Preliminary investigation into the validity of dentists' decisions to restore occlusal surfaces of permanent teeth.

This study investigates the validity of the treatment decisions made by 10 hospital dentists, who examined the fissures of extracted teeth using a visual-only technique. The study shows that 8 of the 10 dentists were more likely to leave carious teeth unrestored than unnecessarily treat sound teeth. The authors suggest that this system of diagnosing occlusal caries is a satisfactory one in terms of its sensitivity and specificity.

'Usage' testing of root canal sealing materials--a personal view.

A number of systems for the biological testing of dental materials have been suggested. This paper reviews the protocols suggested in the ISO standards for the in-use or 'usage' tests for root canal sealing materials.

Initial biological testing of root canal sealing materials--a critical review.

A number of systems for the biological testing of dental materials have been suggested. This paper presents a critical review of the protocols suggested in the ISO standards for the initial and secondary biological testing of root canal sealing materials.

Initial stages in the development of valid criteria for the replacement of amalgam restorations.

OBJECTIVES: Replacement amalgam restorations account for the largest single cost in the General Dental Services in Scotland. There is little practical advice available to practitioners on the maintenance and replacement of amalgam restorations. A distance learning package is being prepared for distribution to general dental practitioners in Scotland and this paper describes the initial stages in the development of the policy statements for the proposed package. METHODS: In the first stage proposals are being developed by a panel of dental academics using a modified Delphi technique. This technique is designed to produce a consensus view. Seventeen statements have been set out by the expert group. RESULTS AND CONCLUSIONS: While agreement was rapidly reached that 'ditching' of amalgam restoration margins did not justify their replacement and that repair was preferable to total replacement, some difficulty was experienced in arriving at a consensus view on the correct management of 'white spot' lesions at restoration margins and dentinal staining adjacent to amalgam restorations. The next stage in the development will be to present these statements to a selected panel of general dental practitioners and to develop their consensus view of the proposals, again using the Delphi technique.

Development and harmonisation of the norms and parameters in biological testing protocols designed for root canal sealing materials within the European Community.

The EC has mounted the BIOMED 1 as a specific programme to facilitate cooperative research programmes in identified areas of interest throughout Europe. They have recently announced support under this programme for a joint initiative designed to evaluate in vitro and in vivo methods of biological testing of root canal sealing materials. This proposal was prepared by a group of research workers in the field. It provides a summary of the current suggested protocols for the biological testing of dental materials and then provides a detailed protocol of the studies to be carried out in the joint programme which commenced in January 1993. The authors are publishing the proposal to invite comments from colleagues and interested parties.

Reported use of sealant restorations in a group of general practitioners in the west of Scotland.

A postal/telephone survey of 452 general practitioners working in the Greater Glasgow and Lanarkshire Health Board areas was carried out between March and June, 1989. The aim was to investigate the use of sealant restorations under section 6 of the National Health Service fee scale for general dental practitioners. Section 6 itemizes fees for fissure sealant, glass-ionomer cement plus sealant, composite resin plus sealant and the laminate restoration. A response rate of 83% was obtained. Eighty-one per cent of the respondents were placing sealant restorations, but less than half were using the laminate or sandwich technique. A wide variety of materials and curing lights were employed. Enamel etching times varied considerably and rubber dam was seldom used. Eighty-nine per cent indicated that they would welcome illustrated fact sheets demonstrating the use of sealant restorations.

Fissure caries diagnosis and resulting treatment decisions by clinical community dental officers and general dental practitioners.

In this in vitro study, 12 General Dental Practitioners and 13 Clinical Community Dental Officers examined the occlusal, buccal and palatal pits and fissures of 35 extracted molar teeth. They were asked to make a management/treatment decision, on the basis of their diagnosis of caries, whether each tooth should be left untreated, fissure sealed or investigated. After all the management/treatment decisions had been made, the teeth were serially sectioned perpendicular to the occlusal surface and examined for the presence of caries in dentine. It was impossible to demonstrate differences in the management/treatment decisions and the diagnosis of caries made by the two groups. No significant difference in sensitivity or specificity could be detected between operators diagnosing by visual inspection alone and those using visual inspection in combination with a tactile method. The use of radiographs did not significantly improve the validity of the diagnosis or management of fissure caries.

Management of fissure caries in the community dental services using sealant restorations: a field trial.

Field trial data two years after the placement of 278 composite or laminate (sandwich) composite sealant restorations by 14 Community Dental Officers, in patients ranging in age from 6 to 16 years, in the West of Scotland, is reported. No restorations were lost and in 76% of the restored teeth, fissure sealant was partly retained. The most common sites of loss of sealant were from the buccal fissures of mandibular molars and from the surface of the restoration. Only 5% of the treated teeth showed complete loss of fissure sealant and the authors considered that after 2 years, 90% of restorations were adequate or only required the simple addition of further fissure sealant.

Development of two new lining/base materials based upon calcium hydroxide/polyacrylic acid.

Two experimental adhesive calcium hydroxide cements containing polyacrylic acid were formulated and tested. These experimental materials were stronger than a proprietary calcium hydroxide formulation and were capable of adhesion to dentine. The properties of these new formulations indicated that preliminary biological testing is warranted.

Pulp response to a novel adhesive calcium hydroxide based cement.

This study compares pulp responses to 3 formulations of calcium hydroxide, namely: a) An experimental adhesive calcium hydroxide cement containing polyacrylic acid, b) Dycal (L.D> Caulk Co, Milford, Delaware) Batch Nos 176970/176990, c) "Analar" calcium hydroxide mixed with sterile distilled water. After 28 days dentine bridges were present in 77% of teeth capped with the test material, 64% of teeth treated with Dycal and in 62% of teeth capped with calcium hydroxide and water. Inflammatory infiltrates were observed in a number of teeth remote from the bridges. Bacteria were detected in these specimens. Exposed rat molar pulp responses to an experimental adhesive calcium hydroxide cement were similar to to those observed with 2 other calcium hydroxide formulations.