Five Year Clinical Evaluation of Restorations Placed in a Low Shrinkage Stress Composite in UK General Dental Practices.

This paper evaluates the five year clinical evaluation of restorations formed in a low shrinkage stress resin composite material (3M ESPE Filtek Silorane, Seefeld, Germany) and placed in the general dental practices of five members of the PREP Panel, a group of UK practice-based researchers. Results indicated satisfactory performance of the material under evaluation, other than for marginal staining, which affected 60% of the restorations evaluated after five years, albeit with less than 10% of the circumference of the restorations being affected. CLINICAL RELEVANCE: The low shrinkage stress material, Filtek Silorane™, demonstrated good clinical performance in the majority of parameters which were assessed at five years.

A randomised controlled trial of a nanofilled composite at three years: Did selective enamel etching have an effect?

General dental practice is increasingly being recognised as the ideal situation for the conduct of clinical trials into the longevity of restorations. The aim of this study was to investigate the survival of 75 nanofilled resin composite restorations placed in an assortment of cavities using a self-etch dentine bonding agent, in five UK dental practices by members of the UK-based practice-based research group, the PREP Panel, with half of the restorations receiving a selective enamel etch and the other half being placed using a self-etching approach. The results indicated good performance of the restorations examined, with no failures being identified and excellent surface characteristics, in terms of colour stability, minimal surface roughness and optimal anatomic form. Selective enamel etching tended to produce less marginal discolouration, although these results were not statistically significant.

A PREP Panel, Practice-Based, Evaluation of the Handling of the Kerr Demi-Ultra Light Curing Unit.

This paper describes the handling evaluation (by a group of practice-based researchers, the PREP Panel) of a recently introduced Light Curing Unit (LCU), the Kerr Demi-Ultra, which possesses a number of novel features such as its ultracapacitor power source, and the Light Emitting Diodes (LEDs) which provide the light output being placed close to the tip of the light guide. CPD/CLINICAL RELEVANCE: Testing of new devices and materials with respect to their handling is of importance, given that an easy to handle device should produce better clinical results than one which is difficult to use.

Twenty years of handling evaluations and practice-based research by the PREP Panel.

UNLABELLED: Dental materials which are user friendly make clinicians' lives simpler by facilitating their placement in patients' teeth: accordingly, the handling of materials is of relevance to the clinician. This paper traces the history of product handling evaluations and practice-based research by the PREP Panel, a group of practice-based researchers based in the UK. CLINICAL RELEVANCE: The ease of handling of dental materials is important in dental practice, given that practitioners may find that a material which is difficult to handle leads to suboptimal clinical results.

Practice-based PREP Panel handling evaluation of a new impression mixing device and the associated material.

AIMS: To evaluate the handling of a new impression mixing device and the associated impression material by general dental practitioner members of the PREP Panel. DESIGN: By means of a questionnaire, the participating practitioners recorded their views on the mixing machine and impression materials, having used these for ten weeks. SETTING: UK general dental practices. PARTICIPANTS: General dental practitioner members of a UK practice-based research group. METHODS: A questionnaire was designed to elicit views on the performance of the mixing device and impression material under test. This was distributed to the practitioners who had used the test materials for 10 weeks and the data thereby obtained collated and presented, principally in the form of VAS scales. OUTCOME MEASURES: Rating of various parameters of the mixing device and impression materials on VAS scales. RESULTS: The Pentamix 3 machine scored well for ease of initial use [4.8 on a visual analogue scale (VAS) where 1 = very difficult to use and 5 = very easy to use]. In a range of criteria (including cleanliness, easy handling, time to fill the tray and overall convenience) the Pentamix scored highly on VAS scales. A maximum score of 5 (on a VAS where 1 = very dissatisfied and 5 = very satisfied) was achieved for reproducible mixing quality. The appreciation of the Pentamix 3 mixing machine was demonstrated by the fact that 85% (n = 11) of evaluators stated that they would recommend it to colleagues. Regarding the impression material under evaluation, 85% (n = 11) of the evaluators stated that they would recommend Impregum Quick impression materials to their colleagues. CONCLUSIONS: Within the limitations of this study, the Pentamix 3 automatic impression mixing device scored highly in this assessment, together with the impression materials assessed.

Two-centre evaluation of a resin composite/ self-etching restorative system: three-year findings.

PURPOSE: This two-centre study evaluated the clinical performance of Class I and Class II restorations of the giomer material Beautifil, placed using Fluorobond, a self-etching adhesive system, to determine the suitability of the test system as an alternative for the restoration of posterior teeth. MATERIALS AND METHODS: A total of 108 restorations, comprising 72 Class II and 36 Class I restorations, was placed predominantly in molars (82%). Evaulations using modified USPHS/Ryge criteria were conducted at baseline and thereafter at 6 months and 1, 2, and 3 years. Die stone replicas of the restored teeth were examined retrospectively. RESULTS: A total of 5 restorations was found to fail during the study-- 3 in the first year and 2 during the third year of the study. Occlusal marginal adaptation was less than ideal at baseline in 11% of cases, primarily as a consequence of overcontouring, as observed in the die stone replicas. The combined percentage Alpha ratings at 3 years were: colour match, 98%; marginal adaptation (occlusal), 78%; marginal adaptation (proximal), 97%; anatomic form (occlusal), 99%; anatomic form (proximal), 95%; surface roughness (occlusal), 100%; surface roughness (proximal), 100%; marginal staining (occlusal), 90%; marginal staining (proximal) 81%; interfacial staining (occlusal), 99%; interfacial staining (proximal), 100%; contacts (occlusal), 95%; contacts (proximal), 93%; sensitivity, 100%; secondary caries, 100%; lustre of restoration, 100%. CONCLUSION: It is concluded that the 3-year performance of Fluorobond-bonded Beautifil for Class I and II restorations demonstrated some marginal changes, but most of the direct evaluation ratings were > 90% Alpha, with the performance observed being similar in the two centres.

A practice-based evaluation of the handling of a new self-adhesive universal resin luting material.

OBJECTIVE: Ease of handling of materials may be considered helpful to achieving good results. The handling properties of a new self-adhesive universal resin luting material were tested in clinical use. METHOD AND MATERIAL: Thirteen practitioners were selected at random from the Product Research and Evaluation by Practitioners (PREP) Panel, a United Kingdom-based group of dental practitioners prepared to complete evaluations of new materials and techniques in the practice environment. Explanatory letters, questionnaires and packs of the luting material were sent to the evaluators. The practitioners were asked to use the material and return the questionnaire. RESULTS: 144 restorations were placed using the new self-adhesive resin luting material, which was rated higher by the evaluators for ease of use (4.7 on a visual analogue scale where 5 represented easy to use and 1 represented difficult to use) than both the pre-trial resin-based and 'conventional' luting materials (rated 3.7 and 4.4 respectively on the same scale). The presentation, instructions, convenience of dispensing and handling and viscosity also received high ratings. CONCLUSION: The new material achieved ratings for ease of use superior to the pre-study resin-based and conventional luting materials in the dental practices of 13 UK dental practitioners.

Clinical evaluation of Solitaire-2 restorations placed in United Kingdom general dental practices: 1-year report.

OBJECTIVE: Packable composites are a comparatively recent addition to the dentist's armamentarium, Solitaire-2 being an example of this type of material. This paper reports the performance of 100 restorations formed in Solitaire-2 in conjunction with the Gluma Solid Bond system and Gluma One Bond bonding systems, in Class I and II cavity restorations in permanent teeth, placed in the practices of five members of the Product Research and Evaluation by Practitioners (PREP) Panel, a group of United Kingdom-based dental practitioners who are prepared to undertake research projects in their practices. METHOD AND MATERIALS: Five members of the PREP Panel were each requested to place 20 Solitaire-2 restorations. These restorations were reviewed at 1 year by a trained and calibrated evaluator, and the PREP panel member who had placed the restorations. RESULTS: A total of 88 restorations (33 Class I, 55 Class II) in 49 patients (mean age 43 years) were reviewed at 1 year. One Class II restoration (a large mesio-occlusodistal restoration) had been replaced at 10 months after a fracture was detected across the distal box. The remaining 87 (99%) of the restorations were intact with no secondary caries detected. CONCLUSION: Ninety-nine percent of the Solitaire-2 restorations, placed in general dental practice conditions in conjunction with the Gluma Solid Bond system and Gluma One Bond bonding systems, were found to be performing satisfactorily at 1 year.

The Effectiveness of Systemp.desensitizer in the treatment of dentine hypersensitivity.

PURPOSE: This study reports the effectiveness of Systemp.desensitizer (Ivoclar Vivadent, Schaan, Liechtenstein), when used both with and without an acid-etch step, in the treatment of patients with dentine hypersensitivity in UK dental practices. MATERIALS AND METHODS: Ten general dental practitioners (GDPs) were selected from two practice-based research groups. The GDPs were each requested to use Systemp.desensitizer in the treatment of at least ten patients who presented with pain due to dentine hypersensitivity. Systemp.desensitizer was applied to the sensitive dentine area in strict accordance with the manufacturer's handling instructions, except that the patients were divided into two groups. For the first, group NE, the procedure was to isolate the tooth, gently blot it dry with cotton wool pellets, rub Systemp.desensitizer into the tooth for 20 seconds, then gently air-dry it. For the second, group E, the procedure was identical except that after isolation, the treatment area was etched for 15 seconds with 35% phosphoric acid. Patients were asked to complete a pro forma using a 10 cm visual analogue scale designed to provide details of the extent of their pain before treatment, 24 hours post-treatment, one week post-treatment, one month post-treatment, and three months post-treatment. The zero end of the scale was marked 'no pain' and the 10 cm end was marked 'extreme pain'. The percentage change in the patients' perception of their pain, relative to pretreatment, was calculated using repeated measures analysis and suitable follow-up confidence intervals for the mean changes in perceived pain. Comparisons were then made between the treatment groups NE and E. RESULTS: Ninety-one patients completed the first pro forma and 77 completed all the pro formas. Overall, there was a significant reduction in pain at each of the time points after treatment but the pattern of pain reduction across the two groups was different. In general, the non-etched group (group NE) saw an 'immediate' reduction in pain which was then fairly consistent across the longer term, whilst, in general, the etched group (group E) saw less reduction in pain 24 hours after treatment, and then further reduction in pain at both one week and one month after treatment. Thus the non-etched group experienced an early reduction whilst the etched group took longer to perceive a reduction in pain; however, there were no statistically significant differences between the reductions in pain scores between the two groups at any of the time points after treatment. CONCLUSION: It is concluded that Systemp.desensitizer was effective in reducing pain from dentine hypersensitivity in the patients treated, and this finding was unaffected by whether or not the tooth was acid-etched prior to application of the reagent.

Two year clinical evaluation of a low-shrink resin composite material in UK general dental practices.

OBJECTIVE: A novel resin composite system, Filtek Silorane (3M ESPE) with reduced polymerization shrinkage has recently been introduced. The resin contains an oxygen-containing ring molecule ('oxirane') and cures via a cationic ring-opening reaction rather than a linear chain reaction associated with conventional methacrylates and results in a volumetric shrinkage of ∼1%. The purpose of this study was to review the literature on a recently introduced resin composite material, Filtek Silorane, and evaluate the clinical outcome of restorations formed in this material. METHODS: Filtek Silorane restorations were placed where indicated in loadbearing situations in the posterior teeth of patients attending five UK dental practices. These were evaluated, after two years, using modified USPHS criteria. RESULTS: A total of 100 restorations, of mean age 25.7 months, in 64 patients, were examined, comprised of 30 Class I and 70 Class II. All restorations were found to be present and intact, there was no secondary caries. Ninety-seven per cent of the restorations were rated optimal for anatomic form, 84% were rated optimal for marginal integrity, 77% were rated optimal for marginal discoloration, 99% were rated optimal for color match, and 93%% of the restorations were rated optimal for surface quality. No restoration was awarded a "fail" grade. No staining of the restoration surfaces was recorded and no patients complained of post-operative sensitivity. SIGNIFICANCE: It is concluded that, within the limitations of the study, the two year assessment of 100 restorations placed in Filtek Silorane has indicated satisfactory clinical performance.