On the fracture behavior of molar teeth with MOD cavity preparation.

Mesial-occlusal-distal (MOD) cavity preparations are commonly used to restore damaged teeth. While numerous in vitro cavity designs have been devised and tested, no analytical frameworks for assessing their resistance to fracture seem to exist. This concern is addressed here by resorting to a 2D slice specimen cut from restored molar teeth with rectangular-base MOD cavity. The evolution of damage due to axial cylindrical indentation is followed in situ. The failure begins with a rapid debonding along the tooth/filler interface and continues with unstable cracking from the cavity corner. The debonding load qd is fairly fixed while the failure load qf is insensitive to the presence of filler, increasing with cavity wall thickness h and reducing with cavity depth D. The growth of the corner crack is studied using a 2D fracture analysis in conjunction with the FEM technique. The ratio h = h/D emerges as a viable system parameter. A simple expression for qf given in terms of h and dentin toughness KC is developed that predicts well the test data. In vitro studies on full-fledged molar teeth with MOD cavity preparation show that the fracture resistance of filled cavities often exceeds by a large margin that of unfilled ones. Indications are that this may reflect load sharing with the filler. Thus, the fracture resistance of the unfilled cavity provides a lower bound to a compromised MOD filling after long-term aging in the mouth. This bound is well predicted by the slice model. Finally, it is recommended that MOD cavities be prepared, if applicable, such that h > D regardless of the tooth size.

In vitro elemental and micromorphological analysis of the resin-dentin interface of bioactive and bulk-fill composites.

PURPOSE: To evaluate the bonding interface and the remineralization potential of a bioactive restorative material on demineralized dentin compared to a conventional bulk-fill resin composite restoration. METHODS: Twelve caries-free human molars were used in this study. Specimens were randomly divided into two groups according to the type of restorative material used (n=12); an injectable resin-modified glass-ionomer restorative [Activa BioActive-Restorative (ABR) ] and a bulk-fill composite [3M Filtek One Bulk Fill Restorative, (BFC) ]. Each restored specimen was sectioned in two semi-equal halves along the long axis of the teeth perpendicular to the resin dentin interface with a water-cooled diamond disk at low speed. The restoration-dentin interfaces were scanned under SEM to observe micromorphological analysis; then an elemental analysis of the interface was performed using an energy dispersive X-ray (EDX) spectroscopy. RESULTS: Quantitative data were described using median (minimum and maximum) after testing normality using the Shapiro-Wilk test. Mann-Whitney U test was used to compare the BFC and ABR. Higher mean values of Ca were identified and related to the ABR material, which provided more Ca ions than BFC. The comparison of Ca and P between materials showed a significant difference in the amount of Ca provided by ABR versus BFC. ABR restorations presented a thicker, and superior remineralization interface compared to the bulk-fill resin composite. CLINICAL SIGNIFICANCE: Activa BioActive Restorative restorations presented a thicker and superior remineralization interface compared to the bulk-fill resin composite.

Restoration longevity: Q: "How long will my crown last?" A: "78 years, Madame" - A case report.

This case report describes a post-retained crown placed on an anterior tooth that survived 78 years, with restoration repairs at 40 years and 58 years following placement. The history of the patient's other dental restorations and care showed a similar longevity.

Can composite packaging and selective enamel etching affect the clinical behavior of bulk-fill composite resin in posterior restorations? 24-month results of a randomized clinical trial.

OBJECTIVES: This is a double-blind, split-mouth, randomized clinical study that aims to evaluate the influence of bulk-fill composite packaging presented in syringes (BSy) and capsules (BCa), and the effect of selective enamel etching (SEE) on the clinical performance of class I and II bulk-fill resin composite restorations after 24 months. METHODOLOGY: A total of 295 class I or class II restorations were performed on 70 patients. One universal adhesive was applied in all restorations. SEE was used in 148 restorations and self-etching mode (SET) in 147 restorations. After the adhesive application, cavities were restored with Filtek Bulk-fill Posterior Restorative in syringes (BSy), Filtek One Bulk-fill in capsules (BCa), or Filtek Supreme Ultra in syringes with the incremental technique (In). All restorations were evaluated using the FDI criteria after one week and after six, 12, and 24 months. Kaplan-Meier survival analysis and Pearson's Chi-square test were used (α=0.05) for statistical analysis. RESULTS: After 24 months, 62 patients were evaluated and four restorations were lost due to fracture (one for SEEBSy, two for SEEIn, and one for SETIn). No significant differences in the fracture and retention rate were found between groups (p>0.05). SEE showed significantly fewer marginal adaptation defects than SET (p<0.05). BCa and BSy groups showed fewer marginal discrepancies compared to In (p<0.05). Restorations performed with BCa showed less color mismatch than BSy or In (p<0.05). CONCLUSION: Although all restorations exhibited satisfactory clinical performance after 24 months of clinical service, the clinical behavior of class I and II restorations' improved when performed with a bulk-fill composite in capsules, mainly when associated with a universal adhesive applied with SEE.

Curing profile and marginal gap formation using a liner containing long-wavelength-absorbing photoinitiator: an in vitro study.

The aim was to evaluate the marginal-gap formation and curing profile of a new restorative technique using a liner with long-wavelength-absorbing photoinitiator (LWAP). Box-shaped preparations (6 mm × 4 mm × 4 mm) were made in third molars. All samples were treated with Clearfill SE Bond and divided into 4 groups (n = 5), according to restorative technique used: (1) incremental technique (INC-Technique); (2) camphorquinone-based liner (CQ-Liner) + bulk-fill resin composite; (3) LWAP-based liner (LWAP-Liner) + bulk-fill resin composite; and (4) bulk-fill technique without liner (BF-Technique). The marginal gaps (%) for all the samples were measured using micro-computed tomography. The restorations were cross-sectioned, and the degree of conversion (DC) and Knoop microhardness were evaluated at different depths (0.3, 1, 2, 3, and 4 mm). INC-Technique, CQ-Liner, and LWAP-Liner groups showed significantly fewer marginal gaps than those from the BF-Technique group. The BF-Technique specimens had the lowest DC and microhardness in depth. All the other techniques presented similar degree of conversion and microhardness at all the depths. The use of liners, regardless of the photoinitiator system, decreased the marginal-gap formation and improved the curing profile of bulk-filling restoration technique.

[Online survey on adhesive dentistry: the results]. / Online enquête over adhesieve tandheelkunde: de resultaten.

In the months leading up to this special issue on adhesive dentistry, an online survey was conducted on various aspects of this. This survey was completed by 133 people, with a similar number of men and women. The results show that half of the oral care providers apply a rubber dam for adhesive restorations. The vast majority prefer to manufacture partial indirect restorations and the majority apply an IDS layer during dentine exposure. The choice of adhesive is not determined by time savings, but the dental technician often pre-treats the indirect restorations.

Reattachment of Fractured Tooth Fragment by Multidisciplinary Treatment Approach.

Dental anterior fractures are common injuries, especially in those who practice extreme sports. This report describes a 25-year-old Bolivian patient who attended our private dental clinic in La Paz, Bolivia after experiencing an accident during downhill mountain biking. An intraoral examination revealed a fracture line on the buccal side in the middle third of the coronal portion of the right central maxillary incisor which extended towards the proximal and lingual sides. Multidisciplinary treatment, including crown lengthening, osteotomy, root canal treatment, fiberglass post insertion, and reattachment of the fracture segment was performed. A follow-up examination at 10 months later revealed that the tooth was completely reestablished both functionally and esthetically and that there was no periapical pathosis or discomfort. This outcome suggests that if a patient seeks a dental consultation soon after a complex crown-root fracture has occurred, and if the broken tooth segment is available, then reattachment offers an economical and simple treatment option which will allow immediate restoration of functionality and esthetic standards. Continued follow-up should form part of such a treatment plan to allow long-term pulp vitality and periodontal health status to be monitored.

Nature-mimicking layering with composite resins through a bio-inspired analysis: 25 years of the polychromatic technique.

OBJECTIVES: For decades, the dental community has discussed which materials would be the ideal substitutes for lost tooth structure. Initially, the biomimetic approach advocated that feldspathic ceramics would be the material of choice for enamel. However, given the complexity of obtaining excellent dental technicians and the financial cost, are composite resins a suitable replacement? The optical properties with opalescence and fluorescence effects, as well as this material's high fracture toughness, indicate it as a long-lasting restorative material. However, because this material depends on the operator's expertise, knowledge of layering techniques and the selection of each material for the different layers is required. Thus, knowledge of the polychromatic technique through a bioinspired approach is necessary to obtain results of life-like restorations. This article aims to review the polychromatic layering technique (PLT), considering the optical and mechanical properties of dentin and enamel and correlating these properties with current composite resins to guide clinicians in selecting the most suitable restoratives for their clinical challenges. CLINICAL CONSIDERATIONS: The polychromatic layering technique is revisited, cross-referencing the properties of dentin and enamel with current composite resin restoratives and their biomimetic properties. The effectiveness and predictability of the PLT are corroborated in clinical cases of varying degrees of difficulty requiring different layering strategies. CONCLUSION: After the bio-inspired analysis, using nature as a model to be understood and followed, it is possible to note how the polychromatic technique remains current and viable in mimicking nature, providing esthetic and natural results in the layering of composite resins. CLINICAL SIGNIFICANCE: Composite resins effectively replicate the optical and mechanical characteristics of natural dentin and enamel through the bioinspired approach presented by the polychromatic layering technique.

[Deep Margin Elevation for adhesive indirect restorations]. / De coronaalwaarts verplaatste preparatiegrens voor adhesieve indirecte restauraties.

Deep subgingival margin elevation is a much-debated topic in adhesive and restorative dentistry. The hydrophobic trait of adhesive materials challenges the restorative procedure of cavities with deep subgingival margins since bonding and isolation by means of rubber dam is complicated. By relocating the deep subgingival preparation outline to epigingival, or supragingival with a direct composite restoration, the impression procedure and the use of rubber dam is simplified and the bonding of an indirect adhesive restoration can be performed more reliably. In the English-language literature, the term 'Deep Margin Elevation' is reserved for this approach. This article discusses the rationale and clinical implementation of Deep Margin Elevation. The current knowledge about the coronal relocated preparation margin is growing and is tersely summarized in this article with special attention to adhesive bonding between dentine, composites, and ceramic.

New digital approach to posterior tooth color reproduction in biomimetic adhesive restorations.

The accurate determination of tooth shade and its reproduction in modern restorations is often an arduous challenge in daily dental practice. The lack of objective methodologies in dental color estimation can make the work of dentists and dental technicians even more complex and frustrating. The purpose of the present article is to suggest shared clinical and laboratory workflows for digital image standardization to achieve an easy optical integration for posterior indirect composite restorations.

The effect of the die material used in the indirect technique on the fracture resistance of a restored molar.

The aim of this study was to evaluate the effect of different die materials used in the indirect resin composite restorative technique on the fracture resistance and failure mode of restored molars and compare it with the direct resin composite restorative technique. Two flexible die silicone materials for dental models (Die Silicone - Voco and Scan die - Yller) and a type IV dental stone material (Fujirock EP - GC) were evaluated. Sixty third molars were selected and divided into four groups: indirect resin composite restoration - Die silicone (IRCR-DS); indirect resin composite restoration - Scan die (IRCR-SD); indirect resin composite restoration - Fujirock EP (IRCR-FR), and direct resin composite restoration (DRCR). Class II MOD cavities were prepared with 5 mm of buccolingual width and depth. The specimens were restored and subjected to an axial compression load until fracture, and the data were analyzed by one-way ANOVA and Tukey's HSD test (α=.05). The fracture mode was classified into restorable and unrestorable fractures. Fracture resistance values were influenced by the die material used for the IRCR fabrication and by the restorative technique (p<.001). Fracture resistance mean values and standard deviation were: IRCR-DS: 1835.5 ± 324.0 A; IRCR-SD: 1732.5 ± 384.1 AB; IRCR-FR: 1419.3 ± 318.8 BC; and DRCR: 1100.6 ± 224.9 C. Restorable fracture was more prevalent. IRCR with flexible die casts promoted higher fracture resistance and lower prevalence of unrestorable fractures.

When (and when not) to use the Dahl Concept.

The Dahl Concept describes the re-establishment of occlusal contacts after the provision of a planned localised appliance or restoration in supraocclusion. Initially developed to create space for prosthetic rehabilitation of anterior teeth suffering from localised wear, the principle has later been successfully applied to a variety of situations, including the Hall technique and resin-bonded bridges cemented in supraocclusion. Despite high levels of success seen in the relevant literature and widespread adoption in specialist care, the wider profession appears to be far more cautious in its use. This article aims to provide a brief summary of the Dahl Concept and discuss the local and general factors that influence its successful implementation in the hope of promoting its increased adoption by the broader dental profession.

Fracture Resistance of Endodontically Treated Maxillary Premolars with Non-carious Cervical Lesions Restored with Different Post Systems.

OBJECTIVE: To test the hypothesis that the (i) presence of non-carious cervical lesions (NCCLs) and (ii) type of post system have no effect on the fracture resistance and pattern in endodontically treated maxillary premolars. METHODS: Human maxillary first premolars (n=60) with two root canals were randomly allocated into four groups (n=15). Buccal wedge-shaped NCCLs were prepared in 45 teeth specimens. Following root canal treatment, the specimens were randomly divided into (i) composite resin core (CRC); (ii) NCCLs + composite resin core (NCCL+CRC); (iii) NCCLs+prefabricated fibre-reinforced composite post + composite resin core (NCCL+PFRC+CRC); (iv) NCCLs+custom fibre posts + composite resin core (NCCL+CFP+CRC). All specimens were subjected to thermocycling (5°C to 55°C/5000 cycles). The compressive load was applied non-axially to the palatal cusp with a universal testing machine at a crosshead speed of 0.5 mm/min at a 30° angle until fracture. Fracture patterns were examined using a loupe magnification (2.5×) under transillumination. Statistical analyses were performed using non-parametric tests and pairwise comparisons of the load-to-fracture among the groups. Chi-square test was used to analyse the fracture patterns (P=0.05). RESULTS: Fracture resistance of NCCL+PFRC+CRC was significantly higher than NCCL+CRC (P=0.011), while NCCL+CFP+CRC did not show any significant difference when compared to NCCL+CRC (P=0.089). No statistical difference was found between CRC, NCCL+PFRC+CRC and NCCL+CFP+CRC (P=1.000). The frequencies of favourable fracture patterns in descending orders were as follows: CRC (80%), NCCL+CFP+CRC (73%), NCCL+PFRC+CRC (60%), and NCCL+CRC (40%). Chi-square test did not show significant differences in fracture patterns among all groups (P=0.110). CONCLUSION: Restoration of the endodontically treated maxillary premolars with NCCLs, with or without post, resulted in similar fracture resistance as their counterparts without NCCLs. Placement of a prefabricated fibre-reinforced composite post exhibited greater fracture resistance to the maxillary premolars with restored NCCLs than those without a post. (EEJ-2022-06-077).

Effect of the Combination of Restorative Material and the Etching Protocol in Enamel Microleakage in Class II Cavities after Thermocycling.

This study is aimed at evaluating the marginal microleakage of bulk-fill class II restorations after thermocycling. Thirty-two human third molars received class II cavities prepared on mesial and distal faces. The cavities were bonded according to the adhesive protocol (total or self-etching). The cavities were then restored with composite and divided into 8 groups based on the composite combination: layering technique with Filtek Z350XT (G1 and G5), first layer with Filtek Z350 XT Flowable Restorative and then Filtek Z350XT (G2 and G6), bulk-fill technique with Filtek One Bulk Fill (G3 and G7), and first layer with Filtek One Bulk Fill Flow and Filtek Z350 XT (G4 and G8). The restorations were then subjected to thermocycling (2000 cycles, 5°C and 55°C, dwell time of 30 s). After aging, the restored teeth were immersed in methylene blue for 48 hours. The restorations (n = 32) were sectioned in the middle (two sections). The microleakage results were analyzed by two-way ANOVA followed by Tukey's post hoc test (α = 0.05). The groups did not differ statistically from each other in terms of marginal microleakage (p = 0.295). It can be concluded that there is no difference in the percentage of microleakage between conventional and bulk-fill resins on both consistencies, as well as there is also no statistically significant difference when the adhesive system is used in a conventional or self-etching mode.

A randomized clinical study of the performance of self-etching adhesives containing HEMA and 10-MDP on non-carious cervical lesions: A 2-year follow-up study.

OBJECTIVE: To evaluate the association of HEMA and 10-MDP in the clinical performance of self-etching adhesives in the restoration of NCCLs during 2-years. MATERIALS AND METHODS: 60 restorations were performed in 17 volunteers and randomized into three groups: G1 (n = 20) - Prime and Bond Universal (10-MDP); G2 (n = 20) - Optibond All-in-One (HEMA); and G3 (n = 20) - Clearfil SE (10-MDP and HEMA). No cavity preparation was performed. After 2 years, the restorations were evaluated using the modified USPHS criteria for retention, marginal adaptation/ staining, postoperative sensitivity and secondary caries. The results were analyzed using Fisher's exact test and Kruskal-Wallis test. RESULTS: All groups showed 100% retention rate, except G1, who lost two restorations (p > 0.05). Regarding marginal adaptation, G1 showed greater deficiency, as only eight restorations (40%) remained intact (p < 0.05). Regarding marginal staining, G1 and G2 showed higher rate, as only 12 restorations (65%) in each one were free of staining (p < 0.05). All groups showed similar results for postoperative sensitivity and secondary caries (p > 0.05). CONCLUSION: The association of HEMA and 10-MDP monomers in the self-etching adhesives did not influence the clinical performance of the NCCL restorations with respect to retention, postoperative sensitivity, and incidence of secondary caries. However, positively influenced the marginal adaptation and marginal staining at the 2-year follow-up. CLINICAL SIGNIFICANCE: The association of HEMA and 10-MDP monomers in the self-etching adhesives positively influence the clinical performance of the NCCL restorations with respect to marginal adaptation and marginal staining.

Clinical longevity of extensive direct resin composite restorations after amalgam replacement with a mean follow-up of 15 years.

OBJECTIVES: The aim of this retrospective clinical study was to determine the survival of extensive direct resin composite restorations after amalgam replacement on vital molars and premolars after a mean observation period of 15 years. METHODS: Between January 2007 and September 2013, a total of 117 extensive cusp replacing direct resin composite restorations were placed in 88 patients in a general dental practice. These were indicated for replacement of existing amalgam restorations. Tooth vitality, the absence of at least one cusp in premolars, and at least two cusps in molars were considered for inclusion. The long-term follow-up of the restorations, re-evaluated after up to 17 years using the original evaluation criteria is reported. RESULTS: 81 of 88 patients (92.1%) and 106 of 117 restorations (90.6%) were available for follow-up. The cumulative success rate was 62.0% (95% CI: 47.3-76.2, AFR 2.79%) after a mean observation time of 163.4 months, the cumulative survival rate was 74.7% (95% CI: 59.8-89.6%, AFR: 1.70%) after a mean observation time of 179.1 months. The number of cusps replaced in premolars had a statistically significant influence on the success and survival rate of the restorations (HR of respectively, 2.974 and 3.175, p = <0.0005). Premolars with two cusps replaced had 297% more chance of failure than premolars with one cusp replaced. CONCLUSIONS: Extensive direct resin composite restorations placed after amalgam replacement showed good survival after a mean observation period of 15 years. The number of cusps involved had a statistically significant influence on the longevity of the restorations in premolars. CLINICAL SIGNIFICANCE: With good survival and low annual failure rates, direct resin composite restorations are a suitable treatment for repairing extensive defects in posterior teeth involving multiple cusps and surfaces, provided that they are placed by a dentist who has long experience and is skilled in the placement of direct composite materials.

Teaching of composite restoration repair in Brazilian dental schools.

OBJECTIVES: The aim was to investigate aspects of the teaching of restoration repair as a minimally invasive alternative to replacing defective direct composite restorations in undergraduate curricula teaching programs in Brazilian dental schools. METHODS: A 14-item validated survey questionnaire was mailed to directors/coordinators of operative/restorative dentistry teachers of Brazilian Dental Schools. Data were collected on demographic characteristics of the teachers and institutions, together with questions on the teaching of the repair of defective resin-based composite restorations as part of the school curriculum; the rationale behind the teaching; the nature of the teaching (preclinical and/or clinical); how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability and expected longevity of completed repairs. RESULTS: Two hundred and twenty-two (94%) directors/ coordinators of dental curricula in Brazil were contacted. One hundred and thirty-one directors/coordinators (59%) replied, providing the e-mail address from the teacher responsible for the operative/restorative dentistry program in their school. Of these, 104 responded to the questionnaire (79% response rate). Ninety-three (89%) of the participating schools reported teaching composite repairs as an alternative to replacing restorations. Of the theoretical content, 43% was taught at preclinical and clinical levels, whereas most practical experience (53%) was acquired at clinical levels. Eighty-eight schools (95%) reported tooth substance preservation being the main reason for teaching repair techniques. All schools that taught repairs reported high patient acceptability. CONCLUSIONS: The teaching of composite restoration repair as an alternative to restoration replacement is established in undergraduate programs in most of the Brazilian dental schools surveyed. CLINICAL SIGNIFICANCE: The reasons for teaching restoration repair in Brazil were found to be quite unanimous among teachers, especially regarding the preservation of tooth structure. Variations were found in the clinical indications for repair, suggesting the need for further investigations. Monitoring repaired restorations should be encouraged and could contribute to future studies.

Effect of ultrasonic vibration on the presence of voids in core build-up materials.

The core build-up procedure is utilized to restore teeth with limited remaining coronal tooth structure. However, voids have been observed radiographically within composite resin- and glass ionomer-based core build-ups, potentially compromising the mechanical strength of a fully restored tooth and requiring build-up replacement before a final restoration can be delivered. The purpose of this in vitro study was to determine whether applying ultrasonic vibration during core build-up placement reduces the presence of radiographically detectable voids. A total of 120 acrylic resin mandibular premolar analogs were fabricated using a 3-dimensional printer and randomly allocated into 4 groups (n = 30). Dual-cured composite resin or glass ionomer core build-ups were placed with or without vibration. The final build-ups were assessed radiographically and rated by 3 independent calibrated clinicians based on a 4-category scale for the severity of voids. In an ordinal logistic regression model with the void severity rating as the outcome, a significant interaction was found for glass ionomer, composite resin, and the use of ultrasonic vibration (P = 0.03). Vibration was associated with worse void severity ratings in glass ionomer specimens (P < 0.01). No effect of vibration was found in the composite resin specimens. The Fleiss kappa score (κ = 0.36) indicated fair agreement in all severity ratings among the 3 raters. These results suggest that the application of ultrasonic vibration during core build-up placement may not be clinically advantageous for improving restorative outcomes.

Survival and success of composite resin restorations in endodontically treated maxillary incisors with minimal structure loss.

The primary aim of this study was to evaluate the clinical performance of nanofilled composite resin restorations in traumatized, endodontically treated maxillary incisors with structural loss of 40% or less. The performance of the restorations was assessed in terms of longevity (survival) and esthetics (success) over a 20-month period. The secondary objective was to employ a novel digital method to quantify preoperative tooth structure loss. Sixty-one fractured maxillary incisors in 55 patients were included in the study. The teeth were photographed with a digital single-lens reflex camera equipped with a macro ring flash. The amount of lost tooth structure was calculated with digital photography software. The teeth were restored with a nanohybrid composite resin and self-etching adhesive system bonding agent. To assess esthetics, color change in the blue-yellow axis (Δb*) of the composite resin restoration was evaluated digitally with the Commission Internationale de l'Eclairage (CIE) L*a*b color system. The Wilcoxon signed-rank test was used to assess Δb*, and a Kaplan-Meier survival analysis was used to assess the longevity of the restorations. The study findings showed a statistically significant difference between pretreatment and posttreatment b* values (P < 0.05), but the difference was too small to be clinically perceptible to the human eye. A total of 5 restorations (9.8%) failed. The remaining restorations survived for a mean (SD) period of 18.6 (4.4) months. The log-rank test did not show any significant association between the amount of residual tooth structure and success of the restoration. The results of this study showed that use of direct composite resin restorations in endodontically treated maxillary incisors resulted in acceptable survival and success rates. Trial registration: Clinical Trial Registry of India No. CTRI/2020/01/023019.

Frequency of missing data in clinical records in pediatric dentistry: a descriptive study.

The aim of the present study was to investigate the frequency of missing data on routine dental care appointments and restorative procedures from the clinical records of children treated at a pediatric dental clinic. A descriptive retrospective study was conducted involving the clinical records of children three to 12 years of age treated only with restorations. The inclusion criteria were clinical records from the past 10 years of children with at least one restored tooth. Data collection was performed by a trained examiner who extracted information from the clinical records on appointments for routine dental care and restorative procedures. The frequency of missing data on clinical records was submitted to descriptive analysis. Among the 249 clinical records analyzed, boys accounted for little more than half (54.2%) and mean patient age was 6.9 ± 1.8 years. Ninety-four of the 249 clinical records were of appointments for routine dental care. Missing data were found for the gingival bleeding index (18.1%), visible plaque index (22.3%) and dietary logs (74.5%). Forty-seven children were submitted to a total of 618 restorative procedures. Information was missing on the type of restorative material (5%), brand of the material used (65.2%), the type of isolation (50.8%) and whether pulp capping was performed (75.9%). The percentage of missing data from clinical records was substantial, demonstrating that important information is not recorded during routine dental care or restorative procedures.