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Anantula K, Vankayala B, Yadav SS. Proximal contact tightness of direct Class II composite resin restorations with various matrix systems: A systematic review. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:11-16. [PMID: 38389748 PMCID: PMC10880478 DOI: 10.4103/jcde.jcde_203_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 02/24/2024]
Abstract
Background Restoring an ideal proximal contact in direct Class II composite resin restorations is challenging due to polymerization shrinkage, absence of condensability of composite materials, thickness of matrix bands, and the use of various separation techniques, retainers, and bands. Aims The aim of this study was to evaluate the proximal contact tightness that is achieved by various matrix systems used to restore a direct Class II cavity with composite resin restoration. Methods A systematic review was carried out according to the PRISMA 2020 statement guidelines. The online search for the articles was done in electronic databases of MEDLINE/PubMed, Cochrane, and Google Scholar. The articles comparing different matrix systems for restoration were selected. Out of 146 articles, a total of 6 articles met the selection criteria and were included. The QUIN risk-of-bias (RoB) tool was used for assessing the study quality. The data extracted from full text articles selected for inclusion, using a standardized software (Office Excel 2013 Software, Microsoft Corporation, Redmond, WA, USA). Results and Conclusion Combination of sectional matrices and separation rings resulted in tighter proximal contact compared to other matrix systems.
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Affiliation(s)
- Kavitha Anantula
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Bhavana Vankayala
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Sarjeev Singh Yadav
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Hyderabad, Telangana, India
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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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Hickel R, Mesinger S, Opdam N, Loomans B, Frankenberger R, Cadenaro M, Burgess J, Peschke A, Heintze SD, Kühnisch J. Revised FDI criteria for evaluating direct and indirect dental restorations-recommendations for its clinical use, interpretation, and reporting. Clin Oral Investig 2023; 27:2573-2592. [PMID: 36504246 PMCID: PMC10264483 DOI: 10.1007/s00784-022-04814-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The FDI criteria for the evaluation of direct and indirect dental restorations were first published in 2007 and updated in 2010. Meanwhile, their scientific use increased steadily, but several questions from users justified some clarification and improvement of the living document. MATERIALS AND METHODS An expert panel (N = 10) initiated the revision and consensus process that included a kick-off workshop and multiple online meetings by using the Delphi method. During and after each round of discussion, all opinions were collected, and the aggregated summary was presented to the experts aiming to adjust the wording of the criteria as precisely as possible. Finally, the expert panel agreed on the revision. RESULTS Some categories were redefined, ambiguities were cleared, and the descriptions of all scores were harmonized to cross-link different clinical situations with possible management strategies: reviewing/monitoring (score 1-4), refurbishment/reseal (score 3), repair (score 4), and replacement (score 5). Functional properties (domain F: fracture of material and retention, marginal adaptation, proximal contact, form and contour, occlusion and wear) were now placed at the beginning followed by biological (domain B: caries at restoration margin, hard tissue defects, postoperative hypersensitivity) and aesthetic characteristics (domain A: surface luster and texture, marginal staining, color match). CONCLUSION The most frequently used eleven categories of the FDI criteria set were revised for better understanding and handling. CLINICAL RELEVANCE The improved description and structuring of the criteria may help to standardize the evaluation of direct and indirect restorations and may enhance their acceptance by researchers, teachers, and dental practitioners.
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Affiliation(s)
- Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
| | - Sabine Mesinger
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Niek Opdam
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bas Loomans
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Milena Cadenaro
- Department of Medical Sciences, University of Trieste, Trieste, Italy and Children's Hospital "Burlo Garofolo," Institute for Maternal and Child Health, Trieste, Italy
| | - John Burgess
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Arnd Peschke
- IvoclarVivadent AG, Research & Development, Schaan, Liechtenstein
| | | | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
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Kumari S, Raghu R, Shetty A, Rajasekhara S, Padmini SD. Morphological assessment of the surface profile, mesiodistal diameter, and contact tightness of Class II composite restorations using three matrix systems: An in vitro study. J Conserv Dent 2023; 26:67-72. [PMID: 36908728 PMCID: PMC10003278 DOI: 10.4103/jcd.jcd_403_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/16/2022] [Accepted: 10/03/2022] [Indexed: 12/12/2022] Open
Abstract
Context Sectional matrices and contact rings are valuable aids to establish proximal contact tightness in Class II composite restorations. Aims This study aims to evaluate the proximal contact area in Class II composite restorations using three matrix systems based on morphological analysis, mesiodistal (M-D) diameter and contact tightness. Subjects and Methods A standardized DO cavity was prepared in 30 plastic molar teeth. They were randomly divided into three groups (n = 10) and restored using Tetric N-Ceram composite material and three matrix systems - Saddle matrix, Palodent system, and Palodent Plus system. The quality of proximal contacts was assessed by measuring the maximum M-D diameter of the restored teeth using a digital caliper; the tightness of the proximal contact area using Unifloss and a standardized metal blade (30 μm). Qualitative assessment of contact morphology was done by visual means while quantitative assessment of contour was done using Medit scanner superimposing method and ExoCAD software. Statistical Analysis Used One-way ANOVA test was used to compare the mean M-D diameter (in mm) in the occlusal third, middle third, and the proximal contact area between the three groups. Chi-square test was used to compare the proximal contact area tightness using the passage of Unifloss. The buccolingual and occluso-gingival morphology was also compared among the three groups. The level of significance (P value) was set at P < 0.05. Results For the occlusal and middle third, significantly larger diameters were achieved with the Palodent Plus system than with the Saddle matrix. More flat contours were seen in the case of the Saddle matrix than in the case of the Palodent system while the Palodent Plus system exhibited a minimal depth of concavity as determined by three-dimensional imaging of the contact morphology. Conclusions Palodent Plus and Palodent matrix systems established superior contacts and contours than the Saddle matrix.
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Affiliation(s)
- Suchitra Kumari
- Department of Conservative Dentistry and Endodontics, Bangalore Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - Ramya Raghu
- Department of Conservative Dentistry and Endodontics, Bangalore Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - Ashish Shetty
- Department of Conservative Dentistry and Endodontics, Bangalore Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - Subhashini Rajasekhara
- Department of Conservative Dentistry and Endodontics, Bangalore Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - Souparnika Divakaran Padmini
- Department of Conservative Dentistry and Endodontics, Bangalore Institute of Dental Sciences, Bengaluru, Karnataka, India
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Almushayti M, Arjumand B. Operators’ Ease and Satisfaction in Restoring Class II Cavities With Sectional Matrix Versus Circumferential Matrix System at Qassim University Dental Clinics. Cureus 2022; 14:e20957. [PMID: 35004091 PMCID: PMC8730797 DOI: 10.7759/cureus.20957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives: This study aimed to investigate the operator’s ease, satisfaction, and comfort of using a circumferential matrix system and sectional matrix system on the proximal contact points and contours when restoring class II cavities in posterior teeth. Materials and methods: This cross-sectional study was performed at the clinics in the Department of Conservative Dental Sciences, College of Dentistry, Qassim University. A total of 105 dental students randomly participated in this study to restore a class II cavity with direct composite resin restoration. Operators' comfort and satisfaction were evaluated according to their assessment of the contact points they reproduced and the emergence profiles of restorations, using a circumferential matrix system and sectional matrix system. Results: Out of 105 operators, 57 were satisfied with using circumferential matrix bands for most of their cases while 78 of the operators were satisfied with sectional matrix bands. There were no significant differences between operator satisfaction and the use of circumferential matrix band system (P > 0.05) and sectional matrix band system (P = 0.134) but there was a significant difference between difficulty levels in the use of both matrix band systems (P < 0.05; P = 0.000). Conclusion: Circumferential and sectional matrix band systems showed no significant differences with operators' satisfaction during restoring class II cavities in posterior teeth but using a sectional matrix band system was considered easier than using a circumferential matrix band system.
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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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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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Cerdán F, Ceballos L, Fuentes MV. Quality of approximal surfaces of posterior restorations in primary molars. J Oral Sci 2021; 63:347-351. [PMID: 34511588 DOI: 10.2334/josnusd.21-0264] [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] [Indexed: 11/01/2022]
Abstract
PURPOSE To evaluate the influence of the restorative material and matrix system on proximal contact tightness and morphological characteristics of class II restorations in primary molars. METHODS Occluso-mesial cavities in second primary artificial molars were randomly restored using different materials (Filtek Z500 or Filtek Bulk Fill composites or high-viscosity glass ionomer cement Ketac Universal) and different matrix system (Tofflemire, AutoMatrix, matrix band with ring, contoured sectional matrix) (n = 12). Proximal contact tightness was measured using a custom-made device in an Instron 3345, and proximal surface morphology and marginal adaptation were scored after digital scanning. Two-way ANOVA, Tukey and Fischer's exact tests were performed (P < 0.05). RESULTS Proximal contact tightness values were significantly influenced by the restorative material (P < 0.05), the matrix system (P < 0.001), and their interaction (P < 0.01). Both resin composites showed statistically differences in proximal shape according to the matrix used to restore and exhibited overhanging margins. Ketac Universal restorations showed similar morphology and gaps on the margins regardless of the matrix system. CONCLUSIONS Overall, both composite restorations achieved tighter proximal contact than those restored with the high-viscosity glass ionomer cement. None of the matrix systems tested provided a convex seamless proximal morphology.
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Affiliation(s)
- Fátima Cerdán
- IDIBO Research Group, Nursing and Stomatology Department, Health Sciences Faculty, Rey Juan Carlos University.,European University of Madrid, Villaviciosa de Odón Campus
| | - Laura Ceballos
- IDIBO Research Group, Nursing and Stomatology Department, Health Sciences Faculty, Rey Juan Carlos University
| | - María Victoria Fuentes
- IDIBO Research Group, Nursing and Stomatology Department, Health Sciences Faculty, Rey Juan Carlos University
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Shaalan O, Ibrahim S. Clinical evaluation of sectional matrix versus circumferential matrix for reproduction of proximal contact by undergraduate students and postgraduate dentists: A randomized controlled trial. J Int Oral Health 2021. [DOI: 10.4103/jioh.jioh_303_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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10
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Shaalan OO. Evaluation of Matrix Band Systems for Posterior Proximal Restorations among Egyptian Dentists: A Cross-Sectional Survey. Acta Stomatol Croat 2020; 54:392-400. [PMID: 33642603 PMCID: PMC7871436 DOI: 10.15644/asc54/4/6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Objectives This study aimed to investigate the techniques of matricing used by Egyptian dentists, and evaluate the influence of these techniques on the reproduction of optimum proximal contacts for posterior proximal resin composite restorations. Material and methods An online questionnaire was developed and sent to 785 dentists via e-mail and social media platforms. The survey asked the participants about the following: the highest academic degree achieved and their experience, techniques of matricing used, brands of matricing systems used, assessment of proximal contact points, their evaluation of the contact points they reproduced, and their assessment of the restorations' emergence profiles. Results A total of 415 dentists participated in the study (response rate 52.8%). 308, (74%), dentists preferred using the sectional matrix system, while 107 dentists, (26%), preferred using the circumferential matrix system. One hundred twenty-six dentists, (31%), reported that the circumferential matrix systems reproduced optimum contacts, 105 dentists, (25%), reported tight contacts and 184 dentists, (44%), reported open contacts. However, for the sectional matrix systems, the optimum contacts were reported by 279 dentists, (67%), tight contacts by 109 dentists, (26%), and open contacts by 27 dentists, (7%). There was a statistically significant difference between the sectional matrix systems and the circumferential matrix systems regarding the tightness of the proximal contact points (P<0.0001). Conclusions Egyptian dentists preferred using the sectional matrix systems. The survey indicated that optimum contact points were highly associated with the sectional matrix systems, while poor (open and tight) contacts were highly associated with the circumferential matrix systems.
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Affiliation(s)
- Omar Osama Shaalan
- Cairo University, Faculty of Dentistry, Conservative Dentistry Department, Egypt
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11
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El-Shamy H, Sonbul H, Alturkestani N, Tashkandi A, Loomans BA, Dörfer C, El-Badrawy W. Proximal contact tightness of class Ⅱ bulk-fill composite resin restorations: An in vitro study. Dent Mater J 2019; 38:96-100. [PMID: 30381630 DOI: 10.4012/dmj.2017-279] [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: 11/23/2022]
Abstract
This study investigated the effect of bulk-fill composites on proximal contact tightness (PCT) of composite restorations using different matrix systems. 150/standardized-MO-ivorine cavity preparations were divided into 5 groups; Smart Dentin Replacement (SDR), SonicFill (SF), Tetric EvoCeram Bulk-Fill (TEB), G-ænial Universal Flo (GF) and Tetric EvoCeram (TE). Each group was subdivided into 3 sub-groups (n=10); Dixieland band in Tofflemire retainer, FenderMate and Palodent plus matrix systems. PCT was measured 24 h post-curing using Tooth Pressure Meter. PCT means were calculated and statistically-analyzed using ANOVA and Tukey's post-hoc test (p<0.05). Means and SD of PCT for Tofflemire subgroup were: 1.75(0.13), 3.21(0.1), 3.06(0.19), 2.49(0.21) and 3.18(0.1) for (SDR), (SF), (TEB), (GF) and (TE), respectively. Using FenderMate, values were: 1.87(0.08), 3.35(0.12), 3.17(0.16), 2.64(0.1) and 3.26(0.11) for (SDR), (SF), (TEB), (GF) and (TE), respectively, while with Palodentplus; 3.16(0.17), 4.23(0.11), 4.1(0.1), 3.46(0.17) and 3.98(0.1) for (SDR), (SF), (TEB), (GF) and (TE), respectively. ANOVA revealed significant differences (p<0.05) between all samples except between (SF), (TEB) and (TE) and also significant difference between Palodentplus and two subgroups. Effect of bulk-fill composites on PCT is material dependent. Separation ring is recommended for proper PCT.
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Affiliation(s)
- Hassan El-Shamy
- Department of Operative Dentistry Faculty of Dentistry, King Abdulaziz University.,Nahda University, Faculty of Dentistry, Conservative Dentistry Department
| | - Helal Sonbul
- Department of Operative Dentistry Faculty of Dentistry, King Abdulaziz University
| | - Najlaa Alturkestani
- Department of Operative Dentistry Faculty of Dentistry, King Abdulaziz University
| | - Abeer Tashkandi
- Department of Operative Dentistry Faculty of Dentistry, King Abdulaziz University
| | - Bas Ac Loomans
- Radboud University Nijmegen Medical Center, Department of Preventive and Restorative Dentistry
| | - Christof Dörfer
- Clinic for Conservative Dentistry and Periodontology, School for Oral Medicine, Christian-Albrechts-University at Kiel
| | - Wafa El-Badrawy
- Restorative Discipline, Faculty of Dentistry, University of Toronto
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12
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Mackenzie L, Banerjee A. Minimally invasive direct restorations: a practical guide. Br Dent J 2018; 223:163-171. [PMID: 28798466 DOI: 10.1038/sj.bdj.2017.661] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2017] [Indexed: 11/09/2022]
Abstract
The primary objectives of minimum intervention dentistry (MID) are to prevent or arrest active disease using non-operative management techniques. However, patients commonly present with cavitated caries lesions or failed restorations that are in need of operative intervention. Although much of clinical practice is devoted to preventing and managing the effects of caries and subsequent failure of the tooth-restoration complex, the clinical survival of restorations is often poor and becomes significantly worse as they increase in size and complexity. Minimally invasive (MI) restorative techniques present a range of well-documented advantages over more tissue-destructive traditional restorations by minimising unnecessary tooth tissue loss, insult to the dentine-pulp complex and reducing the risk of iatrogenic damage to adjacent hard and soft tissues. They also maximise the strength of the residual tooth structure by use of optimal adhesive restorative materials designed to restore function and aesthetics with durable, long-lasting restorations that are easy for the patient to maintain. In contemporary oral healthcare practice, if patients are to give valid consent for operative interventions, minimally invasive options must be offered, and may be expected to be the first choice of fully informed patients. This paper describes concepts of MID and provides an update of the latest materials, equipment and clinical techniques that are available for the minimally invasive restoration of anterior and posterior teeth with direct restorations.
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Affiliation(s)
- L Mackenzie
- Conservative Dentistry, University of Birmingham School of Dentistry, Mill Pool Way, Edgbaston, Birmingham, B4 6NN
| | - A Banerjee
- Conservative &MI Dentistry, King's College London Dental Institute at Guy's Hospital, King's Health Partners, Floor 26, Tower Wing, Guy's Dental Hospital, London, SE1 9RT
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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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Gomes IA, Filho EMM, Mariz DCBR, Borges AH, Tonetto MR, Firoozmand LM, Kuga CM, De Jesus RRT, Bandéca MC. In vivo Evaluation of Proximal Resin Composite Restorations performed using Three Different Matrix Systems. J Contemp Dent Pract 2015; 16:643-647. [PMID: 26423500 DOI: 10.5005/jp-journals-10024-1735] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this in vivo study was to radiographically evaluate the proximal contour of composite resin restorations performed using different matrix systems. MATERIALS AND METHODS Patients with premolars needing class II type resin composite restorations involving the marginal ridge were selected. Thirty premolars were selected and randomly divided into three groups (n = 10 each) to receive restorations using different matrix systems: group 1: metal matrix coupled to a carrier matrix and wood wedge (G1-MMW); group 2: sectioned and precontoured metal matrix and elastic wedge (G2-SME); and group 3: a polyester strip and reflective wedge (G3-PMR). After the restorative procedure, bitewing radiographs were performed and analyzed by three calibrated professionals. The quality of the proximal contact and marginal adaptation of the proximal surfaces was classified as either correct or incorrect (undercontour/overcontour). RESULTS The Pearson Chi-square statistical test (α = 5%) revealed a statistically difference between frequencies of correct and incorrect restorations (α(2) = 6.787, p < 0.05). The group G2 SME produced a higher frequency of correct proximal contours (90%), while G1-MMW and G3-PMR had a ratio of 40% correct and 60% incorrect contours respectively. CONCLUSION None of the matrix systems was able to prevent the formation of incorrect proximal contours; however, the sectioned and precontoured metal matrix/elastic wedge configuration provided better results as compared to the other groups.
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Affiliation(s)
| | | | | | - Alvaro Henrique Borges
- Department of Postgraduate in Integrated Dental Science University of Cuiaba, Cuiaba, MT, Brazil
| | - Mateus Rodrigues Tonetto
- Department of Postgraduate in Integrated Dental Science University of Cuiaba, Cuiaba, MT, Brazil
| | | | - Carlos Milton Kuga
- Department of Restorative Dentistry, Araraquara Dental School, Univ Estadual Paulista, Araraquara, Sao Paulo, Brazil
| | | | - Matheus Coelho Bandéca
- Professor, Department of Postgraduate in Dentistry, CEUMA University, Sao Luis, MA, University Rua Jossue Montello, 01, Sao Luis, MA, Brazil, e-mail:
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CHANG WENJEN, CHANG YENHSIANG, WANG HSUAN, LIN CHUNLI. COMPARISON OF PROXIMAL IN VITRO TOOTH CONTACTS IN CLASS II RESTORATIONS WITH DIFFERENT RESTORATIVE MATERIALS AND CAVITY SIZES USING A NEW MEASUREMENT DEVICE. J MECH MED BIOL 2015. [DOI: 10.1142/s0219519415500578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study used a newly developed proximal contact strength (PCS) device to evaluate the tightness of proximal tooth contact for Class II cavity size restoration with different materials using an auxiliary separation ring system. A measurement device based on the equilibrium of forces acted on the clamp rod converts a pull-out force between interdental spaces on a force sensing resistor to express the PCS. This device was designed using dental floss as the test end and can be moved with constant speed during measurement through a bevel gear that transforms the rotation of motor shaft into linear movement of clamp rod. A manikin model was used with 60 artificial first molars in which an mesial occlusal (MO) preparation was ground. Samples were divided into six groups (each n = 10) for simulating amalgam and resin composite restoration with three different cavity sizes. The different cavities were defined using the ratio of the actual isthmus width to the intercuspal width (W) to 1/3, 2/3 and 1. The PCS value in each sample was measured after restoration. The result showed that the mean PCS value and standard deviation were 2283.1 ± 216.5 gf, 2419.1 ± 375 gf and 1737.6 ± 372.7 g for 1/3 W, 2/3 W and W cavities of the amalgam restoration, respectively. The corresponding PCS values were 1178.0 ± 230.4 gf, 1205.8 ± 249.1 gf and 1247.0 ± 157.5 gf for 1/3 W, 2/3 W and W cavities of the resin composite restoration. PCS values with amalgam restoration were larger than those for resin composite restorations under the same cavity size. Large cavity (W) PCS might be lost with amalgam restoration. No significant difference was found in resin composite restoration PCS among the different cavity sizes.
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Affiliation(s)
- WEN-JEN CHANG
- Department of Information Management, Chang Gung University, 259 Wen-Hua 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan
| | - YEN-HSIANG CHANG
- Department of General Dentistry, Chang Gung Memorial Hospital, 123, Ding-Hu Road, Kuei-Shan, Tao-Yuan 333, Taiwan
| | - HSUAN WANG
- Department of Biomedical Engineering, National Yang-Ming University, 2 No.155, Sec. 2, Linong Street, Taipei 112, Taiwan
| | - CHUN-LI LIN
- Department of Biomedical Engineering, National Yang-Ming University, 2 No.155, Sec. 2, Linong Street, Taipei 112, Taiwan
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Alexander G, Hopcraft MS, Tyas MJ, Wong RHK. Dentists' restorative decision-making and implications for an 'amalgamless' profession. Part 1: a review. Aust Dent J 2014; 59:408-19. [PMID: 25090909 DOI: 10.1111/adj.12209] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2014] [Indexed: 11/27/2022]
Abstract
The Minamata Convention has agreed to a worldwide reduction and ultimate elimination in the production and use of mercury containing products. This will have implications for the practice of dentistry. Australian organizations' pronouncements on the issue are limited and research examining the Australian context dated. The restoration of teeth with direct materials has changed significantly since the 1980s. Up to this time amalgam was the material of choice for direct posterior restorations. Its properties and guidelines for placement were, and remain, well established. Resin composite has replaced amalgam as the material of choice in many clinical situations. Despite inherent clinical disadvantages compared to amalgam, there continues to be a shift toward greater use of resin composite. There is consensus worldwide that the restoration of posterior teeth using resin composite now exceeds that of amalgam. The reasons for this are reviewed in this article along with current evidence and commentary relating to direct restorative and evidence-based decision-making, minimally invasive approaches, and approaches to education. The implications for these in an 'amalgamless' profession are identified.
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Affiliation(s)
- G Alexander
- Melbourne Dental School, The University of Melbourne, Victoria; Department of Dentistry and Oral Health, La Trobe University, Victoria
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Alexander G, Hopcraft MS, Tyas MJ, Wong RHK. Dentists' restorative decision-making and implications for an ‘amalgamless’ profession. Part 2: a qualitative study. Aust Dent J 2014; 59:420-31. [DOI: 10.1111/adj.12212] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2014] [Indexed: 11/28/2022]
Affiliation(s)
- G Alexander
- Melbourne Dental School; The University of Melbourne; Victoria
- Department of Dentistry and Oral Health; La Trobe University; Victoria
| | - MS Hopcraft
- Melbourne Dental School; The University of Melbourne; Victoria
| | - MJ Tyas
- Melbourne Dental School; The University of Melbourne; Victoria
| | - RHK Wong
- Melbourne Dental School; The University of Melbourne; Victoria
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Goncalves FS, Castro CDL, Bueno AC, Freitas ABDAD, Moreira AN, Magalhaes CS. The short-term clinical performance of a silorane-based resin composite in the proximal contacts of class II restorations. J Contemp Dent Pract 2012; 13:251-6. [PMID: 22917991 DOI: 10.5005/jp-journals-10024-1132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this randomized clinical trial was to compare the proximal contact of a silorane-based resin composite with a conventional methacrylate-based resin composite in class II restorations after a 6 months follow-up period. MATERIALS AND METHODS After obtaining informed consent, 33 patients were randomly allocated into a test group (Filtek P90/Adhesive System-3M ESPE) or control group (Filtek P60/ Adper SE Plus-3M ESPE), and 100 direct resin composite restorations (n = 50) were placed. A single operator performed the cavities and restorations. After rubber dam placement, a metal matrix and wooden wedge were placed. The restorative systems were applied according to the manufacturer's instructions. After 1 week, the restorations were finished and polished. The proximal contacts were assessed blindly and independently by two calibrated examiners (kW = 0.8) at the baseline and after 6 months according to a three-step grading criteria. Data were analyzed with the Mann-Whitney U-test and Wilcoxon signed Rank tests (a = 0.05). RESULTS After 6 months, 96% of the restoration contacts were present for evaluation. The frequencies of restorations classified as Bravo in control and test groups were 6 and 8% at the baseline, and 6.25 and 12.75% after 6 months. No significant difference was found between the restorative materials (p > 0.05; Mann-Whitney U-test) neither between baseline and 6 months period (p > 0.05; Wilcoxon signed Rank tests). CONCLUSION Both materials performed satisfactorily over 6 months follow-up period. CLINICAL SIGNIFICANCE The short-term clinical performance of a silorane-based resin composite in the proximal contacts of class II restorations was similar to the well-known methacrylate-based resin composite.
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Affiliation(s)
- Fabiana Santos Goncalves
- Doctoral Student, Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte MG, Brazil
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El-Shamy H, Saber MH, Dörfer CE, El-Badrawy W, Loomans BAC. Influence of volumetric shrinkage and curing light intensity on proximal contact tightness of class II resin composite restorations: in vitro study. Oper Dent 2012; 37:205-10. [PMID: 22313267 DOI: 10.2341/11-269-l] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Proximal contact tightness of class II resin composite restorations is influenced by a myriad of factors. Previous studies investigated the role of matrix band type and thickness, consistency of resin composite, and technique of placement. However, the effect of volumetric shrinkage of resin and intensity of curing light has yet to be determined. Thus, the aim of this study was to identify the influence of these factors on the proximal contact tightness when restoring class II cavity preparations in vitro. METHODS Sixty artificial molars were restored with either a low-shrinkage (Filtek Silorane, 3M ESPE) or a conventional (Z100, 3M ESPE) composite and polymerized with low-intensity (Smartlite IQ2, Dentsply) or high-intensity light curing units (Demi(TM), Kerr). Proximal contact tightness was measured using the Tooth Pressure Meter. Data were statistically analyzed using one-way analysis of variance and Tukey post hoc test. RESULTS Use of low-shrinkage composite (Filtek Silorane) resulted in significantly tighter proximal contacts compared to the use of conventional composite (Z100) when cured with the same polymerization unit (p<0.001). Moreover, the low-intensity curing unit (IQ2) resulted in significantly tighter contacts than the high-intensity unit when material is constant (p<0.001). CONCLUSIONS Low-shrinkage resin composite and low curing light intensity is associated with tighter proximal contact values.
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Affiliation(s)
- H El-Shamy
- Department of Conservative Dentistry, King Abdulaziz University, Jeddah City, Saudi Arabia
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Saber MH, El-Badrawy W, Loomans BAC, Ahmed DR, Dörfer CE, El Zohairy A. Creating Tight Proximal Contacts for MOD Resin Composite Restorations. Oper Dent 2011; 36:304-10. [DOI: 10.2341/10-210-l] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective
The purpose of this study was to compare proximal contact tightness (PCT) of MOD resin composite restorations placed with different matricing protocols.
Methods
Forty-five ivorine lower right first molars with standardized MOD cavities were equally divided into three groups according to the restoration protocol. Group 1: Sectional matrix (Standard matrix, Palodent, Dentsply) secured with a wedge (Premier Dental Products Co.) and separation ring (BiTine I, Palodent, Dentsply, York, PA, USA) was used to restore the mesial surface first and then removed and repeated for the distal surface. Group 2: Identical to group 1, but separation rings were placed at both the mesial and distal sides (BiTine I+II, Palodent) prior to restoration. Mesial surface was restored followed by distal. Group 3: Walser matrix (O-form, Dr. Walser Dental GmbH) was used. Following composite resin restoration, PCT was measured using the tooth pressure meter. Data were analyzed using analysis of variance and a Tukey post hoc test (p<0.05).
Results
PCT values for mesial contacts were 2.99 ± 0.47N for group 1, 4.57 ± 0.36N for group 2, and 3.03 ± 0.79N for group 3. For the distal contacts, the values were 4.46 ± 0.44N for group 1, 5.12 ± 0.13N for group 2, and 0.76 ± 0.77N for group 3. Significantly tighter contacts were obtained for mesial and distal contacts for group 2 compared to groups 1 and 3 (p<0.05). For groups 1 and 3, mesial contacts were not significantly different (p=0.993), while distal contacts for group 1 were significantly tighter (p<0.001).
Conclusion
Within the limitations of this study, tighter contacts can be obtained when sectional matrices and separation rings are applied to both proximal surfaces prior to placement of the resin composite in MOD cavities.
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Wirsching E, Loomans BA, Klaiber B, Dörfer CE. Influence of matrix systems on proximal contact tightness of 2- and 3-surface posterior composite restorations in vivo. J Dent 2011; 39:386-90. [DOI: 10.1016/j.jdent.2011.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 03/07/2011] [Accepted: 03/07/2011] [Indexed: 10/18/2022] Open
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Chuang SF, Su KC, Wang CH, Chang CH. Morphological analysis of proximal contacts in class II direct restorations with 3D image reconstruction. J Dent 2011; 39:448-56. [PMID: 21504778 DOI: 10.1016/j.jdent.2011.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 04/01/2011] [Accepted: 04/03/2011] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES To evaluate the proximal contact on class II composite restorations constructed using various restorative approaches by a morphological analysis. METHODS Sixty plastic premolar teeth were prepared for class II cavities. These teeth were divided into six groups and restored using different materials and matrix systems. Two composite materials used were a microhybrid composite Filtek Z100 (3M/ESPE) and a packable composite P60 (3M/ESPE). Three interproximal matrix systems were two circumferential metal matrices (0.05 mm and 0.03 mm thin, respectively) combined with a Tofflemire retainer, and a pre-contoured sectional matrix system (Palodent). The contact morphologies of the restorations were visually inspected with regard to their buccolinugal and mesiodistal aspects. The contact tightness was measured by inserting different amounts of metal strips. For quantitatively morphologic analysis, three-dimensional (3D) scans of proximal contacts were performed. The results were analysed with two-way ANOVA and the Tukey test. RESULTS Under visual observation, contact surfaces in sectional matrix groups showed anatomic profile but concave in the centre, whilst the circumferential matrix groups showed flat profiles. The sectional matrix improved the contact tightness. The 3D analysis revealed that the matrix system was correlated with the contact morphology, since the sectional matrix generated significantly deeper and wider surface concavity. CONCLUSIONS All the interproximal matrix systems presented some deficiency in either the contact tightness or contours. Although the sectional matrix system enhanced contact tightness, it caused contact concavity by formation of interproximal marginal overhang. The quantitative morphologic analysis helps to examine improper proximal contact and the associated problems.
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Affiliation(s)
- Shu-Fen Chuang
- Institute of Oral Medicine, National Cheng Kung University, Tainan 701, Taiwan.
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Cho SD, Browning WD, Walton KS. Clinical use of a sectional matrix and ring. Oper Dent 2010; 35:587-91. [PMID: 20945751 DOI: 10.2341/09-338-t] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sopanis D Cho
- Department of Restorative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA.
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Kampouropoulos D, Paximada C, Loukidis M, Kakaboura A. The Influence of Matrix Type on the Proximal Contact in Class II Resin Composite Restorations. Oper Dent 2010; 35:454-62. [DOI: 10.2341/09-272-l] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
The types of matrices assessed, metal or transparent, circumferential or sectional, straight or pre-contoured, were not able to adequately reconstruct all the characteristics of the proximal contact area of an intact tooth in Class II resin composite restorations.
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Abstract
When placing posterior composite resin restorations, clinicians often struggle to achieve good contacts. Frequently contacts that are successful are only confined to the occlusal aspect of the proximal wall. A clinical technique is discussed which achieves the correct contour as well as tight contacts. The technique is also minimally invasive and highly aesthetic.
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Saber MH, Loomans BAC, El Zohairy A, Dörfer CE, El-Badrawy W. Evaluation of proximal contact tightness of Class II resin composite restorations. Oper Dent 2010; 35:37-43. [PMID: 20166409 DOI: 10.2341/09-037l] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of the current study was to compare in-vitro the proximal contact tightness (PCT) of Class II resin composite restorations (RCR) placed with different established and new placement techniques. METHODS 105 ivorine lower left first molars with standardized MO cavities were randomly divided into seven groups (n = 15) as follows: SRing: sectional matrix and separation ring (Garrison Dental); CRing: circumferential matrix (1101-c, KerrHawe SA) with separation ring; CWedge: circumferential matrix with a wedge only; COptra: circumferential matrix and OptraContact (Vivadent); CCerana: circumferential matrix and a Cerana insert (Nordiska Dental); CElliot: circumferential matrix and Elliot separator (PFINGST & Co) and Walser: Walser matrix O-type (Dr Walser Dental GmbH). In all the groups, the matrix band was secured using a wooden wedge except for the Walser group, following manufacturer's recommendations. A Tofflemire retainer (Kerr Corporation) was used to apply the circumferential matrix band whenever it was used. All the prepared teeth were restored with resin composite (Premise, Kerr) mounted in a manikin head to simulate the clinical environment. PCT was measured using the Tooth Pressure Meter (University of Technology, Delft). The data were analyzed using one-way ANOVA and Tukey post-hoc tests (p < 0.05). RESULTS Compared to the control group (SRing) (6.64 +/- 1.06N), all other systems resulted in significantly lower PCT values (p < 0.001). Within the circumferential matrix groups, CRing (4.01 +/- 0.53N) and CElliot (4.29 +/- 1.08N) showed significantly tighter contacts compared to the CWedge (0.37 +/- 0.22N), COptra (0.91 +/- 0.49N), CCerana (2.99 +/- 1.98N) and Walser (1.34 +/- 0.55N) (p < 0.05) group. Between CWedge and COptra, no significant difference was found (p = 0.57). CONCLUSION The use of separation rings with sectional matrices provides superior contacts when placing Class II RCRs.
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Affiliation(s)
- Mohamed H Saber
- Faculty of Dentistry, Cairo University, Department of Operative Dentistry, Cairo, Egypt
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Demarco FF, Pereira-Cenci T, de Almeida André D, de Sousa Barbosa RP, Piva E, Cenci MS. Effects of metallic or translucent matrices for class II composite restorations: 4-year clinical follow-up findings. Clin Oral Investig 2010; 15:39-47. [DOI: 10.1007/s00784-009-0362-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Accepted: 12/01/2009] [Indexed: 10/20/2022]
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Investigations on mechanical behaviour of dental composites. Clin Oral Investig 2009; 13:427-38. [DOI: 10.1007/s00784-009-0258-4] [Citation(s) in RCA: 153] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Revised: 02/04/2009] [Accepted: 02/05/2009] [Indexed: 10/21/2022]
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Kiremitci A, Alpaslan T, Gurgan S. Six-year Clinical Evaluation of Packable Composite Restorations. Oper Dent 2009; 34:11-7. [DOI: 10.2341/08-48] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
As a posterior composite, Filtek P60 exhibited very good clinical performance in Class II cavities for six years.
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Loomans BA, Opdam NJM, Bronkhorst EM, Roeters FJM, Dörfer CE. A clinical study on interdental separation techniques. Oper Dent 2007; 32:207-11. [PMID: 17555170 DOI: 10.2341/06-73] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The effect of interdental separation of a special separation ring and wooden wedge was investigated. In a split-mouth design, 27 patients were randomly assigned to one of two groups (W or S). In 11 patients, an interdental wooden wedge (Hawe-Neos) was placed (group W), and in 16 patients, a separation ring (Composi-Tight Gold) was placed at the contact between teeth 4/5 and 5/6. Simultaneously, in both groups, a wooden wedge, combined with a separation ring (Composi-Tight Gold), was placed on the contact between teeth 4/5 and 5/6 (reference group W+S). To measure proximal contact tightness, frictional forces were recorded at the removal of a 0.05 mm thick metal matrix band inserted between adjacent teeth. Contact tightness was measured at contacts 4 and 5 and at 5 and 6 in the third and fourth quadrant using the Tooth Pressure Meter prior to applying separation devices (TO) five minutes after application (T1) and five minutes after removal of the devices (T2). The effect of separation was determined by calculating the differences between contact tightness before application and contact tightness with the devices in situ (T1-T0). Interdental recovery was calculated by the difference in contact tightness before application and after removal of the devices (T2-T0). To assess the presence of statistically significant differences between these measurement times, paired t-tests were applied. With each patient, either a comparison between W and W+S or S and W+S was made. For both W versus W+S and S versus W+S, paired t-tests were applied to compare differences (T1-T0 and T2-T0) between the separation devices. Within a patient, groups W and S could not be compared, therefore, to compare separation achieved between these two devices, unpaired t-tests were used. The increase in contact tightness measured at contact 4 and 5 for group W (0.98 +/- 0.26 N) was statistically significantly less compared to the increase in group S (5.48 +/- 0.88 N) (p < 0.001) or group W+S (4.62 +/- 0.68 N) (p = 0.02). No significant differences were found between groups S and W+S (p = 0.77). For all groups, five minutes after removal of the devices, the contact tightness at contact 4 and 5 and at contact 5 and 6 were still significantly weaker compared to the tightness at baseline (p < 0.02). When separation is required for restorative procedures, such as at placement of a Class II resin composite restoration, special separation rings may be more useful than wooden wedges.
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Affiliation(s)
- Bas A Loomans
- Department of Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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32
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Gilmour ASM, Evans P, Addy LD. Attitudes of general dental practitioners in the UK to the use of composite materials in posterior teeth. Br Dent J 2007; 202:E32. [PMID: 17510663 DOI: 10.1038/bdj.2007.472] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2006] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine the opinions and current methods used in placing posterior composite restorations by general dental practitioners. SETTING The study was completed by general dental practitioners randomly selected from across the UK. METHOD A questionnaire was devised to gain this information. It was sent to 500 UK dentists chosen at random from the general dental register, with an explanatory letter and reply-paid envelope. RESULTS Two hundred and sixty-seven replies were received. Sixty-one percent of dentists felt amalgam use had decreased over the last five years, 75% felt posterior composite use had increased. Regarding choice of posterior material, almost all cited clinical indication as the most influential factor while patient's aesthetic demands (89%),wish for a certain material (78%) and the dentist's confidence using a certain restorative material (76%) were contributing factors. Regarding the techniques used, contemporary techniques were employed although there was confusion regarding the need for rubber dam and the most appropriate method of lining the cavity. A case scenario of a pregnant patient who required treatment found that 66% of respondents would place a restoration other than a temporary dressing, with 16% placing an amalgam restoration. CONCLUSIONS The majority of dentists surveyed place load bearing posterior composite restorations regularly. Their choice of restorative material is influenced by clinical indications and the patient's aesthetic demands. The techniques used were appropriate, although there was confusion around the need for rubber dam and the most appropriate method to line the cavity. There was also confusion in relation to the most appropriate materials for use in pregnancy.
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Affiliation(s)
- A S M Gilmour
- Senior Lecturer/Honorary Consultant in Restorative Dentistry, Cardiff University Dental Hospital, Heath Park, Heath, Cardiff, CF14 4XY.
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Ersin NK, Candan U, Aykut A, Onçağ O, Eronat C, Kose T. A clinical evaluation of resin-based composite and glass ionomer cement restorations placed in primary teeth using the ART approach: results at 24 months. J Am Dent Assoc 2007; 137:1529-36. [PMID: 17082278 DOI: 10.14219/jada.archive.2006.0087] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors evaluated the 24-month performance of a packable resin-based composite/dentin bonding system and a high-viscosity glass ionomer cement (GIC) in restorations placed in primary molars with the atraumatic restorative treatment (ART) approach. METHODS Three dentists placed 419 restorations in 219 children aged 6 through 10 years who had bilateral matched pairs of carious posterior Class I and II primary teeth. They used a split-mouth design to place the two materials, which were assigned randomly to contralateral sides. The authors evaluated the restorations according to U.S. Public Health Service Ryge criteria. RESULTS After 24 months, 96.7 percent of the Class I GIC restorations and 91 percent of the resin-based composite restorations survived, while the success rates for the Class II restorations were 76.1 percent and 82 percent for the GIC and resin-based composite restorations, respectively. The survival rate of the Class II resin-based composite restorations was 5.9 percent higher than that of the GIC restorations at the 24-month evaluation, but this difference was not statistically significant. However, the study results showed a statistically significant difference in survival rates between Class I and II restorations for both materials. CONCLUSION AND CLINICAL IMPLICATIONS The two-year clinical performance of both materials was satisfactory for the restoration of Class I and II primary molars using the ART approach.
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Affiliation(s)
- Nazan Kocatas Ersin
- Department of Pediatric Dentistry, Ege University, Bornova-Izmir, 35100 Turkey.
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An overview of treatment considerations for esthetic restorations: a review of the literature. J Prosthet Dent 2007; 96:433-42. [PMID: 17174661 DOI: 10.1016/j.prosdent.2006.09.018] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Controversy persists regarding the treatment planning criteria for esthetic restorations. This article reviews the literature regarding the biocompatibility, marginal adaptation, color matching, patient selection, technique sensitivity, and mode and rate of failure of tooth-colored restorations. A Medline search was completed for the period from 1986 to 2006, along with a manual search, to identify pertinent English peer-reviewed articles and textbooks. The key words used were amalgam, posterior composite resin, ceramic inlays/onlays, CEREC, porcelain laminate veneers, all-ceramic crowns, and all-ceramic fixed partial dentures.
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Demarco FF, Cenci MS, Lima FG, Donassollo TA, André DDA, Leida FL. Class II composite restorations with metallic and translucent matrices: 2-year follow-up findings. J Dent 2007; 35:231-7. [PMID: 17034926 DOI: 10.1016/j.jdent.2006.07.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2006] [Revised: 07/25/2006] [Accepted: 07/29/2006] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The aim of this randomized, clinical study was to evaluate the performance of composite restorations placed with two matrix and wedge systems after a 2-year follow-up. METHODS Twenty-three patients were selected, and received at least two Class II restorations, one with metallic matrix and wooden wedge and other with polyester matrix and reflective wedge. One dentist placed all the 109 restorations. All cavities were restored using Single Bond and P-60 (3M ESPE), according to manufacturer's instructions. In the metal matrix group, polymerization was performed from occlusal, and in the polyester group, through the reflective wedge. Restorations were evaluated at baseline and after 12 and 24 months by the modified USPHS criteria, and data were analyzed with Mann-Whitney and Wilcoxon Signed Rank tests (alpha=0.05). RESULTS Fifteen subjects and 78 restorations were re-evaluated after 24 months. A significant decrease in the quality of cervical adaptation and proximal contacts by radiographic evaluation was evidenced (p<0.05), but no differences between the two matrix systems were detected (p>0.05). In the clinical evaluation there were no significant differences between matrices after 2 years (p>0.05). A compromising of marginal adaptation, marginal staining and proximal contacts aspects for both matrix systems was evidenced, and restorations placed with translucent matrices showed loss of color stability (p<0.05). CONCLUSIONS Whereas restorations presented some clinical aspects somewhat compromised after 2 years, the matrix and wedge systems evaluated showed similar clinical performance.
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Affiliation(s)
- Flávio Fernando Demarco
- Department of Operative Dentistry, School of Dentistry, Federal University of Pelotas, RS, Brazil
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Loomans BAC, Opdam NJM, Roeters FJM, Bronkhorst EM, Burgersdijk RCW. Comparison of proximal contacts of Class II resin composite restorations in vitro. Oper Dent 2007; 31:688-93. [PMID: 17153978 DOI: 10.2341/05-133] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study investigated the tightness of the proximal contact when placing posterior resin composite restorations with circumferential and sectional matrix systems in an in vitro model using a special measuring device (Tooth Pressure Meter). A manikin model was used with an artificial first molar in which an MO-preparation was ground, simulating the clinical situation of an amalgam replacement. This preparation was duplicated, resulting in 160 identically prepared teeth. These teeth were divided into 8 groups (n=20). In 2 groups, circumferential matrix bands (flat or contoured) in a Tofflemire retainer were applied. In the remaining 6 groups, 3 different separation rings were combined with 2 types of sectional matrix bands. All the cavities were restored using Clearfil Photo Bond and Clearfil AP-X. The tightness of the proximal contact was measured using the Tooth Pressure Meter. Data were statistically analyzed using SPSS 12. ANOVA was used to find differences in proximal contact tightness between the groups. Tukey tests were used to find differences between the homogeneous subgroups. The use of sectional matrices combined with separation rings resulted in tighter proximal contacts compared to when circumferential systems were used (p<0.001). The use of these devices is therefore recommended when posterior resin composite restorations are placed.
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Affiliation(s)
- B A C Loomans
- Department of Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Centre, College of Dental Sciences, Nijmegen, The Netherlands.
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Hickel R, Roulet JF, Bayne S, Heintze SD, Mjör IA, Peters M, Rousson V, Randall R, Schmalz G, Tyas M, Vanherle G. Recommendations for conducting controlled clinical studies of dental restorative materials. Clin Oral Investig 2007; 11:5-33. [PMID: 17262225 DOI: 10.1007/s00784-006-0095-7] [Citation(s) in RCA: 210] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2006] [Accepted: 12/14/2006] [Indexed: 10/23/2022]
Abstract
About 35 years ago, Ryge provided a practical approach to evaluation of clinical performance of restorative materials. This systematic approach was soon universally accepted. While that methodology has served us well, a large number of scientific methodologies and more detailed questions have arisen that require more rigor. Current restorative materials have vastly improved clinical performance and any changes over time are not easily detected by the limited sensitivity of the Ryge criteria in short term clinical investigations. However, the clinical evaluation of restorations not only involves the restorative material per se but also different operative techniques. For instance, a composite resin may show good longevity data when applied in conventional cavities but not in modified operative approaches. Insensitivity, combined with the continually evolving and non-standard investigator modifications of the categories, scales, and reporting methods, has created a body of literature that is extremely difficult to meaningfully interpret. In many cases, the insensitivity of the original Ryge methods is misinterpreted as good clinical performance. While there are many good features of the original system, it is now time to move to a more contemporary one. The current review approaches this challenge in two ways: (1) a proposal for a modern clinical testing protocol for controlled clinical trials, and (2) an in-depth discussion of relevant clinical evaluation parameters, providing 84 references that are primarily related to issues or problems for clinical research trials. Together, these two parts offer a standard for the clinical testing of restorative materials/procedures and provide significant guidance for research teams in the design and conduct of contemporary clinical trials. Part 1 of the review considers the recruitment of subjects, restorations per subject, clinical events, validity versus bias, legal and regulatory aspects, rationales for clinical trial designs, guidelines for design, randomization, number of subjects, characteristics of participants, clinical assessment, standards and calibration, categories for assessment, criteria for evaluation, and supplemental documentation. Part 2 of the review considers categories of assessment for esthetic evaluation, functional assessment, biological responses to restorative materials, and statistical analysis of results. The overall review represents a considerable effort to include a range of clinical research interests over the past years. As part of the recognition of the importance of these suggestions, the review is being published simultaneously in identical form in both the "Journal of Adhesive Dentistry" and the "Clinical Oral Investigations." Additionally an extended abstract will be published in the "International Dental Journal" giving a link to the web full version. This should help to introduce these considerations more quickly to the scientific community.
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Affiliation(s)
- R Hickel
- Department of Operative Dentistry and Periodontology, University of Munich, Goethestrasse 70, 80336, Munich, Germany.
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van Dijken JWV, Sunnegårdh-Grönberg K. Fiber-reinforced packable resin composites in Class II cavities. J Dent 2006; 34:763-9. [PMID: 16580114 DOI: 10.1016/j.jdent.2006.02.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2006] [Revised: 02/20/2006] [Accepted: 02/23/2006] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To evaluate the 6-year performance of two glass fiber-reinforced packable resin composites in Class II cavities. METHODS Sixty-three participants received 87 medium to large, cervically dentin bordered, Class II restorations of two fiber-reinforced resin composites, 42 Nulite F (N) and 45 Alert (A). The restorations were evaluated clinically, according to slightly modified USPHS criteria at baseline, after 6 months, and yearly during 6 years. RESULTS At 2 years the cumulative failure frequencies for N and A were 4.8% and 2.2%, respectively, which increased at 6 years to 25.0% and 12.8%. Reasons for failure were secondary caries, material and cusp fracture. The majority of the failures occurred after 3 years. Secondary caries occurred between 4 and 6 years. The incorporation of fibers resulted in very rough surface characteristics. CONCLUSIONS A rather high failure rate was observed for one of the fiber-reinforced resin composites, while the other fulfilled the ADA criteria. The occurrence of most failures after 3 years indicated the necessity of long-term evaluations of new materials.
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Affiliation(s)
- Jan W V van Dijken
- Dental Hygienist Education, Department of Odontology, Dental School, Umeå University, Umeå, Sweden.
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39
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Loomans BAC, Opdam NJM, Roeters FJM, Bronkhorst EM, Plasschaert AJM. The long-term effect of a composite resin restoration on proximal contact tightness. J Dent 2006; 35:104-8. [PMID: 16904254 DOI: 10.1016/j.jdent.2006.05.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2006] [Revised: 05/22/2006] [Accepted: 05/29/2006] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate changes in proximal contact tightness up to 6 months after the restorative treatment. MATERIALS AND METHODS In a randomised clinical trial Class II composite resin restorations were placed in 52 patients. Proximal contact tightness was measured before, directly after, and 6 months after treatment. These data were analysed statistically using linear regression and t-tests. RESULTS Proximal contacts, that increased in tightness as result of the treatment tend to loose tightness after a 6-months period but remain tighter than before treatment. Proximal contacts, that decreased after treatment hardly change after 6 months. CONCLUSIONS A change in contact tightness after restorative treatment will not always remain stable over time.
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Affiliation(s)
- B A C Loomans
- Department of Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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Cassoni A, Youssef MN, Prokopowitsch I. Bond strength of a dentin bonding system using two techniques of polymerization: visible-light and argon laser. Photomed Laser Surg 2006; 23:493-7. [PMID: 16262580 DOI: 10.1089/pho.2005.23.493] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this work was to study one dentin-bonding system associated with posterior teeth restorative composite resin by means of tensile bond strength tests varying the technique of polymerization: visible light and argon laser. BACKGROUND DATA Previous studies have demonstrated the ability of the argon laser to polymerize light-activated materials. METHODS Sixty specimens were prepared by grinding the labial surface of bovine teeth embedded in acrylic resin. The dentin bonding system used was Single Bond (3M), which has a poliacenoic acid copolimer, associated with a posterior teeth restorative composite resin (Filtek P60, 3M). The bonding sites were treated according to the instruction of the manufacturers. The 60 teeth, duly embedded and ground, were assigned to four groups with 15 teeth each: group 1, the adhesive was light cured during 10 sec with visible light (Curing Light, 3M) with power density of 410 mW/cm2 and the composite resin was light cured during 20 sec with visible light; group 2, the adhesive and the composite resin were cured during 10 seconds with argon laser with 150 mW of power; group 3, the adhesive and the composite resin were cured during 10 sec with argon laser with 200 mW of power; and group 4, the adhesive and the composite resin were cured during 10 sec with argon laser with 250 mW of power. The composite resin was light cured in layers of 1 mm of thickness until the model of teflon with 3 mm in height was completely filled. RESULTS The tensile bond strength test was performed in a Mini-Instron (model 4442) and the results for group 1 were 19.75 MPa (+/-4.65), group 2 were 16.09 MPa (+/-7.27), group 3 were 11.56 MPa (+/-4.50), and group 4 were 11.90 MPa (+/-5.78). CONCLUSIONS One can conclude that the tensile bond strength promoted by the polymerization with visible light presented greater tensile bond strength than the polymerization with argon laser with 200 mW and 250 mW, but there was no significant difference between visible light and argon laser with 150 mW. There was no significant difference between argon laser with 150 mW and argon laser with 200 mW or 250 mW.
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Affiliation(s)
- Alessandra Cassoni
- Department of Restorative Dentistry, University of São Paulo, São Paulo, Brazil.
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Hofmann N, Hunecke A. Influence of Curing Methods and Matrix Type on the Marginal Seal of Class II Resin-based Composite Restorations In Vitro. Oper Dent 2006; 31:97-105. [PMID: 16536200 DOI: 10.2341/04-194] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
Selection of photo-curing protocol (high intensity vs soft-start) and matrix type (transparent vs metal) did not influence the margin quality and marginal seal of Class II resin-based composite restorations.
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Affiliation(s)
- Norbert Hofmann
- Department of Operative Dentistry and Periodontology, Julius-Maximilians-University of Wuerzburg, Wuerzburg, Germany.
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42
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Blalock JS, Chan DCN, Browning WD, Callan R, Hackman S. Measurement of clinical wear of two packable composites after 6 months in service. J Oral Rehabil 2006; 33:59-63. [PMID: 16409518 DOI: 10.1111/j.1365-2842.2006.01540.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Original large-particle composites exhibited poor wear characteristics. With the packable composites, there has been a reintroduction of large particles. The clinical wear characteristics of such packable composites are relatively unknown. The purpose of this study was to compare wear between two types of packable composites: Alert (Jeneric Pentron) and Surefil (Dentsply Caulk). Each material was compared with and without a surface sealant. Fifty-two subjects were included. Subjects had to have two to four eligible teeth, be 21 years of age, in good health and in need of moderate to large class 2 restorations on molars, and/or a two-surface class 1 on molars. Wear was assessed, using the Moffa-Lugassy (ML) scale, by evaluating stone models made from polyvinyl siloxane (PVS) impressions taken at baseline and 6 months. Rating was done by four calibrated examiners using a forced consensus model. The use of a surface sealant with Alert significantly reduced the median wear rate at 6 months compared with that of the SureFil restorations.
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Affiliation(s)
- J S Blalock
- Division of Operative Dentistry and Clinical Research, Department of Oral Rehabilitation, Medical College of Georgia, Augusta, GA, USA.
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43
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Poon ECM, Smales RJ, Yip KHK. Clinical evaluation of packable and conventional hybrid posterior resin-based composites. J Am Dent Assoc 2005; 136:1533-40. [PMID: 16329416 DOI: 10.14219/jada.archive.2005.0083] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors evaluated clinical performances of a packable and a conventional hybrid resin-based composite used with a self-etch adhesive system. METHODS Three dentists placed 105 posterior restorations in 65 adults. They placed a packable (SureFil, Dentsply DeTrey GmbH, Konstanz, Germany) and a conventional (Spectrum, Dentsply DeTrey GmbH) resin-based composite using a self-etch resin adhesive system. The authors evaluated the restorations using Ryge modified criteria, photographs and die stone replicas. RESULTS After 3.5 years, six large SureFil and two Spectrum restorations had failed from bulk fracture and secondary caries, resulting in cumulative survival rates of 81.3 and 92.0 percent, respectively. Failed SureFil restorations generally were larger than the remaining intact restorations. Other ratings were satisfactory, with no significant differences between the two materials for any restoration parameter. Alfa ratings for both materials were approximately 80 percent or greater for marginal discoloration, anatomical form, surface texture and surface staining. Lower percentages of restorations were rated Alfa for color match, marginal integrity and gingival health. No postoperative sensitivity was reported. Net mean occlusal wear (+/- standard deviation) was 28.9 (+/- 32.9) micrometers for SureFil and 33.8 (+/- 29.6) microm for Spectrum restorations; the difference was not statistically significant. CONCLUSIONS When used with a self-etch adhesive, the 3.5-year clinical performances of both composites were similar and satisfactory for the restoration of Class I and moderate-sized Class II cavities. Clinical Implications. The two composites placed in this study have an increased risk of bulk fracture when placed in large intracoronal Class II molar preparations.
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Affiliation(s)
- Eric C M Poon
- Faculty of Dentistry, The University of Hong Kong, SAR, PR China
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44
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Loomans BAC, Opdam NJM, Roeters FJM, Bronkhorst EM, Burgersdijk RCW, Dörfer CE. A randomized clinical trial on proximal contacts of posterior composites. J Dent 2005; 34:292-7. [PMID: 16157438 DOI: 10.1016/j.jdent.2005.07.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2005] [Revised: 07/12/2005] [Accepted: 07/18/2005] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The objective of this study was to investigate clinical changes in proximal contact strength inserting Class II composite resin restorations according to one of three randomly assigned protocols. MATERIALS AND METHODS Seventy-one Class II restorations (MO/DO) were placed by two calibrated operators. Restorations were randomly assigned to one of three groups: one using a circumferential and two a sectional matrix system with separation rings. Proximal contacts were measured by one independent observer with a Tooth Pressure Meter immediately before treatment, and directly after finishing the restoration. RESULTS Compared to the situation before treatment groups with a sectional matrix system resulted in a statistical significant stronger mean proximal contact strengths (p<0.05), whereas the use of a circumferential matrix system with hand-instrument resulted in a lower proximal contact strength (p<0.05). CONCLUSION Class II posterior composite resin restorations placed with a combination of sectional matrices and separation rings resulted in a stronger proximal contact than when a circumferential matrix system was used.
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Affiliation(s)
- B A C Loomans
- Department of Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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Roeters JJM, Shortall ACC, Opdam NJM. Can a single composite resin serve all purposes? Br Dent J 2005; 199:73-9; quiz 114. [PMID: 16041332 DOI: 10.1038/sj.bdj.4812520] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2004] [Accepted: 02/22/2005] [Indexed: 11/09/2022]
Abstract
The consensus view less than a decade ago was that direct posterior composites should be restricted to small restorations, preferably in premolar teeth with little, if any, occlusal function. Major advances in adhesive systems, materials and restorative techniques have combined to allow us to question this view and our increased clinical evidence base makes it appropriate to reconsider this viewpoint.
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Affiliation(s)
- J J M Roeters
- Department of Cariology and Endodontology, Radboud University Nijmegen, The Netherlands
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Abe Y, Braem MJA, Lambrechts P, Inoue S, Takeuchi M, Van Meerbeek B. Fatigue behavior of packable composites. Biomaterials 2005; 26:3405-9. [PMID: 15621229 DOI: 10.1016/j.biomaterials.2004.09.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2004] [Accepted: 09/20/2004] [Indexed: 10/26/2022]
Abstract
The aim of this study was to investigate the flexural fatigue behavior of 11 packable composites. Of each material 30 rectangular samples (1.2 x 5 x 35 mm) for flexural fatigue test were prepared. The clamped fracture strength and flexural fatigue limit (FFL) of each material were determined using a custom-made fatigue machine, after storage of the samples for one month in water at 37 degrees C. All data were analyzed using one-way ANOVA and Bonferroni/Dunn's test for multiple comparisons (p<0.05). Regression analysis was used to evaluate the relationship between elastic modulus (Abe et al., 2001), clamped fracture strength or FFL and inorganic filler fraction (vol%). The fracture strengths of all but two materials were in between those of the compact-filled densified composites and the microfine ones. The FFL of the packable composites tested were significantly lower than those of the compact-filled densified composites. Three of the tested materials showed even significantly lower FFL than did the microfine composites. There were statistically significant relationships between both the elastic modulus and the volumetric filler fraction (R(2)=0.974, p=1.990 x 10(-7)). The great diversity in packable composites makes clinical assessment necessary with regard to a justified use in posterior teeth.
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Affiliation(s)
- Y Abe
- Leuven BIOMAT research cluster- Department of Conservative Dentistry, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Kapucijnenvoer 7, Leuven 3000, Belgium
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Roeters FJM, Opdam NJM, Loomans BAC. The amalgam-free dental school. J Dent 2004; 32:371-7. [PMID: 15193785 DOI: 10.1016/j.jdent.2004.02.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2003] [Accepted: 02/03/2004] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To review the change in teaching of Restorative Dentistry at Nijmegen dental school over the period 1986 to the present. KEY POINTS In 1986, class I and II resin composite restorations were included in the pre-clinical program. However, these courses still started with class I and II amalgam restorations. From 1990 on, the number of amalgam restorations placed in the clinic gradually decreased while the number of resin composite restorations increased. Meanwhile, resin composite had become the first choice for treatment of primary caries (class I and class II) lesions. Finally in 1994, the pre-clinical training started with resin composite restorations before dental amalgam was taught and the advantage of a minimal preparation was further emphasized. Since 2001 the teaching of dental amalgam ceased at the dental school. This was not an abrupt change but the result of a long transitional stage during which it was gradually substituted by resin composite. This step-by-step introduction allowed the acceptance of composite resin by the staff as an alternative for dental amalgam in posterior restorations. As in 2001 students placed only 2.5 amalgam restorations before graduation, it was decided to stop with the pre-clinical training program. CONCLUSIONS The introduction of resin composites meant an important change in teaching restorative dentistry at Nijmegen dental school. It was not just a change in materials and techniques but also a change in treatment philosophy. The reduced need for preparation and the strengthening effect on the remaining tooth were the principal reasons for the shift from dental amalgam to adhesive dentistry with resin composite at Nijmegen dental school.
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Affiliation(s)
- F J M Roeters
- Department of Cariology and Endodontology, College of Dental Sciences, University Medical Centre Nijmegen, P O Box 9101, 6500 HB Nijmegen, The Netherlands.
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48
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Yip KHK, Poon BKM, Chu FCS, Poon ECM, Kong FYC, Smales RJ. Clinical evaluation of packable and conventional hybrid resin-based composites for posterior restorations in permanent teeth: results at 12 months. J Am Dent Assoc 2004; 134:1581-9. [PMID: 14719754 DOI: 10.14219/jada.archive.2003.0103] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Packable resin-based composites and simplified resin bonding systems are marketed to offer many advantages over conventional posterior hybrid composites and total-etch bonding systems. The authors conducted a study to evaluate the initial clinical performances of a packable and a conventional hybrid resin-based composite used with a simplified bonding system. METHODS A total of 57 Class I and 45 Class II restorations were placed in the permanent teeth of 65 adult patients. The carious lesions were restored with either packable resin-based composite (SureFil, Dentsply DeTrey GmbH, Konstanz, Germany) or conventional hybrid resin-based composite (SpectrumTPH, Dentsply DeTrey GmbH), using a resin adhesive (Non-Rinse Conditioner and Prime & Bond NT, both manufactured by Dentsply DeTrey GmbH). The authors evaluated the restorations using U.S. Public Health Service-Ryge modified criteria (in which Alfa is the highest rating) and by using color transparencies and die stone replicas. RESULTS Three SureFil restorations failed before their baseline evaluation. There were no failures among the 78 SpectrumTPH restorations evaluated at 12 months. For both resin-based composites, Alfa ratings were 90 percent or higher for marginal discoloration, anatomical form, surface texture and surface staining. Lower percentages of restorations were rated Alfa for color match, marginal integrity and gingival health. Occasional mild postoperative sensitivity was reported for four SureFil restorations and one SpectrumTPH restoration. The mean occlusal wear rate was 38 micrometers for the larger SureFil restorations and 25 microm for the smaller SpectrumTPH restorations. CONCLUSIONS The 12-month clinical performances of the two restorative materials were satisfactory and not significantly different for each of the parameters evaluated. CLINICAL IMPLICATIONS A packable and a conventional hybrid resin-based composite placed with a simplified bonding system in posterior permanent teeth showed satisfactory and similar results after 12 months.
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Affiliation(s)
- Kevin H K Yip
- Faculty of Dentistry, The University of Hong Kong, The Prince Philip Dental Hospital, Hong Kong SAR, PR China.
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49
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Lopes GC, Vieira LCC, Araujo E. Direct Composite Resin Restorations: A Review of Some Clinical Procedures to Achieve Predictable Results in Posterior Teeth. J ESTHET RESTOR DENT 2004; 16:19-31; discussion 32. [PMID: 15259540 DOI: 10.1111/j.1708-8240.2004.tb00446.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED The interest of patients in having tooth-colored restorations and the development of techniques and materials that make these restorations easier have contributed to make the esthetic restoration of posterior teeth popular. The direct use of composites in posterior teeth is a technique-sensitive procedure. Some difficulties, nevertheless, can be overcome or at least minimized by a heedful clinician by paying thorough attention to the various stages of the restorative technique. The present article seeks to review some concepts about this adhesive restorative procedure and to illustrate the possibilities of the technique with clinical reports. CLINICAL SIGNIFICANCE The direct posterior composite restorative technique offers the possibility of closely matching the natural optical characteristics of the lost tooth structure. Aimed at showing the potential of this technique, this article presents two step-by-step case reports and also reviews some concepts related to these clinical procedures.
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Affiliation(s)
- Guilherme Carpena Lopes
- Department of Operative Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
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50
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Görücü J, Özgünaltay G. Fracture strength of class II slot cavities restored with polymerizable restorative materials. POLYM ADVAN TECHNOL 2003. [DOI: 10.1002/pat.377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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