Objectives. The level of evidence (LOE) of Saudi dental research from 2000 to 2020 was evaluated, and factors associated with the LOE were determined. Methods. This study was a systematic review. PubMed, Web of Science, and Medline databases were utilized to retrieve available dental articles published in English between January 2000 and May 2020. The inclusion criteria consisted of clinical studies conducted in Saudi Arabia with at least one Saudi dental affiliation. The retrieved eligible articles were evaluated independently by two reviewers using a modified Oxford LOE scale. The LOE of the studies was compared between the last two decades. Results. Of the 7237 articles identified, 1557 articles met the inclusion criteria. Approximately 78% of the published articles reported Level IV evidence. A higher trend toward Level I, II, and III publications has occurred in recent years (i.e., 2010–2020). However, no statistically significant difference existed in LOE proportions between the two decades. The presence of international collaboration and high journals’ impact factor was significantly associated with a higher LOE. Conclusion. Most published dental research studies were low LOE studies (i.e., Level IV). National and international collaboration is highly encouraged as this is a factor, according to our findings, that would be a positive addition toward publishing dental research of a higher LOE in Saudi Arabia.

This in vitro study aimed to compare the fracture strength of direct non-reinforced class II composite resin restorations and polyethylene fiber-reinforced restorations, and also to investigate the influence of the locations of polyethylene fibers within the cavity on the fracture strength. Sixty freshly extracted human teeth were disinfected and prepared (class II cavity design). The teeth were assigned randomly into four groups (n = 13). Group I (control) was restored with nano-hybrid composite resin. The other three experimental groups were restored with the same composite resin material reinforced by polyethylene fibers (Ribbond) at different locations. Fibers were placed either on the axial wall (Group II), on the gingival floor (Group III), or on the axial wall and pulpal/gingival floor (Group IV) of the proximal cavity. All the teeth were subjected to thermocycling to simulate the oral environment. The fracture strength was measured using a universal testing machine. Group IV had the highest mean fracture strength at maximum load (148.74 MPa), followed by Group II (140.73 MPa), Group III (136.34 MPa), and Group I (130.08 MPa), with a statistically significant difference from the control group (p = 0.008) but not between groups II and III.

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Background: Mesio–occluso–distal (MOD) cavity preparations are often fragile due to the amount of tooth and carious structure removed. MOD cavities can often fracture if left unsupported. Aim: The study investigated the maximum fracture load of mesi–occluso–distal cavities restored using direct composite resin restorations with various reinforcement techniques. Method: Seventy-two freshly extracted, intact human posterior teeth were disinfected, checked, and prepared according to predetermined standards for mesio–occluso–distal cavity design (MOD). The teeth were assigned randomly into six groups. The first group was the control group restored conventionally with a nanohybrid composite resin (Group I). The other five groups were restored with a nanohybrid composite resin reinforced with different techniques: the ACTIVA BioACTIVE-Restorative and -Liner as a dentin substitute and layered with a nanohybrid composite (Group II); the everX Posterior composite resin layered with a nanohybrid composite (Group III); polyethylene fibers called “Ribbond” placed on both axial walls and the floor of the cavity, and layered with a nanohybrid composite (Group IV); polyethylene fibers placed on both axial walls and the floor of the cavity, and layered with the ACTIVA BioACTIVE-Restorative and -Liner as a dentin substitute and nanohybrid composite (Group V); and polyethylene fibers placed on both axial walls and the floor of the cavity and layered with the everX posterior composite resin and nanohybrid composite (Group VI). All teeth were subjected to thermocycling to simulate the oral environment. The maximum load was measured using a universal testing machine. Results: The highest maximum load was exhibited by Group III with the everX posterior composite resin, followed by Group IV, Group VI, Group I, Group II, and Group V. A statistically significant difference was demonstrated between groups (p = 0.0023). When adjusting for multiple comparisons, there were statistical differences specific to comparisons between Group III versus I, Group III versus II, Group IV versus II, and Group V versus III. Conclusions: Within the limitations of the current study, it can be concluded that a higher maximum load resistance can be achieved (statistically significant) when reinforcing nanohybrid composite resin MOD restorations with everX Posterior.

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