Background: Class II MOD cavity in maxillary premolar creates a specific challenge for the restoration material in terms of longevity and fracture resistance due to the anatomical shape of premolars that render them susceptible to fracture and the microleakage issue of composite restoration at the gingival margin of the proximal boxes. Bulk-fill composite was introduced to provide more strength and resistance and also to provide less polymerization shrinkage and better cure depth. With the advances in dental material science and technology, several attempts have also been made to increase the advantage of bulk-fill composite: by modifying the monomers, utilizing special restoration placement instrument, and adding fiber reinforcement to its composition, which have not been compared adequately. Hence, this study was undertaken to evaluate the effect of different bulk-fill composites in class II MOD cavities on upper premolars in terms of fracture resistance. Materials and methods: A total of 30 sound upper premolars were divided into three groups of 10 each. Teeth were prepared in the form of class II MOD cavity and restored accordingly: group I restored with Filtek bulk-fill (3M), group II with Sonicfill bulk-fill (Kerr), and group III with EverX bulk-fill (GC). Afterward, samples were thermocycled at 5°C and 55°C for 500 cycles. Fracture resistance test was done using Torsee's Electronic System Universal Testing Machine. Data obtained were analyzed with one-way ANOVA and post hoc least significant difference (LSD) test to determine the difference between groups. Results: ANOVA statistical test showed no significant differences (p > 0.05) in all groups. However, resin composite EverX bulk-fill (GC) has a higher fracture resistance (882.94 ± 64.41 N) compared to other groups, Sonicfill bulk-fill (Kerr) (856.48 ± 101.35 N), and Filtek bulk-fill (3M) (812.15 ± 66.89 N). Conclusion:The use of different bulk-fill resin composites did not yield significant effects in terms of fracture resistance in the restoration of class II MOD cavity on upper premolars (p > 0.05). However, bulk-fill resin composite did offer advantages in clinical applications due to the simplified restoration process and reduced working time.

BACKGROUNDEndodontically treated teeth are more susceptible to fracture as a result of increased brittleness and are weakened because of coronal destruction. Endodontically treated teeth with small or minimal cavities can be restored with direct composites in the presence of buccal and palatal cusp with intact marginal ridge. Bulk fill has minimal polymerisation shrinkage rate, curing depth of 4 mm, better bond strength and good physical properties. Other advantages include fewer void in the restorative material and lesser risk of contamination between layers. MATERIALS AND METHODSForty intact human upper premolars were selected for this study. In G1 to G4 standard class I cavity preparation with mesiodistal length of 4 mm and bucco-palatal width of 3 mm were done. A conservative endodontic access was done. All canals were prepared with Ni-Ti K files using a step-back technique. All teeth were obturated with gutta-percha. The teeth were randomly divided into four groups, G1 Tetric N Ceram bulk fill, G2 Filtek bulk fill, G3 Smart Dentin Replacement bulk fill and G4 Packable composite Filtek P60. RESULTSThere was a statistically significant effect on the fracture resistance of endodontically treated premolars with class I cavities using bulk fill composites (p < 0.05). CONCLUSIONBulk fill composite can be used as a final restoration in endodontically treated premolars with class I cavity, as it can also preserve sound tooth structure which can increase fracture resistance of the tooth.

One of pandemic effect is that people being afraid to have their regular dental treatment and tends to have their own medication. Dentist and dental nurses as workerin public health provider also afraid on doing dental treatment on a reason highly contamination and transmission of the virus. Delaying aerosol generating procedures is found as the only choice, except for emergency case. However, the uncertainty of pandemic era and dental treatment needs, urge the health workers to have innovation in dental treatment service.  Using mobile dental clinic Dinas Kesehatan Kabupaten Langkat di Puskesmas Sambirejo is a solution. The implementation of service activities in mobile dental clinic are mainly in self Protection equipment, SOP in  Standart Precaution, sterlisation and aseption and also patients admision flow in pandemic era for health care providers as a way to improve their knowledge in handling patient in pandemic era. The delay of action in dental procedur can be solved by facilitating mobile dental clinic according to standard health protocol. Instead of only reaching rural area, this mobile dental clinic can also be used in narrow building with limited space. The SOP protocol can also be used by dentis and dental nurses to control infection in mobile dental clinic. This article tries to support government in raising the degree of mouth and dental health services in pandemic era.

Aim This study aims to evaluate the difference in fracture resistance of the short fiber-reinforced composite (SFRC) thickness as intermediate layer of class II composite restoration. Materials and methods Thirty human maxillary premolars were selected and divided into three groups. In groups I, II, and III, class II cavities were prepared. Groups I and II were restored with 2 mm and 4 mm thickness of SRFC as intermediate layer. Group III as control group was restored with nanohybrid composite. Thermocycling procedure was performed manually 250 times. Fracture resistance was measured by using Universal Testing Machine. Data were analyzed statistically using One-way Analysis of Variance (ANOVA) and post hoc least significant difference (LSD) test. Results The result showed that group II had the highest fracture resistance and group III had the lowest fracture resistance. The difference between groups was statistically significant (p value < 0.05). Conclusion The conclusion showed that adding 4 mm of SFRC as an intermediate layer increased the fracture resistance. Clinical significance The use of SFRC as intermediate layer enhanced the fracture resistance of class II composite restoration. How to cite this article Hartanto C, Farahanny W, Dennis D. Comparative Evaluation of Short Fiber-reinforced Composite Resin Thickness on Fracture Resistance of Class II Composite Restoration: An In Vitro Study. J Contemp Dent Pract 2020;21(11):1201–1204.

The bond strength between resin-dentine is determined by the integrity of collagen, dentine and resin monomers. The susceptibility of the dentine bond results from the instability of the bonding structure that adheres to the bonding material. This can be achieved by using collagen cross-linker, synthetically and naturally in dentine substrates which are effective in protecting collagen fibrils from degradation, as proanthocyanidine. The aim of this study was to see the effect of grape seed extract as a crosslinker on the stability of dentine collagen and see the differences between groups. This study used 27 fresh premolars or third molars which were divided into 3 groups, namely group I giving grape seed extract 6.5%, group II giving chlorhexidine 2%, and group III only giving bonding ingredients. Samples were analyzed using SEM with 1000x magnification.  Data was analyzed using the kappa statistic, Kruskal-Wallis, dan Mann-Whitney. The result of the study significant differences between treatment groups (P <0.05), the 2% chlorhexidine group showed the highest value compared to the grape seed extract group and without treatment. Grape seed extract can be used as an alternative to chlorhexidine as a crosslinker to maintain bone strength of the composite restoration