Informed consent: direct posterior composite versus amalgam.

Survey data were obtained from 144 dentists and 116 patients concerning their attitudes and preferences toward direct composite and amalgam restorations in the posterior segment. Some dentists report that they take the initiative in recommending direct composites in these cases and others report that patients request them. Selection criteria for direct composite posterior restorations are similar to those advocated in the dental literature. Those characteristics of alternative materials emphasized in obtaining informed consent mirror the characteristics of the materials dentists report most often performing. Patients report an interest in tooth-colored restorations and trust dentists' professional opinion, but also express a strong desire for full information as part of informed consent.

Minimizing patients' exposure to uncured components in a dental sealant.

BACKGROUND: The authors conducted research to examine the effectiveness of six surface treatments in reducing the oxygen-inhibited layer of a commercially available, freshly polymerized, light-cured unfilled dental sealant. METHODS: Surface treatments of a light-cured sealant (Delton Light Curing Pit & Fissure Sealant, Dentsply Ash) included no treatment (the control treatment), a 20-second exposure to an air/water syringe spray, 20 seconds' manual application of a wet or dry cotton roll, 20 seconds' manual application of pumice with a cotton pellet, and 20 seconds' application of a water/pumice slurry using a prophy cup on a slow-speed handpiece. The authors used high-pressure liquid chromatography to analyze the amount of monomers--bisphenol A glycidyl dimethacrylate, or Bis-GMA; triethylene glycol dimethacrylate, or TEGDMA; and bisphenol A dimethacrylate, or Bis-DMA--remaining after each treatment. RESULTS: A one-way analysis of variance indicated that use of only an air/water spray removed the least (P = .0001) amount of all monomers (only 68.3 percent of the control value). Application of wet or dry cotton reduced equivalent amounts of monomers (86.1 to 88.9 percent of the control value), and the amount of monomer remaining was less than that for the air/water syringe treatment (P = .0001). The use of pumice on either a cotton ball or in a prophy cup achieved the greatest reduction (P = .0001) in total amount of residual monomer (92.9 to 95.3 percent of the control value). CONCLUSIONS: Treatment that used pumice eliminated the greatest amount (from 93 percent to 95 percent of the untreated control values) of any type of residual monomer. A slurry of pumice is significantly more effective in removing the oxygen-inhibited layer from freshly cured sealants than either an air/water spray or wet or dry cotton alone. CLINICAL IMPLICATIONS: Clinicians can most effectively reduce patients' exposure to the uncured components in the oxygen-inhibited layer of sealants by using a mild abrasive, such as pumice, either on a cotton applicator or in a prophy cup.

Assessing the effect of extraneous light on photoactivated resin composites.

The authors investigated the effect of an operatory light and ambient fluorescent illumination on the curve values of three photoactivated resin composite materials. Infrared spectroscopy was used to evaluate the specimens after they were exposed to an operatory light at a distance of 30 inches for two, five or 10 minutes as well as after a blue-blocker shield was placed between the light source and the composite. The authors also measured cure values after exposing some specimens to 10 minutes of ambient ceiling fluorescent light only. Maximal cure values were determined by conventionally photocuring specimens. After 10 minutes' exposure to the operatory light, specimens were cured at a level from 70 to 80 percent of the maximal cure resulting from conventional light curing. The blue-blocker shield reduced curing to a level equivalent to that of a 10-minute exposure to ambient fluorescent lighting, which was nearly 0 percent.