Preparo inicial em periodontia: avaliações perfilométricas e microscópias pós-remoção de excesso cervicais de restaurações

Forty recently extracted teeth with Class II amalgam restorations with overhangs were divided in four groups of ten teeth each. The overhangs were removed using one of the following instruments in each gruop: trimmer, chisel, surgical blade and reciprocating.motor.driven diamond tip. Instrumentation was performed until no irregularity could be detected clinically with a nº 3 explorer. The tooth.amalgam interfaces were examined by combined use of a surface measuring instrument and a scanning electron microscope. Four tracings from each specimen were recorded and the vertical discrepancy at the tooth.restoration interfaces measured. The mean score for tooth was determined, and the results were photographed aí 140 magnification with the SEM. The results indicated that all instruments tested were effective in removing overhangs, since none of the discrepancies registered after instrumenntation exceeded 4 Um. The surgical blade, and especially the reciprocting-motor.driven diamond tip eliminated overhangs better than the chisel. Both SEM photographs and the profilometric tracing revealed gaps at the tooth amalgam interface, rancing from 10 t o 50 Um in width.

The evaluation of effectiveness of adhesive systems on dental amalgam restorations

Aim: The purpose of this study was to evaluate the effectiveness of different adhesive systems in amalgam restorations and their effects on microleakage. Methodology: In this study, 105 caries-free extracted human permanent molar teeth were used. Teeth were randomly assigned to five groups (n=21), and class I cavities were created on the surface of each tooth. The first was a control group to which no adhesive system was applied. Amalgam Liner (VOCO GmbH, Cuxhaven Germany) was applied to Group II, Clearfil SE-Bond (Kuraray Europe GmbH, Frankfurt Germany) was applied to Group III, Panavia F 2.0 (Kuraray Europe GmbH, Frankfurt Germany) was applied to Group IV, Amalgambond Plus (Parkell Inc.Edgewood, NY USA) was applied to Group V, and then amalgam (Tytin, Kerr, California USA) restorations were placed. After the polishing process, samples were subjected to thermocycling 1,000 times. Teeth were sectioned bucco-palatinally/lingually, and microleakage scores of the occlusal walls were evaluated under a stereomicroscope at 15X magnification by a standardized scale ranging from 0 to 4. One tooth was selected randomly from each group for SEM (Scanning Electron Microscope), and SEM LEO EVO 40 (LEO Ltd., Cambridge UK) photographs of amalgam-tooth hard tissue interfaces were also taken at different magnifications. The results of the microleakage tests were statistically analyzed by both the Kruskal-Wallis Test and the Mann Whitney U Test. Results: In terms of microleakage among groups, the differences that were determined were significant (p<0.05). Microleakage within the control group was determined to be the highest, and statistically important differences were observed between the other groups. Group V (Amalgambond Plus) was determined to have the lowest microleakage scores. Conclusion: In prepared class I cavities, amalgam adhesive systems are effective in preventing occlusal microleakage but do not completely blocked it. How to cite this article: Ünal M, Atakul F. The evaluation of effectiveness of adhesive systems on dental amalgam restorations. Int Dent Res 2021;11(2):83-92. https://doi.org/10.5577/intdentres.2021.vol11.no2.5 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Effect of Amalgam Restorations and Operation Parameters on Diagnostic Accuracy of Caries Detection Using Cone Beam Computed Tomography: An In Vitro Study

This study was aimed to evaluate the diagnostic accuracy of cone beam computed tomography (CBCT) in detecting noncavitated approximal caries at different exposure parameters and to assess the impact of artifacts generated by amalgam restorations in an in vitro study. Seventy-eight approximal surfaces of extracted teeth were prepared with intentionally created noncavitated approximal caries of different depths; then, thirteen teeth with class 2 amalgam restorations were replaced with one tooth with normal surfaces in each block. CBCT volumes for all teeth were acquired using a Planmeca Promax 3D Mid imaging unit before and after placement of amalgam teeth, with different exposure parameters at low and high definition, both applying and omitting the Metal Artifact Reduction algorithm. The lesions were classified into four groups with regard to lesion extension. All teeth underwent histological analysis as gold standard. The histological examination showed that the distribution of lesions was as follows: 39.8% sound, enamel lesions of less and more than half the enamel thickness each 17.8%, and 24.6% dentin lesions. The detection sensitivity was found to be 0.972%, and specificity was found to be 0.937% for the detection of noncavitated approximal initial enamel and dentin caries. The highest diagnostic accuracy was found when using operating parameters of 90 kVp, 8 mA, and high resolution (75 μm) with nonamalgam teeth; all modes showed statistically significant higher AUCs than mode 2 (80 kVp, 7 mA, and 75 μm). However, for teeth with amalgam restorations, the highest accuracy was obtained at low resolution (200 μm) with the other parameters kept the same. It could be concluded that increasing the peak voltage and current improves diagnostic accuracy for the detection of noncavitated approximal caries. Moreover, diagnostic accuracy was found to be higher upon using high spatial resolution when diagnosing caries without adjacent amalgam restorations. There is a statistically significant difference with and without amalgam with respect to all modes.

Changing concepts and trends from dental amalgam to composites

An increase in concern regarding the safety and inferior aesthetics of amalgam restorations in dentistry has resulted in a transition from amalgam to other alternative dental materials such as composite resins. This article would critically analyze both the materials and the need for this changeover by means of scientific literature.

Is Dental Amalgam a Higher Risk Factor rather than Resin-Based Restorations for Systemic Conditions? A Systematic Review

Objective: The aim of this study was to confirm the hypothesis that patients with one or more amalgam restorations have an increased risk for systemic diseases rather than patients with resin-based restorations. Data: The data search produced an initial 3568 total number of records. All titles and abstract were reviewed by five independent examiners, and only 36 records were selected for full text in depth examination. Out of these, only nine publications matched the inclusion criteria and were included in this systematic review. Sources: Electronic databases (MEDLINE, Scopus, Embase, and Web of Knowledge) were searched up to June 2019. In addition, a manual search was carried out on journals related to this topic. Study selection: All selected human clinical studies compared patients with dental amalgam restorations to patients with non-amalgam restorations on restorative material related diseases/health conditions with at least 50 patients and a reasonable follow up. The systemic effects of dental restorations were analyzed. As for any systemic effects, there was no difference between amalgam and composite restoration. Conclusions: With the limitations of the few available randomized controlled trials (RCTs) on the matter, amalgam restorations, similarly to other modern resin-based materials, were not related to an increased risk of systemic diseases or conditions. Clinical significance: On the basis of the available RCTs, amalgam restorations, if compared with resin-based fillings, do not show an increased risk for systemic diseases. There is still insufficient evidence to exclude or demonstrate any direct influence on general health. The removal of old amalgam restorations and their substitution with more modern adhesive restorations should be performed only when clinically necessary and not just for material concerns. In order to better evaluate the safety of dental amalgam compared to other more modern restorative materials, further RCTs that consider important parameters such as long and uniform follow up periods, number of restorations per patient, and sample populations representative of chronic or degenerative diseases are needed.

An overview of composite versus amalgam for dental restorations

When any loss of the tooth structure happens, it’s restoration using different filling materials is essential to compensate for the defective parts. Among the most commonly used dental restorative materials, dental amalgam & composite resins prevail. We have searched the relevant studies that compared composite resins and amalgam restorations to review them in different aspects including the clinical, economic, biocompatibility and patients’ perspectives. Regarding the clinical perspective, most of the reviewed investigations showed that composite resin restorations were associated with higher failure rates and developed dental caries more than restorations made by the amalgam alloys. There were no significant differences noticed between the two materials regarding the side effects as both caused nearly similar neurological and renal affection. Based on the findings from previous studies, we could only notice that some studies reported that microalbuminuria may be associated with composite resins. We have also found that patients’ satisfaction with the amalgam restorations was low due to the potential development of some side effects that were attributable to lead intoxication. In conclusion, we recommend that further investigations should be conducted.

The Effect of the Different Service Lives of Class II Amalgam Restorations on Periodontal Health among Type 2 Diabetes Patients

Background: This comparative cross-sectional study evaluated the effect of the different service lives of class II amalgam restorations on periodontal health among type 2 diabetes patients.