Observations on a composite resin for class II restorations: two-year report

A clinical study was conducted to compare the performance of a commercial composite direct-filling resin with that of amalgam in Class II cavities. Of 124 paired restorations placed in 73 patients, 92 pairs were available at the two-year period. The restorations were subsequently evaluated at one and two years by a team of examiners from the Materials and Technology Branch of the Division of Dental Health, United States Public Health Service, San Francisco.     

Reported use of sealant restorations in a group of general practitioners in the west of Scotland

A postal/telephone survey of 452 general practitioners working in the Greater Glasgow and Lanarkshire Health Board areas was carried out between March and June, 1989. The aim was to investigate the use of sealant restorations under section 6 of the National Health Service fee scale for general dental practitioners. Section 6 itemizes fees for fissure sealant, glass-ionomer cement plus sealant, composite resin plus sealant and the laminate restoration. A response rate of 83% was obtained. Eighty-one per cent of the respondents were placing sealant restorations, but less than half were using the laminate or sandwich technique. A wide variety of materials and curing lights were employed. Enamel etching times varied considerably and rubber dam was seldom used. Eighty-nine per cent indicated that they would welcome illustrated fact sheets demonstrating the use of sealant restorations.     

两种椅旁CAD/CAM瓷块制作的全瓷冠在种植修复中的临床效果研究

目的　评价两种椅旁CAD/CAM瓷块制作的全瓷冠在种植修复中的临床效果。方法　选取2013年5月至2014年9月于济南市口腔医院综合科行下颌第一磨牙种植修复患者65例，共计修复缺失牙65颗。待种植体植入3 ~ 6个月后，采用Vita MarkⅡ瓷块制作全瓷冠25颗，采用E.max瓷块制作全瓷冠40颗，均通过Cerec omnicam设计和制作。全瓷冠用树脂水门汀粘接完成。修复后每12个月按照改良USPHS标准对临床效果进行评价。结果　修复48个月后，Vita MarkⅡ全瓷冠完整性评价为A的达到88%，边缘密合性评价为A的达到88%，邻接松紧度评价为A的达到84%；E.max全瓷冠完整性评价为A的达到97.5%，边缘密合性评价为A的达到95%，邻接松紧度评价为A的达到95%。结论　采用经Cerec omnicam设计和制作的种植修复全瓷冠，可在一次就诊时间内完成修复体的设计、制作等过程，减少了患者的就诊次数，且临床效果较好；Vita MarkⅡ与E.max瓷块均可用于制作种植义齿的全瓷冠。     

Tunnel restorations placed in routine practice and observed for 24 to 54 months.

OBJECTIVE: The purpose of this study was to evaluate the feasibility and performance of tunnel restorations placed in routine public dental service. METHOD AND MATERIALS: A total of 420 small approximal lesions received tunnel restorations 12 general practitioners. Three hundred two restorations in 179 patients were available for evaluation after a minimum period of 24 months. The restorations were evaluated by modified US Public Health Service criteria. RESULTS: After service periods up to 54 months, 57% of the restorations were found to be clinically and radiographically acceptable. The remainder had already been replaced or were assessed as unacceptable. High levels of carious activity and internal-type preparations resulted in the poorest prognosis. The success rates varied considerably among the operators, but these differences did not reach statistical significance. CONCLUSION: The indications for use of the tunnel restoration technique for the treatment of primary approximal lesions seem to be limited at present. Partial tunnel restorations may have a somewhat better prognosis than the internal tunnels, but high carious activity has a detrimental effect. Tunnel restorations may be considered for particularly cooperative patients with a low caries rate as a semipermanent treatment for small lesions.     

Clinical evaluation of two "packable" posterior composite resins

The purpose of this study was to evaluate the clinical performance of two "packable" posterior composites: Prodigy Condensable (P) (Kerr) and Definite (D) (Degussa). Thirty-six patients participated in the study. A total of 78 restorations were made, 40 with D and 38 with P. Each patient received at least two restorations, one of each studied material. The materials were handled according to the manufacturer's instructions. The restorations were finished and polished after 1 week. They were evaluated at baseline and after 1 year by two independent evaluators using the United States Public Health Service (USPHS) criteria. Colored slides were made of all the restorations. After 1 year, 35 patients and 76 restorations (39 with D and 37 with P) were available for evaluation. All restorations received A criteria except the following ones, which received B criteria: color P (one restoration) and D (one restoration), marginal staining P (three restorations) and D (two restorations), surface staining P (nine restorations) and D (three restorations), anatomic form P (one restoration) and D (three restorations), and marginal adaptation P (one restoration) and D (eight restorations). The obtained data were tabulated and statistically analyzed using the Fisher and McNemar tests. After 1 year, P showed a significant increase in superficial staining. For D, the marginal adaptation became significantly worse than baseline and P. The studied materials can be considered acceptable during this evaluation period. Further evaluations are necessary for a better clinical performance analysis.     

Five year evaluation of class III composite resin restorations in cavities pre-treated with an oxalic- or a phosphoric acid conditioner

An oxalic acid solution has been proposed as a conditioning agent for resin composite restorations in two commercial adhesive systems. The durability of 163 class III restorations, including 12 class IV restorations, in cavities pre-treated with an oxalic acid total etch technique or an enamel etch with phosphoric acid was studied. Each of 52 patients received at least one of each of three experimental restorations. The restorations were evaluated yearly with slightly modified United States Public Health Service (USPHS) criteria. After 5 years 95% of the restorations were evaluated as acceptable. Reasons for failure were the fracture of four fillings, including three class IV, secondary caries contiguous to two fillings and a non-acceptable colour match for one restoration. For eight class III restorations a fracture of the incisal tooth structure was registered. No differences were seen between the three experimental restorations.     

VITABlocs（R）多层色全瓷修复体临床疗效的观察

目的：探讨CAD-CAM系统VITABlocs（@）多层色长石质陶瓷材料的临床修复效果.方法：选取临床47人需进行贴面、嵌体和高嵌体修复的病例,采用CAD-CAM系统VITABlocs（@）多层色长石质陶瓷修复材料进行修复,其中贴面54例,高嵌体10例,嵌体8例.进行1年半的随访,采用美国公共健康协会的修正标准进行评价分析.结果：对47人72例修复体随访观察1年半,有1例修复体发生折裂.贴面组中A级占96％,嵌体组中A级占97％.结论：对于前牙的美容修复、后牙形态的恢复以及骀龈距离低无法进行冠修复的后牙牙体组织缺损,CAD-CAM VITABlocs（@）系统多层色长石质陶瓷修复体以良好的边缘适合性、色泽稳定性和生物相容性具有很好的临床效果.     

Clinical evaluation of paired compomer and glass ionomer restorations in primary molars: final results after 42 months

OBJECTIVES: To undertake a clinical trial comparing the efficiency of a compomer restoration with a glass ionomer restoration in the management of caries in primary molar teeth. DESIGN: Subjects were admitted to the trial if they required at least one pair of restorations in primary molar teeth. SETTING: Department of Child Dental Health, Newcastle Dental Hospital and School. SUBJECT: Twenty nine children, aged 4-9 years, had 56 pairs of restorations placed between January 1995 and November 1997. METHOD: The durability of the restorations was assessed during a 42-month follow-up period using modified United States Public Health Service criteria. Survival analysis and the McNemar paired test were used to compare the performance of the two restorative materials. RESULTS: The compomer restorations had a higher mean survival time (42 months, SE 1.40) compared with 37 months (SE 1.90) for the glass ionomer restorations and this was significant at the 5% level. The compomer also performed significantly better in terms of anatomical form, marginal integrity, cavo surface discoloration and maintenance of interproximal contact. CONCLUSIONS: The present trial demonstrated that Dyract compomer performed significantly better than Chemfil Superior a glass ionomer cement for all modified United States Public Health Service criteria over a period of 42 months.     

Clinical performance of a nanofilled resin composite with and without an intermediary layer of flowable composite: a 2-year evaluation

The objective of this prospective clinical follow-up was to evaluate the 2-year clinical performance of a nanofilled resin composite in class II restorations. The restorations were made with and without intermediary layer of a nanofilled flowable resin composite studied in an intraindividual comparison. Each participant received at least two, as similar as possible, class II restorations of the nanofilled resin composite. One restoration of each pair (54) was chosen at random to be restored with an intermediary layer with flowable nanofilled resin composite. The other was restored without. The restorations were evaluated with slightly modified US Public Health Services criteria at baseline, 1, and 2 years. Ninety-two restorations, 46 pairs, were evaluated at 2 years. A prediction of the caries risk showed that 22 of the evaluated 48 patients were considered as high-risk patients. Two failures were observed, one in each group, resulting in a 2.2% failure rate. No statistical difference was seen between the restorations restored with and without layer of flowable resin composite. The nanofilled resin composite showed very good surface characteristics and color match, which did not change significantly during the follow-up period. The nanofilled resin composite showed a good clinical performance with a 2.2% failure rate after 2 years. No differences were observed between the restorations with and without the nanofilled flowable resin intermediary layer.     

Clinical evaluation of two packable posterior composites: 2-year follow-up

The clinical performance of two packable posterior composites, Alert (A)—Jeneric/Pentron and SureFil™ (S)—Dentsply, was evaluated in 33 patients. Each patient received one A and one S restoration, resulting in a total of 66 restorations. The restorations were placed by one operator according to the manufacturer’s specifications and were finished and polished after 1 week. Photographs were taken at baseline and after 2 years. Two independent evaluators conducted the clinical evaluation by using modified United States Public Health Service criteria. After 2 years, 60 restorations (30 A and 30 S), 27 class I (16 A and 11 S) and 33 class II (14 A and 19 S) were evaluated in 30 patients. Criterion A for recurrent caries, vitality, and retention was applicable to all 60 restorations. Criterion B was distributed among 40 restorations as follows: surface texture (15 A; 2 S), color (5 A; 6 S), postoperative sensitivity (1 S), marginal discoloration (8 A), marginal adaptation (3 A), and wear resistance (2 A). Data were analyzed using the Exact Fisher and McNemar tests. After 2 years, S showed a significantly better performance than A with respect to surface texture and marginal discoloration. The clinical performance of both materials was considered acceptable over the 2-year period. Further evaluations are necessary for a more in-depth analysis.     

Long-term survival estimates of cast gold inlays and onlays with their analysis of failures

The aim of the present study was to assess the clinical behaviour of cast gold restorations with respect to define a gold control against current and future ceramic and composite restorations. The study sample included 50 patients with 303 cast gold restorations. All restorations were cemented with a non-adhesive technique. A total of 303 restorations were evaluated clinically and radiographically using modified United States Public Health Service criteria. Restorations recorded as having an A- or a B-rating were defined as successful. Of the 303 restorations, 42 were judged as failures, which resulted in a failure rate of 13.8% for a mean observation time (+/- s.d.) of 18.7 ( +/- 9.5) years. The estimated Kaplan-Meier survival rates (s.e.) were 96.1% (+/- 1.1%) at 10 years, 87.0% (+/- 2.2%) at 20 years and 73.5% (+/- 5.4%) at 30 years. In total, biological reasons were counted 25 times in comparison to 17 technical reasons for those 42 failed cast gold restorations, with 17 secondary caries (40%) as the most common biological reason and with 13 retention losses (31%) as the most common technical reason. The endodontically treated tooth was exclusively identified as a risk factor. The restoration type (inlay versus onlay) did not influence the survival rate.     

Causes of failure among cuspal-coverage amalgam restorations: a clinical survey

BACKGROUND: Investigations of cuspal-coverage amalgam restorations suggest that tooth fracture is the leading cause of failure, while for Class I and II restorations, the leading cause is caries. In this study, the authors evaluated the causes of failure for a large number of cuspal-coverage restorations. METHODS: The causes of failure for 706 cuspal-coverage amalgam restorations were determined through the use of a questionnaire. Dentists from a variety of dental schools; Army, Navy, Air Force, Public Health and Veterans Affairs dental clinics; and private practice were asked to record pertinent information regarding patients and restoration failures from choices provided on a survey form. RESULTS: The survey documented 706 failed restorations. Mandibular first molars accounted for 36.25 percent of all failures. The majority of failures were caused by fractured teeth (24.3 percent), caries (20 percent) and fractured restorations (17.1 percent). Among all of the failed restorations, 82.15 percent were restorable, 9.35 percent were repairable and 8.50 percent were nonrestorable. Among the fractured teeth, 80 percent were restorable, 14.5 percent were nonrestorable and 5.5 percent were repairable. Among the carious teeth, 84 percent were restorable, 8 percent were nonrestorable and 8 percent were repairable. A chi 2 analysis revealed that tooth fracture was more likely to be associated with nonrestorability than either caries (chi 2 = 5.013, P < .05) or restoration fracture (chi 2 = 6.202, P < .05). CONCLUSIONS: The leading cause of failure among the 706 restorations was tooth fracture, which resulted in significantly greater numbers of nonrestorable teeth than either caries or fractured restorations. CLINICAL IMPLICATIONS: Tooth fracture creates a greater risk of nonrestorability than any other cause of failure. Replacement or coverage of fracture-prone cusps is likely to improve the life expectancy of complex amalgam restorations.     

IPS e.max Press LT易美铸瓷低度透明瓷块铸造全冠修复后牙缺损的临床观察

目的观察和评价IPS e.max Press LT易美铸瓷低度透明瓷块铸造全冠修复后牙缺损的效果。方法共选取63例98个IPS e.max Press LT易美铸瓷低度透明瓷块整体铸造全瓷冠修复体,修复3~12个月后按照美国公共健康协会的修正标准进行修复体评估。结果有93%的修复体颜色、形态、边缘着色、边缘密合度等各项检查达到A级,无崩瓷情况发生。结论IPS e.max Press LT易美铸瓷低度透明瓷块整体铸造全瓷冠具有较好的修复效果。     

Six-year follow up of atraumatic restorative treatment restorations placed in Chinese school children

OBJECTIVES: This study aimed to evaluate the clinical performance of atraumatic restorative treatment (ART) restorations placed in school children in China over a 6-year period. METHODS: This study was implemented in 1996 and 294 ART restorations were placed in 197 children aged 12-13 years by five assistant dentists in four schools. Standard ART procedures and instruments were used combined with a high-strength glass-ionomer restorative material. One examiner evaluated the restorations annually using the ART criteria while at 5 years an independent external examiner used US Public Health Service (USPHS) criteria. RESULTS: Fifty-eight per cent of the restorations were followed for 6 years. At the 6-year evaluation examination, 76% and 59% of the small and large restorations respectively were present and were without major wear or defect (P < 0.01). Similar results were obtained when using the USPHS criteria. Results of a multilevel survival analysis show that the correlation between restoration failure and operator was small but failure of restorations placed in the same child was substantial. Net wear of the small and large restorations after 6 years were 176 and 172 microm respectively (P > 0.05). CONCLUSION: The 6-year survival rate of the class I ART restorations in this study, especially the smaller ones, was satisfactory. This suggests that the ART approach can be used in the school setting to improve the oral health of large populations of underserved children.     

The integrity of bonded amalgam restorations: a clinical evaluation after five years

BACKGROUND: Bonded amalgam restorations have been studied extensively in vitro, but few long term clinical studies exist. The authors examined the clinical performance of bonded amalgam restorations after five years of clinical service an compared it with that of nonbonded amalgam restorations. METHODS: The authors placed 75 bonded and 62 nonbonded amalgam restorations in patients needing restorations. Most of the restorations were placed in conventional preparations; six bonded restorations were placed in nonretentive cavities. They were evaluated after a five-year period of clinical service by two trained dentists using a mirror and explorer and following modified U.S. Public Health Service criteria. RESULTS: Statistical analysis (via Fisher exact test) showed no significant differences between the two techniques when conventional preparations were used. Restorations in nonretentive preparations were successful during this period. CONCLUSIONS: Bonded and nonbonded amalgam restorations yielded similar results in conventional preparations after five years of clinical service. Bonded amalgam restorations were clinically successful in a limited number of nonretentive preparations over a five-year period. CLINICAL IMPLICATIONS: Bonded amalgam restorations can be used successfully in conventional preparations and possibly in nonretentive preparations as well, and can be expected to last at least five years.     

A one-year clinical evaluation of a high-viscosity glass ionomer cement in primary molars

In this study one-year clinical results of high-viscosity glass ionomer cement (GIC) (Fuji IX, A3, GC, Japan) were determined in class I and class II restorations in 68 primary molars with occlusal or approximal caries. Following caries removal and cavity preparation, the teeth were restored with Fuji IX. The restorations were evaluated according to the U.S. Public Health Service's (USPHS) criteria at the end of one year. Statistical analyses of the data obtained were analyzed using the X2 test. The evaluations showed no statistically significant difference between class I and class II restorations in terms of the color mismatch, anatomic form, marginal adaptation, and secondary caries (P>0.05), but they were statistically significant with regard to cavosurface marginal discoloration (P<0.05). At the end of one year, the success rate of the class I and class II restorations of the primary molars restored with Fuji IX was 94%.     

Clinical evaluation of packable and conventional hybrid resin-based composites for posterior restorations in permanent teeth: results at 12 months

BACKGROUND: Packable resin-based composites and simplified resin bonding systems are marketed to offer many advantages over conventional posterior hybrid composites and total-etch bonding systems. The authors conducted a study to evaluate the initial clinical performances of a packable and a conventional hybrid resin-based composite used with a simplified bonding system. METHODS: A total of 57 Class I and 45 Class II restorations were placed in the permanent teeth of 65 adult patients. The carious lesions were restored with either packable resin-based composite (SureFil, Dentsply DeTrey GmbH, Konstanz, Germany) or conventional hybrid resin-based composite (SpectrumTPH, Dentsply DeTrey GmbH), using a resin adhesive (Non-Rinse Conditioner and Prime & Bond NT, both manufactured by Dentsply DeTrey GmbH). The authors evaluated the restorations using U.S. Public Health Service-Ryge modified criteria (in which Alfa is the highest rating) and by using color transparencies and die stone replicas. RESULTS: Three SureFil restorations failed before their baseline evaluation. There were no failures among the 78 SpectrumTPH restorations evaluated at 12 months. For both resin-based composites, Alfa ratings were 90 percent or higher for marginal discoloration, anatomical form, surface texture and surface staining. Lower percentages of restorations were rated Alfa for color match, marginal integrity and gingival health. Occasional mild postoperative sensitivity was reported for four SureFil restorations and one SpectrumTPH restoration. The mean occlusal wear rate was 38 micrometers for the larger SureFil restorations and 25 microm for the smaller SpectrumTPH restorations. CONCLUSIONS: The 12-month clinical performances of the two restorative materials were satisfactory and not significantly different for each of the parameters evaluated. CLINICAL IMPLICATIONS: A packable and a conventional hybrid resin-based composite placed with a simplified bonding system in posterior permanent teeth showed satisfactory and similar results after 12 months.     

Short-Term Results of IPS-Empress Inlays and Onlays

Purpose A leucite-reinforced, glass-ceramic material was recently introduced for clinical use. In this clinical trial, IPS-Empress inlays and onlays were evaluated using the modified United States Public Health Service (USPHS) criteria. Materials and Methods The teeth of 36 patients were restored with 105 posterior inlays and 25 onlays, fabricated by an indirect technique. After etching the restorations with hydrofluoric acid, they were silanized and luted using composite cements. The restorations were evaluated visually, clinically with a mirror and probe, and by bitewing radiographs and clinical photographs, using modified USPHS criteria. Restorations having neither charlie nor delta criteria were defined as successful, and their survival rate was calculated according to Kaplan-Meier analysis. Results The mean observation period for the 130 restorations was 23.4 ± 6.1 months. After 2 years, 127 restorations were successful with an estimated survival rate of 97.5%. Three restorations failed because of fractures. The esthetic results were excellent. Conclusions The initial clinical results of this esthetic restorative material are encouraging. However, because of fatigue phenomena for all ceramic materials, a longer observation period is needed to provide a definitive prognosis of the long-term clinical behavior.     

Prosthetic dental restorations in Swedish samples: prevalence and agreement between self-report,clinical findings,and influence on quality of life

Objective: To determine the prevalence of dental prosthetic restorations in an adult population, to study the agreement between self-reports and clinical findings of prosthetic restorations, and to study answers from a questionnaire in relation to the prevalence of prosthetic restorations.

Material and methods: A questionnaire was sent to a sample of 10,000 adults. A further sample of 1000 individuals was invited to answer the questionnaire and also participate in a clinical study. The agreement between self-report and clinical findings was analyzed, as were the associations between prosthetic restorations and questionnaire responses, using the chi² test.

Results: A total of 40% of the sample had fixed dental prostheses (FDP), 2.7% had removable dentures. The agreement between self-report and clinical findings was 93%. 34.7% of the individuals with no prosthetic restorations were university graduates and 4% of individuals with removable complete dentures. Oral health had the greatest impact on the quality of life of younger individuals with FDP, with an OHIP-14 (Oral Health Impact Profile) score of 7.3 for the age group 20–39 years compared to 4.9 for the age group 65–89 years. Conclusion: The questionnaire method can be a cost-effective way to determine the prevalence of prosthetic restorations.     

间接或直接树脂修复无髓磨牙的临床疗效观察

目的观察间接或直接树脂充填修复根管治疗后磨牙缺损的临床疗效。方法将完成根管治疗的磨牙212颗随机平均分为A组和B组,A组采用间接修复:先制备好树脂块雏形,再用双固化树脂充填并将树脂块粘接于缺损处;B组采用树脂直接行常规修复。于修复后6和18个月对2组患牙进行随访,参照美国公共卫生署修复体评价标准对其缺损的临床修复效果进行评价。结果修复后6个月,2组修复成功率间的差异无统计学意义(P>0.05);修复后18个月,A组的修复成功率为88.7%(86/97),B组的修复成功率为75.0%(72/96),两者差异有统计学意义(P<0.05)。结论间接树脂充填修复无髓磨牙可避免直接充填带来的不利因素,提高树脂修复的远期疗效,适用于磨牙根管治疗后的缺损修复。