Cost‐effectiveness of an experimental caries‐control regimen in a 3.4‐yr randomized clinical trial among 11–12‐yr‐old Finnish schoolchildren

The aim of this study was to assess the cost‐effectiveness of an experimental caries‐control regimen in a randomized clinical trial (RCT) conducted in Pori, Finland, in 2001–2005. Children (n = 497) who were 11–12 yr of age and had at least one active initial caries lesion at baseline were studied. The children in the experimental group (n = 250) were offered an individually designed patient‐centered regimen for caries control. The children in the control group (n = 247) received standard dental care. Furthermore, the whole population was exposed to continuous community‐level oral health promotion. Individual costs of treatment procedures and outcomes (DMFS increment score) for the follow‐up period of 3.4 yr were calculated for each child in both groups. The incremental cost‐effectiveness ratio was €34.07 per averted DMF surface. The experimental regimen was more effective, and also more costly. However, the total costs decreased year after year, and for the last 2 yr the experimental regimen was less expensive than the standard dental care. The experimental regimen would probably have been more cost‐effective than standard dental care if the follow‐up period had been longer, the regimen less comprehensive, and/or if dental nurses had conducted the preventive procedures.     

Bulk‐filled posterior resin restorations based on stress‐decreasing resin technology: a randomized,controlled 6‐year evaluation

This randomized study evaluated a flowable resin composite bulk‐fill technique in posterior restorations and compared it intraindividually with a conventional 2‐mm resin composite layering technique over a 6‐yr follow‐up period. Thirty‐eight pairs of Class II restorations and 15 pairs of Class I restorations were placed in 38 adults. In all cavities a single‐step self‐etch adhesive (Xeno V) was applied. In the first cavity of each pair, the flowable resin composite (SDR) was placed, in bulk increments of up to 4 mm. The occlusal part was completed with a layer of nanohybrid resin composite (Ceram X mono). In the second cavity of each pair, the hybrid resin composite was placed in 2‐mm increments. The restorations were evaluated using slightly modified US Public Health Service (USPHS) criteria at baseline and then annually for a time period of 6 yr. After 6 yr, 72 Class II restorations and 26 Class I restorations could be evaluated. Six failed Class II molar restorations, three in each group, were observed, resulting in a success rate of 93.9% for all restorations and an annual failure rate (AFR) of 1.0% for both groups. The AFR for Class II and Class I restorations in both groups was 1.4% and 0%, respectively. The main reason for failure was resin composite fracture.     

Long‐Term Stability of Contour Augmentation With Early Implant Placement Following Single Tooth Extraction in the Esthetic Zone: A Prospective,Cross‐Sectional Study in 41 Patients With a 5‐ to 9‐Year Follow‐Up

Background: Early implant placement with simultaneous contour augmentation is documented with short‐ and medium‐term studies. The long‐term stability of contour augmentation is uncertain. Methods: In this prospective, cross‐sectional study, 41 patients with an implant‐borne single crown were examined twice, in 2006 and 2010. Clinical, radiologic, and esthetic parameters were assessed at both examinations. In addition, a cone beam computed tomographic (CBCT) image was obtained during the second examination to assess the dimensions of the facial bone wall. Results: All 41 implants demonstrated ankylotic stability without signs of peri‐implant infection at both examinations. The clinical parameters remained stable over time. Satisfactory esthetic outcomes were noted, as assessed by the pink and white esthetic score (PES/WES) indices. Overall, the PES scores were slightly higher than the WES scores. None of the implants developed mucosal recession over time, as confirmed by values of the distance between implant shoulder and mucosal margin and cast measurements. The periapical radiographs yielded stable peri‐implant bone levels, with a mean distance between implant shoulder and first visible bone‐implant contact value of 2.18 mm. The CBCT analysis demonstrated a mean thickness of the facial bone wall ≈2.2 mm. In two implants (4.9%) no facial bone wall was detectable radiographically. Conclusions: This prospective cross‐sectional study demonstrates stable peri‐implant hard and soft tissues for all 41 implants examined and satisfactory esthetic outcomes overall. The follow‐up of 5 to 9 years confirmed again that the risk for mucosal recession is low with early implant placement. In addition, contour augmentation with guided bone regeneration was able to establish and maintain a facial bone wall in 95% of patients.