Seven-year clinical performance of resin composite versus resin-modified glass ionomer restorations in noncarious cervical lesions.

PURPOSE: The purpose of this study was to comparatively assess the seven-year clinical performance of a one-bottle etch-and-rinse adhesive with resin composite (RC) and resin-modified glass ionomer (RMGI) restorations in noncarious cervical lesions. METHODS AND MATERIALS: One operator placed 70 restorations (35 restorations in each group) in 30 patients under rubber dam isolation without mechanical preparation. The restorations were directly assessed by two independent examiners, using modified US Public Health Service criteria at baseline and 6, 12, 24, 60, and 84 months. The obtained data were tabulated and statistically analyzed using the Fisher and McNemar tests. A difference was significant if p<0.05. RESULTS: Twenty patients were available for recall after seven years (66.6%), and 25 RC and 26 RMGI restorations out of 70 restorations were evaluated. Excellent agreement was registered for all criteria between examiners (κ≥0.85). Alfa and bravo scores were classified as clinically acceptable. The McNemar test detected significant differences within RC restorations between baseline and seven-year evaluations for anatomic form, marginal integrity, and retention (p<0.05). For RMGI restorations, a significant difference was identified for marginal integrity (p<0.05). As to material comparison, the Fisher exact showed a better retention performance for RMGI restorations than for RC restorations (p<0.05). Twelve composite restorations were dislodged (52.0% retention) and three ionomer restorations were lost (88.5% retention). The cumulative success rate for RC and RMGI was 30% and 58.1%, respectively. CONCLUSIONS: After seven years of service, the clinical performance of RMGI restorations was superior to that of the adhesive system/resin composite restorations in this study.

Reproducing the natural aspects of dental tissues with resin composites in proximoincisal restorations.

Patients who require restorative intervention in the anterior teeth expect esthetics to be integrated with other teeth that compose the smile. Therefore, not only should clinicians have a scientific technique for restoration of dental biology and function, but also their esthetic sense should direct them in the reproduction of polychromatic and anatomic characteristics of the tooth, rendering the restoration imperceptible. The introduction of new resin composites with better mechanical and optical properties, combined with better understanding of the optical behavior of dental tissues, has allowed a more artistic approach for accomplishment of direct bonded restorations with resin composite. Reproduction of optical behavior characteristics in restorations requires proper interpretation of shade variations, with use of resources and effects with resin composite to allow correspondence with the tooth substrates, and correct use of resin composite at the proper place and of exact thickness. This article describes, with the aid of a case report, a technique for shade selection and choice of resin composites. Moreover, a clinical sequence for application of resin composites is presented that allows reproduction of the interaction between tooth structures and light in proximoincisal restorations. With this technique, the restorative procedure achieves a satisfactory and predictable final esthetic outcome.

Clinical evaluation of two "packable" posterior composite resins: two-year results.

The purpose of this study was to evaluate the clinical performance of two "packable" posterior composites: Prodigy Condensable/Optibond Solo-Kerr (PC-OS) and Definite/Etch & Prime-Degussa (D-EP). Thirty-six patients participated in this study. A total of 78 restorations (40 with D-EP and 38 with PC-OS) were made. Each patient received at least two restorations (one of each studied material). The materials were handled according to the manufacturer's instructions. The occlusal adjustments were made at the placement visit. The restorations were finished and polished after 1 week. They were evaluated at baseline, and after 1 year and 2 years by two independent evaluators using the USPHS criteria. Colored slides were made of all the restorations. After 2 years, 34 patients and 74 restorations (38 with D-EP and 36 with PC-OS) were available for evaluation. A total of 50% of PC-OS restorations received A criterion and 50% received B criterion (2.8% color, 11.1% marginal staining, 27.8% superficial staining, 2.8% anatomic form and 5.6% marginal adaptation). For D-EP, 60.5% of restorations received A criterion and 39.5% received B criterion (2.6% color, 5.3% marginal staining, 10.5% superficial staining, 7.9% anatomic form and 13.2% marginal adaptation). The C criterion was observed only for marginal adaptation with D-EP (2 restorations-5.3%). The obtained data were tabulated and statistically analyzed using the Fisher, Chi-square and McNemar tests. After 2 years, PC-OS showed a significant increase in superficial and marginal staining. For D-EP the marginal adaptation and superficial staining became significantly worse than baseline.

Clinical evaluation of two "packable" posterior composite resins.

The purpose of this study was to evaluate the clinical performance of two "packable" posterior composites: Prodigy Condensable (P) (Kerr) and Definite (D) (Degussa). Thirty-six patients participated in the study. A total of 78 restorations were made, 40 with D and 38 with P. Each patient received at least two restorations, one of each studied material. The materials were handled according to the manufacturer's instructions. The restorations were finished and polished after 1 week. They were evaluated at baseline and after 1 year by two independent evaluators using the United States Public Health Service (USPHS) criteria. Colored slides were made of all the restorations. After 1 year, 35 patients and 76 restorations (39 with D and 37 with P) were available for evaluation. All restorations received A criteria except the following ones, which received B criteria: color P (one restoration) and D (one restoration), marginal staining P (three restorations) and D (two restorations), surface staining P (nine restorations) and D (three restorations), anatomic form P (one restoration) and D (three restorations), and marginal adaptation P (one restoration) and D (eight restorations). The obtained data were tabulated and statistically analyzed using the Fisher and McNemar tests. After 1 year, P showed a significant increase in superficial staining. For D, the marginal adaptation became significantly worse than baseline and P. The studied materials can be considered acceptable during this evaluation period. Further evaluations are necessary for a better clinical performance analysis.

Fracture strength of weakened human premolars restored with amalgam with and without cusp coverage.

PURPOSE: To determine the effect of cusp coverage with amalgam restorations on the fracture strength of weakened human maxillary premolars. MATERIALS AND METHODS: 30 extracted human maxillary premolars were divided into three groups; Group A (control): uncut teeth, Group B: wide MOD cavities prepared and the pulp chamber's roof removed. The teeth were restored with amalgam without cusp coverage, Group C: same as Group B plus cusp reduction and restored with amalgam. The teeth were included in metal rings with self-curing polystyrene resin and stored in water for 24 hrs. The restorations were refined with rubber points, polished and further stored in water for 24 hrs before being subjected to a compressive axial load in a Universal testing machine at 0.5 mm/min. RESULTS: The mean fracture strength obtained was: Group A: 173.3 Kgf, Group B: 47.3 Kgf and Group C: 127.7 Kgf. All values were statistically significantly different (P < 0.05). The amalgam restoration of weakened human premolars with cusp coverage amalgam significantly increased the fracture strength of the teeth (63%) as compared to teeth restored without cusp coverage. The results showed that cusp coverage with amalgam might be an option for restoring weakened endodontically-treated teeth.

Clinical evaluation of gallium alloy as a posterior restorative material.

This study evaluated 30 gallium alloy (Gallium alloy GF) and 31 amalgam (Dispersalloy) restorations over a period of 8 months in both Class I and Class II cavity preparations in 28 human subjects. At baseline, all gallium alloy and amalgam restorations were considered acceptable (Alfa) in terms of caries, anatomic form, marginal adaptation, surface texture, and bulk fracture. Postoperative sensitivity was reported in 67% of the gallium alloy restorations and in 29% of the amalgam restorations. At 8 months, 61% of the gallium alloy restorations were rated Beta for marginal adaptation, and all restorations exhibited tarnish and corrosion. With a few exceptions, the amalgam restorations were rated Alfa for those criteria. Three gallium alloy restorations had to be replaced during the evaluation period because of severe postoperative sensitivity and 39% of gallium restorations still presented some sensitivity at 8 months. Additional problems exhibited by gallium restorations were tooth fractures, tooth cracks, and marginal whitening.

[Motives for placement and replacement of dental restoration]. / Motivos da realização e substituição de restauraçoes dentárias.

Aiming to evaluate placement and replacement of dental restorations, a questionnaire has been elaborated and distributed in Clinics of the Operative Dentistry Department, Bauru Dental Scholl--USP, for the students to point out some information about the operatory procedures performed. The analysis of the results made possible the observation that of the 241 restorations achieved, 45.64% were made due to primary caries and 54.36% were replacement of deficient restorations. The reasons for replacement as well as the possible factors responsible for failure of tooth-colored and amalgam restorations are analyzed and discussed.

Clinical evaluation of Dycal under amalgam restorations.

Sixty-eight clinical amalgam restorations were removed to examine the consistency of the calcium hydroxide bases. The variation of the base consistency was influenced by the age and/or clinical profile of teeth and the status of the restorations. The clinical conditions affected the calcium hydroxide base consistency.

[Determination of casting contraction of alternative copper based alloys]. / Determinação da contração de fundição de ligas alternativas à base de cobre.

This study is about the cast contraction of 10 alternative alloys developed in the Dentistics Department of the Faculdade de Odontologia de Bauru that were compared with type III and type IV gold alloys and alternative commercial alloys.