Further Interventions after Root Canal Treatment Are Most Common in Molars and Teeth Restored with Direct Restorations: A 10-11-Year Follow-Up of the Adult Swedish Population.

INTRODUCTION: The aims were to investigate 1) the frequency of nonsurgical retreatment, root-end surgery, extraction, and further restorative treatment during a follow-up of 10-11 years after root filling and compare the frequencies according to tooth group and type of coronal restoration and 2) the timing of nonsurgical retreatment, root-end surgery, and extraction. METHODS: Data were collected from the Swedish Social Insurance Agency's register. A search for treatment codes identified teeth root filled in 2009 and the type of coronal restoration (direct, indirect, and unspecified) registered within 6 months of root filling. The root-filled teeth were followed 10-11 years, and further interventions were recorded. Descriptive statistics and chi-square tests were used for statistical analysis. RESULTS: In 2009, root fillings were registered for 215,611 individuals/teeth. Nonsurgical retreatment, root-end surgery, and extraction were undertaken in 3.5%, 1.4%, and 20% teeth, respectively. The frequency of further interventions varied with respect to tooth group and type of coronal restoration, but only slightly for endodontic retreatments. Further interventions, except for root-end surgery, were registered more often for molars and directly restored teeth (P < .001). The majority of endodontic retreatments were undertaken within 4 years, while extractions were evenly distributed over 10-11 years. CONCLUSIONS: The frequency numbers of nonsurgical retreatment and root-end surgery were low, despite 1 in 5 root-filled teeth registered as extracted. Further interventions were most common in molars and directly restored teeth. Endodontic retreatments were performed more often during the first 4 years.

Exploring Recent Decreases in First Molar Sealants among US Children.

Analyses of National Health and Nutrition Examination Survey (NHANES) data suggested a significant decrease in sealant prevalence among children between 2011 to 2014 and 2015 to 2018. We explore whether this decrease could be associated with possible changes in 1) clinical sealant delivery, 2) dental materials (i.e., increased use of glass ionomer [GI] sealants resulting in an inability to detect sealant fragments that still provide preventive benefits or increased use of composite restorations leading to misclassifying sealants as restorations), and 3) examination sensitivity and specificity. We used NHANES data to estimate the prevalences of sealants, untreated caries, and restorations in ≥1 first permanent molar among children aged 7 to 10 y and used Medical Expenditure Panel Survey data to estimate the annual clinical delivery of sealants and fluoride treatments. We examined changes in outcomes between 2 periods (P < 0.05) controlling for selected sociodemographic characteristics. NHANES sealant examination quality was based on the reference examiner's replicate examinations. The adjusted prevalence of sealants decreased relatively by 27.5% (46.6% vs. 33.8%). Overall, untreated caries decreased. Untreated caries and restoration decreased among children without sealants. Annual clinical sealant delivery did not change, whereas fluoride treatment delivery increased. The decrease in sealant prevalence held when assessed for various age ranges and NHANES cycle combinations. While sealant examination specificity remained similar between the periods, sensitivity (weighted by the proportion of exams by each examiner) decreased relatively by 17.4% (0.92 vs. 0.76). These findings suggest that decreased sealant prevalence was not supported by decreased clinical sealant delivery nor increased use of composite restorations. Decreased examination sensitivity, which could be due to an increased use of GI sealants, could contribute to the decrease in sealant prevalence. The decrease in caries among children without sealants could suggest the increased use of GI sealants. However, we could not rule out that the decrease in caries could be attributable to increased fluoride treatment delivery.

Incidencia de fracturas dentales reportadas en la Ciudad de Chihuahua durante la pandemia por COVID-19 / Incidence of dental fractures reported in Chihuahua city during COVID-19 pandemic

Se presentan los casos de fracturas verticales sintomáticos que ameritaron la extracción de las órganos dentales afectados en un periodo de cinco meses durante la pandemia por COVID-19 en la ciudad de Chihuahua, México. Material y métodos: Se recolectaron 26 muestras para el estudio, proporcionadas por los cirujanos dentistas integrantes del Grupo de Egresados de la Facultad de Odontología de la Universidad Autónoma de Chihuahua. Resultados: Los resultados muestran diferencias a lo reportado previamente respecto al tipo de diente involucrado, sexo de los pacientes, restauraciones coronales y tratamientos endodóncicos previos. Conclusiones: Se puede suponer que las modificaciones en el estilo de vida de la población, sumadas a la angustia permanente, pueden ser factores que contribuyen a las fracturas dentales (AU)

There are cases of symptomatic vertical fractures that warranted the extraction of affected teeth are presented, over a period of five months during the COVID-19 pandemic in Chihuahua City, Mexico. Material and methods: 26 samples were collected for the study, provided by the dentist who were members of the Graduate Group of the Faculty of Dentistry of the Autonomous University of Chihuahua. Results: The results show differences from what was previously reported regarding the type of tooth involved, sex of patients, coronal restorations and previous endodontic treatments. Conclusions: It can be assumed that changes in the lifestyle of the population, added to permanent distress, may be factors to preserve dental fractures (AU)

The Use of Hall's Technique Preformed Metal Crown (HTPMC) by Pediatric Dentists in Malaysia.

INTRODUCTION: Hall's technique preformed metal crown (HTPMC) has been used widely by pediatric dentists in developed countries as a new approach for managing decayed primary molars without local anesthesia, caries removal, and tooth preparation. Currently, inadequate information is available regarding the implementation of this technique (HTPMC) in Malaysia. This study is aimed at evaluating the implementation of HTPMC by Malaysia's pediatric dentists and identify the co-occurrence frequencies of the HTPMC implementation with the respondents' demographic profile. MATERIALS AND METHODS: A cross-sectional questionnaire-based research was conducted among 65 pediatric dentists in Malaysia. Online questionnaires were distributed to the pediatric dentists employed at public hospitals (MOH) and universities in Malaysia. RESULT: It was found that over half of the respondents (65.6%) employed HTPMC. The analysis of the co-occurrence network frequency revealed that a high frequency of female pediatric dentists who were within the age group of 31-40 years old had fulfilled their postgraduation overseas and was employed in the university mainly applied HTPMC. CONCLUSION: The application of HTPMC among respondent pediatric dentists in Malaysia was high. However, most respondents considered HTPMC a treatment option only to manage carious primary molar rather than a treatment of choice.

The Association of Caries Increment Dynamics in Preschool Children with Risk Factors: The 3-Year Prospective Study.

This prospective study monitored the dental status, the presence of plaque, and cariogenic microorganism levels of identical children over three years. The aim was to determine the dynamics of caries increment as well as the relationship between risk factors and caries prevalence. A total number of 125 children (72 boys and 53 girls) was included in the study, with an average age of 3.95 ± 0.06 years at the baseline. During the clinical examination at the nursery schools, the presence of dental plaque was recorded, and saliva samples were collected from the tongue of children for the DentoCult SM test providing easy detection of mutans streptococci from saliva samples. At baseline, 65.6% of the children had no caries, 4% had restored teeth with fillings or crowns or missing teeth due to caries, and 30.4% had at least one untreated caries. The percentages of intact teeth, restored or missing teeth, and untreated caries were 52.8%, 8.8%, 38.4% in the second year and 49.1%, 13.8%, and 31.1% in the third year. The dmft index value was 1.41 ± 0.24 in the first year, 2.29 ± 0.30 in the second year, and 2.33 ± 0.31 in the third year. There was a significant correlation between plaque presence and dt and dmft values (p < 0.05; the statistical analyses were performed using the Kolmogorov-Smirnov test). This 3-year longitudinal study highlighted the importance of examining both the oral hygiene and the level of cariogenic microorganisms when undertaking the evaluation of caries risk evaluation in preschool children.

Development and calibration of biochemical models for testing dental restorations.

Currently, resin composites are the most popular materials for dental restoration in clinical practice. Although the properties of such materials have been improved significantly, together with better clinical techniques used for their placement, early restoration failure still occurs too frequently. As clinical studies take years to complete, and new resin composites are being produced at ever increasing pace, laboratory assessment using accelerated but representative tests is necessary. The main types of failure in resin-composite restoration are tooth/restoration fracture and secondary caries, which are caused by a combination of mechanical and biochemical challenges. In this study, a biofilm model (S. mutans) and a chemical model (lactic-acid buffer) for producing artificial caries in bovine dentin are developed and calibrated against in situ data. Using a power law relationship between the demineralization depth and challenge duration, scale factors that convert the in vitro durations to the equivalent clinical durations are determined for different pH values for each model. The scale factors will allow the synchronization of biochemical and mechanical challenges in terms of their rates of action to potentially test resin-composite restoration in an accelerated but clinically representative manner. STATEMENT OF SIGNIFICANCE: Although the properties of resin composites for dental restoration have been improved significantly, early restoration failure still occurs too frequently. As clinical studies take years to complete, accelerated laboratory testing is necessary. Resin-composite restoration fail mainly through fracture and secondary caries, caused by a combination of mechanical and biochemical challenges. In this study, a biofilm and a chemical model for producing artificial caries in bovine dentin are calibrated against in situ data. Using a power law relationship between demineralization depth and challenge duration, scale factors are determined for different pH for each model. The scale factors will allow the synchronization of biochemical and mechanical challenges in testing resin-composite restoration in an accelerated but clinically representative manner.

Factors associated with the number of filled teeth in adolescents from public schools: a cohort study.

This study aimed to assess the association of demographic conditions, socioeconomic status, clinical variables, and psychosocial factors with the number of filled teeth in adolescents from public schools. This cohort study comprised 1,134 12-year-old adolescents enrolled in public schools in Santa Maria, Brazil, in 2012. They were followed-up in 2014, where 743 individuals were reassessed (follow-up rate of 65.52%) for the number of filled teeth. Data were collected via dental examinations and structured interviews. Demographic and socioeconomic characteristics were collected from parents or legal guardians. The psychosocial factor comprised students' subjective measurement of happiness (Brazilian version of the Subjective Happiness Scale - SHS). Dental examinations were performed to assess the number of filled teeth through decay, missing, and filled teeth index (DMF-T). Unadjusted and adjusted Poisson regression analyses were performed to assess the association between baseline variables and filled teeth at follow-up. The number of filled teeth in 2012 and 2014 were 193 (17.02%) and 235 (31.63%), respectively. The incidence of filled teeth in 2014 was 42 (5.65%). Adolescents with untreated dental caries, those who visited the dentist in the last 6 months, those that exhibited being happier, and those who had filled teeth at baseline were associated with a higher number of filled teeth at follow-up. We conclude that the number of filled teeth in adolescents was influenced by clinical and psychosocial factors, emphasizing the need to focus on oral health policies in individuals with higher disease burden and those who feel psychologically inferior.

Threshold values affect predictive accuracy of caries risk assessment.

OBJECTIVE: To evaluate effects of thresholds on estimates of predictive accuracy of methods for caries risk assessment. MATERIAL AND METHODS: Adolescents, aged 12 visiting two dental clinics, were examined by visual/tactile examination and bitewing radiography at baseline and after one year. Three methods for caries risk assessment were applied: previous caries experience, dentists' risk assessment according to set criteria (presence or absence of caries lesion) and acid tolerance of dental biofilm. The measure for validity (the reference standard) comprised caries lesion progression at 1 year. Predictive accuracy estimates were calculated for several thresholds. RESULTS: Accuracy estimates changed with threshold values of the methods and the reference standard. Patient spectrum differed between the clinics, which resulted in different accuracy estimates for the two samples. Generally, negative predictive values were high while positive ones were low indicating that these methods were more efficient in finding individuals who are at low risk of developing caries lesions than those with increased risk. CONCLUSIONS: As thresholds and patient spectrum affected predictive accuracy, it may be difficult to design a universal model with set thresholds for caries risk assessment. Foremost, a model should consider the level of aspiration for prediction and clinical decisions that will be made based on the risk assessment in the actual clinical setting.

Prosthetic dental restorations in Swedish samples: prevalence and agreement between self-report, clinical findings, and influence on quality of life.

OBJECTIVE: To determine the prevalence of dental prosthetic restorations in an adult population, to study the agreement between self-reports and clinical findings of prosthetic restorations, and to study answers from a questionnaire in relation to the prevalence of prosthetic restorations. MATERIAL AND METHODS: A questionnaire was sent to a sample of 10,000 adults. A further sample of 1000 individuals was invited to answer the questionnaire and also participate in a clinical study. The agreement between self-report and clinical findings was analyzed, as were the associations between prosthetic restorations and questionnaire responses, using the chi2 test. RESULTS: A total of 40% of the sample had fixed dental prostheses (FDP), 2.7% had removable dentures. The agreement between self-report and clinical findings was 93%. 34.7% of the individuals with no prosthetic restorations were university graduates and 4% of individuals with removable complete dentures. Oral health had the greatest impact on the quality of life of younger individuals with FDP, with an OHIP-14 (Oral Health Impact Profile) score of 7.3 for the age group 20-39 years compared to 4.9 for the age group 65-89 years. CONCLUSION: The questionnaire method can be a cost-effective way to determine the prevalence of prosthetic restorations.

Indications for root canal treatment in a Swedish county dental service: patient- and tooth-specific characteristics.

AIM: To study patient- and tooth-specific characteristics of teeth indicated for root canal treatment, in the public dental service of the county of Västra Götaland, Sweden. METHODOLOGY: During a designated 8-week period, general dental practitioners working at 20 different public dental clinics consecutively registered indications for undertaking root canal treatment. The patients' subjective level of pain was also registered (visual analogue scale) at the very first appointment. The following information was retrieved from computerized dental records and radiographs: gender, age, number of remaining teeth, tooth group, previous restoration, number of restored surfaces, dental caries and tooth substance loss. Gender and age were compared using both descriptive and analytical statistics. RESULTS: The material comprised 243 teeth in 243 patients: 128 (52.7%) women and 115 (47.3%) men, mean age 48.3 years. Molar teeth predominated (47.7%). Most of the teeth (83.5%) had previously been restored and exhibited significant loss of tooth substance, more than a third of the crown (71.3%). Dental caries was present in 127 teeth (62.9%). Dental trauma was implicated in only seven cases (2.9%). Initial treatment was frequently undertaken at an emergency visit, for relief of symptoms (64.9%). The most commonly registered indication was pulpal necrosis with apical periodontitis (38.1%), followed by pulpitis (37.7%). Retreatment of a root filled tooth was reported in 18 teeth (7.4%). CONCLUSIONS: In the general Public Dental Service of Sweden, root canal treatment is most frequently undertaken in molars. The primary indication is relief of symptoms. Retreatment of root filled teeth is uncommon.

Factors associated with the number of filled teeth in adolescents from public schools: a cohort study

Abstract This study aimed to assess the association of demographic conditions, socioeconomic status, clinical variables, and psychosocial factors with the number of filled teeth in adolescents from public schools. This cohort study comprised 1,134 12-year-old adolescents enrolled in public schools in Santa Maria, Brazil, in 2012. They were followed-up in 2014, where 743 individuals were reassessed (follow-up rate of 65.52%) for the number of filled teeth. Data were collected via dental examinations and structured interviews. Demographic and socioeconomic characteristics were collected from parents or legal guardians. The psychosocial factor comprised students' subjective measurement of happiness (Brazilian version of the Subjective Happiness Scale - SHS). Dental examinations were performed to assess the number of filled teeth through decay, missing, and filled teeth index (DMF-T). Unadjusted and adjusted Poisson regression analyses were performed to assess the association between baseline variables and filled teeth at follow-up. The number of filled teeth in 2012 and 2014 were 193 (17.02%) and 235 (31.63%), respectively. The incidence of filled teeth in 2014 was 42 (5.65%). Adolescents with untreated dental caries, those who visited the dentist in the last 6 months, those that exhibited being happier, and those who had filled teeth at baseline were associated with a higher number of filled teeth at follow-up. We conclude that the number of filled teeth in adolescents was influenced by clinical and psychosocial factors, emphasizing the need to focus on oral health policies in individuals with higher disease burden and those who feel psychologically inferior.

Oral health experiences of individuals with Rett syndrome: a retrospective study.

BACKGROUND: There is relatively little literature on the oral health experiences of individuals with Rett syndrome. This study described the incidence of dental extractions and restorations in a population-based cohort, according to a range of demographic and clinical factors. The association between bruxism and age was also investigated. METHODS: Existing questionnaire data in the population-based Australian Rett Syndrome Database for the years 2004, 2006, 2009 or 2011 on genetically confirmed female cases (n = 242) were analysed. RESULTS: The incidence rate of restorations and extractions were 6.8 per 100 person years (py) and 9.3 per 100 py respectively. The incidence of extractions decreased with increasing levels of income. Compared to those with a C-terminal mutation, the incidence rate of extraction was higher for those with large deletions (Incidence Rate Ratio (IRR) 4.93; 95% CI 1.46-16.7, p = 0.01). There was a 5% decrease in the risk of frequent bruxism for every one-year increase in age (Risk Ratio 0.95; 95% CI 0.94-0.97). CONCLUSIONS: Social advantage may provide some protection for dental health in individuals with Rett syndrome. Those with more severe genotypes seemed to have poorer oral health outcomes.

Consequences of community water fluoridation cessation for Medicaid-eligible children and adolescents in Juneau, Alaska.

BACKGROUND: The general aim of this research was to determine whether cessation of community water fluoridation (CWF) increased oral health disparities, as measured by dental caries procedures and restoration costs for children and adolescents. METHODS: The analysis was based on all Medicaid dental claims records of 0- to 18-year-old patients residing in zip code 99801 (Juneau, Alaska) during an optimal CWF year (2003, n = 853) compared to all claims for the same age group from 2012 (n = 1052), five years after cessation of CWF. A bivariate analysis (Mann-Whitney U test) of the mean number of caries procedures performed per client was conducted in the study groups under both independent CWF conditions. Furthermore, logistic regression was performed using the dependent variables of caries procedures and the cost of caries-related procedures, with adjustments for CWF group, gender, and race. RESULTS: The statistically significant results included a higher mean number of caries-related procedures among 0- to 18-year-old and < 7-year-old patients in the suboptimal CWF group (2.35 vs. 2.02, p < 0.001; 2.68 vs. 2.01, p = 0.004, respectively). The mean caries-related treatment costs per patient were also significantly higher for all age groups, ranging from a 28 to 111% increase among the suboptimal CWF cohorts after adjusting for inflation. The binary logistic regression analysis results indicated a protective effect of optimal CWF for the 0- to 18-year-old and < 7-year-old age groups (OR = 0.748, 95% CI [0.62, 0.90], p = 0.002; OR = 0.699, 95% CI [0.52, 0.95], p = 0.02, respectively). Additionally, the age group that underwent the most dental caries procedures and incurred the highest caries treatment costs on average were those born after CWF cessation. CONCLUSIONS: These results expand our understanding of caries epidemiology under CWF cessation conditions and reaffirm that optimal CWF exposure prevents dental decay. These findings can offer fiscal estimates of the cost burden associated with CWF cessation policies and help decision-makers advance oral health, prevent dental caries, and promote equity in oral health outcomes.

The ultimate guide to restoration longevity in England and Wales. Part 8: Canine teeth: time to next intervention and to extraction of the restored tooth.

Aim: It is the aim of this paper to present data on the survival of restorations in canine teeth by analysis of the time to re-intervention on the restorations and time to extraction of the restored tooth, and to discuss the factors which may influence this. Methods: A data set was established, consisting of General Dental Services (GDS) patients, this being obtained from all records for adults (aged 18 or over at date of acceptance) in the GDS of England and Wales between 1990 and 2006. The data consist of items obtained from the payment claims submitted by GDS dentists to the Dental Practice Board (DPB) in Eastbourne, Sussex, UK. This study examined the recorded intervals between placing a restoration in a canine tooth and re-intervention on the tooth, and the time to extraction of the restored tooth. Results: Data for more than three million different patients and more than 25 million courses of treatment were included in the analysis. Included were all records for adults (aged 18 or over at date of acceptance). Overall, 1,232,052 restorations involving canine teeth were included in the analysis. With regard to time to re-intervention, 33% of restorations had survived at 15 years, and with regard to time to extraction of the restored tooth, cumulative survival was 78% at 15 years. Veneers and crowns performed best in terms of time to re-intervention, but crowns performed worst when time to extraction was analysed. Conclusions: Overall, crowns and porcelain veneers placed on canine teeth perform best to re-intervention after 15 years, but crowns perform worst when the time to extraction of the restored tooth is examined and veneers perform best, with a 20 percentage point difference in cumulative survival at fifteen years between crowns and the best performing restoration in the under-40 year age group, this effect being accentuated in the over-40 year age group. Other factors influencing restoration longevity in canine teeth include: patient age, dentist age and the patient's annual need for dental treatment.

Oral Health Status of 12-year-olds from Regions with and without Coverage of the National Oral Health Comprehensive Intervention Program for Children in China.

OBJECTIVE: To investigate the oral health status and related factors of 12-year-olds from regions with and without coverage of the National Oral Health Comprehensive Intervention Program in China by means of analysing national data from the 4th National Oral Health Survey. METHODS: Data of 12-year-olds participating in the 4th National Oral Health Survey of China were used for statistical analysis. Children who were recruited in the survey completed a dental examination and filled in a questionnaire. Oral health status, pit-and-fissure sealant history, oral hygiene behaviours, sugar consumption habits, status of dental service utilisation, and oral health knowledge were compared between children from regions with and without coverage of the national programme. For the number of decayed, missing and filled permanent teeth (DMFT) and its components, as well as the number of teeth with pit-and-fissure sealants, mean values were statistically tested to see if significance existed between regions covered by the national programme and uncovered regions, whereas caries prevalence and percentage of pit-and-fissure sealants presented were also compared. RESULTS: Data from 27,821 12-year-old children were analysed, among whom 7,726 were from regions covered by the national programme and 20,095 were from uncovered regions. Statistical significance was found in caries experience and activity, pit-and-fissure sealant history, sugar consumption habits, utilisation of dental services and oral health knowledge when compared between the covered and uncovered regions. Prevalence of dental caries and indices for caries experience and activity was lower in regions covered by the national programme than those not covered, while the percentage of pit-and-fissure sealants presented and the number of teeth with pit-and-fissure sealants exhibited higher in the covered regions. This remained the same even if we focused only on the first molars instead of the full dentition. CONCLUSION: The National Oral Health Comprehensive Intervention Program for Children in China potentially contributed to better oral health status, behaviour and knowledge in 12-year-old children. The expansion and extension of coverage of the national programme was expected to be beneficial for improving oral health status in children, as well as constructing teams of oral and dental workforce and working mechanisms in some underdeveloped regions.

Time expended on managing molar incisor hypomineralization in a pediatric dental clinic in Nigeria.

This study assessed the difference in the number of visits made to a dental care clinic and the time spent providing specific dental treatment for children with and without molar incisor hypomineralization (MIH). Children aged 8 to 16 years who presented at the Pediatric Dental Unit of the Obafemi Awolowo University Teaching Hospital Complex, in Ile-Ife, Nigeria, were eligible for the study. A comprehensive medical and dental history was taken, and each child was clinically examined, diagnosed, and treated according to a drawn-up plan. The time taken to establish a diagnosis and to provide specific treatments (scaling and polishing, restoration, pulpectomy, extraction, and placement of stainless steel crowns) and the number of visits made to complete the treatment plan were recorded for each child. Differences in the number of visits, time expended to make a diagnosis and to treat children with and without MIH were analyzed. The average time for diagnosis (p = 0.001) and the average time for placing amalgam restorations (p = 0.008) were significantly longer in children with MIH than in those without it. Children with MIH made more visits to the clinic (p < 0.001).There was no significant difference in the average time for scaling and polishing (p = 0.08), glass ionomer cement restorations (p = 0.99), composite restorations (p = 0.26), pulpectomy (p = 0.42), tooth extraction (p = 0.06), and placement of a stainless steel crown (p = 0.83) in children with and without MIH. In conclusion, children with MIH required more time for oral health care. Placing amalgam restorations took significantly longer than placing tooth bonding restorative materials in children with MIH than in those without it.

Clinical Performance of CAD/CAM Tooth-Supported Ceramic Restorations: A Systematic Review.

Owing to an increased demand for safe and esthetically pleasing dental materials, ceramics have been developed and optimized to rehabilitate anterior and posterior teeth. This evolution in ceramic materials is directly related to the development of sophisticated processing technologies and systems for use in dental medicine, particularly computer-aided design/computer-assisted manufacture (CAD/CAM) technology. This study is a systematic review outlining long-term clinical survival rates of single-tooth restorations fabricated with CAD/CAM technology with a minimum follow-up of 3 years. A bibliographic search up to September 2016 was performed using two databases: MEDLINE (PubMed) and Embase. Selected keywords and well-defined inclusion and exclusion criteria guided the search of relevant results. All articles were first reviewed by title, then by abstract, and subsequently by a full text reading. Data were assessed and extracted through a standardized form. The pooled results were statistically analyzed, and the overall failure rate was calculated by random effects model. Reported failures were analyzed by CAD/CAM system, type of restoration, restorative material, and luting agent. From a total of 2,916 single-tooth restorations with a mean exposure time of 7.0 years and 351 failures, the failure rate was 2.17% per year, estimated per 100 restoration years (95% confidence interval [CI]: 1.35% to 3.51%). The estimated total survival rate after 5 years was 89.7% (95% CI: 88.1% to 91.1%). The overall survival rate of single-tooth ceramic restorations fabricated with CAD/CAM technology was similar to those conventionally manufactured.

Comparison Of Frequency Of Post Operative Sensitivity In Amalgam Restorations Using Copal Varnish And Dentin Adhesive Liner.

BACKGROUND: Micro leakage around the margins of a restoration is believed to be one of the main causes of postoperative sensitivity. Dental amalgam is a non-insulating material and has the potential to transfer heat and cold causing irritation of the pulp. Different dentin tubule sealers are used under amalgam restoration to compensate for this post-operative sensitivity. This study was conducted to compare the frequency of sensitivity in amalgam restorations using copal varnish and dentin adhesive liner (dentin bonding agent). METHODS: A total of 60 patients of either gender, aged 18-40 years having class 1 carries in posterior teeth were included. Teeth with restorations, dentinal sensitivity and patients taking analgesic drugs for chronic pain conditions were excluded. The selected patients were placed randomly into Group A (copal varnish) & Group B (dentin adhesive liner), by using computer generated table of random numbers. Restored teeth were evaluated 1-month post operatively for sensitivity. RESULTS: Mean age was 25.63±5.42 years. Out of 60 patients, 68.0% were females and 32.0% were males with a female to male ratio of 2:1. The mean post-operative pain score was 2.83±2.79 in Group A and in Group B, it was 1.43±2.14 with a p-value of 0.03. There was no pain on application of a cold stimulus in 14 (46.7%) patients in Group A (copal varnish) while in Group B (Dentin adhesive), no pain was seen in 23 (76.7%) patients with p-value of 0.02. CONCLUSIONS: This study concluded that dentin adhesive liner (dentin bonding agent) is better than copal varnish in reducing postoperative sensitivity in amalgam restorations.

The longevity of posterior restorations in primary teeth.

Data sourcesSciVerse Scopus, ISIS Web of Science, Cochrane library, Medline/PubMed. Studies published from 1996 to 2017 in English were considered.Study selectionTwo independent reviewers screened the literature. Randomised clinical trials, non-randomised clinical trials with parallel groups or single group, retrospective studies) evaluating different posterior restorations (class I, class II restorations and crowns) with different materials (amalgam, compomer, composite, glass ionomer cement, stainless steel crown) placed in primary teeth by reporting different outcomes measures (survival rate, success rate, annual failure rate).Data extraction and synthesisTwo independent reviewers extracted data. Risk of bias was assessed using the Cochrane tool. A qualitative analysis was conducted.ResultsThirty-one studies were included. Seven different materials were used for restorations: amalgam (six studies), compomer (nine studies), composite (six studies), conventional glass ionomer cement (five studies), metal-reinforced glass ionomer cement (MRGIC) (four studies), resin-modified glass ionomer cement (ten studies), and stainless steel crown (SSC) (three studies). When considering the annual failure rate (AFR), composite showed the lowest (1.7-12.9%) and MRGIC showed the highest (10.0-29.9%). For the success rate, SSC presented the highest (96.1%) and MRGIC presented the lowest (57.4%). Class I restorations and restorations placed under the use of rubber dam revealed better results in both AFR and success rate. The main reason for failure was secondary caries.ConclusionsThere is a large variation in longevity of posterior restorations in primary teeth. Secondary caries is the main reason causing failure.