Background This study systematically reviewed survival of direct composite to restore worn teeth. Materials and Methods A comprehensive electronic search of databases sourced from Medline-PubMed, Embase, Cochrane Central, Scopus, Google scholar was performed on literature published between January 1990 and December 2018. Grey literature was also reviewed. Data extraction included sample size, number of composite restorations, operators, composite type, mean or total follow-up time and success rate expressed as either percent of successful restorations or median survival time (MST). Methodological quality was rated using the Joanna Briggs Institute appraisal checklist for case series. Studies on children, non-carious cervical lesions, cast and all-ceramic restorations, case reports and case series with <5 participants were excluded. Results A total of 1563 studies were identified and 1472 were screened. Sixty-two full-text papers were assessed for eligibility which resulted in 10 studies that met inclusion criteria. These were mainly case series and assessed 3844 direct composite restorations placed in 373 patients mostly in hospital settings. Survival ranged from 50% to 99.3%. Methodological quality improved from the earlier studies and was rated low to moderate in 7 studies and good in 3. The funnel plot showed a low risk of publication bias but there was considerable heterogeneity (I 2 =97.7%). There was a non-significant weak negative association between age and survival (Spearman’s rho=−0.12). Conclusion Qualitative evaluation of the studies proved difficult because of the nature of case series but reporting improved in the later studies. Despite the generally short duration of studies, small sample sizes in terms of patient numbers and composite restorations, the survival rates of direct hybrid composite resin in the short to medium term are acceptable and support their application for the restoration of worn teeth.

Objectives: Acquiring the ability to identify deviations in dental aesthetic norms has been considered as an essential skill for the development of a dental professional. The timing and quality of this development of aesthetic perception has not been explicitly discussed in the dental education literature. This study aimed to evaluate the impact of dental training on the development of smile aesthetic perception, and to compare this perception between dental students and medical students in a similar cohort.Methods: One-hundred dental and medical students were invited to complete a self-administered questionnaire, designed to evaluate eight images; using a visual analogue scale (1 least attractive; 100 most attractive). The students rated the smile aesthetics of one 'model' smile image, and seven digitally modified smiles representing major variations in smile features. Data were analyzed using the independent student's t-test.Results: forty-four male and fifty-five female participants were successfully recruited, with a response rate of 99%. Dental students' ratings of smile aesthetics were significantly lower than medical students for seven of the eight images (p<0.05). This difference was greatest for the model smile image, and least for the diminutive lateral incisors image. There were no statistically significant gender-related differences. Conclusions:Within the limitation of this study, the dental curriculum has a significant impact on developing students' perception of dental aesthetics. Longitudinal studies with larger samples sizes, are needed to examine if progress through the dental curriculum affects students' perception of dental aesthetics.

No abstract