Survival rate of primary molar restorations is not influenced by hand mixed or encapsulated GIC: 24 months RCT

Background Glass ionomer cements (GIC) have been considered the top option to restore primary teeth by dentists. The most common supply forms are hand mixed and encapsulated GIC. There is a lack of information about the impact of different GIC supply forms on restoration survival. Methods This randomized clinical trial compared the survival rate of occlusal and occlusoproximal restorations in primary molars using two glass ionomer cements versions: hand-mixed (H/M) and encapsulated (ENC) after 24 months. Children aged 3–10 years who presented dentin caries lesions in primary molars were selected at School of Dentistry, University of São Paulo, Brazil. They were randomly assigned to groups: H /M (Fuji IX®, GC Europe) or ENC (Equia Fill®, GC Europe). The occurrence of restoration failure was evaluated by two blinded and calibrated examiners. The analyses were performed in Stata 13 (StataCorp, USA). To evaluate the primary outcome (restoration survival), we performed a survival analysis. Additionally an intention to treat (ITT) analysis were done at 24 months of follow-up. Cox Regression with shared frailty was performed to assess association between restoration failure and independent variables (α = 5%). Results A total of 324 restorations were performed in 145 children. The survival for H/M group was 58.2% and 60.1% for ENC, with no difference (p = 0.738). Occlusoproximal restorations had lower survival rate when compared to occlusal ones (HR = 3.83; p < 0.001). Conclusions The survival rate in primary molars is not influenced by the different supply forms of GIC. Also, occlusoproximal restorations present reduced performances when compared to occlusal cavities. Trial Registration This randomized clinical trial was registered on ClinicalTrials.Gov on 10/15/2014 under protocol (NCT 02274142).

Comparative Evaluation of Microleakage of Two Step Etch and Rinse, Two Step Self Etch and Universal Dentin Bonding

Introduction: Dental composites have been extended as the selected material in most of recent restorations. However, the contraction caused by their polymerization remains the main issue. The stress made by this contraction could cause the divide of composite-tooth junction to be severed. Bacteria, liquids, molecules or ions could cross the gap made between the repair and the cavity wall which this process is called micro-leakage. Micro-leakage causes leakage, tenderness, secondary decay, damage to the pulp, marginal discoloration, which finally results in restoration failure. It can be said that the success of resin restoration material depends perfectly on the ability of the enamel and dentin bonds. This research aims to determine the best bonding to decline micro-leakage. Materials and Methods: In this research, 48 human premolar teeth were prepared without decay, restoration, fracture and wear. Each class V standard cavity was prepared on buccal and lingual surfaces. The shaved teeth were randomly divided into 4 groups including 12 ones. They were polished after restoration. All samples of the 4 groups were subjected to the heat cycling. Apex was sealed with adhesive wax and all parts of the tooth were covered with two layers of nail polish. The samples were incubated in 0.5% Fuchsin solution for 24 hours at room temperature. After that, they were washed under the faucet and the nail polish was removed from tooth surface. Teeth were divided into two mesio distal sections by a cutting machine. Samples were observed by stereo microscope. samples were evaluated based on the micro-leakage grading. Kruskal-Wallis, Mann-Whitney and Will Coxson tests were used to evaluate the results. Results: In each group, 48 cavities were examined. The results of this research showed that in none of enamel surface of bindings, micro-leakage was observed. In the dentine area, the least amount of micro-leakage was related to the Clearfil SE Bond. There was no statistically significant difference between the micro-leakage of Clearfil SE Bond and G Premio Bond by Self Etch method (P value> 0.05). Also, there was no significant difference between micro-leakage of G_Premio Bond by Self Etch and G_Premio Bond by Etch and Rinse method. The micro-leakage of Adper Single Bond 2 was significantly higher in the dentin rather than the other groups. Conclusions: In dentine level, the highest micro-leakage was related to Adper Single Bond 2 bonding and the least one was in Clearfil SE Bond and G Premio Bond by Self Etch method.

THE COMPARISON OF RESIN-BASED COMPOSITES PHYSICAL PROPERTIES BETWEEN BULK-FILL TECHNIQUE AND INCREMENTAL TECHNIQUE

ABSTRACT:Composite resins are currently the most popular restorative material in dentistry. This is due to good aesthetics and maximum conservation ability. Behind these advantages, there are disbenefits of composite resin materials, such as polymerization shrinkage, which can lead to restoration failure. Various attempts have been investigated to reduce the shrinkage incidence of composite resins, one of which is the technique of placing the restorative material into the cavity. The restoration filling technique is recognized as a significant factor in shrinkage stress. By using a special filling technique, the polymerization shrinkage damage stress can be reduced. There are several techniques in performing composite resin fillings, including bulk and incremental techniques. These techniques have their respective advantages and disadvantages. The aim of this literature review was to compare the physical properties of composite resin restorations with bulk filling and incremental techniques. Physical properties that being studied include polymerization shrinkage, stress shrinkage, degree of conversion, bonding strength, water resorption, color stability, and temperature increase. Comparing the two techniques, composite resin with incremental filling technique has superior physical properties compared to bulk technique. From the comparison of the two techniques, the composite resin with incremental filling technique has superior physical properties compared to the bulk technique, especially in higher conversion which causes lower shrinkage stress. This situation makes the incremental technique provide better bond strength, water resorption, color stability, and lower temperature rise.Keywords: Bulk, Composite Resin, Incremental, Physical Properties, Restoration, Restoration Technique

Failure Mechanisms of GFRP Scarf Joints under Tensile Load

A potential repair alternative to restoring the mechanical properties of lightweight fiber-reinforced polymer (FRP) structures is to locally patch these areas with scarf joints. The effects of such repair methods on the structural integrity, however, are still largely unknown. In this paper, the mechanical property restoration, failure mechanism, and influence of fiber orientation mismatch between parent and repair materials of 1:50 scarf joints are studied on monolithic glass fiber-reinforced polymer (GFRP) specimens under tensile load. Two different parent orientations of [−45/+45]2S and [0/90]2S are exemplarily examined, and control specimens are taken as a baseline for the tensile strength and stiffness property recovery assessment. Using a layer-wise stress analysis with finite element simulations conducted with ANSYS Composite PrepPost to support the experimental investigation, the fiber orientation with respect to load direction is shown to affect the critical regions and thereby failure mechanism of the scarf joint specimens.

Survival rate of primary molar restorations is not influenced by hand mixed or encapsulated GIC: 24 months RCT

Background: Glass ionomer cements (GIC) have been considered the top option to restore primary teeth by dentists. The most common supply forms are hand-mixed and encapsulated GIC. There is a lack of information about the impact of different GIC supply forms on restoration survival. This randomized clinical trial compared the survival rate of occlusal and occlusoproximal restorations in primary molars using two of glass ionomer cements versions: hand-mixed (H/M) and encapsulated (ENC) after 24 months. Children aged 3-10 years who presented dentin caries lesions in primary molars were selected at School of Dentistry, University of São Paulo, Brazil. They were randomly assigned to groups: H /M (Fuji IX®, GC Europe) or ENC (Equia Fill®, GC Europe). The occurrence of restoration failure was evaluated by two blinded and calibrated examiners. The analyses were performed in Stata 13 (StataCorp, USA). To evaluate the primary outcome (restoration survival), we performed an intention to treat (ITT) analysis at 24 months of follow-up. Kaplan-Meier survival analysis was used to verify the survival of the restorations while Cox Regression with shared frailty was performed to assess association between restoration failure and independent variables (α=5%). Results: A total of 324 restorations were performed in 145 children. The survival for H/M group was 58.2% and 60.1% for ENC, with no difference (p=0.738). Occlusoproximal restorations had lower survival rate when compared to occlusal ones (HR=3.83; p<0.001). Conclusions: The survival rate in primary molar is not influenced by the different supply forms of GIC This randomized clinical trial was registered on ClinicalTrials.Gov on 10/15/2014 under protocol (NCT 02274142).

Long-Term Survival and Complication Rates of Porcelain Laminate Veneers in Clinical Studies: A Systematic Review

The presented study aimed to assess the survival rate of porcelain laminate veneers (PLV) based on a systematic review of the literature. An electronic search was last updated in February 2021. Eligibility criteria included clinical series of patients rehabilitated with PLVs published in the last 25 years, with a minimum follow-up of 3 years. Survival analysis methods were applied. Twenty-five studies were included, with 6500 PLVs. The 10-year estimated cumulative survival rate (CSR) of PLVs was 95.5%. The 10-year CSR of PLVs when fracture, debonding, occurrence of secondary caries, and need of endodontic treatment were considered as isolated reasons for failure were 96.3%, 99.2%, 99.3%, and 99.0%, respectively. PLVs without incisal coverage had a higher failure rate than PLVs with incisal coverage. Non-feldspathic PLVs performed better than feldspathic PLVs. As a conclusion, the 10-year CSR of PLVs was 95.5%, when fracture, debonding, occurrence of secondary caries, and need of endodontic treatment were considered as reasons for restoration failure. Fracture seems to be most common complication of PLVs, followed by debonding, with both more commonly happening within the first years after PLV cementation. PLVs with incisal coverage and non-feldspathic PLVs presented lower failure rates than PLVs without incisal coverage and feldspathic PLVs.

Clinical Performance of Two Types of Primary Molar Indirect Crowns Fabricated by 3D Printer and CAD/CAM for Rehabilitation of Large Carious Primary Molars

Objectives This randomized clinical trial aimed to evaluate clinical outcomes of two types of esthetic crowns fabricated using a three-dimensional (3D) dental printer and computer-aided design and manufacturing (CAD/CAM) system as an alternative full-coronal restoration for extensively carious pulp-treated primary molars. Materials and Methods Randomization was done for 50 lower primary molars in 50 child patients, split into two groups based on the fabrication method used: Group A: CAD/CAM crowns using polymethyl methacrylate (PMMA) blocks and Group B: 3D dental printed crowns using GC photopolymer resin. All crowns were evaluated at baseline and at 3rd, 6th, and 12th months using the U.S. Public Health Service criteria for gingival health, retention, and marginal integrity for both groups. Statistical Analysis The survival rate of 3D-printable crowns was 84% compared with 80% survival rate using CAD/CAM fabricated crowns at the end of the 12th-month follow-up. No statistically significant differences were noted in restoration failure. In the evaluation of gingival health between the two groups’ follow-up times, no statistically significant differences were noted at the 3rd- and 6th-month follow-ups, yet at the 12th month, statistically significant differences were noted (p = 0.022) when comparing gingival health. No statistically significant differences were noted between the two groups when comparing marginal integrity scores in all the follow-up periods. Conclusion Resin crowns fabricated via 3D dental printer and PMMA crowns fabricated using CAD/CAM are acceptable esthetic choices in restoring pulp-treated primary molars with great marginal integrity and crowns retention. 3D-printed resin crowns showed less cementing failure and performed better regarding gingival response compared with PMMA crowns.

Survival of silver diamine fluoride among patients treated in community dental clinics: a naturalistic study

Background Silver diamine fluoride (SDF) is a minimally-invasive preventive service used in the U.S. to avert and arrest caries since 2014. No studies document survival outcomes based in real world delivery. We analyzed 12-month survival outcomes of SDF applied independently or concurrently with other restorative procedures among a population receiving community dental care. Methods We analyzed data on SDF applications from de-identified dental claims on Oregon Health Plan patients served by Advantage Dental in 2016, who had been seen in 2015 (patient n = 2269; teeth n = 7787). We compared survival rates of SDF alone, SDF applied with a sedative filling, and SDF with a same-day restoration. Failure was defined as a restoration or extraction of the tooth 7 to 365 days after initial application. Survival was defined as a patient returning 180 or more days after application whose tooth did not have a restoration or extraction. Differences were assessed through Wilcoxon equality of survivor function tests and log-rank equality of survivor tests to compare failure rates, Cox Proportional Hazards models to assess factors associated with survival of SDF, and Kaplan–Meier survival estimate to calculate the probability of survival over time. Results SDF alone had an overall survival rate of 76%. SDF placed with sedative filling and with a same-day restoration had survival rates of 50% and 84% respectively, likely reflecting treatment intent. SDF alone survived exceptionally well on primary cuspids, permanent molars, and permanent bicuspids and among patients aged 10 to 20 years, with modest variation across caries risk assessment categories. A single annual application of SDF was successful in 75% of cases. Among SDF failures on permanent dentition, more than two-thirds of teeth received a minor restoration. Conclusion SDF is a minimally invasive non-aerosolizing option that prevented non-cavitated lesions and arrested early decay among community dentistry patients when applied independently or concurrently with restorative procedures. Professional organizations, policy makers, providers, and payors should broaden optional SDF use by informing clinical guidelines, reimbursement policies, and treatment decisions. Future research should address clinical, social, service delivery, workforce, and economic outcomes using diverse population-based samples, and the mechanisms underlying single application success and caries prevention potential.

Survival of silver diamine fluoride among patients treated in community dental clinics: A naturalistic study

Background: Silver diamine fluoride (SDF) is a minimally-invasive preventive service used in the U.S. to avert and arrest caries since 2014. No studies document survival outcomes based in real world delivery. We analyzed 12-month survival outcomes of SDF applied independently or concurrently with other restorative procedures among a population receiving community dental care.Methods: We analyzed data on SDF applications from de-identified dental claims on Oregon Health Plan patients served by Advantage Dental in 2016, who had been seen in 2015 (patient n=2,269; teeth n=7,787). We compared survival rates of SDF alone, SDF applied with a sedative filling, and SDF with a same-day restoration. Failure was defined as a restoration or extraction of the tooth 7 to 365 days after initial application. Survival was defined as a patient returning 180 or more days after application whose tooth did not have a restoration or extraction. Differences were assessed through Wilcoxon equality of survivor function tests and log-rank equality of survivor tests to compare failure rates, Cox Proportional Hazards models to assess factors associated with survival of SDF, and Kaplan-Meier survival estimate to calculate the probability of survival over time. Results: SDF alone had an overall survival rate of 76%. SDF placed with sedative filling and with a same-day restoration had survival rates of 50% and 84% respectively, likely reflecting treatment intent. SDF alone survived exceptionally well on primary cuspids, permanent molars, and permanent bicuspids and among patients aged 10 to 20 years, with modest variation across caries risk assessment categories. A single annual application of SDF was successful in 68% of cases. Among SDF failures on permanent dentition, more than two-thirds of teeth received a minor restoration. Conclusions: SDF is a minimally invasive non-aerosolizing option that prevented non-cavitated lesions and arrested early decay among community dentistry patients when applied independently or concurrently with restorative procedures. Professional organizations, policy makers, providers, and payors should broaden optional SDF use by informing clinical guidelines, reimbursement policies, and treatment decisions. Future research should address clinical, social, service delivery, workforce, and economic outcomes using diverse population-based samples, and the mechanisms underlying single application success and caries prevention potential.

Survival of silver diamine fluoride among patients treated in community dental clinics: A naturalistic study

Background: Silver diamine fluoride (SDF) is a minimally-invasive preventive services used in the U.S. to avert and arrest caries since 2014. Survival outcomes based in real world delivery settings have not been documented. We analyzed 12-month survival outcomes of SDF applied independently or concurrently with other restorative procedures among a population receiving community dental careMethods: We analyzed data on SDF applications from de-identified dental claims on Oregon Health Plan patients served by Advantage Dental in 2016, who had been seen in 2015 (patient n=2,269; teeth n=7,787). We compared survival rates of SDF alone, SDF applied with a sedative filling, and SDF with a same-day restoration. Failure was defined as a restoration or extraction of the tooth 7 to 365 days after initial application. Survival was defined as a patient returning 180 or more days after application whose tooth did not have restoration or extraction. Differences were assessed through Wilcoxon equality of survivor function tests and log-rank equality of survivor tests to compare failure rates, Cox Proportional Hazards models to assess factors associated with survival of SDF, and Kaplan-Meier survival estimate to calculate the probability of survival over time.Results: SDF alone had an overall survival rate of 76%. SDF placed with sedative filling and with a same-day restoration had survival rates of 50% and 84% respectively, likely reflecting treatment intent. SDF alone survived exceptionally well on primary cuspids, permanent molars, and permanent bicuspids and among patients aged 10 to 20 years, with modest variation across caries risk assessment categories. A single annual application of SDF was successful in 68% of cases. Among SDF failures on permanent dentition, more than two-thirds of teeth received a minor restoration.Conclusions: SDF is a minimally invasive non-aerosolizing option that prevented and arrested early stage dental caries among patients in one community dentistry setting. Professional organizations, policy makers, providers, and payors should broaden optional SDF use by informing clinical guidelines, reimbursement policies, and treatment decisions. Future research should address clinical, social, service delivery, workforce, and economic outcomes using diverse population-based samples, and the mechanisms underlying single application success and caries prevention potential. Trial registration: N/A