Research, education, caries, and care--taming and turning the restorative tiger.
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Radiopacity is an indispensable property of composite resins for clinical diagnosis. The level of radiopacity that is most compatible with the radiographic diagnosis of recurrent caries was studied in a two-part experiment. In the first part, 16 composities were evaluated and divided into four groups based on their levels of radiopacity compared with an aluminum stepwedge. In the second part, caries was simulated by grooves of increasing depth in aluminum blocks of a thickness equivalent in radiopacity to enamel and the detectability assessed beneath differing thicknesses of three representative composite resins, P-30, Brilliant Lux and Occlusin. The relative radiographic density was measured and P-30 found to have the greater contrast. It is proposed that composite materials with a radiopacity similar to enamel are best for the detection of recurrent caries.
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The application of multi-surfaced posterior tooth-coloured restorations is an exercise in risk tolerance when dentine occupies the bulk of the tooth substrate. Success with posterior tooth-coloured restorations is dependent on interfacial integrity. Although the literature is full of guidelines on producing aesthetically pleasing restorations, most practising clinicians appreciate that clinical success involves more than aesthetics: success is strongly dependent on operative competence. This article describes a number of innovative clinical techniques and discusses the probationary status of current adhesive options and the need for excellence in all phases of these demanding restorative sequences.
This case study describes the management of Callum, an anxious 7-year-old boy with extensive caries. Callum's dental care was carried out in a general dental practice in the North of England under the terms of the National Health Service. A preventive programme was carried out in conjunction with the restorative philosophy according to guidelines published by the Dental Practice Board in 1997.
This article describes a technique for treating anterior toothwear. The technique allows the placement of direct composite on the palatal surface of upper anterior teeth in an efficient and accurate manner. The advantages of an indirect wax-up technique and a direct intra-oral approach are combined to give an aesthetic and conservative result.
PURPOSE OF THE INVESTIGATION: To investigate, by questionnaire, the direct restorative materials used by a sample of practitioners from the United Kingdom. BASIC PROCEDURES: A postal questionnaire was distributed to a group of self-selected practitioners, who volunteered to participate in the study. In all 110 practitioners participated in the study. MAIN FINDINGS: The most used material for the restoration of occlusal (Class I) and approximal (Class II) lesions was amalgam with 61% and 73% of practitioners indicating that they used amalgam in this situation. Adhesive tooth-coloured materials, specifically composites and compomers, were preferred by the majority of practitioners for anterior approximal (Class III) and incisal (Class IV) restorations with compomer preferred for Class V restorations including non-carious cervical lesions and for the restoration of primary teeth. PRINCIPAL CONCLUSIONS: It is concluded that the general practitioners surveyed in this study tend to use amalgam for the restoration of Class I and II lesions as opposed to resin composite. The majority of practitioners in this study used compomers, a relatively new group of restorative materials, with little evidence of traditional glass-ionomer cements being used routinely.
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The literature pertaining to amelogenesis imperfecta is reviewed as it applies specificity to two reports of cases. Psychologic, mechanical, or economic factors may warrant a transitional treatment of the teeth. Treatment with the use of an etchant and composite material and glaze is described.
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A review of the literature on research in expanded functions for dental auxiliaries is presented. Summaries of each of the training and evaluation studies sponsored by both private and government agencies are given. Wide variation in research methods of these studies and the failure to report important details make it difficult to interpret and use the research findings. Results from all studies indicate that dental auxiliaries can, with the proper training, perform selected reversible and irreversible dental procedures at an acceptable level of quality. Future research should be conducted in private practice settings and in new oral health care delivery systems with various configurations of expanded function dental auxiliaries.
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A two-year study was conducted to compare the qualitative advantages, if any, of a conventional, cold-curing composite resin to amalgam in occlusal Class I cavities in posterior teeth. The composite was placed into modified, conservative cavity preparations using the acid etch technique. Sixty-one pairs of contralateral restorations were evaluated. Forty-six percent of the amalgams and 42.6% of the composites were considered sound. The major deficiency of each material was rough or chipped margins of the amalgams (38%) and worn surfaces of the composites (26%). The use of conservative cavity preparations and the acid-etch technique with bonding agent and final glaze improved the longevity of the composite restorations compared to previous studies. However, the improvement does not suggest that this method will have a long-term effect on clinical success nor does it indicate that composite is superior to amalgam other than in marginal integrity and esthetics.
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Although esthetic dentistry techniques have grown more sophisticated, the fabrication and control of color in dentistry can be improved. An organized and precise system is necessary to combine artistic and scientific approaches. For this, a color order system, based on Munsell's notations and spectrophotometric research on the color space of natural teeth, would provide restorations of excellent color.