTP ( p  < 0.05). Clinical trial number None.

A dental luting material aids in the retention and stability of indirect restorations on the prepared tooth structure. In dentistry, clinicians are using a wide range of luting materials for the cementation of indirect restorations. Zinc oxide eugenol and non-eugenol cements, zinc phosphate cement, zinc polycarboxylate cement, glass ionomer cement and resin cements are common dental cements used in dentistry. Each luting material or cement possesses unique properties and clinical implications. An ideal luting cement should be biocompatible, insoluble, resistant to thermal and chemical assaults, antibacterial, aesthetic, simple and easy to use. It should have high strength properties under tension, shear and compression to resist stress at the restoration–tooth interface, as well as adequate working and setting times. So far, no luting material possesses all of these properties of an ideal cement. Scientists have been modifying the conventional luting cements to improve the material’s clinical performance and developing novel materials for clinical use. To achieve the best clinical outcome, clinicians should update their knowledge and gain a good understanding of the luting materials so that they can make a wise clinical decision on the material selection and obtain an insight into the development of luting cements. Therefore, the objective of this study is to provide a discussion on the physical, chemical, adhesive and aesthetic properties of common luting materials. The clinical indications of these luting materials are suggested based on their properties. In addition, overviews of the modification of the conventional luting materials and the newly developed luting materials are provided.

Background Different crown types are used for the full-coverage restoration of primary teeth with extensive caries. Bioflx crowns are hybrid polymer-resin crowns designed to combine the benefits of Stainless Steel and Zirconia. The longevity and clinical efficacy of dental restorations are significantly affected by crown retention. We aim to assess the retention of Bioflx, Zirconia, and Stainless Steel crowns using two different luting materials. Methods Fifty-four ( n  = 54) freshly extracted mandibular second primary molars were divided into three main groups ( n  = 18): Bioflx crowns, Zirconia crowns, and Stainless Steel crowns (SSCs). Each group was further subdivided into two subgroups ( n  = 9), using either Conventional Glass Ionomer luting cement (GIC) or Resin Modified Glass Ionomer luting cement (RMGIC). A retention test was performed to determine the retentive force required for crown removal after the samples underwent 2,000 cycles of thermocycling. A stereo light microscope was used to examine the debonding failure. Data were analysed using two-way analysis of variance (ANOVA) and Pearson’s chi-square test. Results Stainless Steel crowns exhibited the highest retention in both subgroups (GIC = 307.44 ± 53.58 N, RMGIC = 324.11 ± 52.04 N). Bioflx crowns outperformed Zirconia crowns (Bioflx: GIC = 138.11 ± 30.87 N, RMGIC = 218.11 ± 34.61 N; Zirconia: GIC = 35.50 ± 5.14 N, RMGIC = 131.78 ± 11.91 N). All differences between the GIC and RMGIC subgroups were significant ( p  < 0.001), except for Stainless Steel crowns ( p  = 0.5). RMGIC had greater retention values than GIC in all groups, and the difference was significant ( p  < 0.001), except for the SCCs group ( p  = 0.5). Conclusions Stainless Steel crowns showed the highest retention across all tested luting cements, followed by Bioflx crowns, which exhibited superior retention compared with Zirconia crowns. RMGIC showed superior retention compared with GIC.

ObjectivesFor a conventional indirect restoration, temporary cementation inevitably contaminated collapsed dentin collagen. The purpose of this review was to evaluate the optimal strategy for minimizing its negative effects.Material and methodsDatabases such as PubMed, Web of Science, EMBASE, and the Cochrane Library were searched for in vitro studies, involving the influence of immediate dentin sealing (IDS), different temporary cements, and their removal strategies on dentin bond strength. The meta-analysis used the inverse variance method with effect method of the standardized mean difference and statistical significance at p ≤ 0.05. The I2 value and the Q-test were used to assess the heterogeneity.ResultsA total of 14 in vitro trials were subjected to the meta-analysis. Within the study’s limitations, we assumed that IDS eliminated the negative effects of temporary bonding, achieving the comparable immediate bond strength with the control (p = 0.46). In contrast, under delayed dentin sealing (DDS), temporary cementation statistically decreased bond strength (p = 0.002). Compared with resin-based and non-eugenol zinc oxide cements, polycarboxylate and calcium hydroxide cements performed better on bond strength with no statistical difference from the control group (p > 0.05). Among the removal methods of temporary cements, the Al2O3 abrasion restored the decreased bond strength (p = 0.07) and performed better than hand instruments alone (p = 0.04), while pumice removal slightly reduced the bond strength in contrast with the control group (p = 0.05, 95% CI =  − 1.62 to 0).ConclusionsThe choices of IDS, polycarboxylate and calcium hydroxide temporary cements, Al2O3 abrasion removal method were feasible and efficient to enhance the bond strength.Clinical relevanceIt is worthwhile applying IDS technique, polycarboxylate and calcium hydroxide temporary cements during indirect restoration. The Al2O3 abrasion of cleaning dentin can minimize the negative effects of temporary cement.

Background This study aimed to evaluate the effect of virtual cement space and restorative materials on the fit of computer-aided design and computer-aided manufacturing (CAD-CAM) endocrowns. Methods A mandibular first molar tooth model received a butt joint margin endocrown preparation with a 2-mm occlusal thickness. Then, using a 3D-printing system, 120 copies of this prepared die were printed and assigned equally to three groups with different cement space settings (30, 60, and 120 μm) during the chairside CAD design. In the milling process, CAD-based models with a particular space setting were subdivided into four groups (n = 10) and fabricated from different CAD-CAM materials: Vita Suprinity (VS), Celtra Duo (CD), Lava Ultimate (LU), and Grandio blocs (GR). Finally, the endocrowns were stabilized over their corresponding models with siloxane and subjected to micro-computed tomography to measure the fit. Results The cement space that was predesigned at 30 μm generated the largest marginal discrepancy (from 144.68 ± 22.43 μm to 174.36 ± 22.78 μm), which was significantly different from those at 60 μm and 120 μm ( p  < 0.001). The combination of VS or CD with a pre-setting cement space of 60 μm and the combination of LU or GR with a cement space of 120 μm showed better agreement between the predesigned and actual measured marginal gap widths. For internal adaptation, only the cement space set to 30 μm exceeded the clinically acceptable threshold (200 μm). Conclusions The setting of the cement space and restorative material significantly affected the marginal adaptation of CAD-CAM endocrown restorations. Considering the discrepancy between design and reality, different virtual cement spaces should be applied to ceramic and resin composite materials.

Background The objective of this study was to examine the impact of various types of cements on primary molar tooth restored with a Bioflx crown. Methods Three distinct finite element models were developed to represent three different cements; (1) conventional glass ionomer cement (GIC) (approximately 17 μm thick), (2) self-curing resin-modified GIC (RMGIC) (approximately 10 μm thick), and (3) self-cure resin cement (RC) (approximately 30 μm thick), all supporting/securing the Bioflx crown (approximately 330 microns thick). The geometry of the lower second primary molar was captured by laser scanning and then processed to create a solid model. This model was then imported into finite element software to assign materials, create a mesh, and evaluate stress and deformation under average normal occlusal loads. An applied load of 330 N was evaluated at three angles: vertical, oblique at 45°, and lateral. Results The results indicated that model #2 (self-curing resin-modified GIC) exhibited the greatest deformation across all model components under the three loading conditions. The results for conventional GIC cement were comparable to those of self-cure resin cement. The resin-modified self-curing GIC (model #2) demonstrated high stress levels under lateral and oblique loads. Additionally, elevated stress concentrations were observed in the cortical bone region. Conclusions A cement type with a higher modulus of elasticity may be preferred over other types, in addition to the potential for use with a thinner thickness. Therefore, conventional GIC demonstrated the best performance among the cements evaluated in this study. This was followed by self-cure resin cement, while self-curing resin-modified GIC might be excluded due to expectation of failure.

Background This in vitro study compared the physical characteristics and drug release patterns of a bioactive cement containing with 0.1 μM Simvastatin (SimCeram) with mineral trioxide aggregate (MTA; Angelus, Brazil). Methods SimCeram, a calcium silicate-based cement was prepared with the powder composition of 25 wt% silicon-doped hydroxyapatite, 25 wt% strontium-doped hydroxyapatite, and 50 wt% tricalcium silicate/dicalcium silicate. SimCeram liquid contained 0.1 μM dissolved in distilled water. After preparing SimCeram and MTA, the initial setting time of cements was determined with a Gillmore needle. Compressive strength was measured at 1 h, 1 day, and 1 week using a Universal Testing Machine. Cement solubility was assessed according to ISO 6876 after one day, two, and four weeks. Calcium ion release was measured with an ICP-AES device, and simvastatin release was also examined using a UV-spectrophotometer at 238 nm. Results MTA setting time was significantly shorter (12.33 ± 0.57 min) compared to SimCeram (36.33 ± 1.15 min; P  < 0.001). MTA exhibited significantly higher compressive strength than SimCeram after 1 h and 1 day ( P  < 0.05). However, after 1 week, the compressive strength of SimCeram (10.82 ± 1.93 MPa) surpassed that of MTA (6.79 ± 3.24 MPa; P  = 0.009). SimCeram showed greater calcium ion release and solubility throughout all time points tested compared to MTA ( P  < 0.05). Simvastatin release demonstrated an initial burst after 1 h and reached a plateau after 24 h. Conclusion SimCeram showed higher compressive strength and calcium release compared to MTA. Given simvastatin's beneficial properties—such as anti-inflammatory effects, angiogenesis promotion, and the ability to induce differentiation of dental pulp stem cells—along with the significant calcium ion release from the calcium silicate-based component of the cement, SimCeram could be a promising material for vital pulp therapy.