Adhesive restoration of molars affected by molar incisor hypomineralization: a randomized clinical trial.

OBJECTIVE: This randomized clinical trial evaluated the survival of direct restorations on first permanent molars (FPMs) with molar incisor hypomineralization (MIH) and its impact on self-reported dental pain and dental anxiety. MATERIAL AND METHOD: FPMs with MIH of 35 patients aged 7 to 16 years were included. The FPMs were randomized into the following two groups: total-etch (TE-37% phosphoric acid etching) and self-etch (SE-no prior etching). The FPMs were restored with universal adhesive and bulk-fill resin composites. The restoration survival was evaluated according to USPHS criteria modified by a blinded examiner. Dental anxiety (Venham picture test) and dental pain (Faces pain scale-revised) were evaluated before treatment and at 1, 6, and 12 months post-treatment. Survival rates were analyzed by the Kaplan-Meier method and the log-rank test. Nonparametric tests compared pain and anxiety in the follow-up periods. RESULTS: A total of 64 FPMs were restored (TE = 33; SE = 31). Survival rates were 96.9% (TE) and 96.7% (SE) after 1 month, 90.5% (TE) and 80.6% (SE) after 6 months, and 80.8% (TE) and 62.3% (SE) after 12 months (p > 0.05). Self-reported dental pain and anxiety level decreased after treatment in both groups (p < 0.05). Self-reported pain decreased after 1 month in SE, but it occurred at 6 months in TE. CONCLUSION: Both restorative protocols presented similar longevity, decreasing self-reported pain and anxiety levels. CLINICAL RELEVANCE: A universal adhesive could be appropriate for restoration of MIH-affected teeth, and the survival of restorations could be higher in the total-etch technique, reducing dental pain and anxiety.

Radiographic analysis of dental maturation in children with amelogenesis imperfecta: A case-control study.

AIMS: To assess dental maturation in children with amelogenesis imperfecta (AI) and compare their estimated dental age with the age of non-AI children. METHODS AND RESULTS: Panoramic radiographs of children with (n = 27) and without (n = 54) AI were retrospectively collected in the ratio of 1:2. The former consisted of case group, while the latter figured as control group. Both groups were paired by sex and age (P > .05). Dental maturation was assessed in each radiograph using Demirjian's staging technique and Willems' method. Intra- and interexaminer reproducibility reached >0.8. The mean estimated dental age in subjects with AI was 12.5 ± 2.69 years, while in subjects without AI it was 11.73 ± 2.48 years (P = .21). The comparison of mean chronological (12.26 ± 2.6 years) and estimated dental age (12.5 ± 2.69 years) in subjects with AI did not reveal statistically significant differences (P = .38). CONCLUSION: This study highlights the similarity of dental maturation between subjects with and without AI from the radiographic perspective of crown-root formation.

Eighteen-month randomized clinical trial on the performance of two etch-and-rinse adhesives in non-carious cervical lesions.

PURPOSE: An 18-month randomized, controlled prospective study evaluated, in an intra-individual comparison, the clinical performance of two-step etch-and-rinse adhesives in non-carious cervical lesions (NCCL). METHODS: 35 subjects, with at least two similar sized NCCL participated in this study. After sample size calculation, 70 restorations were placed, according to one of the following groups: Adper Single Bond 2 (SB) and Ambar (AM). The restorations were placed incrementally using a resin composite (Opallis). The restorations were evaluated at baseline and after 6 and 18 months according to the FDI criteria. The differences in the ratings of the two materials after 6 and 18 months were tested with Fisher's exact test (α = 0.05), and the performance of the each material at baseline and after 6 and 18 months was evaluated by Wilcoxon test (α = 0.05). RESULTS: All subjects attended the 18-month recall. No significant differences were observed between the materials for any criteria evaluated. Only four restorations (two from each material) were lost after 18 months. Thus, the retention rates of both materials at 18 months were 94.2% (95% CI 81-98%). Nine restorations (four Ambar and five Adper Single Bond 2) showed marginal discoloration which was solved with a polishing procedure. Both adhesive systems showed acceptable clinical retention rates after 18 months.

Effect of enamel bevel on the clinical performance of resin composite restorations placed in non-carious cervical lesions.

STATEMENT OF THE PROBLEM: Laboratory testing of enamel bevel reports many advantages; however clinical studies on this topic are scarce and controversial. PURPOSE OF THE STUDY: To evaluate the effect of enamel bevel on the retention rates of composite restorations placed in non-carious cervical lesions (NCCLs). MATERIALS AND METHODS: Forty-two patients with more than 20 teeth in occlusion and having at least two NCCLs participated in this study. The cavities were divided into non-beveled (control) and beveled (short bevel [45°, 1-2 mm long] prepared with a diamond bur) groups. The NCCLs were restored with the 2-step etch-and-rinse adhesive ExciTE and the resin composite 4 Seasons (Ivoclar Vivadent). Eight-four restorations were placed and evaluated at baseline, after 6 and 12 months according to the modified U.S. Public Health Service criteria. RESULTS: The 12-month retention rates (95% confidence interval) for the beveled (91% [77-97%]) and non-beveled [88% (73-95%)] groups were similar. No significant differences were detected between groups in other criteria (Fisher test, p > 0.05). No significant differences were detected in the same group compared across different recall times (McNemar test, p > 0.05). CONCLUSION: Enamel beveling may not be clinically relevant for the retention of composite restorations in NCCLs after 12 months. CLINICAL SIGNIFICANCE: Beveling enamel margins may not be necessary in NCCL restorations restored with the 2-step etch-and-rinse systems.

Durability of composite repair using different surface treatments.

OBJECTIVE: To evaluate the surface treatment and hydrophilicity of the bonding agent on the composite repair strength (RS), silver nitrate uptake (SNU), surface roughness (SR) and estimation of surface area (SA). METHODS: Fifty resin blocks (Opallis, FGM) were polished and divided in 5 groups: no treatment (NT); roughening with a fine (FDB); medium (MDB); coarse-grit (CDB) and 50-µm aluminium oxide sandblasting (AO). A hydrophobic (Adhesive, Scotchbond Multi-Purpose Plus, 3M ESPE) or hydrophilic (Adper Single Bond 2, 3M ESPE) adhesive was applied, followed by composite placement (Opallis, FGM). Composite-composite bonded sticks (0.9 mm2) were tested in tension (1.0mm/min) immediately [IM] or after 6 months [6M] of water storage. Two sticks from each tooth, at each time, were immersed in a 50% silver nitrate solution and evaluated by SEM. A profilometer was used to measure SR. SEM images were used to estimate the SA using the Image J software. Data were analysed by ANOVA and Tukey's tests. RESULTS: The AO showed the highest CR strength for both adhesives, whilst the NT group showed the lowest, irrespective of the storage period. The diamond burs had intermediate performance. Silver nitrate deposits were seen after 6M for the hydrophilic adhesive. The ranking of SR values (Ra) from the lowest to the highest was: NT

Application of etch-and-rinse adhesives on dry and rewet dentin under rubbing action: a 24-month clinical evaluation.

BACKGROUND: Researchers conducting laboratory investigations have reported that bonding to dry demineralized dentin can be feasible technically as long as the adhesives are rubbed vigorously onto the dentin surface. The authors aimed to evaluate the 24-month clinical performance of resin-based composites in noncarious cervical lesions (NCCLs) in teeth restored with two etch-and-rinse adhesives that had been applied with a vigorous rubbing action to both dry and rewet dentin. METHODS: The authors enrolled 40 patients in this study. They inserted 160 restorations and evaluated them at baseline and at six, 12 and 24 months of service. They divided the restorations into four groups: One-Step (OS) Universal Dental Adhesive System (Bisco, Schaumburg, Ill.) (acetone-based adhesive) with rewet dentin; OS with dry dentin; Adper Single Bond (SB) Plus Adhesive (3M ESPE, St. Paul, Minn.) (ethanol/water-based adhesive) with rewet dentin; and SB with dry dentin. The authors used the same resin-based composite for all restorations. They evaluated the restorations according to modified U.S. Public Health Service criteria. RESULTS: The 24-month retention rates for the rewet and dry conditions, respectively, were 95.0 percent and 97.5 percent for SB and 97.5 percent and 91.9 percent for OS. The authors detected no significant difference between rewet and dry groups for either adhesive (P > .05). In terms of marginal discoloration, OS performed significantly worse than did SB, irrespective of dentin moisture (P > .05). CONCLUSIONS AND CLINICAL IMPLICATIONS: Dentin moisture seems not to be important for the retention of etch-and-rinse adhesives as long as the adhesives have been rubbed vigorously onto the dentin surface. The ethanol/water-based adhesive showed a better overall performance than did the acetone-based system.