OBJECTIVES: The aim of the present article was to review the current literature on the fracture loads and fracture modes of SRCR implant restorations - in vitro studies, and also studies demonstrating the clinical performance of such design.

MATERIAL AND METHODS: A literature search was conducted from January 2000 to June 2022, using 6 databases to identify studies on fracture load and clinical performance that fulfilled the eligibility criteria. Thirty-eight studies met the inclusion criteria (22 in vitro and16 in vivo). The in vivo studies comprised case reports/series/letters (9), clinical techniques (2), retrospective/prospective studies (3), and randomized controlled trials (RCTs) (2).

RESULTS: The reviewed articles reported the effects of the SRCR design on the fracture risk if screw access channels were filled or unfilled, with regard to their diameter, and the preparation before or after glazing. The effect of the type of material used in the construction on the fracture modes SRCR restorations was also reported. The long-term clinical data was mainly retrospective and referred to metal-ceramic constructions. Limited long-term clinical data was available for all-ceramic materials and high-performance polymers (HPPs).

MATERIALS AND METHODS: A questionnaire consisting of 35 questions was distributed by mail or an online survey to 425 registered dentists selected according to place of work by stratified random sampling.

RESULTS: One hundred fifty-three dentists responded to the survey. A positive attitude towards FS and PRR was noted among most Malaysian dentists. About half of the respondents used FS/PRR occasionally (48.4%), while few (13.7%) applied them routinely. The majority of the dentists agreed that minimally invasive dentistry is important and FS are effective in caries prevention, using them on high caries-risk individuals. Most of the dentists used pumice or paste to clean teeth before placing FS/PRR. A significant number of dentists used a bonding agent prior to placing FS. Although only 57.5% dentists were aware of guidelines for FS use, most dentists agreed that guidelines are important.

MATERIALS AND METHODS: An experimental adhesive system based on bis-GMA, HEMA and hydrophobic monomer was doped with RF0.125 (RF - Riboflavin) or RF/VE-TPGS (0.25/0.50) and submitted to μTBS evaluation. Resin dentine slabs were prepared and examined using SEM and TEM. Adhesion force was analysed on ends of AFM cantilevers deflection. Quenched peptide assays were performed using fluorescence scanner and wavelengths set to 320nm and 405nm. Cytotoxicity was assessed using human peripheral blood mononuclear cell line. Molecular docking studies were carried out using Schrödinger small-molecule drug discovery suite 2018-2. Data from viable cell results was analyzed using one-way ANOVA. Bond strength values were analysed by two-way ANOVA. Nonparametric results were analyzed using a Kruskal-Wallis test at a 0.05 significance level.

RESULTS: RF/VE-TPGS0.25 groups showed highest bond strength results after 24-h storage in artificial saliva (p<0.05). RF/VE-TPGS0.50 groups showed increased bond strength after 12-months of ageing. RF/VE-TPGS modified adhesives showed appreciable presence of a hybrid layer. Packing fraction indicated solid angle profiles describing well sized density and topology relations for the RF/VE-TPGS adhesives, in particular with the RF/VE-TPGS0.50 specimens. Qualitative analysis of the phenotype of macrophages was prominently CD163+ in the RF/VE-TPGS0.50. Both the compounds showed favourable negative binding energies as expressed in terms of 'XP GScore'.

METHODS: Six makes, three each monocrystalline (M) and polycrystalline (P) were used; PureSapphire (M), SPA Aesthetic (M), Ghost (M), Mist (P), Reflections (P), and Dual Ceramic (P). The Ortholux™ Light Curing Unit (LCU) was used to cure the orthodontic adhesive Transbond™XT. The LCU's tip irradiance was measured and TLE transmitted through the ceramic bracket was obtained, then adhesive added to the bracket, and transmitted TLE measured through bracket-plus-adhesive samples. The LCU was set at five seconds as recommended for curing adhesive through ceramic brackets.

RESULTS: Mean tip irradiance was 1859.2±16.2mW/cm2. The TLE transmitted through brackets alone ranged 1.7 to 3.9J/cm2, in the descending order: Ghost>Pure Sapphire>Reflections>Mist>SPA Aesthetics>Dual Ceramic. The TLE transmitted through bracket-plus-adhesive samples ranged 1.6 to 3.7J/cm2, in the descending order: Ghost>Mist>Reflections>Pure Sapphire>SPA Aesthetics>Dual Ceramic. TLE was reduced with the addition of adhesive (range -0.1 to -0.7J/cm2). There was a significant difference for Pure Sapphire, Reflections, and Mist (P<0.05), but not for SPA Aesthetics, Ghost, and Dual Ceramic. There was no overall significant difference between the monocrystalline and polycrystalline makes. The two best makes were of the monocrystalline type, concerning TLE transmission, but with the exception of polycrystalline Dual Ceramic; the next worst make was a monocrystalline bracket, SPA Aesthetics.