Performance of resin composite restorations placed in high caries risk children: a clinical retrospective study / Rendimiento de las restauraciones de resina compuesta colocadas en niños con alto riesgo de caries: un estudio clínico retrospectivo

Background: Resin composite has been usually used for restoring primary teeth. Nevertheless, there is a lack of supporting clinical data regarding the survival of resin composite restorations and risk factors that may dictate the service time of the treatment in children. Aim: To evaluate the survival and factors associated with composite resin restoration failure in high caries risk children treated under risk-factor management clinical protocol for dental caries prior to restorative therapy. Design: A total of 230 restorations in primary teeth from records of 48 patients were included in the study. Restoration longevity, up to 3-year follow-up, was assessed using the Kaplan-Meier survival test. Multivariate Cox regression analysis with shared frailty was used to evaluate the factors associated with failures (p<0.05). Results: Mean survival time was 2.7 -year (95 percent CI: 0.75-0.87). Restoration survival reached 82.5 percent up to 3-year evaluation, with an overall annual failure rate of 6.2 percent. The unadjusted model showed restorations performed in children with dmf-t greater than 10 had more restoration failure risk (HR 5.59, 95 percent CI 1.03-30.34; p=0.04) However, this association lost significance in the adjusted analysis (p=0.08). Conclusions: Composite resin restorations in primary teeth presented satisfactory survival after 3-year follow-up (AU)

Antecedentes: El composite de resina se ha utilizado habitualmente para restaurar dientes primarios. Sin embargo, se carece de datos clínicos de apoyo sobre la supervivencia de las restauraciones de resina compuesta y los factores de riesgo que pueden dictar el tiempo de servicio del tratamiento en los niños. Objetivo: Evaluar la supervivencia y los factores asociados al fracaso de las restauraciones de resina compuesta en niños con alto riesgo de caries tratados con un protocolo clínico de gestión de factores de riesgo de caries dental antes del tratamiento restaurador. Diseño: Se incluyeron en el estudio un total de 230 restauraciones en dientes primarios de registros de 48 pacientes. La longevidad de las restauraciones, hasta los 3 años de seguimiento, se evaluó mediante la prueba de supervivencia de Kaplan-Meier. Se utilizó un análisis multivariante de regresión de Cox con fragilidad compartida para evaluar los factores asociados a los fracasos (p<0,05). Resultados: El tiempo medio de supervivencia fue de 2,7 -años (IC95 por ciento: 0,75-0,87). La supervivencia de la restauración alcanzó el 82,5 por ciento hasta la evaluación a los 3 años, con una tasa global anual de fracasos del 6,2 por ciento. El modelo no ajustado mostró que las restauraciones realizadas en niños con dmf-t superior a 10 tenían más riesgo de fracaso de la restauración (HR 5,59; IC 95 por ciento: 1,03-30,34; p=0,04). Sin embargo, esta asociación perdió significación en el análisis ajustado (p=0,08). Conclusiones: Las restauraciones de resina compuesta en dientes primarios presentaron una supervivencia satisfactoria tras un seguimiento de 3 años (AU)

Correspondence between advances of dental composites and adhesives and clinical guidelines for direct restorations / 中华口腔医学杂志

The longevity of direct adhesive restoration is related to the restorative materials, the patient and the professional. On one hand, dental composites/adhesives have been modified and developed to fulfill the criteria for clinical application. On the other hand, the clinical guidelines for adhesive restorations have been released and updated accordingly, which would prolong the longevity of restorations. In this commentary, the removal of carious tissues, interface preparation for bonding and application of adhesives are emphasized. The administrative measures for registration and clinical evaluation criteria for adhesive restorative material are also introduced.

Status of Mongolian dentistry viewed from information resources and selection of adhesive dental restorative materials and continuing education

PURPOSE: To investigate the information acquisition, selection criteria and selection methods of Mongolian dentists regarding adhesive agents for bonded restorations, and to provide future direction for continuing education. MATERIALS AND METHODS: One hundred Mongolian dentists were interviewed and asked to complete a questionnaire containing 7 questions on general information about the responder, 8 questions on information acquisition and selection of bonded restoration agents, and 10 questions on continuing education. RESULTS: Objective and credible information regarding bonded restoration materials were not being acquired, and logical material selection was not being made. The extent of continuing education was inadequate and not enough information regarding education was being acquired. The participants responded positively to online supplementary education. CONCLUSION: A systemized approach needs to be established in Mongolian dentistry to enable organized delivery of evidence-based guidelines and information, and logical selection of the numerous and various bonded restoration agents. Furthermore, the education of dentists, through various means, is required to enable proper use of the selected materials.

Restablecimiento estético y funcional de la guía anterior utilizando la técnica de estratificación con resina compuesta

En Odontología, un problema observado constantemente en pacientes adultos en este inicio de siglo es sin duda, el desgaste dental patológico. Este tipo de desgaste ocurre cuando existe pérdida acentuada de la estructura dentaria, lo que generalmente ocasiona el compromiso estético de los dientes antero superiores. En consecuencia, la sociedad se está concientizando sobre la importancia de la salud y de la estética, de esta manera, la demanda por tratamientos estéticos rehabilitadores en casos de desgaste dental patológico ha aumentado. La rehabilitación estética puede ser realizada tanto por medio de tratamientos directos como indirectos. Debido a las ventajas de las resinas compuestas, el presente trabajo tiene por finalidad describir la técnica operatoria para el restablecimiento de la guía anterior con resina compuesta, mediante la técnica de estratificación, que permite simular las características ópticas de la estructura dental. Así, con la evolución de los sistemas adhesivos, asociado a las mejoras en las propiedades químicas, mecánicas y estéticas de las resinas compuestas, tratamientos restauradores extensos, como la reconstrucción directa de las guías anteriores en los casos de desgaste dental patológico, se tornan viables.

In Dentistry, a common problem observed in this beginning of century is the pathologic tooth wear. This type of wear occurs when there is accentuated loss of tooth structure, which frequently results in aesthetic compromise of the anterior maxillary teeth. As a result of the society’s awareness of the importance of health and aesthetics, the request for reparative aesthetic treatments in cases of pathologic tooth wear has increased. This aesthetic rehabilitation may be achieved either through indirect or direct treatments. Due to the advantages of the resin composites, the aim of the present paper is to show specifically the direct approach throughout the use of a layering technique to simulate the optical characteristics of the tooth structure. Hence with the evolution of the adhesive systems associated with improving in the chemical-mechanical-aesthetical charecterics of the resin composites, extensive restorative treatments as the direct reconstruction of the anterior guidance in cases of pathologic tooth wear are now feasible.

Influence of eugenol-containing temporary restorations on the microleakage of total-etch and self-etching adhesive systems / Influência de restaurações temporárias contendo eugenol na microinfiltração de sistemas adesivos convencional e autocondicionante

Purpose: This in vitro study evaluated the influence of zinc oxide-eugenol temporary cement (ZOE-TC) on the sealing ability of composite restorations using two adhesive systems. Methods: Standard Class V cavities were prepared in 20 bovine incisors and restored with either ZOE-TC (IRM®) or eugenol-free cement (Cavit®) (n=10/temporary cement type). After 7 days, five teeth per material group were restored using Single Bond® (SB) and five using Adper Prompt® (AP). The cavities were filled with composite (Filtek Z-250), thermal cycled (500 cycles), immersed in basic fuchsine solution, and longitudinally sectioned. Dye penetration was evaluated using optical-microscopy and scored. Data were analyzed by Kruskal-Wallis test (P = 0.05). Results: Overall, leakage in dentin was similar to that in enamel. In enamel margins, only the group with Cavit® cement associated with AP presented significant higher leakage. In dentin margins, AP exhibited higher leakage than the groups restored with SB; there was no significant difference between eugenol-free cement and ZOE-TC. Conclusion: In general, SB showed better marginal sealing than AP, and ZOE-TC did not increase dye leakage. Eugenol in the temporary cement did not affect the marginal sealing of adhesive restorations.

Objetivo: Este estudo in vitro avaliou a influência de um cimento restaurador temporário à base de óxido de zinco-eugenol (CT-OZE) no selamento marginal de restaurações diretas, utilizando dois sistemas adesivos. Metodologia: Cavidades classe V foram preparadas em 20 incisivos bovinos e restauradas com dois cimentos temporários, CT-OZE (IRM®) ou cimento livre de eugenol (Cavit®) (n=10/cimento temporário). Após sete dias, cinco dentes de cada grupo de cimento temporário foram restaurados utilizando o sistema Single Bond® (SB) e os demais cinco com o sistema Adper Prompt® (AP). As cavidades foram restauradas com resina composta (Filtek Z-250), termocicladas (500 ciclos), imersas em fucsina básica e longitudinalmente seccionadas. A penetração do corante foi avaliada em microscópio ótico. Os dados foram analisados por teste de Kruskal-Wallis (P = 0,05). Resultados: A infiltração em dentina foi similar à do esmalte. Em esmalte, o grupo com Cavit® e AP apresentou infiltração significativamente maior. Em dentina, AP exibiu maior infiltração que SB, e não houve diferença entre CT-OZE e Cavit®. Conclusão: Em geral, SB produziu melhor selamento marginal que AP, e CT-OZE não aumentou a penetração de corante. A presença de eugenol no material restaurador temporário não afetou o selamento marginal de restaurações adesivas.