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Alonso ALL, Tirapelli C, Cruvinel PB, Cerqueira NM, Miranda CS, Corona SAM, Souza-Gabriel AE. Longevity of composite restorations in posterior teeth placed by dental students: a 12-year retrospective study. Clin Oral Investig 2024; 28:253. [PMID: 38630376 DOI: 10.1007/s00784-024-05631-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES To evaluate the longevity of resin composite restorations placed in posterior teeth by dental students, using data from electronic records from 2008 to 2019. MATERIALS AND METHODS Demographic (gender and age) and clinical variables (dental group, position in dental arch, and the number of restored surfaces) were evaluated. The 5-year follow-up was assessed according to the day the restoration was placed. Kaplan-Meier curves were generated to calculate the annual failure rate. Data were analyzed by Chi-Square, Kruskal-Wallis, and Mann-Whitney tests (α = 0.05). RESULTS In total, 3.883 records relative to return periodicity were analyzed. The final sample consisted of 900 restorations from 479 patients. The majority were females, aged between 31 and 60. In total, 256 failures were reported (success rate = 78%), showing an annual failure rate of 2.05%. The main reasons for failures were restoration replacement (55.5%), endodontics (21.9%), prosthetics (14.5%) and extraction (8.2%). There was a higher risk of failure in restorations involving three or more surfaces (p = 0.000) and in patients over 60 years (p < 0.001). In females (p = 0.030), molars (p = 0.044), and maxillary teeth (p = 0.038) failed in a shorter time. CONCLUSIONS Resin composite restorations placed in permanent posterior teeth by dental students had high survival rates. The main reason for failure was the replacement of restorations. The age group and the number of restored surfaces significantly affected the success of the restorations. CLINICAL RELEVANCE The electronic health records over 12 years showed that 78% of the resin restorations in posterior teeth placed by dental students were successful for a minimum of five years.
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Affiliation(s)
- Ana Laura Lima Alonso
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Camila Tirapelli
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Pedro Bastos Cruvinel
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Nathália Mancioppi Cerqueira
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Claudio Souza Miranda
- Department of Accounting, School of Economics, Business and Accounting of University of São Paulo, Ribeirão Preto, Brazil
| | - Silmara Aparecida Milori Corona
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Aline Evangelista Souza-Gabriel
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, São Paulo, 14040-904, Brazil.
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Bailey O, Shand B, Ellis I. Class II composite restoration technique teaching: A randomised controlled crossover laboratory-based trial involving a novel ringless sectional matrix technique. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:963-973. [PMID: 36539980 DOI: 10.1111/eje.12888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/11/2022] [Accepted: 10/30/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Objectives were to assess how different techniques (including a novel ringless sectional matrix approach) affect students' restorative outcomes, and their preferences for and preparedness to clinically implement new techniques with the aim of introducing appropriate techniques to the undergraduate curriculum. MATERIALS AND METHODS Students performed two class II composite restorations in plastic teeth using two sectional matrix techniques (separating ring vs. without [ringless]), and two composite restorative techniques (incremental vs. injection-moulded bulk-fill). Restorations were assessed on multiple parameters which were combined to rate them as "good" or not. Online surveys assessed students' preferences for and preparedness to clinically implement new techniques. RESULTS Contact area concavity (OR = 106, p < .001) and cervical marginal overhang (OR = 7.4, p < .001) were much more likely with the separating ring compared to the ringless sectional matrix technique. "Good" restorations were 29.5 times more likely when using ringless compared to separating ring techniques and 3.3 times more likely when using the injection-moulding bulk-fill compared to layered composite technique. A majority of students preferred the ringless to separating ring sectional matrix technique and the injection-moulding bulk-fill to layered composite technique. Large majorities felt prepared to implement the new techniques clinically with no or minimal guidance. CONCLUSIONS A classic sectional matrix technique with separating ring resulted in a much greater occurrence of contact area concavity and cervical marginal overhang than a novel ringless approach. When allied with student preferences and clinical preparedness, inclusion of the novel ringless approach in the undergraduate curriculum can be supported alongside bulk-fill injection-moulding techniques.
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Affiliation(s)
- Oliver Bailey
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Bonnie Shand
- Dental Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ian Ellis
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Jebur N, Vinall-Collier K, Umair AA, Aggarwal VR. Dental amalgam teaching phase-out - a step too soon? Foundation trainees' experience of amalgam use in dental school compared to practice: a mixed-methods survey. Br Dent J 2023; 235:329-334. [PMID: 37684467 PMCID: PMC10491489 DOI: 10.1038/s41415-023-6228-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/09/2023] [Indexed: 09/10/2023]
Abstract
Aim This study aimed to explore disparities in experience of UK dental foundation trainees in amalgam use at dental school compared to their first year in dental practice.Methods A modified version of the 'survey of Yorkshire dentists' targeted the dental foundation trainees. A mixed-method of quantitative and thematic content analysis was undertaken for the close-ended and free-text responses, respectively.Results Only 35% of participants described their confidence level as 'satisfactory' in placing dental amalgam before starting their dental foundation training and 51% scored the level of teaching between 'very poor' and 'satisfactory'. In total, 63% of respondents were in favour of receiving additional support in placing amalgam restorations during their undergraduate training. Participants indicated that the consequences of amalgam phase-out are increased appointment times and decreased quality of care due to patient and health service unaffordability of amalgam alternatives.Conclusion These findings raise concerns regarding newly qualified undergraduates' confidence, experience and skill in placing amalgams. This suggests the need to increase undergraduate education and training to improve undergraduates' skills and confidence in amalgam procedures to reduce the gap between the dental schools and real-world practice.
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Affiliation(s)
- Noor Jebur
- School of Dentistry, University of Leeds, United Kingdom
| | | | - Abdul-Ahad Umair
- School of Dentistry, University of Leeds, UK; Associate General Dental Practitioner, Bupa Dental Care, United Kingdom
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Kanzow P, Lechte C, Wiegand A, Wilson NHF, Lynch CD, Blum IR. Teaching of posterior composites for the restoration of permanent teeth in undergraduate dental training programmes: Systematic review and meta-analysis. J Dent 2023; 135:104589. [PMID: 37336355 DOI: 10.1016/j.jdent.2023.104589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVES To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools. STUDY SELECTION Quantitative studies reporting on dental schools' teaching regarding the placement of PCRs in permanent teeth. Random-effects meta-analyses and meta-regressions were performed. Risk of bias was assessed based on the Medical Education Research Study Quality Instrument (MERSQI). SOURCES Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Web of Science, and Scopus) were searched in January 2023. DATA Forty sources reporting on 34 studies having surveyed 1,286 dental schools were included. Overall, 92.7% (95%-CI: 88.2-95.5) of dental schools reported to teach PCRs. PCRs in three-surface Class II cavities are taught by 82.0% (95%-CI: 70.4-89.7). The mandatory use of liners in deep cavities is taught by 78.3% (95%-CI: 68.9-85.5), and 44.0% (95%-CI: 34.3-54.2) reported to teach bulk-fill composites. While most posterior restorations placed by students were composites (56.1%; 95%-CI: 46.0-65.8), 94.7% (95%-CI: 86.6-98.0) of dental schools (still) teach posterior amalgam restorations. The proportion of dental schools teaching PCRs in three-surface Class II cavities increased and the mean proportion of PCRs among all posterior restorations increased over time (padj.≤0.003). CONCLUSIONS The teaching of PCRs in dental schools around the world reflects the increased use of resin composite in clinical practice, with students in countries where dental amalgam continues to be used, placing more posterior composites than restorations of dental amalgam. The teaching of PCRs, which is anticipated to increase, will continue to be refined with further developments in adhesive materials, devices, instrumentation, and techniques. CLINICAL SIGNIFICANCE Graduating dentists can be expected to be familiar with the use of resin composites for the restoration of posterior teeth.
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Affiliation(s)
- Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany.
| | - Clemens Lechte
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany
| | | | - Christopher D Lynch
- University Dental School & Hospital, University College Cork, Wilton, Cork, Ireland
| | - Igor R Blum
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, United Kingdom
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Wilson N, Lynch C. The great amalgam debate or debacle: a perspective. Br Dent J 2022; 233:870-871. [DOI: 10.1038/s41415-022-5219-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/27/2022]
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Sadaghiani L, Alshumrani AM, Gleeson HB, Ayre WN, Sloan AJ. Growth Factor release and dental pulp stem cell attachment following dentine conditioning- an in vitro study. Int Endod J 2022; 55:858-869. [PMID: 35638345 PMCID: PMC9541952 DOI: 10.1111/iej.13781] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 05/13/2022] [Accepted: 05/13/2022] [Indexed: 12/02/2022]
Abstract
Aim The aim of the study was to investigate the effect of dentine conditioning agents on growth factor liberation and settlement of dental pulp progenitor cells (DPSCs) on dentine surfaces. Methodology The agents used included ethylenediaminetetraacetic acid (EDTA; 10%, pH 7.2), phosphoric acid (37%, pH < 1), citric acid (10%, pH 1.5) and polyacrylic acid (25%, pH 3.9). Human dentine slices were conditioned for exaggerated conditioning times of 5 and 10 min, so that the growth factor liberation reached quantifiable levels above the limit of detection of the laboratory methods employed. Transforming growth factor beta‐1 (TGF‐β1) release and surface exposure were quantified by enzyme‐linked immunosorbent assay (ELISA) and immunogold labelling. Scanning electron microscopy (SEM) was used to assess the morphology of cells and coverage by DPSCs cultured on dentine surfaces for 8 days. Results After 5‐min conditioning of dentine slices, citric acid was the most effective agent for growth factor release into the aqueous environment as measured by ELISA (Mann–Whitney U with Bonferroni correction, p < .01 compared with phosphoric and polyacrylic acid). As well as this, dentine slices treated with phosphoric acid for the same period, displayed significantly less TGF‐β1 on the surface compared with the other agents used, as measured by immunogold labelling (MWU with Bonferroni correction, p < .05). After 8 days, widespread coverage by DPSCs on dentine surfaces conditioned with citric acid and EDTA were evident under SEM. On dentine surfaces conditioned with phosphoric and polyacrylic acid, respectively, less spread cells and inconsistent cell coverage were observed. Conclusions Based on the findings of this in vitro study, a desirable biological growth factor‐mediated effect may be gained when conditioning dentine by milder acidic or chelating agents such as citric acid and EDTA. The results must be interpreted in the context that the potential of the applied materials inducing a desirable biological response in DPSCs is only one consideration amongst other important ones in a clinical setting. However, it is crucial to look beyond the mere physical effects of materials and move towards biologically based treatment approaches as far as the restorative management of teeth with viable dental pulps are concerned.
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Affiliation(s)
- L Sadaghiani
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, UK
| | | | - H B Gleeson
- Department of General Dentistry and Orthodontics, Addenbrookes Hospital, Cambridge University Hospitals NHS foundation trust, UK
| | - W Nishio Ayre
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, UK
| | - A J Sloan
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia
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Hall AF. Reflections from undergraduate teaching experiences: some problems and solutions of restoring teeth with dental resin composite instead of dental amalgam. Br Dent J 2022; 232:607-610. [PMID: 35562451 DOI: 10.1038/s41415-022-4201-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/21/2022] [Indexed: 11/09/2022]
Abstract
This is a simple personal reflection on some of the problems and solutions related to the increasing use of composite resin to replace dental amalgam when dental students learn to place restorations at the start of their careers. To the author, much seems common sense. Much is not, or cannot, be backed up by ideal science and some may still be considered outdated to the more progressive practitioner. Unfortunately, prospective, ideally-designed clinical trials may no longer be possible to seek the answers we lack due to ethical, organisational, financial or other constraints.
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Affiliation(s)
- Andrew F Hall
- Unit of Restorative Dentistry, Dundee University Dental School, Dundee, DD1 4HR, UK.
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Castro AS, Maran BM, Gutierrez MF, Chemin K, Mendez-Bauer ML, Bermúdez JP, Reis A, Loguercio AD. Effect of Dentin Moisture in Posterior Restorations Performed with Universal Adhesive: A Randomized Clinical Trial. Oper Dent 2022; 47:E91-E105. [PMID: 35405005 DOI: 10.2341/20-215-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This double-blind, randomized clinical trial evaluated the influence of dentin moisture on postoperative sensitivity (POS), as well as, on clinical performance in posterior bulk-fill composite restorations, using a universal adhesive, until 12 months after clinical service. METHODS AND MATERIALS In accordance with a split-mouth design, 45 patients received posterior restorations, restored with a bulk-fill resin composite (Filtek Bulk Fill, 3M Oral Care) and a universal adhesive used in etch-and-rinse mode (SBU; Single Bond Universal Adhesive), which were applied on dry or moist dentin, with a cavity depth of at least 3 mm. Three operators placed 90 Class I/Class II restorations. Patients were evaluated for spontaneous and stimulated POS in the baseline, and after 48 hours, 7 days, and at 6 and 12 months. In addition, secondary parameters (marginal discoloration, marginal adaptation, fracture, and recurrent caries) were evaluated by World Dental Federation (FDI) criteria after 7 days and at 6 and 12 months. Statistical analyzes were performed using the Chi-square, Fisher exact, Friedman, Kruskall-Wallis, and Mann-Whitney tests (α=0.05). RESULTS No significant spontaneous and stimulated POS was observed when SBU was applied in dry and moist dentin (p>0.05). A significant and higher risk of spontaneous POS (20.0%; 95%CI 10.9-33.82 for dry dentin and 22.22%; 95%CI 12.54-36.27 for moist dentin) occurred up to 48 hours after restoration placement for the dry and moist dentin groups (p<0.02). However, the POS intensity was mild up to 48 hours with no significant difference between dry and moist dentin groups (p>0.79). When secondary parameters were evaluated, no significant differences between the groups were observed. CONCLUSION Dentin moisture did not influence POS in posterior bulk-fill composite restorations when associated with a universal adhesive applied in etch-and-rinse mode.
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Affiliation(s)
- A S Castro
- Andrea S Castro, DDS, MS, assistante professor, School of Dentistry, Tuiuti University, Curitiba, PR, Brazil
| | - B M Maran
- Bianca M Maran, DDS, MS, PhD, Department of Restorative Dentistry, School of Dentistry, State University of Western Paraná, Cascavel, PR, Brazil
| | - M F Gutierrez
- Mario F Gutierrez, DDS, MS, PhD, assistant professor, University de los Andes, Chile; assistant professor, Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - K Chemin
- Kaprice Chemin, DDS, MS, PhD, assistant professor, School of Dentistry, Department of Health Sciences, School Unicesumar, Ponta Grossa, PR, Brazil
| | - M L Mendez-Bauer
- Maria L Mendez-Bauer, DDS, MSc, PhD, associate professor, Research Department, School of Dentistry, University Francisco Marroquin, Guatemala City, Guatemala
| | - J P Bermúdez
- Jorge P Bermúdez, DDS, MS, PhD student, Department of Prosthodontics, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - A Reis
- Alessandra Reis, DDS, PhD, associate professor, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - A D Loguercio
- *Alessandro D Loguercio, DDS, MS, PhD, associate professor, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
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Abstract
Sectional matrix techniques offer more predictable solutions to achieving contact areas when placing direct interproximal posterior composites than circumferential matrix techniques, resulting in reduced reported complaints of food packing from patients. Despite this, a large majority of UK dentists and therapists don't currently use them. Sectional matrix systems are technique-sensitive to use, which can be a barrier to implementation for inexperienced users. The matrices can easily distort during their placement and stabilisation and when placing the restorative material. This can result in unwanted, clinically relevant problems in the resulting restorations, some of which may not be discernible once they have occurred. This paper explores the advantages and disadvantages of sectional matrices and the processes and techniques involved in their use, before discussing the potential for distortion at each step. It offers solutions to some of the commonly seen problems which will provide more predictable outcomes for those already using these techniques and encourage non-users to add them to their armamentarium.
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Alreshaid L, El-Badrawy W, Lawrence HP, Santos MJ, Prakki A. Composite versus Amalgam Restorations Placed in Canadian Dental Schools. Oper Dent 2021; 46:621-630. [PMID: 35507902 DOI: 10.2341/20-212-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To investigate the latest teaching policies of posterior composite placement versus amalgam and to determine the actual numbers of posterior composites versus amalgam restorations placed in Canadian dental schools, over the years from 2008 to 2018. METHODS Emails were sent to Chairs/Heads of Restorative Departments and Clinic Directors of all 10 Canadian dental schools to collect data in the forms of: 1) Questionnaire on current teaching policies of posterior composite and amalgam restorations; 2) data entry form to collect the actual numbers of posterior composite and amalgam restorations placed in their clinics. RESULTS For the teaching questionnaire, the response rate was 90% (n=9). Seven (78%) of the responding schools reported that they assign 25%-50% of their preclinical restorative teaching time towards posterior composite placement. While, three (33%) of the responding schools allocated 50%-75% of their restorative teaching towards amalgam placement. Data entry response rate was 80% (n=8). Amalgam material was dominant in the restoration distribution from 2008 to 2012. While from 2013 to 2018, resin composite material was dominant in all eight responding schools. Linear regression analysis revealed a significant increasing trend in placing posterior composites in all the responding schools over time (p<0.05). CONCLUSIONS Data analysis revealed a clear trend towards an increase of posterior composite restoration placement and a decrease in the number of amalgam restorations placed. However, the teaching time assigned for posterior composite is not aligned with quantity placed. Review and adjustment of time allocated for teaching and training of each material are recommended.
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Affiliation(s)
- L Alreshaid
- Lulwah Alreshaid, BDS, PhD candidate, Department of Clinical Sciences, Faculty of Dentistry, University of Toronto, Toronto M5G 1G6 ON, Canada; Department of Restorative Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - W El-Badrawy
- Wafa El-Badrawy, BDS, MSc, Department of Clinical Sciences, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - H P Lawrence
- Herenia P Lawrence, DDS, MSc, PhD, Department of Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - M J Santos
- Maria J Santos, DDS, MSc, PhD, Department of Restorative Dentistry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | - A Prakki
- *Anuradha Prakki, DDS, MSc, PhD, Department of Clinical Sciences, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
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Reddy JK, Malini DL, Ballullaya SV, Pushpa S, Devalla S, Reddy AV. Influence of "MOTRCS" factors on the performance of various direct and indirect restorations: A finite element analysis. J Conserv Dent 2021; 24:15-23. [PMID: 34475674 PMCID: PMC8378485 DOI: 10.4103/jcd.jcd_471_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/25/2020] [Accepted: 02/22/2021] [Indexed: 11/13/2022] Open
Abstract
Aim of the Study: The purpose of the study is to evaluate the occlusal relationship of the mesiobuccal cusp of a mandibular first molar with the marginal ridge of maxillary first molar and second premolar and to analyze the effect of the above occlusal relation on different direct and indirect restorations using finite element analysis (FEA). Methodology: Four hundred volunteers studying in a dental college were screened, of which 100 volunteers were selected for studying occlusal relationships based on the inclusion and exclusion criteria. The two most common occlusal relationships were considered for analyzing two direct (amalgam and direct composite restorations) and two indirect restorations (composite and ceramic restorations). Three-dimensional (3D) scanning of the models was performed, and Class II tooth preparations specific for each restorative material were prepared digitally on 3D models. FEA was employed to study von Mises (VM) stress, principal stresses, and cuspal deflection for each restorative material, and failure of the tooth-restoration unit was calculated using the modified Mohr failure criterion. Results: Among all the analyzed materials, cuspal deformation, principal stresses, and VM stresses were high for direct composite restoration and least for ceramic inlay. According to modified Mohr criteria, except for direct composite, all other materials performed better. Conclusion: Silver amalgam and ceramic restorations presented with minimal stress concentration and cuspal deflection, and Type I occlusal relationship presented with higher stress concentration compared to Type II.
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Affiliation(s)
- Jonnala Kruthika Reddy
- Department of Conservative Dentistry and Endodontics, St. Joseph Dental College, Eluru, Andhra Pradesh, India
| | - Duvvuri Lakshmi Malini
- Department of Conservative Dentistry and Endodontics, Government Dental College, Vijayawada, Andhra Pradesh, India
| | - Srinidhi Vishnu Ballullaya
- Department of Conservative Dentistry and Endodontics, St. Joseph Dental College, Eluru, Andhra Pradesh, India
| | - S Pushpa
- Department of Conservative Dentistry and Endodontics, St. Joseph Dental College, Eluru, Andhra Pradesh, India
| | - Srihari Devalla
- Department of Conservative Dentistry and Endodontics, St. Joseph Dental College, Eluru, Andhra Pradesh, India
| | - A Venkat Reddy
- Department of Prosthodontics and Crown and Bridge, St. Joseph Dental College, Eluru, Andhra Pradesh, India
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Balhaddad AA, Marghalani AA, Raderman MA, Miginsky E, Massey W, Strassler H, Anne Melo M. Hands-on training based on quantifying radiant exposure improves how dental students cure composites: Skill retention at 2-year follow-up. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:582-591. [PMID: 33220151 DOI: 10.1111/eje.12635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 11/18/2020] [Accepted: 11/18/2020] [Indexed: 05/27/2023]
Abstract
INTRODUCTION The durability and longevity of composite restoration are much dependent on the accurate delivery of the energy required to polymerise the material. This study aimed to investigate the extent to which undergraduate dental students acquire and retain light-curing skills following hands-on training. MATERIALS AND METHODS Hands-on training comprises faculty tutoring for critical aspects of the light-curing procedure, such as distance and angulation of the light-curing tip. Assessments of the students' ability to deliver a specified radiant exposure to class III and I simulated RBCs using a dental simulator (MARC-PS® ) at three different time points after the training. Data were analysed using repeated measure ANOVA. RESULTS Immediately after the training, students' performance on curing was improved (p < .05). Overall, the radiant exposure increased after training, but the students lost some of the benefits with time. For curing in the anterior section (anterior sensor-class III), the mean radiant exposure values increased by approximately 20% after the training. After 2 years, the values were 15% greater than baseline values. For curing in the posterior section (posterior sensor-class I), the mean radiant exposure values increased by approximately 150% after the training. A significant decrease (p < .05) was observed; however, the radiant exposure values were still 82% greater than the baseline after 2 years. CONCLUSION A hands-on training dedicated to light-curing procedures facilitated acquisition and retention up to a 2-year follow-up of skill on how light cure composite inside the mouth. The training was more relevant for curing in posterior areas, where orientation can significantly impact light-curing. A hands-on training where the radiant exposure can be measure gave objective measurement metrics to guide the curing performance. This approach is an effective means of teaching practical skills to dental students.
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Affiliation(s)
- Abdulrahman A Balhaddad
- Dental Biomedical Science PhD Program, University of Maryland School of Dentistry, Baltimore, MD, USA
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah A Marghalani
- Department of Preventive Dentistry, Faculty of Dentistry, Um Al-Qura University, Makkah, Saudi Arabia
- Division of Pediatric Dentistry, Department of Orthodontics and Pediatric Dentistry, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Michael A Raderman
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Elaine Miginsky
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Ward Massey
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Howard Strassler
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Mary Anne Melo
- Dental Biomedical Science PhD Program, University of Maryland School of Dentistry, Baltimore, MD, USA
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, MD, USA
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Nassar M, Al-Fakhri O, Shabbir N, Islam MS, Gordan VV, Lynch CD, Wilson NH, Blum IR. Teaching of the repair of defective composite restorations in Middle Eastern and North African Dental Schools. J Dent 2021; 112:103753. [PMID: 34339798 DOI: 10.1016/j.jdent.2021.103753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 07/15/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate the status of teaching of repair of defective resin-based composite restorations in dental schools in the Middle Eastern and North African (MENA) countries. METHODS A validated 14-item questionnaire was mailed to the directors of the operative/restorative dentistry department in 40 MENA dental schools. Data were collected on teaching, including whether the repair of resin-based composite restorations was part of the dental school curriculum; the rationale behind the teaching; how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability and expected longevity of the repair procedure. RESULTS Thirty-two schools responded to the survey (response rate of 80%). Twenty-two (69%) schools reported the teaching of resin-based composite repairs as an alternative to the replacement of restorations. Of the schools not teaching repairs, 80% indicated that they plan to include this topic in the curriculum within the next five years. Most schools taught theoretical and practical aspects of repair at a clinical level only. Two-thirds of schools reported tooth substance preservation being the main reason for teaching repair techniques. The main indications for repair treatment were marginal defects (59%), followed by partial loss of restoration (56%). Most schools that performed repairs reported high patient acceptability. Considerable variation was noted in relation to expected longevity of resin- based composite repairs. CONCLUSIONS The repair of defective resin-based composite restorations is actively taught within most of the surveyed schools. Advantages of repair, compared to replacement include minimum intervention, preservation of tooth structure, and savings of time and cost. CLINICAL SIGNIFICANCE The decision between replacing or repairing a defective resin-based composite restoration in the MENA region tends to be based on clinicians' subjective experience and judgement. However, to further enhance the teaching of resin-based composite repair standardised guidelines need to be developed based on existing evidence.
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Affiliation(s)
- Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ola Al-Fakhri
- Ras Al Khaimah College of Dental Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Nafisa Shabbir
- Ras Al Khaimah College of Dental Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Md Sofiqul Islam
- Ras Al Khaimah College of Dental Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Valeria V Gordan
- Department of Restorative Dental Sciences, Operative Dentistry Division, College of Dentistry, University of Florida, Gainesville, FL, United States
| | - Christopher D Lynch
- Cork University Dental School & Hospital, University College Cork, Wilton, Cork, Ireland
| | | | - Igor R Blum
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom.
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Current and future trends in the teaching of direct posterior resin composites in Malaysian dental schools: a cross-sectional study. J Dent 2021; 110:103683. [PMID: 33957189 DOI: 10.1016/j.jdent.2021.103683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate the current and future teaching of posterior composite restorations in undergraduate curricula in Malaysian dental schools. METHODS A 24-item validated questionnaire including closed and open questions on the teaching of posterior composites was emailed to faculty members in all 13 Dental Schools in Malaysia. Responses were compiled on Excel and analysed. RESULTS All 13 dental schools responded to the survey yielding a 100 % response. All schools indicated the use of posterior composites for 2- and 3-surface cavities in premolars and molars. The didactic teaching time devoted to composites was greater than for amalgam (38 h vs 29 h). Clinically, most posterior restorations placed by students were composites (average 74.1 %, range 10 %-100 %); the remaining 25.9 % were amalgams (range, 0 %-50 %). Slot-type cavities were the preparation techniques most commonly taught (n = 11,84.6 %). The use of rubber dam for moisture control was mandatory in most schools (n = 11, 84.6 %). History of adverse reaction to composites was found to be the most common contraindication to composite placement. The phase down of teaching and use of amalgam in Malaysia is expected to occur within the next six years. CONCLUSION The trend to increase the teaching of posterior composites reported for other countries is confirmed by the findings from Malaysian dental schools. Notwithstanding this trend, the use of amalgam is still taught, and future studies are required to investigate the implications of the phase down of amalgam in favour of posterior composites. CLINICAL SIGNIFICANCE Notwithstanding the increase in the teaching of posterior composites there is a pressing need to update and refine clinical guidelines for the teaching of posterior composites globally.
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Benn DK, Cooper RL, Nunn ME, Edwards SE, Rocha-Sanchez SM. A radiographic method for distinguishing noncavitated from cavitated proximal carious lesions. A proof of concept clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:715-726. [PMID: 34083157 DOI: 10.1016/j.oooo.2021.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 01/05/2021] [Accepted: 02/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We propose a new topical radiographic contrast method for distinguishing noncavitated from cavitated radiolucencies. Laboratory tests and a pilot clinical trial were designed to test the feasibility and efficacy of the method. STUDY DESIGN Twenty-two adults with 27 proximal radiolucencies had conventional bitewing (BW) examinations. After exclusion, 21 surfaces were evaluated. A concentrated solution of sodium iodide was placed in the interdental spaces via a microsyringe and BWs were again exposed. A class II cavity preparation was made in the adjacent tooth and polysiloxane impressions were made of the study surfaces. The impressions were scanned by visible light, creating a high resolution 3D replica. Cavitations, if present, were measured. RESULTS Nine surfaces were noncavitated and 12 surfaces were cavitated. The microsyringe dispensed a variable volume of liquid, which affected the accuracy of the test. The sensitivity for cavitation was 50%, specificity was 88.9%, and accuracy was 66.7%. This compares to a reported 60% sensitivity, 62% specificity, and 62% accuracy for BW examinations. Intraexaminer reliability for classifying noncavitated or cavitated lesions using the kappa test was 0.649. CONCLUSIONS This method needs improvement but was an advance over conventional BWs and could result in reduction of restorations in low- and high-risk patients.
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Affiliation(s)
- Douglas K Benn
- Creighton University School of Dentistry, Omaha, NE, USA.
| | - Ryan L Cooper
- Creighton University School of Dentistry, Omaha, NE, USA
| | - Martha E Nunn
- Creighton University School of Dentistry, Omaha, NE, USA
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A retrospective clinical study on the survival of posterior composite restorations in a primary care dental outreach setting over 11years. J Dent 2021; 106:103586. [PMID: 33465448 DOI: 10.1016/j.jdent.2021.103586] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To investigate the survival in terms of time to re-intervention of composite restorations in posterior teeth among patients attending for treatment at a primary care dental outreach setting over an 11-year period and to determine whether dental, patient or operator factors influenced this. METHODS Electronic primary dental care data were collected on individual patients, including information on their dental treatment and socio-demographics as well as service provision, key performance indicators and student activity. RESULTS A total of 1086 patients had at least one posterior composite placed between 2007 and 2018. This amounted to 3194 restorations placed of which 308 had a re-intervention within the 11-year period. For all restorations, the annual failure rate at 1 year was 5.73 %, at 5 years was 16.78 % and at 10 years was 18.74 %. A logistic regression showed that when compared to the least deprived 5th quintile, the most deprived 1st and 2nd quintiles were significantly less likely to have a re-intervention, being 49.2 % (p = 0.022) and 53.2 % (p = 0.031) less likely, respectively. CONCLUSIONS The survival rates of posterior composite restorations placed at a single outreach centre providing undergraduate dental training in the South of England, mirrors other studies. The new findings presented suggest similar re-intervention rates between dental students and dental hygiene-therapy students. This study's findings around patient deprivation and rate and time of re-intervention raises important questions related to the need for targeted dental and after care for certain groups in the population. CLINICAL SIGNIFICANCE Understanding the factors associated with re-intervention of restorations provided to patients has an impact on patients and dental practices. Also, as we consider widening use of skill mix in dentistry to increase access to care, parity in provision of treatments within the dental team increases opportunities for delegation of tasks.
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Reher V, Reher P, Peres KG, Peres MA. Fall of amalgam restoration: a 10-year analysis of an Australian university dental clinic. Aust Dent J 2020; 66:61-66. [PMID: 33197295 DOI: 10.1111/adj.12807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The use of amalgam in Dentistry has decreased since the 1980s. This study aimed to (i) assess the time trend in the usage of amalgam and composite in posterior teeth at Griffith University Dental Clinic from 2010 to 2019; (ii) to test whether this trend varied according to the dental health provider. METHODS We analysed clinic records from 2010 to 2019. Prais-Winsten analyses were performed, and the average annual percentages change (AAPC) for amalgam and composite was estimated. RESULTS There were 397,013 procedures, including 80,995 direct posterior restorations. Amalgam use decreased from 12.9% in 2010 to 0.5% in 2019 among students, while composite use increased from 87.1% to 99.5% of posterior restorations. The annual increase of the composite was 1.4% per year for students, while amalgam decreased by 30.2% per year on average. A similar trend was noted among the dentists. CONCLUSIONS A significant decrease in the use of amalgam was observed over time for both students and professionals. This trend raises questions about curriculum reviews, focusing on the repair, maintenance and safe removal of amalgam while reinforcing the learning on Minimally Invasive Dentistry and composite restorations based on the patient's caries risk.
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Affiliation(s)
- V Reher
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - P Reher
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - K G Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia.,National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
| | - M A Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
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18
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Adou-Assoumou MN, Djolé SX, Krah-Sinan AA, Adou JA, Siendou D, Mansilla EC. Direct technique premolar coronal restorations: From metallic material to "complete adhesive restoration". J Conserv Dent 2020; 22:568-572. [PMID: 33088067 PMCID: PMC7542080 DOI: 10.4103/jcd.jcd_330_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 03/14/2020] [Accepted: 07/03/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction: The choice of restorative materials has for a long time been determined by the tooth position. Thus, premolar restoration depended on the practitioner's clinical assessment and practical experience in regard to the material to be handled. Aim: The objective of this study was to assess, in the students' practice, the change in the choice of materials used for premolars restoration. Materials and Methods: This was a retrospective study based on the available care records in the department of conservative dentistry and endodontics of a dental school. Variables analyzed included the year of restoration, the type of material, the premolar position in the arch, and the coronal restoration site (occlusal, proximal, and cervical). Data collected were processed with the SPSS software version 22 (SPSS Inc., Chicago, IL, USA; 2013). The statistical significance threshold was set at 5% for Pearson's Chi-square test. Results: Between 1994 and 2017, 1738 restored premolars were identified. Over the years, amalgam restorations declined from 99.2% in 1994 to 1.3% in 2017, contrary to composite whose frequency increased from 0.6% to 88.6%. Maxillary premolars were exclusively restored with composite in 2017 when amalgam was still, somewhat, used for mandibular premolars. Conclusion: The reversal in the choice of materials in favor of composites reflects the global trend. This seems to be related to the current awareness of the prohibition, among others, of medical devices containing mercury.
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Affiliation(s)
- Marie Nwon Adou-Assoumou
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
| | - Stéphane X Djolé
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
| | - Aline A Krah-Sinan
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
| | - Jonas A Adou
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
| | - Dao Siendou
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
| | - Edmée C Mansilla
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
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de Cássia Romano B, Soto-Montero J, Rueggeberg FA, Giannini M. Effects of extending duration of exposure to curing light and different measurement methods on depth-of-cure analyses of conventional and bulk-fill composites. Eur J Oral Sci 2020; 128:336-344. [PMID: 32502304 DOI: 10.1111/eos.12703] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2020] [Indexed: 11/30/2022]
Abstract
This study evaluated the effect of extending the duration of exposure to curing light on the depth of cure of two conventional (RBC1-conventional and RBC2-conventional) and two bulk-fill (RBC1-bulk and RBC2-bulk) resin composites. Polywave and single-peak photocuring units were used. Cylinder-shaped specimens were exposed to curing light either for the time period recommended by the manufacturer or twice the length of that time, and depth of cure was estimated using manual scraping (similar to the ISO-4049 standard) and solvent immersion techniques. Depth of cure was analyzed, using two-way ANOVA, for the factors measurement method and exposure time. For RBC1-conventional and RBC1-bulk, the solvent immersion technique estimated a greater depth of cure than did manual scraping; for RBC1-conventional, both techniques and both light-exposure time periods resulted in a depth of cure of >2 mm; and for RBC1-bulk, only the solvent method after photocuring for twice the manufacturer's recommended time resulted in a depth of cure of 5 mm. For RBC2-conventional and RBC2-bulk, neither technique nor exposure time resulted in estimated depths of cure that matched those indicated by the manufacturer. The results suggest that extending the duration of photopolymerization increases depth of cure. Also, calculation of depth of cure can vary according to the measurement technique used.
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Affiliation(s)
- Beatriz de Cássia Romano
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Jorge Soto-Montero
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.,Department of Restorative Dentistry, School of Dentistry, University of Costa Rica, Montes de Oca, Costa Rica
| | - Frederick A Rueggeberg
- Department of Restorative Sciences, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Marcelo Giannini
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Alexander G, Hopcraft MS, Tyas MJ, Wong RHK. Dental educators' attitudes towards the teaching of dental amalgam. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:282-291. [PMID: 31925893 DOI: 10.1111/eje.12496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 11/03/2019] [Accepted: 01/07/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To ascertain dental educators' attitudes towards the teaching of dental amalgam at dental schools in Australia and identify preferred curricular approaches in a potentially "amalgamless" profession. METHODS A mixed methods analysis was employed based on an open-ended response survey followed by a closed-ended questionnaire. Identification of key issues from the survey helped frame the questionnaire. Participants included those with expertise in operative and restorative dentistry, with direct involvement in curriculum development or delivery, at Australian dental schools. RESULTS Participants numbered fifteen and represented seven of the nine dental schools in Australia. Key themes identified and explored included the following: (in)consistency of approach to teaching restorative dentistry; a perceived disconnect between undergraduate study and the "real world"; a need for a focus on teaching of alternatives to dental amalgam (80 per cent (strongly) agreeing); the contradictory nature of the evidence base and literature that is not readily understood; the need for more post-graduate education relating to adhesive restorative materials (86 per cent (strongly) agreeing); the need for dental amalgam to continue to be available; formal understandings (guidelines) as to the use of dental amalgam; dental schools in Australia being heard on these issues; and the relevance of this issue (100 per cent (strongly) agreeing the issue is topical and important). CONCLUSION There is a broad consensus of dental educators at Australian dental schools as how best to approach the teaching of amalgam if a phase-down is to occur and the issues any such approach may face.
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Affiliation(s)
- George Alexander
- Melbourne Dental Clinic, University of Melbourne, Carlton, Vic., Australia
| | - Matthew S Hopcraft
- Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
| | - Martin J Tyas
- Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
| | - Rebecca H K Wong
- Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
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Kanzow P, Büttcher AF, Wilson NH, Lynch CD, Blum IR. Contemporary teaching of posterior composites at dental schools in Austria, Germany, and Switzerland. J Dent 2020; 96:103321. [DOI: 10.1016/j.jdent.2020.103321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 12/27/2022] Open
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Soto-Montero J, Nima G, Rueggeberg FA, Dias CTS, Giannini M. Influence of Multiple Peak Light-emitting-diode Curing Unit Beam Homogenization Tips on Microhardness of Resin Composites. Oper Dent 2020; 45:327-338. [DOI: 10.2341/19-027-l] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
This study evaluated the effect of light curing unit (LCU) guide type (regular or homogenizing) on top and bottom microhardness of conventional and bulk-fill resin-based composites (RBCs). A polywave light-emitting-diode (LED) LCU (Bluephase Style, Ivoclar Vivadent AG) was used with two different light guides: a regular tip (RT, 935 mW/cm2 emittance) and a homogenizer tip (HT, 851 mW/cm2 emittance). Two conventional RBCs (Herculite Ultra [HER], Kerr Corp; Tetric EvoCeram [TEC], Ivoclar Vivadent AG) and two bulk-fill RBCs (SonicFill [SOF], Kerr Corp; Tetric EvoCeram Bulk Fill [TBF], Ivoclar Vivadent AG) were tested. Disc-shaped samples (10 mm Ø), 2-mm thick for conventional composites and 4-mm thick for bulk-fill composites were prepared. Samples were light cured according to manufacturer-recommended times. Knoop microhardness values (KHN) were obtained on the top and bottom surfaces of each specimen at locations correlated with the output of the three LED chips emitting blue (456 nm) or violet light (409 nm). Beam profile analysis using both light guides was also performed. Microhardness of each composite was analyzed using three-way analysis of variance and Tukey honestly significant difference post hoc test (α=0.05). Beam profile images showed better light distribution across the surface of the HT light guide. Use of the HT decreased KHN of HER at the locations of the blue LED chips at bottom of the sample but had no effect on the top surface. For TEC, use of HT increased KHN of all three LED locations at the top surface. Use of the HT increased KHN of SOF at locations corresponding to one of the blue and the violet LED chips at the bottom surface. For TBF, HT increased KHN at all top surface locations. All RBCs showed higher mean KHN at the top compared with the bottom surfaces. In general, all composites presented a higher KHN at the blue LED areas regardless of the surface or the tip used. Results suggest that the homogenizer light guide resulted in significantly increased microhardness at the top, in composite resins containing alternative photoinitiators; however, that effect was not observed at the bottom surfaces.
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Affiliation(s)
- J Soto-Montero
- Jorge Soto-Montero, DDS, MS, MS, PhD student, Operative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil and professor, Department of Restorative Dentistry, University of Costa Rica - School of Dentistry, San José, Costa Rica
| | - G Nima
- Gabriel Nima, DDS, MSc, PhD student, Dental Materials, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - FA Rueggeberg
- Frederick A Rueggeberg, DDS, MSc, professor, Dental Materials, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - CTS Dias
- Carlos TS Dias, DDS, MS, PhD, titular professor, Department of Statistical Mathematics, Luiz de Queiroz Higher School of Agriculture, University of São Paulo, Piracicaba, Brazil
| | - M Giannini
- Marcelo Giannini, DDS, MS, PhD, associate professor, Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Kanzow P, Wiegand A. Teaching of composite restoration repair: Trends and quality of teaching over the past 20 years. J Dent 2020; 95:103303. [DOI: 10.1016/j.jdent.2020.103303] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 11/30/2022] Open
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Zabrovsky A, Neeman Levy T, Bar-On H, Beyth N, Ben-Gal G. Next generation of dentists moving to amalgam-free dentistry: Survey of posterior restorations teaching in North America. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2019; 23:355-363. [PMID: 31009156 DOI: 10.1111/eje.12437] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 04/16/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The dental field is gradually reducing the use of amalgam and moving towards adhesive restoration. This change is in accordance with the advancement and improvement of composite resin materials and adhesion systems. Consequently, posterior cavity preparations teaching should be re-examined to determine whether dental schools are adapting their curriculum to fit the current trends in dentistry and what rationale supports their decisions. METHODS An online questionnaire was constructed to assess the time dedicated to teaching composite materials and amalgam, in addition to the principles of posterior preparations, for composite restorations in North American dental schools. RESULTS A total 33 schools responded to the questionnaire. A large variation was found in teaching methods and techniques of posterior restorations. The reasoning for teaching amalgam restorations was diverse as were the principles of composite resin preparation taught. CONCLUSION No agreed principles of cavity preparation for resin composite restorations were found, as opposed to explicit agreement on amalgam cavity preparations. The results demonstrate a lack of clear guidelines for cavity preparation of resin composite restorations. Dental schools may benefit when a consensus on this topic is achieved.
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Affiliation(s)
- Asher Zabrovsky
- Department of Prosthodontics, Faculty of Dental Medicine, The Hebrew University-Hadassah, Jerusalem, Israel
| | - Tal Neeman Levy
- Department of Prosthodontics, Faculty of Dental Medicine, The Hebrew University-Hadassah, Jerusalem, Israel
| | - Hilit Bar-On
- Department of Prosthodontics, Faculty of Dental Medicine, The Hebrew University-Hadassah, Jerusalem, Israel
| | - Nurit Beyth
- Department of Prosthodontics, Faculty of Dental Medicine, The Hebrew University-Hadassah, Jerusalem, Israel
| | - Gilad Ben-Gal
- Department of Prosthodontics, Faculty of Dental Medicine, The Hebrew University-Hadassah, Jerusalem, Israel
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Martos R, Hegedüs V, Szalóki M, Blum IR, Lynch CD, Hegedüs C. A randomised controlled study on the effects of different surface treatments and adhesive self-etch functional monomers on the immediate repair bond strength and integrity of the repaired resin composite interface. J Dent 2019; 85:57-63. [PMID: 31054292 DOI: 10.1016/j.jdent.2019.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/26/2019] [Accepted: 04/30/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To evaluate the effects of different surface conditioning methods on the immediate repair bond strength and integrity of the repaired composite interface. METHODS One hundred and five resin composite blocks made of a nanohybrid resin composite were randomly assigned to one of the following surface conditioning groups (n = 15/group): Group 1: Gluma Self Etch™ adhesive system, Group 2: Tokuyama Bond Force II™ adhesive system, Group 3: non-roughened and non-conditioned surfaces, Group 4: sandblasting and Gluma Self Etch™, Group 5: sandblasting and Tokuyama Bond Force II™, Group 6: sandblasting only. A positive control group was also used. Resin composite identical to the substrate was applied and the repaired specimens were subjected to shear bond strength (SBS) testing. Representative samples from all groups were subjected to scanning electron microscopy and surface profilometry to determine their mode of failure. The data were analysed statistically using Analysis of Variance (ANOVA) and two independent sample t-test (α = 0.05). RESULTS The mean SBS of all test groups ranged between 1.92 and 5.40 MPa and varied with the degree of composite surface roughness and the type of adhesive system employed. Significantly highest SBS values (5.40 ± 0.36 MPa) were obtained in Group 5 (p = 0.017) which were comparable to the coherent strength of the resin composite in the positive control group (p > 0.05). CONCLUSIONS Under the tested conditions, significantly greater SBS of repaired resin composite was achieved when the substrate surface was conditioned by sandblasting followed by the application of the Tokuyama Bond Force II™ adhesive system. CLINICAL SIGNIFICANCE Effecting a repair of a nanohybrid composite restoration with sandblasting and the application of TBF II would seem to enhance the interfacial bond strength and integrity of the repaired resin composite interface. Clinical trials are necessary to determine the usefulness of this technique.
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Affiliation(s)
- Renata Martos
- Department of Restorative Dentistry, Faculty of Dentistry, University of Debrecen, Hungary.
| | - Viktória Hegedüs
- Department of Orthodontics, Faculty of Dentistry, University of Debrecen, Hungary.
| | - Melinda Szalóki
- Department of Biomaterials and Prosthetic Dentistry, Faculty of Dentistry, University of Debrecen, Hungary.
| | - Igor R Blum
- Department of Primary Dental Care & Outreach, Faculty of Dentistry, Craniofacial & Oral Sciences, King's College London, UK.
| | - Christopher D Lynch
- Department of Restorative Dentistry, University Dental School & Hospital, University College Cork, Ireland.
| | - Csaba Hegedüs
- Department of Biomaterials and Prosthetic Dentistry, Faculty of Dentistry, University of Debrecen, Hungary.
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Loch C, Liaw Y, Metussin AP, Lynch CD, Wilson N, Blum IR, Brunton PA. The teaching of posterior composites: A survey of dental schools in Oceania. J Dent 2019; 84:36-43. [DOI: 10.1016/j.jdent.2019.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/19/2018] [Accepted: 01/17/2019] [Indexed: 11/29/2022] Open
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Wilson NHF, Burke FJT, Brunton PA, Creanor S, Hosey MT, Mannocci F. Dental practice in the UK in 2015/2016. Part 2: aspects of direct restorations, bleaching, endodontics and paediatric dentistry. Br Dent J 2019; 226:sj.bdj.2019.50. [PMID: 30631156 DOI: 10.1038/sj.bdj.2019.50] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2018] [Indexed: 11/09/2022]
Affiliation(s)
- N H F Wilson
- King's College London Dental Institute, London, UK
| | - F J T Burke
- Primary Dental Care Research Group, University of Birmingham School of Dentistry, Birmingham, UK
| | - P A Brunton
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - S Creanor
- Medical Statistics, Plymouth University Peninsula Schools of Medicine & Dentistry, Plymouth, UK
| | - M T Hosey
- Paediatric Dentistry, King's College London Dental Institute, London, UK
| | - F Mannocci
- Endodontology, King's College London Dental Institute, London, UK
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Montagner AF, Sande FHVD, Müller C, Cenci MS, Susin AH. Survival, Reasons for Failure and Clinical Characteristics of Anterior/Posterior Composites: 8-Year Findings. Braz Dent J 2018; 29:547-554. [PMID: 30517477 DOI: 10.1590/0103-6440201802192] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/30/2018] [Indexed: 11/22/2022] Open
Abstract
This retrospective study aimed to compare the annual failure rate (AFR), reasons for failure and factors influencing survival of posterior and anterior composite restorations placed by undergraduate students. Composite restorations placed by undergraduate students were evaluated. The restorations should be in occlusion, with at least one adjacent tooth; and patients should have been present for check-up, with at least 1 annual recall. The investigation was performed in two separate analysis: 1) dental electronic records of 100 patients (n=333 restorations) were selected to assess factors influencing survival; 2) clinical evaluation of 30 patients by examining restorations (n=123) to assess clinical characteristics and failure type distribution. Data were subjected to Kaplan-Meier method, Log-rank test, Cox regression and Fisher's Exact test (p<0.05). After 8-year period, the AFR was 2.62%. There was difference between anterior and posterior restorations (p=0.005), with anterior showing a higher AFR. The patient caries-risk (p<0.001) and the number of surfaces restored (p=0.010) affected restoration survival. The superficial brightness (p=0.029), fracture (p=0.025) and retention (p=0.011) were clinical criteria with differences between anterior and posterior restorations. Income (p<0.001), caries activity (p<0.001), caries risk (p<0.001) and oclusal risk (p<0.001) also influenced on the restorations survival. After 8-year, the AFR of restorations placed by undergraduate students was acceptable and affected by patient risk factors and the position of the tooth in the arch: anterior restorations failed more than posterior.
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Affiliation(s)
| | | | - Clecila Müller
- Graduate Program in Dentistry, UFSM - Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | | | - Alexandre Henrique Susin
- Graduate Program in Dentistry, UFSM - Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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Zabrovsky A, Mahmoud R, Beyth N, Ben-Gal G. Direct Posterior Restorations: A 13-Year Survey of Teaching Trends and Use of Materials. Oper Dent 2018; 43:E273-E279. [DOI: 10.2341/17-361-c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARYObjective:The study aimed to evaluate teaching trends and use of materials in direct posterior restorations during a 13-year period in an Israeli dental school.Methods:Data registered in computerized files, relating to posterior restorations performed in the student clinic during the past 13 years (2004-2016), were collected. The restorative materials used (ie, amalgam vs composite), the type of tooth, and the number of surfaces restored were analyzed.Results:Data analysis included 26,925 restorations performed during 13 years. The number of one-surface composite restorations increased from 54.7% (n=330) to 81.9% (n=873). Two-surface restorations increased from 33.3% (n=254) to 64.3% (n=721). The percentage of amalgam restorations in three-surface restorations decreased from 72.08% to 51.34% (n=173). Analysis of tooth type showed that in 2016, the number of composite restorations performed in premolars reached 80.87% (n=723) and in molars 63.50% (n=1035). The percentage of composite restorations in the mandible and the maxilla was virtually equal.Conclusions:A clear trend in favor of composite resin restorations is evident in the 13-year survey and suggests a move toward an amalgam-free era.
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Affiliation(s)
- A Zabrovsky
- Asher Zabrovsky, DMD, Department of Prosthodontics, Hadassah School of Dental Medicine, Hebrew University, Jerusalem, Israel
| | - R Mahmoud
- Reema Mahmoud, Department of Prosthodontics, Hadassah School of Dental Medicine, Hebrew University, Jerusalem, Israel
| | - N Beyth
- Nurit Beyth, DMD, PhD, Department of Prosthodontics, Hadassah School of Dental Medicine, Hebrew University, Jerusalem, Israel
| | - G Ben-Gal
- Gilad Ben-Gal, DMD, MSc, PhD, Department of Prosthodontics, Hadassah School of Dental Medicine, Hebrew University, Jerusalem, Israel
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An ex-vivo model to determine dental pulp responses to heat and light-curing of dental restorative materials. J Dent 2018; 79:11-18. [PMID: 30176259 DOI: 10.1016/j.jdent.2018.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/30/2018] [Accepted: 08/30/2018] [Indexed: 11/22/2022] Open
Abstract
AIM Based on histological studies from the 1960s, it is recommended that dental pulp temperature increases should not exceed 5.5 °C. However, no contemporary reliable models exist to explore the effects of heat on living dental pulp. The aim of this project was to develop a clinically valid model for studying temperature increases caused by three commonly-used light curing units (LCUs). METHODS Temperature increases caused by LCUs at varying exposure times and via various thicknesses of dentine were recorded using traditional approaches (i.e. thermocouple device on a laboratory bench) and an ex-vivo tooth slice model. Histomorphometric and immunohistochemical (IL-1β, HSP70, caspase-3) analysis was performed of the tooth slice model following varying exposure and culture times. RESULTS Reduced dentine thickness and increased exposure time led to increases in temperature. Whilst the majority of temperature increases recorded using the traditional approach (53 of 60) were greater than the recommended 5.5 °C, 52 of the 60 reference points recorded using the ex-vivo tooth slice model resulted in temperature increases of less than 5.5 °C. Temperature increases of 5.5 °C or more that are prolonged for 40 s caused an immediate decrease in cell number. IL-1β was not detected in any samples, while HSP70 was detectable immediately after exposure to a temperature increase of 6 °C or more. Higher levels of HSP70 were detected after 24 h culture in tooth slices that experienced a temperature increase of 7.5 °C or more. Low levels of caspase-3 were detected in tooth slices exposed to temperature increase of 7.5 °C or more. CONCLUSION Experimental arrangements for assessing LCU performance that measure temperature increases using a thermocouple device on a laboratory bench should no longer be used. Future studies in this area should include replication of the clinical environment using greater sophistication, such as the use of an ex-vivo tooth slice model as described here. Temperature increases of 5.5 °C or more for 40 s caused an immediate decrease in cell number, which supports previous findings. However, complex interactions at an immunohistochemical level suggest that while temperature increases of 5 °C or less are ideal, there may be some cell damage between 5-7 °C which might not result in pulpal death. Further investigations are indicated.
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Kanzow P, Wiegand A, Wilson NH, Lynch CD, Blum IR. Contemporary teaching of restoration repair at dental schools in Germany – Close to universality and consistency. J Dent 2018; 75:121-124. [DOI: 10.1016/j.jdent.2018.06.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 06/18/2018] [Indexed: 01/19/2023] Open
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Jones RJ, Cowpe JG, Bullock AD, Gilmour ASM. Clinical skills of a new foundation dentist: the experience of dental foundation educational supervisors. Br Dent J 2018; 225:177-186. [PMID: 30050194 DOI: 10.1038/sj.bdj.2018.536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2018] [Indexed: 11/09/2022]
Affiliation(s)
- R J Jones
- Cardiff University, School of Dentistry, Heath Park, Cardiff, UK
| | - J G Cowpe
- Cardiff University, School of Dentistry, Heath Park, Cardiff, UK
| | - A D Bullock
- Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), School of Social Sciences, Cardiff University, 12 Museum Place, Cardiff, CF10 3BG, UK
| | - A S M Gilmour
- Cardiff University, School of Dentistry, Heath Park, Cardiff, UK
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Lynch CD, Farnell DJJ, Stanton H, Chestnutt IG, Brunton PA, Wilson NHF. No more amalgams: Use of amalgam and amalgam alternative materials in primary dental care. Br Dent J 2018; 225:171-176. [DOI: 10.1038/sj.bdj.2018.538] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 11/09/2022]
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Lynch CD, Blum IR, McConnell RJ, Frazier KB, Brunton PA, Wilson NHF. Teaching posterior resin composites in UK and Ireland dental schools: do current teaching programmes match the expectation of clinical practice arrangements? Br Dent J 2018; 224:967-972. [DOI: 10.1038/sj.bdj.2018.446] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2018] [Indexed: 11/09/2022]
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36
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Eltahlah D, Lynch CD, Chadwick BL, Blum IR, Wilson NH. An update on the reasons for placement and replacement of direct restorations. J Dent 2018. [DOI: 10.1016/j.jdent.2018.03.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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The undergraduate preparation of dentists: Confidence levels of final year dental students at the School of Dentistry in Cardiff. Br Dent J 2018; 221:349-54. [PMID: 27659639 DOI: 10.1038/sj.bdj.2016.686] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 11/08/2022]
Abstract
Objective To investigate the self-reported confidence and preparedness of final year undergraduate students in undertaking a range of clinical procedures.Methods A questionnaire was distributed to final year dental students at Cardiff University, six months prior to graduation. Respondents rated their confidence in undertaking 39 clinical procedures using a 5-point scale (1 = can undertake on own with confidence, 5 = unable to undertake). Students also responded yes/no to experiencing four difficulties and to three statements about general preparedness.Results 71% (N = 51) responded of which 55% (N = 28) were female. Over half reported being 'anxious that the supervisor was not helping enough' (57%) and 'relying heavily on supervisor for help' (53%). Eighty percent 'felt unprepared for the clinical work presented' and gender differences were most notable here (male: 65% N = 33; females: 93% N = 47). Mean confidence scores were calculated for each clinical procedure (1 = lowest; 5 = highest). Confidence was highest in performing 'simple scale' and 'fissure sealant' (mean-score = 5). Lowest scores were reported for 'surgical extractions involving a flap (mean-score = 2.28)', 'simple surgical procedures' (mean-score = 2.58) and the 'design/fit/adjustment of orthodontic appliances' (mean-score = 2.88).Conclusions As expected complex procedures that were least practised scored the lowest in overall mean confidence. Gender differences were noted in self-reported confidence for carrying out treatment unsupervised and feeling unprepared for clinical work.
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Hayashi M, Yamada T, Lynch CD, Wilson NHF. Teaching of posterior composites in dental schools in Japan - 30 years and beyond. J Dent 2018; 76:19-23. [PMID: 29474951 DOI: 10.1016/j.jdent.2018.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/19/2018] [Accepted: 02/19/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The teaching of posterior composites has been a major part of the curriculum in Japanese dental education for several decades. The aim of this paper was to investigate the current trends in the teaching of posterior composites to undergraduate dental students in Japan by comparing the results of surveys conducted for over 30 years. METHODS In late 2016-early 2017, a questionnaire seeking information on the teaching of posterior composites was distributed via e-mail to the persons responsible for teaching operative dentistry in 29 dental schools having undergraduate dental degree programs in Japan. The results obtained were compared to those from surveys conducted in 1986, 1997, and 2007. RESULTS All 29 schools that were sent the questionnaire completed the responses (response rate = 100%). All 29 schools reported teaching the placement of composite in occlusal and two-surface occluso-proximal cavities in both premolars and molars. Four schools reported not teaching the placement of three-surface occluso-proximal composites in premolars and five schools reported not teaching it for molars. Twenty-seven (93%) schools taught composite first as a part of the preclinical curriculum, whereas 15 (65%) schools did so in the survey of 2007. Variations were noted between schools in the teaching of, cavity design. In contrast, greater consistency was observed in the teaching of techniques for protecting exposed dentin and light-curing technologies. CONCLUSIONS It is hoped that measures intended to increase the clinical experience of restoring teeth with direct composite-resin for dental students in Japan will be effective, providing opportunity to bring dental education in Japan more into line with international norms.
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Affiliation(s)
- Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.
| | - Tomomi Yamada
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Christopher D Lynch
- University Dental School & Hospital, University College Cork, Wilton, Cork, Ireland
| | - Nairn H F Wilson
- King's College London Dental Institute, King's College London, United Kingdom
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Blum IR, Wilson NHF. An end to linings under posterior composites? J Am Dent Assoc 2018; 149:209-213. [PMID: 29366458 DOI: 10.1016/j.adaj.2017.09.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/06/2017] [Accepted: 09/19/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OVERVIEW There is an uncertainty among dentists as to whether to place a lining under a direct posterior composite restoration and, if so, what material or combination of materials to use. In this article, the authors consider the evidence for the placement of a lining under posterior composites of different depths, including indications and contraindications for different lining materials. CONCLUSIONS The available evidence does not support the use of linings under direct, bonded posterior composites, unless being placed in deep cavities for therapeutic reasons. PRACTICAL IMPLICATIONS The best available evidence indicates that dentists can place posterior composites without linings, except for therapeutic purposes, with no adverse effect on postoperative complications, with possible improvements in performance in clinical service, and with efficiency savings in chairside time.
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40
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Sabbagh J, McConnell R, McConnell MC. Posterior composites: Update on cavities and filling techniques. J Dent 2017; 57:86-90. [DOI: 10.1016/j.jdent.2016.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 11/02/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022] Open
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TSUJIMOTO A, BARKMEIER WW, TAKAMIZAWA T, LATTA MA, MIYAZAKI M. Depth of cure, flexural properties and volumetric shrinkage of low and high viscosity bulk-fill giomers and resin composites. Dent Mater J 2017; 36:205-213. [DOI: 10.4012/dmj.2016-131] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Akimasa TSUJIMOTO
- Department of Operative Dentistry, Nihon University School of Dentistry
- Department of General Dentistry, Creighton University School of Dentistry
| | - Wayne W. BARKMEIER
- Department of General Dentistry, Creighton University School of Dentistry
| | | | - Mark A. LATTA
- Department of General Dentistry, Creighton University School of Dentistry
| | - Masashi MIYAZAKI
- Department of Operative Dentistry, Nihon University School of Dentistry
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Loomans B, Hilton T. Extended Resin Composite Restorations: Techniques and Procedures. Oper Dent 2016; 41:S58-S67. [DOI: 10.2341/15-212-lit] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
This article gives an overview of the state of the art of different restorative treatment procedures and techniques needed for placing extended posterior resin composite restorations. Clinical aspects related to the procedure are discussed and reviewed based on the current literature, such as the use of proper adhesive restorative materials, use of liners and bases, moisture control, reconstruction of proximal contacts, extended resin composite restorations, and techniques to address restoring teeth with deep subgingival margins.
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Affiliation(s)
- B Loomans
- Bas Loomans, DDS, PhD, Radboud Institute for Molecular Life Sciences, Department of Dentistry, Radboud university medical center, Nijmegen, PO Box 9101, Nijmegen 6500 HB, The Netherlands
| | - T Hilton
- Thomas Hilton, DMD, MS, Department of Restorative Dentistry, Oregon Health and Science University, 2730 S.W. Moody Ave. Portland, OR 97201-0007, USA
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Burke FJT. Minamata: two years on. DENTAL UPDATE 2015; 42:801. [PMID: 26749787 DOI: 10.12968/denu.2015.42.9.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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You M. Interpretation of the source-specific substantive control measures of the Minamata Convention on Mercury. ENVIRONMENT INTERNATIONAL 2015; 75:1-10. [PMID: 25461410 DOI: 10.1016/j.envint.2014.10.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 10/23/2014] [Accepted: 10/28/2014] [Indexed: 05/04/2023]
Abstract
Being persistent, toxic, and bio-accumulative, Mercury (Hg) seriously affects the environment and human health. Due to Hg's attribute of long-range environmental transport across national borders, especially through atmospheric transport, no country can fully protect its environment and human health with its own efforts, without global cooperation. The Minamata Convention on Mercury, which was formally adopted and opened for signature in October 2013, is the only global environmental regime on the control of Hg pollution. Its main substantive control measures are source-specific: its phasing-out, phasing-down, and other main substantive requirements all direct to specific categories of pollution sources through the regulation of specific sectors of the economy and social life. This Convention does not take a national quota approach to quantify the Parties' nationwide total allowable consumption or discharge of Hg or Hg compounds, nor does it quantify their nationwide total reduction requirements. This paper attempts to find the underlying reasons for this source-specific approach and offers two interpretations. One possible interpretation is that Hg might be a non-threshold pollutant, i.e., a pollutant without a risk-free value of concentration. The existence of a reference dose (RfD), reference concentration (RfC), provisional tolerable weekly intake (PTWI), minimal risk level (MRL) or other similar reference values of Hg does not necessarily mean that Hg cannot be regarded as non-threshold because such reference values have scientific uncertainties and may also involve policy considerations. Another interpretation is that Hg lacks a feasibly determinable total allowable quantity. There is evidence that negotiators might have treated Hg as non-threshold, or at least accepted that Hg lacks a feasibly determinable total allowable quantity: (1) The negotiators were informed about the serious situations of the current emissions, releases, and legacy deposition; (2) the UNEP Secretariat took the position that Hg is non-threshold and should be eliminated to the maximum; (3) European countries, the USA and other western countries were in a better position to regard Hg as non-threshold and push forward a global reduction of Hg emissions and releases to the minimum; (4) the negotiators took the Stockholm Convention on Persistent Organic Pollutants (POPs) as a model; and (5) a fairly large number of non-governmental organizations (NGOs) were organized under umbrella NGO networks such as the Zero Mercury Working Group (ZMWG) and the International POPs Elimination Network (IPEN) and made a significant contribution to the negotiation process. The interpretations for the Minamata Convention might similarly be used to interpret the source-specific approach of the Stockholm Convention on POPs and the national quota approach of global environmental regimes on stratospheric ozone and climate mitigation. These two interpretations focus on the features of the pollutants and for this reason may be useful for future negotiators of other international environmental treaties to select appropriate models. They also suggest that the source-specific approach may be adopted in the future for pollutants with similar features of being possibly non-threshold and without a feasibly determinable total allowable quantity.
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Affiliation(s)
- Mingqing You
- Zhongnan University of Economics and Law, Hubei Water Affairs Research Center, 182 South Lake Avenue, East Lake High-Tech Development Zone, Wuhan 430073, China.
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Kearns JO, Barry JG, Fleming GJ. Cuspal deflection and cervical microleakage scores to determine the adhesive potential of universal bonding systems. J Dent 2014; 42:970-6. [DOI: 10.1016/j.jdent.2014.05.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 05/21/2014] [Accepted: 05/23/2014] [Indexed: 11/26/2022] Open
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Khalaf ME, Alomari QD, Ngo H, Doméjean S. Restorative treatment thresholds: factors influencing the treatment thresholds and modalities of general dentists in Kuwait. Med Princ Pract 2014; 23:357-62. [PMID: 24943861 PMCID: PMC5586903 DOI: 10.1159/000363184] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 04/27/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This study investigated the thresholds at which general dentists in Kuwait would restore approximal and occlusal carious lesions and examined the demographic characteristics of the dentists in relation to their decision making. SUBJECTS AND METHODS The study population consisted of a random sample of 185 general dentists practicing in the Ministry of Health of Kuwait. A survey questionnaire was administered. The questionnaire presented different stages and locations of carious lesions; the participants were asked to identify the stage at which a restoration is required under different conditions, the preparation technique, and their choice of restorative material. RESULTS For approximal carious lesions, 74 (40%) of the participants reported that they would restoratively intervene when the carious lesion reached the outer third of the dentin. A total of 91 (49.2%) reported the use of traditional class II restorations. For occlusal carious lesions, 128 (69.2%) said they would intervene when lesions reached the middle third of the dentin. 146 (78.9%) said they would remove the carious tissue only in their preparation. For both approximal and occlusal lesions, the participants preferred resin composite as the material for restoration. CONCLUSIONS The respondents tended to delay restorative intervention until dentinal penetration of the caries. Resin restorative materials were used in conservatively prepared cavities. Participants chose a conservative approach for occlusal lesions but still believed in a traditional approach when it concerned approximal lesions. Experience, university dental education, and participation in continuous education courses were most significantly related to restorative treatment.
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Affiliation(s)
- Mai E. Khalaf
- Department of Restorative Sciences, Faculty of Dentistry, Health Sciences Centre, Kuwait University, Jabriya, Kuwait
- *Dr. Mai E. Khalaf, Department of Restorative Sciences, Faculty of Dentistry, Health Sciences Centre, Kuwait University, PO Box 24923, Safat, Jabriya 13110 (Kuwait), E-Mail
| | - Qasem D. Alomari
- Department of Restorative Sciences, Faculty of Dentistry, Health Sciences Centre, Kuwait University, Jabriya, Kuwait
| | - Hien Ngo
- Department of Restorative Sciences, Faculty of Dentistry, Health Sciences Centre, Kuwait University, Jabriya, Kuwait
| | - Sophie Doméjean
- CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
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