New resin composites used to restore both anterior and posterior teeth

Over the last few years, the advancements made in the field of adhesive techniques have significantly modified operative techniques, from cavity preparation to final restoration. On one hand, a predictable bond between restoration and dental tissues allows us to operate with very conservative techniques, saving sound dental tissue; on the other hand, it must be considered that such procedures are not simple. Additionally, it is easy to observe that all of our everyday dental practice is strictly influenced by the type of material and techniques used. Knowing such procedures as well as adhesive mechanisms, quality of sound dental tissue and its conservation - both in vital and endodontically treated teeth - is now considered significantly relevant for restorative purposes.     

An amalgam and composite resin splint for posterior teeth

A combined amalgam and composite resin splint was constructed for a 35-year-old man with pathologic tooth mobility. This type of stabilization was selected because of the poor prognosis, economic considerations, and poor alignment of the teeth. Amalgam restorations were inserted with strong contacts. Composite resin material was used to fill the channel cut through all amalgam restorations and reinforced with braided stainless steel wire. The poor alignment of the teeth would have caused other types of splints to fail.     

Use of a posterior composite resin to restore teeth and support enamel: report of case

In selected cases in which appearance is important, a posterior composite resin may be used successfully to reinforce and restore a tooth with undermined, nonfunctional cusps. The restoration of teeth with compromised functional cusps is not recommended. Once the decision has been made to restore the tooth with a posterior composite resin, care must be taken to follow a technique to prevent problems after treatment that result from microleakage and contraction shrinkage.     

The combined composite resin and amalgam restoration for posterior teeth: a clinical report.

This paper presents a technique for restoring maxillary posterior teeth with a combined composite resin and amalgam restoration when the preparation extends buccally into an esthetically critical area. This technique has two major advantages over traditional combined restorations: it requires only one clinical appointment, and it provides an esthetically acceptable result while maintaining the advantages of an amalgam restoration. A clinical assessment of 12 of these restorations, in vivo for 0.8 to 6.4 years, is presented. All but one restoration received a score of excellent or acceptable.     

A resin alternative for posterior teeth: questions and answers on dental amalgam

Amalgam has been used to restore cavities in posterior teeth for over 100 years, but formulations used today are different from those used a century ago. Amalgam restorations have been blamed for a number of problems, such as cusp fracture and higher rates of secondary caries. This article discusses these issues, along with possible toxic effects, in the light of current literature.     

Restoration of endodontically treated posterior teeth with amalgam.

A technique for restoring endodontically treated posterior teeth has been presented. The pin-amalgam restoration may be used as an acceptable alternative to the cast restoration for situations where a cast restoration is not indicated.     

Use of a matrix to form directly applied resin composite to restore worn anterior teeth

The technique of using directly applied resin composite is increasingly being chosen to restore worn anterior teeth. This paper describes the use of a vacuum-formed matrix ('suck-down') to shape the directly applied resin composite, avoiding demanding freehand build-ups.     

Direct restoration of worn maxillary anterior teeth with a combination of composite resin materials: a case report

Tooth loss, alterations on tooth structure, and reduced vertical dimension are known to severely compromise the stomatognathic system. This case report describes the treatment of a patient who presented with an extremely worn maxillary anterior dentition with a loss of posterior support owing to the loss of almost all the posterior teeth, except the mandibular premolars. Provisional removable partial dentures were used to create an optimum maxillomandibular relationship and to provide restorative space prior to the restoration of the remaining teeth. This restoration was accomplished with a combination of layered hybrid and microfilled composite materials, which restored the maxillary anterior teeth to optimum esthetics and function.     

In vivo fractures of endodontically treated posterior teeth restored with amalgam

The cumulative survival rate (retention of both cusps) and the fracture pattern of 1639 endodontically treated posterior teeth were assessed in a retrospective study. All teeth had an MO/DO or an MOD cavity restored with amalgam without cuspal overlays. The 20-year survival rate of teeth with an MO/DO cavity was markedly higher than that of teeth with an MOD cavity. The lowest survival rate was found for the upper premolars with an MOD cavity: 28% of these teeth fractured within 3 years after endodontic therapy, 57% were lost after 10 years, and 73% after 20 years. Generally, the cusp most prone to fracture was the lingual one, and lingual fractures caused significantly more damage to the periodontal tissues than did facial or total crown fractures. The severity of periodontal damage increased with posterior location of the tooth. By far the most serious failures, irrespective of the cavity type, were found for the upper second molar, as 10 of 29 fractures led to extraction. It is concluded that amalgam, especially in MOD cavities, is an unacceptable material for restoration of endodontically treated posterior teeth if used without cuspal overlays.     

In vivo fractures of endodontically treated posterior teeth restored with amalgam

Abstract The cumulative survival rate (retention of both cusps) and the fracture pattern of 1639 endodontically treated posterior teeth were assessed in a retrospective study. All teeth had an MO/DO or an MOD cavity restored with amalgam without cuspal overlays. The 20-year survival rate of teeth with an MO/ DO cavity was markedly higher than that of teeth with an MOD cavity. The lowest survival rate was found for the upper premolars with an MOD cavity: 28% of these teeth fractured within 3 years after endodontic therapy, 57% were lost after 10 years, and 73% after 20 years. Generally, the cusp most prone to fracture was the lingual one, and lingual fractures caused significantly more damage to the periodontal tissues than did facial or total crown fractures. The severity of periodontal damage increased with posterior location of the tooth. By far the most serious failures, irrespective of the cavity type, were found for the upper second molar, as 10 of 29 fractures led to extraction. It is concluded that amalgam, especially in MOD cavities, is an unacceptable material for restoration of endodontically treated posterior teeth if used without cuspal overlays.     

Fiber-reinforced composite fixed partial denture to restore missing posterior teeth: a case report

In patients refusing implant surgery for psychological reasons, when minimal tooth reduction is desired, a fiber-reinforced composite inlay fixed partial denture (IFPD) can be used to replace missing teeth. In comparison to other restorative systems this conservative approach carries a lower risk of pulp exposure and/or periodontal inflammation, maintaining the health of supporting tissues. The purpose of this case report is to describe the clinical procedure for fabricating an IFPD with a pre-impregnated glass fiber system and a hybrid composite. Fiber-reinforced composite, in combination with adhesive techniques, appears promising for an IFPD. Further clinical investigation will be required to provide additional information on this technique.     

Periodontal and prosthetic biologic considerations to restore biological width in posterior teeth

The biologic width is an essential dental space that always needs to be maintained to ensure periodontal health in any dental prosthetic restorations. An iatrogenic partial fixed prosthesis constructed in lower posterior teeth predisposed the development of subgingival caries, which induced violation of the biologic width in involved teeth, resulting in an uncontrolled inflammatory process and periodontal tissue destruction. This clinical report describes a periodontal surgical technique to recover a violated biologic width in lower posterior teeth, by crown lengthening procedure associated with free gingival graft procedure, to ensure the possibility to place a modified partial fixed prosthesis in treated area. The procedure applied to recover the biologic width was crown lengthening with some modifications, associated with modified partial fixed prosthesis to achieve health in treated area. The modified techniques in both surgical and prosthetic procedures were applied to compensate the contraindications to recover biologic width by osteotomy in lower posterior teeth. The result, after 4 years under periodic control, seems to achieve the projected goal. Treating a dental diseased area is necessary to diagnose, eliminate, or control all etiologic factors involved in the process. When the traditional methods are not effective to recover destructed tissues, an alternative, compensatory, and adaptive procedure may be applied to restore the sequelae of the disease, applying a restorative method that respects the biology of involved tissues.     

Randomized clinical comparison of endodontically treated teeth restored with amalgam or with fiber posts and resin composite: five-year results

Prospective clinical studies comparing the results of different types of restorations of endodontically treated teeth are lacking. This study compared the clinical success rate of endodontically treated premolars restored with fiber posts and direct composite to the restorations of premolars using amalgam. Premolars with Class II carious lesions were selected and randomly assigned to one of two experimental groups: (1) restoration with amalgam or (2) restoration with fiber posts and composite. One hundred and nine teeth were included in Group 1 and 110 in Group 2. Patients were recalled after 1, 3 and 5 years. No statistically significant difference was found between the proportion of failed teeth in the two experimental groups. Significant differences were observed between the proportion of root fractures (p=0.029) and caries (p=0.047), with more root fractures and less caries observed in the teeth restored with amalgam at the five-year recall. Within the limits of this study, it can be concluded that restorations with fiber posts and composite were found to be more effective than amalgam in preventing root fractures but less effective in preventing secondary caries.     

A 5-year study comparing a posterior composite resin and an amalgam

Eighty class I and class II light-cured posterior composite resin restorations were compared with 43 class I and class II amalgam restorations during a 5-year period after placement. The results of this clinical study showed that both materials were satisfactory during the time period and that the only significant statistical differences are a poorer marginal integrity for the amalgam and a greater wear rate for the composite resin.