SUMMARY Objectives: The aim of this study was to assess four post-retained restorative strategies for endodontically treated teeth using cost-minimization analysis. Methods and Materials: The cost-minimization analysis was based on primary data from a randomized clinical trial and followed the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. Two hundred twenty-five teeth (141 patients) restored using four strategies—teeth with ferrules+ restored with either glass fiber posts or direct composite or crowns, and teeth without ferrules- restored with either glass fiber or cast metal posts with crowns—were evaluated annually between 2009 and 2018. Initial costs and incremental costs per year were calculated. Survival curves were created using the Kaplan-Meier method and log-rank test. Kruskal-Wallis analysis was followed by Dunn's test, which was used to compare restorative treatments, with a significance level of 5%. Results: Initial costs were greater for cast metal posts without crowns (US$153.14). Glass fiber posts with composite (US$27.11) were least costly; the most failures occurred in this group, but they were primarily repairable restoration fractures. The number of extractions, and thus cost, was greater for glass fiber posts with crowns. The mean annual cost was significantly lower for teeth restored with composite ( p <0.001). Ferrule presence did not significantly impact annual costs. Conclusions: The use of glass fiber posts and direct composite incurred significantly lower annual costs than did other alternatives involving crowns or metal posts.

SUMMARY This article describes an indirect composite restoration technique for diastema closure and tooth lengthening with a noninvasive approach using regularly available materials such as silicone, composite resin, and an adhesive system. The procedure resulted in occlusal and functional improvement, with diastema closure, protrusive guide adjustment, and an increase in central incisor length. The procedure provided an adequate proportion of the central incisors with an esthetically natural appearance. It also resulted in simple, fast, and accurate manufacturing with a noninvasive esthetic indirect rehabilitation compared with more invasive preparation of ceramic veneers.

SUMMARY Objectives: The aim of this prospective randomized multicenter clinical trial was to evaluate the survival rate of glass fiber–reinforced posts cemented with self-adhesive or regular resin cements. Methods: The sample was comprised of 152 teeth randomized within two centers and in accordance with the adhesive strategies for RelyX U100/U200 (3M ESPE) or Single Bond and RelyX ARC (3M ESPE). The cementation procedures were standardized and performed by previously trained operators. The primary outcome evaluated was post debonding. A trained evaluator, one for each center, assessed all subjects at intervals of 12 months for up to 6 years. Statistical analysis was performed using the Kaplan-Meier method. Results: There was no statistically significant difference in survival rates between the two strategies assessed ( p =0.991), with a 92.7% survival rate for the self-adhesive cement and 93.8% for the regular cement. Conclusion: Both the self-adhesive and the regular resin cements are good alternatives for glass fiber post cementation.

SUMMARY The role of silanes in the bonding of resin luting agents to glass-fiber posts (GFPs) is a controversial topic, and the question still remains whether post silanization is able to improve the retention of GFPs luted into root canals. Thus, this study was designed to determine whether evidence exists to justify silanization of GFPs before cementation to increase their retention into root canals. In vitro studies that evaluated the retention of GFPs cemented into root canals or artificial substrates and that used silane coupling agents for pretreatment of the post were selected. Searches were carried out in PubMed and Scopus databases with no publication year or language limits. The last search was carried out in August 2014. Two distinct data analyses were carried out: 1) control group (no post pretreatment) vs silane only and 2) post pretreatment + silane vs silane only. Pooled-effect estimates were obtained by comparing the difference between each bond strength mean value and were expressed as the weighted mean difference between groups ( p ≤0.05). A total of 178 articles were found, and 23 were included in the review. The results were affected by the substrate into which the GFPs were luted (teeth or artificial devices). The analysis between control group and silane only for studies that used artificial devices favored the use of silane ( p <0.0001), but considering studies that used teeth as substrate, no significant difference was observed ( p =0.35). The analysis between silane only and pretreatment + silane did not show a significant difference between groups when artificial devices were used ( p =0.71), whereas the analysis favored the use of post pretreatment + silane over silane ( p <0.00001) only when the GFPs were luted into teeth. In conclusion, this review indicates that silanization improves the retention of GFPs luted into root canals provided that selective surface pretreatments are applied to the post before silanization.

SUMMARY Because there are several ways to cement glass-fiber posts (GFPs) into root canals, there is no consensus on the best strategy to achieve high bond strengths. A systematic review was conducted to determine if there is difference in bond strength to dentin between regular and self-adhesive resin cements and to verify the influence of several variables on the retention of GFPs. This report followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. In vitro studies that investigated the bond strength of GFPs luted with self-adhesive and regular resin cements were selected. Searches were carried out in the PubMed and Scopus databases. No publication year or language limit was used, and the last search was done in October 2012. A global comparison was performed between self-adhesive and regular resin cements. Two subgroup analyses were performed: 1) Self-adhesive × Regular resin cement + Etch-and-rinse adhesive and 2) Self-adhesive × Regular resin cement + Self-etch adhesive. The analyses were carried out using fixed-effect and random-effects models. The results showed heterogeneity in all comparisons, and higher bond strength to dentin was identified for self-adhesive cements. Although the articles included in this meta-analysis showed high heterogeneity and high risk of bias, the in vitro literature seems to suggest that use of self-adhesive resin cement could improve the retention of GFPs into root canals.

Clinical Relevance The results of this study suggest that immediate polishing procedures can result in improved short-term surface smoothness results but do not influence smoothness or sealing ability after one-year storage. SUMMARY Since there is a lack of information on the surface properties of composite restorations achieved with standard polishing procedures after aging processes, this study evaluated the effects of immediate (IM) and delayed (DE) polishing on the surface roughness (Ra), microhardness (KHN) and microleakage (ML) of microfilled (Filtek A110) and hybrid (Filtek Z250) resin composites after one-year storage. Standardized preparations were made on the buccal surface of 256 bovine teeth, where half were restored with each composite. For each composite, the specimens were randomly allocated to two subgroups. The first group (IM) was polished immediately after gross finishing using three different systems/techniques (n=16): Sof-Lex, Flexicups and Flexicups + Jiffy Polishing Brush + Flexibuffs (sequential), then stored for three weeks in saline. The DE group was stored for two weeks, polished with the same systems and stored for one week. From each subgroup, eight specimens were assessed after three weeks regarding Ra, KHN and ML (baseline), and the eight remaining specimens were stored for one year before analysis. The data were analyzed (α=0.05) with ANOVA, paired Student's t -test (Ra and KHN) or Kruskal-Wallis and Signed Rank tests (microleakage). After one year, microfilled resin composite specimens showed the lowest Ra and KHN ( p <0.05). No difference in microleakage was observed among the different groups ( p >0.05). The sequential technique provided the lowest roughness and Sof-Lex the lowest hardness ( p <0.05). IM showed similar or better performance than DE for ML and Ra ( p <0.05). In conclusion, aging increased the composites Ra and ML in all experimental conditions ( p <0.05).