Two-year clinical evaluation of resinous restorative systems in non-carious cervical lesions.

This controlled clinical trial evaluated the 2-year clinical performance of a one-bottle etch-and-rinse adhesive and resin composite system (Excite/Tetric Ceram) compared to a resin-modified glass ionomer cement (RMGIC) (Vitremer/3M) in non-carious cervical lesions. Seventy cervical restorations (35 resin composite - RC- restorations and 35 RMGIC restorations) were placed by a single operator in 30 patients under rubber dam isolation without mechanical preparation. All restorations were evaluated blindly by 2 independent examiners using the modified USPHS criteria at baseline, and after 6, 12 and 24 months. Data were analyzed statistically by Fisher's exact and McNemar tests. After 2 years, 59 out of 70 restorations were evaluated. As much as 78.8% retention rate was recorded for RC restorations, while 100% retention was obtained for RMGIC restorations. Fisher's exact test showed significant differences (p=0.011) for retention. However, there were no significant differences for marginal integrity, marginal discoloration, anatomic form and secondary caries between the RC and RMGIC restorations. The McNemar test detected significant differences for Excite/TC between baseline and the 2-year recall for retention (p=0.02), marginal integrity (p=0.002) and anatomic form (p=0.04). Therefore, the one-bottle etch-and-rinse bonding system/resin composite showed an inferior clinical performance compared to the RMGIC.

Two-year clinical evaluation of resinous restorative systems in non-carious cervical lesions

This controlled clinical trial evaluated the 2-year clinical performance of a one-bottle etch-and-rinse adhesive and resin composite system (Excite/Tetric Ceram) compared to a resin-modified glass ionomer cement (RMGIC) (Vitremer/3M) in non-carious cervical lesions. Seventy cervical restorations (35 resin composite - RC- restorations and 35 RMGIC restorations) were placed by a single operator in 30 patients under rubber dam isolation without mechanical preparation. All restorations were evaluated blindly by 2 independent examiners using the modified USPHS criteria at baseline, and after 6, 12 and 24 months. Data were analyzed statistically by Fisher's exact and McNemar tests. After 2 years, 59 out of 70 restorations were evaluated. As much as 78.8 percent retention rate was recorded for RC restorations, while 100 percent retention was obtained for RMGIC restorations. Fisher's exact test showed significant differences (p=0.011) for retention. However, there were no significant differences for marginal integrity, marginal discoloration, anatomic form and secondary caries between the RC and RMGIC restorations. The McNemar test detected significant differences for Excite/TC between baseline and the 2-year recall for retention (p=0.02), marginal integrity (p=0.002) and anatomic form (p=0.04). Therefore, the one-bottle etch-and-rinse bonding system/resin composite showed an inferior clinical performance compared to the RMGIC.

Esse estudo avaliou o desempenho clínico de restaurações de lesões cervicais não-cariosas por um período de 2 anos empregando um sistema adesivo de condicionamento total (Excite/Tetric Ceram) e um cimento de ionômero de vidro modificado por resina (Vitremer). Setenta restaurações (35 por material) foram realizadas por um único operador. Todas as lesões cervicais não-cariosas foram restauradas sem a execução de preparo cavitário e sob isolamento absoluto. As restaurações foram avaliadas por 2 examinadores independentes usando os critérios USPHS modificados nos períodos inicial, 6, 12 e 24 meses. A análise estatística foi realizada pelos testes de Fisher e McNemar. Cinquenta e nove restaurações foram avaliadas após 2 anos, obtendo-se um índice de retenção de 78,8 por cento para resina composta e 100 por cento para o cimento de ionômero de vidro modificado por resina. O teste exato de Fischer detectou diferença significante (p=0,011) para retenção entre os dois materiais. Contudo, não houve diferença significante para integridade marginal, descoloração marginal, forma anatômica e cárie secundária. O teste de McNemar detectou diferença estatística para o sistema Excite/Tetric Ceram entre o período inicial e 2 anos para os critérios de retenção (p=0,02), integridade marginal (p=0,002) e forma anatômica (p=0,04). Portanto, o sistema adesivo de condicionamento total apresentou um desempenho clínico inferior comparado ao cimento de ionômero de vidro modificado por resina.

Clinical evaluation of a 3% potassium oxalate gel and a GaAlAs laser for the treatment of dentinal hypersensitivity.

OBJECTIVES: This study evaluated the immediate and 3 month clinical effects of a low-level gallium-aluminum-arsenide (GaAlAs) laser and a 3% potassium oxalate gel for the treatment of dentinal hypersensitivity. MATERIALS AND METHODS: A total of 164 teeth from 30 patients with clinical diagnoses of dentinal hypersensitivity were selected for this randomized, placebo-controlled, double-blind clinical study. The teeth were randomized to three groups: GaAlAs laser, oxalate gel, and placebo gel. The treatment sessions were performed at 7 d intervals for four consecutive weeks. The degree of sensitivity in response to an air blast and tactile stimuli was assessed according to a visual analogue scale at baseline, immediately after the fourth application, and then 3 months after the fourth application. The reductions in dentinal hypersensitivity from baseline at the two follow-up assessments were evaluated as the main outcome. RESULTS: In both the active and control groups, there were statistically significant reductions in dentinal hypersensitivity immediately after and 3 months after the treatments, when compared with the hypersensitivity at baseline. No significant differences among the three groups could be detected in their efficacy at either the immediate or 3 month evaluations irrespective of the stimulus. CONCLUSIONS: The treatments under study were effective for reducing dentinal hypersensitivity, and longer observational periods could enhance the ability of studies to detect differences between active and placebo groups.

Management of dentinal hypersensitivity.

Dentinal hypersensitivity is a complex condition that can cause considerable concern in the dental office. Despite the large number of available treatment modalities, no current desensitizing agent is considered ideal for managing this uncomfortable condition. Selecting the right therapy requires a complete understanding of how applying a stimulus to the exposed dentin surface can influence the nerve fibers and produce hyperesthesia. This article reviews the etiology and critically analyzes management of dentinal hypersensitivity by reviewing laboratory and clinical investigations.