Frequency of Restoration Replacement in Posterior Teeth for U.S. Navy and Marine Corps Personnel

2014 ◽  
Vol 39 (1) ◽  
pp. 43-49 ◽  
Author(s):  
M Laccabue ◽  
RL Ahlf ◽  
JW Simecek
Keyword(s):  
Military Personnel ◽  
Proportional Hazards Model ◽  
Resin Composite ◽  
Dental Amalgam ◽  
Cox Proportional Hazards Model ◽  
Caries Risk ◽  
Risk Status ◽  
Posterior Teeth ◽  
Dental Records ◽  
Amalgam Restorations

SUMMARY Statement of Problem There are no recent data that describe the replacement rates of resin composite and dental amalgam restorations placed by US Navy dentists. Information is needed to provide the best possible care for our military personnel which would minimize the probability of dental emergencies, especially for those who are deployed. Purpose The purpose of this study was to determine if the frequency of posterior restoration replacement in military personnel differed based on the type of restorative material utilized. Methods and Materials Data contained in dental records in an observational study (retrospective cohort) were evaluated to identify resin composite and dental amalgam restorations placed by navy dentists in posterior teeth. The status of all erupted, unerupted, missing, and replaced teeth was documented. The type and condition of all existing restorations were recorded for each posterior tooth. Investigators reviewed 2921 dental records, and of those, 247 patients met the criteria for inclusion in the study. A total of 1050 restorations (485 resin composite and 565 amalgam) were evaluated. Results A Cox proportional hazards model was adjusted for number of tooth surfaces restored, caries risk, and filled posterior surfaces at initial exam. The overall rate of replacement for all restorations in the sample was 5.7% during the average 2.8-year follow-up. No significant elevation of risk for restoration replacement existed when comparing resin composite and amalgam. Both the number of restored surfaces and caries risk status were independent risk factors for replacement. When restoring multisurface cavity preparations, providers placed amalgams by an approximate 2:1 ratio over resin composites for this study population. Conclusion The results for this study show that no difference existed in the rate of replacement for amalgam vs resin composite. When restorations increased from just a single occlusal surface to additional surfaces, the rate of replacement was elevated and statistically significant for both materials. A higher caries risk status was also significant in elevating replacement rates for both materials.

Survival rates of resin composite restorations in loadbearing situations in posterior teeth

Dental Update ◽  
2019 ◽  
Vol 46 (6) ◽  
pp. 524-536 ◽  
Author(s):  
F J Trevor Burke ◽  
Louis Mackenzie ◽  
Adrian CC Shortall
Keyword(s):  
Cohort Studies ◽  
Systematic Reviews ◽  
Clinical Relevance ◽  
Resin Composite ◽  
Survival Rates ◽  
Inclusion Criteria ◽  
Posterior Teeth ◽  
Medline Search ◽  
Composite Restorations ◽  
Amalgam Restorations

The use of resin composite for routine restoration of cavities in posterior teeth is now commonplace, and will increase further following the Minamata Agreement and patient requests for tooth-coloured restorations in their posterior teeth. It is therefore relevant to evaluate the published survival rates of such restorations. A Medline search identified 144 possible studies, this being reduced to 24 when inclusion criteria were introduced. Of these, ten directly compared amalgam and composite, eight were cohort studies, and six were systematic reviews. It was concluded that posterior composites may provide restorations of satisfactory longevity and with survival rates generally similar to those published on amalgam restorations. However, the ability of the operator in placing the restoration may have a profound effect. CPD/Clinical Relevance: With the increasing use of composite for restorations in posterior teeth, it is relevant to note that these may provide good rates for survival.

scholarly journals Perceptions of dental therapy students regarding the teaching and training with dental amalgam, in a dental school in KwaZulu-Natal, South Africa

2021 ◽  
Vol 76 (5) ◽  
pp. 258-269
Author(s):  
Sharmila Bissoon ◽  
Rajeshree Moodley
Keyword(s):  
South Africa ◽  
Resin Composite ◽  
Dental Materials ◽  
Cost Effective ◽  
Dental Amalgam ◽  
Posterior Teeth ◽  
The Past ◽  
Kwazulu Natal ◽  
Ceramic Restorations ◽  
And Training

Dental amalgam has been used as a restorative material in dentistry for the past 150 years. This material has been used to restore posterior teeth throughout the world and is also used in South Africa. Dental amalgam has been the material of choice for patients presenting with large tooth decay areas, including the loss of cuspal areas. The reason for this is that dental amalgam was always considered strong and durable. Compared to alternate dental materials, this material could also withstand the significant forces associated with chewing and biting. Dental amalgam is also considered more cost-effective than alternate dental materials such as conventional glass ionomers, resin-modified glass ionomers, resin composite and ceramic restorations, making it more feasible and material of choice in lower economic countries, including South Africa.

scholarly journals Should dental amalgams be used in dental training? The perspectives of dental academics at a university in South Africa

2021 ◽  
Vol 76 (09) ◽  
pp. 524-531
Author(s):  
Sharmila Bissoon ◽  
Rajeshree Moodley
Keyword(s):  
Resin Composite ◽  
Academic Staff ◽  
Dental Materials ◽  
Dental Amalgam ◽  
Mercury Content ◽  
Restorative Dentistry ◽  
Posterior Teeth ◽  
Waste Products ◽  
Clinical Supervisors ◽  
Dental Amalgams

Dental amalgam has been used in dentistry for the last 150 years to restore posterior teeth. Concerns regarding the safety issues with amalgam due to its mercury content have lead to the introduction of composite dental material to restore posterior teeth. This has transformed the teaching and training trends of direct restorative materials for posterior teeth. This descriptive study aimed to gain insight into academic staff and clinical supervisors’ perceptions regarding the use of dental amalgams in the teaching of restorative dentistry. This study used a qualitative method of data collection. Two focus group discussions were conducted between March and May 2020. Seventeen participants were invited to participate. Fourteen responded and participated, yielding an 82% response rate. The data identified two major themes, viz. the challenges experienced with the teaching of dental amalgam and curriculum development recommendations. Clinical quota requirements, disposal of waste products, and occupational and environmental risks regarding mercury exposure were sub-themes. Some of the curriculum recommendations included the skills gained during cavity preparations, the training and quota requirements of dental materials, and teaching trends locally, nationally and internationally.This study revealed that dental amalgam is still an integral part of the restorative dentistry curriculum at the university. However, the teaching of resin composite now occupies more than fifty percent of the restorative dentistry curriculum. Academics and clinical supervisors show a greater affinity for the placement of composite restorations.

Amalgam and Composite Use among Dental Students in Saudi Arabia

2019 ◽  
pp. 6830-6836
Author(s):  
Rahaf Al-Safadi ◽  
Riham Al-Safadi ◽  
Noor Al-Lowaim ◽  
Fatimah Al-Alwi ◽  
Duaa Al-Yahya ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Resin Composite ◽  
Individual Case ◽  
Dental Students ◽  
Chi Square ◽  
Posterior Teeth ◽  
Mandibular Molar ◽  
Chi Square Test ◽  
Tooth Type ◽  
Amalgam Restorations

Aim: The aim of this study was to detect the use of resin composite and amalgam restorations placed inpermanent posterior teeth by undergraduate dental students in university dental hospitals in Saudi Arabia.Materials and Methods: 276 patients aged ≥8 years were randomly selected and clinically examined foramalgam and resin composite restorations placed in permanent posterior teeth with living pulps byundergraduate dental students in university dental hospitals in Saudi Arabia. The restorations were placedin teeth preparations Class I and Class II. Also, bitewing and or periapical radiographs were used to definethe depth of the cavity. The data obtained were documented in a patient examination form then statisticallyanalyzed using Chi-Square Test or Fisher-Freeman-Halton Test.Results: Composite was the main kind of restoration placed by dental students. There was an insignificantrelationship between the kind of restoration (amalgam or composite) and the tooth type(maxillary/mandibular premolar and maxillary/mandibular molar), the class of tooth preparation, the cavitydepth, the age of the patient, and the gender of the patient p > 0.05.Conclusion: Composite was the most commonly restorative material used by dental students. Gradualreduction in the use of amalgam should be evidence-based. Students should obtain the necessarycompetencies for decision making according to each individual case.

scholarly journals MMP-9 Levels and NaOCl Lavage in Randomized Trial on Direct Pulp Capping

2021 ◽  
pp. 002203452110468
Author(s):  
N.V. Ballal ◽  
H.F. Duncan ◽  
D.B. Wiedemeier ◽  
N. Rai ◽  
P. Jalan ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Proportional Hazards Model ◽  
Outcome Expectations ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Great Promise ◽  
Direct Pulp Capping ◽  
Pulp Tissue ◽  
Posterior Teeth ◽  
Pulp Capping

Outcome expectations of direct pulp capping in carious teeth are obscured by a clinically unknown infiltration and breakdown of the dental pulp tissue. Histologic studies showed that this soft tissue breakdown is related to the innate immune system. We hypothesized 1) that a neutrophil biomarker could predict the outcome of direct pulp capping and 2) that using sodium hypochlorite (NaOCl) as a lavage solution to remove necrotized infected pulp tissue could improve it. In this randomized trial in mature posterior teeth causing no or mild discomfort with carious pulpal exposures, pulpal fluid was collected to assess neutrophil gelatinase (matrix metalloproteinase 9 [MMP-9]) per total protein (TP) levels as a predictive local biomarker. Subsequently, the dentin-pulp wound was randomly washed with a 2.5% NaOCl or a physiologic saline solution (1:1 allocation), capped with mineral trioxide aggregate, and the tooth was immediately restored with a resin-based composite restoration. Ninety-six patients were included, and 84 individuals could be followed up to treatment failure or clinically confirmed pulp survival after a minimum of 1 y. The entire data were fitted to a Cox proportional hazards model to assess the influence of the observational variables MMP-9/TP and discomfort with the randomized lavage treatment on pulp survival. The Kaplan-Meier pulp survival rates after 1 y were 55% for saline and 89% for NaOCl lavage. The inflammatory state of the pulp tissue as reflected by MMP-9/TP levels and NaOCl lavage had a highly significant ( P < 0.001 and P = 0.004, respectively) impact on pulp survival, while mild preoperative discomfort did not. In conclusion, MMP-9/TP showed great promise as a predictive local biomarker, and NaOCl lavage considerably improved the survival time of cariously exposed and directly capped pulps.

Prevention and Management of Scale and Polish Damage to Resin Composite Restorations

2014 ◽  
Vol 3 (2) ◽  
pp. 70-71
Author(s):  
Nairn HF Wilson ◽  
Christopher D Lynch
Keyword(s):  
Life Expectancy ◽  
Resin Composite ◽  
Dental Amalgam ◽  
Posterior Teeth ◽  
Minimal Intervention ◽  
Composite Restorations ◽  
The Aesthetic

Background The use of resin composite in the restoration of, in particular, posterior teeth is increasing. This trend is set to continue, with the momentum-gathering shift towards minimal-intervention direct approaches to the restoration of diseased, damaged and worn teeth, and subsequent to the signing of the Minamata Convention, aimed, amongst other measures, at ‘phasing down’ the use of dental amalgam.1–3 As a result, members of the dental team should, it is suggested, give consideration to the prevention and management of the damage that routine scaling and polishing may cause to the margins and surfaces of restorations of resin composite, or indeed restorations of other tooth-coloured restorative systems. Such damage may compromise the aesthetic qualities and reduce the life expectancy of tooth-coloured restorations. This article focuses on the prevention and management of scale and polish damage to resin composite restorations.

Age at Exposure to Parental Suicide and the Subsequent Risk of Suicide in Young People

Crisis ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 27-36 ◽  
Author(s):  
Kuan-Ying Lee ◽  
Chung-Yi Li ◽  
Kun-Chia Chang ◽  
Tsung-Hsueh Lu ◽  
Ying-Yeh Chen
Keyword(s):  
Young People ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Birth Registry ◽  
Data Set ◽  
Parental Suicide ◽  
The Impact ◽  
Age At Exposure

Abstract. Background: We investigated the age at exposure to parental suicide and the risk of subsequent suicide completion in young people. The impact of parental and offspring sex was also examined. Method: Using a cohort study design, we linked Taiwan's Birth Registry (1978–1997) with Taiwan's Death Registry (1985–2009) and identified 40,249 children who had experienced maternal suicide (n = 14,431), paternal suicide (n = 26,887), or the suicide of both parents (n = 281). Each exposed child was matched to 10 children of the same sex and birth year whose parents were still alive. This yielded a total of 398,081 children for our non-exposed cohort. A Cox proportional hazards model was used to compare the suicide risk of the exposed and non-exposed groups. Results: Compared with the non-exposed group, offspring who were exposed to parental suicide were 3.91 times (95% confidence interval [CI] = 3.10–4.92 more likely to die by suicide after adjusting for baseline characteristics. The risk of suicide seemed to be lower in older male offspring (HR = 3.94, 95% CI = 2.57–6.06), but higher in older female offspring (HR = 5.30, 95% CI = 3.05–9.22). Stratified analyses based on parental sex revealed similar patterns as the combined analysis. Limitations: As only register-­based data were used, we were not able to explore the impact of variables not contained in the data set, such as the role of mental illness. Conclusion: Our findings suggest a prominent elevation in the risk of suicide among offspring who lost their parents to suicide. The risk elevation differed according to the sex of the afflicted offspring as well as to their age at exposure.

Proliferation-dominant high-grade astrocytoma: survival benefit associated with extensive resection of FLAIR abnormality region

2020 ◽  
Vol 132 (4) ◽  
pp. 998-1005 ◽  
Author(s):  
Haihui Jiang ◽  
Yong Cui ◽  
Xiang Liu ◽  
Xiaohui Ren ◽  
Mingxiao Li ◽  
...  
Keyword(s):  
Survival Benefit ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Characteristic Curve ◽  
Extent Of Resection ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
High Grade ◽  
Extensive Resection ◽  
High Grade Astrocytoma

OBJECTIVEThe aim of this study was to investigate the relationship between extent of resection (EOR) and survival in terms of clinical, molecular, and radiological factors in high-grade astrocytoma (HGA).METHODSClinical and radiological data from 585 cases of molecularly defined HGA were reviewed. In each case, the EOR was evaluated twice: once according to contrast-enhanced T1-weighted images (CE-T1WI) and once according to fluid attenuated inversion recovery (FLAIR) images. The ratio of the volume of the region of abnormality in CE-T1WI to that in FLAIR images (VFLAIR/VCE-T1WI) was calculated and a receiver operating characteristic curve was used to determine the optimal cutoff value for that ratio. Univariate and multivariate analyses were performed to identify the prognostic value of each factor.RESULTSBoth the EOR evaluated from CE-T1WI and the EOR evaluated from FLAIR could divide the whole cohort into 4 subgroups with different survival outcomes (p < 0.001). Cases were stratified into 2 subtypes based on VFLAIR/VCE-T1WIwith a cutoff of 10: a proliferation-dominant subtype and a diffusion-dominant subtype. Kaplan-Meier analysis showed a significant survival advantage for the proliferation-dominant subtype (p < 0.0001). The prognostic implication has been further confirmed in the Cox proportional hazards model (HR 1.105, 95% CI 1.078–1.134, p < 0.0001). The survival of patients with proliferation-dominant HGA was significantly prolonged in association with extensive resection of the FLAIR abnormality region beyond contrast-enhancing tumor (p = 0.03), while no survival benefit was observed in association with the extensive resection in the diffusion-dominant subtype (p=0.86).CONCLUSIONSVFLAIR/VCE-T1WIis an important classifier that could divide the HGA into 2 subtypes with distinct invasive features. Patients with proliferation-dominant HGA can benefit from extensive resection of the FLAIR abnormality region, which provides the theoretical basis for a personalized resection strategy.

Association of time to surgery with leg pain after lumbar discectomy: is delayed surgery detrimental?

2020 ◽  
Vol 32 (2) ◽  
pp. 160-167 ◽  
Author(s):  
Alessandro Siccoli ◽  
Victor E. Staartjes ◽  
Marlies P. de Wispelaere ◽  
Marc L. Schröder
Keyword(s):  
Rating Scale ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Lumbar Discectomy ◽  
Cox Proportional Hazards Model ◽  
Neurological Deficits ◽  
Leg Pain ◽  
Specific Method ◽  
Time To Surgery ◽  
Patient Reported

OBJECTIVEWhile it has been established that lumbar discectomy should only be performed after a certain waiting period unless neurological deficits are present, little is known about the association of late surgery with outcome. Using data from a prospective registry, the authors aimed to quantify the association of time to surgery (TTS) with leg pain outcome after lumbar discectomy and to identify a maximum TTS cutoff anchored to the minimum clinically important difference (MCID).METHODSTTS was defined as the time from the onset of leg pain caused by radiculopathy to the time of surgery in weeks. MCID was defined as a minimum 30% reduction in the numeric rating scale score for leg pain from baseline to 12 months. A Cox proportional hazards model was utilized to quantify the association of TTS with MCID. Maximum TTS cutoffs were derived both quantitatively, anchored to the area under the curve (AUC), and qualitatively, based on cutoff-specific MCID rates.RESULTSFrom a prospective registry, 372 patients who had undergone first-time tubular microdiscectomy were identified; 308 of these patients (83%) obtained an MCID. Attaining an MCID was associated with a shorter TTS (HR 0.718, 95% CI 0.546–0.945, p = 0.018). Effect size was preserved after adjustment for potential confounders. The optimal maximum TTS was estimated at 23.5 weeks based on the AUC, while the cutoff-specific method suggested 24 weeks. Discectomy after this cutoff starts to yield MCID rates under 80%. The 24-week cutoff also coincided with the time point after which the specificity for MCID first drops below 50% and after which the negative predictive value for nonattainment of MCID first surpasses ≥ 20%.CONCLUSIONSThe study findings suggest that late lumbar discectomy is linked with poorer patient-reported outcomes and that—in accordance with the literature—a maximum TTS of 6 months should be aimed for.

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