Parental attitudes on restorative materials as factors influencing current use in pediatric dentistry.

PURPOSE: The purpose of this study was to determine pediatric dentists' current practices and the perceptions about parents' opinions and how those parental preferences regarding dental materials influence dentists' practices. METHODS: A questionnaire was sent to 500 randomly selected active members of the American Academy of Pediatric Dentistry. Twenty-five items queried demographics, use of restorative materials, perceptions of parents' attitudes towards materials, and dentists' reactions to parents' concerns. RESULTS: The survey response rate was 61%. Parental concerns about materials in decreasing order were: (1) esthetics; (2) cost; (3) toxicity; and (4) durability. Parents' greatest concerns about stainless steel crowns were: (1) esthetics; and (2) cost. Among respondents, 43% followed parental preferences when challenged, and 28% currently never use amalgam. Amalgam use and the dentists' perception of parental challenge were each related to the socioeconomic status of the practice population, with lower socioeconomic practices feeling less parental challenge than higher socioeconomic practices and being more likely to use amalgam than "white" filling materials (P = .001). CONCLUSIONS: Mercury concerns occur more frequently with higher than lower socioeconomic status parents (P = .002). Stainless steel crowns are challenged based on esthetics and cost. When confronted, many pediatric dentists (43%) follow parental preferences, even when that action is contrary to their initial clinical judgment.

Composite rebonding to stainless steel metal using different bonding agents.

The purpose of this study was to determine the in vitro bond strengths of composite rebonded to stainless steel crown metal (SS) using five different bonding agents after composite to SS bond failure had been produced. The adhesive systems were applied to the failed bonds following the manufacturers' instructions and, as a control, composite was bonded to SS without using a bonding agent. Each group was then divided into two subgroups: mechanically prepared (MP), in which the SS was roughened by a diamond bur, and unprepared (NMP), in which no modification of the SS was done. ESPE VISIO-GEM composite was placed in a plastic mold and light cured to the treated SS. Samples were stored in water at 37 degrees C for 72 hr, thermocycled for 500 cycles between 5 and 55 degrees C, and mounted in an Instron Universal Testing Machine. Caulk's Adhesive System provided significantly higher rebond strength (228.97 +/- 106.9 kg/cm2) than the other materials, and mechanical surface preparation offered no significant advantages.

A genetic contribution to dental caries, occlusion, and morphology as demonstrated by twins reared apart.

The heritability of dental characteristics has been systematically studied in animals, human populations, families, and twins, but not in twins reared apart. Under the assumption that environmental factors are no different for monozygotic twins reared apart than for dizygotic twins reared apart, the present study measured the genetic variance of several dental characteristics in twins reared apart. Ninety-seven subjects (44 twin pairs, three triplet sets) of mean age 40.6 years (S.D. 11.7) were examined over a six-year period by means of clinical and radiographic examinations, study models, and dental history questionnaires. Characteristics assessed retrospectively were: dentate status, treatment status, treatment/caries status, tooth size, malalignment, occlusion, and morphology. Data were analyzed by two-way ANOVA, intraclass correlations, heritability estimates, and concordance. There was statistically significant resemblance within monozygotic but not dizygotic pairs in the number of teeth present (p less than 0.001), percentage of teeth and surfaces restored (p less than 0.001), percentage of teeth and surfaces restored or carious (p less than 0.001), tooth size (p less than 0.001), and malalignment (p less than 0.009). Intercanine and intermolar arch width showed significant resemblance within both monozygotic (p less than 0.001) and dizygotic (p less than 0.01, p less than 0.05) pairs, whereas overjet and overbite showed no significant resemblance within pairs. Morphological features (Carabelli's trait and mandibular first premolar groove configuration) were more highly concordant in monozygous than in dizygous twins. This study provides new evidence for a marked genetic component to dentate status and dental caries experience and confirms previous reports of acknowledged inherited contributions to tooth size, malalignment, occlusion, and morphology.