1
|
Girotto LPDS, Chisini LA, Lynch CD, Blum IR, Wilson NH, Sarkis-Onofre R, Carvalho RVD, van de Sande FH. Teaching of composite restoration repair in Brazilian dental schools. J Dent 2023; 130:104410. [PMID: 36626975 DOI: 10.1016/j.jdent.2023.104410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The aim was to investigate aspects of the teaching of restoration repair as a minimally invasive alternative to replacing defective direct composite restorations in undergraduate curricula teaching programs in Brazilian dental schools. METHODS A 14-item validated survey questionnaire was mailed to directors/coordinators of operative/restorative dentistry teachers of Brazilian Dental Schools. Data were collected on demographic characteristics of the teachers and institutions, together with questions on the teaching of the repair of defective resin-based composite restorations as part of the school curriculum; the rationale behind the teaching; the nature of the teaching (preclinical and/or clinical); how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability and expected longevity of completed repairs. RESULTS Two hundred and twenty-two (94%) directors/ coordinators of dental curricula in Brazil were contacted. One hundred and thirty-one directors/coordinators (59%) replied, providing the e-mail address from the teacher responsible for the operative/restorative dentistry program in their school. Of these, 104 responded to the questionnaire (79% response rate). Ninety-three (89%) of the participating schools reported teaching composite repairs as an alternative to replacing restorations. Of the theoretical content, 43% was taught at preclinical and clinical levels, whereas most practical experience (53%) was acquired at clinical levels. Eighty-eight schools (95%) reported tooth substance preservation being the main reason for teaching repair techniques. All schools that taught repairs reported high patient acceptability. CONCLUSIONS The teaching of composite restoration repair as an alternative to restoration replacement is established in undergraduate programs in most of the Brazilian dental schools surveyed. CLINICAL SIGNIFICANCE The reasons for teaching restoration repair in Brazil were found to be quite unanimous among teachers, especially regarding the preservation of tooth structure. Variations were found in the clinical indications for repair, suggesting the need for further investigations. Monitoring repaired restorations should be encouraged and could contribute to future studies.
Collapse
Affiliation(s)
| | - Luiz Alexandre Chisini
- Department of Dentistry, Institute of Health Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil.
| | - Christopher D Lynch
- Cork University Dental School & Hospital, University College Cork, Cork, Ireland.
| | - Igor R Blum
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom.
| | - Nairn Hf Wilson
- College of General Dentistry, 124 City Road, London, EC1V2NX United Kingdom.
| | - Rafael Sarkis-Onofre
- Graduate Program in Dentistry, Atitus Educação, Passo Fundo, Rio Grande do Sul, Brazil.
| | - Rodrigo Varella de Carvalho
- Department of Dentistry, Institute of Health Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil.
| | - Françoise Hélène van de Sande
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
| |
Collapse
|
2
|
Nassar M, Al-Fakhri O, Shabbir N, Islam MS, Gordan VV, Lynch CD, Wilson NH, Blum IR. Teaching of the repair of defective composite restorations in Middle Eastern and North African Dental Schools. J Dent 2021; 112:103753. [PMID: 34339798 DOI: 10.1016/j.jdent.2021.103753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 07/15/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate the status of teaching of repair of defective resin-based composite restorations in dental schools in the Middle Eastern and North African (MENA) countries. METHODS A validated 14-item questionnaire was mailed to the directors of the operative/restorative dentistry department in 40 MENA dental schools. Data were collected on teaching, including whether the repair of resin-based composite restorations was part of the dental school curriculum; the rationale behind the teaching; how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability and expected longevity of the repair procedure. RESULTS Thirty-two schools responded to the survey (response rate of 80%). Twenty-two (69%) schools reported the teaching of resin-based composite repairs as an alternative to the replacement of restorations. Of the schools not teaching repairs, 80% indicated that they plan to include this topic in the curriculum within the next five years. Most schools taught theoretical and practical aspects of repair at a clinical level only. Two-thirds of schools reported tooth substance preservation being the main reason for teaching repair techniques. The main indications for repair treatment were marginal defects (59%), followed by partial loss of restoration (56%). Most schools that performed repairs reported high patient acceptability. Considerable variation was noted in relation to expected longevity of resin- based composite repairs. CONCLUSIONS The repair of defective resin-based composite restorations is actively taught within most of the surveyed schools. Advantages of repair, compared to replacement include minimum intervention, preservation of tooth structure, and savings of time and cost. CLINICAL SIGNIFICANCE The decision between replacing or repairing a defective resin-based composite restoration in the MENA region tends to be based on clinicians' subjective experience and judgement. However, to further enhance the teaching of resin-based composite repair standardised guidelines need to be developed based on existing evidence.
Collapse
Affiliation(s)
- Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ola Al-Fakhri
- Ras Al Khaimah College of Dental Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Nafisa Shabbir
- Ras Al Khaimah College of Dental Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Md Sofiqul Islam
- Ras Al Khaimah College of Dental Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Valeria V Gordan
- Department of Restorative Dental Sciences, Operative Dentistry Division, College of Dentistry, University of Florida, Gainesville, FL, United States
| | - Christopher D Lynch
- Cork University Dental School & Hospital, University College Cork, Wilton, Cork, Ireland
| | | | - Igor R Blum
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom.
| |
Collapse
|
3
|
Kanzow P, Wiegand A. Teaching of composite restoration repair: Trends and quality of teaching over the past 20 years. J Dent 2020; 95:103303. [DOI: 10.1016/j.jdent.2020.103303] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 11/30/2022] Open
|
4
|
Kiran R, Chapman J, Tennant M, Forrest A, Walsh LJ. Fluorescence-aided selective removal of resin-based composite restorative materials: An in vitro comparative study. J ESTHET RESTOR DENT 2019; 32:310-316. [PMID: 31618521 DOI: 10.1111/jerd.12536] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/17/2019] [Accepted: 09/26/2019] [Indexed: 11/29/2022]
Abstract
AIM During removal of resin-based composite (RBC) restorations, removal of adjacent sound tooth structure can easily occur. The aim of the study was to compare the fluorescence-aided identification of restorations (FAIR) method with the conventional method (CM) using white light illumination for the selective removal of tooth-colored RBC restorations. MATERIALS AND METHODS Sixty extracted teeth were used to prepare 15 sets of models, each with four teeth. Cavities were prepared in each tooth and a digital three-dimensional scan of each model was taken in STL format. The teeth were then restored with either Admira Fusion, GRADIA DIRECT X, or TPH Spectra LV (20 teeth for each). Five dentists removed the restorations from sets of 12 teeth (six each using FAIR, and six using CM). From a postoperative scan, changes in intercuspal cavity width were measured using the 3D tool CAD software. RESULTS Using FAIR, changes in cavity width were not significant (P = .17), and there was no significant interoperator variance (P = .3). In contrast, when using CM, there was a significant increase in cavity width (P = .0025), and considerable interoperator variance (P = .03). FAIR allowed faster completion of the task of restoration removal (average time 100.23 seconds, vs 165.13 seconds from CM). CONCLUSION The FAIR method facilitates the selective removal of tooth-colored RBC restorations, with reduced time and less inadvertent removal of sound tooth structure. CLINICAL SIGNIFICANCE By enhancing the differentiation between the restorative material and adjacent tooth structure, the FAIR method facilitates removal of tooth-colored restorations, while concurrently prevents unnecessary removal of healthy tooth structure. The same approach may have applications for removal of resin-based materials such as resin cements under restorations, resin fissure sealants, and orthodontic brackets bonding resins.
Collapse
Affiliation(s)
- Ramya Kiran
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - James Chapman
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia.,School of Science, RMIT University, Melbourne, Victoria, Australia
| | - Marc Tennant
- International Research Collaborative, Oral Health and Equity, School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Alexander Forrest
- The University of Queensland School of Dentistry, UQ Oral Health Centre, Herston, Queensland, Australia
| | - Laurence J Walsh
- The University of Queensland School of Dentistry, UQ Oral Health Centre, Herston, Queensland, Australia
| |
Collapse
|
5
|
Martos R, Hegedüs V, Szalóki M, Blum IR, Lynch CD, Hegedüs C. A randomised controlled study on the effects of different surface treatments and adhesive self-etch functional monomers on the immediate repair bond strength and integrity of the repaired resin composite interface. J Dent 2019; 85:57-63. [PMID: 31054292 DOI: 10.1016/j.jdent.2019.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/26/2019] [Accepted: 04/30/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To evaluate the effects of different surface conditioning methods on the immediate repair bond strength and integrity of the repaired composite interface. METHODS One hundred and five resin composite blocks made of a nanohybrid resin composite were randomly assigned to one of the following surface conditioning groups (n = 15/group): Group 1: Gluma Self Etch™ adhesive system, Group 2: Tokuyama Bond Force II™ adhesive system, Group 3: non-roughened and non-conditioned surfaces, Group 4: sandblasting and Gluma Self Etch™, Group 5: sandblasting and Tokuyama Bond Force II™, Group 6: sandblasting only. A positive control group was also used. Resin composite identical to the substrate was applied and the repaired specimens were subjected to shear bond strength (SBS) testing. Representative samples from all groups were subjected to scanning electron microscopy and surface profilometry to determine their mode of failure. The data were analysed statistically using Analysis of Variance (ANOVA) and two independent sample t-test (α = 0.05). RESULTS The mean SBS of all test groups ranged between 1.92 and 5.40 MPa and varied with the degree of composite surface roughness and the type of adhesive system employed. Significantly highest SBS values (5.40 ± 0.36 MPa) were obtained in Group 5 (p = 0.017) which were comparable to the coherent strength of the resin composite in the positive control group (p > 0.05). CONCLUSIONS Under the tested conditions, significantly greater SBS of repaired resin composite was achieved when the substrate surface was conditioned by sandblasting followed by the application of the Tokuyama Bond Force II™ adhesive system. CLINICAL SIGNIFICANCE Effecting a repair of a nanohybrid composite restoration with sandblasting and the application of TBF II would seem to enhance the interfacial bond strength and integrity of the repaired resin composite interface. Clinical trials are necessary to determine the usefulness of this technique.
Collapse
Affiliation(s)
- Renata Martos
- Department of Restorative Dentistry, Faculty of Dentistry, University of Debrecen, Hungary.
| | - Viktória Hegedüs
- Department of Orthodontics, Faculty of Dentistry, University of Debrecen, Hungary.
| | - Melinda Szalóki
- Department of Biomaterials and Prosthetic Dentistry, Faculty of Dentistry, University of Debrecen, Hungary.
| | - Igor R Blum
- Department of Primary Dental Care & Outreach, Faculty of Dentistry, Craniofacial & Oral Sciences, King's College London, UK.
| | - Christopher D Lynch
- Department of Restorative Dentistry, University Dental School & Hospital, University College Cork, Ireland.
| | - Csaba Hegedüs
- Department of Biomaterials and Prosthetic Dentistry, Faculty of Dentistry, University of Debrecen, Hungary.
| |
Collapse
|
6
|
|
7
|
Blum IR. Restoration Repair as a Contemporary Approach to Tooth Preservation: Criteria for Decision Making and Clinical Recommendations. Prim Dent J 2019; 8:38-42. [PMID: 31122330 DOI: 10.1308/205016819826439466] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite the growing body of evidence-based knowledge, evidence-based restoration repair is not always applied in the clinical setting. This article is intended to give an evidence-based insight into the indications, importance, benefits and long-term success of resin composite restoration repair, together with details of relevant operative techniques aimed at conserving as much sound tooth structure as possible.
Collapse
|
8
|
Repair increases the survival of failed primary teeth restorations in high-caries risk children: a university-based retrospective study. Clin Oral Investig 2019; 24:71-77. [PMID: 31016542 DOI: 10.1007/s00784-019-02899-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 04/04/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES We investigated factors associated with failure of adhesive restorations in primary teeth and whether repair may increase the survival of failed restorations placed in high-caries risk children. MATERIALS AND METHODS The sample comprised children who attended a university dental service to perform restorative treatment in primary teeth. Data were collected retrospectively from clinical records to assess the longevity of restorations. The outcomes were calculated in two levels: "Success" (Level 1)-when any re-intervention was considered as failure; "Survival" (Level 2)-when repaired restorations were considered clinically acceptable. The Kaplan-Meier survival test was used to analyze the longevity of restorations. Multivariate Cox regression with shared frailty was used to assess factors associated with failures (p < 0.05). RESULTS A total of 584 primary teeth restorations (178 patients) were included in the analysis. The longevity of restorations up to 36 months (Level 1) was 34.8% (AFR 29.6%). Multi-surface restorations showed significantly more failures than single-surface ones (HR 1.69; 95% CI 1.18, 2.41), and endodontically treated teeth presented more failures compared to vital teeth (HR 2.22; 95% CI 1.35, 3.65). There was an increase in restoration survival when repair was not considered as failure (p < 0.001). The survival of repaired restorations (Level 2) reached 43.7% (AFR 24.1%). CONCLUSIONS Adhesive restorations placed in primary teeth of high-caries risk children showed restricted longevity; however, the repair of failed restorations has increased its survival over time. CLINICAL RELEVANCE Repair is a more conservative and technically simple procedure that increases the survival of failed restorations in primary teeth.
Collapse
|
9
|
Abstract
Purpose of Review Defective dental restorations are amongst the most common encounters in general dental practice. Replacement of defective restorations is often costly and commonly results in the sacrifice of sound tooth structure, thereby compromising the vitality of the dental pulp, potentially resulting in the acceleration of the restoration cycle and premature loss of the restored tooth. With advances in adhesive dentistry, ‘reparative dentistry’ is becoming an important area of minimally invasive dentistry. This article highlights the detrimental biological effects of restoration replacement and provides an overview of current knowledge and understanding of restoration repair as a safe and effective alternative approach to replacement. Recent Findings The literature reviewed showed that a growing body of evidence from clinical studies indicates that repaired restorations have similar survival outcomes in patients with low and medium caries risk compared to replaced restorations and are clinically acceptable over a 12-year follow-up of clinical service. Teeth with repaired restorations are less likely to require aggressive interventions such as endodontic treatment or extraction compared to those with replaced restorations. Summary Repair options should be carried out wherever possible as minimally interventional procedures in order to increase the longevity of the remaining part of the restoration and the restored tooth unit. Restoration replacement should be considered as the last resort when there are no other viable alternatives.
Collapse
Affiliation(s)
- Igor Robert Blum
- 1King's College Hospital & King's College London Dental Institute, Division of Primary Dental Care and Maurice Wohl Dental Centre, Department of Restorative Dentistry, University of London, Bessemer Road, Denmark Hill, London, SE5 9RS UK
| | - Mutlu Özcan
- 2Division of Dental Materials, Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, University of Zurich, Zurich, Switzerland
| |
Collapse
|
10
|
Kanzow P, Wiegand A, Wilson NH, Lynch CD, Blum IR. Contemporary teaching of restoration repair at dental schools in Germany – Close to universality and consistency. J Dent 2018; 75:121-124. [DOI: 10.1016/j.jdent.2018.06.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 06/18/2018] [Indexed: 01/19/2023] Open
|
11
|
Kaisarly D, El Gezawi M, Xu X, Rösch P, Kunzelmann KH. Shrinkage vectors of a flowable composite in artificial cavity models with different boundary conditions: Ceramic and Teflon. J Mech Behav Biomed Mater 2017; 77:414-421. [PMID: 29020664 DOI: 10.1016/j.jmbbm.2017.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/28/2017] [Accepted: 10/02/2017] [Indexed: 10/18/2022]
Abstract
Polymerization shrinkage of dental resin composites leads to stress build-up at the tooth-restoration interface that predisposes the restoration to debonding. In contrast to the heterogeneity of enamel and dentin, this study investigated the effect of boundary conditions in artificial cavity models such as ceramic and Teflon. Ceramic serves as a homogenous substrate that provides optimal bonding conditions, which we presented in the form of etched and silanized ceramic in addition to an etched, silanized and bonded ceramic cavity. In contrast, the Teflon cavity presented a non-adhesive boundary condition that provided an exaggerated condition of poor bonding as in the case of contamination during the application procedure or a poor bonding substrate such as sclerotic or deep dentin. The greatest 3D shrinkage vectors and movement in the axial direction were observed in the ceramic cavity with the bonding agent followed by the silanized ceramic cavity, and smallest shrinkage vectors and axial movements were observed in the Teflon cavity. The shrinkage vectors in the ceramic cavities exhibited downward movement toward the cavity bottom with great downward shrinkage of the free surface. The shrinkage vectors in the Teflon cavity pointed towards the center of the restoration with lateral movement greater at one side denoting the site of first detachment from the cavity walls. These results proved that the boundary conditions, in terms of bonding substrates, significantly influenced the shrinkage direction.
Collapse
Affiliation(s)
- Dalia Kaisarly
- Department of Operative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; Biomaterials Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
| | - Moataz El Gezawi
- Department of Restorative Dentistry, University of Dammam, Dammam, Saudi Arabia
| | - Xiaohui Xu
- Department of Operative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Peter Rösch
- Faculty of Computer Science, University of Applied Sciences, Augsburg, Germany
| | - Karl-Heinz Kunzelmann
- Department of Operative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| |
Collapse
|
12
|
Kanzow P, Wiegand A, Göstemeyer G, Schwendicke F. Understanding the management and teaching of dental restoration repair: Systematic review and meta-analysis of surveys. J Dent 2017; 69:1-21. [PMID: 28943362 DOI: 10.1016/j.jdent.2017.09.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 09/19/2017] [Accepted: 09/20/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Repair instead of complete replacement is recommended to manage partially defective restorations. It is unclear if and why such treatment is taught at dental schools or practiced by dentists. We aimed to identify barriers and facilitators for repairs using a systematic review and meta- and qualitative analysis. SOURCES Electronic databases (PubMed, CENTRAL, Embase, PsycINFO) were searched. STUDY SELECTION Quantitative studies reporting on the proportion of (1) dentists stating to perform repairs, (2) dental schools teaching repairs, (3) failed restorations having been repaired were included. We also included qualitative studies on barriers/facilitators for repairs. Random-effects meta-analyses, meta-regression and a thematic analysis using the theoretical domains framework were conducted. DATA 401 articles were assessed and 29, mainly quantitative, studies included. 7228 dentists and 276 dental schools had been surveyed, and treatment data of 30,172 restorations evaluated. The mean (95% CI) proportion of dentists stating to perform repairs was 71.5% (49.7-86.4%). 83.3% (73.6-90.0%) of dental schools taught repairs. 31.3% (26.3-36.7%) of failed restorations had been repaired. More recent studies reported significantly more dentists to repair restorations (p=0.004). Employment in public health practices and being the dentist who placed the original restoration were facilitators for repairs. Amalgam restorations were repaired less often, and financial aspects and regulations came as barriers. CONCLUSIONS While most dentists state to perform repairs and the vast majority of dental schools teach repairs, the proportion of truly repaired restorations was low. A number of interventions to implement repair in dental practice can be deduced from our findings. CLINICAL SIGNIFICANCE Partially defective restorations are common in dental practice. While repairs are taught and dentists are aware of the recommendation towards repairs, the actually performed proportion of repairs seems low.
Collapse
Affiliation(s)
- Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany; Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Germany.
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany
| | - Gerd Göstemeyer
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Germany
| |
Collapse
|
13
|
Casagrande L, Laske M, Bronkhorst EM, Huysmans MCD, Opdam NJ. Repair may increase survival of direct posterior restorations – A practice based study. J Dent 2017; 64:30-36. [DOI: 10.1016/j.jdent.2017.06.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/04/2017] [Accepted: 06/06/2017] [Indexed: 11/27/2022] Open
|
14
|
Maria A, Charikleia P, Panagiotis L. Attitudes of Greek dentists towards repair of conservative restorations. An online survey. Int Dent J 2017; 67:351-359. [PMID: 28736971 DOI: 10.1111/idj.12319] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Repair versus replacement of a defective direct restoration is one important step for conserving tooth structure. This study was designed to collect information on the attitudes of Greek dentists towards repairing direct restorations. METHODS An electronic questionnaire with 16 multiple-choice and rank-ordering questions was created online and its URL address was randomly emailed to 800 dentists in the area of Athens, Greece. The questionnaire remained open for 3 months, and after two reminder emails the data collected were analysed statistically to identify differences between clinician's sex or years of practicing dentistry, using the chi-square and Kruskal-Wallis tests at α = 0.05. RESULTS Three-hundred and twenty dentists completed and submitted the questionnaire (response rate = 40%). A high proportion (86.8%) of the respondents reported that they routinely repair defective restorations, ranking the order of their frequency as 2.47 for amalgam and 2.41 for resin restorations. The reasons, with the highest ranks, for repairing amalgams were the restoration of bulk fractures (4.10) and restoration of marginal fractures (3.69). For repair of resin restorations, the reasons with the highest ranks were improving their colour (4.04) and removing marginal discoloration (3.99). Moreover, 94.1% of the respondents stated that they were enough, much and very much satisfied with the repair, 1 year after it was performed. CONCLUSIONS A high percentage of Greek dentists are repairing defective direct restorations. There are discrepancies in the indications, techniques and materials used for repairs, such as bulk fractures and marginal restorations. Further studies on the efficacy of repairs, the criteria and procedure protocols are needed. Further, additional clinical education should be offered at the undergraduate or continuing education levels.
Collapse
Affiliation(s)
- Antoniadou Maria
- Department of Operative Dentistry, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Paximada Charikleia
- Department of Operative Dentistry, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Lagouvardos Panagiotis
- Department of Operative Dentistry, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
15
|
Ruschel VC, Stolf SC, Shibata S, Baratieri LN. A Conservative Technique for Repairing Class IV Composite Restorations. Oper Dent 2017; 42:E10-E15. [DOI: 10.2341/15-316-t] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Composite resin may make a restoration noticeable as time passes, on account of its color instability. The repair technique is a minimally invasive treatment for class IV composite resin restorations that show unsatisfactory coloration. Thus, the objective of the present article was to report a clinical case involving a conservative technique used for repairing a class IV composite resin restoration in the left maxillary central incisor and the replacement of a class IV restoration in the right maxillary central incisor.
Collapse
Affiliation(s)
- VC Ruschel
- Vanessa Carla Ruschel, DDS, MSD, PHD, Federal University of Santa Catarina, Operative Dentistry, Florianopolis, Brazil
| | - SC Stolf
- Sheila Cristina Stolf, DDS, MS, PhD, Federal University of Santa Catarina, Operative Dentistry, Florianopolis, Brazil
| | - S Shibata
- Shizuma Shibata, DDS, MSD, PhD, Federal University of Santa Catarina, Operative Dentistry, Florianópolis, Brazil
| | - LN Baratieri
- Luiz Narciso Baratieri, DDS, MSD, PhD, Federal University of Santa Catarina, Operative Dentistry, Florianopolis, Brazil
| |
Collapse
|
16
|
Wilson N, Lynch CD, Brunton PA, Hickel R, Meyer-Lueckel H, Gurgan S, Pallesen U, Shearer AC, Tarle Z, Cotti E, Vanherle G, Opdam N. Criteria for the Replacement of Restorations: Academy of Operative Dentistry European Section. Oper Dent 2016; 41:S48-S57. [PMID: 27689930 DOI: 10.2341/15-058-o] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The replacement of a restoration is one of the most common procedures in dentistry. However, the criteria for such intervention, excluding catastrophic failure and persistent discomfort and pain, continue to be the subject of considerable debate. The decision-making process remains subjective on the part of the treating clinician, while the evidence base for refurbishment and repair rather than replacement for the management of defective and failing restorations continues to grow and strengthen. This article, prepared as an Academy of Operative Dentistry European Section consensus publication, reviews existing criteria for the replacement of restorations and encourages practitioners to shift, if not already doing so, to considering the replacement of a restoration as a last resort rather than as a prudent action to be taken if in any doubt about clinical acceptability. Further research in the area, spanning the risk assessment of defective and failing restorations and new diagnostic tools and processes, together with work to enhance the evidence base of restoration repair vs replacement, would be of immense value.
Collapse
|
17
|
Attitudes, practice, and experience of German dentists regarding repair restorations. Clin Oral Investig 2016; 21:1087-1093. [DOI: 10.1007/s00784-016-1859-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 05/20/2016] [Indexed: 10/21/2022]
|
18
|
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.
Collapse
|
19
|
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.
Collapse
|
20
|
Tantbirojn D, Fernando C, Versluis A. Failure Strengths of Composite Additions and Repairs. Oper Dent 2015; 40:364-71. [DOI: 10.2341/14-042-l] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Purpose
When adding composite to a cured composite restoration, the intent is to achieve the same failure strength as the original restorative material. This study evaluated the failure strengths of added or repaired composite using various chemical and/or mechanical surface treatments.
Methods
Failure strengths were determined using a four-point bending test. Beam-shaped specimens were fabricated by adding new composite to cured composite (Filtek Supreme Ultra). The cured composites were either fresh or aged seven days (N=10-14). The composite surfaces were left unground or were ground before treatment with various combinations of roughening, acid etching, silane, and dental adhesives (conventional Adper SingleBond Plus or new multimode Scotchbond Universal) and/or tribochemistry (CoJet system). Monolithic composite specimens were the control. Failure strengths were statistically analyzed using one-way analysis of variance and the Fisher protected least significant difference (α=0.05).
Results
Failure strengths (mean ± standard deviation) when composite was added to unground freshly cured composites (111±25 MPa) and aged composites using a new multimode adhesive with (102±22 MPa) or without (98±22 MPa) tribochemical treatment were not significantly lower than the monolithic specimens (122±23 MPa). Grinding the surfaces of freshly cured composite significantly reduced failure strength, either with (81±30 MPa) or without (86±31 MPa) use of conventional adhesive. Failure strengths of aged composites were also significantly lower (51±21 MPa with SingleBond Plus), even after tribochemical treatment (71±29 MPa with SingleBond Plus; 73±35 MPa with Silane-Visiobond).
Conclusions
Using a new multimode adhesive when adding composite to freshly cured or aged composite substrates recovered the failure strength to that of the original monolithic composite.
Collapse
Affiliation(s)
- D Tantbirojn
- Daranee Tantbirojn, DDS, MS, PhD, Department of Restorative Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - C Fernando
- Christini Fernando, BS, Biology Department, School of Sciences, Christian Brothers University, Memphis, TN, USA
| | - A Versluis
- Antheunis Versluis, PhD, Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| |
Collapse
|
21
|
Donovan TE, Marzola R, Becker W, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP. Annual review of selected scientific literature: report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2014; 112:1038-87. [PMID: 25443419 DOI: 10.1016/j.prosdent.2014.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 09/02/2014] [Accepted: 09/02/2014] [Indexed: 12/14/2022]
Affiliation(s)
- Terence E Donovan
- Chair, Committee on Scientific Investigation, American Academy of Restorative Dentistry (AARD); Professor and Section Head for Biomaterials, Department of Operative Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | | | - William Becker
- Clinical Professor, Advanced Education in Prosthodontics, Herman Ostrow School of Dentistry, University of Southern California; private practice, Tucson, Ariz
| | - David R Cagna
- Associate Dean, Professor and Director, Advanced Prosthodontics, University of Tennessee, Health Science Center, College of Dentistry, Memphis, Tenn
| | | | | | | | | |
Collapse
|
22
|
Fernández E, Martín J, Vildósola P, Oliveira Junior OB, Gordan V, Mjor I, Bersezio C, Estay J, de Andrade MF, Moncada G. Can repair increase the longevity of composite resins? Results of a 10-year clinical trial. J Dent 2014; 43:279-86. [PMID: 24907560 DOI: 10.1016/j.jdent.2014.05.015] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 05/25/2014] [Accepted: 05/27/2014] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of this double-blind clinical trial was to assess the longevity of repairs to localized clinical defects in composite resin restorations that were initially planned to be treated with a restoration replacement. METHODS Twenty-eight patients aged 18-80 years old with 50 composite resin restorations (CR) were recruited. The restorations with localized, marginal, anatomical deficiencies and/or secondary caries adjacent to CR that were "clinically judged" to be suitable for repair or replacement according to the USPHS criteria were randomly assigned to Repair (n=25) or Replacement (n=25) groups, and the quality of the restorations was scored according to the modified USPHS criteria. The restorations were blind and two examiners scored them at baseline (Cohen Kappa agreement score 0.74) and at ten years (Cohen Kappa agreement score 0.87) restorations. Wilcoxon tests were performed for comparisons within the same group (95% CI), and Friedman tests were utilized for multiple comparisons between the different years within each group. RESULTS Over the decade, the two groups behaved similarly on the parameters of marginal adaptation (MA) (p>0.05), secondary caries (SC) (p>0.05), anatomy (A) (p<0.05), and colour (C) (p>0.05). CONCLUSIONS Given that the MA, SC, A and C parameters behaved similarly in both groups, the repair of composite resins should be elected when clinically indicated, because it is a minimally invasive treatment that can consistently increase the longevity of restorations. CLINICAL SIGNIFICANCE The repair of defective composite resins as an alternative treatment to increase their longevity proved to be a safe and effective treatment in the long term.
Collapse
Affiliation(s)
- E Fernández
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile; Department of Restorative Dentistry, School of Dentistry, University Estadual Paulista-Unesp, Rua Humaitá 1680, Centro, Araraquara, CEP: 14801-903, Brazil.
| | - J Martín
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile; Department of Restorative Dentistry, School of Dentistry, University Estadual Paulista-Unesp, Rua Humaitá 1680, Centro, Araraquara, CEP: 14801-903, Brazil
| | - P Vildósola
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile; Department of Restorative Dentistry, School of Dentistry, University Estadual Paulista-Unesp, Rua Humaitá 1680, Centro, Araraquara, CEP: 14801-903, Brazil
| | - O B Oliveira Junior
- Department of Restorative Dentistry, School of Dentistry, University Estadual Paulista-Unesp, Rua Humaitá 1680, Centro, Araraquara, CEP: 14801-903, Brazil
| | - V Gordan
- Restorative Dental Sciences Department, Division of Operative Dentistry, University of Florida, College of Dentistry, PO Box 100415, Gainesville, FL 32610-0415, United States.
| | - I Mjor
- Restorative Dental Sciences Department, Division of Operative Dentistry, University of Florida, College of Dentistry, PO Box 100415, Gainesville, FL 32610-0415, United States
| | - C Bersezio
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile; Department of Restorative Dentistry, School of Dentistry, University Estadual Paulista-Unesp, Rua Humaitá 1680, Centro, Araraquara, CEP: 14801-903, Brazil
| | - J Estay
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile; Department of Restorative Dentistry, School of Dentistry, University Estadual Paulista-Unesp, Rua Humaitá 1680, Centro, Araraquara, CEP: 14801-903, Brazil
| | - M F de Andrade
- Department of Restorative Dentistry, School of Dentistry, University Estadual Paulista-Unesp, Rua Humaitá 1680, Centro, Araraquara, CEP: 14801-903, Brazil
| | - G Moncada
- Department of Restorative Dentistry, School of Dentistry, University Estadual Paulista-Unesp, Rua Humaitá 1680, Centro, Araraquara, CEP: 14801-903, Brazil; Faculty of Dentistry, Universidad Mayor, Alameda 2001, Santiago, Chile
| |
Collapse
|
23
|
Lynch CD, Opdam NJ, Hickel R, Brunton PA, Gurgan S, Kakaboura A, Shearer AC, Vanherle G, Wilson NH. Guidance on posterior resin composites: Academy of Operative Dentistry - European Section. J Dent 2014; 42:377-83. [DOI: 10.1016/j.jdent.2014.01.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 01/13/2014] [Indexed: 11/30/2022] Open
|