Twenty-four-month clinical performance of a glass hybrid restorative in non-carious cervical lesions of patients with bruxism: a split-mouth, randomized clinical trial

Sixty-month comperative evaluation of a glass hybrid restorative and a composite resin in non-carious cervical lesions of bruxist individuals

OBJECTIVE

To compare the clinical performance of a glass hybrid (GH) restorative and a nano-ceramic composite resin (CR) in the restoration of non-carious cervical lesions (NCCLs) of bruxist individuals in a 60-month randomized clinical trial.

MATERIALS AND METHODS

Twenty-five bruxist candidates having NCCLs were recruited in this clinical study. The depth, height (cervico-incisal), width (mesio-distal), internal angles of the NCCLs, degree of tooth wear (TWI) and gingival index (GI) were measured. One hundred-and-forty-eight NCCLs were restored either with a GH restorative (Equia Forte Fil) or a CR (Ceram.X One Universal). Modified USPHS criteria was used to evaluate restorations after 1 week and 12, 24, 36 and 60 months. Pearson's Chi-Square, Fisher's Exact and Cochran Q tests were run for analysis. Survival rates of the restorations were compared with Kaplan-Meier analysis (p < 0.05).

RESULTS

After 60 months, 97 restorations in 15 patients were examined. The recall rate was 60.0%. Retention rates were 73.5% for CR and 66.7% for GH. A total of 29 restorations were lost (13CR (26.5%), 16GH (33.3%)). There was not a significant difference between tested restoratives in retention (p = 0.464), marginal adaptation (p = 0.856) and marginal discoloration (p = 0.273). There was no relationship between internal angle, depth, height or width and retention of the GH or CR restorations (p > 0.05). The increase in retention loss and marginal discoloration of both restorations over time were significant (p < 0.001). Sensitivity or secondary caries were not detected after 60 months.

CONCLUSION

GH and nano-ceramic CR showed similar clinical performances in NCCLs after 60 months in patients with bruxism.

CLINICAL SIGNIFICANCE

After 60 months, CR and GH materials showed clinically acceptable performances in restoration of NCCLs in patients with bruxism.

Do bioactive materials show greater retention rates in restoring permanent teeth than non-bioactive materials? A systematic review and network meta-analysis of randomized controlled trials

OBJECTIVES

To answer the following research question: does the clinical evaluation of restorations on permanent teeth with bioactive materials show greater retention rates than those with non-bioactive materials?

MATERIALS AND METHODS

A search strategy was used in the following databases: MEDLINE via PubMed, Scopus, Web of Science, LILACS, BBO, Embase, The Cochrane Library, and OpenGrey. Randomized controlled trials (RCTs), with a minimum of 2-year follow-up and evaluating at least one bioactive material in permanent teeth were included. Risk of bias was detected according to the Cochrane Collaboration tool for assessing the risk of bias (RoB 2.0), and network meta-analysis was performed using a random-effects Bayesian-mixed treatment comparison model.

RESULTS

Twenty-seven studies were included. The success of the restorations was assessed using modified USPHS system in 24 studies and the FDI criteria in 3 studies. Network meta-analysis revealed three networks based on restoration preparations. Resin composites were ranked with higher SUCRA values, indicating a greater likelihood of being the preferred treatment for class I, II, and III restorations. In class V, resin-modified glass ionomer cement was ranked with the highest value.

CONCLUSION

Bioactive restorative materials showed similar good clinical performance in terms of retention similarly to conventional resin composites.

CLINICAL SIGNIFICANCE

The findings must be interpreted with caution because many RCT on restorative materials aim to verify the equivalence of new materials over the gold standard material rather than their superiority. The present systematic review also suggests that new RCT with longer follow-up periods are necessary.

Conservative Treatment of Dental Non-Carious Cervical Lesions: A Scoping Review

This scoping review aims to evaluate methods of conservative reconstruction of dental enamel lesions resulting from abrasions and evaluate the effect of diode laser in reducing the symptoms of tooth sensitivity. The cementoenamel junction is more prone to substance loss because the enamel thickness is substantially decreased, resulting in a much weaker enamel-dentin bond.

METHODS

Dental abrasion was examined in the mechanical cause alone. Pubmed, Scopus, and Web of Science were used to discover publications that matched our topic from 1 January 2018 to 20 March 2023. A comparison of various non-carious cervical lesion (NCCL) restoration treatments was generated mostly by mechanical considerations.

RESULTS

A final number of 11 clinical trials and randomized controlled trials were included in the review for qualitative analysis. Composite resins performed well in clinical trials for the restoration of NCCLs.

CONCLUSIONS

Composite, in its different forms of filling and consistency, preceded by the use of adhesives, is an efficient and effective material for the treatment of NCCLs. Diode laser use prior to NCCL restoration of teeth does not diminish restoration retention rate, may lessen hypersensitivity, and may affect restoration success.

Clinical comparison of different glass ionomer-based restoratives and a bulk-fill resin composite in Class I cavities: A 48-month randomized split-mouth controlled trial

OBJECTIVE

The aim of this study is to compare the retention rates (primary outcome) of high-viscosity glass ionomer (GI), glass carbomer (GC), zirconia-reinforced GI (ZIR), and bulk-fill (BF) composite resin restorations. Secondary outcomes included anatomical form, marginal adaptation, marginal discoloration, color match, surface texture, post-operative sensitivity and secondary caries.

METHODS

Two calibrated operators placed 128 restorations in 30 patients with a mean age of 21 years. The restorations were evaluated by one examiner at baseline and at 6, 12, 18, 24, and 48 months using the modified US Public Health Service criteria. The data were statistically analyzed using Friedman test. Differences between restorations were analyzed using Kruskal-Wallis test.

RESULTS

After 48 months, 23 patients and 97 restorations (23 GI, 25 GC, 24 ZIR, and 25 BF) were evaluated. Patient recall rate was 77%. No significant difference was observed between the retention rates of the restorations (p > 0.05). GC showed significantly lower results than the other three fillings in terms of anatomical form (p < 0.05). There was no significant difference in the anatomical form and retention between GI, ZIR, and BF (p > 0.05). No significant change was observed in the postoperative sensitivity or secondary caries for any of the restorations (p > 0.05).

CONCLUSIONS

GC restorations showed statistically lower anatomical form values, indicating lower wear resistance than the other materials. However, no significant difference was observed in the retention rates (as primary outcome) as well as the other secondary outcomes of the four different restorative materials after 48 months.

CLINICAL SIGNIFICANCE

GI-based restorative materials and BF composite resin restorations in Class I cavities yielded satisfactory clinical performance after 48 months.

Secondary caries and marginal adaptation of ion-releasing versus resin composite restorations: a systematic review and meta-analysis of randomized clinical trials

This systematic review was aimed to evaluate occurrence of secondary caries and marginal adaptation in ion-releasing materials versus resin composite. Electronic search of PubMed, Scopus, and Open Grey databases with no date or language restrictions until May 21st, 2021, was conducted. Randomized clinical trials that compared ion-releasing restorations versus resin composite were included. For quantitative analysis, a random-effects meta-analysis with risk difference as an effect measure and a 95% confidence interval was used. Quality of evidence was assessed using The Grading of Recommendations, Assessment, Development, and Evaluation criteria. The risk of bias was evaluated using the Cochran Collaboration Risk of Bias tool. The inclusion criteria were met by 22 studies, and 10 studies were included in the meta-analysis. Three follow-up periods (1 year, 18 months-2 years, and 3 years) were evaluated. The overall quality of evidence for secondary caries and marginal adaptation outcomes was low. The results of the meta-analysis showed no significant difference (p > 0.05) in both outcomes between ion-releasing materials and resin composite. The occurrence of secondary caries was not dependent on the nature of the restorative material. It is more likely a complex process that involves the same risk factors as primary carious lesions.

B, Garoushi S. Fracture Behavior and Integrity of Different Direct Restorative Materials to Restore Noncarious Cervical Lesions

The purpose of this study was to analyze the fracture resistance and marginal leakage of noncarious cervical lesion (NCCL) restorations made of different restorative materials. Eighty upper premolars were randomly divided into four groups (n = 20/group). Standardized NCCL cavity preparations were performed on the buccal surface of the teeth and then restored with four different materials. Group 1: Packable resin composite (PC); Group 2: Highly flowable resin composite (HF); Group 3: Low flowable resin composite (LF); Group 4: Resin modified glass ionomer cement (RMGIC). After restorations were completed, cyclic and static fracture behavior was evaluated using a loading testing machine. Extra restored teeth were sectioned and then stained (n = 5/group). The specimens were viewed under a stereo microscope and the percentage of microgaps at the tooth–restoration interface was calculated. All restored teeth survived after fatigue loading. There was no statistically significant (p > 0.05) difference between the tested restorations after the static loading test. NCCLs restored with highly filled flowable composite showed the least microleakage among the tested groups (p < 0.05). The investigated restorative materials are acceptable for NCCL restorations in terms of fracture resistance and microleakage.

36 Months' Clinical Performance of Primary Incisors Restorations Depending on the Type of Restorative Technique Used: A Randomized Controlled Trial

Background: Depending on the stage of the disease and the child’s age, different types of interventions can be used to treat early childhood caries. As a result, there is not enough clinical evidence to show that one kind of restoration is better than another. The objective of this longitudinal study was to compare the results of 36 months of clinical performance of primary incisors restorations using an incremental layering technique with the ceram.x^® SphereTECTM nanoceramic composite (Dentsply) or a full coverage technique with transparent strip crowns (Frasaco GmbH) with the same composite in children with or without biological caries risk factors. Methods: 80 patients (females 42/52.5%) were included in the study. A total of 160 restorations were performed. Restorations were evaluated at baseline and at 6, 12, 24, and 36 months, according to modified Ryge criteria. Conclusion: Restorations with both techniques were clinically highly successful and showed similar clinical performance at postoperatively regardless of the presence of biological factors of caries risk.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2020 professional literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to this work to cover this broad topic. Specific subject areas addressed include prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders (TMDs); sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence day-to-day dental treatment decisions with a keen eye on future trends in the profession. With the tremendous volume of dentistry and related literature being published today, this review cannot possibly be comprehensive. The purpose is to update interested readers and provide important resource material for those interested in pursuing greater detail. It remains our intent to assist colleagues in navigating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the dental patients they encounter.

Glass hybrid versus composite for non-carious cervical lesions: Survival, restoration quality and costs in randomized controlled trial after 3 years

OBJECTIVE

This study compared survival, restoration quality and costs of glass hybrid (GH; EQUIA Forte Fil/EQUIA Forte Coat) and resin composite restorations (RC; OptiBond FL/Filtek Supreme XTE) of sclerotic non-carious cervical lesions.

METHODS

This is a cluster-randomized trial (ClinicalTrials.gov: NCT02631161). 88 patients (50-70 years) with 175 sNCCLs were randomized to receive GH or RC. Restorations were placed without mechanical cavity preparation and followed for a mean 36 (min/max: 31/55) months (variable follow-up due to COVID-19 lockdown). Restoration quality was re-evaluated at 1-, 18- and 36-months using FDI-criteria. Survival was assessed using multi-level Cox-regression analysis. Costs were estimated from a payer's perspective in Germany. Initial costs were determined based on micro-costing using time recordings and hourly costs, and follow-up costs based on statutory insurance fee-item-catalogues.

RESULTS

88 patients (175 restorations) were treated; 43 received GH (83 restorations), 45 RC (92 restorations). 17  GH and 19 RC showed total retention loss, 5  GH were partially lost (p = 0.396/Cox). FDI ratings were not sufficiently different for any domain except surface luster, where RC showed higher score (p < 0.001). Costs were initially lower for GH (32.57; SD 16.36 €) than RC (44.25; SD 21.40 €), while re-treatment costs were similar (GH: 9.15; SD 15.70 €; RC: 7.35; SD 14.51 €), resulting in significantly lower costs for GH (GH: 41.72; SD 25.08 €) than RC (51.60; 26.17 €) (p < 0.001/GLM).

CONCLUSIONS

While survival was not significantly different, GH was significantly less costly both initially and long-term than RC for restoring non-carious cervical lesions.

CLINICAL SIGNIFICANCE

Within this trial, survival was not significantly different between GH and RC to restore sclerotic NCCLs. As GH was significantly less costly both initially and long-term than RC, using RC was only cost-effective for payers willing to invest high additional expenses per minimal survival gains.

[Evaluation of wear property of Giomer and universal composite in vivo]

OBJECTIVE

To observe the wear performance of Giomer and universal composite for posterior restorations by 3D laser scan method, in order to guide the material selection in clinic.

METHODS

In this study, 48 patients (108 teeth) were selected according to the inclusion and exclusion criteria. All the patients in need of a minimum of 2 Class Ⅰ and/or Class Ⅱ restorations were invited to join the study. The teeth were restored with Giomer (Beautifil Ⅱ, BF) and universal composite (Filtek Z350, Z350) randomly. The restorations were evaluated at baseline and after 6-, 18-, 48-month using the modified United States Public Health Service (USPHS) criteria for clinical performance. The in vivo images and gypsum replicas were taken at each recall. A 3D-laser scanner and Geomagic Studio 12 were used to analyze the wear depth quantitatively. Statistical analysis was performed with SPSS 20.0.

RESULTS

After 4 years, 89.6% patients were recalled. The survival rate of both materials was 95.8% (Kaplan-Meier survival analysis). Seven restorations of the two materials failed due to loss of restoration, bulk fracture, secondary caries and pulp necrosis. The wear patterns of restorations were divided into 2 classes. Pattern Ⅰ: occlusal contact areas showed the deepest and fastest wear depth; pattern Ⅱ: the wear depth was slow and uniform. Both materials showed a rapid wear in the first 6 months. Then the wear rate was decreased. The occlusal wear depth after 4 years were (58±22) μm and (54±16) μm for BF group and Z350 group respectively, which were in accordance with the American Dental Association (ADA) guidelines (wear depth for 3 years < 100 μm). No significant differences (P>0.05) were observed between the two groups. Regarding the restorations with wear pattern Ⅰ, the wear depth of BF group was higher than Z350 group at 6- and 48-month (P < 0.05), while there was no significant difference between restorations with wear pattern Ⅱ (P>0.05).

CONCLUSION

Within the limitation of the study, after 4 years, the survival rate and wear resistance of Giomer met ADA guidelines for tooth-colored restorative materials for posterior teeth. When the two materials were applied in occlusal contact areas, wear resistance of Giomer was slightly lower than universal composite resin. No significant difference was found when they were applied in none of the occlusal contact areas.

In vitro wear of (resin-coated) high-viscosity glass ionomer cements and glass hybrid restorative systems

OBJECTIVES

The aim of the present study was to investigate the volumetric abrasive wear of a high-viscosity glass ionomer cement (hvGIC; Equia Fil) and a glass hybrid restorative system (ghRS; Equia Forte), each being recommended as amalgam alternatives. Both materials were applied with or without their respective resinous coating, and were compared with a conventional GIC (Ketac Fil) and a hybrid composite resin (CR; G-ænial Posterior).

METHODS

78 standardized occlusal Class I cavities were restored with the various materials (n = 13 per group). Before and after chewing simulation (30,000 cycles at 40 N), each sample underwent optical scanning procedures (Omnicam). A comparison of the total wear using a fluorescence-aided identification technique (OraCheck) followed, and differences (α = 5%) between groups were compared by means of MANOVA.

RESULTS

Regarding the wear rates of hvGIC and ghRS, no differences could be observed (p > .050), and this was not affected by the resinous coating. All hvGIC and ghRS restorations showed significantly higher abrasive wear than CR (p < .001), while the conventional GIC displayed a significant underperformance compared with any other material (p < .001).

CONCLUSIONS

Resinous coating of hvGIC or ghRS does not appear to exert an effective long-term protection against advanced abrasive wear. Compared to the conventional GIC showing a considerable substance loss, both hvGIC and ghRS materials revealed an improved abrasion resistance, but clearly failed to meet the excellent values of the CR.

CLINICAL SIGNIFICANCE

Occlusal loading should be carefully considered when using hvGIC or ghRS as amalgam (or composite resin) alternatives for the restoration of posterior teeth.

One-year evaluation of a new restorative glass ionomer cement for the restoration of non-carious cervical lesions in patients with systemic diseases: a randomized, clinical trial

OBJECTIVE

This randomized and clinical trial aimed to evaluate the performance of a new restorative Glass Ionomer Cement (GIC) for the restoration of non-carious cervical lesions (NCCLs) of patients with systemic diseases compared with a posterior resin composite after 12 months.

METHODOLOGY

134 restorations were placed at 30 patients presenting systemic diseases by a single clinician. NCCLs were allocated to two groups according to restorative system used: a conventional restorative GIC [Fuji Bulk (GC, Tokyo Japan) (FB)] and a posterior resin composite [G-ænial Posterior (GC, Tokyo Japan) (GP)] used with a universal adhesive using etch&rinse mode. All restorative procedures were conducted according to manufacturer's instructions. Restorations were scored regarding retention, marginal discoloration, marginal adaptation, secondary caries, surface texture, and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after 1 week (baseline), 6, and 12 months. Descriptive statistics were performed using chi-square tests. Cochran Q and Mc Nemar's tests were used to detect differences over time.

RESULTS

After 12 months, recall rate was 93% and the rates of cumulative retention failure for FB and GP were 4.9% and 1.6% respectively. Both groups presented similar alpha rates for marginal adaptation (FB 86.2%, GP 95.5%) and marginal discoloration (FB 93.8%, GP 97%) at 6-month recall, but FB restorations showed higher bravo scores than GP restorations for marginal adaptation and marginal discoloration after 12 months (p<0.05). Regarding surface texture, 2 FB restorations (3.1%) were scored as bravo after 6 months. All restorations were scored as alpha for secondary caries and postoperative sensitivity after 12 months.

CONCLUSION

Although the posterior resin composite demonstrated clinically higher alpha scores than the conventional GIC for marginal adaptation and discoloration, both materials successfully restored NCCLs at patients with systematic disease after a year.

CLINICAL RELEVANCE

Due to its acceptable clinical results, the tested conventional restorative GIC can be used for the restoration of NCCLs of patients with systemic diseases.