Database: MEDLINE <: biomedical, nursing & dental literature, 1960 - Dec 2000.> Search Strategy (You Saved Citations 1-300 From Set 60): ----------------------------------------------------------------------------- 1 "Pit and fissure sealants"/ 1835 2 ((dental or tooth or teeth or fissure$1 or pit$1) adj5 1906 (seal$1 or sealant$1 or sealing)).mp. 3 or/1-2 2189 4 exp Glass ionomer cements/ 2837 5 (glass adj ionomer).mp. 3026 6 ((polyalkenoate or cermet) adj3 cement$1).mp. 309 7 (ketac adj silver adj3 cement$1).mp. 19 8 or/4-7 3063 9 or/3,8 5088 10 exp Tooth demineralization/ 22727 11 demineralization.mp. 1642 12 caries.mp. 15378 13 caires.mp. 1 14 craies.mp. 0 15 careis.mp. 4 16 carise.mp. 0 17 (teeth adj3 cavit:).mp. 424 18 (tooth adj3 cavit:).mp. 217 19 (dental adj3 cavit:).mp. 277 20 (dentin adj3 cavit:).mp. 256 21 (enamel adj3 cavit:).mp. 183 22 (teeth adj3 decay:).mp. 382 23 (tooth adj3 decay:).mp. 325 24 (dental adj3 decay:).mp. 252 25 (dentin adj3 decay:).mp. 12 26 (enamel adj3 decay:).mp. 20 27 (active adj decay).mp. 9 28 (rampant adj3 decay:).mp. 14 29 (recurrent adj3 decay:).mp. 30 30 (white adj spot:).mp. 517 31 carious.mp. 2088 32 cariology.ti,ab. 56 33 (non-cavitated adj3 lesion:).mp. 15 34 (noncavitated adj3 lesion:).mp. 2 35 Tooth remineralization/ 480 36 (dental adj3 fissure:).mp. 100 37 (tooth adj3 fissure:).mp. 51 38 (teeth adj3 fissure:).mp. 98 39 caries-free.mp. 607 40 cariesfree.mp. 17 41 Cariogenic agents/ 730 42 precavit:.mp. 8 43 (filled adj3 teeth).mp. 518 44 (filled adj3 tooth).mp. 117 45 (oral adj fissure:).mp. 6 46 (tooth adj3 remineraliz:).mp. 28 47 (teeth adj3 remineraliz:).mp. 24 48 dft.mp. 420 49 dfs.mp. 1286 50 dmf:.mp. 6429 51 cariogeni:.mp. 1794 52 or/10-51 32447 53 (disease adj free adj (survival or patient:)).mp. 6954 54 52 not 53 31603 55 9 and 54 1867 56 limit 55 to (human and english language and yr=1980-2001) 1221 57 limit 56 to (adolescence < 13 to 18 years > or adult < 19 415 to 44 years > or middle age < 45 to 64 years > or "aged < 65 and over >" or "aged, < 80 and over >") 58 "Root caries"/ 301 59 exp Tooth root/ 7060 60 57 not (58 or 59) 394 61 from 60 keep 1-300 300 *************************** <1> UI - 20329395 AU - Folwaczny M AU - Mehl A AU - Kunzelmann KH AU - Hickel R IN - Department of Operative Dentistry and Periodontology, Ludwig-Maximilians University, Munich, Germany. mfolwa@dent.med.uni-muenchen.de TI - Determination of changes on tooth-colored cervical restorations in vivo using a three-dimensional laser scanning device. SO - European Journal of Oral Sciences 2000 Jun;108(3):233-8 AB - The present study aimed at the determination of changes of tooth-colored cervical restorations in vivo using an optical 3-dimensional laser scanning device. The study was performed on 197 cervical restorations placed on incisors, canines, and premolars. Four different tooth-colored restoration materials, a composite, a polyacid-modified resin composite, and two resin-modified glass ionomer cements, were used for the restoration of the lesions. For the determination of changes, images were taken at baseline and 15, 24 and 36 months after the placement of the fillings using a 3D-laser scanning device. The images were superimposed automatically, and digital subtraction was made by a specially developed image analysis software. The total substance loss on the entire filling surface at 36 months for the resin-modified glass ionomer Photac-Fil was 44 (+/-23) microm, for Fuji II LC 45 (+/-26) microm, for Dyract 71 (+/-47) microm and for Tetric 18 (+/-12) microm. Differentiating between the class of lesion, a higher wear rate was observed at 36 months on restorations which had been placed in erosion/non-carious cervical cavities (66 (+/-33) microm). In conclusion, the composite material demonstrated a distinctly lower surface wear rate over time in comparison to the resin-modified glass ionomer cements and the polyacid-modified resin composite. <2> UI - 20373046 AU - Fiset L AU - Grembowski D AU - Del Aguila M IN - University of Washington, School of Dentistry, Department of Dental Public Health Sciences, Seattle, USA. TI - Third-party reimbursement and use of fluoride varnish in adults among general dentists in Washington State. SO - Journal of the American Dental Association 2000 Jul;131(7):961-8 AB - BACKGROUND: Studies have indicated that a minority of dentists regularly use fluoride varnish to control caries. To increase the use of this new technology, Washington Dental Service, or WDS, began reimbursing dentists for providing fluoride varnish in January 1996. The aim of the authors' study was to determine whether reimbursement increased dentists' use of fluoride varnish. METHODS: In the fall of 1995, the authors asked a random sample of 532 general dentists in Washington state to complete a mail questionnaire on their use of caries control services. The survey was conducted before the institution of payment for fluoride varnish use, and dentists were unaware that fluoride varnish use would be a paid service in January 1996. In the fall of 1997 the same dentists were asked to complete a second questionnaire on the same topic. RESULTS: About 32 percent of dentists used fluoride varnish regularly before WDS started reimbursement for the service. Two years after reimbursement began, about 44 percent of dentists regularly used fluoride varnish (P = .004). Dentists' rates of use of other caries-control services (chlorhexidine rinses for caries control and adult pit-and-fissure sealants) did not change. Dentists' reasons for not using fluoride varnish included lack of awareness, lack of convincing evidence of a favorable cost:benefit ratio, patients' rejection of the service and low caries risk among adult patients. CONCLUSIONS: After fluoride varnish became a covered benefit, the use of fluoride varnish among general dentists increased after two years, but a majority of dentists still had not adopted the technology. The increase in use may be due to reimbursement, as well as other factors. PRACTICE IMPLICATIONS: Reimbursement by itself cannot increase dentists' use of caries control services. <3> UI - 20285798 AU - Rahimtoola S AU - van Amerongen E AU - Maher R AU - Groen H IN - Dental Clinics, Aga Khan University Hospital, Karachi, Pakistan. TI - Pain related to different ways of minimal intervention in the treatment of small caries lesions. SO - ASDC Journal of Dentistry for Children 2000 Mar-Apr;67(2):123-7, 83 AB - Pain during invasive treatment of dental caries is a common phenomenon, if no local analgesia has been used before cavity preparation. Atraumatic restorative technique (ART) is a suggested procedure which is at least less traumatic for the patient. Although the ART approach has been received well by both children and adults who belong to population groups hardly ever exposed to regular oral health care, it has not yet been proven that this particular procedure really causes less pain, compared to more conventional techniques with rotating instruments. In the present study, pain was reported in connection with tooth restoration in 19.3 percent of the cases, when the ART technique was used, which is significantly less than with a conventional restorative technique (35.7 percent). Finally the results show a clear relationship in the pain reports between the first and the following treatments in both ART and the conventional technique groups. <4> UI - 20317920 AU - Rethman J TI - Trends in preventive care: caries risk assessment and indications for sealants. [Review] [27 refs] SO - Journal of the American Dental Association 2000 Jun;131 Suppl:8S-12S AB - BACKGROUND: In the 21st century, risk assessment models will continue to be developed. By understanding patients' susceptibility to disease, better treatment and preventive regimens can be offered. As the causative agent of dental caries is bacterial, the interaction between the susceptible host, the causative agent and the environment determine whether caries occurs--regardless of the patient's age. CLINICAL IMPLICATIONS: This article reviews risk assessment for dental caries and the implication for developing preventive strategies. It also describes the indications and uses of sealants in the prevention of dental caries. [References: 27] <5> UI - 20285626 AU - Manhart J AU - Hickel R IN - Department of Restorative Dentistry, Dental School, LMU-University, Munich, Germany. manhart@dent.med.uni-muenchen.de TI - Esthetic compomer restorations in posterior teeth using a new all-in-one adhesive: case presentation. SO - Journal of Esthetic Dentistry 1999;11(5):250-8 AB - Compomers have continually gained in importance since their introduction in 1993, especially because of their ease of handling. The main indications are cervical lesions, Class III restorations, and restorations in the primary dentition. To extend the indications of compomers to esthetic Class I and II restorations in the permanent dentition, improvements in wear resistance and bond strength need to be accomplished. Studies have shown an improved bond strength and less marginal gap formation between compomers and enamel and dentin with acid etching of the tooth before application of conventional mild self-etching adhesives. Newly formulated, improved self-etching adhesives with a higher demineralization potential recently have been developed. The objective of this case presentation is to demonstrate step-by-step the clinical procedure for the application of a newly developed self-etching adhesive with high demineralization potential in combination with a compomer material in occlusal cavities. CLINICAL SIGNIFICANCE: Improved self-etching adhesives provide a faster and simplified application technique and allow effective conditioning and priming of enamel and dentin in one step, without waiving sufficient bond strengths. With limited indications, compomers are used in combination with these self-etching primers to restore occlusal cavities in posterior teeth. Evidence-based dentistry requires exact scientific data to evaluate whether this new trend results in benefits for patients. However, until clear evidence from controlled clinical studies supports the use of improved compomer systems in Class I and II cavities in the permanent dentition, dentists should be careful with this indication. <6> UI - 20321761 AU - Luo Y AU - Wei SH AU - Fan MW AU - Lo EC IN - Faculty of Dentistry, University of Hong Kong, Hong Kong. TI - Clinical investigation of a high-strength glass ionomer restorative used with the ART technique in Wuhan, China: one-year results. SO - Chinese Journal of Dental Research 1999 Dec;2(3-4):73-8 AB - OBJECTIVE: To evaluate the safety and effectiveness of a new glass ionomer restorative, ChemFlex, and to compare its clinical performance and wear to another popular material, Fuji IX GP, when used with the atraumatic restorative treatment (ART) approach in posterior teeth in school children. METHODS: Ninety-two subjects aged between 6 and 14 years who had bilateral matched pairs of carious posterior teeth were selected. A split-mouth experimental design was used in which the two restorative materials were randomly placed on contralateral sides. The restorations were assessed directly and also indirectly from color transparencies and die replicas. RESULTS: After one year, the success rates of ART restorations in the primary teeth were 96.6% for ChemFlex restorations and 89.7% for Fuji IX GP restorations placed in the Class I cavity preparations, whereas only 46.2% (ChemFlex) and 61.5% (Fuji IX GP) of Class II restorations were assessed as clinically satisfactory. In the permanent dentition, the success rates were 94.6% and 98.2% for ChemFlex and Fuji IX GP, respectively; however, there was no statistically significant difference between the two restoratives for either the permanent or primary teeth. The mean occlusal wear after one year in the permanent teeth was 53.2 microns for ChemFlex and 56.3 microns for Fuji IX GP. Again, there were no statistically significant differences in wear between the two materials (P > 0.05). CONCLUSION: The clinical performance of both ChemFlex and Fuji IX GP over a 12-month period was highly satisfactory and completely adequate for the ART technique, particularly in Class I cavities. <7> UI - 20316567 AU - Sgan-Cohen HD AU - Saadi S AU - Weissman A IN - Department of Community Dentistry, Hebrew University-Hadassah, Faculty of Dental Medicine, Jerusalem, Israel. TI - Dental knowledge and attitudes among Arab schoolteachers in northern Israel. SO - International Dental Journal 1999 Oct;49(5):269-74 AB - A representative random sample of 597 Arab school-teachers in northern Israel, was surveyed regarding sources and levels of knowledge and attitudes about dental caries prevention. Data were measured according to a self-administered questionnaire from a 91.4 per cent response rate. When ranking the effectiveness of different caries preventive measures teachers on average listed optimal water fluoridation as a lower priority compared to toothbrushing, dental visits, fluoride mouthrinses and eating fewer sweet products. Placing of fissure sealants was ranked as the second least effective caries preventive measure, with 39.6 per cent not knowing the effectiveness. Only 68.5 per cent of the school-teachers were aware of the anti-bacterial role of fluoride, and only a small minority knew of fluoride's potential in healing incipient caries. Teachers seemed less motivated to being involved in dental health school programmes which involved dedicating school time and their active involvement, such as fissure sealant programmes at school, supervision of brushing and flossing, and school mouthrinsing programmes. They revealed positive attitudes towards: informing parents about the importance of oral hygiene and teaching children about preventive dentistry. Teachers' main reported source of knowledge was the dental office. It is the responsibility of the dental profession to ensure that updated knowledge is correctly conveyed to schoolteachers, who are an important and potentially influential sector of dental health consumers and health education agents. <8> UI - 20316554 AU - Tveit AB AU - Espelid I AU - Skodje F IN - Faculty of Dentistry, Department of Odontology-Cariology, University of Bergen, Norway. anne.tveit@odont.uib.no TI - Restorative treatment decisions on approximal caries in Norway. SO - International Dental Journal 1999 Jun;49(3):165-72 AB - A random sample of dentists in Norway were asked which radiographic criterion for assessing the initiation of restorative treatment of approximal caries they would use, and which type of cavity preparation and filling material they would prefer for a distal lesion on an upper second premolar. Only 19 per cent stated that they would treat approximal lesions confined to enamel, with 81 per cent opting to wait until lesions had reached dentine, compared with 66 per cent in a similar study performed in 1983. The tunnel preparation was cited most often as the preparation of choice (47.3 per cent), while 28.2 per cent preferred traditional class II preparations and 24.3 per cent a saucer shaped preparation. Only 15.5 per cent of the dentists chose amalgam as the restorative, 15.8 per cent composite, 22.3 per cent a conventional glass ionomer cement, 7.2 per cent a resin modified glass ionomer cement and 22.4 per cent a combination of glass ionomer and composite. There has been a shift in operative treatment criteria among the majority of dentists in Norway from 1983 to 1995, with most now waiting until the lesion is diagnosed in dentine radiographically before restoring. Most dentists prefer new preparation techniques for approximal caries using tooth coloured materials. Only every fifth dentist has amalgam as a first choice for approximal restorations in the posterior region. <9> UI - 20305853 AU - Allukian M Jr TI - The neglected epidemic and the surgeon general's report: a call to action for better oral health [editorial]. SO - American Journal of Public Health 2000 Jun;90(6):843-5 <10> UI - 20291716 AU - Dennison JB AU - Straffon LH AU - Smith RC IN - Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor 48109, USA. TI - Effectiveness of sealant treatment over five years in an insured population. SO - Journal of the American Dental Association 2000 May;131(5):597-605 AB - BACKGROUND: The authors analyzed an insurance claim database to evaluate the use and effectiveness of placing sealants on first and second permanent molars of children in private dental practices. METHODS: A retrospective study was conducted using an insured population with sealant coverage at 70 percent of the usual fee in a preferred provider organization than that limited reapplication to once every three years. Children were selected who were eligible for sealant benefits from July 1, 1990, to June 30, 1991. Two groups were selected for analysis, based on age, as determined by permanent molar eruption dates. Children who received sealants were compared with those who did not to determine post-sealant restorative outcomes after five years. RESULTS: During the full year of coverage, sealants were used in only 16.3 percent of first permanent molars and 11.6 percent of second permanent molars. The five-year incidence of an occlusal restoration having been placed was 13.7 percent and 20.8 percent, respectively, on nonsealed first and second molars and 6.5 percent and 10.4 percent, respectively, on sealed first and second molars. From years three to five, sealant placement provided only nominal additional preventive effect. CONCLUSIONS: In the population selected, both the incidence of occlusal caries and the use of sealants were lower than expected for both age groups. However, within these groups, molar occlusal surfaces were only half as likely to have been restored in sealed teeth than in nonsealed teeth after five years. CLINICAL IMPLICATIONS: Based on the five-year data from a population with a low incidence of caries, the authors found that 15 sealed first permanent molars or 10 sealed second permanent molars prevented placement of one occlusal restoration. Therefore, sealants are more effective when placed in patients with risk factors for occlusal caries. <11> UI - 20229207 AU - Poorterman JH AU - Weerheijm KL AU - Groen HJ AU - Kalsbeek H IN - Department of Social Dentistry and Dental Health Education, Academic Centre for Dentistry Amsterdam, The Netherlands. j.poorterman@acta.nl TI - Clinical and radiographic judgement of occlusal caries in adolescents. SO - European Journal of Oral Sciences 2000 Apr;108(2):93-8 AB - In this study, the clinical and radiographic material of two groups of 17- and 20-yr-old adolescents, born either in 1970 or in 1976, was compared to study changes in the prevalence of occlusal dentine caries and to determine the additional value of the bitewing radiographs. The first and second molars of 478 participants were included. Clinical data were derived from an epidemiological project. Two examiners judged the bitewing radiographs, of which about 10% was examined by both. The overall Cohen's kappa for interexaminer agreement was 0.87. The prevalence of occlusal caries had not changed for the two age groups; after clinical and radiographic examination, around 33% of the occlusal surfaces of the 17 yr olds and around 25% of the 20 yr olds exhibited dentine caries. The clinical prevalence of occlusal caries in first and second molars was highly underestimated when compared with the radiographs. In the 1976 group, more sealants were recorded during the clinical examination. On the bitewing radiographs, radiolucencies were found underneath one-half of the sealants of the 17 yr olds and underneath one quarter of the sealants present in the 20 yr olds. <12> UI - 20282496 AU - Gordan VV AU - Mjor IA AU - Moorhead JE IN - University of Florida, College of Dentistry, Department of Operative Dentistry, Gainesville, FL 32610-0415, USA. TI - Amalgam restorations: postoperative sensitivity as a function of liner treatment and cavity depth. SO - Operative Dentistry 1999 Nov-Dec;24(6):377-83 AB - The purpose of this clinical study was to assess the sensitivity reported by patients following the insertion of class 1 or class 2 amalgam restorations in the treatment of primary carious lesions of different depths. Ninety subjects with previously untreated teeth requiring restorations due to caries lesions were selected: 32 teeth had lesions that were clinically and radiographically judged to be located in the outer one-third of dentin, 30 were located in the middle one-third of dentin, and 28 were located in the inner one-third of dentin. Four different lining regimens were employed: Group 1--no linear; Group 2--two coats of Copalite liner; Group 3--a dentin adhesive resin liner (Scotchbond Multi-Purpose); Group 4--a resin-modified glass ionomer (Fuji Bond LC). Patients were contacted on days 2 and 7 postoperatively and questioned regarding the presence or absence of sensitivity, the stimuli that created the sensitivity, if any, the duration of any sensitivity, and the intensity of any sensitivity using a rating from None to Severe. If sensitivity was experienced on day 7, patients were also contacted on days 14, 30, and 90 to assess the sensitivity at those intervals. The chi-square test of independence showed no significance at the 0.05 level between the different dentin treatments and cavity depths. By day 2, 19% of lesions located in the outer one-third, 27% of lesions located in the middle one-third, and 29% of lesions located in the inner one-third of dentin were sensitive. On day 30, four teeth were still sensitive, two located in the middle one-third and two located in the outer one-third of dentin. On day 90 all teeth were without sensitivity. <13> UI - 20274726 AU - Hassall DC AU - Mellor AC AU - Blinkhorn AS IN - Division of Restorative Dentistry, Leeds Dental Institute, UK. TI - Prevalence and attitudes to fissure sealants in the general dental service in England. SO - International Journal of Paediatric Dentistry 1999 Dec;9(4):243-51 AB - OBJECTIVES: The study objectives were to investigate changes in the prevalence of fissure sealants over a 5-year period among a comparable group of 14-15-year-old regular dental attenders registered with general dental practitioners in 1989 and 1994, and to investigate attitudes towards this form of care amongst general dental practitioners in 1994. METHODS: Random samples of 14-15-year-old pupils were selected from school lists in three areas in England (Doncaster, Hereford/Worcester and Wycombe) in 1989 and 1994. Once parental consent had been gained to examine the children, the Dental Practice Board (DPB) indicated which subjects were 'regular attenders', only these subjects were included in the study. All the subjects in each area were examined by a single trained and calibrated examiner using a standardized technique. In 1994, a group of randomly selected dentists in each area completed a telephone questionnaire assessing attitudes and treatment patterns regarding fissure sealants. RESULTS: In 1989, 2836 letters were posted to parents asking for consent to examine their child and 2174 positive responses were received (response rate 77%). Of the 1919 children examined, 459 were classed as regular attenders, 140 in Doncaster, 159 in Hereford/Worcester and 160 in Wycombe. In 1994, 2560 consent letters were distributed to children in school to pass to their parents and 1587 positive responses were received (response rate 62%). Of the 1388 children examined, 891 were classed as regular attenders, 294 in Doncaster, 318 in Hereford/Worcester and 279 in Wycombe. Large rises in sealant prevalence were observed in all areas, but particularly in Doncaster where sealant prevalence increased from 13% in 1989 to 50% in 1994. In Hereford/Worcester it increased from 25% to 47% and in Wycombe it increased from 16% to 30%. There was also a fall in mean DMFT in all areas. In Doncaster it fell from 2.97 in 1989 to 1.82 in 1994, in Hereford/Worcester it fell from 2.60 to 1.83 and in Wycombe it fell from 1.86 to 1.29. In all three areas the changes in sealant prevalence and DMFT were statistically significant. The questionnaire revealed positive attitudes towards fissure sealants and their usage as well as a number of areas of concern that could potentially hinder sealant usage. CONCLUSIONS: Dramatic increases in sealant prevalence and considerable reductions in dental caries among these regularly attending adolescents have been demonstrated. Some concerns were highlighted regarding sealant usage, which may be prejudicing further increases in their application. <14> UI - 99139131 AU - Morgan MV AU - Campain AC AU - Adams GG AU - Crowley SJ AU - Wright FA IN - School of Dental Science, University of Melbourne, Victoria, Australia. TI - The efficacy and effectiveness of a primary preventive dental programme in non-fluoridated areas of Victoria, Australia [see comments]. CM - Comment in: Community Dent Health 1999 Jun;16(2):123 SO - Community Dental Health 1998 Dec;15(4):263-71 AB - OBJECTIVE: To determine the efficacy and effectiveness of a primary preventive dental programme. DESIGN: A field trial comparing an intervention and control group over three years. The intervention group received a preventive programme which consisted of a weekly fluoride mouthrinse (0.2% neutral NaF), an annual application, replacement or repair of pit and fissure sealants, and an annual oral hygiene education programme. The control group received the oral hygiene education programme only. Examinations to record dental caries status were conducted annually for both study groups. SETTING: Five secondary colleges in two non-fluoridated regions of Victoria, Australia. SUBJECTS: 522 subjects aged 12-13 years and considered at high risk of developing dental caries were recruited for the study; 256 received the preventive programme and 266 acted as controls. OUTCOME MEASURES: Dental caries was diagnosed according to World Health Organization criteria. RESULTS: Subjects in the intervention group who completed the three-year preventive programme (efficacy) incurred an average of 1.49 fewer decayed, missing or filled tooth surfaces than the control group. The difference was highly statistically significant. The programme also had a statistically significant impact when analysed by intention-to-treat (effectiveness), even when it was assumed that subjects lost to follow-up received minimal future benefit. Approximately 70% of the improvement in oral health was in the pit and fissure surfaces, with the remainder in the smooth surfaces. CONCLUSION: A comprehensive preventive dental programme introduced into adolescent populations at high risk of developing dental caries can result in significant improvements in their dental health. Further research is required to clarify the public health impact of school-based fluoride mouth rinsing. <15> UI - 20198789 AU - Eklund SA AU - Pittman JL AU - Heller KE IN - University of Michigan, School of Public Health, Department of Epidemiology, Ann Arbor 48109-2029, USA. saeklund@umich.edu TI - Professionally applied topical fluoride and restorative care in insured children. SO - Journal of Public Health Dentistry 2000 Winter;60(1):33-8 AB - OBJECTIVES: This study evaluates the association between use of professionally applied topical fluoride and use of interproximal restorations in primary and permanent teeth of children. METHODS: Insurance claims from 15,190 children, for treatment provided by 1,556 different dentists, were analyzed to look for associations between frequency of use of professionally applied topical fluoride and use of interproximal restorations. The average follow-up period for the children included in the analysis was 5.3 years, with the range from 3.0 to 7.9 years. RESULTS: Both tabular and regression results failed to demonstrate an association between frequency of use of professionally applied topical fluoride and use of interproximal restorations in either the primary or permanent dentition. The most powerful predictor of restorative care for these children was the overall propensity of the dentist to place restorations in children. CONCLUSIONS: In this group of insured children, we were unable to find an association between the frequency of use of professionally applied topical fluoride and restorative care. Further, despite numerous recommendations that professionally applied topical fluorides should be used only in moderate- and high-caries children, approximately two-thirds of these children received topical fluoride at every recall visit, nearly two times per year. <16> UI - 20228682 AU - Lui JL IN - Department of Conservative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia. TI - Enhanced post crown retention in resin composite-reinforced, compromised, root-filled teeth: a case report. SO - Quintessence International 1999 Sep;30(9):601-6 AB - The introduction of an intraradicular composite reinforcing technique, in conjunction with the reestablishment of matching post canal spaces, has allowed compromised, root-filled teeth to be restored with functional, esthetic post crowns. This clinical case report suggests that reconstituted post canals, in accurately adapting to passive, parallel-sided, matching, and well-fitting posts, can enhance the retention of post crowns. Other factors of clinical importance relating to the resin-reinforced technique are discussed, including fracture resistance, depth of polymerization, dentin adhesion, polymerization shrinkage, and coronal microleakage. <17> UI - 20192964 AU - Vrbic V IN - Division of Dental Medicine, Medical Faculty, University of Ljubljana, Slovenia. TI - Reasons for the caries decline in Slovenia. SO - Community Dentistry & Oral Epidemiology 2000 Apr;28(2):126-32 AB - In 1987, 1993 and 1998, nationwide surveys on the prevalence of dental caries were carried out in Slovenia. Sampling and examinations were performed according to WHO standards. The age groups 6, 12, 15, 18, 35-44 and 65 years or older were studied. In each age group, 200 persons or more were examined on each occasion. The results showed that the proportion of caries-free children and adolescents increased considerably over the 12-year period between the first and the last survey (from 6% to 40% for 12-year-olds). In the same period, the mean DMFT values decreased as follows: from 5.1 to 1.8 for 12-year-olds, from 10.2 to 4.3 for 15-year-olds, from 12.9 to 7.0 for 18-years-olds, from 20.5 to 14.7 for 35-44-year-olds, and from 27.0 to 22.5 for subjects aged 65 years or more. The notable improvement of dental health can be explained by the preventive programmes in operation in various periods. The most recent decline was most likely due to supervised brushing (with concentrated fluoride gel) taking place some 16-18 times a year in primary schools attended by children aged 7-15 years, improved oral hygiene, and a comprehensive programme of applying fissure sealants, particularly on first molars. <18> UI - 20162073 AU - Frame PS AU - Sawai R AU - Bowen WH AU - Meyerowitz C IN - Tri-County Family Medicine, Cohocton, New York 14826, USA. TI - Preventive dentistry: practitioners' recommendations for low-risk patients compared with scientific evidence and practice guidelines. [Review] [16 refs] SO - American Journal of Preventive Medicine 2000 Feb;18(2):159-62 AB - INTRODUCTION: The purpose of this article is to compare published evidence supporting procedures to prevent dental caries and periodontal disease, in low-risk patients, with the actual preventive recommendations of practicing dentists. METHODS: Methods included (1) a survey questionnaire of general dentists practicing in western New York State concerning the preventive procedures they would recommend and at what intervals for low-risk children, young adults, and older adults; and (2) review of the published, English-language literature for evidence supporting preventive dental interventions. RESULTS: The majority of dentists surveyed recommended semiannual visits for visual examination and probing to detect caries (73% to 79%), and scaling and polishing to prevent periodontal disease (83% to 86%) for low-risk patients of all ages. Bite-wing radiographs were recommended for all age groups at annual or semiannual intervals. In-office fluoride applications were recommended for low-risk children at intervals of 6 to 12 months by 73% of dentists but were recommended for low-risk older persons by only 22% of dentists. Application of sealants to prevent pit and fissure caries was recommended for low-risk children by 22% of dentists. Literature review found no studies comparing different frequencies of dental examinations and bite-wing radiographs to determine the optimal screening interval in low-risk patients. Two studies of the effect of scaling and polishing on the prevention of periodontal disease found no benefit from more frequent than annual treatments. Although fluoride is clearly a major reason for the decline in the prevalence of dental caries, there are no studies of the incremental benefit of in-office fluoride treatments for low-risk patients exposed to fluoridated water and using fluoridated toothpaste. CONCLUSIONS: Comparative studies using outcome end points are needed to determine the optimal frequency of dental examinations and bite-wing radiographs for the early detection of caries, and of scaling and polishing to prevent periodontal disease in low-risk persons. There is no scientific evidence that dental examinations, including scaling and polishing, at 6 month intervals, as recommended by the dentists surveyed in this study, is superior to annual or less frequent examinations for low-risk populations. There is also no evidence that in-office fluoride applications offer incremental benefit over less costly methods of delivering fluoride for low-risk populations. [References: 16] <19> UI - 99442596 AU - Reekie D TI - Ending the misery of child dental decay [see comments]. CM - Comment in: Br Dent J 1999 Oct 9;187(7):348 SO - British Dental Journal 1999 Aug 28;187(4):174-6 AB - Dental caries in children's teeth has drastically declined in the last 30 years. We should be proud of this achievement but there is much still to do. One of the greatest stumbling blocks to further progress is, I believe, the current payment system for NHS children's dentistry which has failed to promote effective prevention amongst the most caries prone. To remedy this I propose some simple, low cost changes which could make decay in a child's tooth a rarity in our practices. <20> UI - 20113834 AU - Crall JJ AU - Szlyk CI AU - Schneider DA IN - Department of Pediatric Dentistry, University of Connecticut Health Center, Farmington 06030-1610, USA. crall@nso.uchc.edu TI - Pediatric oral health performance measurement: current capabilities and future directions. SO - Journal of Public Health Dentistry 1999 Summer;59(3):136-41 AB - This paper offers an overview of performance measurement in health care, provides a synopsis of the findings and recommendations of an Oral Health Expert Panel organized by the National Committee for Quality Assurance (NCQA) under contract with the Health Care Financing Administration (HCFA), and discusses challenges and possible future directions for pediatric oral health care performance measures development. Existing performance measures for pediatric oral health care are extremely limited; however, several new measures have been proposed and are in various stages of development and testing. Measures capable of being implemented in the short-term focus on access and use of services, rely on administrative data sources, and represent refinements and enhancements of current measures. Measures proposed for future implementation focus more on the effectiveness of care, consumer assessments of care and plan performance, and the value of services provided to enrolled children. Recommendations are targeted toward high-risk children who, for the most part, are covered by public programs (e.g., Medicaid and the Children's Health Insurance Program). Nevertheless, the entire set of recommended measures is considered to be relevant to all pediatric populations and applicable to all forms of dental care coverage, including state-administered programs and commercial third party arrangements. <21> UI - 20114193 AU - Brackett WW AU - Browning WD AU - Ross JA AU - Gregory PN AU - Owens BM IN - Department of Adult Restorative Dentistry, College of Dentistry, University of Nebraska Medical Center, Lincoln 68583-0750, USA. wbracket@unmc.edu TI - 1-year clinical evaluation of Compoglass and Fuji II LC in cervical erosion/abfraction lesions. SO - American Journal of Dentistry 1999 Jun;12(3):119-22 AB - PURPOSE: This study was undertaken to compare the clinical performance of a polyacid-modified resin-based composite and a resin-modified glass-ionomer restorative material over 1 year. MATERIALS AND METHODS: Thirty-four pairs of restorations of Compoglass (C) and Fuji II LC (F) were placed in 31 patients, with no patient receiving more than two pairs, and with materials assigned at random within the pairs. Caries-free cervical erosion/abfraction lesions of the facial surface were restored without tooth preparation according to manufacturers' instructions, except that tooth structure to be restored was etched with 37% phosphoric acid prior to placement of Compoglass. Restorations were clinically evaluated by two blinded examiners at baseline, 6 months, and 1 year, using modified Ryge/USPHS criteria. Restorations receiving a score of "Charlie" in either retention or secondary caries were classified as failed restorations. The incidence of failures was statistically analyzed as a pairwise comparison, using an exact binomial test. RESULTS: Thirty-one pairs of restorations were available for recall at 1 year. The percentage of Alfa scores for each material in each category were: Retention (C = 84%, F = 100%), Color match (C = 81%, F = 100%), Marginal discoloration (C = 78%, F = 97%), Secondary caries (C = 88%, F = 100%), Anatomic form (C = 92%, F = 100%), and Marginal adaptation (C = 26%, F = 46%). Except for the failed restorations, no other Charlie scores were assigned. A significant difference in the incidence of failed restorations was found between the materials (P = 0.01). <22> UI - 20075337 AU - Wenderoth CJ AU - Weinstein M AU - Borislow AJ IN - Albert Einstein Medical Center, The Maxwell S. Fogel Department of Dental Medicine, Division of Orthodontics, Philadelphia, PA 19141-3098, USA. TI - Effectiveness of a fluoride-releasing sealant in reducing decalcification during orthodontic treatment. SO - American Journal of Orthodontics & Dentofacial Orthopedics 1999 Dec;116(6):629-34 AB - Decalcification and caries during orthodontic treatment still remains a problem. A method to protect the susceptible area beneath and adjacent to bonded attachments, independent of patient compliance, would be extremely beneficial. A clinical trial was performed using a dual-cured lightly filled BIS-GMA fluoride-releasing sealant. The barrier effect of this material on white spot formation, gingival irritation, and plaque accumulation during fixed orthodontic therapy was examined. Twenty patients with a total of 225 metal brackets placed on anterior teeth participated in this study. Brackets were placed in both arches in a conventional manner with a chemically cured, unfilled bonding resin; 112 teeth (every other tooth) received the barrier material after bracket placement, while the remaining 113 teeth served as controls. Intraoral photographic slides were taken before and after treatment and were evaluated blindly by 7 observers for white spot formation. Gingival and plaque indexes were recorded initially and consecutively every 6 months. Observation time ranged from 5 to 18 months. The results of this prospective clinical study indicated that there was no significant difference (P >.05) between the decalcification rates of the treatment or control groups. Likewise there was no added benefit with respect to plaque accumulation or gingival irritation. <23> UI - 20079758 AU - Bryant CL TI - The role of air abrasion in preventing and treating early pit and fissure caries. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1999 Nov;65(10):566-9 <24> UI - 20067060 AU - van Amerongen WE AU - Rahimtoola S IN - Department of Cariology, Endodontology Pedodontology, ACTA, Amsterdam, The Netherlands. w.e.van.amerongen@acta.nl TI - Is ART really atraumatic?. SO - Community Dentistry & Oral Epidemiology 1999 Dec;27(6):431-5 AB - Atraumatic restorative treatment (ART) is an approach to the management of carious lesions that uses only hand instruments to remove carious tissue and to restore the tooth involved. The name ART implies that the approach is atraumatic to both the patient and the tooth. This study set out to evaluate whether ART is atraumatic in terms of both patient discomfort and tooth tissue conservation. Three hundred and fifty-nine patients were divided in two groups: one group was treated with hand instruments and the other with rotary equipment. Each patient received two restorations: one using amalgam and one using glass ionomer as the restorative material, placed without the use of anaesthesia. Less discomfort was reported with the ART approach compared to conventional restorations made using rotary instruments and amalgam. Moreover, preparations with hand instruments were smaller than those produced with rotary instruments. Reported discomfort was associated with the size of the preparation, although the influence of the operator on both criteria was considerable. A patient effect was also observed since patients who reported discomfort during the first treatment were more likely to report discomfort after the second treatment. In conclusion, the choice of the term "ART" as an atraumatic procedure is defensible. <25> UI - 20067059 AU - Frencken JE AU - Holmgren CJ IN - Department of Preventive and Community Dentistry, University of Nijmegen, The Netherlands. j.frencken@dent.kun.nl TI - How effective is ART in the management of dental caries?. SO - Community Dentistry & Oral Epidemiology 1999 Dec;27(6):423-30 AB - The ART approach involves excavating cavitated dentine caries with hand instruments, then restoring the cavity and sealing any associated fissures and pits with an adhesive restorative material, resulting in a sealant restoration. Until recently, ART has mainly been used under field conditions, and thus the adhesive restorative material used has been glass ionomer which does not require mixing machines and curing lights. Since the inception of ART, a growing number of studies world-wide have taken place. A total of four studies have reported 3-year survival percentages for one-surface ART restorations. The highest 3-year survival percentage in permanent teeth was 88%, which is comparable to the 85% survival of one-surface amalgam restorations placed under the same field conditions after 3 years. The outcomes depend to some extent on the material used, operator experience and presence of caries. The presence of caries as a reason for failure was higher in the early than in the most recent studies. Only one study has reported on the use of ART restorations in the deciduous dentition. It is concluded that: a very large proportion of dentine lesions in the permanent teeth can be treated using the ART approach; the 3-year survival rate of the more recently placed one-surface ART restorations in permanent teeth was higher than that of ART restorations placed in the beginning; the survival of one-surface ART restorations in the permanent dentition with newer glass ionomers is comparable to that of one-surface conventional restorations placed using amalgam in a comparable setting after 3 years; more studies of longer duration are needed to confirm these findings; ART should be considered a caries treatment modality that benefits people; and educational courses need to be organised before the approach is applied in the clinic. <26> UI - 20027169 AU - van Dijken JW AU - Ormin A AU - Olofsson AL IN - Umea University Dental School, Umea, Sweden. Jan.van.Dijken@oralbio.umu.se TI - Clinical performance of pressed ceramic inlays luted with resin-modified glass ionomer and autopolymerizing resin composite cements. SO - Journal of Prosthetic Dentistry 1999 Nov;82(5):529-35 AB - STATEMENT OF PROBLEM: Several in vitro studies have been published showing the incapability of the chemical cure of dual-cured resin composite luting agents to compensate for absence of visible light activation. PURPOSE: This study evaluated and compared pairs of Empress ceramic inlays luted with 2 chemical-cured luting agents: a resin-modified glass ionomer cement and a resin composite within individual patients. MATERIAL AND METHODS: Seventy-nine ceramic inlays were placed in class II cavities in 29 patients. In each patient half of the inlays were luted with a resin-modified glass ionomer cement and the other half with a chemical-cured resin composite cement. The inlays were evaluated clinically, according to modified USPHS criteria, at baseline, after 6 months, and 1 and 2 years. RESULTS: No failed inlays were observed during the 2-year follow-up. A slight ditching of the cement margins was observed in both luting groups. No significant difference was seen between the 2 luting techniques. CONCLUSION: IPS Empress inlays luted with both chemical-cured luting agents functioned satisfactorily in the short-term follow-up. Longer observation periods are necessary to evaluate the long-term clinical behavior of both luting techniques. <27> UI - 99351672 AU - van Dijken JW IN - Department of Oral Biology, Dental School, Umea University, Sweden. Jan.van.Dijken@oralbio.umu.se TI - Longevity of new hybrid restorative materials in class III cavities. SO - European Journal of Oral Sciences 1999 Jun;107(3):215-9 AB - The aim of this study was to evaluate the durability of two new tooth-colored restorative materials, a polyacid-modified resin composite (compomer) and a resin-modified glass ionomer cement. In an intra-individual comparison with a resin composite, the materials were studied during a 5-yr period. In 50 patients, 154 large class III restorations were placed. Most patients received one of each of the three materials. The restorations were evaluated by modified United States Public Health Service (USPHS) criteria. Of the 144 restorations evaluated, 15 were found unacceptable. No significant differences were seen between the materials concerning recurrent caries incidence. The resin composite showed a significantly better color match. No difference was found between resin composite fillings in enamel- or total-etched cavities. Significantly higher surface roughness was found in the aged resin-modified glass ionomer cement restorations. Fracture of the incisal enamel corner was observed adjacent to 10 restorations. None of the three total-etch techniques resulted in postoperative sensitivity or loss of vitality. All the restorative techniques showed a low failure rate during the 5-yr follow-up. <28> UI - 99407371 AU - Smales RJ AU - Wong KC IN - Faculty of Dentistry, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong. rjsmales@schmuck.mad.adelaide.edu.au TI - 2-year clinical performance of a resin-modified glass ionomer sealant. SO - American Journal of Dentistry 1999 Apr;12(2):59-61 AB - PURPOSE: To compare the 2-year clinical performance of an experimental resin-modified glass ionomer cement sealant (K-512 = Fuji III LC) with that of a light-cured resin-based sealant (Delton Opaque) in young adults: MATERIALS AND METHODS: 14 subjects with 47 K-512 and 41 Delton sealants were recalled at 2 years for clinical examination, photographs after enamel etching, impressions and radiographs. RESULTS: K-512 showed 0% complete retention, 62% partial retention, and 38% nil retention. The corresponding percentages for Delton were 32%, 58% and 10%, respectively. There was one instance of fissure caries for K-512 and three for Delton. Sealants deemed to need retreatments because of retention failures were 62% for K-512 and 34% for Delton. The K-512 sealants continued to darken over the study, many becoming slightly darker than the sealed teeth. <29> UI - 99312083 AU - Ho TF AU - Smales RJ AU - Fang DT IN - Faculty of Dentistry, The University of Hong Kong, Hong Kong. TI - A 2-year clinical study of two glass ionomer cements used in the atraumatic restorative treatment (ART) technique. SO - Community Dentistry & Oral Epidemiology 1999 Jun;27(3):195-201 AB - The purpose of the study was to evaluate, in a clinical study over 2 years, the deterioration of two glass ionomer cements used with the atraumatic restorative treatment (ART) technique or approach. Fifty-five Fuji IX and 45 ChemFil Superior restorations were placed randomly in 23 adult patients, mainly in small occlusal preparations in molar teeth. The restorations were placed in a dental hospital by one dentist using the ART technique. Photographs, radiographs and replicas were obtained at baseline and subsequent recalls. Both cements were easy to mix and place, but the radiolucency of ChemFil Superior was a disadvantage. Both cements also showed early high losses of sealant and restorative material. After 2 years, 34.5% of the sealants appeared to be completely lost, with caries recorded in 5.3% of the exposed fissures. In some instances, these small lesions may have been present, but not detected clinically, at the time of sealing. Restoration failures of 7.0% were from wear and fracture of the cements and recurrent caries. Mean cumulative wear was 83.1 microm for Fuji IX and 104.0 microm for ChemFil Superior, which was not statistically significant. The cements became darker after their placement to more closely match the restored teeth, but there were few exact matches. There was no surface staining and only minor marginal discrepancies and staining associated with the restorations. Although the short-term clinical performance of the two glass ionomer cements was reasonable, the materials require further improvements in their mechanical properties, to reduce sealant losses and wear. The cements evaluated appear suitable for restricted use only, in posterior teeth. <30> UI - 99333859 AU - Gray GB IN - Department of Restorative Dentistry, Bristol Dental School. TI - An evaluation of sealant restorations after 2 years. SO - British Dental Journal 1999 Jun 12;186(11):569-75 AB - AIM: To obtain evidence of the efficacy of sealant restoration used in the management of fissure caries. DESIGN: A controlled study in a UK dental hospital environment. METHODS: Suspect fissure lesions were investigated in 164 young adult patients attending for routine dental care. Only one test tooth per subject was included in the study. Patients were recalled after 6, 12 and 24 months at which time the fissure sealant retention and the performance of the restorative materials were noted. RESULTS: Successful recall was achieved with 91.5% of patients. Most teeth treated (92%) involved the preparation of an investigative cavity. The mean age of patients treated was 23.9 years and second permanent molar teeth were the most commonly affected teeth requiring treatment in this age group. The presence of small composite restorations did not adversely affect fissure sealant retention but after 2 years, significantly more sealant was lost from the surface of light cured glass-ionomer cement and larger composite restorations. CONCLUSIONS: Sealant restorations provide an effective method of management of fissure caries in young adult patients. <31> UI - 99305402 AU - Donly KJ AU - Segura A AU - Wefel JS AU - Hogan MM IN - Department of Pediatric Dentistry, Dental School, University of Texas Health Sciences Center at San Antonio 78284, USA. TI - Evaluating the effects of fluoride-releasing dental materials on adjacent interproximal caries. SO - Journal of the American Dental Association 1999 Jun;130(6):817-25 AB - BACKGROUND: The authors examined several restorative materials to evaluate their ability to inhibit demineralization and enhance remineralization of incipient carious lesions on the interproximal enamel of teeth adjacent to those restored with the materials. METHODS: Twenty-one subjects in need of a crown on a mandibular molar and a Class II inlay on an adjacent tooth took part in this six-phase study. Artificial enamel lesions were created and positioned within the interproximal portion of a crown. Lesions were photographed with polarized light microscopy and characterized before and after 30-day intraoral exposures. Each phase included the placement of a new section in the crown model and a new Class II inlay restorative material in the adjacent tooth. RESULTS: Results demonstrated that nonfluoridated resin composite, fluoridated resin composite and resin-modified glass ionomer restorative materials, when placed in subjects who brushed with a fluoridated dentifrice, demonstrated significantly (P < .05) less enamel demineralization than the nonfluoridated resin composite control placed in subjects who brushed with a nonfluoridated dentifrice. The resin-modified glass ionomer cement, however, even when brushed with a nonfluoridated dentifrice, exhibited significantly (P < .05) less demineralization than the nonfluoridated resin composite control brushed with a nonfluoridated dentifrice. CONCLUSIONS: Resin-modified glass ionomer cement appears to significantly inhibit demineralization of interproximal enamel of teeth adjacent to those restored with the material. CLINICAL IMPLICATIONS: Resin-modified glass ionomer cement restorations can enhance prevention of enamel demineralization on adjacent teeth. <32> UI - 99330253 AU - van Dijken JW AU - Kieri C AU - Carlen M IN - Institution of Oral Biology, Dental School, Umea University, Sweden. TI - Longevity of extensive class II open-sandwich restorations with a resin-modified glass-ionomer cement. SO - Journal of Dental Research 1999 Jul;78(7):1319-25 AB - Several new techniques have been introduced for use in the esthetic restoration of posterior cavities to substitute for the presumed toxicity of amalgam. Composite-laminated glass-ionomer cement restorations, the sandwich technique, have been recommended for caries-risk patients. Clinical evaluation of the use of conventional glass-ionomer cements in the open-sandwich restoration has shown a high failure rate. The aim of this study was to evaluate the durability and cariostatic effect of a modified open-sandwich restoration utilizing a resin-modified glass-ionomer cement (RMGIC) in large cavities. The materials consisted of 274 mostly extensive Class II Vitremer/Z100 restorations performed by four dentists in 168 adults. Six experimental groups were investigated. In four groups a thick and in two groups a thin layer of cement was placed. Cavity conditioning before application of the RMGIC self-etching primer was done in 3 groups with polyacrylic acid and in one group with maleic acid; in two groups, only water rinsing was performed. The restorations were evaluated at baseline and after 6, 12, 24, and 36 months according to modified USPHS criteria (van Dijken, 1986). After 3 years, 239 restorations were evaluated. Twelve (5%) were estimated as non-acceptable. Two were replaced, and seven were repaired with resin composite. Tooth fractures were observed in 2.5%. Slight erosion of the RMGIC part was seen in 4%, and in one case operative treatment was indicated. Post-operative sensitivity was reported for 9 teeth. Forty-three percent of the patients were considered as caries-risk patients. Only one restoration showed secondary caries. The three-year results indicated that the modified open-sandwich restoration is an appropriate alternative to amalgam including extensive restorations. <33> UI - 99230647 AU - Albert DA IN - Division of Community Health, Columbia University School of Dental and Oral Surgery, USA. TI - Sealant use in public and private insurance programs [see comments]. CM - Comment in: N Y State Dent J 1999 Feb;65(2):24-5 SO - New York State Dental Journal 1999 Feb;65(2):30-3 AB - Dental sealants are a safe and efficacious method for preventing caries in pits and fissures. An increase in sealant use has been observed in the NHANES III survey. However this increase still accounts for less than one fifth of children aged 5-17 having sealants on their teeth. Reimbursement and coverage of sealants by public and private insurance programs have lagged behind the widespread acceptance of this methodology by the profession. Medicaid preventive services are poorly used by patients and the profession: and the inclusion of sealants in traditional, indemnity, fee-for-service commercial plans has been inconsistent. Managed care programs include dental sealants, but lack financial incentives to increase their use. <34> UI - 99256535 AU - Gordan VV AU - Mjor IA AU - Hucke RD AU - Smith GE IN - Department of Operative Dentistry, University of Florida, College of Dentistry, Health Science Center, Gainesville 32610-0415, USA. TI - Effect of different liner treatments on postoperative sensitivity of amalgam restorations. SO - Quintessence International 1999 Jan;30(1):55-9 AB - OBJECTIVE: The purpose of this clinical study was to assess the sensitivity experienced and reported by patients following treatment of primary carious lesions with Class I or Class II amalgam restorations. METHOD AND MATERIALS: Only previously untreated teeth were selected. The cavity preparations were treated according to one of four regimens: group 1 = no liner; group 2 = two coats of a copal varnish; group 3 = a dentin adhesive resin liner; group 4 = a resin-modified glass-ionomer liner. Patients were contacted on days 2 and 7 postoperatively and questioned regarding the presence or absence of sensitivity. If sensitivity was experienced, they were asked which stimuli created the sensitivity, the length of time it lasted, and its intensity on a subjective scale. If sensitivity was experienced on day 7, patients were also contacted on days 14, 30, and 90 to assess the degree of sensitivity. Nineteen teeth were included in each of the four groups. RESULTS: By days 2 and 7, no significant difference existed among groups; by day 14, 22% of restorations in group 2 and 17% of those in group 3 were sensitive, while teeth in groups 1 and 4 exhibited no sensitivity reactions. CONCLUSION: Use of a resin-modified glass-ionomer liner or no dentin treatment resulted in short-term sensitivity in fewer than one third of the teeth. Almost one third of the teeth restored with a dentin adhesive resin liner or copal varnish exhibited initial sensitivity, which lasted up to 30 days in a few teeth. <35> UI - 99269586 AU - Brackett WW AU - Gilpatrick RO AU - Browning WD AU - Gregory PN IN - University of Tennessee-Memphis, College of Dentistry, Department of General Dentistry 38163, USA. TI - Two-year clinical performance of a resin-modified glass-ionomer restorative material. SO - Operative Dentistry 1999 Jan-Feb;24(1):9-13 AB - This study was a 2-year clinical evaluation of a conventional and a resin-modified glass-ionomer restorative material. Thirty-four restorations each of Ketac-Fil and Photac-Fil were placed without tooth preparation in cervical abrasion/abfraction lesions, primarily in premolar teeth. Patients ranged in age from 30 to 73 years, with a median age of 45 years. Isolation for the restorations was accomplished with cotton rolls. Restorations of both materials were retained at the rate of 93%, and both were comparable in appearance, receiving Alfa ratings for more than 85% of the restorations. One occurrence of secondary caries was observed for each material. No significant difference between the materials was observed for any evaluation category (exact binomial test, P > 0.05). <36> UI - 99223941 AU - Pilebro CE AU - van Dijken JW AU - Stenberg R IN - Department of Pedodontics, Institute of Oral Biology, Umea, Sweden. carin.pilebro@oralbio.umu.se TI - Durability of tunnel restorations in general practice: a three-year multicenter study. SO - Acta Odontologica Scandinavica 1999 Feb;57(1):35-9 AB - Twelve dentists, clinically experienced and familiar with the tunnel technique, placed 374 tunnel restorations in permanent teeth. Mean age of the patients was 19.1 years (range 10-74). The filling material used was a glass cermet cement, Ketac Silver. After 1, 2 and 3 years the teeth were controlled by the dentists. The bitewing radiographs from baseline, 1, 2 and 3 years were also analyzed by 2 of the authors, independently. The baseline radiographs showed technical defects in 6% and indicated remaining dentin caries in 8% of the restorations. After 3 years, 305 restorations were accessible for examination. The cumulative replacement rate was 20%. The main reasons for replacement were marginal ridge fracture (14%) and dentin caries (3%). The number of restorations showing untreated progressive caries increased during the study. After 3 years, untreated dentin caries was seen in 28 cases (11%) and almost half of the left enamel lesions showed progression. <37> UI - 99144785 AU - Millett DT AU - Nunn JH AU - Welbury RR AU - Gordon PH IN - Unit of Orthodontics, Glasgow Dental Hospital and School, UK. TI - Decalcification in relation to brackets bonded with glass ionomer cement or a resin adhesive. SO - Angle Orthodontist 1999 Feb;69(1):65-70 AB - Forty randomly selected patients had brackets bonded on one side of the of the maxillary labial segment with glass ionomer cement. Teeth on the opposite side were bonded with a resin adhesive. Teeth were assessed for decalcification pretreatment, at debond, and at review using a standardized photographic technique and a modified DDE index. The mean number of teeth affected by decalcification and the mean extent of decalcification per tooth increased during the treatment period, but from debond to review both of these measurements decreased for teeth bonded with either material (p)<0.01, t-test). Decalcification appears to become less severe posttreatment, but does not appear to be significantly affected during 12 to 18 months of orthodontic treatment by bonding with glass ionomer cement. Dietary and other environmental factors, including fluoride preparations, may be of greater importance in the prevention of decalcification during fixed appliance therapy. <38> UI - 99110707 AU - Weerheijm KL AU - Kreulen CM AU - de Soet JJ AU - Groen HJ AU - van Amerongen WE IN - Departments of Cariology, Endodontology, Pedodontology, ACTA, Amsterdam, The Netherlands.K.Weerheijm@acta.nl TI - Bacterial counts in carious dentine under restorations: 2-year in vivo effects. SO - Caries Research 1999;33(2):130-4 AB - Little is known about the long-term effects of fluoride-releasing materials on carious dentine in vivo. The aim was to investigate the 2-year influence of a resin-modified glass ionomer cement (RM-GIC) and amalgam on the bacteriological counts of carious dentine that remained under class I restorations. To enable a split-mouth design, 33 molar pairs in 33 patients (mean age 15.1 years, SD 1.4) were selected, based on clinically and radiographically diagnosed occlusal dentine caries. The enamel of the carious molars was removed, and the carious dentine was sampled under aseptic conditions just beneath the dentinoenamel junction. The molars were alternately restored with RM-GIC or amalgam without further removal of carious dentine. The samples were processed for microbiological determination of total viable counts (TVC), mutans streptococci (MS), and lactobacilli (LB). The molar pairs of 25 patients were reevaluated after 2 years using the same clinical techniques and were permanently restored after complete caries removal. Both materials showed a substantial decrease in numbers of TVC and LB of the carious dentine after the 2-year period. Compared to amalgam, the decrease in the numbers of LB was significantly more pronounced for RM-GIC. No microorganisms were detected in only 11 molars (6 RM-GIC and 5 amalgam) after the 2-year period. Based on this study, we suggest that complete removal of carious dentine is still the best conservative treatment, irrespective of the restorative material used. <39> UI - 99456240 AU - Keltjens HM AU - Creugers TJ AU - van't Hof MA AU - Creugers NH IN - Department of Occlusal Reconstruction and Oral Function, College of Dental Science, Faculty of Medical Sciences, University of Nijmegen, The Netherlands. secr:of@dent.kun.nl TI - A 4-year clinical study on amalgam, resin composite and resin-modified glass ionomer cement restorations in overdenture abutments. SO - Journal of Dentistry 1999 Nov;27(8):551-5 AB - OBJECTIVE: To assess the performance of three different filling materials in overdenture abutment teeth. METHODS: In 49 patients amalgam, resin composite and resin-modified glass ionomer cement were used to seal the root canal orifices of 155 overdenture abutment teeth. After initial preparation of the cavities, the three restorative materials were randomly assigned to the abutment teeth using a number of balancing criteria. All patients were reviewed every six months and received the same preventive regimen. Survival was assessed at two levels: Sorig (survival of the restoration independent from eventual maintenance treatments) and Scomp (restorations survived even without maintenance treatments). RESULTS: The calculated overall survival percentage of the original restorations (Sorig) after four years was 63 +/- 6% (mean +/- SE). Calculation for the overall complete survival (Scomp) revealed a percentage survival of 57 +/- 6%. At both levels, the differences between the survivals of the investigated materials were not statistically significant (p-values > 0.05). Two abutments were lost, severe caries was the reason for one extraction and another abutment tooth was extracted for periodontal reasons. CONCLUSIONS: The results of this study did not point out a superior restorative material for the seal of root canal orifices of overdenture abutments. The distribution of failures over the patients indicates a certain patient dependency. <40> UI - 99308067 AU - Gladys S AU - Van Meerbeek B AU - Lambrechts P AU - Vanherle G IN - BIOMAT-Department of Operative Dentistry and Dental Materials, School for Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Belgium. TI - Marginal adaptation and retention of a glass-ionomer, resin-modified glass-ionomers and a polyacid-modified resin composite in cervical Class-V lesions. SO - Dental Materials 1998 Jul;14(4):294-306 AB - OBJECTIVES: An 18-month follow-up clinical trial of one conventional glass-ionomer (HIFI Master Palette), three resin-modified glass-ionomers (Fuji II LC, Vitremer, 3M Exp. 155) and one polyacid-modified resin composite (Dyract) was conducted to evaluate their clinical effectiveness in Class-V cervical lesions. In addition, the interface between dentin and two resin-modified glass-ionomers and one polyacid-modified resin composite was examined by scanning electron microscopy (SEM). METHODS: After evaluation of the restorations immediately following placement (baseline), all patients were subjected to a strict recall schedule with controls at 6, 12 and 18 months. The clinical effectiveness was recorded in terms of retention and marginal integrity, clinical microleakage, caries recurrence, and tooth vitality. A chi 2-test (p < 0.05) was used to test for significant differences between materials. In case of restoration loss or special defects, a replica was made to examine the surface texture and restoration margins by SEM. In vitro, the interface was examined by SEM after an argon-ion-beam etching technique was used to enhance surface relief and disclose interfacial substructures. RESULTS: Retention appeared to be good for all the materials tested. Marginal discrepancies were localized at the incisal enamel and/or the cervical dentin margin, except for the polyacid-modified resin composite that showed most of the defects at the incisal enamel margin. None of the systems could guarantee margins free of microleakage for a long time. In vitro, the type of dentin pre-treatment defines to a great extent the morphology of the resultant interface between dentin and the restorative material tested. SIGNIFICANCE: In this clinical study, the retention rate of the tested materials was good and even excellent for some products. Perfect marginal adaptation deteriorated too fast. The marginal adaptation of the polyacid-modified resin composite at the enamel site would probably have been better by the use of selective enamel or total acid etching. Marginal sealing remains a problem. Future research should concentrate on improving the marginal adaptation and sealing capacities before a broader clinical use can be advocated. <41> UI - 99314444 AU - Prati C AU - Chersoni S AU - Cretti L AU - Montanari G IN - School of Dentistry, University of Bologna, Department of Emergency and Operative Dentistry, Italy. TI - Retention and marginal adaptation of a compomer placed in non-stress-bearing areas used with the total-etch technique: a 3-year retrospective study. SO - Clinical Oral Investigations 1998 Dec;2(4):168-73 AB - The aim of this clinical study was to evaluate class V and class III cavities restored with a polyacid-modified resin composite (compomer) restorative material in association with two different dentin-enamel bonding systems: Dyract-PSA (Primer Sealer Adhesive-DentSply, Germany) and Prime & Bond 2.0 (DentSply, Germany). The control group was a hybrid composite used with ProBond bonding system (DentSply, Germany). A total of 116 restorations (79 class V, 37 class III) were made and reevaluated after 1, 2 and 3 years in 55 patients in two private practices and in a university department. Class V nonretentive cavities were located at the CEJ level and class III at interproximal level close to CEJ. Each cavity was prepared using a water-cooled, high-speed handpiece with a fine diamond burr. A small bevel was prepared along enamel margin. Cavity dimensions were no more than 3.5 x 3.5 mm (using burr as reference point). Each restoration was finished immediately with fine diamond burrs and Sof-Lex disks (3 M, USA). The criteria that were evaluated by the USPHS method included: retention, color match, marginal integrity, marginal discoloration, and secondary caries. Results indicated that all compomer restorations were fully retained at 3 years, and that no secondary caries detected. Seven composite restorations were lost during the 3-year study. No statistical differences were observed between class III and class V or among other conditions (e.g., upper-lower arc, sex, age). This study demonstrates that compomers are suitable restorative materials for class III-V restorations. They may represent a clinical alternative to composites in class V and III restorations. <42> UI - 99086083 AU - Frencken JE AU - Makoni F AU - Sithole WD IN - Department of Preventive and Community Dentistry, University of Nijmegen, The Netherlands. j.frencken@dent.kun.nl TI - ART restorations and glass ionomer sealants in Zimbabwe: survival after 3 years. SO - Community Dentistry & Oral Epidemiology 1998 Dec;26(6):372-81 AB - Atraumatic restorative treatment (ART) consists of removing demineralised tooth tissues with hand instruments only, restoring the prepared cavity and sealing the adjacent pits and fissures with an adhesive filling material. This relatively painless, no-handpiece, minimal intervention approach to controlling dental caries is described. ART was applied in an oral health care programme in Zimbabwe that was carried out amongst secondary school students from 1994 to 1997. A new glass ionomer (Fuji IX) was used as the restorative and sealant material. Sealants were placed in high caries risk students using the 'press-finger' technique. A total of 297 one-surface ART restorations and 95 glass ionomer sealants were placed in 142 and 66 students, respectively. After 3 years, the lost-to-follow-up percentages for one-surface ART restorations and glass ionomer sealants were 30.6% and 30.5%, respectively. Actuarial (life table) analysis resulted in 3-year survival rates of one-surface ART restorations of 88.3% (95% CI: 92.4%-84.2%), ranging from 94.3% to 65.4% per operator. A total of 28 ART restorations placed in 25 students failed. Reasons for failure related to the material and the operator (11 restorations or 5.3% each), and to caries adjacent to the restoration (one restoration or 0.5%). Reasons for failure were not recorded for five restorations (2.3%). Sealants were placed on surfaces diagnosed as early enamel lesions. After 3 years, 71.4% (95% CI: 81.7%-61.1%) of the fully and partially retained sealants survived with a range of 100% to 55.6% per operator. Of the sealed surfaces 96.3% (95% CI: 100%-92.2%) survived 3 years without developing caries. Experienced operators placed better ART restorations than inexperienced operators. This study has demonstrated that ART with a glass ionomer restorative material and sealants provided high quality preventive and restorative dental care to this student population. ART has become one of the treatment modalities available to oral health workers in managing dental caries. <43> UI - 99067542 AU - Holst A AU - Brannstrom M IN - Department of Paediatric Dentistry, Blekinge County Council, Karlskrona, Sweden. TI - Restoration of small proximal dentin lesions with the tunnel technique. A 3-year clinical study performed in Public Dental Service clinics. SO - Swedish Dental Journal 1998;22(4):143-8 AB - The aim of this study was to evaluate the 3-year performance of tunnel restorations in Public Dental Service clinics in the county of Blekinge, Sweden. The restorations were made at the indication of a radiographically observed small proximal caries lesion extending into the outer part of dentin in permanent premolars and molars. A total of 302 restorations made by 17 dentists were evaluated 1 yr, 2 yrs and 3 yrs after placement using modified USPHS criteria. The preparations were filled with a cermet glass polyalkenoate cement (Ketac Silver, ESPE Gmbh, Germany). Evaluation was carried out by clinical and radiographical means. The percentage of successful and acceptable restorations was 92.7% after 1 yr, 89.5% after 2 yrs and 84.3% after 3 yrs. Eight % of the restorations failed due to caries, 6% fractured and 1% were replaced due to deep margin discoloration. The results indicate that tunnel restoration is a useful technique in small proximal dentin lesions in permanent premolars and molars. <44> UI - 99067543 AU - Wendt LK AU - Koch G AU - Birkhed D IN - Department of Preventive Dental Care, Jonkoping County, Sweden. TI - Replacements of restorations in the primary and young permanent dentition. SO - Swedish Dental Journal 1998;22(4):149-55 AB - The present study focused on the type of restorative material used and the reasons for replacements of restorations in the primary and the young permanent dentition. All patients with restorations and who were 8 and 19 years of age in 1995 and were regularly treated at 11 Public Dental Health clinics in Jonkoping County, Sweden, participated in the study. Data were extracted from the records for all types of restorations in canines and molars for the preceeding of 5 years for the 8-year-olds (i.e. from 3 to 8 years of age; n = 546) and for approximal restorations in premolars and molars for the preceeding 13 years for the 19-year-olds (i.e. from 6 to 19 years of age; n = 606). In all, 6012 restorations were evaluated. The two most common restorative materials used in the primary dentition were compomer and glass ionomer cement and in the young permanent dentition composite and amalgam. In the primary dentition, 29% of the restorations had been replaced and 4% of the teeth with restorations had been extracted. Thus, 33% of the restorations in the primary dentition failed. The corresponding figure for the young permanent dentition was 13%. The most common reason for replacements in the permanent dentition was secondary caries. That restorations often fail because of caries and that the development of secondary caries is not prevented by replacement of an old restoration indicate that more attention should be paid to preventive dental care for patients with restorations in the primary as well as in the young permanent dentition. <45> UI - 99073081 AU - Burrow MF AU - Tyas MJ IN - University of Melbourne, School of Dental Science, Australia. TI - Clinical evaluation of a resin-modified glass-ionomer adhesive system. SO - Operative Dentistry 1998 Nov-Dec;23(6):290-3 AB - One hundred cervical caries-free, nonundercut lesions were restored in 13 patients of mean age 60.5 years, using Silux Plus or Estio LC resin composite bonded with Fuji Bond LC. Patients were recalled at 6 months and 1 year. A 1-year cumulative retention rate of 98% was recorded, while marginal staining was absent. <46> UI - 99109387 AU - Dostalova T AU - Jelinkova H AU - Kucerova H AU - Krejsa O AU - Hamal K AU - Kubelka J AU - Prochazka S IN - Institute of Dental Research, Prague, Czech Republic. dostalova@vus.cz TI - Noncontact Er:YAG laser ablation: clinical evaluation. SO - Journal of Clinical Laser Medicine & Surgery 1998 Oct;16(5):273-82 AB - OBJECTIVE: The aim of this study is to evaluate the quality of laser ablation in comparison with the classical drilling preparation. METHODS: For the experiment, the Er:YAG laser drilling machine was used. The system had a laser head, water cooler, and power supply with automatic control. Spot size of 300-350 microns was used for the preparation. Repetition rate of 1-4 Hz, and pulse energies of 100-400 mJ with water spray were chosen. Cavity shape in comparison with classical drill, time of preparation, and influence of cavity shape on filling materials retention in accordance with the U.S. Public Health Service System were used. The evaluation criteria for noncontact Er:YAG ablation were done. RESULTS: The cavity shape is irregular, but spot surface has larger area and microretentive appearance. Caries of enamel and dentin were treated with a noncontact preparation. It was possible to remove the old insufficient fillings, except for amalgam or metal alloys. The average number of pulses was 111.22 (SE 67.57). Vibrations of microexplosions during preparation were felt by patients on 14 cavities; however, nobody felt unpleasant pain. The qualities of filling materials in laser cavities were very stable; however, cavo surface margin discoloration of 82-86% of Alfa rating could be a problem. Changes of the color and anatomic form of the tooth were observed in 4-8%. CONCLUSIONS: In comparison with the classical treatment, it could be said that the retention and quality of filling materials is the same or very similar. <47> UI - 99020276 AU - Gale TJ AU - Hanes CM AU - Myers DR AU - Russell CM IN - Department of Pediatric Dentistry, Medical College of Georgia, Augusta, USA. TI - Performance of sealants applied to first permanent molars in a dental school setting. SO - Pediatric Dentistry 1998 Sep-Oct;20(5):341-4 AB - PURPOSE: The purpose of this study was to assess the performance of sealants placed by senior dental students as part of a comprehensive dental care program that included periodic patient recall. METHODS: The dental records of 100 patients ranging in age from 6 to 13 years were selected for review to determine the treatments provided for first permanent molars over time. Criteria for inclusion were: 1) at least five documented recall examinations and 2) all four first permanent molars had to have been treated with an occlusal pit and fissure sealant. The data collected included: 1) the age of the patient at the time of initial sealant placement; 2) the subsequent treatment provided to the first permanent molars, including retreatment with sealant or restoration and the date the services were provided; 3) the last date of follow-up examination in the pediatric dental program. RESULTS: A total of 400 molars were followed for an average of 54 months. Fifty-two percent of all molars received no further treatment after initial placement of sealant. Approximately 35% received retreatment with sealant only. The total number of molars receiving sealant material only was 343 (86%). The total number of teeth that were judged to require restoration was 57 (14%). No relationship was noted between the patient's age at placement of the occlusal sealant and sealant performance. CONCLUSION: In a dental school clinic, occlusal sealants were effective at preventing caries in a comprehensive care program that included periodic recall. <48> UI - 99007998 AU - Scheibenbogen A AU - Manhart J AU - Kunzelmann KH AU - Hickel R IN - Department of Operative Dentistry, School of Dentistry, Ludwig-Maximilians-University, Munich, Germany. TI - One-year clinical evaluation of composite and ceramic inlays in posterior teeth. SO - Journal of Prosthetic Dentistry 1998 Oct;80(4):410-6 AB - STATEMENT OF PROBLEM: There are only a few studies available that deal with the clinical behavior of composite and ceramic inlay systems as potential substitutes for amalgam restorations. PURPOSE: This prospective clinical trial evaluated composite and ceramic inlay systems for clinical acceptability as restorative materials in single or multisurface cavities of posterior teeth and provided 1-year results. MATERIAL AND METHODS: Forty-seven composite inlays (Tetric, Blend-a-lux, Pertac) and 24 heat-pressed ceramic inlays (IPS Empress) were placed in 45 patients by 7 student operators under the supervision of an experienced dentist. The first clinical evaluation was performed 11 to 13 months after placement of the restorations and used modified United States Public Health Services criteria. RESULTS: Satisfactory results over this period were found, as 100% of ceramic inlays and 94% of composite inlays were assessed to be clinically excellent and acceptable. Only 3 composite inlay restorations were scored delta (unacceptable). Two inlays exhibited secondary caries and 1 demonstrated loss of pulp vitality. For the criteria "anatomic form of the surface" and "marginal integrity," ceramic inlays were significantly better than composite inlays. CONCLUSION: Posterior tooth-colored inlays provided acceptable and excellent clinical service, even if they are placed by relatively inexperienced student operators. <49> UI - 98429393 AU - Seppa L AU - Karkkainen S AU - Hausen H IN - Institute of Dentistry, University of Oulu, Finland. liisa.seppa@oulu.fi TI - Caries frequency in permanent teeth before and after discontinuation of water fluoridation in Kuopio, Finland. SO - Community Dentistry & Oral Epidemiology 1998 Aug;26(4):256-62 AB - The piped water of Kuopio, Finland, was fluoridated in 1959. Owing to strong opposition by different civic groups, water fluoridation was stopped at the end of 1992. OBJECTIVES: The aim of this study was to examine the consequences of the discontinuation on dental health. METHODS: In 1992 and 1995, independent random samples of all children aged 6, 9, 12 and 15 years were drawn from Kuopio and Jyvaskyla, a nearby low fluoride town whose distribution of demographic and socio-economic characteristics was fairly similar to Kuopio's. The total number of subjects examined was 550 in 1992 and 1198 in 1995. Caries was registered clinically and radiographically by the same two calibrated dentists in both towns. RESULTS: In 1992, the mean DMFS values were lower in the fluoridated town for the two older age groups, the percentage differences for 12- and 15-year-olds being 37% and 29%, respectively. For the two younger age groups no meaningful differences could be found. In 1995, the only difference with possible clinical significance was found in the 15-year-olds in favor of the fluoridated town (18%). In 1995, a decline in caries was seen in the two older age groups in the nonfluoridated town. In spite of discontinued water fluoridation, no indication of an increasing trend of caries could be found in Kuopio. The mean numbers of fluoride varnish and sealant applications decreased sharply in both towns between 1992 and 1995. In spite of that caries declined. CONCLUSIONS: These findings suggest that the decline of caries has little to do with professional preventive measures performed in dental clinics. <50> UI - 99007432 AU - Hubbard LG TI - Laser-assisted restorative dentistry. SO - Dentistry Today 1998 Apr;17(4):92-5 AB - A case of rampant decay influenced by the use of a high-sugar, high-caffeine, citrus drink was presented. A pulsed Nd:YAG was used to achieve a clear operative area by removal of redundant tissue. An argon curing laser was used to effectively cure a sandwich technique of glass ionomer and microfill-resin restoration. While lasers increased the effectiveness and efficiency of routine dental care, diet control of sugar intake is crucial for long-term success. <51> UI - 99022277 AU - Mjor IA AU - Moorhead JE IN - Department of Operative Dentistry, College of Dentistry, University of Florida, USA. imjor@dental.ufl.edu TI - Selection of restorative materials, reasons for replacement, and longevity of restorations in Florida. SO - Journal of the American College of Dentists 1998 Fall;65(3):27-33 AB - The purpose of the present study was to obtain information relating to the types of restorative materials used, the main reason for replacement of restorations, and the age of failed restorations. Dentists in general dental practice in Florida were invited to record details from their own work pertaining to restorations. The diagnostic criteria were described and coded. The clinicians were not calibrated in the use of the criteria but they could call in for further explanation if needed. The 27 clinicians involved placed 2,035 restorations of which 53% were replacements of failed restorations. The increased use of resin based restorative material was clearly evident including posterior composites. The clinical diagnosis secondary caries was the most common reason for replacement of amalgam (56%) and composite (59%) restorations. Only discoloration showed a statistically significant difference in the reason for replacement of the two types of materials. The median age of the replaced amalgam restoration was 15 years and that of composite restoration was 8 years. <52> UI - 98351515 AU - Bjarnason S IN - Faculty of Odontology, Goteborg University, Sweden. TI - High caries levels: problems still to be tackled. SO - Acta Odontologica Scandinavica 1998 Jun;56(3):176-8 AB - According to the World Health Organization more than 60% of European countries have achieved the goal of no more than 3 DMFT at the age of 12 years. The others, including the newly independent Baltic states, still have high caries levels. Data from recent studies show that mean caries prevalence among 12-year-olds in Latvia, Lithuania, and Estonia was 5.8, 4.9, and 4.6, respectively. Absence of caries was recorded in 5% of Latvian and Estonian and 12% of Lithuanian 12-year-olds. Fifteen-year-old Latvians and Lithuanians averaged 8.1 and 7.0 DMFT, which, owing to the absence of radiographic examination, may be a substantial underestimation of real caries levels. The possible adverse effects of the privatization of dental care and the benefits of increased access to fluoride dentifrice in these countries have not yet been evaluated. The extremely poor oral hygiene seen in epidemiologic surveys indicates that fluoride dentifrices may not be widely used. The caries levels in the Baltic states resemble those commonly encountered a couple of decades ago in the Nordic countries. Data from two follow-up studies in Iceland show 66% and 52% decline in caries prevalence for 12- and 15-year-old children, respectively, over a period of 7 years. However, the caries experience of the 15-year-olds in the latter study was similar to that of 12-year-olds 10 years earlier, both in mean caries score (DMFS 11.3 and 12.1) and frequency distribution. Nor has the proportion of occlusal and approximal DF values changed in spite of frequent use of fissure sealants. While caries has become mainly a pit and fissure phenomenon in 12-year-olds, 44.3% of Swedish 19-year-olds reportedly have approximal lesions, and, when enamel lesions are recorded, approximal caries dominates the DFS scores. Analyses of trends in Nordic countries show that, despite a substantial decline in caries prevalence, vigilance is required to prevent a delayed caries development in the future adult population. <53> UI - 98364585 AU - Fennis-Ie YL AU - Verdonschot EH AU - van't Hof MA IN - Department of Cariology and Endodontology/117, Faculty of Medical Sciences, University of Nijmegen, The Netherlands. Y.Fennis-Ie@dent.kun.nl TI - Performance of some diagnostic systems in the prediction of occlusal caries in permanent molars in 6- and 11-year-old children. SO - Journal of Dentistry 1998 Jul-Aug;26(5-6):403-8 AB - OBJECTIVES: Attempts have been made to develop diagnostic methods which enable an early diagnosis of occlusal lesions which are not detectable by visual inspection. The aim of this study was to compare the performance of visual inspection focused on finding signs of fissure decalcification and discoloration, visual inspection upon fibre-optic transillumination (FOTI), and electrical conductance measurements (ECMs) in predicting the onset of occlusal caries in 6- and 11-year-old children. METHODS: Fifty children aged 5-7 and 11-15 years, having first or second permanent molar teeth that were not exposed to the oral environment for more than half a year, participated in the study. Following baseline data recording, the diagnostic measurements were repeated six times at 6-month intervals over a period of 2.5 years. RESULTS: Data were collected at predefined sites in the fissures. During the study, 220 of the 652 sites, i.e. 75 of 197 molars in 31 of the 50 children were judged to require a sealant or a sealant restoration. Two examiners jointly decided on the decay status at the sites. Survival plots showed that ECMs were superior to FOTI and fissure discoloration in predicting the onset of occlusal caries, although the differences were small. CONCLUSION: ECM is a better predictor of occlusal caries than fissure discoloration and FOTI, although the differences among the performance of the three methods in this study were very small. A cost-effective analysis is envisaged to obtain insight into the practical value of ECMs in the prediction of occlusal caries and, thus, into the effectiveness of sealant application. <54> UI - 98364604 AU - Chung CK AU - Millett DT AU - Creanor SL AU - Gilmour WH AU - Foye RH IN - Unit of Orthodontics, Glasgow Dental Hospital and School, UK. TI - Fluoride release and cariostatic ability of a compomer and a resin-modified glass ionomer cement used for orthodontic bonding. SO - Journal of Dentistry 1998 Jul-Aug;26(5-6):533-8 AB - OBJECTIVES: The aims of this study were to compare the local and systemic uptake of fluoride released from a compomer material (Dyract Ortho) and a resin-modified glass ionomer cement (Vitremer) with that of a conventional resin adhesive (Right-On) and to compare the cariostatic ability of each of the test materials with that of the resin control. METHODS: Twenty six patients were randomly allocated to have a bracket bonded to a premolar on one side of the arch with one of the test materials and on the opposite side with the control material. Premolars destined for extraction as part of an orthodontic treatment plan were selected for bonding. A non-fluoride toothpaste was used by all participants for 4 weeks prior to bracket bonding and throughout the 4 week trial period. Fluoride release was measured in saliva, plaque and urine samples taken pre-bonding and 4 weeks post-bonding. Enamel demineralisation was assessed by scoring the buccal surface of each extracted tooth using a caries index. RESULTS: Neither Vitremer nor Dyract Ortho altered salivary or urinary fluoride concentration significantly 4 weeks post-bonding but plaque fluoride concentration increased significantly around premolars bonded with Vitremer. The test materials as a combined group were associated with significantly less demineralisation than the control material but there was no significant difference in cariostatic ability detected between either Dyract Ortho or Vitremer when each group was compared separately with the control. CONCLUSIONS: Fluoride released from Dyract Ortho or Vitremer is likely to exert a local and not a systemic effect. In a 4-week clinical study, the cariostatic ability of the fluoride-releasing cements, as a combined group, was superior to that of the non-fluoride releasing control but there was no significant difference in cariostatic ability between the two test materials when each test group was compared separately with the control. <55> UI - 98310355 AU - Hasselrot L IN - Public Dental Service, Visby, Sweden. TI - Tunnel restorations in permanent teeth. A 7 year follow up study. SO - Swedish Dental Journal 1998;22(1-2):1-7 AB - The aim of the study was to perform a long-time evaluation of tunnel restorations made in a general dental practice concerning survival time and type of failures. 267 Class I (87%) and II (13%) tunnel restorations in permanent teeth on 193 patients--mostly teenagers and young adults--were evaluated at annual recalls. The observation time-span was 1-7 years. The restoration material was a conventional glass ionomer cement in Class I tunnels and a silver cermet glass ionomer cement in Class II tunnels. The yearly failure rate was 7% and the 50% survival time was 6 years. The reasons for replacement were: marginal ridge fracture (41%), recurrent caries (40%) and cavitation in approximal enamel (19%). No differences in failure rate between Class I and II tunnels could be seen, but recurrent caries was more frequent in Class I tunnels. Restorations made during the second year of the study were more successful, indicating a learning effect. Class I tunnel restorations in general practice can be an alternative to conventional Class II restorations with narrow indications, i.e. patients with relatively low caries activity, small approximal lesions in combination with small demineralization zones in the enamel wall. <56> UI - 98271369 AU - Morgan MV AU - Crowley SJ AU - Wright C IN - School of Dental Science, University of Melbourne, Australia. m.morgan@dent.unimelb.edu.au TI - Economic evaluation of a pit and fissure dental sealant and fluoride mouthrinsing program in two nonfluoridated regions of Victoria, Australia. SO - Journal of Public Health Dentistry 1998 Winter;58(1):19-27 AB - OBJECTIVES: This study assessed the cost effectiveness of a three-year school-based pit and fissure dental sealant and fluoride mouthrinsing program in two nonfluoridated regions in Victoria, Australia. METHODS: The analysis was based on a community intervention in five schools comparing an intervention group receiving the pit and fissure dental sealant, a weekly fluoride mouthrinsing, and an annual oral hygiene education session, with a control group receiving oral hygiene education only. The study measured mean differences in DMFS increments between study groups. RESULTS: The mean discounted DMFS difference in increment (DMFS avoided) between study groups was 1.22 DMFS over three years. The incremental cost-effectiveness ratio comparing intervention to control group varied between a net savings of $7.00 to a cost of $35.60 per DMFS avoided, depending on assumptions used in the analysis. Results were sensitive to assumptions on program effectiveness, dental examination rates, and baseline DMFS of students. The program became more cost effective with each successive year of the program. CONCLUSIONS: The introduction of such a preventive program in nonfluoridated regions of Victoria will represent an efficient use of community resources. Policy issues that need consideration include whether to target areas where adolescents have a history of high dental disease experience, and whether dentists or auxiliaries are used as service providers. The need exists for a systematic evaluation (including an economic evaluation component) of dental prevention and treatment programs in Australia. <57> UI - 98271370 AU - Selwitz RH AU - Nowjack-Raymer RE AU - Kingman A AU - Driscoll WS IN - National Institute of Dental Research, Division of Intramural Research, Bethesda, MD 20892-6401, USA. selwitzr@de45.nidr.nih.gov TI - Dental caries and dental fluorosis among schoolchildren who were lifelong residents of communities having either low or optimal levels of fluoride in drinking water. SO - Journal of Public Health Dentistry 1998 Winter;58(1):28-35 AB - OBJECTIVE: This paper reports findings for dental caries and dental fluorosis in 8-10- and 13-16-year-old schoolchildren who were lifelong residents of communities having either naturally occurring low (Broken Bow and Holdrege, NE; < 0.3 ppm) or optimal (Kewanee, IL; 1 ppm) levels of fluoride in drinking water. METHODS: Findings are reported for participants who received both dental caries and dental fluorosis examinations (n = 495). The DMFS and TSIF indices, respectively, were used to assess dental caries and dental fluorosis. RESULTS: The mean DMFS score adjusted for age, sealant presence, and fluoride use was significantly lower in Kewanee (1.8) than was the adjusted mean caries score in either Holdrege (2.9) or Broken Bow (3.6). Adjusted mean DMFS scores in Broken Bow and Holdrege were not statistically different. The mean percent of fluorosed tooth surfaces per person, adjusted for age and use of dietary fluoride supplements, was similar in the three communities (approximately 15%); more than 80 percent of tooth surfaces in all participants were fluorosis-free. CONCLUSIONS: Findings from the present study suggest that water fluoridation still is beneficial and that dental sealants can play a significant role in preventing dental caries. In addition, findings from this survey appear to support the premise that the difference in dental fluorosis prevalence between fluoridated and nonfluoridated communities has narrowed considerably in recent years. <58> UI - 98345862 AU - Gray GB AU - Paterson RC IN - Department of Restorative Dentistry, Bristol Dental School. TI - Management of fissure caries in the community dental services using sealant restorations: a field trial. SO - European Journal of Prosthodontics & Restorative Dentistry 1998 Mar;6(1):33-40 AB - Field trial data two years after the placement of 278 composite or laminate (sandwich) composite sealant restorations by 14 Community Dental Officers, in patients ranging in age from 6 to 16 years, in the West of Scotland, is reported. No restorations were lost and in 76% of the restored teeth, fissure sealant was partly retained. The most common sites of loss of sealant were from the buccal fissures of mandibular molars and from the surface of the restoration. Only 5% of the treated teeth showed complete loss of fissure sealant and the authors considered that after 2 years, 90% of restorations were adequate or only required the simple addition of further fissure sealant. <59> UI - 98305519 AU - Ekstrand KR AU - Ricketts DN AU - Kidd EA AU - Qvist V AU - Schou S IN - Department of Cariology and Endodontics, Faculty of Health Sciences, University of Copenhagen, Denmark. KIM.EKSTRAND@ODONT.KU.DK TI - Detection, diagnosing, monitoring and logical treatment of occlusal caries in relation to lesion activity and severity: an in vivo examination with histological validation. SO - Caries Research 1998;32(4):247-54 AB - The aims of the present study were to investigate the ability of 3 experienced clinicians to detect occlusal carious lesions, assess their depth, diagnose their activity and define a logical management for each lesion. The material consisted of 35 third molars scheduled for extraction or surgical removal making it possible to validate the accuracy of the clinical recordings histologically. Examinations were carried out at baseline and after 4 months in order to monitor lesion progression. At the first visit a radiograph was taken; the number of filled surfaces was counted and the oral hygiene assessed generally and by disclosing occlusal plaque of the tooth under examination. After cleaning the occlusal surface caries was recorded in a selected investigation site using a visual ranked caries scoring system, as well as an electrical conductance recording (ECM). Apart from counting fillings and taking new radiographs the same procedure was performed at the second visit, which then was followed by extraction of the tooth. After sectioning the tooth lesion depth was recorded, and lesion activity, based on acid production, was assessed using methyl red dye. Lesion activity was also judged by means of polarized light microscopic examinations of the sections. Results showed strong relationships between the visual, ECM and radiographic assessments and both lesion depth and lesion activity. In contrast, all other parameters were poorly related to lesion activity. Changes in visual assessments and in conductance readings from first to second examination were poorly associated with lesion activity. In conclusion, clinicians are able to detect lesions, predict activity and severity and define a logical management of occlusal caries on the basis of a single examination. <60> UI - 98262623 AU - Hassall DC AU - Holloway PJ IN - Division of Restorative Dentistry, Leeds Dental Institute. TI - Levels of restorative care under capitation. SO - British Dental Journal 1998 Apr 11;184(7):348-50 AB - OBJECTIVES: 1. To compare the prevalences of fissure sealants in similar groups of 14-15-year-old, regularly-attending patients treated under fee-for-service in 1989 and capitation in 1994. 2. To calculate the effect of including sealants in the restorative index on estimates of interventional treatment carried out on 14-15-year-old regularly attending patients treated by general dental practitioners in 1994. DESIGN: A randomised epidemiological study. SETTING: Secondary schools in the Wycombe, Doncaster and Hereford/Worcester areas. METHOD: Random samples of 14-15-year-old, regularly attending patients treated by dentists practising under capitation in three contrasting areas of England were examined in 1994 for the presence of decayed, missing and filled teeth and fissure sealants. Restorative indices were calculated with and without the inclusion of sealants. The latter were compared with restorative indices calculated without the inclusion of sealants on regularly attending patients of the same age group when the dentists in the same three areas were working under fee-for-service in 1989. RESULTS: The prevalence of fissure sealants increased between 1989 and 1994 from 16% to 30% in Wycombe, from 13% to 50% in Doncaster and from 25% to 47% in Hereford/Worcester. Without fissure sealants the restorative indices fell between 1989 and 1994 from a range of 76.5-94.4 to 63.3-87.1. When sealants were included in the restorative indices for 1994, they ranged from 79.5-92.9. CONCLUSIONS: There were increases in the prevalences of fissure sealants between 1989-1994. When these sealants were included in the calculation of restorative indices for 1994, the level of restorative care provided by general dental practitioners remained relatively high since the introduction of capitation. Although there has been some increase in the level of untreated disease, if the restorative index is calculated without the inclusion of sealants then there is a risk of underestimating the treatment provided by general dental practitioners to control the carious process. Dentists appear to be redirecting their efforts into newer treatment/preventive items. <61> UI - 98219235 AU - Mallow PK AU - Durward CS AU - Klaipo M IN - World Concern, Phnom Penh, Cambodia. TI - Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement. SO - International Journal of Paediatric Dentistry 1998 Mar;8(1):35-40 AB - Several recent studies have demonstrated the success of the ART (atraumatic restorative treatment) technique under field conditions in developing countries. The ART technique involves removal of caries using only hand instruments, and placing a glass ionomer cement (GIC) restoration. OBJECTIVES: To estimate the longevity of Fuji II GIC ART restorations placed in permanent teeth by dental nurse students under field conditions in rural Cambodia. DESIGN: Clinical field trial. SETTING: One high school in rural Cambodia. SAMPLE AND METHODS: 53 subjects between the ages of 12 and 17 who had dental caries were selected to participate. Subjects were randomly assigned to a dental nurse student for cavity preparation and placement of ART restorations (without cavity conditioning). RESULTS: 92.1% of the carious lesions required class I or class V restorations, and 85.4% were in the lower molars. 89 teeth were filled. At 1 and 3 years 86.4% and 79.5% of restorations were still present. Restorations were assessed by one dentist according to standard criteria. 76.3% of the restorations were judged to be successful at 1 year, and 57.9% at 3 years. CONCLUSIONS: Factors which may have affected the success rates included: the material used, technical factors, failure to condition the cavity prior to restoration, and inexperience of the operators. The results suggest that ART restorations in permanent teeth using Fuji II GIC are only moderately successful after 3 years. Better results could be expected by using a dentine conditioner in conjunction with one of the newer stronger glass ionomer cements. <62> UI - 98203986 AU - Chisick MC AU - Poindexter FR AU - York AK IN - U.S. Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, MD, USA. TI - The need for and prevalence of dental sealants in active duty U.S. military personnel. SO - Military Medicine 1998 Mar;163(3):155-8 AB - This paper explores the need for and the prevalence of dental sealants in active duty U.S. military personnel. The data come from the 1994 Tri-Service Comprehensive Oral health Survey. Data were collected on 13,050 Army, Air Force, Marine Corps, and Navy active duty personnel at 26 sites. Women and minorities were oversampled. Both bivariate and logistic regression analyses were done on the need for at least one dental sealant and the prevalence of at least one dental sealant in service members. Weighted data (1,669,662) were used for the bivariate analyses; unweighted data were used for the regressions. Results show that 3.6% of service members need dental sealants and that 6.8% have dental sealants. The need for dental sealants varies across age, rank, and branch of service. The prevalence of dental sealants varies across age, race, rank, and branch of service. The cost-effectiveness of dental sealants in this population should be established. <63> UI - 98203515 AU - Cirino SM AU - Scantlebury S IN - Columbia University School of Dental and Oral Surgery, USA. TI - Dental caries in developing countries. Preventive and restorative approaches to treatment. SO - New York State Dental Journal 1998 Feb;64(2):32-9 AB - The rate of dental caries in developing countries is rising. Because more than 80 percent of the world's children live in these countries, this alarming trend is of great concern from a public health standpoint. Currently, most dental care in developing nations consists of dental surgery in urban areas. Decay is usually left untreated until it becomes so extensive and/or painful that extraction is the only option. Traditional approaches to treating carious lesions have met with marginal success. There is a need for widespread implementation of preventive strategies, which have proven extremely effective in industrialized nations. Also, promising new techniques and materials are being developed that are enabling dentists and dental personnel to make less costly treatment of dental caries more readily available to underserved populations. <64> UI - 98256829 AU - van Dijken JW AU - Hoglund-Aberg C AU - Olofsson AL IN - Department of Cariology, Dental School, Umea University, Sweden. Jan.van.Dijken@oralbio.umu.se TI - Fired ceramic inlays: a 6-year follow up. SO - Journal of Dentistry 1998 Mar;26(3):219-25 AB - OBJECTIVES: The aim of this study was to evaluate feldspathic ceramic inlays luted with dual-cured resin composite or glass polyalkenoate (ionomer) cement (GIC) during a 6-year follow-up. METHODS: One-hundred and eighteen Class II fired feldspathic ceramic inlays were placed in 50 patients. In each patient half of the inlays were luted with a dual-cured resin composite and the other half with a conventional glass ionomer cement. The inlays were evaluated clinically, according to modified USPHS criteria, at baseline, after 6 months and then annually over a 6-year period. RESULTS: Of the 115 inlays evaluated at 6 years, 12% in the resin composite group and 26% in the GIC group were assessed as having failed. The main reason for failure in both groups was partial fracture or total loss of the inlays. Secondary caries was found to be associated with three inlays in one high caries risk patient. One inlay was replaced because of postoperative sensitivity. CONCLUSION: A relatively high and increasing failure rate was observed over the 6-year period of the study. The failure rate was more pronounced in the GIC group. <65> UI - 98204420 AU - Frencken JE AU - Makoni F AU - Sithole WD AU - Hackenitz E IN - Dental Department, Ministry of Health and Child Welfare, Harare, Zimbabwe. TI - Three-year survival of one-surface ART restorations and glass-ionomer sealants in a school oral health programme in Zimbabwe. SO - Caries Research 1998;32(2):119-26 AB - An oral health care programme in secondary schools using the atraumatic restorative treatment (ART) approach for dental caries was started in 1993. Glass ionomer (restorative type II, 1) was used as the restorative and sealant material. Sealants were placed using the 'press-finger' technique. Results after 3 years revealed a survival percentage for one-surface ART restorations of 85.3 (95% CL: 89.7-80.9%), which ranged from 96.1 to 69.3% per operator. Failures were related to 'unacceptable marginal defects' (8.1%), 'falling out' (6.1%) and 'excessive wear' (2.5%). Of the 33 failed one-surface ART restorations, 17 were material-related, 7 had caries and no information was available for 9 restorations. Sealants were placed only on surfaces diagnosed as early enamel lesions and on some small dentinal lesions. After 3 years, 50.1% (95% CL: 55.1-45.1%) of the fully and partially retained sealants survived with a range of 68.5-25.9% per operator. Regardless of the low rate of retention, the sealed surfaces had a 4 times lower chance of developing caries than unsealed surfaces with early enamel lesions over the 3-year period. The retention of sealants and the survival of one-surface ART restorations were influenced by an operator effect. The mean treatment time for one-surface ART restorations without chairside assistance was 22.1 min (range per operator of 19.8-23.6 min), whilst the mean time for placing sealants was 9.3 min (range per operator of 8.2-10.8 min). It is concluded that the ART approach and the use of glass-ionomer sealants have made preventive and restorative dental care available for this student population and further that ART seems to be appropriate for population groups currently not receiving preventive and restorative dental care. <66> UI - 98109767 AU - Mertz-Fairhurst EJ AU - Curtis JW Jr AU - Ergle JW AU - Rueggeberg FA AU - Adair SM IN - Department of Oral Rehabilitation, Medical College of Georgia, School of Dentistry, Augusta, USA. TI - Ultraconservative and cariostatic sealed restorations: results at year 10 [see comments]. CM - Comment in: J Am Dent Assoc 1998 Apr;129(4):410, 412 SO - Journal of the American Dental Association 1998 Jan;129(1):55-66 AB - Changes in restorative techniques and the development of newer restorative materials have allowed for the use of more conservative cavity preparations. This 10-year study evaluated bonded and sealed composite restorations placed directly over frank cavitated lesions extending into dentin vs. sealed conservative amalgam restorations and conventional unsealed amalgam restorations. The results indicate that both types of sealed restorations exhibited superior clinical performance and longevity compared with unsealed amalgam restorations. Also, the bonded and sealed composite restorations placed over the frank cavitated lesions arrested the clinical progress of these lesions for 10 years. <67> UI - 98109772 AU - Slavkin HC IN - National Institute of Dental Research, Bethesda, Md. 20892-2290, USA. TI - Placing health promotion into the context of our lives [see comments]. CM - Comment in: J Am Dent Assoc 1998 Apr;129(4):406, 408, 410 SO - Journal of the American Dental Association 1998 Jan;129(1):91-5 <68> UI - 98190712 AU - Staninec M AU - Eakle WS AU - Silverstein S AU - Marshall GW AU - Artiga N IN - Department of Restorative Dentistry, University of California, San Francisco School of Dentistry 94143-0758, USA. TI - Bonded amalgam sealants: two-year clinical results [see comments]. CM - Comment in: J Am Dent Assoc 1998 Jun;129(6):676 SO - Journal of the American Dental Association 1998 Mar;129(3):323-9 AB - The authors used bonded amalgams as pit and fissure sealants without mechanical preparation. They compared the two-year retention of the bonded amalgams with that of resin-based pit and fissure sealants. Clinical examinations at six months, one year and two years revealed no difference between the retention of the two sealants. This technique opens up the possibility of using bonded amalgam in pits and fissures surrounding very conservative preparations in a preventive amalgam restoration. <69> UI - 98170786 AU - Forss H AU - Halme E IN - Institute of Oral and Dental Diseases, University of Kuopio, Finland. Helena.Forss@uku.fi TI - Retention of a glass ionomer cement and a resin-based fissure sealant and effect on carious outcome after 7 years. SO - Community Dentistry & Oral Epidemiology 1998 Feb;26(1):21-5 AB - The aim of this study was to compare the retention and caries preventive efficacy of glass ionomer (Fuji III; GIC) and light-cured resin-based (Delton; LCR) fissure sealants. One hundred and sixty-six 5-14-year-old schoolchildren received sealants on their newly erupted first or second molars; a split mouth design was used. Previously reported 2-year results showed low retention rates for GIC sealants, but no difference in the caries increment between the groups. The same persons were invited to a dental check-up 6.1 to 7.8 (mean 7.1) years after the application of sealants; 111 persons (66.8% of the original group) participated in the study. The retention of sealants, and the caries status of occlusal surfaces and adjacent proximal surfaces was recorded. On the sealed occlusal surfaces, 10% of GIC and 45% of LCR sealants