Using dental students' preclinical performance as an indicator of clinical success.

The purpose of this study was to evaluate part of one dental school's predoctoral curriculum by investigating correlations between students' final grades in two preclinical courses and their performance in the related clinical courses. The sample consisted of 301 students at Tufts University School of Dental Medicine who graduated in 2010 and 2011. All final grades used as data were obtained from the Registrar's Office and evaluated anonymously. The average preclinical final grades differed significantly for students in the 2010 (M=84.92, SD=3.35) and 2011 (M=79.67, SD=4.67) classes, as did their average clinical final grades (2010: M=88.38, SD=2.13; 2011: M=87.45, SD=2.06). The data for each class were therefore examined separately. Results showed that the correlation between students' preclinical grades and clinical grades in operative dentistry and fixed prosthodontics was statistically significant (2010: r(2)=0.144, p<0.001; 2011: r(2)=0.261, p<0.001). This finding suggests there may be a positive relationship between preclinical and clinical performance of these students; however, the discrete factors contributing to that relationship were not investigated in this study and require further research.

Microleakage in Class II composite restorations with margins below the CEJ: in vitro evaluation of different restorative techniques.

OBJECTIVES: The purpose of this in vitro study was to evaluate the microleakage in "deep" Class II composite restorations with gingival cavosurface margin below the CEJ (cemento-enamel junction) and restored with different techniques. STUDY DESIGN: Fifty human teeth were used. In each tooth two standardized Class II slot cavities (on mesial and on distal surfaces) were prepared: the buccolingual extension of the cavities was 4 mm; the gingival wall was located in dentin/cementum (2 mm beyond the CEJ). The prepared teeth were randomly assigned to 5 experimental groups (of 10 specimens and 20 cavities each) and restored. Group 1: Filtek TM Supreme XTE Flowable (3MESPE) + Universal Filtek Supreme XTE (3MESPE), Group 2: GrandioSO Heavy Flow (Voco) + GrandioSo (Voco), Group 3: SDR™ (Dentsply Caulk) + Esthet-X® HD (Dentsply Caulk), Group 4: SonicFill (Kerr), Group 5: Grandio (Voco). After thermocycling, the specimens were immersed in a 0.5% basic fuchsine dye solution and incubated at 37°C for 24 hours. The teeth were subsequently sectioned mesiodistally. All specimens were examined at 25 in a stereomicroscope and standardized digital images were obtained. Dye penetration was measured from gingival margins. RESULTS: The results demonstrated no significant leakage differences between Group 4 and Group 5, that both showed significantly higher frequency distribution of Score 0. Group 2 and Group 3 showed a significant prevalence of Score 1, whereas Group 1 showed significantly higher frequency of Score 2. CONCLUSIONS: None of the restorative techniques tested completely eliminated microleakage dye penetration in dentin margins; marginal adaptation in Class II composite restorations with gingival wall below the CEJ varied in both substrates and from different restorative techniques used.

Clinical effectiveness and soft tissue compatibility of a temporary restorative material.

OBJECTIVE: The purpose of this six-week study was to evaluate in vivo the effectiveness of Systemp.inlay as a temporary restorative material. METHOD: Subjects with the proper indication for a class II restoration were entered into the study. Twenty-three subjects and twenty-nine temporary restorations were evaluated at time of placement, three and six weeks. Two faculty members were calibrated to evaluate the material. Following the six-week trial, the temporary restorative material was removed and the test teeth were restored with a definitive restorative material. RESULTS: The temporary restorative material provided mechanical and anticariogenic protection of tooth structure while preventing dental sensitivity and patient discomfort. It promoted soft tissue health as evidenced by the enhanced plaque and gingival indices found associated with the temporarily restored teeth. Its ease of placement and removal makes it an attractive alternative for the dental practitioner. The change in color of the material over the six-week duration of the study may limit its use to posterior teeth and to lingual/palatal surfaces of anterior teeth. CONCLUSION: Ease of placement and removal and retention of the temporary restorative material were extremely good. Marginal and surface integrity of the material was maintained and no or minimal sensitivity was reported throughout the study. The material did not promote the accumulation of plaque nor result in gingival inflammation. The color change noted was not of clinical importance. Therefore, this temporary restorative material was demonstrated to be clinically effective in Class II cavity preparations.

Reducing marginal flash in the fabrication of direct provisional restorations: a new technique using light-cured resin and transparent silicone.

The optimum placement of bonded indirect restorations depends to a large extent on establishing and maintaining the patient's gingival health during the provisional treatment phase, as inflamed sulcular tissues may compromise subsequent isolation efforts. Gingival health is best achieved by providing provisional restorations of correct emergence profile and accurate margination. This paper introduces a fully-cured direct provisionalization technique that minimizes marginal flash and improves the accuracy of the restoration in a fraction of the production time needed for traditional direct techniques requiring remargination. The technique, which relies on the use of a unique transparent over-impression registration material and visible light-curing provisional composite resin, is described in a case report.

RESTAURACIONES TEMPORALES DE LARGO PERIODO

Estas restauraciones temporales de largo periodo, proporcionan una guía para el contorno, color y oclusión de la prótesis final. Pueden ser usadas por un período largo y son estéticamente aceptables. Realzan la confianza del paciente en el tratamiento. Como la restauración es hecha en un modelo de yeso éste es más preciso y menos irritante a os tejidos bucales y a la pulpa dental. El uso de los dientes prefabricados de acrílicos, cimo el componente vestibular de una protección provicional de dientes anteriores, permite el incremento en cuanto al control se refiere del color, forma y contorno. Estas restauraciones temporales de largo período protegen a la dentina que se encuentra sencible debido alos desgastes en la preparación del muñon

Restauraçöes cervicais / Cervical restorations

Tendo em vista a freqüência com que a cárie se instala nas porçöes cervicais dos dentes e a enorme dificuldade em se fazer ali o preparo cavitário assim como a restauraçäo, os autores enumeram os procedimentos e as técnicas mais comuns ou freqüêntes para se atingir, com sucesso, tal regiäo permitindo-se amplo acesso ao operador, tanto no preparo como na restauraçäo