Clinical evaluation of composite resins as anterior and posterior restorative materials.
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This clinical report emphasizes that comprehensive treatment planning, whether simple or complex, requires interdisciplinary knowledge. Conservative treatment was implemented for this patient, a 29-year-old woman with a posttraumatic anterior open occlusal relationship, crowding, and a shifted midline. The treatment plan involved selective occlusal grinding, adjunctive orthodontics, periodontal surgery, and cosmetic dentistry and proved to be highly successful.
OBJECTIVES: This study was conducted to evaluate various types of contemporary resin composites and glass ionomer restorative materials for color differences that occur during light curing and after submersion in water. Additionally, translucency was evaluated through the use of a translucency parameter for each of these materials at these times. METHODS: A translucency parameter was calculated from observed colors of 2 mm thick layers of light, medium and dark shades of popular restorative materials on black and white backings. The colors of these materials were also calculated, based on Kubelka-Munk theory, for layers on a B2 shade backing. Repeated measures analyses of variance were used to identify statistically significant factors for color differences and translucency parameters. RESULTS: A statistically significant interaction was found between the products, shades and time intervals or times studied for both color difference and translucency parameter. There is relatively high variability in both lightness and translucency changes among these popular products, with some products increasing and others decreasing in these parameters with curing and subsequent water submersion. SIGNIFICANCE: Kubelka-Munk theory can be used to calculate the color of a layer of material on a backing other than those used to determine the Kubelka-Munk coefficients, thereby increasing the efficiency of research into the optical properties of esthetic restorative materials. The relatively large optical changes which occur as popular esthetic restorative materials are cured and subsequently submersed in water indicate that these changes should be taken into account during any initial clinical appearance match at placement of the unset material.
OBJECTIVE: A search was conducted in biomedical journals from July 1996 to December 1996 to identify dental materials publications and sort them into major categories. They were compared by frequency in different journals and in different categories during recent years. METHODS: Tables of contents for 16 primary and 51 secondary journals were inspected from July to December of 1996 and were divided into 17 categories. The frequencies of citations for primary journals and for different citation categories were examined over a four-year period from 1993 to 1996. RESULTS: There were 334 total citations from July to December 1996. The greatest number of citations continued to involve bonding (n = 159) and resin-based (composites; glass ionomers) restorative materials (n = 158). The numbers of articles by journal and by category were very similar over the last four years. The average number of articles per year was 531 +/- 15. SIGNIFICANCE: The literature citations compiled in this list provide a supplement for researchers and academicians to the current electronic databases.
Diamond ATR FTIR has been used to quantify light catalysed polymerisation and polyacid neutralisation rates in various glass ionomer cements (GIC), resin-modified GICs (RMGIC) and compomers. At 150s after the start of light exposure, levels of methacrylate polymerisation on the lower surfaces of 1mm thick specimens were 97% and 98% for the RMGIC, Vitremer and Fuji II LC and 47% and 37% for the compomers, Compoglass and Dyract. After light exposure, polymerisation rates for the compomers decreased linearly with inverse time. By 50,000s Compoglass and Dyract were 62% and 51% polymerised. Initial rate of polyacid neutralisation in the GIC Shofu HIFI was 0.32 times that of Fuji IX GIC. Those in Vitremer, Fuji II LC, Compoglass and Dyract were 0.16, 0.09, 0.004 and 0.004 times that of Fuji IX. Excluding short initial periods, log of neutralisation rates decreased linearly with log-time. Average gradients were -1.35 for the GIC, -0.80 for the RMGIC and -0.59 for the compomers. By 50,000s, polyacid salt concentrations for the RMGIC and compomers were 0.41 and 0.016 times that of the GIC. Reaction mechanisms have been discussed and used to help interpret material mechanical properties, fluoride release rates and adhesion to tooth structure.
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OBJECTIVES: To give the practising dentist scientifically based data to assist him/her in the responsible decision-making process necessary to weigh the options available to the patient if she/he prefers not to have an amalgam placed. DATA SOURCES: Based on the literature and on the research work, which was done in the author's department, the indications and limitations of the known alternatives of amalgam were formulated. DESCRIPTION OF ALTERNATIVES TO AMALGAM: With the exception of cast gold restorations, all alternatives require the strict use of adhesive techniques. When compared with similar amalgam restorations, placing composite restorations (if they are indicated) takes approximately 2.5 times longer because complex incremental techniques are needed. Despite all the efforts, direct composite restorations placed in large cavities still show unacceptable amounts of marginal openings. Tooth-coloured inlays are a better alternative for large restorations. These restorations must be inserted with adhesive techniques. With composite inlays it is difficult to achieve a composite-composite bond. Ceramic inlays may be micromechanically bonded to the luting composite. They all show clinically a good marginal behaviour and the use of ultrasonic energy may further simplify the application technique of aesthetic inlays. STUDY SELECTION: Papers describing the different techniques were used as a base for the corresponding chapter. To assess and compare the longevity of the different restoration types, literature data were used. We limited ourselves to papers reporting at least 5-year clinical data. Longitudinal, clinically controlled studies were preferred. However, to be more complete, retrospective, cross sectional studies were also included. LONGEVITY OF POSTERIOR RESTORATIONS: Amalgam shows excellent longevity data with studies up to 20 years. The average annual failure rate is 0.3-6.9%. Posterior composites are in the same range (0.5-6.6%), however, the study times are much shorter (max. 10 years). For tooth-coloured inlays much less data are available. Longevity is reported up to 6 years with annual failure rates of 0.6-5%. CONCLUSIONS: All aesthetic alternatives to amalgam require more complex procedures and more time. If cost benefit considerations are a concern, amalgam is still the most convenient restorative material for posterior teeth.
OBJECTIVES: This investigation evaluates the long-term flexural strength behaviour of three different glass-ionomer cement (GIC) based materials. METHODS: The materials under investigation were a conventional GIC (Opusfil), a metal-reinforced GIC (Opus Silver) and a resin-modified GIC (Fuji II LC). Flexural strength specimens of the materials were prepared according to the relevant manufacturers' instructions for clinical use. After 10-min maturation at 37 degrees C, the specimens were placed in water, also at 37 degrees C, until required for testing. Specimens were tested under four-point bend at intervals between 7 and 130 days after manufacture. RESULTS: Opusfil increased in strength up to day 56, but was significantly weaker after this time. Opus Silver was strongest on day 7, although there was no further decline in strength after day 14. Fuji II LC increased in strength up to day 14, but there was deterioration in strength after day 100. Opus Silver had the highest early strength of the three materials, but after day 7 there was no significant difference in strength between the three materials under test. CONCLUSIONS: The three cements tested did not exhibit the continued increase in strength with time that has been attributed to glass-ionomer cements. Each material behaved differently, but they all appeared to be adversely affected by storage in aqueous media. Materials formed by the inclusion of metal or the incorporation of resins into the glass-ionomer cement formulation should be regarded as separate sub-classes of materials in their own rights.
The aim of this study was to analyze the association between dental anxiety, dental attendance, health status and social factors. Our previous studies have shown that dental anxiety declines with age and is associated with poor oral health. In addition, correlations between dental anxiety, dental utilization and dental status have been revealed. However, the association of these factors with general health and social factors has not been analyzed in our previous studies. In a study of women's health in Göteborg, Sweden in 1992, 1.017 urban women aged 38 to 84 years took part in a series of investigations including clinical examinations, interviews and questionnaires. In addition to descriptive and simple inference statistics, a two-part multiple logistic regression model was utilized to investigate dental anxiety and dental utilization. Dental fear was less prevalent among older women, dentate or not, although 10% of females 62 years of age and older still reported high dental anxiety (DAS > or = 12). 94% of the younger (< or = 62 yr) and 76% of the older (> or = 70 yr) women reported regular dental attendance. When separating all women into dentate and edentulous groups, 94% of the dentate and 11% of the edentulous respondents reported regular dental care. Due to the large difference in dental attendance between dentate and edentulous women, these groups were analyzed separately. Multiple logistic regression analyses showed that the following factors were associated with irregular dental utilization among dentate women: high dental anxiety, fewer teeth and restorations, more caries, poorer chewing ability and dissatisfaction with dental esthetics. In the multiple regression for dental anxiety, high fear was shown to be associated with irregular dental care, age (younger), fewer teeth, dissatisfaction with dental esthetics and lower scores on the SF-36 mental health scale. A separate analysis showed that individuals with high fear and regular, as opposed to irregular, dental attendance had more teeth at a statistically significant level, which were less often decayed and more often restored. In spite of the group with high fear and irregular attendance having fewer teeth, their level of decay was seven times higher. Overall, the results indicate a strong association between dental fear and dental attendance. Weak associations were found among socio-economic, dental health and general health factors.
OBJECTIVE: In this investigation, the in vitro sustained fluoride release, weight loss and erosive wear of three conventional glass ionomer cements (Fuji IX, ChemFil Superior, Ketac-Silver), three resin-modified glass ionomer cements (Fuji II LC, Vitremer, Photac-Fil), a polyacid-modified resin composite (Dyract), and a resin composite control material (Z100) were compared. METHODS: The amounts of fluoride released and weight changes were measured for 12 weeks using a fluoride electrode with TISAB III buffer. After 12 weeks, the specimens were recharged with fluoride using 2 mL of 1.23% APF gel. The recharged specimens were assessed for the amounts of fluoride released and weight changes over another 12 weeks. At the end of the experiment, the specimens were examined with SEM and surface profilometry. RESULTS: All materials, with the exception of Z100, showed the highest initial fluoride release rates during the first 2 days, dropping quickly over 2 weeks and becoming largely stabilised after 5 weeks, in an exponential mode. The recharging of the specimens with APF gel caused a large increase in the amounts of fluoride released during the first 2 days only. Analyses for all cements showed strong correlations between mean weight loss and cumulative fluoride release over a 5-week period following the application of the APF gel. SEM and surface profilometry found that roughness increased from the polyacid-modified resin composite to the conventional glass ionomer cements. CONCLUSIONS: APF gel caused erosive wear of the glass ionomer cements especially, and the wear correlated well with the weight losses. To minimise surface erosion, APF gel should not be used on these cements, especially as the recharging effects are transitory.
AIM: The aim of this study was to determine whether an educational intervention delivered by a computer aided learning package improved the sensitivity and specificity of dentists' restorative treatment decisions. METHOD: The study was a randomised controlled study using a Solomon three-group design. Ninety-five dentists were randomly allocated to the three study groups. One group of dentists read the radiographs pre and post an educational intervention, a second group read the radiographs once, after the intervention, and a third group read the radiographs twice, but received no intervention. On each occasion the dentists read 24 surfaces on each of 15 radiographs and made 360 decisions on how certain they were about restoring the tooth surface. Comparisons of mean sensitivity, specificity and areas under ROC curves were made within and between the study groups. Kappa values were used to assess changes in the level of agreement between dentists. RESULTS: There were no significant changes in sensitivity, specificity or area under ROC curves caused by the intervention. There was no evidence that the level of agreement between the dentists improved after the intervention. CONCLUSION: A computer aided learning package had no effect on dentists' treatment decision-making behaviour.
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