First permanent molar restoration differences between those with or without dental sealants.
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An increasing number of cavities in the primary and permanent dentition is restored with tooth-colored materials, especially dental resin composites or glass ionomer cements. Several investigations have revealed that various components are segregated from different composite filling materials into an aqueous environment after polymerization. Most organic substances can be extracted from a set resin by organic solvents (methanol, tetrahydrofuran, ethanol). Furthermore, in most studies, the co-monomer TEG-DMA has been identified as the main compound released from polymerized resin composites into aqueous media. However, small quantities of the monomers (Bis-GMA, UDMA) and other co-monomers, as well as additives, may also be released into water. Very little data have been published about substances released from various types of glass ionomer cements (GIC), except the liberation of fluoride. Erosion studies have revealed that there is a considerable disintegration of GICs at lower pH-values. However, the nature of the eroded substances has not yet been clarified. Altogether, the data presented in this review indicate that information is comparably scarce for resin composites and GICs in comparison to the rich amount of knowledge concerning amalgams. Therefore, further studies are necessary to determine quality and quantity of substances segregated from resin composites and GICs.
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OBJECTIVE: The analysis of reasons for the replacement of 9,805 amalgam, composite, glass ionomer, resin modified glass ionomer and 'other' restorations in permanent teeth in general dental practice. DESIGN: The data were subdivided on the bases of age and gender of the patients, the types of restorations and the clinicians' gender, experience and practice setting. RESULTS: The clinical diagnosis of secondary caries was the main reason for replacement of all types of restorations studied, followed by fracture of restorations, especially bulk fracture, irrespective of patient's age. Bulk discoloration was the third most common reason for replacement of resin based materials in adults, but it rarely occurred in adolescents 18 years and younger. The reasons for replacement of restorations were not associated with the gender of the patients. Subgroupings based on the clinicians' gender showed that female clinicians diagnosed secondary caries more often than male clinicians. Otherwise, the reasons for replacements were similar for both genders of clinicians. Subdivision of restorations based on the years since graduation of the clinicians resulted in small groups. The youngest group of clinicians diagnosed relatively more secondary caries both for amalgam and composite restorations than the most experienced group. CONCLUSION: The clinical diagnosis secondary caries was the main reason for replacement of all types of restorations studied.
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This paper examines the state-of-the-art in the direct restoration of posterior teeth. The existing paradigms for the management of caries are questioned and some existing methods of cavity preparation are reviewed. Dental restorations need to be durable but able to adapt to a changing environment brought about by wear of the adjacent tooth substance and by fatigue processes within the tooth itself. The wear of restorative materials needs to be matched to that of the tooth, otherwise differential loss of either the restorative material or the enamel may destabilize the occlusion. Esthetic instability due to natural darkening of the tooth with age, punctuated by clinical intervention with bleaching procedures, adds a further dimension to the concept of a permanent restoration. Clinical methods that minimize the disruptive effects of dental restorations upon the remaining tooth structure are a continuing challenge.
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