Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Nov 2000.> Search Strategy (You Saved Citations 1-300 From Set 58): ----------------------------------------------------------------------------- 1 Dental cavity preparation/ 4902 2 ((dental or cavit$3) adj5 (design$3 or outline$1 or form$1 4896 or extension$1 or prepar:)).mp. 3 ((convention$2 or amalgam or silver or copper) adj3 4076 (prepar: or restor: or fill$3 or cavit$3)).mp. 4 ((conservative or ultraconservative or ultra-conservative) 457 adj5 (prepar: or restor: or fill$3 or cavit$3)).mp. 5 ((tunnel: or slot: or adhesive: or saucer:) adj5 (prepar: 1162 or restor: or fill$3 or cavit$3)).mp. 6 ((resin or composite$1) adj5 (prepar: or restor: or fill$3 4679 or cavit$3)).mp. 7 (air adj (abrasion: or abrad:) adj5 (prepar: or restor: or 26 fill$3 or cavit$3)).mp. 8 ((minimal or prevent:) adj5 (prepar: or restor: or fill$3 4331 or cavit$3)).mp. 9 (extension adj3 prevent:).mp. 298 10 Dental restoration, permanent/ 10620 11 or/1-10 27229 12 Dental restoration failure/ 810 13 (restoration$1 or filling$1 or implant$1 or bridge$1 or 133863 crown$1 or inlay$1 or denture$1).mp. 14 (survival$1 or failure$1 or longevity or durability or 554896 success: or survival).mp. 15 ((restoration$1 or filling$1 or implant$1 or bridge$1 or 5015 crown$1 or inlay$1 or denture$1) adj5 (survival$1 or failure$1 or longevity or durability or success: or survival)).mp. 16 Survival analysis/ 22680 17 Prosthesis failure/ 7542 18 exp treatment outcome/ 97272 19 co.fs. 842195 20 exp cohort studies/ 369269 21 prognosis/ 161611 22 exp mortality/ 111289 23 exp morbidity/ 106755 24 (natural adj history).ti,ab. 14680 25 prognos$.ti,ab. 128240 26 course.ti,ab. 193298 27 predict$.ti,ab. 237169 28 exp "Outcome assessment (health care)"/ 105414 29 outcome$1.ti,ab. 174575 30 (inception adj cohort$1).ti,ab. 381 31 disease progression/ 13155 32 exp survival analysis/ 28366 33 Recurrence/ 79560 34 ((recurr: or secondary) adj caries).mp. 476 35 exp risk/ 228636 36 or/12,15-35 2016709 37 (class adj ("1" or "one" or "I")).mp. 24724 38 (class adj ("2" or "two" or "II")).mp. 31852 39 ((proximo: or proximal: or approximal: or occlusal:) adj5 1978 (prepar: or restor: or fill$3 or inlay$2 or cavit$3)).mp. 40 Dental amalgam/ 6177 41 exp Composite resins/ 9877 42 (resin$1 adj3 composite$1).mp. 9146 43 exp Molar/ 12309 44 or/37-43 75630 45 11 and 36 and 44 1510 46 "in vitro"/ 292878 47 (disease$1 adj free adj (survival or patient$1)).mp. 6869 48 microleakage.mp. 973 49 (marginal adj (leakage or scaling)).mp. 312 50 exp Tooth demineralization/di 998 51 (bond adj strength).mp. 1894 52 exp Malocclusion/ 19322 53 malocclusion$1.mp. 16835 54 or/46-53 323260 55 45 not 54 1312 56 limit 55 to (human and english language and yr=1975-2000) 1037 57 exp Dentistry/ 208051 58 56 and 57 995 59 from 58 keep 1-300 300 60 from 58 keep 1-300 300 *************************** <1> UI - 20381560 AU - Tyas MJ AU - Burrow MF IN - School of Dental Science, University of Melbourne. TI - Clinical evaluation of EBS dentine bonding agent: one year results. SO - Australian Dental Journal 2000 Jun;45(2):115-7 AB - There are numerous dentine bonding agents currently on the market, the majority of which adhere by means of infiltration of a hydrophilic polymerizable diacrylate into dentinal collagen exposed by acid treatment. The purpose of the present study was to evaluate the clinical performance of one such product, EBS dentine bonding, in non-undercut caries-free cervical lesions. Forty cavities were restored in eight patients of mean age 53 years. The manufacturer's instructions were followed, which involved essentially etching the enamel and dentine for 20 seconds with 32 per cent phosphoric acid, application and evaporation of EBS Primer, followed by placement and curing of EBS Bond, and restoring the cavity with Pertac II (ESPE) hybrid resin composite. Restorations were photographed at base line and one year for evaluation of marginal discolouration on a continuous linear rating scale. At six months, one patient with four restorations was not available; the remaining 36 restorations were all present. At one year, one restoration was missing, giving a cumulative retention rate of over 97 per cent. One of the 36 restorations exhibited very mild marginal discolouration. <2> UI - 20356778 AU - Lundin SA AU - Koch G IN - Postgraduate Dental Education Center, Orebro, Sweden. TI - Class I and II posterior composite resin restorations after 5 and 10 years. SO - Swedish Dental Journal 1999;23(5-6):165-71 AB - The aim of the present study was to compare and evaluate Class I- and Class II-restorations performed in two different composite posterior materials after 5 and 10 years. Both materials were introduced in 1983 and adapted to stress-bearing restorations. The only difference between the two materials was that one contained barium-aluminium silicate, which made the material radiopaque. All 137 restorations were performed according to standardized clinical procedures by two experienced clinicians and placed in premolars (59) or molars (78). Forty-five of the restorations were Class I and 92 Class II. The restorations were followed for the first 5 years according to the U. S. Public Health Service (USPHS) evaluation criteria. After 10 years an evaluation based on the documentation sent in by the patient's present dentist was made. Of the original 137 restorations, 127 could be examined after 5 years and 117 after 10 years. The evaluation showed that after 5 years, 114 of the examined restorations were in clinical function and after 10 years 92, which means 90 and 79 per cent respectively, of the restorations evaluated. <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 - 20383030 AU - el-Mowafy O IN - Department of Restorative Dentistry, Faculty of Dentistry, University of Toronto. oel.mowafy@utoronto.ca TI - Management of extensive carious lesions in permanent molars of a child with nonmetallic bonded restorations--a case report. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 2000 Jun;66(6):302-7 AB - The badly decayed molar teeth of a 12-year-old were restored using resin composite and ceramic restorations. The maxillary first left permanent molar, which had an extensive carious lesion that had destroyed most of the coronal hard tissues of the tooth, was restored to shape and function with a heat-treated resin composite onlay restoration. The restoration was followed up for two years. The mandibular right first molar had a failing large amalgam restoration with extensive recurrent caries. After a three-month period of pulp-capping, the tooth was restored with a bonded ceramic onlay restoration. A nine-month follow-up of this restoration is provided. The maxillary right first molar, which also had a failing large amalgam/resin composite restoration, was restored with a direct resin composite restoration. Under traditional treatment regimens, these extensive cavities would have been treated using more invasive procedures such as pin-retained restorations or elective root canal therapy, post placement, core build-up and crowning. Bonded non-metallic restorations avoid the trauma, time and cost that accompany such extensive procedures and offer a more conservative approach. <5> UI - 20262473 AU - Reusens B AU - D'hoore W AU - Vreven J IN - University of Louvain, School of Dental Medicine and Stomatology, Department of Operative Dentistry, Brussels, Belgium. TI - In vivo comparison of a microfilled and a hybrid minifilled composite resin in Class III restorations: 2-year follow-up. SO - Clinical Oral Investigations 1999 Jun;3(2):62-9 AB - An in vivo comparison was made of two different types of restorative resins over a 2-year period: a microfilled resin (-1158262462Silux Plus, 3M-1158262462, USA) and a hybrid minifilled composite resin (-1158262461Herculite XRV, Kerr-1158262461, USA); 56 restorations were placed in 28 patients by one experienced dentist and examined by two independent evaluators using the United States Public Health Service (UPSHS) rating system for marginal adaptation, marginal discoloration, surface roughness, anatomic form and modified criteria for color match (direct and indirect evaluation). Modified criteria divided the classic A score into A1 for "not detectable" filling and A2 for "slightly discernible filling". Restorations were evaluated at baseline, 1 week, 6 months, 1 year and 2 years later. After 2 years, all materials were considered satisfactory for marginal adaptation, anatomic form and surface roughness (no "Charlie", or "Delta" ratings). No recurrent caries was observed. Clinical evaluation showed a significantly higher rate of marginal discoloration for the microfilled composite resin than the other resin. Hybrid composite resin materials may be expected to perform well as an anterior restorative material. Photographic ratings confirmed the clinical evaluation. The modified evaluation for color match demonstrated differences, which are not discernible with the USPHS system and showed, more rapidly, differences that appear later with the USPHS system. <6> UI - 20262472 AU - Oberlander H AU - Friedl KH AU - Schmalz G AU - Hiller KA AU - Kopp A IN - University of Regensburg, Dental School, Department of Operative Dentistry and Periodontology, Germany. heinrich.oberlaender@klinik.uni-regensburg.de TI - Clinical performance of polyacid-modified resin restorations using "softstart-polymerization". SO - Clinical Oral Investigations 1999 Jun;3(2):55-61 AB - This study investigated the influence of "softstart-polymerization" on the clinical performance and marginal integrity of polyacid-modified resin restorations (PMR) in class V cavities. Eighty PMR restorations were placed in 20 patients [40 Dyract (DY); 40 Hytac (HY)] with (npat = 10) and without preparation (npat = 10). Restorations were light cured for 40 s either conventionally (CP) or with a lower light intensity for the first 10 s (SSP). Each patient received four restorations (DY-CP, DY-SSP, HY-CP, HY-SSP), which were examined clinically according to modified USPHS criteria, and by quantitative SEM-analysis after 7 days (baseline), 6 months and 1 year. Statistical analysis was performed using the Mann-Whitney-U test (P < or = 0.05) and error rates method. Clinically, no restoration showed recurrent caries or crevices. After 1 year, margins of 24-47% of the HY- and 36-53% of the DY-restorations were rated "Bravo". Marginal discoloration occurred in 20-37% in HY- and in 18-21% in DY-restorations. The error rates method revealed no significant differences between materials or between polymerization modes with and without preparation. Pairwise testing showed that without preparation, the marginal adaptation to dentin was significantly worse compared to enamel for HY with both polymerization modes, for DY with SSP. With preparation, no significant differences were found. Cavity preparation may have an influence on differences in marginal quality between enamel and dentin. <7> UI - 20232885 AU - Davis R AU - Overton JD IN - Keesler Air Force Base, Miss., Ocean Springs 39564-9707, USA. TI - Efficacy of bonded and nonbonded amalgam in the treatment of teeth with incomplete fractures. SO - Journal of the American Dental Association 2000 Apr;131(4):469-78 AB - BACKGROUND: This clinical study compared the efficacy of adhesive-retained vs. pin-retained complex amalgam restorations in the treatment of molars with incomplete fractures. Both relief of chewing pain and cold sensitivity were evaluated at two weeks, three months and one year. METHODS: The authors treated 38 patients with a chief complaint of chewing sensitivity on vital molar teeth (40 teeth in the study). A random-number generator determined the treatment method for each tooth. Twenty teeth received bonded amalgam restorations. Twenty teeth received amalgapins or threaded pins to retain the amalgam. Teeth were evaluated for postoperative chewing sensitivity. A visual analog pain scale was used to evaluate cold response to a skin-refrigerant-soaked cotton pellet at each visit. After 12 months, all 40 teeth were available for evaluation. RESULTS: Chewing pain was completely eliminated in all but one tooth. A Student's t-test found no significant difference (P > .05) in preoperative cold sensitivity between the bonded and nonbonded groups. A paired t-test comparison indicated that the teeth in the bonded group were significantly less sensitive to cold after three months and 12 months than they were at the time of the baseline measurements (P < .0001). A paired t-test indicated no significant difference between preoperative and postoperative cold sensitivity scores for teeth in the nonbonded group (P > .05). CONCLUSIONS: Both adhesively bonded and mechanically retained complex amalgam restorations were successful in resolving chewing sensitivity in cracked molars. For 39 of 40 teeth, chewing sensitivity did not return during the one-year follow-up period. At three months and 12 months, cold sensitivity was reduced in the bonded restorations. At all three time periods, cold sensitivity remained similar to baseline levels for the mechanically retained restorations. CLINICAL IMPLICATIONS: Incomplete tooth fracture in molars can be successfully treated by covering fractured cusps with amalgam restorations. This study excluded teeth with prolonged sensitivity to a cold stimulus or those with periodontal evidence of root fracture. With these exclusions, elimination of chewing sensitivity was predictable. Teeth restored with bonded restorations experienced a decrease in sensitivity to a cold stimulus at three months and at 12 months, but not at two weeks. The cold sensitivity of teeth restored with nonbonded restorations was similar at baseline, two weeks, three months and one year. <8> UI - 20317911 AU - Hadley J AU - Young DA AU - Eversole LR AU - Gornbein JA IN - Department of Radiology, University of the Pacific, School of Dentistry, San Francisco, USA. TI - A laser-powered hydrokinetic system for caries removal and cavity preparation. SO - Journal of the American Dental Association 2000 Jun;131(6):777-85 AB - BACKGROUND: Laser systems have been developed for the cutting of dental hard tissues. The erbium, chromium:yttrium-scandium-gallium-garnet, or Er,Cr:YSGG, laser system used in conjunction with an air-water spray has been shown to be efficacious in vitro for cavity preparation. METHODS: The authors randomly selected subjects for cavity preparation with conventional air turbine/bur dental surgery or an Er,Cr:YSGG laser-powered system using a split-mouth design. They prepared Class I, III and V cavities, placed resin restorations and evaluated subjects on the day of the procedure and 30 days and six months postoperatively for pulp vitality, recurrent caries, pain and discomfort, and restoration retention. Sixty-seven subjects completed the study. RESULTS: There were no statistical differences between the two treatment groups for the parameters measured with one exception; there was a statistically significant decrease in discomfort levels for the laser system at the time of cavity preparation for subjects who declined to receive local anesthetic. CONCLUSIONS: The Er,Cr:YSGG laser system is effective for preparation of Class I, III and V cavities and resin restorations are retained by lased tooth surfaces. CLINICAL IMPLICATIONS: Hard-tissue cutting lasers are being introduced for use in operative dentistry. In this study, an Er,Cr:YSGG laser has been shown to be effective for cavity preparation and restoration replacement. <9> 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. <10> UI - 20316549 AU - Mickenautsch S AU - Rudolph MJ AU - Ogunbodede EO AU - Frencken JE IN - Department of Community Dentistry, University of the Witwatersrand, Johannesburg, Braamfontein, South Africa. TI - The impact of the ART approach on the treatment profile in a mobile dental system (MDS) in South Africa. SO - International Dental Journal 1999 Jun;49(3):132-8 AB - The changing profile of oral care rendered through the Mobile Dental System (MDS), after the introduction of the Atraumatic Restorative Treatment (ART) approach is described. During the first year of introduction of ART, the percentages of amalgam restorations and tooth extractions decreased significantly (P < 0.0001). This is partly ascribed to a change in choice of treatment by dental operators in favour of ART and also due to an increase in acceptance by patients because of the reduced fear, and the patient-friendly nature of the ART approach. The reduction in amalgam restorations was 16.0 per cent for permanent and 1.4 per cent for primary posterior teeth. Extraction of posterior teeth was reduced by 17.4 per cent in the permanent and 35.7 per cent in the primary dentitions. The restorative component of oral care increased by 33.4 per cent in the permanent and 37.1 per cent in primary posterior teeth. The one-year survival of one-surface ART restorations using Fuji IX and KetacMolar was 93.6 per cent. Full and partial (more than 90 per cent) retention of the sealant part of the ART restoration was obtained in 75 per cent of the cases after one-year. During the one-year period, infection control was made more simple and this facilitated easier maintenance of mobile dental equipment. The introduction of the ART approach reduced extraction, restored more teeth and made oral care in the MDS more preventive, less threatening and thus more patient-friendly. <11> UI - 20316548 AU - Mjor IA AU - Gordan VV IN - Department of Operative Dentistry, UFCD, Gainesville, FL 32610-0415, USA. TI - A review of atraumatic restorative treatment (ART). SO - International Dental Journal 1999 Jun;49(3):127-31 AB - The purpose of this paper was to critically analyse the results obtained with the Atraumatic Restorative Treatment (ART) technique. The ART approach involves the excavation of cavitated carious lesions with hand instruments and restoration of the cavities and associated pits and fissures with a glass ionomer restorative material. The clinical trial outcomes involving ART include retention rates, cost effectiveness, operative sensitivity, and the effect of personnel with different educational backgrounds involved in this alternative operative treatment. Comparative studies involving permanent and deciduous teeth using amalgam and glass ionomer sealants have also been included in the same projects. Specially defined clinical criteria have been used to evaluate the results. ART offers an opportunity for restorative dental treatment under field conditions where no electricity is available. Three-year data have been published, but long term studies using relevant comparison alternatives are lacking. ART has so far been largely employed on populations with a low DMFT. The technique should also be applied to high risk patients with rampant caries before the maximal benefit of the treatment can be ascertained. <12> UI - 20247324 AU - van Dijken JW IN - Department of Odontology, Dental School Umea, Umea University, 901 87, Umea, Sweden. jan.van.dijken@odont.umu.se TI - Direct resin composite inlays/onlays: an 11 year follow-up. SO - Journal of Dentistry 2000 Jul;28(5):299-306 AB - OBJECTIVES: The aim of this study was to present an 11-year assessment of direct resin composite inlays/onlays. METHODS: One-hundred Class II direct resin composite inlays and 34 direct resin composite restorations were placed in 40 patients. The restorations were evaluated clinically, according to modified USPHS criteria, annually over a 11-year period. RESULTS: Of the 96 inlays/onlays and 33 direct restorations evaluated at 11 years, 17. 7% in the inlay/onlay group and 27.3% in the direct restorations group were assessed as unacceptable. The differences in longevity were not statistically significant. The main reasons for failure for the inlays/onlays and direct restorations were fracture (8.3 and 12. 1%, respectively), occlusal wear in contact areas (4.2 and 6.1%, respectively) and secondary caries (4.2 and 9.1%, respectively). Eight of the non-acceptable inlays/onlays and five of the direct restorations were replaced, while the other ones were repaired with resin composite. Unacceptable wear was observed in occlusal contact areas of six restorations, in patients who were severe bruxers. For the other restorations occlusal wear was not found to be a clinical problem and no difference was observed between the inlays/onlays and direct composite restorations. The marginal adaptation of the inlays/onlays was still good at the end of the study. Ditching was only observed in a few inlays. A higher failure rate was observed in molar teeth than in premolar teeth. CONCLUSIONS: Good durability was observed for the direct resin composite inlay/onlay technique. Excellent marginal adaptation and low frequency of secondary caries in patients with high caries risk were shown. No apparent improvement of mechanical properties was obtained by the secondary heat treatment of the inlays. Also, the difference in failure rate between the resin composite direct technique and the inlay technique was not large, indicating that the more time-consuming and expensive inlay technique may not be justified. The direct inlay/onlay technique is recommended to be used in Class II cavities of high caries risk patients with cervical marginal placed in dentin. <13> UI - 20291717 AU - Browning WD AU - Johnson WW AU - Gregory PN IN - Medical College of Georgia, School of Dentistry, Department of Oral Rehabilitation, Augusta, Ga. 30912-1260, USA. TI - Clinical performance of bonded amalgam restorations at 42 months. SO - Journal of the American Dental Association 2000 May;131(5):607-11 AB - BACKGROUND: Despite a lack of data based on clinical research, many positive characteristics have been attributed to the placement of amalgam restorations with an adhesive resin liner. METHODS: For 42 months, and authors followed two groups of subjects who had amalgam restorations placed in a previous study. In this double-blind study, these subjects had been randomly assigned to have amalgam restorations placed with an adhesive liner or with a copal varnish placed under all restorations and a bulk base of zinc phosphate cement for deeper lesions. The authors evaluated anatomical form, marginal adaptation, retention and the presence of secondary caries at six, 18, 30 and 42 months. RESULTS: At 42 months, the authors found that all restorations in both groups still were retained, were free of secondary caries and were rated clinically acceptable. No difference between the groups was found for any category (P > .05; analysis). CONCLUSIONS: Placement of amalgam restorations with adhesive liners was found to produce results equivalent to that of traditional methods over a 42-month period. CLINICAL IMPLICATIONS: Practitioners wary of using new methods that have not undergone thorough clinical testing can feel comfortable placing adhesive liners under amalgam restorations. <14> UI - 20308812 AU - Lutz F AU - Krejci I IN - Department of Preventive Dentistry, Periodontology and Cariology School of Dentistry, University of Zurich, Switzerland. TI - Resin composites in the post-amalgam age. [Review] [21 refs] SO - Compendium of Continuing Education in Dentistry (Jamesburg, NJ) 1999 Dec;20(12):1138-44, 1146, 1148 AB - Resin-based composites are now being used as either amalgam substitutes or amalgam alternatives for the direct placement of box-shaped, stress-bearing restorations in posterior teeth. The expected longevity of these restorations is 8 years. With amalgam substitutes, preservation of enamel and dentin and restoration of tooth form and function must be warranted for the full length of the envisaged service life. In addition, with amalgam alternatives, the restoration must be, and must remain, imperceptible at a normal talking distance. The limiting factor with amalgam substitutes is the elevated risk of secondary caries, which is a result of the marginal openings that are unavoidably associated with the nature of the operative technique. Restorations in permanent teeth using amalgam substitutes most likely fail in some critical aspect of the Swiss Dental Society quality guidelines. With amalgam alternatives, the high cost and the demanding operative technique remain the main criticisms. However, amalgam alternatives, if they are placed using a sophisticated operative technique resulting in perfectly adapted restorations, meet the high expectations outlined in the Swiss Dental Society quality guidelines and fit the clinical concept of the post-amalgam age. [References: 21] <15> UI - 20308784 AU - Fontana M AU - Gonzalez-Cabezas C AU - Wilson ME AU - Appert C IN - Indiana University, School of Dentistry, Indianapolis 46202, USA. mfontana@iusd.iupui.edu TI - In vitro evaluation of a "smart" dental material for its efficacy in preventing secondary caries using a microbial artificial mouth model. SO - American Journal of Dentistry 1999 Nov;12 Spec No:S8-9 <16> UI - 20308783 AU - Heintze SD IN - Department of Clinical Research, Ivoclar/Vivadent, Schaan, Liechtenstein. siegward.heintze@ivoclar.com TI - A new material concept for inhibiting the formation of secondary caries. SO - American Journal of Dentistry 1999 Nov;12 Spec No:S4-7 <17> UI - 20266260 AU - Cobb DS AU - Dederich DN AU - Gardner TV IN - University of Iowa College of Dentistry, Iowa City, Iowa 5224, USA. TI - In vitro temperature change at the dentin/pulpal interface by using conventional visible light versus argon laser. SO - Lasers in Surgery & Medicine 2000;26(4):386-97 AB - BACKGROUND AND OBJECTIVE: The argon laser has been promoted as a competing technology to multi-wavelength visible light as a curing source for dental restorative resins. However, the comparative thermal risk to the pulp between these two sources of light energy requires determination. The objective of this study is to compare the temperature induced at the dentin-pulpal interface between the argon laser and visible light curing unit at a variety of exposure regimens and conditions. STUDY DESIGN/MATERIALS AND METHODS: In vitro temperatures were measured and recorded at the dentin-pulpal interface upon external light exposure. Independent variables included the dentin thickness, duration and waveform of exposure, and presence of composite resin. RESULTS: In most instances, the argon laser resulted in less temperature rise on the pulpal-dentin interface. CONCLUSION: The argon laser should not pose a serious thermal risk to the pulp if used at recommended energies. Copyright 2000 Wiley-Liss, Inc. <18> UI - 20285616 AU - Wilder AD Jr AU - May KN Jr AU - Bayne SC AU - Taylor DF AU - Leinfelder KF IN - Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, USA. TI - Seventeen-year clinical study of ultraviolet-cured posterior composite Class I and II restorations. SO - Journal of Esthetic Dentistry 1999;11(3):135-42 AB - OBJECTIVES: To compare the clinical performance of four commercial ultraviolet light-cured composite materials, and to evaluate curing-system effects on long-term wear resistance of Class I and II restorations. MATERIALS AND METHODS: Approximately 32 samples of each of four different ultraviolet light-cured composites (n = 130) were inserted into conventional Class I and II cavity preparations by two clinicians. Cavosurface margins of the preparations were not beveled. Enamel walls of the preparation were etched, and the respective bonding agent was applied. Each restoration was evaluated by two clinicians at 5, 10, and 17 years. Direct evaluations were performed using modified United States Public Health Service (USPHS) criteria. Indirect evaluations were performed using the Leinfelder cast evaluation method. RESULTS: After 17 years, 65% of the restorations were recalled and pooled direct evaluations were conducted for color matching (94% alfa), marginal discoloration (100% alfa), marginal integrity (100% alfa), secondary caries (92% alfa), surface texture (72% alfa), and anatomic form (22% alfa). Mean occlusal wear from indirect evaluations at 5, 10, and 17 years was 197 +/- 85 microns, 235 +/- 72 microns, and 264 +/- 80 microns, respectively. For direct and indirect evaluations there were significant differences (p < or = .05) between the baseline and 5-year recall evaluations. CLINICAL SIGNIFICANCE: This study demonstrated that the mean pooled occlusal wear of four ultraviolet light-cured posterior composites at 17 years was 264 microns (approximately 0.25 mm), and that most wear (75%) occurred in the first 5 years. Of all recalled restorations, 76% were judged clinically acceptable at 17 years, and 22% of those exhibited no clinically detectable wear. <19> UI - 20282494 AU - Uyehara MY AU - Davis RD AU - Overton JD IN - 81st Dental Squadron, Keesler AFB, MS 39534, USA. TI - Cuspal reinforcement in endodontically treated molars. SO - Operative Dentistry 1999 Nov-Dec;24(6):364-70 AB - This in vitro study compared the ability of horizontal pins and a dental adhesive to reinforce the facial cusps of endodontically treated mandibular molars. Seventy-two mandibular molars were divided into six groups and mounted in acrylic blocks (n = 12). In Groups 1-5 standardized endodontic access and instrumentation in the coronal one-third of each root canal were completed. In Groups 1-4 the lingual cusps were reduced, leaving the buccal cusps intact. The facial cusps of the teeth in each group received one of the following modes of reinforcement: Group 1--no reinforcement; Group 2--dentin adhesive (Amalgambond Plus); Group 3--two horizontal TMS Minim pins; Group 4--two horizontal TMS Minim pins and Amalgambond Plus. Teeth in Group 5 were prepared for and restored with a complete cuspal coverage amalgam restoration using four vertical TMS Minim pins. Group 6 consisted of intact natural teeth. Using an Instron Universal Testing Machine, the lingual slope of the facial cusp of each specimen was loaded to failure using a compressive force applied at an angle 60 degrees to the long axis of the tooth. The mean fracture strengths for all groups were analyzed using a one-way ANOVA and Student-Newman-Keuls multiple range test (alpha = 0.05). Fracture patterns and modes of failure were also evaluated. RESULTS: The intact teeth (Group 6) were significantly more fracture resistant than all other groups, with the exception of Group 4 (combination of pins and adhesive). Group 1 (non-reinforced teeth) was significantly weaker than all other groups. Groups 2-4 (specimens with reinforced cusps) were not significantly different from each other. The use of horizontal pins or a combination of horizontal pins plus dentin adhesive for cuspal reinforcement resulted in significantly more teeth demonstrating favorable fracture patterns than did the use of adhesives alone. CONCLUSION: The buccal cusps of endodontically treated mandibular molars reinforced with a combination of horizontal pins and dentin adhesive were not significantly weaker than intact teeth. Of the restored teeth, those which had buccal cusps reinforced with horizontal pins and those treated with complete cuspal coverage amalgam restorations exhibited the most favorable restorative prognosis following cusp fracture. <20> UI - 20282490 AU - el-Badrawy WA IN - University of Toronto, Faculty of Dentistry, Department of Restorative Dentistry, Ontario, Canada. TI - Cuspal deflection of maxillary premolars restored with bonded amalgam. SO - Operative Dentistry 1999 Nov-Dec;24(6):337-43 AB - The aims of this study were to measure cuspal deflection of premolars restored with bonded amalgam and to investigate bond resistance to thermo-cycling and cyclic loading. Strain gauges were used to measure cuspal deflection of maxillary premolars restored with MOD bonded amalgam restorations. A nondestructive method was used in which teeth were loaded repeatedly to record cuspal deflection following different restorative procedures. Ten extracted premolars with similar dimensions were selected and their roots mounted in resin bases 2 mm below the CEJ. Two single-element strain gauges were bonded to the buccal and lingual surfaces of the cusps of each tooth at a level that corresponded to the pulpal floor of MOD cavities. These were connected to a strain indicator with a built-in wheat-stone bridge. An Instron machine was used to apply a 100 N compressive load. Micro-strain readings were recorded with each loading at the following stages: (1) sound unprepared teeth (baseline reading), (2) following preparation of a medium-size MOD cavity, (3) 24 hours following restoration with amalgam, (4) following amalgam removal, (5) 24 hours following restoration with bonded amalgam. Durability of the bond was further tested by cyclic loading of 2000, 4000, 6000, and 8000 load cycles. Mean micro-strain values recorded at the buccal cusp were: 48.0 (21.6), 126.8(57.2), 121.4(53.3), 120.8(56.1), and 65.2(36.5) for test stages 1, 2, 3, 4, and 5 respectively. Cuspal deflections following cyclic loading recorded at the buccal cusp were: 60.0(41.0), 63.6(51.9), 59.6(36.3), and 61.6(36.8) at the above four cyclic loading stages respectively. A similar trend was also observed for measurements of the lingual cusp. It was concluded that bonding amalgam restorations decreases cuspal deflection and consequently may assist in restoring tooth strength under conditions of the oral environment. <21> UI - 20274758 AU - Brunton PA AU - Cowan AJ AU - Wilson MA AU - Wilson NH IN - Unit of Operative Dentistry and Endodontology, University Dental Hospital of Manchester, UK. paul.brunton@man.ac.uk TI - A three-year evaluation of restorations placed with a smear-layer-mediated dentin bonding agent in non-carious cervical lesions. SO - Journal of Adhesive Dentistry 1999;1(4):333-41 AB - PURPOSE: To evaluate the handling characteristics, clinical behavior, and effectiveness of Coltene ART Bond/Brilliant restorations in mixed Class V preparations in maxillary premolar and canine teeth of adult patients over a three-year period. MATERIALS AND METHODS: Single-center, uncontrolled, clinical evaluation of 50 restorations in 26 patients extending over 36 months. RESULTS: At three years, 34 restorations, or 68% of those originally placed, in 20 patients were available for review. One of the 34 restorations had been lost 15 months after placement. In terms of marginal integrity and staining, anatomic form, surface texture and staining, and postoperative sensitivity, over 90% of the restorations reviewed at three years were rated alpha. Following difficulties in obtaining excellent color match in relation to 14 (28%) of the restorations at the time of placement, only 44% of the restorations were rated alpha at three years. CONCLUSION: It was concluded that with the possible exception of excellent color match, ART Bond/Brilliant restorations may be found to perform favorably in mixed Class V lesions in selected adult patients over a period of at least three years. The findings indicate that resin composite restorations placed with a smear-layer mediated dentin bonding agent may be found to have a favorable clinical outcome in non-carious cervical lesions. <22> UI - 20274757 AU - Setcos JC AU - Staninec M AU - Wilson NH IN - Dental School, University of Manchester, UK. TI - A two-year randomized, controlled clinical evaluation of bonded amalgam restorations. SO - Journal of Adhesive Dentistry 1999;1(4):323-31 AB - PURPOSE: The clinical performance of adhesively bonded dental amalgam restorations was compared with that of traditionally placed non-bonded control amalgams in a randomized prospective study. MATERIALS AND METHODS: One-hundred thirteen Class II Dispersalloy amalgams were placed in permanent molars and premolars of 31 (21 males, 10 females) human subjects with their informed consent. By random assignment, 60 amalgam restorations were adhesively bonded using ED Primer and Panavia 21 TC (both Kuraray Co, Japan), and 53 traditional non-bonded restorations were placed. Most preparations involved replacement of defective amalgam restorations. Clinical recalls were conducted by experienced evaluators using modified USPHS criteria for occlusal and proximal anatomic form, occlusal and proximal marginal adaptation, and occlusal and proximal surface roughness. RESULTS: For the categories of anatomic form, marginal adaptation, surface quality, and temperature sensitivity, there were no significant differences between bonded and non-bonded amalgam restorations (chi-square analysis, p > 0.05). Three non-bonded restorations were lost at 4, 7, and 24 months from preparations with no deliberate retention. CONCLUSION: After two years' clinical service, there were no failures among the amalgam restorations adhesively bonded using ED Primer and Panavia 21 TC, but three non-bonded restorations failed due to lack of retention. For traditional preparations, adhesively bonded amalgams of the type investigated perform as well as non-bonded amalgams over two years' clinical service. <23> UI - 99420786 AU - Morley J IN - School of Dental Medicine, State University of New York, University at Buffalo, USA. TI - The role of cosmetic dentistry in restoring a youthful appearance [see comments]. [Review] [26 refs] CM - Comment in: J Am Dent Assoc 1999 Nov;130(11):1562, 1564, Comment in: J Am Dent Assoc 2000 Jan;131(1):20 SO - Journal of the American Dental Association 1999 Aug;130(8):1166-72 AB - BACKGROUND: Dentistry is faced with a population that is getting older and keeping more of its natural teeth. Smiles show physical and esthetic signs of aging. Advances in the area of cosmetic dentistry now offer the dental profession new opportunities in conservative and esthetic restorative procedures that have the potential to reverse the signs of dental aging, thereby making patients appear younger. CASE DESCRIPTION: The physical and esthetic attributes of an aged dentition are identifiable. Tooth wear over time alters the appearance of the teeth and smile in a way that is perceptible to dentists and laypeople. Bonding and adhesive ceramic restorative procedures have the potential of reversing the esthetic manifestations of the aging process for teeth. Specific diagnostic tools, including a composite resin mock-up and construction of an incisal putty matrix, allow for previsualization of possible treatment outcomes and allow clinicians to resolve occlusal as well as esthetic treatment concerns before initiating actual treatment. CLINICAL IMPLICATIONS: The ability to make patients look younger through cosmetic enhancement of teeth and smiles has tremendous implications for the future practice of dentistry. Dentists who have the training and skills to meet the increasing demand for esthetic procedures by patients seeking to restore a youthful appearance may find an expanded role within their practices for this type of treatment. [References: 26] <24> UI - 20228683 AU - Gladys S AU - Van Meerbeek B AU - Lambrechts P AU - Vanherle G IN - BIOMAT-Department of Operative Dentistry and Dental Materials, Catholic University of Leuven, Belgium. TI - Evaluation of esthetic parameters of resin-modified glass-ionomer materials and a polyacid-modified resin composite in Class V cervical lesions [published erratum appears in Quintessence Int 1999 Dec;30(12):845]. SO - Quintessence International 1999 Sep;30(9):607-14 AB - OBJECTIVE: The purpose of this study was to compare the esthetics of 3 resin-modified glass-ionomer materials and 1 polyacid-modified resin composite to the esthetics of a conventional glass-ionomer control material. METHOD AND MATERIALS: One hundred eighty-seven Class V cervical restorations were observed clinically over 18 months. The esthetic index system that was used evaluated color match, translucency or opacity, and surface roughness. RESULTS: The tested materials behaved very dissimilarly and inconsistently. In general, the esthetic results of the resin-modified glass-ionomer materials and the polyacid-modified resin composite were far from optimal. The esthetic appearance of restorations seriously deteriorated during clinical service, mainly because of discoloration of margins, changes in translucency and opacity, and rapidly appearing roughness or dullness on the surface. Both the resin-modified glass-ionomer materials and the polyacid-modified resin composite evaluated in this study performed better esthetically than did the conventional glass-ionomer material. CONCLUSION: Indications for these combination materials are limited to areas where esthetics is not a primary concern but where their ease of application may guarantee a more durable functional result. <25> UI - 20180951 AU - Downer MC AU - Azli NA AU - Bedi R AU - Moles DR AU - Setchell DJ IN - National Centre for Transcultural Oral Health, London. TI - How long do routine dental restorations last? A systematic review [see comments]. CM - Comment in: Br Dent J 1999 Dec 25;187(12):632 SO - British Dental Journal 1999 Oct 23;187(8):432-9 AB - OBJECTIVE: To conduct a systematic review of the literature on the longevity of routine dental restorations in permanent posterior teeth, and to identify and examine factors influencing its variability. METHOD: Accepted guidelines were followed. An advisory group oversaw the project. Simple Class I and Class II amalgam, composite resin, glass ionomer and cast gold restorations were covered. Comprehensive searching of electronic databases, hand-searching, and location of 'grey' literature, generated 124 research reports. Those considered relevant were assessed for validity and quality according to agreed criteria. The analysis was descriptive. RESULTS: Eight of 58 relevant research reports were categorised, according to agreed criteria, as being of satisfactory validity and quality. They suggested that 50% of all restorations last 10 to 20 years, although both higher and lower median survival times were reported. The findings were supported by the totality of studies reviewed. However, variability was substantial. Restoration type, materials, the patient, the operator, the practice environment and type of care system appeared to influence longevity. CONCLUSIONS: Many studies were imperfect in design. Those considered to be the most appropriate for analysis were too limited to undertake a formal statistical exploration. Therefore there remains a need for definitive randomised controlled trials of restoration longevity, of sound design and adequate power, employing standardised assessments and appropriate methods of analysis. <26> UI - 20200895 AU - Marks LA AU - van Amerongen WE AU - Borgmeijer PJ AU - Groen HJ AU - Martens LC IN - Department of Cariology, Endodontology, Pedodontology at Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. TI - Ketac Molar Versus Dyract Class II restorations in primary molars: twelve month clinical results. SO - ASDC Journal of Dentistry for Children 2000 Jan-Feb;67(1):37-41, 8-9 AB - The aim of the present clinical study was an in vivo evaluation of an improved conventional glass ionomer cement Ketac Molar (ESPE), compared to a polyacid modified composite resin, Dyract (Dentsply/De Trey), used in primary molars. Fifty-three Ketac Molar and fifty-two Dyract restorations were placed in box-only preparations in primary molars. The application time for the chemically cured Ketac Molar, was longer compared to the light-cured Dyract. In comparing the materials, no differences were found, comparing both materials regarding secondary caries, marginal adaptation, wear and fracture toughness. One case of recurrent caries adjacent to a Ketac Molar restoration and two cases in the Dyract group were reported. Two Ketac Molar restorations and one Dyract showed bulk fracture at the time of evaluation. At the twelve-month evaluation, no difference between the investigated materials was registered, which indicates that Ketac Molar can be used as a proximal restoration in the primary dentition. It should be emphasized, however, that one-year data should not be extrapolated to indicate the long-term success of restorations. <27> UI - 20247871 AU - Nagamine M AU - Alim NN AU - Itota T AU - Torii Y AU - Staninec M AU - Inoue K IN - Department of Operative Dentistry, Okayama University Dental School, Japan. TI - Inhibition of carious lesions in vitro around gallium alloy restorations by fluoride releasing resin-ionomer cement. SO - Dental Materials Journal 1999 Mar;18(1):42-53 AB - A new fluoride releasing resin-ionomer cement was used for bonding of gallium alloy restorations in vitro. Etching, priming, and fluoride releasing resin-ionomer cement were used in the experimental group (ARG), prior to placement of the gallium alloy restorations. Three different controls were used: gallium alloy only (G), no etching, fluoride releasing resin-ionomer cement, gallium alloy (RG), etching, priming, non-fluoride cement and gallium alloy (ACG). The mean shear bond strengths of ARG group to enamel and dentin were higher than those of the three control groups. Artificial secondary caries lesions around the restorations in the experimental group and the control groups were produced, using a strep. mutans culture. The microradiographs were examined for presence of a caries inhibition zone near the restoration. Caries inhibition zones were clearly detected around RG and ARG, but not around G and ACG. The results indicate that the fluoride releasing resin-ionomer cement provided good adhesion and caries inhibition in enamel and dentin. <28> UI - 20247894 AU - Serra JM IN - Las Vegas Institute for Advanced Dental Studies, USA. TI - A predictable, conservative, technique for natural-looking posterior composite placement. SO - Dentistry Today 1999 Jul;18(7):50-3 <29> UI - 20228681 AU - Ribeiro CC AU - Baratieri LN AU - Perdigao J AU - Baratieri NM AU - Ritter AV IN - Department of Pedodontics, Federal University of Maranhao, School of Dentistry, Sao Luis, Brazil. TI - A clinical, radiographic, and scanning electron microscopic evaluation of adhesive restorations on carious dentin in primary teeth. SO - Quintessence International 1999 Sep;30(9):591-9 AB - OBJECTIVE: The purpose of this project was to evaluate the performance of a dentin adhesive system on carious and noncarious primary dentin in vivo. METHOD AND MATERIALS: Forty-eight primary molars with carious lesions were randomly assigned to 2 different treatments: group 1 (control, n = 24)--All identifiable, irreversibly infected dentin was removed prior to the application of the bonding agent and restorative material; group 2 (experimental, n = 24)--Irreversibly infected dentin was partially removed prior to the application of the bonding agent and restorative material. The control and experimental teeth were clinically monitored every 3 months and evaluated 12 months after restoration. The teeth were extracted around the time of exfoliation and processed for scanning electron microscopy. RESULTS: Retention rate, marginal integrity, and pulpal symptoms were identical in both groups. Radiographically, the radiolucent area associated with the experimental restorations did not increase with time in 75% of the cases. For the control group, the adhesive system formed a hybrid layer. In the experimental group, there was morphologic evidence of the formation of an acid-resistant "altered hybrid layer." An acid-resistant tissue, resulting from the interdiffusion of adhesive resin within the area of carious dentin, was observed adjacent to and under the altered hybrid layer. CONCLUSION: Application of an adhesive restorative system to irreversibly infected dentin did not affect the clinical performance of the restoration. <30> UI - 20175637 AU - Chana H AU - Kelleher M AU - Briggs P AU - Hooper R IN - King's Dental Institute, London, United Kingdom. harpal.chana@kcl.ac.uk TI - Clinical evaluation of resin-bonded gold alloy veneers. SO - Journal of Prosthetic Dentistry 2000 Mar;83(3):294-300 AB - STATEMENT OF PROBLEM: Clinical performance of resin-bonded alumina-abraded type III cast gold alloy veneers has not been reported. PURPOSE: This retrospective study evaluated the survival of such restorations for the management of tooth wear and other restorative problems. MATERIAL AND METHOD: This clinical study evaluated 25 patients between 14 and 60 years of age treated with a total of 158 cast gold veneers cemented with Panavia Ex cement. Restorations placed between January 1990 and February 1996 (mean age 48 months) were evaluated. Factors, including age, gender, operator, site, design, the extent of dentin exposure, the presence of previous restorations, dynamic and static occlusion, rubber dam, cause, and methods of interocclusal space creation, were evaluated with Cox regression. Survival probability was evaluated with Kaplan-Meier analyses. Significance was taken as P <.05. RESULTS: Failures occurred for 7.6% of restorations in 28% of patients. Alumina-abraded gold alloys cemented with Panavia Ex cement had an estimated 89% survival probability at 60 months using Kaplan-Meier analyses. The only variable to statistically influence survival was operator (P <.0001). Operator differences were due to a single operator who placed only 2 restorations in the same patient, both of which failed unusually quickly. CONCLUSION: Resin-bonded alumina-abraded type III cast gold alloys can be successfully used to restore both anterior and posterior teeth and were associated with an estimated 89% survival probability at 60 months. <31> UI - 20175636 AU - Hemmings KW AU - Darbar UR AU - Vaughan S IN - Eastman Dental Hospital and Institute for Oral Healthcare Sciences, London, United Kingdom. K.Hemmings@eastman.ucl.ac.uk TI - Tooth wear treated with direct composite restorations at an increased vertical dimension: results at 30 months. SO - Journal of Prosthetic Dentistry 2000 Mar;83(3):287-93 AB - STATEMENT OF PROBLEM: Severe tooth wear localized to the anterior maxillary or mandibular teeth with loss of interocclusal space is difficult to manage. PURPOSE: This study evaluated the outcome of composite restorations placed at an increased vertical dimension of occlusion in such patients. METHODS AND MATERIAL: Sixteen patients were restored with 104 restorations in 2 groups. In group A, Durafill composite and Scotchbond Multipurpose dentine adhesive system were used to place direct anterior restorations (N = 52). In group B, Herculite XRV composite and Optibond dentine bonding agent was used (N = 52). The restorations were placed at an increased vertical dimension of occlusion creating a posterior disclusion of 1 to 4 mm. RESULTS: Clinical follow-up showed that the posterior occlusion remained satisfactorily restored after a mean duration of 4.6 months (range 1 to 11 months). Mean follow-up of 30 months has shown a combined success rate of 89.4% for both groups with 93 of the restorations remaining in service. Maintenance in group A was high with 33 failures, but low in group B with 6 failures. Patient satisfaction was reported as good. CONCLUSION: Direct composite restorations may be a treatment option for localized anterior tooth wear. <32> UI - 20180820 AU - Jackson RD AU - Morgan M TI - The new posterior resins and a simplified placement technique. [Review] [52 refs] SO - Journal of the American Dental Association 2000 Mar;131(3):375-83 AB - BACKGROUND: New heavy-body (packable) composites have been developed for use in posterior direct resin restorations. These materials are promoted as having better handling characteristics and higher physical properties than previous microhybrid composites. METHODS: The authors describe an incremental layering technique that takes advantage of the improved handling characteristics and proposed reduced shrinkage and greater depth of cure. CLINICAL IMPLICATIONS: When this new technique is used with one-bottle adhesives and improved instrumentation, posterior heavy-body composites can be placed faster, easier and possibly more predictably than when medium-body resins and previous techniques are used. [References: 52] <33> UI - 20180815 AU - Randall RC AU - Vrijhoef MM AU - Wilson NH IN - 3M Dental, Laboratoires 3M Sante, Cergy Pontoise, France. TI - Efficacy of preformed metal crowns vs. amalgam restorations in primary molars: a systematic review. [Review] [28 refs] SO - Journal of the American Dental Association 2000 Mar;131(3):337-43 AB - BACKGROUND: The authors evaluated the treatment efficacy of preformed metal crowns, or PMCs, vs. amalgam restorations in primary molars by means of a literature review and meta-analysis. TYPES OF STUDIES REVIEWED: From a literature search, the authors selected clinical studies that evaluated treatment with PMCs vs. amalgam control restorations in primary molars and provided data against which treatment outcomes could be compared. RESULTS: Ten studies with durations ranging from 1.6 to 10 years fulfilled the selection criteria. Their failure rates, based on need for subsequent treatment or retention of the restoration at final evaluation, ranged from 1.9 to 30.3 percent for PMCs and 11.6 to 88.7 percent for amalgam restorations. Overall, PMCs demonstrated greater longevity and reduced retreatment need compared with amalgam control restorations. The odds ratio for all studies fell within the boundary favoring treatment with PMCs. CLINICAL IMPLICATIONS: Analysis of the literature, though mainly retrospective studies, demonstrated evidence of a more favorable outcome for PMCs than for amalgam restorations in primary molars requiring multisurface restorations. [References: 28] <34> UI - 20141558 AU - Anonymous TI - Dental fillings. The silver in them thar molars. [Review] [0 refs] SO - Harvard Health Letter 2000 Mar;25(5):1-3 <35> UI - 20151852 AU - Gryst ME AU - Mount GJ IN - Specialist Services, Adelaide Dental Hospital. TI - The use of glass ionomer in special needs patients. SO - Australian Dental Journal 1999 Dec;44(4):268-74 AB - Placement of restorations for patients who are physically or intellectually disabled or mentally ill can pose considerable difficulties for the general practitioner. Access to the oral environment is often limited and patient tolerance and concentration may be reduced to rather brief periods of time. Oral hygiene routines may be less than ideal leading to a high caries rate. Enamel surfaces which do not normally become carious can develop broad but shallow lesions with a poorly defined outline. Selection of the most suitable restorative material will be important, with longevity of the restoration as the prime consideration. Other factors such as access, isolation of the lesion and patient co-operation must also be taken into account. Also, forces acting on restorative materials may be less than usual due to poor occlusion, teeth opposing dentures or being completely unopposed. Restoration by indirect techniques will often not be possible so the choice will be limited to the three plastic restorative materials normally used in restorative dentistry: amalgam, resin composite and glass ionomer. As a result of clinical experience it is suggested that glass ionomer will often be the material of choice. This paper describes five years experience with the resin-modified glass ionomers in an institutional practice which is limited to patients with special needs. Clinical significance Placement of restorations, with a reasonable expectation of longevity, can pose considerable problems for the patient with special needs. Resin-modified glass ionomer is a useful alternative material and has been placed with a high degree of success over a period of five years. <36> UI - 20138327 AU - Zollner A AU - Gaengler P IN - Department of Prosthodontics, School of Dental Medicine, University of Witten/Herdecke, Alfred Herrhausen Str. 50, 58448 Witten, Germany. dagmark@uni-wh.de TI - Pulp reactions to different preparation techniques on teeth exhibiting periodontal disease. SO - Journal of Oral Rehabilitation 2000 Feb;27(2):93-102 AB - To evaluate the histopathological outcome of two preparation techniques (featheredge preparation/shoulder preparation) on teeth exhibiting pulp reactions due to age and periodontal disease, 11 teeth were prepared for full veneer crowns. Laboratory made resin crowns were fixed with a zinc phosphate cement for a period of 90 days. After extraction, adjacent pulpal areas were histopathologically rated according to the BRD criteria comprising the parameters (i) Bacterial invasion, (ii) Regenerative parameters, (iii) Degenerative parameters. Degenerative reactions were more correlated with tooth preparation than with advanced periodontal disease. The severity of endondontal reactions depends more on remaining dentin thickness than on the type of preparation. <37> UI - 20138329 AU - Rees JS AU - Jacobsen PH IN - Department of Adult Dental Health, Dental School, University of Wales College of Medicine, Cardiff, U.K. TI - The effect of interfacial failure around a class V composite restoration analysed by the finite element method. SO - Journal of Oral Rehabilitation 2000 Feb;27(2):111-6 AB - Partial failure around the tooth-composite interface of a class V restoration is common due to the effects of polymerization shrinkage. The effect that this has on the force distribution of the remaining intact interfaces has not been investigated. The aim of this study was to quantify the effect that partial failure of an isolated cavity wall interface had on the force distribution around the remaining intact interfaces of a class V composite restoration in a lower first premolar using a two-dimensional plane strain finite element model. Partial failure resulted in a 4-6-fold increase in peak tensile and shear forces compared to a tooth with a fully intact cavity wall interface. In some instances, the peak stresses were greater than the known bond strengths of composite to dentine. <38> UI - 20144639 AU - Behnia A AU - Strassler HE AU - Campbell R IN - Department of Endodontics, Dental School, University of Maryland at Baltimore 21201, USA. TI - Repairing iatrogenic root perforations. SO - Journal of the American Dental Association 2000 Feb;131(2):196-201 AB - BACKGROUND: Post preparation is an integral part of restoring endodontically treated teeth in indicated cases. Iatrogenic perforation of the root can result from preparing post space and can severely compromise the prognosis of the tooth. CASE DESCRIPTION: Two years after a patient's maxillary lateral incisor was restored with a post-retained composite resin, he went to a dental school emergency clinic with a chief complaint of soft-tissue swelling adjacent to the tooth. The authors took a periapical radiograph that revealed evidence of a circumscribed radiolucent lesion associated with the distal midroot area and a periapical radiolucency. Based on the radiograph, the authors suspected that the canal preparation for the post and the post placement had perforated the root at the base of the post. CLINICAL IMPLICATIONS: The authors used a combined surgical and orthograde approach with a biocompatible restorative material and a clear, plastic light-transmitting post to repair the iatrogenic perforation. <39> UI - 20144636 AU - McDaniel RJ AU - Davis RD AU - Murchison DF AU - Cohen RB IN - Department of TMJ and Orofacial Pain, University of Minnesota Dental School, USA. TI - Causes of failure among cuspal-coverage amalgam restorations: a clinical survey. SO - Journal of the American Dental Association 2000 Feb;131(2):173-7 AB - BACKGROUND: Investigations of cuspal-coverage amalgam restorations suggest that tooth fracture is the leading cause of failure, while for Class I and II restorations, the leading cause is caries. In this study, the authors evaluated the causes of failure for a large number of cuspal-coverage restorations. METHODS: The causes of failure for 706 cuspal-coverage amalgam restorations were determined through the use of a questionnaire. Dentists from a variety of dental schools; Army, Navy, Air Force, Public Health and Veterans Affairs dental clinics; and private practice were asked to record pertinent information regarding patients and restoration failures from choices provided on a survey form. RESULTS: The survey documented 706 failed restorations. Mandibular first molars accounted for 36.25 percent of all failures. The majority of failures were caused by fractured teeth (24.3 percent), caries (20 percent) and fractured restorations (17.1 percent). Among all of the failed restorations, 82.15 percent were restorable, 9.35 percent were repairable and 8.50 percent were nonrestorable. Among the fractured teeth, 80 percent were restorable, 14.5 percent were nonrestorable and 5.5 percent were repairable. Among the carious teeth, 84 percent were restorable, 8 percent were nonrestorable and 8 percent were repairable. A chi 2 analysis revealed that tooth fracture was more likely to be associated with nonrestorability than either caries (chi 2 = 5.013, P < .05) or restoration fracture (chi 2 = 6.202, P < .05). CONCLUSIONS: The leading cause of failure among the 706 restorations was tooth fracture, which resulted in significantly greater numbers of nonrestorable teeth than either caries or fractured restorations. CLINICAL IMPLICATIONS: Tooth fracture creates a greater risk of nonrestorability than any other cause of failure. Replacement or coverage of fracture-prone cusps is likely to improve the life expectancy of complex amalgam restorations. <40> UI - 20131622 AU - Neo J AU - Chew CL AU - Osborne JW AU - Mahler DB IN - Department of Restorative Dentistry, National University of Singapore, National University Hospital. rsdnnj@nus.edu.sg TI - Clinical evaluation and microstructural analysis of a direct placement gallium restorative alloy. SO - Journal of Dentistry 2000 Feb;28(2):123-9 AB - OBJECTIVES: The objective of this study was to assess the clinical performance of a direct placement gallium alloy sealed with an established dentine adhesive system. In addition, microanalysis of a few gallium restorations that failed in clinical service was performed. Clinical factors such as pulpal sensitivity, fracture of the restoration and of the tooth, marginal deterioration, and tarnish were assessed. METHODS: Sixty-five restorations of Galloy and 62 of Tytin (49 and 51 Class II restorations, respectively) were placed according to a predetermined scheme for randomisation in 37 patients by two operators using rubber dam isolation. For the Galloy restorations, the enamel and dentine were etched, and then sealed with PAAMA 2 dentine adhesive according to the manufacturer's instructions. After carving, PAAMA 2 was applied to the Galloy and light-cured. Cavity preparations for Tytin received no adhesive sealer. All restorations were polished at least 24 h post-operatively. Microstructural analysis of retrieved fragments of failed restorations was conducted using electron probe microanalysis. RESULTS: At 1 year, only one Tytin restoration was found to have failed due to an isthmus fracture. The remaining restorations of Tytin were intact with no reported sensitivity. Of the 65 Galloy restorations placed, 28 had to be removed, including restorations in teeth, which were symptomatic, non-vital and/or fractured, and teeth with fractured restorations. Tarnish was present on many of the Galloy restorations. Retrieved fragments of failed Galloy restorations exhibited a dark surface at the pulpal wall interface and small cracks were observed in that surface. Internal cracks and extensive corrosion was observed using the microprobe. Gallium oxides and chlorides were identified as the predominant corrosion products. CONCLUSIONS: The gallium alloy, Galloy, sealed with PAAMA 2 dentine adhesive system demonstrated a high clinical failure rate. <41> UI - 20131621 AU - Cehreli ZC AU - Altay N IN - Department of Paedodontics, Hacettepe University, Faculty of Dentistry, Ankara, Turkey. zaferc@hotmail.com TI - Three-year clinical evaluation of a polyacid-modified resin composite in minimally invasive occlusal cavities. SO - Journal of Dentistry 2000 Feb;28(2):117-22 AB - OBJECTIVE: The aim of this study was to evaluate the 3-year clinical performance of one polyacid-modified resin composite material (PMRC). Dyract, in minimally invasive occlusal cavities and its neighbouring fissures. METHODS: One hundred and sixteen restorations of the material investigated were placed by a single operator in a group of selected children under controlled conditions. Isolation of the restorations was accomplished with the use of cotton rolls and aspiration. Using modified US Public Health Service (USPHS) codes and criteria, the restorations were reviewed clinically within 1 week of placement (baseline), and thereafter at 6 months, 1, 2 and 3 years. RESULTS: After 3 years, marginal discolouration was present in 8.6% of the restorations. The marginal adaptation was rated as partly sealed (Oscar-Alpha) in 107 (92.2) of the restorations. Five restorations had lost their sealant components, while four restorations were partly sealed with explorer-catch after 3 years. Although wear of the restorations was considerable, restorations rated as 'partly sealed' had at least two-thirds of their sealant components fully retained. Recurrent caries was associated with four (3.4%) restorations. CONCLUSION: In this clinical study, the retention rate of the tested PMRC material was good, although a marked occlusal wear was evident. The marginal adaptation of the PMRC at the enamel site would probably have been better by the use of enamel-etching. Provided the marginal adaptation and wear resistance of the material is further improved, clinical use of PMRCs in minimally invasive occlusal cavities can be advocated. <42> UI - 20131620 AU - Kohler B AU - Rasmusson CG AU - Odman P IN - Undergraduate Clinic, Goteborg, Sweden. kohler@odontologi.gu.se TI - A five-year clinical evaluation of Class II composite resin restorations. SO - Journal of Dentistry 2000 Feb;28(2):111-6 AB - OBJECTIVES: To study the clinical efficacy of posterior composite resin restorations placed in general practice after five years. METHODS: Two commercial composite resin systems were used. Three general practitioners placed the restorations at a Public Dental Health Service Office. The patients were not selected specifically for this study. Class II cavities were restored with Superlux Molar and P-50 APC composite systems on an alternate basis. At baseline, 63 restorations were placed in molars and premolars in 45 patients. For primary caries, generally a conservative cavity design was used (n = 23), while replacements of amalgams resulted in the larger conventional Class II design (n = 40). The restorations were assessed using a modified USPHS criteria. Wear measurements were determined by the Leinfelder method. Photographs and bite-wing radiographs were taken to supplement the clinical evaluation of colour match, marginal adaptation and recurrent caries. Saliva sampling was performed to determine the rate of secretion and the level of mutans streptococci and lactobacilli. RESULTS: At the five-year review 51 restorations were available for examination, of which nine restorations were rated clinically unacceptable. Including the failed restorations (n = 7), at the three-year review, a total of 16 restorations had failed (27.6%) over a five-year period. The most common reasons for failure were recurrent caries (n = 7) and marginal defects (n = 4). The mean wear of Superlux Molar was 167 microns and of P-50 APC 158 microns. Eight of the 11 patients with failed restorations due to caries and marginal defects had high counts of mutans streptococci at baseline. CONCLUSIONS: The failures in the present group of patients did not specifically relate to material, tooth type or cavity design. However, it is suggested that patient factors such as caries activity should be monitored and managed. <43> UI - 20131619 AU - Medeiros VA AU - Seddon RP IN - Department of Paediatric Dentistry, Eastman Dental Institute and Hospital, London, UK. veruska@england.com TI - Iatrogenic damage to approximal surfaces in contact with Class II restorations. SO - Journal of Dentistry 2000 Feb;28(2):103-10 AB - OBJECTIVES: This study investigated the frequency of iatrogenic damage to approximal surfaces in contact with Class II restorations. METHODS: Patients (n = 28) with a Class II restoration in contact with an unrestored surface had elastic separators fitted interproximally. Contralateral (unrestored) control surfaces were also separated. Impressions (light body polyvinylsiloxane) of the separated surfaces were taken 3-6 days later. Interproximal impressions (28 paired, seven unpaired) were examined by binocular microscope and scanning electron microscope (SEM) for iatrogenic damage, attrition and cavitation due to caries. RESULTS: 49-60% of surfaces adjacent to Class II restorations had been iatrogenically damaged. The most frequent types of damage were vertical grooves (26%), extensive damage (17%), indentations (6%) and scratches (6%). Damage was more frequent in maxillary teeth (61%) than mandibular teeth (25%), in permanent teeth (60%) more than deciduous teeth (20%). Qualified dentists produced more iatrogenic damage (64%) than undergraduate students (23%). CONCLUSION: The frequency of iatrogenic damage to approximal surfaces following Class II preparations was 49%, and possibly as much as 60% when questionably damaged surfaces were included. Protection of the adjacent enamel is of paramount importance during Class II cavity preparation. <44> UI - 20151550 AU - Feigal RJ TI - Advantages of new restorative materials in dental care for children. SO - Journal of Michigan Dental Association 1999 Feb;81(2):32-6, 38 <45> UI - 20113837 AU - Bader JD AU - White BA AU - Olsen O AU - Shugars DA IN - Sheps Center for Health Services Research, University of North Carolina, Chapel Hill 27599-7590, USA. jim:bader@unc.edu TI - Dentist reliability in classifying disease risk and reason for treatment. SO - Journal of Public Health Dentistry 1999 Summer;59(3):158-61 AB - OBJECTIVES: The reliability of practicing dentists' classifications of patients' caries risk and periodontal disease risk and reason for treatment for individual teeth were determined. The risk classification protocols had been in use in a group practice for more than a year, and the reason-for-treatment protocol had been introduced six months previously. METHODS: Eight dentists' classifications for caries (n = 66) and periodontal disease risk (n = 66), and six dentists' classifications for reason for treatment (n = 73) were compared to those of a nominal standard examiner. Reliability was expressed as percent agreement and kappa values. RESULTS: Percent agreement was 76 percent, 83 percent, and 74 percent for caries, periodontal disease, and reason for treatment, respectively, with kappa values of 0.56, 0.70, and 0.69. CONCLUSIONS: Dentists can attain reasonable levels of reliability using simple classification protocols with little formal training, although misclassification may be problematic for specific administrative or research-related purposes. <46> UI - 20113835 AU - Bader JD AU - Shugars DA AU - White BA AU - Rindal DB IN - Sheps Center for Health Services Research, University of North Carolina, Chapel Hill 27599-7590, USA. jim:bader@unc.edu TI - Development of effectiveness of care and use of services measures for dental care plans. SO - Journal of Public Health Dentistry 1999 Summer;59(3):142-9 AB - OBJECTIVES: Standardized measures to assess clinical aspects of the performance of managed dental care plans are not available. This project sought to develop and evaluate measures for effectiveness of care and use of services that could be calculated using a plan's administrative data. METHODS: Two panels of stake holders representing dental plans, purchasers, and dental providers participated in a modified Delphi process to refine initial sets of effectiveness of care and use of services measures modeled after HEDIS measures for medical care. The refined measures were then pilot tested in two dental health maintenance organizations. RESULTS: The development process resulted in specification of seven effectiveness of care measures assessing disease activity classification, and prevention and outcomes for caries, periodontal disease, and tooth loss. Six use of services measures focusing on prophylaxes, third molar surgery, preventive, restorative, prosthetic, surgical, and endodontic care also were specified. Pilot testing of the measures indicated reasonable reliability and sensitivity, but also demonstrated the need for supervision or auditing of the process. CONCLUSIONS: These standardized measures for dental care plan performance are available for immediate use. However, because the measures depend on diagnostic information (periodontal probing data and diagnoses associated with restorative treatments) in the administrative data set, their adoption will require changes in most plans' data systems and data collection policies. <47> UI - 20114131 AU - Mahler DB AU - Engle JH IN - School of Dentistry, Department of Biomaterials and Biomechanics, Oregon Health Sciences University, Portland 97201-3097, USA. TI - Clinical evaluation of amalgam bonding in Class I and II restorations. SO - Journal of the American Dental Association 2000 Jan;131(1):43-9 AB - BACKGROUND: Many dental practitioners are bonding amalgam to tooth structure. Although in vitro studies support this procedure, its efficacy has not been adequately confirmed in the clinical environment. METHODS: The authors placed traditional Class I and Class II bonded and unbonded amalgam restorations in 76 patients. Panavia 21 (J. Morita USA Inc.) was the bonding agent selected, and Aristaloy CR (Englehard Dental) and Tytin (Kerr Corp.) were the amalgam alloys used. Postoperative sensitivity and marginal fracture were evaluated at yearly intervals, for up to three years of clinical service. RESULTS: At the patients' appointment for polishing one to two weeks after restoration placement, and at each yearly recall appointment, the authors found no significant difference in postoperative sensitivity between bonded and unbonded restorations for either amalgam alloy (chi 2 analysis, alpha = .05). In addition, there was no significant difference between bonded and unbonded restorations for either amalgam alloy with respect to marginal fracture (analysis of variance and Tukey's contrasts at alpha = .05). Moreover, no cusp fractures were observed for either bonded or unbonded restorations. CONCLUSIONS: After three years of clinical service, amalgam bonding for traditional Class I and Class II restorations had no effect on postoperative sensitivity or marginal integrity. CLINICAL IMPLICATIONS: The merit of using adhesive bonding agents for traditional Class I and Class II amalgam restorations was not demonstrated in this three-year clinical study. <48> UI - 20099336 AU - Fuks AB AU - Ram D AU - Eidelman E IN - Hadassah School of Dental Medicine, Department of Pediatric Dentistry, Hebrew University, Jerusalem, Israel. TI - Clinical performance of esthetic posterior crowns in primary molars: a pilot study. SO - Pediatric Dentistry 1999 Nov-Dec;21(7):445-8 AB - PURPOSE: The aim of this pilot study was to assess the clinical performance of esthetic crowns and to compare these to conventional stainless steel crowns (SSC). METHODS: Twenty two crowns (11 conventional and 11 esthetic) were placed in mandibular primary molars obeying the following criteria: the tooth was not mobile; no fistulae were present; the tooth had at least one caries free or properly restored antagonist and had to be in contact with one adjacent tooth mesially, in the case of the primary second molars or distally in the case of the primary first molars. Crown preparation was done in a conventional manner, but reduction was more extensive for the thicker esthetic crowns, to allow for proper occlusion. The crowns were evaluated clinically and radiographically after 6 months and the following parameters were assessed: gingival health, marginal extension, crown adequacy, proper position or occlusion, proximal contact, chipping of the facing (for esthetic crowns) and cement removal. RESULTS: At the 6 month evaluation all esthetic crowns were intact, without chipping of the facing, and no excess of cement was observed in both groups. No difference was found for marginal extension, occlusion, proximal contact, crown adequacy, and bone resorption, but a significant difference was found for periodontal health between esthetic crowns and conventional SSC (P < 0.001 McNemar test). CONCLUSIONS: The esthetic crowns assessed had several inconveniences, as they resulted in poor gingival health, are very expensive, and, although not measured, are bulky and without a natural appearance. <49> UI - 20087097 AU - Segura A AU - Riggins R IN - Department of Hospital Dentistry, University of Iowa, Iowa City, USA. segura@uthsca.edu TI - Fracture resistance of four different restorations for cuspal replacement. SO - Journal of Oral Rehabilitation 1999 Dec;26(12):928-31 AB - The purpose of this study was to compare the fracture resistance of four posterior restorations involving an entire cusp replacement. Four groups were established, each containing eight caries-free mandibular molars, similar in size and anatomic form. A mesio-occlusal preparation including the lingual cusp was prepared on all teeth. Group A were restored with a pin-retained amalgam. Group B were restored with amalgam and a meta adhesive. Group C were restored with a composite resin with a beta-glass quartz insert. Group D were restored with composite resin and a HEMA adhesive. All specimens were mounted in acrylic and stored in artificial saliva for 30 days. Each specimen was loaded in compression at a 90 degrees angle in an Instron testing machine with a crosshead speed of 0.5 cm/min. Results demonstrated the mean (SD) failure loads in kilograms for each group to be: A, 1155 (388); B, 1232 (436); C, 1345 (375); D, 1595 (373). Analysis of variance indicated no significant difference among groups at P<0.05. Although the values for the composite resin restoration with the adhesive were higher than the other restorative techniques. <50> UI - 20116147 AU - Perry R AU - Kugel G AU - Leinfelder K IN - Department of Biomaterials, University of Alabama, School of Dentistry, Birmingham, USA. TI - One-year clinical evaluation of SureFil packable composite. SO - Compendium of Continuing Education in Dentistry (Jamesburg, NJ) 1999 Jun;20(6):544-50, 552-3 AB - The purpose of this trial was to clinically evaluate SureFil high-density posterior composite for Class II restorations of permanent first and second molars. All teeth were restored in occlusion with the natural dentition. After cavity preparation, the enamel was etched for 15 seconds with 34% phosphoric acid. No liner/base material was used for the dentin. Two applications of Prime and Bond 2.1 were placed for adhesion to the exposed dentin and etched enamel. One coat of adhesive was cured for 10 seconds with a curing light, and one thin coat was spread with a gentle jet of air. The cavity was restored in 3-mm to 5-mm increments. Evaluation was assessed immediately after placement (baseline), and at 3 months, 6 months, 9 months, and 1 year for retention, leakage, marginal integrity, color stability, abrasive resistance, surface staining, surface texture, postoperative sensitivity, and secondary caries. The restorations were evaluated indirectly for wear using a modified USPHS and indirect cast comparison method. At baseline, 25 restorations were graded Alfa in all categories. At 3-, 6-, and 9-month recalls (N = 24), all restorations were graded Alfa in all categories. At the 1-year recall (N = 20), there were three Bravos for surface staining. <51> UI - 20114176 AU - Ferrari M AU - Cagidiaco MC AU - Kugel G AU - Davidson CL IN - Research Center for Dentistry, Livorno, Italy. md3972@mclink.it TI - Clinical evaluation of a one-bottle bonding system for desensitizing exposed roots. SO - American Journal of Dentistry 1999 Oct;12(5):243-9 AB - PURPOSE: To evaluate the effectiveness of a one-bottle adhesive system as a desensitizing treatment, with or without a prior phosphoric acid-etch step. MATERIALS AND METHODS: Two different clinical procedures using a one-bottle adhesive bonding system were tested for its efficacy on desensitizing exposed roots. Thirty subjects with a history of dentin hypersensitivity were selected and 60 exposed sensitive teeth were divided into two groups (n = 30). In Group 1 samples, Scotchbond 1 bonding system (Single Bond in USA) was applied without a prior acid-etching, while in those of Group 2, the exposed sensitive roots were acid-etched with 35% phosphoric acid for 15 seconds, prior to application of bonding agents. The sensitivity was evaluated at 0, 1, 2, 4 weeks and 3 months using cold air blast stimuli, and recorded using a visual-analogue scale. The scores were analyzed as non-parametric data by means of the Mann-Whitney and Sign tests. Five samples from each group were randomly selected in order to make scanning electron microscope observations of the sensitive dentin surfaces at baseline and at each recall using the replica technique. RESULTS: At baseline, after both desensitizing procedures all the patients reported distinct reductions in dentin sensitivity. At 1- and 2-week recalls, 20 teeth of Group 1 and 17 teeth in Group 2 exhibited a return of sensitivity, and in five teeth in each group, the sensitivity score was between 5-8. During the first recall (1-2 weeks), the sensitive teeth were retreated and showed an immediate reduction of sensitivity. At the 1-month recall, eight teeth in Group 1 and four teeth in Group 2 showed a return of some sensitivity, and in six teeth in Group 1 and in three teeth in Group 2, old amalgam restorations were replaced and this procedure almost completely resolved the sensitivity. At the 3-month recall, only five teeth from each group showed residual mild sensitivity (score 1-2). For both Groups 1 and 2 there was a statistically significant (P < 0.0005) reduction in sensitivity levels between the baseline pain scores and immediately after treatment, and between the first recall pre-treatment pain scores and the last recall pain scores. Overall, the two methods of treatment demonstrated a general decrease in sensitivity in both groups over the 3-month study period, adequately solving the clinical and patients' perception of the discomfort of sensitivity. The SEM observations of the replicas showed a progressive loss of the adhesive resin from the treated surfaces. This fact was more evident in the non-etched samples (Group 2) than in those in Group 1. The results of this study showed that exposed root dentin sealed with Scotchbond 1, with or without prior acid-etching, did not show spontaneous sensitivity after 3 months. <52> UI - 20114170 AU - Konishi N AU - Fried D AU - Staninec M AU - Featherstone JD IN - Department of Operative Dentistry, Dental School, Okayama University, Japan. TI - Artificial caries removal and inhibition of artificial secondary caries by pulsed CO2 laser irradiation. SO - American Journal of Dentistry 1999 Oct;12(5):213-6 AB - PURPOSE: To investigate the inhibition of artifical secondary caries around restorations placed after removal of artificial caries by pulsed CO2 laser irradiation and by mechanical means. MATERIALS & METHODS: Beveled cavities were prepared mechanically on the facial surfaces of extracted human molars. Each cavity was subsequently exposed to an artificial caries (demineralizing) solution (pH 5.0) for 7 d to generate a demineralized zone approximately 100-200 microns thick on the cavity surface. The artificial carious/demineralized zones of the cavities were removed by a pulsed CO2 laser operating at a wavelength of 9.3 microns with pulse duration of 100 microseconds and an irradiation intensity of 5 J/cm2. Artificial control caries were removed mechanically with a carbide bur in a slow speed handpiece. The cavities were slightly undercut and restored with a resin-based composite without etching and bonding and the restored teeth were subjected to pH cycling solutions for 10 d as follows: Demineralization solution, pH 4.5 for 6 hrs, followed by remineralization solution, pH 7.0 for 18 hrs. Cycled teeth were sectioned through the restorations and the resulting lesions were analyzed in thin section using polarized light and Knoop microhardness. RESULTS: Mean microhardness delta Z values, indicating mineral loss were: 549 (SD 191) for control, and 140 (SD 127) N = 11. This difference is significant with t = 5.543 and P = 0.000 (Paired t-test). Caries penetration: Control side--231 microns (SD 71), Laser treated side: 123 microns (SD 79) N = 6. This difference is significant with t = 5.198 and P = 0.003 (Paired t-test). The results show that the laser treatment not only removed artificial caries, but also inhibited decalcification of the cavity wall in a subsequent artificial caries challenge by as much as 81% compared to control samples. No etching and bonding was used in this pilot study, which might have influenced the results. Future studies should address the inhibition effect of the laser treatment as compared to adhesive techniques, fluoride treatments and fluoride release restorative materials. CONCLUSION: Caries removal by a pulsed lambda = 9.3 microns CO2 laser produces a cavity surface morphology with marked resistance to artificial secondary caries as compared to mechanical removal. <53> 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). <54> UI - 20116161 AU - Goracci G AU - Mori G IN - Faculty of Dentistry and Dental Prosthesis, University La Sapienza of Rome, Italy. TI - Esthetic and functional reproduction of occlusal morphology with composite resins. SO - Compendium of Continuing Education in Dentistry (Jamesburg, NJ) 1999 Jul;20(7):643-8; quiz 650 AB - The increasing use of composite resin restorations in posterior sectors produces some difficulties in the exact reproduction of occlusal morphology. In this article we present a new operative method that allows a quick and precise reproduction of occlusal morphology with minimal carious destruction of the occlusal enamel of posterior dental elements in the case of initial carious lesions. This method is indicated for class I and II carious lesions and is based on a preoperative record of the occlusal morphology made with a transparent silicone mold. This mold is placed on the tooth after the application of the last layer of composite resin, which is then polymerized through the silicone. Illustrated as a clinical case, the method is particularly rapid, easy to perform, and contributes to the improved quality and subsequent success of composite restorations in posterior sectors. <55> UI - 20101178 AU - Browning WD IN - Department of Oral Rehabilitation, School of Dentistry, Medical College of Georgia, Augusta 30912-1260, USA. wbrownin@mail.mcg.edu TI - Incidence and severity of postoperative pain following routine placement of amalgam restorations. SO - Quintessence International 1999 Jul;30(7):484-9 AB - OBJECTIVE: This study investigated the incidence and severity of postoperative sensitivity, examining several potential sources of pain. METHOD AND MATERIALS: One hundred eighteen subjects were asked about pain that they experienced following an appointment for restoration of a moderate Class I or II carious lesion. The survey required subjects to complete 3 questionnaires, 1, 4, and 7 days posttreatment. Questions covered 9 different potential sources of postoperative pain and the use of pain medication following the dental appointment. RESULTS: A great majority of subjects experienced postoperative pain from at least 1 source, and approximately half of those who reported pain following the appointment found it necessary to take medication for relief. For almost all categories, the level of pain reported at 4 and 7 days was substantially less than that reported after 24 hours. CONCLUSION: Patients commonly experience pain in the first 24 hours after operative treatment. Dentists should consider recommending that patients who are likely to experience postoperative pain take a nonprescription analgesic around the time of the treatment and for 24 hours afterward to prevent discomfort. <56> UI - 20101194 AU - Cardoso M AU - Baratieri LN AU - Ritter AV IN - Department of Operative Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil. TI - The effect of finishing and polishing on the decision to replace existing amalgam restorations. SO - Quintessence International 1999 Jun;30(6):413-8 AB - OBJECTIVE: The purpose of this investigation was to evaluate the influence of finishing and polishing procedures on the decision to replace existing amalgam restorations. METHOD AND MATERIALS: Twenty Class I and Class II amalgam restorations, free from obvious defects, were selected in 6 patients. The restorations were photographed before and after being submitted to a standard finishing and polishing procedure. In the first phase, the preoperative slides were examined by 27 clinicians and senior dental students, who were instructed to inspect each restoration and answer a questionnaire indicating if and why the restoration needed to be replaced. Two weeks later, the postoperative slides were presented to the same examiners, who were asked to answer the same questionnaire as before. RESULTS: At the first phase, there were 236 decisions (44%) to replace existing amalgam restorations. Following the finishing and polishing procedures, 114 decisions (21%) were made to replace existing amalgam restorations. This difference was statistically significant. Secondary caries was the most common reason for replacement. CONCLUSION: The finishing and polishing procedure reversed the decision to replace old amalgam restorations. <57> UI - 20101167 AU - Burke FJ AU - Cheung SW AU - Mjor IA AU - Wilson NH IN - University of Glasgow, Dental School, Scotland. f.j.t.burke@dental.gla.ac.uk TI - Restoration longevity and analysis of reasons for the placement and replacement of restorations provided by vocational dental practitioners and their trainers in the United Kingdom. SO - Quintessence International 1999 Apr;30(4):234-42 AB - OBJECTIVE: This study examined the reasons given by vocational dental practitioners and their trainers for placement and replacement of restorations. METHOD AND MATERIALS: Each participant was asked to record the reason for placement or replacement of restorations. The age and class of the restoration being replaced were also recorded, as was the material being used and the material being replaced (if known). RESULTS: Details of the reason for placement or replacement was received on 9,031 restorations. Of the restorations placed, 53.9% were amalgam, 29.8% were resin composite, and 16.3% were glass-ionomer cement. The reasons for placement or replacement of the restorations were principally primary caries (41.3%), secondary caries (21.9%), tooth fracture (6.4%), marginal fracture or degradation (6.1%), and noncarious defects (5.8%). Of the amalgam restorations, most were placed to restore Class II and Class I preparations (65.8% and 29.9%, respectively). Of the composite restorations, most were placed in Class III and Class V cavities (35.5% and 26.3%, respectively). Glass-ionomer cement was used predominantly to restore Class V cavities (63.5%). CONCLUSION: Secondary caries was the most prevalent reason for replacement of restorations, regardless of material. Statistical analysis indicated that amalgam provided significantly greater longevity than composite or glass-ionomer materials. <58> UI - 20101132 AU - Schoch M AU - Kramer N AU - Frankenberger R AU - Petschelt A IN - Clinic for Operative Dentistry and Periodontology, University of Erlangen-Nuremberg, Germany. schoch@dent.uni-erlangen.de TI - Direct posterior composite restorations with a new adhesive system: one-year results. SO - Journal of Adhesive Dentistry 1999;1(2):167-73 AB - PURPOSE: Syntac Sprint is a new one-bottle adhesive based on the total-etch and total-bond technique. The aim of this study was to compare the new restorative system consisting of Syntac Sprint and the resin composite Tetric Ceram with the clinically proven combination of the dentin adhesive Syntac Classic and the resin composite Tetric. MATERIALS AND METHODS: In a controlled prospective clinical study, 47 cavities (36 premolars, 11 molars; 29 maxillary, 17 mandibular; 6 occlusal, 33 occluso-approximal, 7 MOD, 1 > 3 surfaces) in 33 patients (17 female, 16 male) were filled. Twenty-five fillings were placed with the combination Syntac Sprint/Tetric Ceram under total etching and total bonding conditions. In thirteen restorations, Syntac Sprint was precured prior to the application of the resin composite; in the other twelve cases, restoration and adhesive were cured simultaneously. The control group consisted of 22 cavities restored with Syntac Classic plus the composite Tetric. At baseline and after 6 and 12 months, two calibrated investigators examined the restorations with modified USPHS codes and criteria. RESULTS: The criteria marginal integrity and integrity of the tooth deteriorated significantly between the baseline and the 6- and 12-month investigations (Friedman 2-way ANOVA; p < 0.05). No differences were found in the criteria surface roughness, color matching, anatomic form, step formation, integrity of the filling, proximal contact, hypersensitivity, or satisfaction. After one year, all fillings were in good condition. There was no significant difference between the Syntac Sprint/Tetric Ceram and Syntac Classic/Tetric groups for any criterion (Kruskal-Wallis; p > 0.05). CONCLUSIONS: Within the limits of this study, Tetric Ceram fillings in combination with Syntac Sprint were clinically successful after one year. <59> UI - 20101130 AU - Mannocci F AU - Ferrari M AU - Watson TF IN - Department of Endodontics, University of Siena, Italy. TI - Intermittent loading of teeth restored using quartz fiber, carbon-quartz fiber, and zirconium dioxide ceramic root canal posts. SO - Journal of Adhesive Dentistry 1999;1(2):153-8 AB - PURPOSE: The purpose of the investigation was to compare the performances of teeth restored with quartz fiber, carbon-quartz fiber, and zirconium-dioxide posts covered with all-ceramic crowns when subjected to a cyclic loading test performed in a wet environment. MATERIALS AND METHODS: Forty single-rooted human lower premolars having similar dimensions were endodontically treated and mounted in acrylic resin blocks with a simulated periodontal ligament. The teeth were divided into three experimental groups and one control group. Post holes 8 mm long were prepared in the roots of the experimental groups in which quartz fiber, carbon-quartz fiber, and zirconium dioxide posts were cemented. In the control group, no posts were used. The crown buildup was made with composite resin. The teeth were covered with all-ceramic crowns and intermittently loaded at an angle of 45 degrees to the long axis of the tooth at a frequency of two loads per second. RESULTS: Only one failure (root fracture + post fracture) was observed in each of the fiber post groups, while in the zirconium dioxide post group, six failures were observed (one crown fracture and 5 root fractures + post fractures). The Kaplan-Meier analysis of the three experimental groups showed that the survival rate of zirconium dioxide posts was significantly lower than that of both types of fiber post. All the experimental groups showed a survival rate higher than that of the control group. CONCLUSION: Fiber posts reduced to a minimum the risk of root fractures of teeth restored with composite cores and Empress crowns under the present experimental conditions (intermittent loading in a wet environment). <60> UI - 99131112 AU - Furhoff AK AU - Tomson Y AU - Ilie M AU - Bagedahl-Strindlund M AU - Larsson KS AU - Sandborgh-Englund G AU - Torstenson B AU - Wretlind K IN - Division of Psychiatry, Huddinge University Hospital, Sweden. TI - A multidisciplinary clinical study of patients suffering from illness associated with release of mercury from dental restorations. Medical and odontological aspects [see comments]. CM - Comment in: Scand J Prim Health Care 1999 Jun;17(2):127-8 SO - Scandinavian Journal of Primary Health Care 1998 Dec;16(4):247-52 AB - OBJECTIVE: To describe medical and odontological aspects of patients who believed their illness was caused by mercury in dental fillings. DESIGN: Comparison of self-reported and assessed medical and odontological variables. SETTING: The School of Dentistry, Karolinska Institute. SUBJECTS: Sixty-seven patients, referred for suspected side-effects of mercury in dental fillings, and 64 matched controls. MAIN OUTCOME MEASURES: Incidence of medical and odontological diagnoses, own perception of health, and incidence of self-reported symptoms. RESULTS: Three quarters of the patients were women. The mean age was 49 years. Thirty-seven patients (55%) and 47 controls (73%) (NS) showed no sign of somatic disease. Half of the patients felt ill or very ill at the time of the examination. Patients reported twice as many symptoms as the controls during a 3-month period. Patients reported a higher prevalence of very low resting saliva secretion rate, and a higher number of decayed tooth surfaces and of instances of temporomandibular joint dysfunction. CONCLUSION: Patients' feelings of ill-health were more likely related to psychiatric than somatic diagnoses. This study underlines the importance of making an overall diagnosis, including both mental and somatic disorders, especially in unclear cases and in self-diagnosed illnesses. <61> UI - 20046485 AU - Sengupta A AU - Whittaker DK AU - Barber G AU - Rogers J AU - Musgrave JH IN - Department of Anatomy, School of Veterinary Science, Bristol, UK. A.Sengupta@bristol.ac.uk TI - The effects of dental wear on third molar eruption and on the curve of Spee in human archaeological dentitions. SO - Archives of Oral Biology 1999 Nov;44(11):925-34 AB - The abrasiveness of food is a key determinant in the rate of physiological attrition (dental wear) in humans. With increasing food processing through time, the rate of physiological dental wear in human teeth has decreased markedly. Many consider such wear to be beneficial to oral health and that insufficient wear may result in impaction of the third molars. If enhanced extraoral food processing provides an evolutionary advantage, then it is possible that agenesis of the redundant third molar may follow. One of the aims here was to examine impaction and agenesis of the third molars in four populations of varying antiquity and hence varying dental-wear rates. Paradoxically, whilst there is a decrease in the rate of dental wear with modernity, there is also an increasing prevalence of advanced dental wear due to prolongation of the lifespan of the human dentition. As the effect of dental wear on the curve of Spee was unknown, a second aim was to examine it in an archaeological population with a high rate of dental wear. The results showed an increase in non-eruption and impaction of the third molars with modernity, but did not demonstrate a significant increase in the rate of agenesis. The time period over which impaction and agenesis could be discerned was of the order of 600 years and this may not be sufficient to observe adaptive changes at the genetic level in humans. In molar teeth there was no clear indication of maintenance of the curve of Spee with dental wear. This has potential implications on the design of prostheses for the worn dentition. <62> UI - 20056193 AU - Gohring TN AU - Mormann WH AU - Lutz F IN - Center for Dental and Oral Medicine, University of Zurich, Zurich, Switzerland. goehring@zzmk.unizh.ch TI - Clinical and scanning electron microscopic evaluation of fiber-reinforced inlay fixed partial dentures: preliminary results after one year. SO - Journal of Prosthetic Dentistry 1999 Dec;82(6):662-8 AB - STATEMENT OF PROBLEM: Restorative dentistry searches for nonmetal reinforcement of esthetic fixed partial dentures (FPDs). PURPOSE: This clinical study evaluated conservative fiber-reinforced composite FPDs bonded to inlay abutments. MATERIAL AND METHODS: Twenty fiber-reinforced composite inlay FPDs were made for 15 patients. Restorations were manufactured with the Targis Vectris glass-fiber-reinforced composite system and a simplified laboratory technique. The 20 bonded inlay FPDs were examined clinically and by SEM after 1 year. RESULTS: All 20 FPDs were intact at the 1-year examination. There were no signs of fracture, surface defects, or excessive wear with SEM. SEM marginal analysis exhibited 91.6% +/- 5% excellent margins at the tooth-luting composite interface and 86. 1% +/- 8% excellent margins at luting composite/restoration interface. CONCLUSION: On the basis of the results of this descriptive study, bonded glass-fiber-reinforced composite inlay FPDs were considered clinically successful at the 1-year examination. <63> UI - 20006942 AU - Pyk N AU - Mejare I IN - Ektorp Public Dental Health Clinic and Eastman Dental Institute, Stockholm County Council, Sweden. TI - Tunnel restorations in general practice. Influence of some clinical variables on the success rate. SO - Acta Odontologica Scandinavica 1999 Aug;57(4):195-200 AB - Using bitewing radiographs and clinical inspection, the success rate for tunnel restorations was assessed in a population with low caries activity. The material consisted of 242 tunnel restorations in permanent premolars and molars in 142 individuals (mean age = 18.8 years). The median DFSappr value (decayed and filled approximal surfaces) at the time of restoration was 4.0. The mean follow-up time was 25 months. Bivariate associations between the outcome variable (success/failure of the tunnel restoration) and conceivable explanatory variables were investigated. In a multivariate logistic regression analysis, the independent variables tooth type (premolars vs molars), surface site (mesial vs distal), radiographic stage of approximal carious progression and age of patient at the time of restoration (9-15 years vs > 15 years) were used to estimate the effect on the dependent variable success/failure. Using the life table method, the estimated cumulative proportion of successful restorations was 81% after 2 years and 64% after 3.5 years. The success rate was not related to caries activity and did not differ between the two types of tunnel preparation techniques nor between different follow-up periods. In the multivariate regression analysis, tooth type (molars vs premolars) was the only factor significantly associated with failure. Thus, a failure occurred about 5 times as often in molars as in premolars. Of the failures, half were due to caries; either radiographically observed adjacent to the restoration or progressing enamel caries on the outer proximal surface. Marginal ridge fractures constituted 26% of the failures. From the present results it can be concluded that in a population with low caries activity, the tunnel restoration technique can be recommended for premolars. <64> UI - 20064442 AU - Daugherty D AU - Biggs JT TI - A preliminary evaluation of the effect of ultrasonic root end cavity preparation and reverse filling on the ability of plastic core Thermafil obturations to maintain an air-tight seal. SO - Journal - Oklahoma Dental Association 1998 Fall;89(2):38-44 <65> UI - 20023996 AU - Fietz RJ TI - Predictably restoring endodontically treated teeth [letter]. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1999 Oct;65(9):484-5 <66> UI - 20064433 AU - Allen PF AU - Witter DJ AU - Wilson NH IN - Department of Restorative Dentistry, Dental School, University of Newcastle upon Tyne, U.K. TI - A survey of the attitudes of members of the European Prosthodontic Association towards the shortened dental arch concept. SO - European Journal of Prosthodontics & Restorative Dentistry 1998 Dec;6(4):165-9 AB - A survey of members of the European Prosthodontic Association was undertaken to assess their attitudes to the shortened dental arch concept, and to evaluate their experience with the approach. Data were collected using questionnaires. From an overall response of 42%, 96% of respondents agreed that the approach was acceptable in clinical practice. Almost all respondents had applied the shortened dental arch concept with 72% of respondents having treated less than 50 patients in this way over the previous 5 years. In terms of comfort and function, treatment outcome was satisfactory. However, 42% of respondents indicated that prosthetic extension of shortened dental arches was occasionally required. <67> UI - 20064436 AU - Rajesh P AU - Kamath MP IN - Department of Conservative Dentistry & Endodontics, Yenepoya Dental College, Mangalore, India. TI - Application of glass ionomer cements in restorative dentistry. SO - Indian Journal of Dental Research 1999 Jul-Sep;10(3):88-90 AB - Dentistry was marked with radical changes in clinical restorative procedures. If the inherent characteristic of the ionomer cement was examined, it becomes very clear to the researcher as well as the dentist, that no other material has had an impact as comparable to glass ionomer cements on restorative dentistry. This scientific paper highlights the clinical applications of the cement in restorative dentistry. Glass ionomer cements are bioactive, by forming permanent adhesive bonds to dentin and enamel which enables them to prevent the development of secondary caries by providing an impermeable seal against the intrusion of oral fluids and other caries producing agents. The hydrophilic nature of the cement also makes them susceptible to the action of aqueous fluids before they are fully set, requiring that the freshly placed restoration be protected by varish, petroleum jelly or a low viscosity photo polymerizing bonding agent. <68> UI - 99437101 AU - Peters MC AU - Delong R AU - Pintado MR AU - Pallesen U AU - Qvist V AU - Douglas WH IN - School of Dentistry, University of Michigan, Ann Arbour 48109-1078, USA. mcpete@umich.edu TI - Comparison of two measurement techniques for clinical wear. SO - Journal of Dentistry 1999 Sep;27(7):479-85 AB - OBJECTIVES: Clinical wear of restorations is generally evaluated by marginal integrity over time. In this study, both a subjective and an objective method for wear assessment are compared, and the relative advantages and disadvantages of each are considered. METHODS: A surface evaluation technique for quantitative measurement of wear, as developed at the University of Minnesota (UMN) has been compared to the commonly employed method of wear assessment used by Leinfelder (LF). Measurements were made by comparing suitable casts of restored teeth before and after clinical function. Semi-quantitative wear assessment was studied in comparison with detailed quantitative information about the topology of the pre- and post-wear occlusal surfaces obtained from stylus profilometry and processed by imaging techniques. Fourteen model sets of baseline, 2, 3 and 5 year old Class II composite restorations from a Danish clinical trial were evaluated using both techniques. RESULTS: In general, after 5 years of function, the digitizing method (UMN) generated wear values that were twice as high, indicating that general wear of restorative materials is underestimated by the LF-method. CONCLUSIONS: The comparison clearly revealed the advantages and limitations of each technique. Evaluation of wear by means of the LF technique provides global semi-quantitative data on restoration margins relative to enamel, underestimating general wear of the restorative material. Advanced 3-D measuring techniques such as the UMN method provide extensive quantitative data regarding wear patterns of the entire occlusal surface, i.e. restoration and enamel. Such a highly accurate technique is capable of differentiation between wear behavior of restorative materials early on in clinical studies. In addition, through its digital alignment procedure, the UMN method provides data on accuracy of the replication process used in clinical studies. <69> UI - 99408161 AU - Ahlqwist M AU - Bengtsson C AU - Lapidus L AU - Gergdahl IA AU - Schutz A IN - Department of Oral Diagnostic Radiology, Goteborg University, Gothenburg, Sweden. TI - Serum mercury concentration in relation to survival, symptoms, and diseases: results from the prospective population study of women in Gothenburg, Sweden. SO - Acta Odontologica Scandinavica 1999 Jun;57(3):168-74 AB - A prospective population study of women in Gothenburg, Sweden was started in 1968-69 and comprised 1462 women aged 38, 46, 50, 54, or 60 years at baseline. Follow-up studies were carried out in 1974-75, 1980-81, and 1992-93. The baseline study included an extensive medical and dental examination. Serum mercury concentration (beta-HG) was determined in deep-frozen samples from all participants in 1968-69 and in a random subsample of sera from participants in 1980-81, about 20 years after the baseline examination. S-Hg was statistically significantly correlated with number of amalgam fillings at both examinations. Of 30 defined symptoms and 4 different clusters of symptoms, no one was independently correlated with S-Hg measured in the samples from 1968-69, while there was a negative statistically significant correlation with over-exertion and poor appetite in 1980-81. Blood hemoglobin and serum B-12 concentrations in 1968-69 were statistically significantly and positively correlated with S-Hg, while erythrocyte sedimentation rate and the serum concentrations of potassium and triglycerides were significantly and negatively correlated with S-Hg, also after including potential confounders. Blood hematocrit examined in 1980-81 was negatively correlated with S-Hg. When including potential confounders, serum IgA was also statistically significantly correlated with S-Hg, but not in univariate analysis. No statistically significant correlation was observed between S-Hg, on the one h