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Vervliet P, De Nys S, Duca RC, Boonen I, Godderis L, Elskens M, Van Landuyt KL, Covaci A. Degradation products of resin-based materials detected in saliva in vivo. Clin Oral Investig 2023; 27:7189-7198. [PMID: 38051347 DOI: 10.1007/s00784-023-05075-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/29/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVES Dental composites remain under scrutiny regarding their (long-term) safety. In spite of numerous studies on the release of monomers both in vitro and in vivo, only limited quantitative data exist on the in vivo leaching of degradation products from monomers and additives. The aim of this observational study was for the first time to quantitatively and qualitatively monitor the release of parent compounds and their degradation products in saliva from patients undergoing multiple restorations. MATERIALS AND METHODS Five patients in need of multiple large composite restorations (minimally 5 up to 28 restorations) due to wear (attrition, abrasion, and erosion) were included in the study, and they received adhesive restorative treatment according to the standard procedures in the university clinic for Restorative Dentistry. Saliva was collected at different time points, starting before the restoration up until 24 h after the treatment with composite restorations. Saliva extracts were analyzed by liquid chromatography-mass spectrometry. RESULTS Leaching of monomers and degradation products was highest within 30 min after the placement of the restorations. The highest median concentrations of monomers were recorded for UDMA, BisEMA-3, and TEGDMA; yet, besides BisEMA-3 and TEGDMA, no monomers could be detected after 24 h. Mono- and demethacrylated degradation products remained present up to 24 h and concentrations were generally higher than those of monomers. In patients with multiple restorations, degradation products were still present in the sample taken before the next operation, several weeks after the previous operation. CONCLUSIONS Exposure to residual monomers and degradation products occurs in the first hours after restoration. Monomers are present in saliva shortly after restoration, but degradation products can be detected weeks after the restoration confirming a long-term release. CLINICAL SIGNIFICANCE Future research should focus more on the release of degradation products from monomers and additives from resin-based materials given their prolonged presence in saliva after restoration.
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Affiliation(s)
- Philippe Vervliet
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium.
| | - Siemon De Nys
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & University Hospitals Leuven (UZ Leuven), Dentistry, Louvain, Belgium
| | - Radu Corneliu Duca
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium
- Environmental Hygiene and Human Biological Monitoring, Department of Health Protection, National Health Laboratory (LNS), 1, Rue Louis Rech, L-3555, Dudelange, Luxembourg
| | - Imke Boonen
- Department of Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Ixelles, Belgium
| | - Lode Godderis
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium
| | - Marc Elskens
- Department of Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Ixelles, Belgium
| | - Kirsten L Van Landuyt
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & University Hospitals Leuven (UZ Leuven), Dentistry, Louvain, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium.
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Khodayari A, Jessani A, Adeniyi A, Anderson G, Tam LE, De Souza GM. A survey of amalgam use to guide dental education curriculums. J Dent Educ 2023; 87:1284-1293. [PMID: 37280767 DOI: 10.1002/jdd.13252] [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: 09/11/2022] [Revised: 03/15/2023] [Accepted: 05/10/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To identify behavioral, preferential, and professional factors influencing the use of amalgam in private practices; and to compare the incidence of the placement of amalgam versus composite resin restorations in the province of Ontario and its pedagogical implications on dental curricula. METHODS Participants responded anonymously to a 23-question online survey about their current use of dental amalgam and composite resins as well as their opinions regarding both dental materials. The explanatory variables were associated bivariately with the outcome variables, and the most significant predictors were identified using the multivariate analysis. RESULTS Higher percentages of amalgam use were reported among clinicians who trained in Canada only (P = .009), who graduated before 1980 (p = <.001) and who work outside private practice (p = <.001). Familiarity with amalgam was higher among clinicians who are female (p = <.001), older (p = <.001), trained only in Canada (p = .017), who graduated prior to 2000 (p = <.001), and who work in locations with populations over 100,000 (p = .042). Familiarity with composite resin was higher among clinicians who graduated more recently (p = .002). A higher percentage of females (p = <.001), younger clinicians (p = <.001), recent graduates (p = <.001), and clinicians who work in private practice (p = .043) suggested that over 50% of dental student training time be allocated to amalgam. CONCLUSIONS Decreased amalgam use was reported by later dental graduates and private practitioners; this may be impacted by familiarity with dental amalgam. As amalgam remains a safe and effective dental material, its removal may not be prudent. Dental educators play a crucial role in the future of amalgam opinion and use.
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Affiliation(s)
- Aynaz Khodayari
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Abbas Jessani
- Division of Restorative Dentistry and Director of Community Service Learning, Schulich School of Medicine and Dentistry, Western University, Ontario, Western Ontario, Canada
| | - Abiola Adeniyi
- Clinical Instructor, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Greg Anderson
- Comprehensive Care and Undergraduate Clinical Prosthodontics Programs, University of Toronto, Toronto, Ontario, Canada
| | - Laura E Tam
- Restorative Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Grace M De Souza
- Comprehensive Dentistry, University of Louisville School of Dentistry, Louisville, Kentucky, USA
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Abdollahpour S, Estedlal T, Chiniforush N, Rafeie N, Nikparto N, Abbasi M, Ranjbar Omrani L. Effect of Different Bleaching Methods on Monomer Release from Aged Microhybrid and Nanohybrid Resin Composites. Int J Dent 2023; 2023:2773879. [PMID: 37216177 PMCID: PMC10198759 DOI: 10.1155/2023/2773879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Recently, the application of laser-assisted bleaching has increased in dental practice. This method might affect the physical and chemical properties of resin composite and its monomer release. This study aimed to evaluate the effect of in-office, at-home, and laser-assisted bleaching on the monomer release (bisphenol A diglycidyl dimethacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA), and urethane dimethacrylate (UDMA)) from aged nanohybrid (Grandio, Voco) and microhybrid (Clearfil AP-X Esthetics, Kuraray) resin composites. Methods Thirty-two samples of each composite were prepared. The samples underwent aging procedure with UV light at 65°C for 100 hr. The samples were divided into 4 groups: OB: conventional in-office bleaching with Opalescence Boost PF 40% gel; HB: home bleaching with Opalescence PF 15% gel; LB: bleaching with JW Power bleaching gel followed by diode laser application; and C: control group without bleaching. Then, the samples were immersed in a solution containing 75% ethanol + 25% distilled water. The medium was renewed after 8, 16, 24 hr, and 7 days and was analyzed using high-performance liquid chromatography method to evaluate the monomer release. The data were analyzed using Two-way ANOVA and Post hoc Tukey test. Results The bleaching method had no effect on TEGDMA and BisGMA release in both composites while it affected UDMA release in nanohybrid composite; UDMA release was significantly higher in LB compared to control and also higher in OB and LB compared to HB. No difference was observed in the microhybrid composite in this regard. Conclusion Laser-assisted bleaching did not affect monomer release from microhybrid composite while it increased UDMA release from nanohybrid composite. The bleaching method had no effect on TEGDMA and BisGMA release.
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Affiliation(s)
- Siavash Abdollahpour
- Department of Operative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Tarane Estedlal
- Department of Operative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Department of Surgical Science and Integrated Diagnosis, University of Genoa, Genoa, Italy
| | - Niyousha Rafeie
- Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nariman Nikparto
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Abbasi
- Restorative Dentistry Department, Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ladan Ranjbar Omrani
- Restorative Dentistry Department, Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Awad MM, Alradan M, Alshalan N, Alqahtani A, Alhalabi F, Salem MA, Rabah A, Alrahlah A. Placement of Posterior Composite Restorations: A Cross-Sectional Study of Dental Practitioners in Al-Kharj, Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312408. [PMID: 34886134 PMCID: PMC8656557 DOI: 10.3390/ijerph182312408] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022]
Abstract
Dental practitioner-related factors can affect the quality of composite restorations. This study aimed to investigate the clinical techniques used by dental practitioners (DPs) while placing direct posterior composite restorations. Methods: A questionnaire survey that sought information related to the placement of posterior composite restorations was delivered to 161 DPs working in the Al-Kharj area, Saudi Arabia. The collected data were statistically analyzed using Pearson’s Chi-square test and Fisher’s exact test considering the DP’s working sector and the answered questions. Results: A total of 123 DPs completed the survey (76.4% response rate). There was a statistically significant difference between DPs working in the private sector and those working in the governmental sector in 7 out of 17 questionnaire items namely: preparing a minimum depth of 2 mm, (p = 0.001); mechanical means of retention, (p = 0.003); operative field isolation, (p = 0.004); adhesive strategy, (p < 0.001); light-curing unit used, (p = 0.013); the use of radiometer, (p = 0.023), and dental matrix selection, (p < 0.001). Conclusion: The clinical techniques applied by DPs working in the private sector in Al-Kharj, Saudi Arabia when placing posterior composite restorations, including the specifications of cavity preparation, operative field isolation, and selection of the dental matrix system, may be substandard compared to those applied by DPs working in the governmental sector.
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Affiliation(s)
- Mohamed M. Awad
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (F.A.); (M.A.S.)
- Correspondence: or (M.M.A.); (A.A.)
| | - Mansour Alradan
- College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (M.A.); (N.A.); (A.A.)
| | - Nawaf Alshalan
- College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (M.A.); (N.A.); (A.A.)
| | - Ali Alqahtani
- College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (M.A.); (N.A.); (A.A.)
| | - Feras Alhalabi
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (F.A.); (M.A.S.)
| | - Mohammed Ali Salem
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (F.A.); (M.A.S.)
| | - Ahmed Rabah
- Department of Prosthetic Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia;
| | - Ali Alrahlah
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
- Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
- Correspondence: or (M.M.A.); (A.A.)
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Gallusi G, Libonati A, Piro M, Di Taranto V, Montemurro E, Campanella V. Is Dental Amalgam a Higher Risk Factor rather than Resin-Based Restorations for Systemic Conditions? A Systematic Review. MATERIALS 2021; 14:ma14081980. [PMID: 33920968 PMCID: PMC8071234 DOI: 10.3390/ma14081980] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022]
Abstract
Objective: The aim of this study was to confirm the hypothesis that patients with one or more amalgam restorations have an increased risk for systemic diseases rather than patients with resin-based restorations. Data: The data search produced an initial 3568 total number of records. All titles and abstract were reviewed by five independent examiners, and only 36 records were selected for full text in depth examination. Out of these, only nine publications matched the inclusion criteria and were included in this systematic review. Sources: Electronic databases (MEDLINE, Scopus, Embase, and Web of Knowledge) were searched up to June 2019. In addition, a manual search was carried out on journals related to this topic. Study selection: All selected human clinical studies compared patients with dental amalgam restorations to patients with non-amalgam restorations on restorative material related diseases/health conditions with at least 50 patients and a reasonable follow up. The systemic effects of dental restorations were analyzed. As for any systemic effects, there was no difference between amalgam and composite restoration. Conclusions: With the limitations of the few available randomized controlled trials (RCTs) on the matter, amalgam restorations, similarly to other modern resin-based materials, were not related to an increased risk of systemic diseases or conditions. Clinical significance: On the basis of the available RCTs, amalgam restorations, if compared with resin-based fillings, do not show an increased risk for systemic diseases. There is still insufficient evidence to exclude or demonstrate any direct influence on general health. The removal of old amalgam restorations and their substitution with more modern adhesive restorations should be performed only when clinically necessary and not just for material concerns. In order to better evaluate the safety of dental amalgam compared to other more modern restorative materials, further RCTs that consider important parameters such as long and uniform follow up periods, number of restorations per patient, and sample populations representative of chronic or degenerative diseases are needed.
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6
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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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7
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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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Zica JDSS, Fernandes IA, Faria FBA, Ferreira FC, Albuquerque NAR, Giovannini JFBG, Costa LCM. Comparative analysis of the surface roughness of conventional resins and filling after immersion in mouthwashes. BRAZILIAN JOURNAL OF ORAL SCIENCES 2020. [DOI: 10.20396/bjos.v19i0.8658569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: Bulk Fill composite resins were released on the market in order to reduce the time in clinical sessions by using increments of up to 5.0 mm thickness. The aim of this study was to evaluate the effect of the rinsing solutions on the surface roughness of the conventional composite and Bulk fill composite resins. Methods: 40 specimens were prepared from a 4.0mm x 10.0mm teflon matrix and photoactivated for 20 seconds, with 20 specimens made of Filtek Bulk-Fill composite resin (3M ESPE) and 20 specimens made with Filtek™ Z350 XT composite resin (3M ESPE). Each group was subdivided into 2 subgroups: G1 (Filtek™ Z350 XT-3M ESPE-immersed in Colgate PlaxWhitening®); G2 (Filtek™ Z350 XT-3M ESPE-immersed in PlaxFreshMint®); G3 (Filtek™ Bulk-Fill-3M ESPE-immersed in Colgate PlaxWhitening®) and G4 (Filtek™ Bulk-Fill-3M ESPE-immersed in Colgate PlaxFreshMint®). The surface roughness test was performed initially and after immersion in rinses by the Time Group Inc.-TR200® rugosimeter apparatus and the data were submitted to statistical analysis (two-way repeated measures ANOVA). Results: Surface roughness values of the Filtek™ Bulk-Fill composite resin (3M ESPE) were significantly higher than the Filtek™ Z350 XT composite resin (3M ESPE) (P <0.0001). However, no differences were identified before and after immersion in rinses with or without alcohol. Conclusion: The use of mouthwashes does not interfere with the surface roughness of the tested resins, but the composite resin Filtek Z350 XT (3M ESPE) presents a surface with less roughness.
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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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Umesi DC, Oremosu OA, Makanjuola JO. Amalgam phase down: baseline data preceding implementation in Nigeria. Int Dent J 2019; 70:161-166. [PMID: 31811657 DOI: 10.1111/idj.12536] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The Minimata Convention on mercury includes amalgam phase-down and eventual phase-out from dentistry. To aid its subsequent evaluation it is important to have baseline data of amalgam use in a locality prior to implementing a phase-down. METHODOLOGY Records of patients spanning 5 years from January 2011 to January 2016 were analysed to determine and the compare frequency of amalgam usage with other dental materials for carious teeth restorations in a Nigerian university teaching hospital. Classes of cavities restored and cadres of operators who employed the different materials were included. Institutional ethics committee approval was obtained prior to commencing the study. RESULTS 2,058 patients' records were retrieved, 59% females and 41% males. Their ages ranged 19-80 years, mean 33.5 ± 12.7 years, young adults 20-39 years old were the majority (62.9%). Filling materials included 57.5% amalgam, 17.6% glass ionomer cement (GIC) and 24.9% resin composite. Class I restorations constituted 70.5% of amalgam restorations, while Class II restorations made up 29.4% and Class V restorations accounted for 0.1%. Undergraduate dental students placed most of the amalgam restorations (60.5%), and 78.9% of all their restorations were amalgam. Less experienced dentists used all materials equally; the more experienced dentists placed more composite resin and GIC (43.3%). CONCLUSION Amalgam fillings constituted nearly 60% of the restorations of carious teeth. Training of dental students in placement of non-mercury alternatives to amalgam and Minimum Intervention Dentistry needs to be emphasized in dental schools. Phase-down of amalgam should be intensified in Nigeria with the ultimate aim of a phase-out in line with the Minamata Convention.
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Affiliation(s)
- Donna C Umesi
- Department of Restorative Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria.,Department of Restorative Dentistry, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Omotayo A Oremosu
- Department of Restorative Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria.,Department of Restorative Dentistry, Lagos University Teaching Hospital, Lagos, Nigeria
| | - John O Makanjuola
- Department of Restorative Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
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11
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Vervliet P, Den Plas JV, De Nys S, Duca RC, Boonen I, Elskens M, Van Landuyt KL, Covaci A. Investigating the in vitro metabolism of the dental resin monomers BisGMA, BisPMA, TCD-DI-HEA and UDMA using human liver microsomes and quadrupole time of flight mass spectrometry. Toxicology 2019; 420:1-10. [DOI: 10.1016/j.tox.2019.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 03/16/2019] [Accepted: 03/20/2019] [Indexed: 12/30/2022]
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Laske M, Opdam NJM, Bronkhorst EM, Braspenning JCC, Huysmans MCDNJM. Risk Factors for Dental Restoration Survival: A Practice-Based Study. J Dent Res 2019; 98:414-422. [PMID: 30786222 DOI: 10.1177/0022034519827566] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To improve patient dental care, it is necessary to identify possible risk factors for the failing of restorations. This practice-based cohort study investigated the performance and influence of possible risk factors at the level of the practice, patient, tooth, and restoration on survival of direct class II restorations. Electronic patient files from 11 Dutch general practices were collected, and 31,472 restorations placed between January 2015 and October 2017 were analyzed. Kaplan-Meier statistics were performed; annual failure rates (AFRs) were calculated; and variables were assessed by multivariable Cox regression analysis. The observation time of restorations varied from 0 to 2.7 y, resulting in a mean AFR of 7.8% at 2 y. However, wide variation in AFRs existed among the operators, varying between 3.6% and 11.4%. A wide range of patient-related variables is related to a high risk for reintervention: patient age (elderly: hazard ratio [HR], 1.372), general health (medically compromised: HR, 1.478), periodontal status (periodontal problems: HR, 1.207), caries risk and risk for parafunctional habits (high: HR, 1.687), restorations in molar teeth (HR, 1.383), restorations placed in endodontically treated teeth (HR, 1.890), and multisurface restorations (≥4 surfaces: HR, 1.345). Restorations placed due to fracture were more prone to fail than restorations placed due to caries. When patient-related risk factors were excluded, remaining risk factors considerably changed in their effect and significance: the effect of operator, age of the patient, and endodontic treatment increased; the effect of the diagnosis decreased; and the socioeconomic status became significant (high: HR, 0.873). This study demonstrated that a wide variation of risk factors on the practice, patient, and tooth levels influences the survival of class II restorations. To provide personalized dental care, it is important to identify and record potential risk factors. Therefore, we recommend further clinical studies to include these patient risk factors in data collection and analysis.
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Affiliation(s)
- M Laske
- 1 Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - N J M Opdam
- 1 Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - E M Bronkhorst
- 1 Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - J C C Braspenning
- 1 Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - M C D N J M Huysmans
- 1 Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
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Vervliet P, de Nys S, Boonen I, Duca RC, Elskens M, van Landuyt KL, Covaci A. Qualitative analysis of dental material ingredients, composite resins and sealants using liquid chromatography coupled to quadrupole time of flight mass spectrometry. J Chromatogr A 2018; 1576:90-100. [DOI: 10.1016/j.chroma.2018.09.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/01/2018] [Accepted: 09/18/2018] [Indexed: 01/04/2023]
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Alexander G, Hopcraft MS, Tyas MJ, Wong RHK. Dentists' restorative decision-making and implications for an ‘amalgamless’ profession. Part 5: knowledge factors. Aust Dent J 2017; 62:440-452. [DOI: 10.1111/adj.12533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 12/30/2022]
Affiliation(s)
- G Alexander
- Melbourne Dental School; University of Melbourne; Melbourne Victoria Australia
- Department of Dentistry and Oral Health; La Trobe University; Melbourne Victoria Australia
| | - MS Hopcraft
- Melbourne Dental School; University of Melbourne; Melbourne Victoria Australia
| | - MJ Tyas
- Melbourne Dental School; University of Melbourne; Melbourne Victoria Australia
| | - RHK Wong
- Melbourne Dental School; University of Melbourne; Melbourne Victoria Australia
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Alexander G, Hopcraft MS, Tyas MJ, Wong R. Dentists' restorative decision-making and implications for an 'amalgamless' profession. Part 4: clinical factor. Aust Dent J 2017; 62:363-371. [PMID: 28437002 DOI: 10.1111/adj.12519] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND The Minamata Convention embodies a worldwide reduction in the production and use of mercury and mercury-containing products and processes, including a phase-down of dental amalgam. This will change the approach to the use of direct restorative materials in the near future. There is little research as to the influence of clinical factors on dentists' decision-making which may be of use when determining the impact of any change. METHODS An online survey relating to aspects of and attitudes to the use of direct restorative materials was distributed to all dentists who were members of the Australian Dental Association and/or members or fellows of the Royal Australasian College of Dental Surgeons. Data were statistically analysed. RESULTS There were 408 respondents to the survey. Eighty-seven per cent of respondents (strongly) disagreed that amalgam was a technically more difficult material to place compared with resin composite, 82% (strongly) disagreed that placement time for amalgam was longer than that for resin composite and 69% (strongly) disagreed that amalgam was more difficult to finish than resin composite. Eighty-three per cent of respondents stated they were confident in their ability to place amalgam restorations. Where physical properties were of importance, indirect restorations were preferred (e.g. parafunction) 54%. The factors considered most important when choosing a direct restorative material included moisture control and aesthetics; least important factors were cost and time to place. CONCLUSIONS There is consensus that amalgam is not more technically difficult to use, place or finish than resin composite and vice versa. There is recognition that both amalgam and resin composite have limitations in terms of physical properties. When choosing a direct restorative material, clinical factors considered to be of greatest importance are moisture control, aesthetics and the need to apply minimally invasive approaches. There is little difference in the opinions of users and non-users of amalgam with respect to these findings.
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Affiliation(s)
- G Alexander
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.,Department of Dentistry and Oral Health, La Trobe University, Melbourne, Victoria, Australia
| | - M S Hopcraft
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | - M J Tyas
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | - Rhk Wong
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
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Awad MM, Salem WS, Almuhaizaa M, Aljeaidi Z. Contemporary teaching of direct posterior composite restorations in Saudi dental schools. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.sjdr.2016.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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van de Sande FH, Collares K, Correa MB, Cenci MS, Demarco FF, Opdam N. Restoration Survival: Revisiting Patients' Risk Factors Through a Systematic Literature Review. Oper Dent 2016; 41:S7-S26. [PMID: 27689931 DOI: 10.2341/15-120-lit] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A literature review was conducted to investigate the influence of patient-related factors on restoration survival in posterior permanent teeth as well as to report the methods used to collect these factors. The selection of articles on longitudinal clinical studies investigating the survival of posterior restorations (except full crowns and temporary fillings) and including patient-related factors was performed by applying predefined criteria. The review was organized into two parts, the first describing how patient factors were assessed in the studies (n=45) and the second presenting the statistical significance (n=27) and size of the effect (n=11) of these factors on restoration survival. Patient-related factors mentioned in the studies included age; gender; caries risk; caries activity/severity; decayed, missing, filled teeth; number of restorations; oral hygiene; and bruxism, among others. Sixteen studies included the patient age or age range in the analysis, which was found to be significant in 47% of the studies. Regarding gender, four of 17 reports found a significant effect on survival, showing more failures for men in three studies. The caries risk profile or related variables were included in the analysis of 15 studies, and a significant effect on survival was reported for high-caries-risk individuals (or related variables) in 67% of these studies. Bruxism was also found to influence restoration survival in three of six studies where this variable was investigated. Some issues were found regarding the reporting of methods used to classify patients according to risk and were thoroughly discussed. In view of the information gathered in this review, the assessment of patient factors along with other variables should become part of clinical studies investigating restoration survival, since several of these factors were shown to influence the failure of restorations, regardless of the material type.
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Affiliation(s)
- Andrew MacInnes
- Specialty Registrar in Restorative Dentistry, Glasgow Dental Hospital
| | - Andrew F Hall
- Senior Lecturer and Honorary Consultant in Restorative Dentistry, University of Dundee, Dundee, UK
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Schuster L, Rothmund L, He X, Van Landuyt KL, Schweikl H, Hellwig E, Carell T, Hickel R, Reichl FX, Högg C. Effect of Opalescence® bleaching gels on the elution of dental composite components. Dent Mater 2015; 31:745-57. [DOI: 10.1016/j.dental.2015.03.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 02/10/2015] [Accepted: 03/31/2015] [Indexed: 11/17/2022]
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