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Jebur N, Vinall-Collier K, Umair AA, Aggarwal VR. Dental amalgam teaching phase-out - a step too soon? Foundation trainees' experience of amalgam use in dental school compared to practice: a mixed-methods survey. Br Dent J 2023; 235:329-334. [PMID: 37684467 PMCID: PMC10491489 DOI: 10.1038/s41415-023-6228-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/09/2023] [Indexed: 09/10/2023]
Abstract
Aim This study aimed to explore disparities in experience of UK dental foundation trainees in amalgam use at dental school compared to their first year in dental practice.Methods A modified version of the 'survey of Yorkshire dentists' targeted the dental foundation trainees. A mixed-method of quantitative and thematic content analysis was undertaken for the close-ended and free-text responses, respectively.Results Only 35% of participants described their confidence level as 'satisfactory' in placing dental amalgam before starting their dental foundation training and 51% scored the level of teaching between 'very poor' and 'satisfactory'. In total, 63% of respondents were in favour of receiving additional support in placing amalgam restorations during their undergraduate training. Participants indicated that the consequences of amalgam phase-out are increased appointment times and decreased quality of care due to patient and health service unaffordability of amalgam alternatives.Conclusion These findings raise concerns regarding newly qualified undergraduates' confidence, experience and skill in placing amalgams. This suggests the need to increase undergraduate education and training to improve undergraduates' skills and confidence in amalgam procedures to reduce the gap between the dental schools and real-world practice.
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Affiliation(s)
- Noor Jebur
- School of Dentistry, University of Leeds, United Kingdom
| | | | - Abdul-Ahad Umair
- School of Dentistry, University of Leeds, UK; Associate General Dental Practitioner, Bupa Dental Care, United Kingdom
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Vieira I, Ferraz LN, Vieira Junior WF, Dias CTDS, Lima DANL. Effect of at-home bleaching gels with different thickeners on the physical properties of a composite resin without bisphenol A. J ESTHET RESTOR DENT 2022; 34:969-977. [PMID: 35332985 DOI: 10.1111/jerd.12908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 02/24/2022] [Accepted: 03/13/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate, in vitro, the influence of at-home bleaching with 16% carbamide peroxide (CP) gels containing different thickeners on the color, gloss, roughness, and microhardness of a composite resin with bisphenol A (BPA) and without bisphenol A (BPA-free). MATERIAL AND METHODS Cylindrical samples (7 × 2 mm) of a composite resin with BPA (Filtek Z350 XT®; 3M/ESPE) and composite resin BPA-free (Vittra APS®; FGM) were subdivided into six subgroups (n = 12), according to the bleaching gel used: no bleaching (control), commercial gel with 16% CP and carbopol, experimental gel with 16% CP and carbopol, experimental gel with 16% CP and natrosol, experimental gel with carbopol and experimental gel with natrosol. At the end of the experimental phase, the specimens were analyzed for color (ΔE*ab and ΔE00 ), surface roughness (Ra), gloss (GU), and surface microhardness (SMH). The data for all analyzes were submitted to Levene's test, Shapiro-Wilk's test and ANOVA. RESULTS For ΔE*ab and ΔE00 no statistically significant differences were found between all groups evaluated. Bleaching with experimental 16% CP gel with carbopol resulted in the lowest GU values for both composite resins evaluated. 16% CP experimental gel with natrosol resulted in higher Ra for the BPA composite resin and the bleaching with natrosol resulted in higher Ra for BPA-free. About 16% CP experimental gel with carbopol and 16% CP experimental gel with natrosol resulted in the lowest final SMH for composite resin with BPA. For the BPA-free composite resin, no differences were found between the groups in SMH for the same resin, however they presented the lowest values compared with all others groups. CONCLUSION The effects on physical properties are dependent on the composition of the composite resin and the thickener/bleaching gel used. The BPA-free composite resin showed less changes after exposure to bleaching agent, although its initial physical properties were worse compared to a bleached BPA. CLINICAL RELEVANCE The hydrogen peroxide and thickener of the at-home bleaching gel does impact the properties of composites with BPA or BPA-free such as gloss, roughness and surface microhardness, extremely important factors for maintaining an aesthetically and physically satisfactory restoration. BPA-free composite resins have inferior properties after at-home bleaching with different thickeners.
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Affiliation(s)
- Isabele Vieira
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Laura Nobre Ferraz
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | | | - Carlos Tadeu Dos Santos Dias
- Department of Exact Sciences, Luiz de Queiroz College of Agriculture, University of São Paulo, Piracicaba, SP, Brazil
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Bailey O, Vernazza C, Stone S, Ternent L, Roche AG, Lynch C. Amalgam Phase-Down Part 1: UK-Based Posterior Restorative Material and Technique Use. JDR Clin Trans Res 2020; 7:41-49. [PMID: 33300416 PMCID: PMC8674792 DOI: 10.1177/2380084420978653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Introduction: A European Union amalgam phase-down has recently been implemented. Publicly funded health care predominates in the United Kingdom with the system favoring amalgam use. The current use of amalgam and its alternatives has not been fully investigated in the United Kingdom. Objectives: The study aimed to identify direct posterior restorative techniques, material use, and reported postoperative complication incidence experienced by primary care clinicians and differences between clinician groups. Methods: A cross-sectional survey was distributed to primary care clinicians through British dentist and therapist associations (11,092 invitations). The questionnaire sought information on current provision of direct posterior restorations and perceived issues with the different materials. Descriptive statistical and hypothesis testing was performed. Results: Dentists’ response rate was 14% and therapists’ estimated minimum response rate was 6% (total N = 1,513). The most commonly used restorative material was amalgam in molar teeth and composite in premolars. When placing a direct posterior mesio-occluso-distal restoration, clinicians booked on average 45% more time and charged 45% more when placing composite compared to amalgam (P < 0.0001). The reported incidences of food packing and sensitivity following the placement of direct restorations were much higher with composite than amalgam (P < 0.0001). Widely recommended techniques, such as sectional metal matrix use for posterior composites, were associated with reduced food packing (P < 0.0001) but increased time booked (P = 0.002). Conclusion: Amalgam use is currently high in the publicly funded sector of UK primary care. Composite is the most used alternative, but it takes longer to place and is more costly. Composite also has a higher reported incidence of postoperative complications than amalgam, but time-consuming techniques, such as sectional matrix use, can mitigate against food packing, but their use is low. Therefore, major changes in health service structure and funding and posterior composite education are required in the United Kingdom and other countries where amalgam use is prevalent, as the amalgam phase-down continues. Knowledge Transfer Statement: This study presents data on the current provision of amalgam for posterior tooth restoration and its directly placed alternatives by primary care clinicians in the United Kingdom, where publicly funded health care with copayment provision predominates. The information is important to manage and plan the UK phase-down and proposed phase-out of amalgam and will be of interest to other, primarily developing countries where amalgam provision predominates in understanding some of the challenges faced.
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Affiliation(s)
- O. Bailey
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - C.R. Vernazza
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - S. Stone
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - L. Ternent
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - C. Lynch
- University Dental School & Hospital, University College Cork, Cork, Ireland
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Almassri HNS, Zhang Q, Yang X, Wu X. The effect of oral anti-inflammatory drugs on reducing tooth sensitivity due to in-office dental bleaching: A systematic review and meta-analysis. J Am Dent Assoc 2019; 150:e145-e157. [PMID: 31561766 DOI: 10.1016/j.adaj.2019.05.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 05/16/2019] [Accepted: 05/22/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND The authors' aim was to evaluate the effectiveness of anti-inflammatory drugs on tooth sensitivity (TS) during and after in-office dental bleaching procedures. TYPES OF STUDIES REVIEWED The authors selected randomized controlled trials in which the investigators compared anti-inflammatory drugs with a placebo to evaluate in-office dental bleaching TS. The authors performed an electronic search by using PubMed, ScienceDirect, and Embase. In addition, the authors searched other Web sites, such as ClinicalTrials.gov, to identify ongoing studies. RESULTS The authors included 7 randomized controlled trials (324 adults) in the review. According to the extracted data, the authors performed the meta-analysis by using risk ratios and their 95% confidence intervals or by using the mean difference with a 95% confidence interval. The authors used the Cochrane Collaboration's tool to assess study quality. After the evaluation, the authors considered 6 studies to be high quality and a single study to be low quality. The overall results of the evaluation process revealed the absence of a clinically significant effect of anti-inflammatory drugs. CONCLUSIONS AND PRACTICAL IMPLICATIONS The results of this analytic process indicated that anti-inflammatory drugs have no clinically significant effect on the TS that occurs due to in-office bleaching. Readers must analyze these results carefully given the limitations of this review, such as the small samples size and the heterogeneity among the studies in some stages of the evaluation process. The results of this analytical study highlight the need for more clinical studies to reach a significant conclusion because TS is one of the most important reasons for the cessation of bleaching treatment.
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Burke FJT, Lucarotti PSK. The ultimate guide to restoration longevity in England and Wales. Part 2: Amalgam restorations - time to next intervention and to extraction of the restored tooth. Br Dent J 2019; 224:789-800. [PMID: 29795518 DOI: 10.1038/sj.bdj.2018.354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 11/09/2022]
Affiliation(s)
- F J T Burke
- Primary Dental Care Research Group, University of Birmingham School of Dentistry, College of Medical and Dental Sciences, Pebble Mill, Birmingham, B5 7EG, UK
| | - P S K Lucarotti
- Primary Dental Care Research Group, University of Birmingham School of Dentistry, College of Medical and Dental Sciences, Pebble Mill, Birmingham, B5 7EG, UK
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Direct Restorations, Endodontics, and Bleaching: Materials and Techniques Used by General Dentists of New Zealand. Int J Dent 2019; 2019:6327171. [PMID: 30984263 PMCID: PMC6431498 DOI: 10.1155/2019/6327171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 02/05/2019] [Indexed: 11/18/2022] Open
Abstract
Background To investigate the selection and use of direct restorative materials, endodontic techniques adopted, and approaches to bleaching by general dentists in New Zealand. Methods A questionnaire comprising 19 sections and 125 questions was distributed via mail to 351 general dentists in New Zealand who were selected, at random, from the Dental Council of New Zealand's 2016 register. Results A total of 204 questionnaires were returned, of which 188 were usable. Direct resin composite was the most commonly used material for occlusoproximal cavity restorations in premolars (93.7%) and permanent molars (85.2%). Resin-modified glass ionomer cements (34%) and resin composite materials (31.4%) were more commonly used in the restoration of deciduous molars. Home-based vital bleaching was provided by a significant number of dentists (86%), while only 18% provided practice-based bleaching. Cold lateral condensation was the most commonly used obturation technique (55.8%), and 83% of respondents reported using rubber dam for treatments. Conclusions The findings from this study indicate that dentists in New Zealand are adapting to new materials and technologies to provide high quality care to their patients. Aesthetic treatments such as bleaching have become an integral part of general dental practice.
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Abstract
Objectives To determine, by means of anonymous self-report questionnaires, the changes in demographic profile, practising details and utilisation of clinical techniques/materials of general dental practitioners (GDPs) in the UK between 2002 and 2015. Method A wide-ranging, validated questionnaire, designed to elicit information on the practising arrangements and techniques and materials used, was distributed to UK-based GDPs in 2002, 2008 and 2015 with a request that they complete the questionnaire and return it by post in the reply-paid envelope to the corresponding author. Results Questionnaires were distributed by post to 1,000 UK-based GDPs in 2004 and 2008, with an additional 500 questionnaires being distributed at postgraduate meetings in 2015. Response rates of 70%, 66% and 78% were achieved, respectively. Of the respondents, 73% were male in 2002, while 67% and 60% were male in 2008 and 2015, respectively. In 2002, 65% were practice principals, falling to 51% in 2015. Regarding how patients paid for their dental care, 86% of respondents in 2002 treated patients within the NHS arrangements, compared with 57% and 50% in 2008 and 2015, respectively. The data collected in 2015 indicated that 55% of respondents had an intra-oral camera; while, with regard to recently introduced concepts and techniques, 80% used nickel-titanium files, 47% used zirconia-based bridgework, 25% used tricalcium silicate, and 17% used CAD/CAM restoration. Of great interest, perhaps, is the response to digital radiography/imaging, with the results indicating that, by 2015, 74% of respondents used this form of radiography. Conclusion Results from the three surveys indicated that NHS service provision has dropped to 50%. Regarding the staffing of dental practices, just over half the respondents were practice principals. The results also indicated that UK dentists continue to be innovative and forward-looking in the techniques that they employ.
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Wilson NHF, Burke FJT, Brunton PA, Creanor S, Hosey MT, Mannocci F. Dental practice in the UK in 2015/2016. Part 2: aspects of direct restorations, bleaching, endodontics and paediatric dentistry. Br Dent J 2019; 226:sj.bdj.2019.50. [PMID: 30631156 DOI: 10.1038/sj.bdj.2019.50] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2018] [Indexed: 11/09/2022]
Affiliation(s)
- N H F Wilson
- King's College London Dental Institute, London, UK
| | - F J T Burke
- Primary Dental Care Research Group, University of Birmingham School of Dentistry, Birmingham, UK
| | - P A Brunton
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - S Creanor
- Medical Statistics, Plymouth University Peninsula Schools of Medicine & Dentistry, Plymouth, UK
| | - M T Hosey
- Paediatric Dentistry, King's College London Dental Institute, London, UK
| | - F Mannocci
- Endodontology, King's College London Dental Institute, London, UK
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Lee RJ, Ratnayake J, Veerasamy A, Loch C, Cathro P, Brunton PA. Demographics, Practising Arrangements, and Standards: Survey among New Zealand Dentists. Int J Dent 2018; 2018:7675917. [PMID: 30581468 PMCID: PMC6276479 DOI: 10.1155/2018/7675917] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/14/2018] [Accepted: 10/29/2018] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND To determine the demographic profile and practising arrangements of general dentists in New Zealand. METHODS A questionnaire comprising 19 sections with 125 questions was distributed via mail to 351 general dentists in New Zealand who were selected, at random, from the Dental Council of New Zealand's 2016 register. RESULTS Two hundred and four questionnaires were returned, of which 188 were usable giving a response rate of 53.5%. The majority of the respondents (63.5%) were male and practice principals (56.8%). Fifty-nine percent of the practices were located in city or town centres with a wide geographic distribution. Sole practitioners accounted for 24.1% of respondents, with the mean number of dentists per practice being 3.2. The majority of respondents (71.6%) attended five or more continuing professional development courses in the past year. Ninety-one percent of respondents used a computerized management system, and 95.3% used the Internet. The use of nickel-titanium endodontic files (83.9%) and digital imaging (82.2%) was the most frequently cited clinical innovations. Articaine was the most popular local anaesthetic of choice. CONCLUSIONS Dentistry is an ever-changing profession, with evidence that NZ dentists continue to develop, learn, and embrace advancements in technologies to supply high-quality evidence-based treatment.
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Affiliation(s)
- Robert James Lee
- University of Otago, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand
| | - Jithendra Ratnayake
- University of Otago, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand
| | - Arthi Veerasamy
- University of Otago, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand
| | - Carolina Loch
- University of Otago, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand
| | - Peter Cathro
- University of Otago, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand
| | - Paul A. Brunton
- University of Otago, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand
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Lynch CD, Farnell DJJ, Stanton H, Chestnutt IG, Brunton PA, Wilson NHF. No more amalgams: Use of amalgam and amalgam alternative materials in primary dental care. Br Dent J 2018; 225:171-176. [DOI: 10.1038/sj.bdj.2018.538] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 11/09/2022]
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Burke FJT, Lucarotti PSK. The ultimate guide to restoration longevity in England and Wales. Part 4: resin composite restorations: time to next intervention and to extraction of the restored tooth. Br Dent J 2018; 224:945-956. [DOI: 10.1038/sj.bdj.2018.443] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 11/09/2022]
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The ultimate guide to restoration longevity in England and Wales. Part 1: methodology. Br Dent J 2018; 224:709-716. [DOI: 10.1038/sj.bdj.2018.267] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 11/08/2022]
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Diniz A, Lima S, Tavarez RR, Borges AH, Pinto S, Tonetto MR, Loguercio AD, Bandéca MC. Preventive Use of a Resin-based Desensitizer Containing Glutaraldehyde on Tooth Sensitivity Caused by In-office Bleaching: A Randomized, Single-blind Clinical Trial. Oper Dent 2018; 43:472-481. [PMID: 29570018 DOI: 10.2341/17-020-c] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the risk and intensity of bleaching-induced tooth sensitivity (TS) after in-office bleaching following topical application of a resin-based glutaraldehyde desensitizer. METHODS Thirty-three patients were randomly assigned to the experimental (Gluma Desensitizer Liquid, Heraeus Kulzer, Hanau, Germany) and placebo groups. The placebo or Gluma Desensitizer Liquid was applied for one minute prior to application of an in-office bleaching gel. Bleaching was performed with 35% hydrogen peroxide gel (three applications × 15 minutes each) over two sessions, one week apart. The color of the anterior teeth was evaluated before and 21 days after treatment using the VITA Classical shade guide, Bleachedguide 3D, and Easyshade spectrophotometer. TS during and after the bleaching was recorded according to the visual analog (VAS) and numerical rating (NRS) scales. All data were submitted to statistical analysis (α=0.05). RESULTS There was no significant difference in absolute risk or intensity of TS between the two groups (risk and VAS, p=0.93 and 0.31, respectively; NRS, p≥0.45). At the end of the bleaching protocol, tooth whitening was observed in both groups, as evident from color change in shade guide units (ΔSGU, 4.1-7.1; both guides) and overall color change (ΔE, 7.4-9.3 units); however, there were no significant differences in whitening between the two groups ( p>0.11). CONCLUSION Gluma Desensitizer Liquid was not able to reduce the risk or intensity of TS. Bleaching efficacy was not affected by application of the desensitizer.
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Mehta D, Jyothi S, Moogi P, Finger WJ, Sasaki K. Novel treatment of in-office tooth bleaching sensitivity: A randomized, placebo-controlled clinical study. J ESTHET RESTOR DENT 2018. [PMID: 29520944 DOI: 10.1111/jerd.12374] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Aim of this clinical trial was to investigate the effect of a calcium phosphate based desensitizer paste applied prior to in-office tooth whitening on bleaching sensitivity (BS). METHODS This crossover study was designed as randomized double-blinded, placebo-controlled trial. The desensitizer paste Teethmate AP (TAP) contains tetracalcium phosphate and dicalcium phosphate anhydrous in glycerol and polyethylene glycol, whereas placebo (PLA) is a calcium phosphate free analog. Fifty patients with sound maxillary incisors and canines were enrolled. Tooth shades were determined with a Vitapan Classic Shade guide. Randomly, TAP and PLA were applied to the left or to the right anterior teeth. After rinsing and air-drying the bleaching gel (Opalescence Boost PF 40%) was applied and left on the labial surfaces for 15 minutes. Sensitivity was recorded using a 10 cm visual analog scale (VAS) before, at 5, 10, and 15 minutes during, and at 1 hour, 1, 2, and 7 days after bleaching. Tooth whitening was determined with the shade guide after 1 day and 1 week. RESULTS Prebleaching desensitization with TAP reduced BS significantly when compared with PLA. Between 1 and 7 days the average sensitivity scores were close to zero, whereas the average scores for PLA were significantly higher during this time interval. Independent from the desensitizing treatment after 1 and 7 days the medians of the shades were between 5 and 3.5 units brighter. CONCLUSIONS Prebleaching desensitization with TAP was effective in reducing BS during and after tooth whitening treatment and had no adverse effect on the bleaching result. CLINICAL SIGNIFICANCE Prebleaching topical application of a calcium phosphate containing compound reduced significantly bleaching sensitivity during a single 15 minutes treatment and up to one week with a 40% hydrogen peroxide containing gel without compromising tooth whitening.
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Affiliation(s)
- Deepak Mehta
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College and Hospital, Bangalore, India
| | | | - Prashant Moogi
- Department of Conservative Dentistry and Endodontics, K.L.E. Society's Institute of Dental Sciences, Bangalore, India
| | - Werner J Finger
- Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Keiichi Sasaki
- Department of Oral Function and Morphology, Division of Advance Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Vaez SC, Faria-E-Silva AL, Loguércio AD, Fernandes MTG, Nahsan FPS. Preemptive use of etodolac on tooth sensitivity after in-office bleaching: a randomized clinical trial. J Appl Oral Sci 2018; 26:e20160473. [PMID: 29412363 PMCID: PMC5777424 DOI: 10.1590/1678-7757-2016-0473] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 07/16/2017] [Indexed: 12/13/2022] Open
Abstract
Purpose This study determined the effectiveness of the preemptive administration of etodolac on risk and intensity of tooth sensitivity and the bleaching effect caused by in-office bleaching using 35% hydrogen peroxide. Material and methods Fifty patients were selected for this tripleblind, randomized, crossover, and placebo-controlled clinical trial. Etodolac (400 mg) or placebo was administrated in a single-dose 1 hour prior to the bleaching procedure. The whitening treatment with 35% hydrogen peroxide was carried out in two sessions with a 7-day interval. Tooth sensitivity was assessed before, during, and 24 hours after the procedure using the analog visual scale and the verbal rating scale. Color alteration was assessed by a bleach guide scale, 7 days after each session. Relative risk of sensitivity was calculated and adjusted by session, while overall risk was compared by the McNemar's test. Data on the sensitivity level of both scales and color shade were subjected to Friedman, Wilcoxon, and Mann-Whitney tests, respectively (α=0.05). Results The preemptive administration of etodolac did not affect the risk of tooth sensitivity and the level of sensitivity reported, regardless of the time of evaluation and scale used. The sequence of treatment allocation did not affect bleaching effectiveness, while the second session resulted in additional color modification. The preemptive administration of etodolac in a single dose 1 hour prior to in-office tooth bleaching did not alter tooth color, and the risk and intensity of tooth sensitivity reported by patients. Conclusion A single-dose preemptive administration of 400 mg of etodolac did not affect either risk of tooth sensitivity or level of sensitivity reported by patients, during or after the in-office tooth bleaching procedure.
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Affiliation(s)
| | | | - Alessandro Dourado Loguércio
- Universidade Estadual de Ponta Grossa, Faculdade de Odontologia, Departamento de Odontologia Restauradora, Ponta Grossa, PR, Brasil
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Trevor Burke FJ, Lawson A, Green DJB, Mackenzie L. What’s New in Dentine Bonding?: Universal Adhesives. ACTA ACUST UNITED AC 2018; 44:328-30, 332, 335-8, 340. [PMID: 29172359 DOI: 10.12968/denu.2017.44.4.328] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The ability to bond restorations to dentine successfully is central to minimally invasive restorative dentistry. While dentine-bonding agents have gone through a variety of ‘generations’, it is the purpose of this paper to describe the latest dentine-bonding agents, the Universal Bonding Agents. These materials may be considered ‘Universal’ insofar as they may be considered to be capable of being used for direct and indirect dentistry, as well as being suitable for use in whichever etching modality the clinician considers appropriate, namely self-etch, etch and rinse or selective enamel etch. Laboratory investigations and initial clinical studies hold the promise that Universal Bonding Agents are a forward step in the quest for the ultimate bond to tooth substance.
Clinical relevance: New Universal Bonding Agents appear to present a promising advance in bonding to dentine.
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Campbell I, Kang J, Hyde TP. Randomized Controlled Trial of Postoperative Sensitivity with Warm and Room Temperature Composite. JDR Clin Trans Res 2017; 2:295-303. [PMID: 30938633 DOI: 10.1177/2380084416682934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Physical properties of composite improve when it is preheated prior to polymerization. However, postoperative sensitivity may be considered a potential complication. A review of the literature revealed no reported randomized controlled trials (RCTs) of postoperative sensitivity when using preheated composite resin. The objective of the study was to determine if preheating composite leads to changes in postoperative sensitivity in a parallel RCT. In total, 120 eligible, consenting adults were recruited in private dental practice and randomized into 2 groups of 60 patients. One group had room temperature composite restorations placed and the second had composite preheated to 39°C. The primary outcome was sensitivity after 24 h by the visual analog scale (VAS), recorded blind by patients. Secondary outcomes were VAS scores recorded over a month. Blind statistical analysis used the Mann-Whitney U test to compare the 24-h VAS score between groups and repeated-measures analysis of variance to assess the change over time. Potential confounders were tested using regression models. A total of 115 patients completed the trial: 57 in the heated composite group and 58 in the room temperature group. Analysis of 24-h VAS scores found no statistically significant difference between the 2 groups ( P = 0.162). Examining the potential confounders confirmed the nonsignificant difference between heated and room temperature groups on the 24-h VAS score, after controlling teeth type and preoperative pulp test (effect size = 0.173, P = 0.317). Analysis of the secondary outcomes found significant changes (within-subject effect) in VAS scores over the review period ( F statistic = 4.7, P = 0.002) but not a significant (between-subject effect) difference between heated and room temperature groups over time (effect size = 0.102, P = 0.197). There was a significant correlation between preoperative VAS score and postoperative VAS score ( P < 0.001). For the restorations in this study, there was no detectable difference in postoperative VAS score between preheated and room temperature composite. Postoperative sensitivity decreased throughout the first month. Postoperative sensitivity was correlated to preoperative sensitivity (ISRCTN 76727312). Knowledge Transfer Statement: The results of this study can be used by clinicians when considering the advantages and disadvantages of preheated composite. The study found no evidence of any change in postoperative sensitivity when using preheated composite. Since preheated composite has superior physical properties, its use for routine care can be considered good practice.
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Affiliation(s)
| | - J Kang
- 2 School of Dentistry, University of Leeds, Leeds, UK
| | - T P Hyde
- 2 School of Dentistry, University of Leeds, Leeds, UK
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Al-Rabab'ah MA, Bustani MA, Khraisat AS, Sawair FA. Phase down of amalgam. Awareness of Minamata convention among Jordanian dentists. Saudi Med J 2016; 37:1381-1386. [PMID: 27874155 PMCID: PMC5303778 DOI: 10.15537/smj.2016.12.16163] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess the knowledge of Jordanian dentists toward phase down of dental amalgam as recommended by the Minamata Convention, and their training and competency in placing posterior composites. Methods: This study was conducted through structured questionnaire interviews with randomly selected cohort of dentists in Jordan between March 2015 and June 2015. Out of 230 dentists who were invited, 196 (85.2%) agreed to participate. Dentists were asked if they know about the Minamata Convention. They were also asked about their training in placement of posterior composite. Results: Out of the 196 interviewed, only 13.8% know about Minamata Convention and 17% had an undergraduate training in favor of placing composites in posterior teeth. Approximately 50% of those dentists were not trained in using rubber dam when placing posterior composites, while only 38.3% had training in sectional matrix placement. Undergraduate training did not influence (p=0.00) the dentists' decision to remove old amalgam based on patient's demands. Only 28.1% were of the opinion of discontinuing the use of amalgam due to its alleged health and environmental hazards. There was no general agreement on the type of composite, liner, and bonding strategy when placing posterior composites. Conclusion: Dentists are not well informed on the Minamata Convention and the phase down of amalgam. Training in posterior composite placement should be given more room in undergraduate curriculum and continuous dental education.
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Affiliation(s)
- Mohammad A Al-Rabab'ah
- Conservative Dentistry Department, School of Dentistry, The University of Jordan, Amman, Jordan. E-mail.
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Austin R, Eliyas S, Burke FJT, Taylor P, Toner J, Briggs P. British Society of Prosthodontics Debate on the Implications of the Minamata Convention on Mercury to Dental Amalgam--Should our Patients be Worried? ACTA ACUST UNITED AC 2016; 43:8-10, 12-4, 16-8. [PMID: 27024898 DOI: 10.12968/denu.2016.43.1.8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In 2013, the Minamata Convention on Mercury called for a global phase-down of amalgam use, with a view to reduce environmental mercury pollution. This will significantly impact UK dentistry, given the still extensive use of amalgam in U.K. general dental practice. However, until now there has been little national discussion or debate. In Spring 2015, The British Society of Prosthodontics dedicated a significant part of its Annual Conference to debating the implications of this issue. Clinical case examples were discussed with audience interaction and voting facilitated using innovative Audience Response System Technology. A remarkable range of concerns and opinions were given. The debate elicited specific concerns amongst clinicians regarding the suitability of mercury-free alternatives to amalgam; particularly where cavities are large and extend beneath the gingival anatomy. There are also anecdotal reports of Dental Foundation (DF) dentists not being adequately taught the use of dental amalgam in undergraduate dental schools. CPD/CLINICAL RELEVANCE: Many clinicians, especially those treating patients for whom moisture control is challenging, feel that amalgam should remain available for clinicians to choose in certain clinical circumstances for the restoration of posterior teeth, even in the event of a complete phase-down.
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Golding J, Steer CD, Gregory S, Lowery T, Hibbeln JR, Taylor CM. Dental associations with blood mercury in pregnant women. Community Dent Oral Epidemiol 2015; 44:216-22. [PMID: 26688340 PMCID: PMC4840325 DOI: 10.1111/cdoe.12208] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 11/16/2015] [Indexed: 12/01/2022]
Abstract
Objectives There is curiosity concerning the source of mercury that is absorbed into the mother's blood and which may affect the developing fetus. This study therefore sets out to determine the extent to which dental amalgam (DA) may contribute to total blood mercury (TBHg) levels of pregnant women in the UK. Methods Whole blood samples and information on diet and socio‐demographic factors were collected from pregnant women (n = 4484) enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). The whole blood samples were assayed for total mercury levels using inductively coupled plasma dynamic reaction cell mass spectrometry (ICP‐DRC‐MS), and the women were retrospectively asked about features of their dental care during the pregnancy. Linear regression was used to estimate the relative contributions of DA to TBHg levels (log‐transformed) based on R2 values, compared to the results from dietary and socio‐demographic variables. Results The contribution to the variance of the mothers' TBHg levels by dental variables was 6.47%, a figure comparable to the 8.75% shown for seafood consumption in this population. Dietary and dental variables explained 20.16% of the variance, with socio‐demographic variables contributing only a further 3.40%. The number of amalgams in the mouth at the start of pregnancy accounted for most of the variance in dental variables. Conclusions Dental amalgam contributes a comparable amount of variance in TBHg to seafood consumption in this population. However, because the measures of DA exposure were imprecise, these findings are likely to be an underestimate. There is no evidence to date in the literature that fetal exposures to mercury from maternal DAs have adverse effects on the developing child, but long‐term studies are warranted.
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Affiliation(s)
- Jean Golding
- Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Colin D Steer
- Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Steven Gregory
- Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Tony Lowery
- National Seafood Inspection Laboratory, National Marine Fisheries Service, National Oceanic & Atmospheric Administration, Pascagoula, MS, USA
| | - Joseph R Hibbeln
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Caroline M Taylor
- Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, UK
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Burke FJT. Technique Tips--The Cost of One Post-Operative Sensitivity following Placement of a Posterior Composite Restoration. ACTA ACUST UNITED AC 2015; 42:692-3. [PMID: 26630871 DOI: 10.12968/denu.2015.42.7.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Use a low shrinkage stress composite but, if not, use incremental placement and a layer of flowable at the gingival box; Ensure good bonding to dentine and enamel and avoid (over) etching the dentine; Ensure good adaptation at the gingival floor of a Class II box; Make sure that the restoration has received sufficient light; Provide good isolation; Use reliable and tested materials throughout.
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Predictive factors on the efficacy and risk/intensity of tooth sensitivity of dental bleaching: A multi regression and logistic analysis. J Dent 2015; 45:1-6. [PMID: 26612623 DOI: 10.1016/j.jdent.2015.11.003] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/11/2015] [Accepted: 11/17/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of this study was to identify predictor factors associated with the whitening outcome and risk and intensity of bleaching-induced tooth sensitivity from pooled data of 11 clinical trials of dental bleaching performed by the same research group. METHODS The individual patient data of several published and ongoing studies about dental bleaching was collected and retrospectively analyzed. At the patient-level, independent variables (bleaching techniques [at-home and in-office protocols], sex, age and baseline tooth color in shade guide unit [SGU]) as well as dependent variables (color change in shade guide units (ΔSGU), color change in the CIEL*a*b* system (ΔE), risk and intensity of TS in a visual analog scale) were collected. Multivariable linear regression and multivariable logistic regression models were carried out using backward elimination whenever the p-values were higher than 0.05. RESULTS A significant relationship between baseline color and age on color change estimates was detected (p<0.001). Every increase of one SGU in the baseline color resulted in an increase of approximate 0.66 in the final ΔSGU and 2.48 for the ΔE. For every increase of one year in the participant's age we observed a decrease of the whitening degree of 0.07 for the final ΔSGU and 0.69 for the ΔE. The bleaching technique was shown to be a significant predictor of ΔSGU (p<0.001) but not of ΔE. In regard to TS, baseline color and bleaching technique are significant predictors (p<0.001). The risk of TS for at-home bleaching was 51% (95% CI 41.4-60.6) and for the in-office 62.9% (95% CI 56.9-67.3). CONCLUSIONS Younger patients with darker teeth reach a higher degree of whitening. Patient with darker teeth and submitted to at-home bleaching presents lower risk and intensity of TS. CLINICAL SIGNIFICANCE The baseline color of the teeth and the patient's age is directly related to the effectiveness of dental bleaching and TS.
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Trevor Burke FJ. Technique Tips - The Cost of One Defective Class II Contact (with a Posterior Composite). ACTA ACUST UNITED AC 2015; 42:589. [PMID: 26506819 DOI: 10.12968/denu.2015.42.6.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Managing the phase-down of amalgam: Part I. Educational and training issues. Br Dent J 2015; 215:109-13. [PMID: 23928599 DOI: 10.1038/sj.bdj.2013.737] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2013] [Indexed: 11/08/2022]
Abstract
Following the recently agreed Minamata Convention, a phase-down in the use of dental amalgam will become a priority for the profession. With a lead-in period of a number of years, important changes in the mind-set of the profession are required to ensure that patient safety is not compromised. Posterior composites have been a viable, and in many cases preferable, alternative to amalgam for many years. However, notwithstanding considerable developments in dental school teaching on the application and placement of posterior composites, growing evidence to support the use of composites in the restoration of posterior teeth and advances in composite systems, many practitioners remain reluctant to place composite rather than amalgam. This paper considers the present and future use of posterior composites and highlights ways in which dental school teaching and continuing professional development (CPD) may contribute to the successful phase-down, and now inevitable discontinuation, in the use of dental amalgam.
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Managing the phase-down of amalgam: part II. Implications for practising arrangements and lessons from Norway. Br Dent J 2015; 215:159-62. [PMID: 23969652 DOI: 10.1038/sj.bdj.2013.788] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2013] [Indexed: 11/08/2022]
Abstract
The announcement of the Minamata Convention has triggered the lead into a phase-down in the use of dental amalgam. This paper considers aspects of this development in the context of the experience of banning the use of dental amalgam in Norway. It is suggested that strong top-down leadership and joined-up working by all relevant stakeholders, including patients, may be one of the most important keys to an effective, seamless transition to the provision of preventatively orientated, patient-centred, minimally interventive operative dentistry, based on state-of-the-art selection and application of tooth-coloured restorative materials. The benefits of such a transition are considered to be an important goal for dentistry in the UK.
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Jordal K, Valen A, Örstavik D. Periapical status of root-filled teeth in Norwegian children and adolescents. Acta Odontol Scand 2014; 72:801-5. [PMID: 24931925 DOI: 10.3109/00016357.2014.913193] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To study the periapical status of root-filled permanent teeth of 9-17-year-olds in Møre & Romsdal county, Norway. MATERIALS AND METHODS All permanent teeth with endodontic treatment in patients born in 1994-2001 were identified in the dental records of the Public Dental Service. The data collected consisted of chart entries and radiographs. Of 1182 teeth, 174 teeth in 155 patients met further inclusion criteria, i.e. completed endodontic treatment and a follow-up with a readable radiograph of at least 1 year. Periapical status was assessed with the Periapical Index (PAI) and the technical quality of the root fillings was also quantified on a 4-grade visual scale. RESULTS Apical periodontitis was found on follow-up radiographs in 25% of all teeth and in 48% of the teeth with pre-operative apical periodontitis. Forty-two per cent of root fillings were of adequate technical quality. Adequate technical quality of the root filling was significantly correlated with radiographic success. CONCLUSIONS About one fourth of all root-filled teeth and almost half of the teeth with pre-operative apical periodontitis showed clear signs of the disease at recall.
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Affiliation(s)
- Kristin Jordal
- Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo , Norway
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Alexander G, Hopcraft MS, Tyas MJ, Wong RHK. Dentists' restorative decision-making and implications for an 'amalgamless' profession. Part 1: a review. Aust Dent J 2014; 59:408-19. [PMID: 25090909 DOI: 10.1111/adj.12209] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2014] [Indexed: 11/27/2022]
Abstract
The Minamata Convention has agreed to a worldwide reduction and ultimate elimination in the production and use of mercury containing products. This will have implications for the practice of dentistry. Australian organizations' pronouncements on the issue are limited and research examining the Australian context dated. The restoration of teeth with direct materials has changed significantly since the 1980s. Up to this time amalgam was the material of choice for direct posterior restorations. Its properties and guidelines for placement were, and remain, well established. Resin composite has replaced amalgam as the material of choice in many clinical situations. Despite inherent clinical disadvantages compared to amalgam, there continues to be a shift toward greater use of resin composite. There is consensus worldwide that the restoration of posterior teeth using resin composite now exceeds that of amalgam. The reasons for this are reviewed in this article along with current evidence and commentary relating to direct restorative and evidence-based decision-making, minimally invasive approaches, and approaches to education. The implications for these in an 'amalgamless' profession are identified.
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Affiliation(s)
- G Alexander
- Melbourne Dental School, The University of Melbourne, Victoria; Department of Dentistry and Oral Health, La Trobe University, Victoria
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Lee RJ, Bayne A, Tiangco M, Garen G, Chow AK. Prevention of tea-induced extrinsic tooth stain. Int J Dent Hyg 2014; 12:267-72. [DOI: 10.1111/idh.12096] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2014] [Indexed: 11/28/2022]
Affiliation(s)
- RJ Lee
- Faculty of Medicine and Dentistry; School of Dentistry; University of Alberta; Edmonton AB Canada
| | - A Bayne
- Faculty of Medicine and Dentistry; School of Dentistry; University of Alberta; Edmonton AB Canada
| | - M Tiangco
- Faculty of Medicine and Dentistry; School of Dentistry; University of Alberta; Edmonton AB Canada
| | - G Garen
- Faculty of Medicine and Dentistry; School of Dentistry; University of Alberta; Edmonton AB Canada
| | - AK Chow
- Faculty of Medicine and Dentistry; School of Dentistry; University of Alberta; Edmonton AB Canada
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The teaching of posterior resin composites: Planning for the future based on 25 years of research. J Dent 2014; 42:503-16. [DOI: 10.1016/j.jdent.2014.02.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 02/20/2014] [Indexed: 11/19/2022] Open
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Donovan TE, Anderson M, Becker W, Cagna DR, Carr GB, Albouy JP, Metz J, Eichmiller F, McKee JR. Annual Review of selected dental literature: Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2013; 110:161-210. [DOI: 10.1016/s0022-3913(13)60358-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Gli intarsi adesivi per il restauro dei denti posteriori trattati endodonticamente. GIORNALE ITALIANO DI ENDODONZIA 2012. [DOI: 10.1016/j.gien.2012.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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D'Cruz L. A fascinating insight. Br Dent J 2012; 212:356. [DOI: 10.1038/sj.bdj.2012.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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