The physical and adhesive properties of dental cements used for atraumatic restorative treatment

Evaluation of the antimicrobial activity and compressive strength of a dental cement modified using plant extract mixture

Literature lacks sufficient data regarding addition of natural antibacterial agents to glass ionomer cement (GICs). Hence, the aim of the study was to increase the antimicrobial properties of GICs through its modification with mixture of plant extracts to be evaluated along with an 0.5% chlorohexidine-modified GIC (CHX-GIC) with regard to biological and compressive strength properties. Conventional GIC (freeze-dried version) and CHX were used. Alcoholic extract of Salvadora persica, Olea europaea, and Ficus carcia leaves were prepared using a Soxhlet extractor for 12 h. The plant extract mixture (PE) was added in three different proportions to the water used for preparation of the dental cement (Group 1:1 PE, 2:1 PE, and 1:2 PE). Specimens were then prepared and tested against the unmodified GIC (control) and the 0.5% CHX-GIC. Chemical analysis of the extract mixture was performed using Gas chromatography-mass spectrometry. Antimicrobial activity was evaluated using agar diffusion assay against Micrococcus luteus and Streptoccocus mutans. Compressive strength was evaluated according to ISO 9917-1:2007 using a Zwick testing machine at a crosshead speed of 0.5 mm/min. Antimicrobial activity against Streptoccocus mutans was significantly increased for all the extract-modified materials compared to the unmodified cement, and the highest concentration was comparable to the CHX-GIC mixture. The activity against Micrococcus luteus was also significantly increased, but only for the material with the highest extract concentration, and here the CHX-GIC group showed statistically the highest antimicrobial activity. Compressive strength results revealed that there was no statistically significant difference between the different mixtures and the control except for the highest tested concentration that showed the highest mean values. The plant extracts (PEs) enhanced the antimicrobial activity against S. mutans and also against M. luteus in the higher concentration while compressive strength was improved by addition of the PE at higher concentrations.

Comparative evaluation of compressive strength, diametral tensile strength and shear bond strength of GIC type IX, chlorhexidine-incorporated GIC and triclosan-incorporated GIC: An in vitro study

Aim:

To comparatively evaluate the compressive strength, diametral tensile strength, and shear bond strength of glass ionomer cement type IX, chlorhexidine-incorporated glass ionomer cement, and triclosan-incorporated glass ionomer cement.

Materials and Methods:

In this study, glass ionomer cement type IX was used as a control. Chlorhexidine diacetate, and triclosan were added to glass ionomer cement type IX powder, respectively, in order to obtain 0.5, 1.25, and 2.5% concentrations of the respective experimental groups. Compressive strength, diametral tensile strength, and shear bond strength were evaluated after 24 h using Instron Universal Testing Machine. The results obtained were statistically analyzed using the independent t-test, Dunnett test, and Tukey test.

Results:

There was no statistical difference in the compressive strength, diametral tensile strength, and shear bond strength of glass ionomer cement type IX (control), 0.5% triclosan-glass ionomer cement, and 0.5% chlorhexidine-glass ionomer cement.

Conclusion:

The present study suggests that the compressive strength, diametral tensile strength, and shear bond strength of 0.5% triclosan-glass ionomer cement and 0.5% chlorhexidine-glass ionomer cement were similar to those of the glass ionomer cement type IX, discernibly signifying that these can be considered as viable options for use in pediatric dentistry with the additional value of antimicrobial property along with physical properties within the higher acceptable range.

Comparative evaluation of the antibacterial and physical properties of conventional glass ionomer cement containing chlorhexidine and antibiotics

Objective:

To evaluate the antimicrobial efficacy and compressive strength of conventional glass ionomer cement (GIC) containing chlorhexidine and antibiotics at varying concentrations.

Materials and Methods:

Chlorhexidine diacetate and antibiotics (ciprofloxacin, metronidazole, and minocycline) were incorporated into GIC Fuji IX at 1.5% and 3% w/w ratio to form the experimental groups. The experimental GIC specimens were placed on brain heart infusion agar plates inoculated with Streptococcus mutans, and the area of inhibition was measured after 48 h. The 24-h compressive strength of the set specimens was evaluated using a Universal Testing Machine.

Results:

The control group demonstrated no zone of inhibition. All experimental groups showed inhibition against S. mutans (P < 0.05), with larger zones of inhibition found in the higher concentration groups. Compressive strength at the end of 24 h decreased in the experimental groups as compared to the control group (P < 0.05), but no difference was found between the experimental groups (P > 0.05).

Conclusion:

The present study demonstrated that experimental GICs containing chlorhexidine diacetate and antibiotics were effective in inhibiting S. mutans, and incorporation of 1.5% ABX was optimal to give the appropriate antibacterial and physical properties.

Shear bond strength of Biodentine, ProRoot MTA, glass ionomer cement and composite resin on human dentine ex vivo

Introduction

The aim of this study was to compare the shear bond strength of Biodentine, ProRoot MTA (MTA), glass ionomer cement (GIC) and composite resin (CR) on dentine.

Methods

120 extracted human third molars were embedded in cold-cured-resin and grinned down to the dentine. For each material 30 specimens were produced in standardised height and width and the materials were applied according to manufacturers´ instructions on the dentine samples. Only in the CR group a self-etching dentine-adhesive was used. In all other groups the dentine was not pre-treated. All specimens were stored at 37.5 °C and 100% humidity for 2d, 7d and 14d. With a testing device the shear bond strength was determined (separation of the specimens from the dentine surface). The statistical evaluation was performed using ANOVA and Tukey-test (p < 0.05).

Results

At all observation periods the CR showed the significant highest shear bond strength (p < 0.05). After 2d significant differences in the shear bond strength were detectable between all tested materials, whereby CR had the highest and MTA the lowest values (p < 0.05). After 7d and 14d the shear bond strengths of MTA and Biodentine increased significantly compared to the 2d investigation period (p < 0.05). Biodentine showed a significantly higher shear bond strength than MTA (p < 0.05), while the difference between Biodentine and GIC was not significant (p > 0.05).

Conclusions

After 7d Biodentine showed comparable shear bond values than GIC, whereas the shear bond values for MTA were significantly lower even after 14d. The adhesion of Biodentine to dentine surface seams to be superior compared to that of MTA.

Degree of conversion and hardness of two different systems of the Vitrebond™ glass ionomer cement light cured with blue LED

This study investigated the physicochemical properties of the new formulation of the glass ionomer cements through hardness test and degree of conversion by infrared spectroscopy (FTIR). Forty specimens (n = 40) were made in a metallic mold (4 mm diameter x 2 mm thickness) with two resin-modified glass ionomer cements, Vitrebond™ and Vitrebond™ Plus (3M/ ESPE). Each specimen was light cured with blue LED with power density of 500 mW/cm(2) during 30 s. Immediately after light curing, 24h, 48h and 7 days the hardness and degree of conversion was determined. The Vickers hardness was performed by the MMT-3 microhardness tester using load of 50 gm force for 30 seconds. For degree of conversion, the specimens were pulverized, pressed with KBr and analyzed with FT-IR (Nexus 470). The statistical analysis of the data by ANOVA showed that the Vitrebond™ and Vitrebond™ Plus were no difference significant between the same storage times (p > 0.05). For degree of conversion, the Vitrebond™ and Vitrebond™ Plus were statistically different in all storage times after light curing. The Vitrebond™ showed higher values than Vitrebond™ Plus (p < 0.05). The performance of Vitrebond™ had greater results for degree of conversion than Vitrebond™ Plus. The correlation between hardness and degree of conversion was no evidence in this study.

Diametral tensile strength and water sorption of glass-ionomer cements used in Atraumatic Restorative Treatment

The purposes of this study were to evaluate the diametral tensile strength and the water sorption of restorative (Fuji IX and Ketac Molar) and resin-modified glass-ionomer luting cements (ProTec Cem, Fuji Plus and Vitremer) mixed at both manufacturer and increased powder: liquid ratio, for their use in the Atraumatic Restorative Treatment. A conventional restorative glass-ionomer (Ketac Fil) was used as control. Specimens (6.0 mm in diameter x 3.0 mm in height) were prepared and stored (1 hour, 1 day and 1 week) for a diametral tensile strength test. Data were subjected to two-way ANOVA and Tukey tests (p<0.05). For the water sorption test, specimens of 15.0 mm in diameter x 0.5 mm in height were prepared and transfered to desiccators until a constant mass was obtained. Then the specimens were immersed in deionized water for 7 days, weighed and reconditioned to a constant mass in desiccators. Data were subjected to one-way ANOVA and Tukey tests (p<0.05). Five specimens of each studied material and consistency were prepared for each test. The resin-modified glass-ionomer cements showed significantly higher strength than the conventional materials. Except for ProTec Cem, the diametral tensile strength of the resin-modified materials significantly increased from luting to restorative consistency. Except for ProTec Cem, the water sorption of the resin-modified glass ionomers was higher than the others. The water sorption of resin-modified materials at restorative consistency was significantly lower than at luting consistency. Resin-modified glass-ionomer luting cements mixed at increased powder: liquid ratio showed better properties than at luting consistency.

Six-month evaluation of ART one-surface restorations in a community with high caries experience in Brazil

The aim of this study to evaluate the success rate in one-surface ART restorations placed in permanent molars using a glass ionomer cement especially developed for ART in a community with high caries experience; to evaluate the operator influence on its success, post-operative sensitivity and technique acceptance by patients. Prior to placement of the restorations, the Gingival Bleeding Index, Visible Plaque Index, DMFT, dmft indices and treatment needed were assessed. One hundred and fifty five one-surface restorations were placed in permanent molars of school children, according to the WHO ART manual, 1997. After 6 months, the success rate was verified clinically and by slides. At baseline, the mean DMFT was 2.56 (±1.08) and the mean dmft, 2.53 (±2.33). Operators A and B have placed 102 and 53 ART restorations respectively. The mean time of placement was 16 minutes and 25 seconds to operator A and 14 minutes and 43 seconds to operator B. At 6-month follow up, 152 ART restorations were evaluated and 97.3% were assessed to be successful. Two restorations were excluded from the sample because the ART restorations were replaced by amalgam fillings. Only 4 restorations have failed, in which 2 due to caries, 1 due to fistula presence and the other because the restoration was lost. Four patients reported postoperative sensitivity. At this study period, ART treatment seems to be suitable for its purpose. Further evaluations are necessary to the new glass ionomer cements especially developed for ART technique provided good results at 6-month follow up in a community with high DMFT and dmft indices. The success rate for one-surface cavities in permanent molars was 97.3%, and the studied indices seemed to have no influence in this early evolution period.

Clinical evaluation of multisurface ART restorations

The aim of this study was to evaluate the performance of two different glass-ionomer cements: a high-density (Ketac Molar - ESPE) and a resin-modified cement (Fuji VIII - GC) using the Atraumatic Restorative Treatment technique to restore multisurface cavities in permanent teeth. A total of 60 ART restorations (30 with each material) were placed in schoolchildren (9-16 years of age) by two operators. After a period of 6 months, two independent examiners evaluated 59 restorations according to the criteria used in previous ART studies. Data were submitted to McNemar and Fischer tests. The success rate of the treatment was 98.3%. One restoration (Ketac Molar) was replaced by another material and was recorded as failure. The success rates of the restorations were 100% and 96.6% for Fuji VIII and Ketac Molar, respectively. There was no statistically significant difference in the restorations success between baseline and 6 months (p>0.05). In the same way, no significant differences were found between materials, cavity types or operators (p>0.05). The ART approach was highly appropriate and effective in restorations involving two or more tooth surfaces, after 6 months. The results showed a promising performance of the ART technique with both materials.

Research proposal: evaluation of ART in adult patients

The primary objective of the Atraumatic Restorative Treatment (ART) is to reduce the indication of tooth extraction by means of a low-cost technique. Considering the difficulties of Brazilian public services to meet the demand of care of the low-income population, with lack of care to the adult population, which usually receives only emergency care, the aim of this study is to assess the performance of high-viscosity glass ionomer cements accomplished by the modified atraumatic restorative treatment in one- and multiple-surface cavities, compared to the conventional restorative approach. It will be analyzed the clinical performance of the materials; cost (material and human resources); patient satisfaction with the treatment received; and preventive effect of treatment.

In vitro interactions between lactic acid solution and art glass-ionomer cements

Objectives:

Production of acids such as lactic acid contributes to establish a cariogenic environment that leads to dental substrate demineralization. Fluoride plays an important role in this case and, as fluoride-releasing materials, glass-ionomer cements are expected to contribute to minimize deleterious reactions. This study evaluated interactions of glass-ionomer cements used in atraumatic restorative treatment (ART-GICs) with an aqueous lactic acid solution, testing the null hypotheses that no changes occur in the pH of the solution or on the surface roughness and mass of the ART-GICs when exposed to lactic acid solution over a 6-week period.

Material and Methods:

Ketac Molar, Fuji IX, Vitro Molar and Magic Glass were tested, and compared to Filtek Z250 and Ketac Fil Plus as control groups. Six specimens of each material were made according to manufacturers' instructions. The pH of the solution and roughness and mass changes of each specimen were determined over 6 weeks. Each specimen was individually stored in 2 mL of 0.02 M lactic acid solution for 1 week, renewing the solution every week. pH of solution and mass of the specimens were monitored weekly, and surface roughness of the specimens was assessed before and at the end of the 6-week acid challenge. pH and mass data were analyzed statistically by repeated measures using one-way ANOVA and Tukey's post-hoc tests for each material. Paired t-tests were used for roughness analysis. Tukey's post-hoc tests were applied to verify differences of final roughness among the materials. Significance level was set at 5%.

Results:

The null hypotheses were partially rejected. All materials were able to increase the pH of the lactic acid solution and presented rougher surfaces after immersion, while mass change was minimal and generally not statistically significant.

Conclusions:

These findings can be helpful to predict the performance of these materials under clinical conditions. A protective action against the carious process with significant surface damage due to erosion may be expected.

Bond strengths of two conventional glass-ionomer cements to irradiated and non-irradiated dentin

This study evaluated the influence of irradiation on the dentin shear bond strength of two conventional glass ionomer cements (GICs). Thirty extracted molars were bisected in the mesio-distal direction. One-half of 20 teeth were irradiated with 60 Gy (5 days/week) for 6 weeks, and then GIC was placed on the irradiated dentin surface (Groups A1, B1). For the other halves of these tooth specimens, the GICs were first placed on their dentin surfaces and then the specimens irradiated (Groups A2, B2). The remaining 10 teeth were bisected and used as non-irradiated controls (Groups C1, C2). The GIC-dentin shear bond strengths were examined. Groups A2 and B2 had significantly lower bond strengths than groups A1, B1, C1, and C2 (p < 0.05). No significant differences were found among groups A1, B1, C1, and C2 (p > 0.05). In conclusion, irradiation may have an adverse effect on the bond strength of GICs depending on the application sequence.

In vitro microhardness of glass ionomer cements

This study evaluated the surface microhardness of four glass ionomer cements and a composite resin (Fuji IX, Ketac Molar, Vidrion R, Vitromolar and Z 250). Ten specimens of each glass ionomer cement with 8.0 mm diameter and 5.0 mm high dimensions were made and Vicker's microhardness measurements were taken at 1 day and 1 week after initial setting reaction. The results were analyzed using Student's T test and Tukey test (p < 0.05) and demonstrated that the values of microhardness increased after 1 week, with the exception of Fuji IX. Resin composite Z250 presented the greatest values for microhardness.

UK dentists' attitudes and behaviour towards Atraumatic Restorative Treatment for primary teeth

BACKGROUND

Atraumatic Restorative Treatment (ART) was introduced a decade ago as a minimal intervention treatment for caries in unindustrialised countries, but UK general dental practitioners (GDPs) may also be using this technique.

OBJECTIVE

This study aimed to determine the materials and techniques used by a group of UK GDPs to treat caries in primary teeth.

METHOD

A questionnaire, designed to determine GDPs' use of materials and techniques in the restoration of caries in primary teeth, was distributed to 600 GDPs in Scotland and England, with an explanatory letter and reply-paid envelope. The questionnaire included colour illustrations of two carious cavities in primary molar teeth and a request that respondents draw the cavity outline that they would use on the illustrations. The cavity outlines were assessed independently by two examiners. All other data were collated and analysed.

RESULTS

390 usable replies were received, a response rate of 65%. Of the respondents, 99% treated child patients and 42% of respondents were aware of ART. For treatment of a small Class II cavity, 37% drew a cavity outline without extension beyond removal of caries and a majority suggested use of an adhesive material (51% glass ionomer, 13% compomer). For cavity preparation, 47% of respondents used a drill, 10% an excavator and 41% used both. For treatment of a large occluso-lingual cavity, again most used an adhesive technique (44% glass ionomer, 12% compomer) for its restoration, while 50% used a drill, 7% an excavator and 42% used both for cavity preparation.

CONCLUSION

Most respondents used adhesive materials for restoration of caries in primary molars, but, despite 42% of respondents stating that they were aware of the treatment, "true" ART was adopted by fewer than 10% of respondents.

Microhardness of dentine underlying ART restorations in primary molars: an in vivo pilot study

OBJECTIVE

To evaluate the microhardness of dentine underlying glass ionomer restorations made with Atraumatic Restorative Treatment.

DESIGN

An experimental single-centre study.

SETTING

University Department, Brazil, 2001.

MATERIALS AND METHODS

Sixteen children were selected showing primary molars containing carious cavities (n = 29), which were restored using Fugi IX. Subsequently, some teeth were extracted respecting Nolla stage 7 or 8 of the permanent successor, and categorised according to the post-restoration time in the mouth: G1 (baseline, immediate extraction), G2 (30 days), G3 (90 days) and G4 (180 days). Four teeth were excluded because they were not in time of normal exfoliation. The 25 extracted teeth were resin embedded, sectioned mesiodistally and prepared metallographically. Knoop microhardness analysis (Micromet 2003; 10g for 1.5 sec.) produced identations in three areas of dentine: Zone 1 (just below the restoration), Zone 3 (as close as possible to the pulp) and Zone 2 (intermediate region between 1 and 3). Non-parametric statistical tests were done--at a significance level of 5%.

RESULTS

Four teeth were excluded. No significant difference was noted among the zones, inside the groups. Zones 1 and 2 showed a considerable increase of microhardness according to the time, except for Group 3 (p > 0.05).

CONCLUSION

Although microhardness had increased, it was not sufficiently equal to the microhardness of the healthy dentine, regardless of the depth evaluated.

Evaluation of Class I ART restorations in Brazilian schoolchildren: three-year results

Atraumatic Restorative Treatment (ART) has been adopted around the world to avoid unnecessary extractions, especially in non-industrialized countries. The development of specific glass ionomer cements marketed for the ART technique has contributed to the technical success rate. In this study, Ketac-Molar (3M ESPE, Dental Medzin, Germany) was used to restore 150 Class I cavities in 118 Brazilian public school children, aged from 7-12 years. At baseline and at subsequent recalls, CPI probes with a ball-end of 0.5 millimeters (mm) were used to assess loss of restorative material, and photographic color transparencies of restorations were made. After six months, 83 patients returned for follow-up examinations, with 71.8% of their restorations designated as acceptable. After three years, 49 patients with 57 ART-restorations were evaluated, with 21.0% of these restorations graded as acceptable. Another 29.8% of their restorations had been replaced by more permanent materials. The main objective of the ART technique is tooth retention; this was achieved for 94.7% of the restored teeth in a high caries risk population who returned for recalls.

Selection of restorative materials for the atraumatic restorative treatment (ART) approach: a review

The atraumatic restorative treatment (ART) technique or approach for the restoration of primary and permanent teeth has been widely adopted in, but not limited to, developing countries. However, the requirement for the placement of the restorative materials under often less-than-ideal conditions imposes significant restrictions on their selection; and there have been very few randomized clinical trials or reports comparing different types of restorative materials and treatments. Although conventional glass-ionomer cements (GICs) have relatively poor mechanical and adhesive strengths, their satisfactory biological features, ease of use, and low costs are distinct advantages. Most of the published reports of the clinical performance of the newer, high-strength esthetic conventional GICs specifically marketed for the ART approach have been from short-term studies. Satisfactory clinical performance has been demonstrated for single-surface posterior restorations only, over three years. Findings indicate that further improvements in restorative materials are still required for their use with the ART approach, together with further clinical investigations of the remineralization of shallow open caries lesions, as an alternative to placing definitive restorations.

Bonding of contemporary glass ionomer cements to dentin

OBJECTIVE

The objective of this study was to investigate the microtensile bond strength (microTBS) of contemporary glass ionomer cements (GIC) to sound coronal dentin.

METHODS

Three specimen teeth were prepared for each material tested: Fuji IX GP (GC), ChemFlex (Dentsply) and Ketac-Molar Aplicap (ESPE). GIC buildups were made according to the manufacturers' instructions. After being stored at 37 degrees C, 100% humidity for 24h, the teeth were vertically sectioned into 1x1mm beams for microTBS evaluation. Representative fractured beams were prepared for scanning (SEM) and transmission electron microscopic (TEM) examination.

RESULTS

Results of the microTBS test were: Fuji IX GP (12.4+/-8.6MPa), ChemFlex (15.0+/-9.3MPa) and Ketac-Molar Aplicap (11.4+/-7.7MPa). One-way ANOVA and a multiple comparison test showed that ChemFlex had a statistically higher microTBS (p<0.05). SEM fractographic analysis showed that the predominant failure modes were interfacial and mixed failures. The GIC side of the fractured beams revealed dehydration cracks, a high level of porosity, and voids with an eggshell-like crust. TEM analysis of the demineralized dentin sides of the fractured beams revealed the presence of an intermediate layer along the GIC-dentin interface. This zone was present on the fractured dentin surface in the case of interfacial failure, and beneath GIC remnants in specimens that exhibited a mixed failure mode.

SIGNIFICANCE

The findings suggest that the bonding of GIC to dentin is not weak and that the microTBS values probably represent the weak yield strengths of GICs under tension.

Minimal intervention dentistry--a review. FDI Commission Project 1-97

The concept of minimal intervention dentistry has evolved as a consequence of our increased understanding of the caries process and the development of adhesive restorative materials. It is now recognised that demineralised but noncavitated enamel and dentine can be 'healed', and that the surgical approach to the treatment of a caries lesion along with 'extension for prevention' as proposed by G V Black is no longer tenable. This paper gives an overview of the concepts of minimal intervention dentistry, describes suggested techniques for a minimally invasive operative approach, and reviews clinical studies which have been carried out in this area.

Painting the future for ART

The objective of this paper is to review recent research and developments with respect to the atraumatic restorative treatment (ART) approach and to outline future areas of research and development. Areas identified as requiring further investigation include the evaluation of: ART restorations for longer than 3 years duration using recognised evaluation criteria, multi-surface ART restorations, ART restorations in primary teeth and ART sealants. In addition, the possibility and potential dangers of caries remaining after cavity cleaning with hand instruments must be investigated and the findings balanced against the known damage to sound tooth tissue caused by more routine cavity preparation techniques. New bioactive restorative materials which offer the possibility of healing dentinal caries lesions should be developed and evaluated. Finally, behavioural and educational aspects of the ART approach should be investigated.

A review of atraumatic restorative treatment (ART)

The purpose of this paper was to critically analyse the results obtained with the Atraumatic Restorative Treatment (ART) technique. The ART approach involves the excavation of cavitated carious lesions with hand instruments and restoration of the cavities and associated pits and fissures with a glass ionomer restorative material. The clinical trial outcomes involving ART include retention rates, cost effectiveness, operative sensitivity, and the effect of personnel with different educational backgrounds involved in this alternative operative treatment. Comparative studies involving permanent and deciduous teeth using amalgam and glass ionomer sealants have also been included in the same projects. Specially defined clinical criteria have been used to evaluate the results. ART offers an opportunity for restorative dental treatment under field conditions where no electricity is available. Three-year data have been published, but long term studies using relevant comparison alternatives are lacking. ART has so far been largely employed on populations with a low DMFT. The technique should also be applied to high risk patients with rampant caries before the maximal benefit of the treatment can be ascertained.

ART restorations and glass ionomer sealants in Zimbabwe: survival after 3 years

Atraumatic restorative treatment (ART) consists of removing demineralised tooth tissues with hand instruments only, restoring the prepared cavity and sealing the adjacent pits and fissures with an adhesive filling material. This relatively painless, no-handpiece, minimal intervention approach to controlling dental caries is described. ART was applied in an oral health care programme in Zimbabwe that was carried out amongst secondary school students from 1994 to 1997. A new glass ionomer (Fuji IX) was used as the restorative and sealant material. Sealants were placed in high caries risk students using the 'press-finger' technique. A total of 297 one-surface ART restorations and 95 glass ionomer sealants were placed in 142 and 66 students, respectively. After 3 years, the lost-to-follow-up percentages for one-surface ART restorations and glass ionomer sealants were 30.6% and 30.5%, respectively. Actuarial (life table) analysis resulted in 3-year survival rates of one-surface ART restorations of 88.3% (95% CI: 92.4%-84.2%), ranging from 94.3% to 65.4% per operator. A total of 28 ART restorations placed in 25 students failed. Reasons for failure related to the material and the operator (11 restorations or 5.3% each), and to caries adjacent to the restoration (one restoration or 0.5%). Reasons for failure were not recorded for five restorations (2.3%). Sealants were placed on surfaces diagnosed as early enamel lesions. After 3 years, 71.4% (95% CI: 81.7%-61.1%) of the fully and partially retained sealants survived with a range of 100% to 55.6% per operator. Of the sealed surfaces 96.3% (95% CI: 100%-92.2%) survived 3 years without developing caries. Experienced operators placed better ART restorations than inexperienced operators. This study has demonstrated that ART with a glass ionomer restorative material and sealants provided high quality preventive and restorative dental care to this student population. ART has become one of the treatment modalities available to oral health workers in managing dental caries.

Dental materials citations: Part A, January to June 1997

OBJECTIVE

A search was conducted in biomedical journals published from January 1997 to June 1997 to identify all dental materials publications and sort them into major categories.

METHODS

Tables of contents for 79 journals for the period of January to June, 1997 were inspected and divided into 17 categories. Citations were analyzed by both frequency in journals and in categories, as well as compared to frequencies for previous years.

RESULTS

A total of 445 citations were detected in 79 journals for the period January 1997 to June 1997. Certain journals (n = 19) demonstrated a higher citation frequency (> or = 10 citations for 6 months) and represented 77.8% of all citations. The greatest number of citations continued to involve bonding (n = 97), resin-based restorative materials (composites; glass ionomers) (n = 95), prosthodontic materials (n = 51), and pulp protection/luting materials (n = 48). Frequencies by category were very similar to those for the last four years.

SIGNIFICANCE

The compiled literature citations provide a supplement for researchers and academicians seeking information in existing electronic databases.