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1.
BMC Health Serv Res ; 19(1): 985, 2019 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-31864347

RESUMO

BACKGROUND: Data from countries that have implemented a complete phase out of dental amalgam following the Minamata agreement suggest increased costs and time related to the placement of alternatives with consumers absorbing the additional costs. This aim of this study was to investigate the impact of a complete phase out of dental amalgam on oral health inequalities in particular for countries dependent on state run oral health services. METHODS: A mixed methods component design quantitative and qualitative study in the United Kingdom. The quantitative study involved acquisition and analysis of datasets from NHS Scotland to compare trends in placement of dental amalgam and a survey of GDPs in Yorkshire, UK. The qualitative study involved analysis of the free text of the survey and a supplementary secondary analysis of semi-structured interviews and focus groups with GDPs (private and NHS), dental school teaching leads and NHS dental commissioners to understand the impact of amalgam phase down on oral health inequalities. RESULTS: Time-trends for amalgam placement showed that there was a significant (p < 0.05) reduction in amalgam use compared with composites and glass ionomers. However dental amalgam still represented a large proportion (42%) of the restorations (circa 1.8 million) placed in the 2016-2017 financial year. Survey respondents suggest that direct impacts of a phase down were related to increased costs and time to place alternative restorations and reduced quality of care. This in turn would lead to increased tooth extractions, reduced access to care and privatisation of dental services with the greatest impact on deprived populations. CONCLUSION: Amalgam is still a widely placed material in state run oral health services. The complete phase down of dental amalgam poses a threat to such services and threatens to widen oral health inequalities. Our data suggest that a complete phase out is not currently feasible unless appropriate measures are in place to ensure cheaper, long-lasting and easy to use alternatives are available and can be readily adopted by primary care oral health providers.


Assuntos
Amálgama Dentário/uso terapêutico , Disparidades nos Níveis de Saúde , Saúde Bucal/estatística & dados numéricos , Conjuntos de Dados como Assunto , Serviços de Saúde Bucal , Pesquisa sobre Serviços de Saúde , Humanos , Pesquisa Qualitativa , Escócia , Medicina Estatal , Inquéritos e Questionários , Reino Unido
2.
Rev. habanera cienc. méd ; 18(6): 898-906, nov.-dic. 2019. graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1093915

RESUMO

Introducción: La reparación de restauraciones ha sido estudiada desde muy recientemente, pero a pesar de haber demostrado efectividad y mejoras en la terapéutica de la caries dental, aún tiene seguidores y detractores, lo que justifica la necesidad de estudios que sigan avalando tales prácticas. Objetivo: Describir, a través de la presentación de un caso, la reparación de un defecto localizado en una restauración de amalgama como tratamiento de mínima intervención en cariología. Presentación del caso: Paciente femenina de 16 años con antecedentes de salud acude a consulta refiriendo una pequeña fractura de restauración en diente 4.6 desde hace varias semanas. La regularización del defecto en la restauración, la mínima preparación cavitaria, la eliminación del fragmento de la base intermedia, la protección del complejo dentino-pulpar y el llenado de la cavidad resultante, fueron los primeros pasos de una técnica que se cumplimentó luego del pulido final de la interface tejido dentario-restauración y se evolucionó cinco años después. Se evidenció el estado y presencia de la reparación de la restauración realizada, sin fracturas añadidas, microfiltraciones, sintomatologías, desplazamientos ni pérdidas de la continuidad. Conclusiones: La reparación del defecto localizado de amalgama se realizó con el fin de preservar los tejidos dentarios no afectados como lo dicta la mínima intervención en cariología. Cinco años más tarde, la evolución evidencia una práctica que se tradujo en resultados satisfactorios e incremento de la calidad de vida de la paciente(AU)


Introduction: Restoration repair has been studied recently; but, even when it has demonstrated effectiveness and improvements in the therapy of dental caries, it still has followers and detractors that justify the need for studies that continue supporting such practices. Objective: To describe, through a case presentation, the repair of a defect located in a restoration with amalgam filling as minimal intervention treatment in cariology. Case presentation: Sixteen-year-old female patient with health history that went to the clinic reporting a small fracture of a restoration performed in tooth 4.6 several weeks ago. The regularization of the defect in the restoration, minimum cavity preparation, elimination of the fragment of the intermediate base, protection of the dentin-pulp complex, and filling of the resulting cavity were the first steps of a technique that was completed after the final polishing of the dental tissue/restoration interface that was evolved five years later. The status and presence of the restoration repair performed without added fractures, microfiltration, symptomatology, displacement or loss of continuity was evidenced. Conclusions: The repair of the localized defect in a restoration with amalgam filling was performed with the aim of preserving the unaffected dental tissues as dictated by minimal intervention in cariology. Five years later, the patient´s evolution shows a practice that resulted in satisfactory results and an increase in the patient's quality of life(AU)


Assuntos
Humanos , Feminino , Adolescente , Amálgama Dentário/uso terapêutico , Cárie Dentária/terapia , Reparação de Restauração Dentária/métodos
3.
Braz Oral Res ; 33: e54, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365703

RESUMO

The aim of present study was to estimate the occurrence and associated factors for replacement of amalgam posterior restorations. A representative sample of all 5,914 births from the 1982 in Pelotas birth cohort study was prospectively investigated, and the posterior restorations were assessed at 24 (n = 720) and 31 years of age (n = 539). Individual-level variables, i.e., demographic characteristics, socio-economic factors, oral health conditions and use of dental services, were collected from different waves of the cohort. Tooth-level variables included dental group, estimated time in mouth of each amalgam restoration, and number of restored dental surfaces. Thus, 246 individuals presented 718 amalgam restorations at 24 years of age. After 7 seven years of follow-up, 18.9% of these restorations had been replaced with composite resins. Multilevel Poisson regression models showed that, compared to white individuals, blacks presented a lower risk of replacement of amalgam restorations for composite resins (IRR - 0.39 [0.16-0.95]). Individuals with high educational level at age 31 showed an increased likelihood of replacement of amalgam restorations. Therefore, skin color affects the replacement of amalgam for composite resin in posterior restorations.


Assuntos
Resinas Compostas/uso terapêutico , Amálgama Dentário/uso terapêutico , Reparação de Restauração Dentária/estatística & dados numéricos , Pigmentação da Pele , Adulto , Fatores Etários , Brasil , Estética Dentária/estatística & dados numéricos , Feminino , Humanos , Masculino , Satisfação do Paciente/estatística & dados numéricos , Distribuição de Poisson , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Resultado do Tratamento , Adulto Jovem
5.
Orv Hetil ; 159(42): 1700-1709, 2018 10.
Artigo em Húngaro | MEDLINE | ID: mdl-30334485

RESUMO

Dental amalgam has been used for more than 150 years due to its beneficial mechanical properties and durability in dentistry. In the past and to date, many questions about amalgam restorations have arisen, especially regarding the mercury content, which has been the subject of global disputes. By presenting the past and present of the 'amalgam issue', the aim of our paper is to display the current position of international literature. This summary is based on the publications in the PubMed database, the guidelines of the Council of European Dentists. Although the use of dental amalgam is widespread, concerns have been raised about the adverse effect on human health and the environment, focusing on its heavy metal pollution during waste treatment. In 2017, the European Union (EU) adopted the so-called Mercury Regulation, based on the United Nations Minamata Convention on Mercury, the recommendations of which are presented in the present review. This Regulation includes the requirement for EU Member States to develop a national action plan for the phase-down of amalgam. The feasibility plan for complete phase-out may be guaranteed by 2030. The authors discuss the advantages and disadvantages of possible amalgam alternatives by presenting glass-ionomers and resin-based composites. In the future, more material research programmes and long-term follow-up studies are necessary. In addition to several global health organizations, the Council of European Dentists also draws attention to prevent dental caries, expecting to reduce the number of restorations. Orv Hetil. 2018; 159(42): 1700-1709.


Assuntos
Resinas Acrílicas/uso terapêutico , Resinas Compostas/uso terapêutico , Amálgama Dentário/uso terapêutico , Restauração Dentária Permanente/métodos , Resinas Acrílicas/efeitos adversos , Resinas Compostas/efeitos adversos , Amálgama Dentário/efeitos adversos , Dentição Permanente , Humanos
6.
Oper Dent ; 43(6): E273-E279, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30216130

RESUMO

OBJECTIVE:: The study aimed to evaluate teaching trends and use of materials in direct posterior restorations during a 13-year period in an Israeli dental school. METHODS:: Data registered in computerized files, relating to posterior restorations performed in the student clinic during the past 13 years (2004-2016), were collected. The restorative materials used (ie, amalgam vs composite), the type of tooth, and the number of surfaces restored were analyzed. RESULTS:: Data analysis included 26,925 restorations performed during 13 years. The number of one-surface composite restorations increased from 54.7% (n=330) to 81.9% (n=873). Two-surface restorations increased from 33.3% (n=254) to 64.3% (n=721). The percentage of amalgam restorations in three-surface restorations decreased from 72.08% to 51.34% (n=173). Analysis of tooth type showed that in 2016, the number of composite restorations performed in premolars reached 80.87% (n=723) and in molars 63.50% (n=1035). The percentage of composite restorations in the mandible and the maxilla was virtually equal. CONCLUSIONS:: A clear trend in favor of composite resin restorations is evident in the 13-year survey and suggests a move toward an amalgam-free era.


Assuntos
Restauração Dentária Permanente/tendências , Dentística Operatória/educação , Educação em Odontologia/tendências , Padrões de Prática Odontológica/estatística & dados numéricos , Dente Pré-Molar , Resinas Compostas/uso terapêutico , Amálgama Dentário/uso terapêutico , Humanos , Israel , Dente Molar
7.
J Dent ; 72: 1-7, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29522787

RESUMO

AIM: The aim of this study was to review patterns of restoration placement and replacement. A previous study had been carried out in the late 1990s and this study sought to update the literature in this important aspect of dental practice. METHOD: Studies based on the protocol of Mjör (1981) were selected. Such studies involved participating dentists completing a proforma each time a patient presented for a new or replacement restoration. RESULTS: Twenty-five papers were included in this study, of which 12 were included in the original review. The pre-1998 review reported on the placement of 32,697 restorations, of which 14,391 (44%) were initial placements and 18,306 (56%) were replacements. The new studies included in the post-1998 review reported on an additional 54,023 restorations, of which 22,625 (41.9%) were initial placements and 31,398 (58.1%) were replacements. Therefore, across all studies considered, information is available on 86,720 restorations, of which 37,016 (42.7%) were new placements and 49,704 (57.3%) were replacements. Comparing review periods, there was a reduction in the placement of amalgam restorations from 56.7% (pre-1998 review) to 31.2% (post-1998 review), with a corresponding increase in the placement of resin composites from 36.7% to 48.5%. The most common use of amalgam was seen in Nigeria (71% of restorations), Jordan (59% of restorations) and the UK (47% of restorations). The most frequent use of resin composite was seen in Australia (55% of restorations), Iceland (53% of restorations) and Scandinavia (52% of restorations). Secondary caries was the most common reason for replacing restorations (up to 59% of replacement restorations). CONCLUSION: In the years subsequent to the initial review, replacement of restorations still accounts for more than half of restorations placed by dentists, and the proportion of replacement restorations continues to increase. Trends towards the increased use of resin composites is noted in recent years. CLINICAL SIGNIFICANCE: Further research is required in this area to investigate changes in the approaches to the restoration of teeth, especially with increased understanding of the concept of restoration repair as an alternate to replacement.


Assuntos
Resinas Compostas/uso terapêutico , Amálgama Dentário/uso terapêutico , Restauração Dentária Permanente/estatística & dados numéricos , Cárie Dentária/terapia , Falha de Restauração Dentária , Reparação de Restauração Dentária , Odontólogos , Humanos , Padrões de Prática Odontológica , Retratamento
8.
J Dent ; 70: 80-86, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29289729

RESUMO

OBJECTIVES: When planning primary oral health care services the cost implications of adopting new intervention practices are important, especially in resource-strapped countries. Although on a trajectory to be phased-out, amalgam remains the standard of care in many countries. METHODS: Adopting a government perspective, this study compared the costs of performing amalgam and ART/high-viscosity glass-ionomer cement (HVGIC) restorations and the consequences of failed restorations over 3 years in suburban Brasilia, Brazil. Cost data were collected prospectively; cost estimates were developed for the study sample and a projection of 1000 single- and 1000 multiple-surface restorations per group. Probabilistic sensitivity analysis was conducted in TreeAge Pro. RESULTS: Results were mixed. For single-surface restorations, ART/HVGIC will cost US$51 per failure prevented, while for multiple-surface restorations, ART/HVGIC was cost-effective with a savings of US$11 compared to amalgam. Probabilistic sensitivity analysis (Monte Carlo simulation) predicted amalgam would be cost-effective 49.2% of the time compared to HVGIC at 50.6% of the time at a willingness to pay threshold of US$237 per failure prevented. Personnel accounted for more than half the cost burden for both methods; instruments and supplies accounted for about one third. The per restoration cost to replace amalgam with HVGIC ranges from US$1 to a savings of US$0.84. CONCLUSION: Replacing amalgam with a high-viscosity glass-ionomer as part of the ART method comes at a minimal increase in cost for governments. Increasing the number of restorations seems to diminish the cost burden. CLINICAL SIGNIFICANCE: ART/HVGIC could be considered a viable alternative to amalgam in primary teeth.


Assuntos
Resinas Acrílicas/uso terapêutico , Análise Custo-Benefício , Amálgama Dentário/uso terapêutico , Tratamento Dentário Restaurador sem Trauma/métodos , Cimentos de Ionômeros de Vidro/uso terapêutico , Dióxido de Silício/uso terapêutico , Dente Decíduo , Viscosidade , Resinas Acrílicas/efeitos adversos , Resinas Acrílicas/química , Brasil , Criança , Amálgama Dentário/efeitos adversos , Tratamento Dentário Restaurador sem Trauma/economia , Cárie Dentária , Falha de Restauração Dentária , Sensibilidade da Dentina , Cimentos de Ionômeros de Vidro/economia , Humanos , Dióxido de Silício/efeitos adversos , Dióxido de Silício/química , Fatores de Tempo
9.
Community Dent Oral Epidemiol ; 46(1): 47-53, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28782290

RESUMO

OBJECTIVES: Dental amalgam has been used as a common restorative material since the 1800s, but concerns have been raised regarding its purported neuropsychological effects due to the neurotoxicity of mercury. In this study, a nationwide population-based database was employed to investigate the association of dental amalgam restoration with the risk of attention-deficit/hyperactivity disorder (ADHD). METHODS: After matching, 88 068 young people with at least one tooth restoration during 2002-2010 and no ADHD history before 2001 were selected and then collected the further information until the end of 2011. Cox proportional hazard models were employed to estimate the possible effect of amalgam restorations on the risk of ADHD during the period of 2002-2011. Subgroup analyses were performed according to age, sex and number of amalgam restorations. RESULTS: In total, 2073 people (2.4%) received an ADHD diagnosis during the study period, yielding an incidence rate of 32.4 per 100 000 person-years. Those who had 6 or more amalgam restorations had a higher risk of future ADHD in the unadjusted Cox proportional hazard regression model (hazard ratio=1.20, 95% confidence interval [CI]=1.04-1.38, P=.015) than those who had received composite resin or glass ionomer restorations. However, after adjustment for potential confounding factors, the result was found to be confounded by age. CONCLUSIONS: The univariate analysis results showed that those who had 6 or more amalgam restorations had a 20% higher risk of future ADHD; however, the association disappeared after the model was adjusted for age. Despite this study analysing a larger sample than those analysed in previous studies, no association was observed between young patients' having received amalgam restorations and a future ADHD diagnosis. Further research aimed at evaluating the association between dental amalgam and other subsequent neuropsychological effects is warranted, especially for people who are vulnerable to mercury exposure.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Amálgama Dentário/efeitos adversos , Restauração Dentária Permanente/efeitos adversos , Adolescente , Fatores Etários , Criança , Pré-Escolar , Amálgama Dentário/uso terapêutico , Restauração Dentária Permanente/métodos , Feminino , Humanos , Estudos Longitudinais , Masculino , Modelos de Riscos Proporcionais , Fatores de Risco , Fatores Sexuais
10.
Oper Dent ; 43(1): 12-21, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28976841

RESUMO

OBJECTIVE: The objective of this study was to clinically evaluate repaired posterior amalgam and composite restorations over a 12 year period, investigate the influence of repair in the survival of restorations, and compare their behavior with respect to controls. METHODS: Thirty-four patients, 18 to 80 years of age with 167 restorations, 67 composite resin (RC), and 100 amalgam (AM) restorations, participated. Restorations with localized, marginal, anatomical deficiencies and/or secondary caries, and "clinically judged" suitable for repair or replacement according to US Public Health Service (USPHS) criteria, were randomly assigned to four groups: repair (n=35, 20 AM, 15 RC), replacement (n=43, 21 AM, 22 RC), positive control (n=71, 49 AM, 22 RC), or negative control (n=18, 10 AM, 8 RC). The quality of the restorations was blind scored according to the modified USPHS criteria. Two examiners scored them at initial status (κ=0.74) and after one to five, 10, and 12 years (κ=0.88). Wilcoxon and Mann-Whitney tests provided for comparisons within the same group and between years, respectively. RESULTS: After 12 years, all groups behaved similarly in marginal adaptation, marginal stain, teeth sensitivity, anatomic form, and luster ( p≥0.05). Better behavior in roughness was observed in replaced RC ( p=0.049). CONCLUSIONS: Given that most clinical parameters investigated were similar between all groups during the follow-up, the repair of RC and AM restorations is a good clinical option because it is minimally invasive and can consistently increase the longevity of restorations.


Assuntos
Resinas Compostas/efeitos adversos , Amálgama Dentário/efeitos adversos , Falha de Restauração Dentária , Reparação de Restauração Dentária , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Resinas Compostas/uso terapêutico , Amálgama Dentário/uso terapêutico , Reparação de Restauração Dentária/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
11.
Oper Dent ; 42(6): 587-595, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28857709

RESUMO

OBJECTIVES: The aim of this study was to clinically evaluate posterior amalgam and resin composite restorations refurbished over a period of 12 years by investigating the influence of refurbishing on the survival of restorations and comparing their behaviors with respect to controls. METHODS AND MATERIALS: Thirty-four patients were enrolled, ages 18 to 80 years, with 174 restorations, 48 restorations of resin composite (RC), and 126 restorations of amalgam (AM). Restorations with localized defects in anatomy, roughness, luster, or marginal staining that were clinically judged as suitable for refurbishing according to US Public Health Service (USPHS) Ryge criteria were assigned to group A-refurbishing (n=85; 67 AM, 18 RC)-or group B-control (n=89; 59 AM, 30 RC); the quality of the restorations was evaluated blindly according to the modified USPHS criteria. Two observers conducted evaluations at the initial state (k=0.74) and after one to five, 10, and 12 years (k=0.88). Wilcoxon, Friedman, and Mantel-Cox tests were performed to compare the groups, respectively. RESULTS: After 12 years, both groups experienced a similar decline, except for an evidently better performance in marginal adaptation in RC control (p=0.043) and in anatomy in AM refurbished (p=0.032). CONCLUSIONS: After 12 years, no difference was found in the clinical condition and longevity of the refurbished restorations compared to the control group.


Assuntos
Resinas Compostas/uso terapêutico , Amálgama Dentário/uso terapêutico , Restauração Dentária Permanente/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Falha de Restauração Dentária/estatística & dados numéricos , Reparação de Restauração Dentária/métodos , Reparação de Restauração Dentária/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
12.
Wiad Lek ; 70(3 pt 2): 574-577, 2017.
Artigo em Russo | MEDLINE | ID: mdl-28713085

RESUMO

INTRODUCTION: The problem of treatment of dental caries by fillings in dentistry is the key point in dentistry. Thus the main issue is the long-term functioning of the restorations. Particularly acute, this problem in the reduction of cavities class II according to Black, where the pressure on the filling is sufficiently high. MATERIALS AND METHODS: It was examined and treated 87 patients with different levels of oral hygiene of oral cavity and caries of varying intensity and whom 186 defects of hard tissues of teeth class II Black were fitted. All patients were divided into 3 groups depending on the type of filling material selected. Each group was in turn divided into two groups depending on the type of the prepared cavity. In a subgroup (1) the preparation was carried out without additional primary cavity retention elements. In a subgroup (2) the preparation was carried out with the main cavity in the form of retention elements as extra place on the chewing surface. RESULTS: Analyzing the quality of edge adjacent of fillings and restorations in the long-term period (24 months) depending on the intensity of caries and oral hygiene, we found that the best results were obtained in patients with low intensity of caries, and in patients with a high level of oral hygiene of patients in all study groups. CONCLUSION: The best results in the short and long-term periods were obtained in II and IІІ groups. It should be noted that these groups the particularity of preparation has no influence on the quality of the restoration. According to restorations of group I where the restorative material was composite material as chemical hardening"Charisma PPF" ( "Heraeus Kulser"), this relation takes place. The best results in the short and long-term periods shown those restorations, under which created at preparing retention elements in the form of extra place.


Assuntos
Cárie Dentária/terapia , Materiais Dentários/uso terapêutico , Restauração Dentária Permanente/métodos , Adulto , Resinas Compostas/uso terapêutico , Ligas Dentárias/uso terapêutico , Amálgama Dentário/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
13.
J Small Anim Pract ; 58(12): 720-723, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28612926

RESUMO

Shell ulcers were diagnosed based on clinical appearance in 60 turtles. Under general anaesthesia, surgical curettage was performed using a burr mounted on a micro-grinder. A calcium hydroxide paste was applied to the debrided lesions before the application of restorative material. Lesions were completely filled with rapidly hardening silver amalgam. Treated terrapins were hospitalised in dry containers and later were housed in tanks with controlled temperature 24 hours. Fillings were found spontaneously expulsed at various periods after placement. No signs of mercury poisoning or tissue reaction to the prosthesis were apparent.


Assuntos
Exoesqueleto/cirurgia , Doenças Ósseas/veterinária , Amálgama Dentário/uso terapêutico , Tartarugas/cirurgia , Exoesqueleto/efeitos dos fármacos , Exoesqueleto/patologia , Animais , Doenças Ósseas/tratamento farmacológico , Doenças Ósseas/cirurgia , Hidróxido de Cálcio/uso terapêutico , Amálgama Dentário/efeitos adversos
14.
Swiss Dent J ; 127(4): 300-311, 2017 04 10.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-28480953

RESUMO

The aim of this study was to carry out a representative survey on the implementation of and experience with repairs of single-tooth restorations among dentists in the Canton of Zurich, Switzerland. An anonymous questionnaire was sent to all 1,411 dentists registered in the Canton of Zurich; 38.9% of the delivered questionnaires were returned and 35.3% could be evaluated. The statistical analysis comprised Kendall’s rank correlation coefficient (tau), Wilcoxon signed-rank tests, and Kruskal-Wallis tests. The level of significance was set at p≤0.05. Repair restorations are frequently made (composite: 98.5%, ceramic: 88.9%, crowns: 86.5%, metal: 54.6%, amalgam: 51.5%). Main indications for repairs were the partial loss of an existing restoration or of the adjacent dental hard substance, while restoration failures due to secondary caries were repaired to a lesser extent. The decision to repair is largely dependent on the size of the defect (90%), the size of the original restoration (63%), and the material of the failed restoration (84%). Repair restorations are most frequently made with composite following adequate conditioning of the repair surface. A majority of the dentists rate the lifespan of repair restorations as reduced in comparison with newly made restorations. In summary, repairs of defective single-tooth restorations are frequently performed by dentists in the Canton of Zurich, Switzerland, and constitute a well-established treatment procedure.


Assuntos
Reparação de Restauração Dentária/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde , Inquéritos e Questionários , Cerâmica , Resinas Compostas/uso terapêutico , Coroas/estatística & dados numéricos , Amálgama Dentário/uso terapêutico , Falha de Restauração Dentária/estatística & dados numéricos , Inquéritos Epidemiológicos , Metais/uso terapêutico , Suíça , Revisão da Utilização de Recursos de Saúde/estatística & dados numéricos
15.
Prim Dent J ; 6(1): 54-61, 2017 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-28376964

RESUMO

A case study provides opportunity to discuss treatment planning and the selection of materials and techniques to provide a replacement restoration of an endodontically-treated molar tooth. The discussion highlights treatment options along with the strengths and weaknesses of the alternative approaches to achieving a successful clinical outcome.


Assuntos
Coroas , Restauração Dentária Permanente/métodos , Dente não Vital/terapia , Resinas Compostas , Amálgama Dentário/uso terapêutico , Planejamento de Prótese Dentária , Humanos , Masculino , Pessoa de Meia-Idade , Técnica para Retentor Intrarradicular
16.
J Public Health Dent ; 77(3): 207-215, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28070905

RESUMO

OBJECTIVES: In 2013, the United Nations Environment Programme (UNEP) reached a binding agreement - a.k.a. the Minamata treaty - to decrease dental amalgam use. This study aims to investigate US dentists' current practice and opinions about amalgam use, and to determine factors affecting their amalgam use and opinions. METHODS: A total of 45,557 general dentists and 5,101 pediatric dentists were invited to participate in a pre-tested electronic survey. The survey consisted of 12 close-ended questions using a 5-point Likert Scale. The Qualtrics™ software was used to distribute the survey, followed by three reminders. RESULTS: Response rate was 5.2 percent for general dentists, and 17.6 percent for pediatric dentists. Sixty-two percent of general dentists and 56 percent of pediatric dentists reported using amalgam. Most dentists disagreed with banning amalgam, while agreeing with installing amalgam separators. Environmentally conscious dentists were more likely to agree with banning amalgam and installing amalgam separators. CONCLUSION: Responding dentists favor the continued use of dental amalgam. Their perspectives vary by several factors including dentists' environmental consciousness. Policies toward minimizing amalgam's environmental impact need to be implemented.


Assuntos
Atitude do Pessoal de Saúde , Amálgama Dentário/uso terapêutico , Restauração Dentária Permanente , Padrões de Prática Odontológica/estatística & dados numéricos , Adulto , Estudos Transversais , Amálgama Dentário/efeitos adversos , Feminino , Humanos , Masculino , Inquéritos e Questionários
17.
J Prosthet Dent ; 117(3): 345-353.e8, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27765400

RESUMO

STATEMENT OF PROBLEM: No knowledge synthesis exists concerning when to use a direct restoration versus a complete-coverage indirect restoration in posterior vital teeth. PURPOSE: The purpose of this systematic review was to identify the failure rate of conventional single-unit tooth-supported restorations in posterior permanent vital teeth as a function of remaining tooth structure. MATERIAL AND METHODS: Four databases were searched electronically, and 8 selected journals were searched manually up to February 2015. Clinical studies of tooth-supported single-unit restorative treatments with a mean follow-up period of at least 3 years were selected. The outcome measured was the restorations' clinical or radiological failure. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, the Cochrane Collaboration procedures for randomized control trials, the Strengthening the Reporting of Observational Studies in Epidemiology criteria for observational studies, 2 reviewers independently applied eligibility criteria, extracted data, and assessed the quality of the evidence of the included studies using the American Association of Critical Care Nurses' system. The weighted-mean group 5-year failure rates of the restorations were reported according to the type of treatment and remaining tooth structure. A metaregression model was used to assess the correlation between the number of remaining tooth walls and the weighted-mean 5-year failure rates. RESULTS: Five randomized controlled trials and 9 observational studies were included and their quality ranged from low to moderate. These studies included a total of 358 crowns, 4804 composite resins, and 303582 amalgams. Data obtained from the randomized controlled trials showed that, regardless of the amount of remaining tooth structure, amalgams presented better outcomes than composite resins. Furthermore, in teeth with fewer than 2 remaining walls, high-quality observational studies demonstrated that crowns were better than amalgams. A clear inverse correlation was found between the amount of remaining tooth structure and restoration failure. CONCLUSIONS: Insufficient high-quality data are available to support one restorative treatment or material over another for the restoration of vital posterior teeth. However, the current evidence suggests that the failure rates of treatments may depend on the amount of remaining tooth structure and types of treatment.


Assuntos
Falha de Restauração Dentária/estatística & dados numéricos , Restauração Dentária Permanente/métodos , Restauração Dentária Permanente/estatística & dados numéricos , Resinas Compostas/efeitos adversos , Resinas Compostas/uso terapêutico , Amálgama Dentário/efeitos adversos , Amálgama Dentário/uso terapêutico , Cárie Dentária/terapia , Materiais Dentários/uso terapêutico , Restauração Dentária Permanente/efeitos adversos , Humanos , Metanálise como Assunto , Dente Molar , Ensaios Clínicos Controlados Aleatórios como Assunto , Coroa do Dente , Resultado do Tratamento
18.
J Am Dent Assoc ; 148(2): 75-80, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27863694

RESUMO

BACKGROUND: The authors conducted a retrospective study to evaluate the long-term (18-22 years) clinic results of titanium post and bonded amalgam core restorations with metal-ceramic crowns placed in patients. METHODS: From 1992 through 1996, the authors placed 88 restorations in 66 patients. They measured the ferrule effect in the minor dentin collar area. In 2014, the authors analyzed the following variables: ferrule length, length and thickness of the post, and tooth position. RESULTS: The overall survival of the restorations decreased over time with survival rates of 89.6% after 5 years of follow-up appointments and 64.2% after 18 years of follow-up appointments. There were 42 failures, and the maxillary premolars had the most failures. The teeth with 2 or more millimeters ferrule length had a higher survival rate than those with a 0 to less than 2 mm ferrule length; these results were not statistically significant. CONCLUSIONS: Statistically significant differences were detected according to the location of the tooth. The cores in the anterior teeth were 3.26 times more likely to fail than those in the molars, which presented higher survival rates; maxillary premolars had the most failures (28.5%). Both the metallic post length and its diameter did not influence restoration survival. The ferrule length was not statistically significant. PRACTICAL IMPLICATIONS: The clinical technique to restore endodontically treated teeth that includes a titanium post and bonded amalgam restorations results in greater coronal destruction but shows good long-term results, ease of fabrication, and modest cost in comparison with other techniques.


Assuntos
Amálgama Dentário/uso terapêutico , Falha de Restauração Dentária/estatística & dados numéricos , Técnica para Retentor Intrarradicular/estatística & dados numéricos , Titânio , Adulto , Restauração Dentária Permanente/métodos , Restauração Dentária Permanente/estatística & dados numéricos , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Tempo
19.
PLoS One ; 11(12): e0166552, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27906991

RESUMO

The impact of dental amalgam on the development of Parkinson's disease (PD) is still uncertain, although a positive association between dental amalgam and PD has been found in a few case-control studies. The patients with amalgam fillings restored between 2000 and 2008 were identified by using the National Health Insurance Research Database (NHIRD) in Taiwan. The same number of patients who had no new amalgam filling restored was matched by sex, age, and treatment date. Both cohorts were followed up from the treatment date until the date of diagnosis of PD, death, or the end of the year 2008. The individuals who received amalgam fillings had a significantly higher risk of PD afterward (adjusted hazard ratio [HR]=1.583, 95% confidence interval [CI]=1.122-2.234, p=0.0089) than those who did not. In the individuals who received amalgam fillings, being diagnosed with diabetes or hyperlipidemia demonstrated a significantly lower HR of PD occurrence than in the patients without diabetes or hyperlipidemia (HR=0.449, 95% CI=0.254-0.794, p=0.0059; HR=0.445, 95% CI=0.260-0.763, p=0.0032) after adjusting for comorbidities and Charlson-Deyo Comorbidity Index (CCI) scores. Meanwhile, hypertension increased the hazard risk of PD (HR=1.645, 95% CI=1.098-2.464, p=0.0159). The patients exposed to dental amalgam fillings were 1.583 times more likely to have PD afterward compared to their non-exposed counterparts after adjusting for comorbidities and CCI scores.


Assuntos
Amálgama Dentário/efeitos adversos , Mercúrio/efeitos adversos , Doença de Parkinson Secundária/induzido quimicamente , Doença de Parkinson Secundária/epidemiologia , Adulto , Idoso , Estudos de Casos e Controles , Amálgama Dentário/uso terapêutico , Amálgama Dentário/toxicidade , Feminino , Humanos , Masculino , Mercúrio/uso terapêutico , Pessoa de Meia-Idade , Doença de Parkinson Secundária/patologia , Modelos de Riscos Proporcionais , Fatores de Risco , Taiwan
20.
Cochrane Database Syst Rev ; 12: CD005517, 2016 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-27991646

RESUMO

BACKGROUND: Root canal therapy is a sequence of treatments involving root canal cleaning, shaping, decontamination and obturation. It is conventionally performed through a hole drilled into the crown of the affected tooth, namely orthograde root canal therapy. For teeth that cannot be treated with orthograde root canal therapy, or for which it has failed, retrograde root filling, which seals the root canal from the root apex, is a good alternative. Many materials, such as amalgam, zinc oxide eugenol and mineral trioxide aggregate (MTA), are generally used. Since none meets all the criteria an ideal material should possess, selecting the most efficacious material is of utmost importance. OBJECTIVES: To determine the effects of different materials used for retrograde filling in children and adults for whom retrograde filling is necessary in order to save the tooth. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 13 September 2016); the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8) in the Cochrane Library (searched 13 September 2016); MEDLINE Ovid (1946 to 13 September 2016); Embase Ovid (1980 to 13 September 2016); LILACS BIREME Virtual Health Library (1982 to 13 September 2016); and OpenSIGLE (1980 to 2005). ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. We also searched Chinese BioMedical Literature Database (in Chinese, 1978 to 20 September 2016); VIP (in Chinese, 1989 to 20 September 2016); China National Knowledge Infrastructure (in Chinese, 1994 to 20 September 2016); and Sciencepaper Online (in Chinese, to 20 September 2016). No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We selected randomised controlled trials (RCTs) only that compared different retrograde filling materials, with reported success rate that was assessed by clinical or radiological methods for which the follow-up period was at least 12 months. DATA COLLECTION AND ANALYSIS: Two review authors extracted data independently and in duplicate. Original trial authors were contacted for any missing information. Two review authors independently carried out risk of bias assessments for each eligible study following Cochrane methodological guidelines. MAIN RESULTS: We included six studies (916 participants with 988 teeth) reported in English. All the studies had high risk of bias. The six studies examined five different comparisons, including MTA versus intermediate restorative material (IRM), MTA versus super ethoxybenzoic acid cement (Super-EBA), Super-EBA versus IRM, dentine-bonded resin composite versus glass ionomer cement and glass ionomer cement versus amalgam. There was therefore little pooling of data and very little evidence for each comparison.There is weak evidence of little or no difference between MTA and IRM at the first year of follow-up (risk ratio (RR) 1.09; 95% confidence interval (CI): 0.97 to 1.22; 222 teeth; quality of evidence: low). Insufficient evidence of a difference between MTA and IRM on success rate at the second year of follow-up (RR 1.06; 95% CI: 0.89 to 1.25; 86 teeth, 86 participants; quality of evidence: very low). All the other outcomes were based on a single study. There is insufficient evidence of any difference between MTA and Super-EBA at the one-year follow-up (RR 1.03; 95% CI: 0.96 to 1.10; 192 teeth, 192 participants; quality of evidence: very low), and only weak evidence indicating there might be a small increase in success rate at the one-year follow-up in favour of IRM compared to Super-EBA (RR 0.90; 95% CI: 0.80 to 1.01; 194 teeth; quality of evidence: very low). There was also insufficient and weak evidence to show that dentine-bonded resin composite might be a better choice for increasing retrograde filling success rate compared to glass ionomer cement at the one-year follow-up (RR 2.39; 95% CI: 1.60 to 3.59; 122 teeth, 122 participants; quality of evidence: very low). And there was insufficient evidence of a difference between glass ionomer cement and amalgam at both the one-year (RR 0.98; 95% CI: 0.86 to 1.12; 105 teeth; quality of evidence: very low) and five-year follow-ups (RR 1.00; 95% CI: 0.84 to 1.20; 82 teeth; quality of evidence: very low).None of these studies reported an adverse event. AUTHORS' CONCLUSIONS: Based on the present limited evidence, there is insufficient evidence to draw any conclusion as to the benefits of any one material over another. We conclude that more high-quality RCTs are required.


Assuntos
Cimentos Dentários/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Adulto , Criança , Amálgama Dentário/uso terapêutico , Cimentos de Ionômeros de Vidro/uso terapêutico , Humanos , Éteres de Hidroxibenzoatos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Cimentos de Resina/uso terapêutico
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