Repair of dimethacrylate-based composite restorations by a silorane-based composite: a one-year randomized clinical trial.

PURPOSE: To investigate clinical performance of a low-shrinkage silorane-based composite resin when used for repairing conventional dimethacrylate-based composite restorations. BACKGROUND: Despite the continued development of resin-based materials, polymerization shrinkage and shrinkage stress still require improvement. A silorane-based monomer system was recently made available for dental restorations. This report refers to the use of this material for making repairs and evaluates the clinical performance of this alternative treatment. MATERIALS AND METHODS: One operator repaired the defective dimethacrylate-based composite resin restorations that were randomly assigned to one of two treatment groups: control (n=50) repair with Adper SE Plus (3M/ESPE) and Filtek P60 Posterior Restorative (3M/ESPE), and test (n=50) repair with P90 System Adhesive Self-Etch Primer and Bond (3M/ESPE) and Filtek P90 Low Shrink Posterior Restorative (3M/ESPE). After one week, restorations were finished and polished. Two calibrated examiners (Kw≥0.78) evaluated all repaired restorations, blindly and independently, at baseline and one year. The parameters examined were marginal adaptation, anatomic form, surface roughness, marginal discoloration, postoperative sensitivity, and secondary caries. The restorations were classified as Alpha, Bravo, or Charlie, according to modified US Public Health Service criteria. Mann-Whitney and Wilcoxon tests were used to compare the groups. RESULTS: Of the 100 restorations repaired in this study, 93 were reexamined at baseline. Dropout from baseline to one-year recall was 11%. No statistically significant differences were found between the materials for all clinical criteria, at baseline or at one-year recall (p>0.05). No statistically significant differences were registered (p>0.05) for each material when compared for all clinical criteria at baseline and at one-year recall. CONCLUSIONS: The hypothesis tested in this randomized controlled clinical trial was accepted. After the one-year evaluations, the silorane-based composite exhibited a similar performance compared with dimethacrylate-based composite when used to make repairs.

Dimensional stability of elastomeric impression materials: a critical review of the literature.

The aim of the present paper was to review the literature concerning the dimensional stability of dental elastomeric impression materials, to support recommendations to control the variables that influence the accuracy of these materials. An electronic search of the Scopus and PubMed databases was performed in November 2010. Articles were selected according to the following inclusion criteria: investigation of the dimensional stability of dental elastomers, an experimental study, sample size reported, laboratory tests described, and published in an English language peer-reviewed journal. The search resulted in 47 articles published between 1958 and 2008; of these, 24 were selected for inclusion in the present study. Great variability was discovered in the experimental methodologies used, such as different working times, temperatures and storage mediums for the impressions, impression techniques, material thicknesses, tray types, and methods of evaluation. Despite the lack of standardization among the studies, this review supports the following recommendations to control the dimensional stability: impressions should be stored at temperatures between 21 +/- 2 degrees C; polyether impressions should be stored in an environment with a relative humidity below 50%; time until pouring has been settled for each elastomer material.