In vivo Evaluation of Proximal Resin Composite Restorations performed using Three Different Matrix Systems

Evaluation of Matrix Systems on the Proximal Contact of Class II Composite Restorations: A Systematic Review

When restoring proximal surfaces in posterior teeth, dentists frequently encounter the difficulty of reproducing the proximal contact that is naturally present in unrestored teeth. In order to guarantee the durability of restorations made from class II composite resin, it is imperative that both functional and aesthetic requirements are met. This entails the choice of the matrix system that replicates the optimal proximal contact subsequent to the insertion of restorations made of class II composite resin. The objective of this systematic review is to assemble current research conducted on the various matrix systems utilized in class II composite restorations and assess their impact on the pre-existing composite proximal contact. Three examiners conducted an independent electronic search utilizing the subsequent databases: Web of Science, Cochrane Library, Scopus, PubMed, and Embase. Publications on proximal contact in class II composite restorations were compiled from the time of their inception until August 2022, in accordance with predetermined inclusion and exclusion criteria. The methodological quality assessment was conducted utilizing the Effective Public Health Practice Project (EPHPP) instrument. Among the six studies that were included, it was observed that the sectional matrix system generated greater proximal contact tightness than the circumferential matrix system (Tofflemire). However, no significant distinction was found between the metal and polyester matrix systems. In contrast to alternative circumferential matrix systems, the utilization of a sectional matrix system yields a statistically significant improvement in the optimum proximal contact of class II composite restorations, according to the studies.

Class II composite restoration technique teaching: A randomised controlled crossover laboratory-based trial involving a novel ringless sectional matrix technique

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.

Impact of matrix systems on proximal contact tightness and surface geometry in class II direct composite restoration in-vitro

BACKGROUND

Poor contact tightness and contour in class II composite restorations are significant problems in clinical practice. They affect occlusal stability and periodontal health. The aim of this study was to evaluate proximal contact tightness and contour established after completing class II direct composite restorations using two pre-contoured matrix systems.

METHODS

Standardized mesio-occlusal cavities were prepared in twenty typodont lower right first permanent molar teeth. Prepared teeth were randomly divided into two groups according to matrix system: Group 1, Sectional matrix system with a separation ring (Palodent V3); and Group 2, Circumferential matrix system with integrated tightener (Palodent 360). Contact tightness was evaluated using universal testing machine. Area, depth and curvature radius of proximal surface concavity in the restoration were evaluated using contact stylus profilometer. T-test was used for comparison between groups.

RESULTS

Sectional matrix showed higher contact tightness than circumferential matrix system. The results of proximal surface concavity in the restoration showed significantly higher area and depth of concavity with lower radius of curvature in circumferential matrix compared to sectional matrix.

CONCLUSIONS

The use of separation ring with sectional matrix provides superior contact tightness compared to circumferential matrix. However, both matrix systems presented some deficiency regarding proximal contour of direct class II resin composite restoration.

Restoring black triangle with bioclear matrix versus conventional celluloid matrix method: a randomized clinical trial

BACKGROUND

Open gingival embrasures form complex aesthetic and functional problems. This clinical trial assessed the bioclear matrix using injection molding technique against conventional celluloid matrix technique in management of black triangle.

METHODS

A total of 26 participants were randomly divided into two groups (13 participants each) according to the technique used. In group (A) celluloid conventional matrix method was used, while in group (B) bioclear matrix with injection molding technique was used. The different outcomes (Esthetic evaluation, marginal integrity and patient satisfaction) were evaluated following the FDI criteria by two blinded examiners. The evaluation was done at (T0) (immediate after restoration); (T6) after 6 months; and (T12) after 12 months. Statistical analysis was done as categorical and ordinal data were presented as frequency and percentage values. Categorical data were compared using fisher's exact test. Intergroup comparisons for ordinal data were analyzed utilizing the Mann-Whitney U test, while intragroup comparisons were analyzed using Friedman's test followed by the Nemenyi post hoc test. The significance level was set at p ≤ 0.05 within all tests.

RESULTS

Regarding radiographic marginal integrity and marginal adaptation, the bioclear matrix group revealed superior results when compared to celluloid matrix group with a significant difference between both groups at all intervals (p < 0.05); however no significant difference was detected at different intervals. While for proximal anatomical form and esthetic anatomical form, as well as phonetics and food impaction, all cases in both groups were successful with no statistical significant difference between groups. For the periodontal response, there was no significant difference between groups. However, there was a significant difference between scores measured at different intervals, with T0 being significantly different from other intervals (p < 0.001). Marginal staining revealed that there was no significant difference between groups. While, a significant difference between scores measured at different intervals.

CONCLUSIONS

The restorative management of the black triangle with both protocols was able to deliver superior aesthetic and good marginal adaptation; suitable biological properties; with adequate survival time. Both techniques were almost equally successful, however they are depending on the operator skills.

TRIAL REGISTRATION

The clinical trial was registered in the ( www.

CLINICALTRIALS

gov/ ) database in 23/07/2020; with the unique identification number NCT04482790.

Sectional matrix solutions: the distorted truth

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.

Compliance of randomized controlled trials in posterior restorations with the CONSORT statement: a systematic review of methodology

OBJECTIVES

This study aims to investigate the compliance of randomized controlled trials (RCTs) in posterior restorations with the Consolidated Standards of Reporting Trials Statement (CONSORT) statement and to analyze the risk of bias (RoB) of these studies.

METHODS

A systematic search was performed in PubMed, Scopus, Web of Science, LILACS/BBO, and Cochrane Library. Only RCTs published in peer-reviewed journals were included. The compliance with the CONSORT was evaluated in a 0-2 scale where 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the CONSORT mean score by journal, country, and RoB were performed. The RoB in RCTs was evaluated by using the Cochrane Collaboration's tool version 1.0.

RESULTS

A total of 15,476 studies were identified after duplicates removal. O only 202 meet the eligibility criteria, among which 31 were follow-up studies. Concerning the overall RoB, only 29 out of 171 were classified as low risk of bias. The overall mean CONSORT score was 19 ± 5.4 points, which means compliance of approximately 59%. Significant differences among countries, publication period, and RoB were observed (p < 0.001). The journal's impact factor was not correlated with the overall CONSORT score (p = 0.36).

CONCLUSIONS

The adherence of RCTs conducted in posterior restorations to the CONSORT Statement is still low. In addition, most studies were classified as at unclear risk of bias. These results call up an urgent need for improvement.

CLINICAL RELEVANCE

Most RCTs conducted in posterior teeth have poor reporting and are mainly classified as having an unclear risk of bias.

Restoration of Proximal Contacts in Decayed Primary Molars Using Three Different Matrix Systems in Children Aged 5-9 Years: An In Vivo Study

Aims and objectives

Proximal contacts and their interdigitation through occlusal contact with opposing teeth play a major role in children, for the eruption of permanent teeth into normal position. Determining the ideal matrix band system for proximal restorations helps in the construction of contacts and contours. This study is designed to determine the most suitable matrix band system for proximal restorations.

Materials and methods

A total of 96 proximal cavities were selected among patients aged 5–9 years and were equally divided into three groups. Group I: T-band, group II: ProMatrix, and group III: FenderMate. Pre- and postoperative radiographs were taken to evaluate carious lesions and restorations. Class II cavity was prepared and glass ionomer restorations were done using matrix systems. The efficacy of matrix bands was evaluated through the operator's questionnaire and postoperative radiographs.

Results

No statistical significance was found between the three matrix bands but FenderMate showed few clinical drawbacks that were statistically significant (p < 0.005).

Interpretation and conclusion

Matrix systems used in this study showed good results in restoring proximal contacts and contours. FenderMate showed few drawbacks when compared with the other two matrix systems. None of the matrix systems used in the present study were able to create 100% accurate proximal contacts and contours.

How to cite this article

Dindukurthi MK, Setty JV, Srinivasan I, et al. Restoration of Proximal Contacts in Decayed Primary Molars Using Three Different Matrix Systems in Children Aged 5–9 Years: An In Vivo Study. Int J Clin Pediatr Dent 2021;14(1):70–74.

Randomized Prospective Clinical Trial of Class II Restorations Using Low-shrinkage Flowable Resin Composite

PURPOSE

The aim of this prospective, randomized, split-mouth clinical trial was to evaluate postoperative sensitivity, clinical performance, and interproximal contacts after using different restorative systems.

METHODS AND MATERIALS

Fifty-three subjects each received three class II restorations according to the restorative systems: conventional resin composite (PA: Peak Universal+Amelogen Plus, Ultradent), low-shrinkage flowable and nanoparticulate resin composites (ABF: Adper Single Bond 2+Filtek Bulk Fill Flow+Filtek Z350XT, 3M ESPE), and low-shrinkage flowable and microhybrid resin composites (XST: XP Bond+SDR+TPH3, Dentsply). Postoperative sensitivity was assessed at 24 hours, seven days, 90 days, and six months. The clinical performance and interproximal contacts were evaluated at baseline, six months, and one year. Friedman, Wilcoxon, Kruskal-Wallis, and Mann-Whitney tests were used to evaluate postoperative sensitivity and interproximal contacts. The equality test of two proportions and logistic regression analysis were used to assess the clinical performance.

RESULTS

No statistically significant differences were observed among groups for postoperative sensitivity. The highest spontaneous sensitivity was reported at 24 hours. ABF was the only group that did not present a reduction in cold sensitivity. Color, marginal discoloration, and superficial staining showed differences among the groups. XST did not show superficial staining after one year. No differences were observed among groups in relation to interproximal contacts. XST resulted in the loss of interproximal contact after one year.

CONCLUSIONS

Different types of restorative systems do not influence postoperative sensitivity; however, ABF maintained cold sensitivity over time. Marginal discoloration occurred for all groups but occurred earliest for PA. XST presented a reduction of interproximal contact after one year of evaluation.

Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry

STATEMENT OF PROBLEM

It is clear the contemporary dentist is confronted with a blizzard of information regarding materials and techniques from journal articles, advertisements, newsletters, the internet, and continuing education events. While some of that information is sound and helpful, much of it is misleading at best.

PURPOSE

This review identifies and discusses the most important scientific findings regarding outcomes of dental treatment to assist the practitioner in making evidence-based choices. This review was conducted to assist the busy dentist in keeping abreast of the latest scientific information regarding the clinical practice of dentistry.

MATERIAL AND METHODS

Each of the authors, who are considered experts in their disciplines, was asked to peruse the scientific literature published in 2015 in their discipline and review the articles for important information that may have an impact on treatment decisions. Comments on experimental methodology, statistical evaluation, and overall validity of the conclusions are included in many of the reviews.

RESULTS

The reviews are not meant to stand alone but are intended to inform the interested reader about what has been discovered in the past year. The readers are then invited to go to the source if they wish more detail.

CONCLUSIONS

Analysis of the scientific literature published in 2015 is divided into 7 sections, dental materials, periodontics, prosthodontics, occlusion and temporomandibular disorders, sleep-disordered breathing, cariology, and implant dentistry.