Compomers for the restorative treatment of dental caries in primary teeth: An umbrella review.

OBJECTIVES: This umbrella review comprehensively appraised the evidence on the use of compomers in comparison to other dental filling materials for restorative treatment of decayed primary teeth. DATA: The literature search was conducted based on the question: "Is the use of compomers as a dental filling material more successful in the restorative treatment of decayed primary teeth than other dental filling materials?" No language restriction was applied and systematic reviews published up to May 2023 were included. The ROBIS tool was used to assess the methodological quality of the included systematic reviews. Data were extracted for narrative synthesis, considering the restoration failure/success outcomes. SEARCH: Online search was conducted in three databases (PubMed/Medline, Embase and Cochrane library). STUDY SELECTION: The electronic search yielded a total of 779 publications. Finally, 18 systematic reviews were included in this umbrella review. Four systematic reviews presented a low risk of bias, 11 presented an unclear risk of bias and three presented a high risk of bias. Most systematic reviews presenting low risk of bias reported no difference in the success rates of compomers compared to other dental filling materials used for restoration of decayed primary teeth. Studies that found a significant difference or that made clear recommendations towards the use of compomers were commonly rated with a high risk of bias. CONCLUSION: Compomers are similar to other dental filling materials for the placement of direct restorations in primary teeth. CLINICAL SIGNIFICANCE: The results of this umbrella review indicate a similar clinical performance of compomers compared to other materials containing a resin component for direct restoration in primary teeth. Therefore, the choice of restorative material will depend on multiple factors, such as clinician's skills/preferences, patients' wishes, costs, and cavity type/location.

Treatment success of carious primary molars with marginal breakdown: comparison of three treatment approaches in a real-world clinical setting (using decision tree analysis).

OBJECTIVES: Treatment of carious primary molars is always indicated, especially on young children; however, there are no clear guidelines that precisely explain the best treatment approach for Class II carious molars with marginal breakdown (International Caries Detection and Assessment System [ICDAS] 5). The objective of this prospective observational clinical study was to assess the efficacy of three restorative techniques in treating ICDAS 5 Class II lesions in primary molars: compomer fillings (CF), preformed metal crowns (PMC), and pulpotomy and conventional preformed metal crowns (PMC+P). The secondary goal was to evaluate the impact of some cofactors on the course of treatment. METHOD AND MATERIALS: Overall, 92 children (female, n = 50, 54.3%; male, n = 42, 45.7%) aged 2 to 9 years old (mean age = 5.9 ± 1.9 years) with 166 treated teeth were included. The average number of decayed, missing, or filled teeth (d3mft) of the whole sample was 8.0 ± 3.4. The distribution of the sample according to type of treatment was CF = 53 (31.9%), PMC = 64 (38.6%), and PMC+P = 49 (29.5%). Paired t test, nonparametric Friedman ANOVA test, and decision tree analysis were used as the basis for the statistics. RESULTS: After 12 months, data from 75.8% (72/95) treated patients, corresponding to 62.0% (103/166) of the treated teeth (CF = 42/53, 79.2%; PMC = 38/64, 59.4%; PMC+P = 23/49, 46.9%) were available for analysis. The mean patients age was 6.8 ± 1.8 years; 32 (47.1%) boys and 36 (52.9%) girls. The mean d3mft of the remaining sample was 7.8 ± 3.35. PMC and PMC+P arms showed the highest success rates (> 91%) as compared to the CF arm, which showed the lowest success rates (61.9%), with 9/42 teeth of the CF group (21.4%) presenting with minor failures, and 7/42 teeth (16.7%) with major failures (P < .0001). CONCLUSION: According to the decision tree analysis, PMC and PMC+P had a success rate of 99%, whereas CF had a success rate of only 69%. Some cofactors (treatment decision, Approximal Plaque Index, and tooth number) had a higher impact on the decision tree analysis than others (age, dmfs, and dmft values), especially when the treatment selection was CF. In future studies it is necessary to examine the impact of other cofactors on the outcomes of conventional fillings using a larger sample size.

Compomers Reinforced with Bioactive Glass and Hydroxyapatite Particles.

PURPOSE: To understand the effect of the addition of hydroxyapatite (HA) and bioactive glass (BAG) to compomer restorative materials on the remineralisation capacity of the material. MATERIALS AND METHODS: 1%, 2%, 3% and 4% w/w HA and BAG particles were added mechanically to the compomers. To examine the resistance to demineralisation, Class V cavities were prepared in extracted teeth and restored with experimental filling materials. Demineralised lesions were created in 72 enamel samples. Vickers microhardness measurements of samples were performed at three different areas including the margin of the restoration, the varnish-protected enamel and the exposed enamel areas. Measurements performed on protected enamel were used as reference enamel values for each group. SEM was used to evaluate the surface texture of the specimens. The statistical analyses were performed by one-way ANOVA, Tukey's HDS and paired-samples t-tests. RESULTS: BAG and HA groups revealed higher microhardness values at the exposed enamel and exposed marginal enamel than did the control group (p = 0.001). 3% and 4% HA and BAG groups produced higher microhardness values than did 1% modified groups on exposed enamel (p = 0.001). 4% HA group revealed the highest microhardness values on marginal exposed enamel (p = 0.001). 2%, 3%, 4% and HA, as well as 3% and 4% BAG groups showed higher microhardness values than did the control group on marginal exposed enamel at 20 µm depth (p = 0.001). SEM images revealed that HA and BAG particles were not distributed homogeneously and the particles seemed to be grouped in the matrix. CONCLUSIONS: Within the limits of this study, the addition of the BAG and HA into compomers improved the demineralisation resistance properties of enamel, depending on the amount of additive.

Long-term clinical evaluation of Dyract compomer in the restoration of non-caries cervical lesions: A 20-year retrospective study.

OBJECTIVE: The restoration of non-caries cervical lesions has long been a challenge. Until recently, compomers were the restorative materials of choice. The aim of this in-vivo study was to evaluate the long-term clinical performance of Dyract restorations in non-caries cervical lesions. METHOD AND MATERIALS: Forty-two patients with Dyract restorations of non-caries cervical lesions performed in 1995 by the same operator were included in this in-vivo retrospective study. After 20 years, restorations were evaluated by two calibrated examiners following the USPHS criteria modified by Ryge. RESULTS: After 20 years, 38 of the 54 restorations included in this study remain in service (70.4%). Debonding was the cause of all failures. Marginal adaptation and marginal discoloration were the categories with poor values. CONCLUSION: Dyract restorations can be considered a treatment option for non-caries cervical lesions, because they show good long-term clinical performance for 20 years. CLINICAL RELEVANCE: Dyract restorations continue to be an option to restore non-caries cervical lesions, due their good long-term clinical performance and the ease of the clinical procedure. The survival rate of these Dyract restorations was high after 20 years (70.4%). However, the limitations of marginal discoloration, marginal adaptation, and color match should be considered.

Effect of 3 cements on white spot lesion formation after full-coverage rapid maxillary expander: A comparative in-vivo study.

INTRODUCTION: The aim of this study was to assess the effects of 3 luting agents (glass ionomer cement, compomer, and polycarboxylate cement) on white spot lesion formation in patients with full-coverage bonded acrylic splint expanders. White spot lesion formation was assessed with quantitative light-induced fluorescence. METHODS: Full-coverage rapid maxillary expanders were cemented with glass ionomer cement, compomer, and polycarboxylate cement in groups 1, 2, and 3, respectively. A control group comprised patients who never had orthodontic treatment. Quantitative light-induced fluorescence images taken before and after rapid maxillary expansion treatment were analyzed for these parameters: the percentages of fluorescence loss with respect to the fluorescence of sound tooth tissue (ΔF) and maximum loss of fluorescence intensity in the whole lesion; lesion area with ΔF equal to less than a -5% threshold; and the percentage of fluorescence loss with respect to the fluorescence of sound tissue times the area that indicated lesion volume. RESULTS: All 3 groups showed statistically significantly greater demineralization than the control group. The 3 experimental groups differed from each other in half of the parameters calculated. Teeth in the polycarboxylate group developed the most white spot lesions. CONCLUSIONS: With the highest rate of white spot lesion formation, polycarboxylate cements should not be used for full-coverage bonded acrylic splint expanders. Compomers may be preferred over glass ionomer cements, based on the findings of this study.

WITHDRAWN: Dental fillings for the treatment of caries in the primary dentition.

BACKGROUND: Childhood caries (tooth decay) consists of a form of tooth decay that affects the milk teeth (also known as baby or primary teeth) of children. This may range from tooth decay in a single tooth to rampant caries affecting all the teeth in the mouth. Primary teeth in young children are vital to their development and every effort should be made to retain these teeth for as long as is possible. Dental fillings or restorations have been used as an intervention to repair these damaged teeth. Oral health professionals need to make astute decisions about the type of restorative (filling) material they choose to best manage their patients with childhood caries. This decision is by no means an easy one as remarkable advances in dental restorative materials over the last 10 years has seen the introduction of a multitude of different filling materials claiming to provide the best performance in terms of durability, aesthetics, symptom relief, etc when placed in the mouth. This review sought to compare the different types of dental materials against each other for the same outcomes. OBJECTIVES: The objective of this review was to compare the outcomes (including pain relief, survival and aesthetics) for restorative materials used to treat caries in the primary dentition in children.  Additionally, the restoration of teeth was compared with extraction and no treatment. SEARCH METHODS: Electronic searches of the following databases were undertaken: the Cochrane Oral Health Group's Trials Register (up to January 2009); CENTRAL (The Cochrane Library 2009, Issue1); MEDLINE (1966 to January 2009); EMBASE (1996 to January 2009); SIGLE (1976 to 2004); and conference proceedings on early childhood caries, restorative materials for paediatric dentistry, and material sciences conferences for dental materials used for children's dentistry (1990 to 2008). The searches attempted to identify all relevant studies irrespective of language.Additionally, the reference lists from articles of eligible papers were searched, handsearching of key journals was undertaken, and personal communication with authors and manufacturers of dental materials was initiated to increase the pool of suitable trials (both published and unpublished) for inclusion into this review. SELECTION CRITERIA: Randomised controlled trials (RCTs) or quasi-randomised controlled trials with a minimum period of 6 months follow up were included. Both parallel group and split-mouth study designs were considered. The unit of randomisation could be the individual, group (school, school class, etc), tooth or tooth pair. Included studies had a drop-out rate of less than 30%. The eligible trials consisted of young children (children less than 12 years) with tooth decay involving at least one tooth in the primary dentition which was symptomatic or symptom free at the start of the study. DATA COLLECTION AND ANALYSIS: Data were independently extracted, in duplicate, by two review authors. Disagreements were resolved by consultation with a third review author. Authors were contacted for missing or unclear information regarding randomisation, allocation sequence, presentation of data, etc. A quality assessment of included trials was undertaken. The Cochrane Collaboration statistical guidelines were followed for data analysis. MAIN RESULTS: Only three studies were included in this review. The Fuks 1999 study assessed the clinical performance of aesthetic crowns versus conventional stainless steel crowns in 11 children who had at least two mandibular primary molars that required a crown restoration. The outcomes assessed at 6 months included gingival health (odds ratio (OR) 0.3; 95% confidence interval (CI) 0.01 to 8.32), restoration failure (OR 3.29; 95% CI 0.12 to 89.81), occlusion, proximal contact and marginal integrity. The odds ratios for occlusion, proximal contact and marginal integrity could not be estimated as no events were recorded at the 6-month evaluation. The Donly 1999 split-mouth study compared a resin-modified glass ionomer (Vitremer) with amalgam over a 36-month period. Forty pairs of Class II restorations were placed in 40 patients (21 males; 19 females; mean age 8 years +/- 1.17; age range 6 to 9 years). Although the study period was 3 years (36 months), only the 6- and 12-month results are reported due to the loss to follow up of patients being greater than 30% for the 24- and 36-month data. Marks 1999a recruited 30 patients (age range 4 to 9 years; mean age 6.7 years, standard deviation 2.3) with one pair of primary molars that required a Class II restoration. The materials tested were Dyract (compomer) and Tytin (amalgam). Loss to follow up at 24 and 36 months was 20% and 43% respectively. This meant that only the 24-month data were useable. For all of the outcomes compared in all three studies, there were no significant differences in clinical performance between the materials tested.No studies were found that compared restorations versus extractions or no treatment as an intervention in children with childhood caries. AUTHORS' CONCLUSIONS: It was disappointing that only three trials that compared three different types of materials were suitable for inclusion into this review. There were no significant differences found in all three trials for all of the outcomes assessed. Well designed, randomised controlled trials comparing the different types of filling materials for similar outcomes are urgently needed in dentistry. There was insufficient evidence from the three included trials to make any recommendations about which filling material to use.

Marginal integrity of restorations produced with a model composite based on polyhedral oligomeric silsesquioxane (POSS).

UNLABELLED: Marginal integrity is one of the most crucial aspects involved in the clinical longevity of resin composite restorations. OBJECTIVE: To analyze the marginal integrity of restorations produced with a model composite based on polyhedral oligomeric silsesquioxane (POSS). MATERIAL AND METHODS: A base composite (B) was produced with an organic matrix with UDMA/TEGDMA and 70 wt.% of barium borosilicate glass particles. To produce the model composite, 25 wt.% of UDMA were replaced by POSS (P25). The composites P90 and TPH3 (TP3) were used as positive and negative controls, respectively. Marginal integrity (%MI) was analyzed in bonded class I cavities. The volumetric polymerization shrinkage (%VS) and the polymerization shrinkage stress (Pss - MPa) were also evaluated. RESULTS: The values for %MI were as follows: P90 (100%) = TP3 (98.3%) = B (96.9%) > P25 (93.2%), (p<0.05). The %VS ranged from 1.4% (P90) to 4.9% (P25), while Pss ranged from 2.3 MPa (P90) to 3.9 MPa (B). For both properties, the composite P25 presented the worst results (4.9% and 3.6 MPa). Linear regression analysis showed a strong positive correlation between %VS and Pss (r=0.97), whereas the correlation between Pss and %MI was found to be moderate (r=0.76). CONCLUSIONS: The addition of 25 wt.% of POSS in methacrylate organic matrix did not improve the marginal integrity of class I restorations. Filtek P90 showed lower polymerization shrinkage and shrinkage stress when compared to the experimental and commercial methacrylate composite.

Marginal integrity of restorations produced with a model composite based on polyhedral oligomeric silsesquioxane (POSS)

Marginal integrity is one of the most crucial aspects involved in the clinical longevity of resin composite restorations.Objective To analyze the marginal integrity of restorations produced with a model composite based on polyhedral oligomeric silsesquioxane (POSS).Material and Methods A base composite (B) was produced with an organic matrix with UDMA/TEGDMA and 70 wt.% of barium borosilicate glass particles. To produce the model composite, 25 wt.% of UDMA were replaced by POSS (P25). The composites P90 and TPH3 (TP3) were used as positive and negative controls, respectively. Marginal integrity (%MI) was analyzed in bonded class I cavities. The volumetric polymerization shrinkage (%VS) and the polymerization shrinkage stress (Pss - MPa) were also evaluated.Results The values for %MI were as follows: P90 (100%) = TP3 (98.3%) = B (96.9%) > P25 (93.2%), (p<0.05). The %VS ranged from 1.4% (P90) to 4.9% (P25), while Pss ranged from 2.3 MPa (P90) to 3.9 MPa (B). For both properties, the composite P25 presented the worst results (4.9% and 3.6 MPa). Linear regression analysis showed a strong positive correlation between %VS and Pss (r=0.97), whereas the correlation between Pss and %MI was found to be moderate (r=0.76).Conclusions The addition of 25 wt.% of POSS in methacrylate organic matrix did not improve the marginal integrity of class I restorations. Filtek P90 showed lower polymerization shrinkage and shrinkage stress when compared to the experimental and commercial methacrylate composite.

Effect of various endodontic irrigants on the push-out bond strength of biodentine and conventional root perforation repair materials.

INTRODUCTION: The aim of this study was to evaluate the effect of various endodontic irrigants on the push-out bond strength of Biodentine (Septodont, Saint Maur des Fossés, France) in comparison with contemporary root perforation repair materials. METHODS: Midroot dentin of canine teeth was horizontally sectioned into 1-mm-thick slices. The canal space of each dentin slice was enlarged with a diamond bur to 1.4 mm in diameter. The samples were divided into 5 groups (n = 40), and the following materials were placed, respectively: Biodentine, ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), amalgam, Dyract AP (Dentsply DeTrey, Konstanz, Germany), and intermediate restorative material (IRM, Dentsply DeTrey). The samples were wrapped in wet gauze for 10 minutes and divided into 3 subgroups (n = 10) to be immersed into 3.5% sodium hypochlorite, 2% chlorhexidine gluconate (CHX), or saline for 30 minutes. No irrigation was performed in the controls (n = 10), and a wet cotton pellet was placed over each test material. After incubation for 48 hours, the dislodgement resistance of the samples was measured using a universal testing machine. The samples were examined under a stereomicroscope to determine the nature of the bond failures. RESULTS: Biodentine showed significantly higher push-out bond strength than MTA (P < .05). The statistical ranking of push-out bond strength values was as follows: Dyract AP > amalgam ≥ IRM ≥ Biodentine > MTA. The push-out bond strength of Dyract AP, amalgam, IRM, and Biodentine was not significantly different when immersed in NaOCl, CHX, and saline solutions, whereas MTA lost strength when exposed to CHX. CONCLUSIONS: Biodentine showed considerable performance as a perforation repair material even after being exposed to various endodontic irrigants, whereas MTA had the lowest push-out bond strength to root dentin.

[One-year clinical evaluation of compomer restorations in cervical lesions of different aetiology].

INTRODUCTION: The aim of this one-year prospective clinical study was to evaluate the treatment results of compomer restorations (Dyract eXtral Dentsply/De Trey, Konstanz, Germany) with a single step self-etching dental adhesive (Xeno III Dentsply/De Trey, Konstanz, Germany) used for restoring class V lesions (non-carious and primary carious cervical lesions). MATERIAL AND METHODS: A total number of 62 class V restorations (n = 62) were placed by one dentist in 30 patients on incisors, canines and premolars. The fillings were placed due to different indications: non-carious cervical defects (n = 32) and primary carious lesions (n = 30). The restorations were evaluated by a single-blind design, according to the Modified United States Public Health Service system 6 and 12 months following the placement. The following were evaluated: retention, marginal integrity, marginal discoloration, wear; postoperative sensitivity and secondary caries. The statistical analysis compared the ratings of each criteria between materials using the Pearson chi-square or Fisher's exact test at a level of significance of 5% (p < 0.05). RESULTS: Two restorations of the non-carious lesion group were lost after 6 months, and after 12 months one restoration was lost in the group of primary carious lesions. There were no statistically significant differences between restorations for all evaluated criteria in both groups. CONCLUSION: The compomer restorations in combination with a single step self-etching dental adhesive showed acceptable clinical performance in Class V lesions after one year of clinical service.

Periodontal ligament fibroblast response to root perforations restored with different materials: a laboratory study.

AIM: To compare the effect of several materials on the attachment of periodontal ligament (PDL) fibroblasts to experimentally perforated root surfaces. METHODOLOGY: Root specimens (size 5 × 5 mm) were obtained from extracted human molar teeth and perforations with a 1 mm diameter were created. One group was kept as a control and the rest were repaired with the following materials: Amalgam, Dyract, IRM, Super Bond C&B and Mineral trioxide aggregate (MTA). PDL fibroblasts were placed at a density of 8 × 10(4) cells on the root specimens, incubated on tissue culture inserts (48 h) and then transferred to 48 well-plates. MTT assays were performed at 48 and 96 h for PDL fibroblast survival. Cell attachment was observed using confocal microscopy on days 2 and 5. Total RNAs from the root specimens were isolated on day 5 and type I collagen (COL I) and Runt-related transcription factor 2 (Runx2) mRNA expressions were checked using Quantitative-Polymerase Chain Reaction (QPCR). For the MTT assay and QPCR, one-way analysis of variance (anova) and Tukey HSD multiple comparison tests were used to compare the groups. RESULTS: Mineral trioxide aggregate resulted in a significantly higher cell density (P < 0.001). Dyract, IRM and Super Bond C&B groups had a lower cell density when compared with the control and MTA groups at 48 h (P < 0.001). Confocal microscopy revealed that, among the experimental groups, the MTA group had the largest viable cell population over the restoration site when compared with the other materials; however, reduced cell attachment was noted in all groups when compared with the control. Increased Runx2 mRNA expressions were noted in MTA (P < 0.001) and IRM (P < 0.01) groups when compared with control and other tested materials. COL I transcripts were increased in IRM (P < 0.01), D, C&B and MTA (P < 0.001) when compared with the control. CONCLUSION: Mineral trioxide aggregate provided a more favorable environment for PDL cell adhesion and growth.

Avaliação clínica de restaurações reparadas por resina composta à base de silorano: estudo longitudinal randomizado controlado / Repair of dimethacrylate-based composite restorations using a silorane-based composite: a prospective, randomized clinical trial

Objetivo: Este estudo investigou o desempenho clínico de restuarações Classe I e II de resina composta à base de dimetacrilato reparadas por uma resina composta de baixa contração à base de silorano ou por uma resina composta à base de dimetacrilato, em baseline e ao longo de 6 a 12 meses. Materiais e métodos: cem restaurações defeituosas de resina composta à base de dimetacrilato foram reparadas neste estudo. Destas, 93 foram examinadas uma semana após terem sido reparadas - baseline, 91 após 6 meses e 83 após 12 meses. As restaurações foram alocadas aleatoriamente em dois grupos de tratamento - Controle (n=50): Adper SE/ESPF + Filtek P90 3M/ESPE...

Literature review: Restorations of class II cavities in the primary dentition with compomers.

BACKGROUND: A large number of studies concerning the use of compomers in class II cavities in the primary dentition already exist, but the variety of the research perspectives is even bigger. AIM: This study therefore intends to abridge and evaluate the existing research through a systematic literature review. METHODS: In order to gather relevant articles an extended literature research was carried out. The criteria for the evaluation of the resulting articles were based on the article of Kilpatrick and Neumann [2007]. RESULTS: According to the subject of the research, the articles were divided into the following groups: PAM-C; PAM-C and amalgam; PAM-C and GIC; PAM-C and hybrid composites; PAM-C and pre-treatment. CONCLUSIONS: The findings lead to the conclusion that PAM-C can be an alternative to other restorative materials in the primary dentition in class II cavities, except in the case of teeth with pulpectomies or pulpotomies. The placement of compomers takes longer than placing amalgam, but the procedure consists of fewer steps compared to composites. However, patient-compliance remains essential.

Dental fillings for the treatment of caries in the primary dentition.

BACKGROUND: Childhood caries (tooth decay) consists of a form of tooth decay that affects the milk teeth (also known as baby or primary teeth) of children. This may range from tooth decay in a single tooth to rampant caries affecting all the teeth in the mouth. Primary teeth in young children are vital to their development and every effort should be made to retain these teeth for as long as is possible. Dental fillings or restorations have been used as an intervention to repair these damaged teeth. Oral health professionals need to make astute decisions about the type of restorative (filling) material they choose to best manage their patients with childhood caries. This decision is by no means an easy one as remarkable advances in dental restorative materials over the last 10 years has seen the introduction of a multitude of different filling materials claiming to provide the best performance in terms of durability, aesthetics, symptom relief, etc when placed in the mouth. This review sought to compare the different types of dental materials against each other for the same outcomes. OBJECTIVES: The objective of this review was to compare the outcomes (including pain relief, survival and aesthetics) for restorative materials used to treat caries in the primary dentition in children. Additionally, the restoration of teeth was compared with extraction and no treatment. SEARCH STRATEGY: Electronic searches of the following databases were undertaken: the Cochrane Oral Health Group's Trials Register (up to January 2009); CENTRAL (The Cochrane Library 2009, Issue1); MEDLINE (1966 to January 2009); EMBASE (1996 to January 2009); SIGLE (1976 to 2004); and conference proceedings on early childhood caries, restorative materials for paediatric dentistry, and material sciences conferences for dental materials used for children's dentistry (1990 to 2008). The searches attempted to identify all relevant studies irrespective of language.Additionally, the reference lists from articles of eligible papers were searched, handsearching of key journals was undertaken, and personal communication with authors and manufacturers of dental materials was initiated to increase the pool of suitable trials (both published and unpublished) for inclusion into this review. SELECTION CRITERIA: Randomised controlled trials (RCTs) or quasi-randomised controlled trials with a minimum period of 6 months follow up were included. Both parallel group and split-mouth study designs were considered. The unit of randomisation could be the individual, group (school, school class, etc), tooth or tooth pair. Included studies had a drop-out rate of less than 30%. The eligible trials consisted of young children (children less than 12 years) with tooth decay involving at least one tooth in the primary dentition which was symptomatic or symptom free at the start of the study. DATA COLLECTION AND ANALYSIS: Data were independently extracted, in duplicate, by two review authors. Disagreements were resolved by consultation with a third review author. Authors were contacted for missing or unclear information regarding randomisation, allocation sequence, presentation of data, etc. A quality assessment of included trials was undertaken. The Cochrane Collaboration statistical guidelines were followed for data analysis. MAIN RESULTS: Only three studies were included in this review. The Fuks 1999 study assessed the clinical performance of aesthetic crowns versus conventional stainless steel crowns in 11 children who had at least two mandibular primary molars that required a crown restoration. The outcomes assessed at 6 months included gingival health (odds ratio (OR) 0.3; 95% confidence interval (CI) 0.01 to 8.32), restoration failure (OR 3.29; 95% CI 0.12 to 89.81), occlusion, proximal contact and marginal integrity. The odds ratios for occlusion, proximal contact and marginal integrity could not be estimated as no events were recorded at the 6-month evaluation. The Donly 1999 split-mouth study compared a resin-modified glass ionomer (Vitremer) with amalgam over a 36-month period. Forty pairs of Class II restorations were placed in 40 patients (21 males; 19 females; mean age 8 years +/- 1.17; age range 6 to 9 years). Although the study period was 3 years (36 months), only the 6- and 12-month results are reported due to the loss to follow up of patients being greater than 30% for the 24- and 36-month data. Marks 1999a recruited 30 patients (age range 4 to 9 years; mean age 6.7 years, standard deviation 2.3) with one pair of primary molars that required a Class II restoration. The materials tested were Dyract (compomer) and Tytin (amalgam). Loss to follow up at 24 and 36 months was 20% and 43% respectively. This meant that only the 24-month data were useable. For all of the outcomes compared in all three studies, there were no significant differences in clinical performance between the materials tested.No studies were found that compared restorations versus extractions or no treatment as an intervention in children with childhood caries. AUTHORS' CONCLUSIONS: It was disappointing that only three trials that compared three different types of materials were suitable for inclusion into this review. There were no significant differences found in all three trials for all of the outcomes assessed. Well designed, randomised controlled trials comparing the different types of filling materials for similar outcomes are urgently needed in dentistry. There was insufficient evidence from the three included trials to make any recommendations about which filling material to use.

Comportamiento de los compómeros en restauraciones de molares temporales. Revisión de la literatura / No disponible

La actual demanda de tratamientos estéticos y mínimamente invasivosen odontología, han provocado un incremento en el uso derestauraciones adhesivas.Los compómeros o resinas modificadas con componentes poliacídicos(RMCP) son materiales híbridos, donde el componente de resinaha sido añadido al cemento de ionómero de vidrio, para mejorar suspropiedades físicas y químicas. Los compómeros podrían superaralgunas de las limitaciones del cemento de ionómero de vidrio, talescomo: control del tiempo de curado, baja fuerza mecánica, estéticadesfavorable, sensibilidad a la humedad y difícil manipulación.Estas propiedades les confieren grandes ventajas al compómero.Sin embargo, los compómeros no presentan la reacción ácido-basetradicional observada en el cemento de ionómero de vidrio. La resistenciaal desgaste y las propiedades mecánicas de los compómerosson generalmente bajas en comparación con las de las resinas, perodichos materiales actúan como un reservorio permanente de flúor,previniendo la desmineralización y provocando la remineralización.El objetivo de este artículo es realizar una revisión bibliográficapara conocer cuales son las propiedades, composición y evaluaciónclínica del compómero; evaluar la polimerización, absorción del agua,microfiltración, actividad antibacterial y liberación de flúor llevadasa cabo por el mismo material (AU)

The current demand for aesthetic treatments and minimally invasivedentistry, which avoids removal of healthy dental tissue, increasesthe placement of adhesive tooth-colored restorations. At present,there is a vast range of adhesive materials available for clinicians.Compomers or polyacid-modified resin composites are hybridmaterials where resinous components have been added to glassionomer cements to improve their mechanical properties and bondstrength. Compomers could overcome some of the limitations ofglass ionomer cements, such as control curing time, low mechanicalstrength, unsatisfactory aesthetics and moisture sensitivity, and easyhandling, which justifies their widespread use. However, compomersdo not present the traditional acid-base reaction observed in glassionomer cements. The wear resistance and mechanical properties ofcompomers are generally lower than those of composites, but theyrelease fluoride and therefore act as a fluoride reservoir, preventingdemineralization and enhancing remineralization.This article aims to present a bibliographical review to ascertain theproperties, composition and clinical evaluation of the compomer;as well as observe the aspect of polymerization, water sorption,microleakage, antibacterial activity and fluoride release carried outby the same material (AU)

A randomized trial of resin-based restorations in class I and class II beveled preparations in primary molars: 24-month results.

PURPOSE: The authors conducted a randomized clinical trial to evaluate the survival rate of esthetic restorations in Class I and Class II beveled preparations in primary molars 24 months after placement. The null hypothesis was that there is no difference among survival rates of the restorative materials used. METHODS: Forty-eight children (mean age, 5 years 9 months) received 141 restorations in beveled cavosurface margins in primary molars randomly assigned by lottery method: 46 received treatment with Vitremer Tri-Cure Glass Ionomer System (3M ESPE Dental Products, St. Paul, Minn.) (33 Class I and 13 Class II restorations), 51 received treatment with Freedom (SDI, Bayswater, Victoria, Australia) (36 Class I and 15 Class II restorations); 44 received treatment with TPH Spectrum (Dentsply, Petropolis, Rio de Janeiro, Brazil) (30 Class I and 14 Class II restorations). Two examiners whose technique had been calibrated (weight kappa > 0.85) evaluated the restorations using modified U.S. Public Health Service criteria and Visible Plaque Index score at baseline and at 12, 18 and 24 months. RESULTS: After two years, the authors censored data for 17 restorations, considered 101 restorations to be clinically successful and deemed 23 restorations failed because of loss of marginal integrity, anatomical form discrepancies and secondary caries. For Class I and Class II restorations, the cumulative survival rates were higher than 80 percent and 55 percent, respectively, for all materials (life table, Gehan-Wilcoxon Test, P > .05; P > .05). CONCLUSIONS: At the 24-month clinical recall, the authors found no differences among materials in Class I (P > .05) or Class II beveled preparations (P > .05) in primary molars, but all materials showed higher survival rates in Class I than in Class II restorations.

Factors influencing dentists' choice of amalgam and tooth-colored restorative materials for Class II preparations in younger patients.

OBJECTIVE: To identify factors associated with dentists' decisions on choice of restorative material in children and adolescents. MATERIAL AND METHODS: In the period 2001-2004, 27 dentists in the Public Dental Health Service in Norway placed 4030 Class II restorations in 1912 patients. The reason for placement, previous caries experience (DMFT), oral hygiene, and characteristics of the cavity were recorded. RESULTS: The most frequently used material was resin composite (81.5%), followed by compomer (12.7%), amalgam (4.6%), and glass ionomer cement (1.2%). Tooth-colored restorations were more frequently placed than amalgam in younger patients (p=0.017). Female patients received fewer amalgam restorations than male patients (p=0.006). Amalgam was more often used in patients with high DMFT (p<0.001) and more commonly in treatment of deeper dentine caries than caries near the dentino-enamel border (p=0.021). Amalgam was more frequently placed in molars than in premolars (p<0.001). In a logistic regression model, gender, DMFT, caries severity, and tooth type were significantly related to choice of material. CONCLUSION: Dentists' choices of restorative material indicate that the majority prefer amalgam in more challenging restorations with respect to caries activity, lesion depth, and tooth type. The findings indicate that in a period when the use of amalgam was phasing out, resin composite was the predominant material of choice for Class II restorations in children and adolescents.

Ability of different restorative materials to prevent in situ secondary caries: analysis by polarized light-microscopy and energy-dispersive X-ray.

Secondary caries is the main cause of direct restoration replacement. The purpose of this study was to analyze enamel adjacent to different restorative materials after in situ cariogenic challenge using polarized-light microscopy (PLM), scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDS). Twelve volunteers, with a low level of dental plaque, a low level of mutans streptococci, and normal salivary flow, wore removable palatal acrylic appliances containing enamel specimens restored with Z250 composite, Freedom composite, Fuji IX glass-ionomer cement, or Vitremer resin-modified glass-ionomer for 14 days. Volunteers dripped one drop of 20% sucrose solution (n = 10) or distilled water (control group) onto each specimen 8 times per day. Specimens were removed from the appliances and submitted to PLM for examination of the lesion area (in mm(2)), followed by dehydration, gold-sputtering, and submission to SEM and EDS. The calcium (Ca) and phosphorus (P) contents were evaluated in weight per cent (%wt). Differences were found between Z250 and Vitremer, and between Z250 and FujiIX, when analyzed using PLM. Energy-dispersive X-ray analysis results showed differences between the studied materials regarding Ca %wt. In conclusion, enamel adjacent to glass-ionomer cement presented a higher Ca %wt, but this material did not completely prevent enamel secondary caries under in situ cariogenic challenge.

Approximal caries development in surfaces in contact with fluoride-releasing and non-fluoride-releasing restorative materials: an in situ study.

This study investigated the effect of compomer on initial interproximal caries development. One-hundred and sixty cylindrical, and 40 semispherical, bovine enamel samples (control) were prepared, polished, and sterilized. Sixty semicircular samples were prepared from each of the compomer Dyract eXtra and the fluoride-free composite Spectrum TPH. Samples were stored in water and fluoridated twice daily for 28 d. A baseline quantitative light fluorescence (QLF) image was made of each cylindrical sample. Twenty volunteers received intra-oral appliances with eight sample chambers. Each wing contained 1 control sample and either 3 Dyract eXtra or 3 Spectrum TPH samples in contact with the enamel surface of a cylindrical enamel sample. Appliances were worn for 24 h a day for 28 d except during toothbrushing (twice daily) and placement in 10% sucrose solution (five times daily). A final QLF image was made after 28 d. Caries development was analyzed as the lesion area x mean fluorescence loss (DeltaQ % mm(2)) between these and the baseline images using QLF subtract software. The median DeltaQ was significantly lower in the Dyract eXtra group (-6.1% mm(2)) than in the Spectrum TPH (-13.9% mm(2), P

Restorative caries therapy in nursing home residents using composite resins and compomers without a rubber dam.

OBJECTIVE: This study was designed to investigate the prognosis of restorative caries therapy applied in nursing home residents. METHOD AND MATERIALS: In 25 consecutive patients a total of 42 restorations were placed, 23 of composite resin (APX/SE Bond) and 19 of compomer (Dyract). The working conditions, such as patient cooperation, quantity of saliva, location of cavity margins, cavity size, and gingival inflammation, were evaluated prior to treatment. The restorations were evaluated qualitatively at baseline, after 6 months, and after 12 months. RESULTS: At 12 months, all examined restorations were clinically acceptable (6 patients had died). There was no significant difference between the quality of the restorations in composite resin and compomer. The plaque scores increased significantly during the study period. CONCLUSIONS: The study showed that, within the limitation of a short-term follow-up, restorative caries therapy using composite resin or compomer was successful in nursing home residents although rubber dam was not used.