Fall of amalgam restoration: a 10-year analysis of an Australian university dental clinic.

BACKGROUND: The use of amalgam in Dentistry has decreased since the 1980s. This study aimed to (i) assess the time trend in the usage of amalgam and composite in posterior teeth at Griffith University Dental Clinic from 2010 to 2019; (ii) to test whether this trend varied according to the dental health provider. METHODS: We analysed clinic records from 2010 to 2019. Prais-Winsten analyses were performed, and the average annual percentages change (AAPC) for amalgam and composite was estimated. RESULTS: There were 397,013 procedures, including 80,995 direct posterior restorations. Amalgam use decreased from 12.9% in 2010 to 0.5% in 2019 among students, while composite use increased from 87.1% to 99.5% of posterior restorations. The annual increase of the composite was 1.4% per year for students, while amalgam decreased by 30.2% per year on average. A similar trend was noted among the dentists. CONCLUSIONS: A significant decrease in the use of amalgam was observed over time for both students and professionals. This trend raises questions about curriculum reviews, focusing on the repair, maintenance and safe removal of amalgam while reinforcing the learning on Minimally Invasive Dentistry and composite restorations based on the patient's caries risk.

Enamel demineralization and bracket bond strength when etching with acid and /or Er:YAG laser.

BACKGROUND: Enamel etching for brackets is usually done with phosphoric acid. Er:YAG lasers have been recently used for this purpose with conflicting results. The effects of lasers on tooth demineralization and the effects of different combinations of laser treatments and bonding agents were evaluated in this study. METHODS: The enamel contents of fluorine, calcium oxide and phosphorus pentoxide (P(2) O(5)) were analysed using acid etching, laser treatment or both. The tensile bond strength of metallic and ceramic brackets using Transbond XT and Fuji Ortho LC were also tested, using acid etching, laser treatment or a combination of both. RESULTS: All treatments reduced the contents of fluorine, P(2)O(5) and calcium oxide, and acid reduced P(2) O(5) levels more than laser. The bond strength with laser was weaker than with acid, and stronger when combining both. When using laser, the best adhesive was the Fuji Ortho LC. The combination of laser and acid produced the best results when using Transbond XT. CONCLUSIONS: The demineralization promoted by laser was lower than the one produced with acid. Laser treatment produced lower tensile stress strength than acid, but still enough to produce clinically efficient retention. The combination of laser and acid produced the best retention results.