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 61 from 58 keep 301-600 300 62 from 58 keep 601-900 300 *************************** <1> UI - 93319697 AU - Ianzano JA AU - Mastrodomenico J AU - Gwinnett AJ IN - Department of Oral Biology & Pathology, SUNY at Stony Brook, Stony Brook, NY 11794. TI - Strength of amalgam restorations bonded with Amalgambond. SO - American Journal of Dentistry 1993 Feb;6(1):10-2 AB - The objective of this study was to determine the strength of bonded amalgam restorations involving an entire cusp. Four groups were established, each containing 13 caries-free, recently extracted molar teeth of similar size and anatomic form. The teeth were stored in 70% alcohol prior to the removal of a cusp and the cutting of a conventional preparation with an occlusal lock. Group A were restored with amalgam only, Group B with amalgam and a pin, Group C with amalgam and Amalgambond (4-META) and Group D with amalgam, a pin and Amalgambond. The teeth were blocked in stone and stored for 7 days in water at 37 degrees C. Using an Instron, a force was delivered at right angles to the inclined cuspal plane of the amalgam at its midcuspal point at a crosshead speed of 5 mm per minute. The load at failure was recorded and the assemblies recovered for fracture analysis using SEM. Group A failed at 33.61 +/- 15.17 Kg, Group B at 32.28 +/- 12.10 Kg, Group C at 48.53 +/- 21.93 Kg and Group D at 47.84 +/- 14.79 Kg. No statistically significant difference existed between Groups A and B, and Groups C and D. A significant difference (P < 0.002) existed between Groups A and C and B and D. Failure commonly occurred between cusp and occlusal lock or within the cusp when a pin was used. Bonded restorations with a pin incurred cohesive root failure. It was concluded that the strength of the amalgam restorations benefitted significantly from bonding but the Amalgambond system may be contraindicated for use with pins due to root fracture. <2> UI - 93288834 AU - Boksman L AU - McConnell RJ AU - Carson B AU - McCutcheon-Jones EF IN - Division of Fixed Prosthodontics, Faculty of Dentistry, University of Western Ontario, London, Canada. TI - A 2-year clinical evaluation of two pit and fissure sealants placed with and without the use of a bonding agent. SO - Quintessence International 1993 Feb;24(2):131-3 AB - The purpose of the study was to evaluate whether the clinical effectiveness of pit and fissure sealant was increased (as demonstrated by an increased retention rate) when a bonding agent was used prior to the placement of the sealant. Two pit and fissure sealants, Concise Light Cured White Sealant and Prisma Shield Light Cured Sealant, were placed in vivo with and without the use of the bonding agents, Scotchbond 2 and Prisma Universal Bond. After 2 years, 55% of the sample was available for recall. The retention rates for the sealants were 77% for Concise with Scotchbond 2, 84% for Concise with no bonding agent, 77% for Prisma Shield with Universal Bond, and 77% for Prisma Shield with no bonding agent. Results of this study indicated that the use of a bonding agent prior to the application of a pit and fissure sealant does not increase the retention rate. <3> UI - 93246541 AU - Woods PW AU - Marker VA AU - McKinney TW AU - Miller BH AU - Okabe T IN - Department of Biomaterials Science, Baylor College of Dentistry, Dallas 75246-2098. TI - Determining amalgam marginal quality: effect of occlusal surface condition [see comments]. CM - Comment in: J Am Dent Assoc 1993 Aug;124(8):12, 14 SO - Journal of the American Dental Association 1993 May;124(5):60-5 AB - Currently there is no "standard" finishing and polishing procedure for dental amalgam restorations. This investigation evaluated the effect of four different finishing techniques on the durability of dental amalgam restorations as determined by the marginal breakdown. Burnishing immediately before carving or as part of the condensation process seems to improve the carving characteristics of the amalgam. <4> UI - 93246951 AU - Wang HL AU - Burgett FG AU - Shyr Y IN - Department of Periodontics/Prevention and Geriatrics, School of Dentistry, University of Michigan, Ann Arbor. TI - The relationship between restoration and furcation involvement on molar teeth. SO - Journal of Periodontology 1993 Apr;64(4):302-5 AB - The purpose of this cross-sectional study was to examine the correlation between the presence of a crown (CR) or a proximal restoration (RE) and furcation involvement (FI) on molar teeth. Data were collected from 134 periodontal maintenance patients who had restored and non-restored molars present both with and without FI. A majority of the restorations that were present in these patients had been in place for at least 5 years prior to the study. First and second molars were examined clinically using the following criteria: CR, RE, FI, mobility (MO), and probing periodontal attachment level (AL). Data were analyzed with a statistical program utilizing Pearson chi-square and the pair-difference t test. The results indicated that molars with CR or RE had a significantly (P < 0.01) higher percentage of FI but no greater mobility when compared to molars without restorations. Mean probing periodontal attachment loss was greater for restored than non-restored molars but only with marginal significance (P = 0.051). There was a greater difference in mean AL between restored versus non-restored maxillary molars than for mandibular molars. This cross-sectional study provides evidence that molars with crowns or restorations involving the proximal tooth surfaces had a higher prevalence of FI and greater AL than molars without restorations. <5> UI - 93247010 AU - Denissen HW AU - Wijnhoff GF AU - Veldhuis AA AU - Kalk W IN - University of Nijmegen, School of Medicine and Dentistry, The Netherlands. TI - Five-year study of all-porcelain veneer fixed partial dentures. SO - Journal of Prosthetic Dentistry 1993 May;69(5):464-8 AB - Improvements in enamel-dentinal bonding systems combined with the introduction of new ceramics have encouraged replacement of missing anterior teeth in specific patients with porcelain veneer fixed partial dentures. Metal substructures are not needed, and more natural tooth structure can be preserved because the preparation of abutments is conservative. Twelve porcelain veneer fixed partial dentures were monitored for 5 years, and fractures attributed to degradation of the gingival margins occurred in the veneer surface of the fixed partial dentures. The success rate of 75% was dependent on rigid patient selection criteria, strength of the major connectors, and precise adjustment of occlusion to prevent overloading. The failing margins were attributed to the degeneration, attrition, and deterioration of the composite resin cements. Despite these limitations, patients were extremely satisfied with the esthetics. Improvement in the mechanical properties of composite resin cement will ameliorate the prognosis with this approach. <6> UI - 93249807 AU - Smales RJ IN - Department of Dentistry, University of Adelaide, Australia. TI - Rubber dam usage related to restoration quality and survival [see comments]. CM - Comment in: Br Dent J 1993 Jun 5;174(11):397 SO - British Dental Journal 1993 May 8;174(9):330-3 AB - The effects of rubber dam or cotton roll isolation on the initial quality and later survival of 644 amalgam and 149 anterior enamel-bonded composite resin restorations were evaluated over periods of up to 15 and 10 years, respectively. All restorations were placed by one operator and their quality assessed at the time of finishing, using seven clinical characteristics. The influence of six other clinical parameters on the survival of the restorations was also evaluated. There were no clinically-significant differences present in the initial high quality of the restorations, or in their later survivals, which could be directly related to the use or otherwise of rubber dam. Overall, the restoration survivals were excellent. However, there were significantly more amalgam restoration failures, from bulk fracture, in patients with severe bruxism. <7> UI - 93253173 AU - Kreulen CM AU - van Amerongen WE AU - Gruythuysen RJ AU - Borgmeijer PJ AU - Akerboom HB IN - Department of Pediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. TI - Prevalence of postoperative sensitivity with indirect Class II resin composite inlays. SO - ASDC Journal of Dentistry for Children 1993 Mar-Apr;60(2):95-8 AB - In this clinical trial, the prevalence of postoperative sensitivity is studied in a comparison of standard size indirect class II resin composite inlays with class II amalgam restorations. Fifteen percent of the 240 restored teeth (resin composite and amalgam restorations) showed some form of sensitivity, the majority of them of a passing nature. No difference was found between amalgam and composite restorations. Molars appear to show more complaints than premolars and, rather than the restorative material applied, the patient seems to determine the results. Differences in prevalence of sensitivity between direct resin composite restorations in a previous study and the indirect restorations are discussed, using among others the differences in sensitivity that were found between the amalgam-control restorations of both studies. <8> UI - 93269615 AU - Hansen EK AU - Asmussen E IN - Department of Dental Materials, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark. TI - Cusp fracture of endodontically treated posterior teeth restored with amalgam. Teeth restored in Denmark before 1975 versus after 1979. SO - Acta Odontologica Scandinavica 1993 Apr;51(2):73-7 AB - The aim of the present study was to analyze the frequency and the severity of cuspal fracture for posterior teeth endodontically treated by 91 Danish dentists and restored with amalgam either before 1975 or after 1979. A database from a previous study was analyzed (1584 teeth with an MO, a DO, or an MOD amalgam restoration without cuspal overlays). Teeth restored before 1975 had a significantly lower frequency of cusp fracture than teeth restored after 1979. Moreover, when comparing the frequency of subcrestal fractures, that of the second group (after 1979) was more than twice as high as that of the first group (before 1975). Two factors with a bearing on these findings changed in the time period 1975-1979; the high-copper amalgams took over in Denmark, and the use of Gates-Glidden burs to achieve straight-line access to the root canal was introduced. It is suggested that the weakening of the coronal part of the root, caused by the use of Gates-Glidden burs, and the expansion and low creep of high-copper amalgams may be two of the reasons for the increased frequency and severity of cuspal fracture found in the past decade in Denmark. <9> UI - 93269617 AU - Stenberg R AU - Matsson L IN - Public Dental Health Service, County of Vasterbotten, Sweden. TI - Clinical evaluation of glass ceramic inlays (Dicor). SO - Acta Odontologica Scandinavica 1993 Apr;51(2):91-7 AB - The purpose of the study was to evaluate the clinical behavior of ceramic class-II inlays (Dicor) in the first 2 years after placement. As a reference, a similar number of dental amalgam restorations were followed up during the same period. Twenty-five inlays and 25 dental amalgams were placed on premolars and first molars of 20 and 19 patients (15-19 years old), respectively. The inlay preparations were made in accordance with the manufacturer's recommendations, and the inlays were produced by a licensed Dicor laboratory. The inlays were luted, using a glass ionomer cement. The dental amalgam preparations were made using standard class-II preparation techniques and filled with ANA 2000. The inlays were evaluated after 6, 12, and 24 months, and the dental amalgam restorations after 24 months, using the criteria suggested by Ryge. In addition, the 24-month examination included proximal recording of dental plaque and gingivitis. With the exception of two inlays that fractured during the observation period, all ceramic inlays showed excellent ratings for anatomic form, marginal discoloration, and marginal caries at all examinations. Two inlays showed minor marginal defects but were classified within the range of acceptance with no need for replacement. The two fractured inlays were replacements of earlier fractured dental amalgams. The clinical behavior of the dental amalgam restorations was in most respects similar to that of the ceramic inlays. Unlike the inlays, however, no dental amalgams fractured during the observation period.(ABSTRACT TRUNCATED AT 250 WORDS) <10> UI - 93223242 AU - Dickerson WG TI - Indirect resin restoration-a proper technique to ensure success. SO - Compendium 1993 Feb;14(2):216, 218, 220 passim <11> UI - 93232395 AU - Kilpatrick NM IN - Department of Child Dental Health, Dental School, Newcastle upon Tyne, UK. TI - Durability of restorations in primary molars. [Review] [46 refs] SO - Journal of Dentistry 1993 Apr;21(2):67-73 AB - Techniques used to restore carious primary molars have changed over the past decade as new adhesive materials have been developed. The most meaningful way of assessing the efficacy of a technique is by clinical trials. This article reviews the information concerning amalgam, composite and glass polyalkenoate (ionomer) cement as well as extracoronal restorations. Stainless steel/nickel chrome crowns provide the most durable restoration, often surviving until the tooth exfoliates. Class II amalgam restorations, whilst being prone to fracture, have been shown to survive about 3 years, a figure that improves with increasing age of the child and the use of local anaesthesia. Over the shorter term resin-based composites appear to be at least as durable as amalgam, particularly with respect to the maintenance of a good anatomical form. In contrast, when assessed at 6 years the failure rate of composite restorations is high, 62%, whereas the failure rate of amalgam restorations at 5 years is as low as 20%. Glass ionomer cements and cermets are alternative materials for use in the primary dentition. The reported success rate of 33% over 5 years for conventional glass ionomer cements is encouraging, however cermets appear to be less successful but have not been evaluated over the longer term. Glass ionomer cements provide a means of restoring primary molars with minimal amount of destruction of sound tooth tissue and reduced treatment time for the young patient, whilst the local fluoride release is also a potential advantage.(ABSTRACT TRUNCATED AT 250 WORDS) [References: 46] <12> UI - 93232396 AU - Willems G AU - Lambrechts P AU - Braem M AU - Vanherle G IN - Department of Operative Dentistry and Dental Materials, Katholieke Universiteit te Leuven, Belgium. TI - Three-year follow-up of five posterior composites: in vivo wear. SO - Journal of Dentistry 1993 Apr;21(2):74-8 AB - The wear of five posterior composites at occlusal contact areas (OCA) and contact free occlusal areas (CFOA) was evaluated in Class II cavities over a 3-year period with an accurate 3D-measuring technique. A clinical evaluation was also performed. The ultrafine compact-filled composites (Willems et al., 1992) showed acceptable OCA-wear rates ranging from 110 to 149 microns after 3 years. This is very similar to the OCA-wear rate of human enamel on molars, which is about 122 microns after 3 years. The fine compact-filled composite had an unacceptable OCA-wear value of 242 microns after 3 years. The ultrafine midway-filled composite showed an exceptionally high CFOA-wear value of 151 microns after 3 years, which gave the impression of it being gradually washed out of the cavity. Clinically, 70% of the restorations made with the ultrafine midway-filled composite showed excellent colour match after 3 years. For most of the compact-filled composites slightly opaque fillings were noted and 63% of the restorations made with one of these materials were clearly opaque. It can be concluded that the investigated ultrafine compact-filled composites can be considered as amalgam alternatives as far as their wear resistance is concerned. <13> UI - 93232397 AU - Willems G AU - Lambrechts P AU - Lesaffre E AU - Braem M AU - Vanherle G IN - Department of Operative Dentistry, Katholieke Universiteit te Leuven, Belgium. TI - Three-year follow-up of five posterior composites: SEM study of differential wear. SO - Journal of Dentistry 1993 Apr;21(2):79-86 AB - Assessing the wear of both enamel and composite at a shared occlusal contact area offers the opportunity to determine the differential wear between enamel and composite on the same tooth. Differential wear measurements were carried out on five posterior composite materials with an accurate 3D-measuring technique. The distinct wear step between enamel and composite was visualized by means of scanning electron photomicrographs. Both investigated ultrafine midway-filled and fine compact-filled composites (Willems et al., 1992a) have a considerably higher differential wear value and are, therefore, less suitable for rehabilitation of posterior teeth than are the ultrafine compact-filled composites, which have, in this study, a very satisfactory differential wear rate and appear to be highly wear resistant materials suitable for use in stress-bearing areas. <14> UI - 93184910 AU - Jordan RE AU - Suzuki M IN - Faculty of Dentistry, University of Manitoba. TI - Early clinical evaluation of four new bonding resins used for conservative restoration of cervical erosion lesions. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1993 Jan;59(1):81-4 <15> UI - 93147346 AU - Huysmans MC AU - Van der Varst PG IN - Department of Cariology and Endodontology, TRIKON: Institute for Dental Clinical Research, University of Nijmegen, The Netherlands. TI - Finite element analysis of quasistatic and fatigue failure of post and cores [published erratum appears in J Dent 1993 Jun;21(3):190]. SO - Journal of Dentistry 1993 Feb;21(1):57-64 AB - Finite element (FE) analysis of the mechanical behaviour of materials and structures facilitates the investigation of their internal stress distributions. However, the validity of the model is not always ascertained. In this study a three-dimensional (3D) FE model was developed, representing a laboratory set-up of direct post and core restored upper premolars. These restorations, using either composite or amalgam for core material, have been the subject of study in previous quasistatic and fatigue strength tests. The aim of this study was to validate the FE model for prefailure and failure modelling, by comparing the computational results with the laboratory observations and failure results. Two failure criteria were selected for investigation: Modified Von Mises and Drucker-Prager equivalent stress. Four model variations were carried out, representing different conditions at the core-tooth interface. Prefailure modelling was found to be adequate. The calculated failure results could only partly be fitted to the quasistatic tests. The best fit was effected with a model using partial bonding of the core, for the composite core. Fatigue failure was reproduced somewhat better by a model using no bonding at all, again to a higher degree for the composite core. Calculations of post stress using a model simulating increased core mobility supported an observation made previously (M. C. D. N. J. M. Huysmans et al., in press; Int. Endodont. J. XX, XXX-XXX), implying that a composite core raises the demands made on the post. The conclusion is made that validation of FE calculations is essential. A 3D model as presented here shows a satisfactory fit to fatigue data but not to quasistatic results.(ABSTRACT TRUNCATED AT 250 WORDS) <16> UI - 93163470 AU - Full CA AU - Hollander WR IN - University of Iowa, School of Dentistry. TI - The composite resin restoration: a literature review. Part II. Comparisons between composite and alloy restorations. [Review] [43 refs] SO - ASDC Journal of Dentistry for Children 1993 Jan-Feb;60(1):52-6 AB - Composite resin restorations have been advocated as a posterior restoration for Class II lesions, due to their esthetic quality and lack of mercury content. This report investigates early studies that compared amalgam and composite restorations, and cites their advantages and disadvantages. The various methods previous investigators implemented to assess the longevity of the restorations are also described. [References: 43] <17> UI - 93163469 AU - Full CA AU - Hollander WR IN - University of Iowa, School of Dentistry. TI - The composite resin restoration: a literature review. Part I. Proper cavity preparation and placement techniques. [Review] [51 refs] SO - ASDC Journal of Dentistry for Children 1993 Jan-Feb;60(1):48-51 AB - Interest in nonalloy restorations have increased the usage of composite resins for Class II posterior lesions. Modifications of G.V. Black's original cavity design are discussed, to familiarize the practitioner with successful techniques that have increased the longevity of these restorations. The usage of bonding agents, and placement of the filled resin materials are also described. [References: 51] <18> UI - 93161711 AU - Akerboom HB AU - Advokaat JG AU - Van Amerongen WE AU - Borgmeijer PJ IN - Department of Pediatric Dentistry, Academic Centre for Dentistry Amsterdam, The Netherlands. TI - Long-term evaluation and rerestoration of amalgam restorations. SO - Community Dentistry & Oral Epidemiology 1993 Feb;21(1):45-8 AB - In this study, 1544 class-II amalgam restorations were made and evaluated for 10 yr and the reasons for rerestoration were registered. Two categories of failure could be established: failures due to poor restorative technique (true failures) and those not due to poor restorative technique (false failures). After 10 yr, 1415 restorations were evaluated. Only 120 restorations (8.5%) had been replaced, most of these replacements being true failures (105 = 87.5%), which could be divided into: isthmus fracture (37), fracture of the enamel cusp (25), recurrent caries (16), partial fracture of the restoration (9), severe marginal breakdown (5), pulpal pathology (7) and others (6). The false failures (15) could only be classified into: caries elsewhere in the tooth (15). Origins of the true failures were the operator, the material (amalgam) and the type and size of the restoration. In this study, there were significantly more replacements of larger restorations than of smaller ones and more replacements in molars than in premolars. There is also a significant difference among the replacements by the various operators but not between the various types of amalgam. Origins of the false failures seem to be more related to patient factors like caries activity, caries susceptibility and oral hygiene, but chewing habits (bruxism) may also play a role. <19> UI - 93161710 AU - Ahlqwist M AU - Bengtsson C AU - Lapidus L IN - Department of Oral Radiology, Sahlgrenska Hospital, University of Gothenburg, Sweden. TI - Number of amalgam fillings in relation to cardiovascular disease, diabetes, cancer and early death in Swedish women. SO - Community Dentistry & Oral Epidemiology 1993 Feb;21(1):40-4 AB - Altogether 1462 women aged 38, 46, 50, 54 and 60 yr were initially examined in 1968-69 in a combined medical and dental population study in Gothenburg, Sweden. Number of tooth surfaces restored with amalgam fillings was assessed. The incidences of myocardial infarction, stroke, diabetes, cancer and overall mortality were determined during a 20-yr follow-up period. Women with few amalgam tooth fillings had increased incidence of myocardial infarction, stroke, diabetes and early death compared with women with a large number of fillings. However, the significant inverse correlations between number of amalgam tooth fillings and the endpoints studied disappeared when number of teeth and socioeconomic group were included in a multivariate analysis. The study thus did not provide any evidence for a correlation between amalgam fillings and cardiovascular disease, diabetes, cancer or early death. <20> UI - 93288818 AU - Mertz-Fairhurst EJ AU - Smith CD AU - Williams JE AU - Sherrer JD AU - Mackert JR Jr AU - Richards EE AU - Schuster GS AU - O'Dell NL AU - Pierce KL AU - Kovarik RE AU - et al IN - Department of Restorative Dentistry, Medical College of Georgia, School of Dentistry, Augusta 30912. TI - Cariostatic and ultraconservative sealed restorations: six-year results. SO - Quintessence International 1992 Dec;23(12):827-38 AB - The objective of this clinical study was to determine the ability of an ultraconservative, sealed composite resin restoration, without a traditional cavity preparation and without the removal of the carious lesion, to arrest Class I caries. Tooth preparation was limited to placing a bevel in the enamel. These restorations were compared, over 6 years, with (1) ultraconservative, localized, sealed amalgam restorations with no extension for prevention and (2) traditional, unsealed amalgam restorations with the usual extension for prevention outline form. Caries was arrested by the ultraconservative, sealed composite resin restorations for 6 years. Complete sealant retention on the sealed amalgam restorations was somewhat lower than that on the sealed composite resin restorations; conversely, partial sealant retention was higher for the sealed amalgam group. The marginal integrity of the sealed amalgam restorations was significantly superior to that of the unsealed amalgam restorations. The sealant also protected Class I posterior composite resin restorations against wear. <21> UI - 93288808 AU - Stadtler P IN - Department of Conservative Dentistry, University Clinic for Dental, Oral and Maxillofacial Surgery, Karl-Franzens-University, Graz, Austria. TI - A 3-year clinical study of a hybrid composite resin as fissure sealant and as restorative material for Class I restorations. SO - Quintessence International 1992 Nov;23(11):759-62 AB - After 3 years, 78.0% of 64 reexamined fissure restorations (extended sealants) and small occlusal restorations were clinically acceptable or excellent, and 21.9% had to be repaired or replaced because they had fractured (6.3%) or were no longer clinically acceptable by some other criterion (15.6%). The conservative preventive resin restoration seems to be an effective treatment for small occlusal defects. Meticulous dental hygiene by the patient and regular examinations by the dentist are mandatory. <22> UI - 93268581 AU - Harris RK IN - Indiana University, School of Dentistry, Department of Operative Dentistry, Indianapolis 46202. TI - Dental amalgam: success or failure?. [Review] [41 refs] SO - Operative Dentistry 1992 Nov-Dec;17(6):243-52 AB - A review of recent literature suggests that reasons for amalgam failure can generally be identified and avoided. These include: retentive failure, marginal breakdown, fracture of the tooth or restoration, reasons for sensitivity, poor surface characteristics, and contributions to periodontal disease. Materials themselves are least often the source of problems; rather, most of the failures can be attributed to lack of attention to detail in cavity preparation and handling of the materials. [References: 41] <23> UI - 93268578 AU - Bryant RW AU - Marzbani N AU - Hodge KV IN - University of Sydney, Department of Operative Dentistry, Australia. TI - Occlusal margin defects around different types of composite resin restorations in posterior teeth. SO - Operative Dentistry 1992 Nov-Dec;17(6):215-21 AB - Using stone replicas of individual restorations from a clinical study investigating three types of posterior composite resins, four types of defects were identified on the occlusal margins. It was observed that particular types of defects were commonly associated with each type of composite resin. The microfilled composite usually exhibited crevice formation (marginal fracture), the small-particle hybrid showed evidence of both wear and crevice formation, and a coarse composite resin most noticeably exhibited wear. Fracture of excess composite was associated with the fine-textured composites. <24> UI - 93266004 AU - Qualtrough AJ AU - Wilson NH IN - Department of Restorative Dentistry, Unit of Conservative Dentistry, Turner Dental School, University of Manchester Hospital. TI - Matrices: their development and in clinical practice. [Review] [18 refs] SO - Dental Update 1992 Sep;19(7):281-2, 284-6 AB - Recent developments in amalgam alloys composite resin materials have highlighted the importance of meticulous restoration placement by the dentist. This paper discusses the selection and use of the matrix which is significant in both the quality and longevity of the final restoration. [References: 18] <25> UI - 93228929 AU - Smales RJ IN - Department of Dentistry, University of Adelaide, South Australia. TI - Effect of rubber dam isolation on restoration deterioration. SO - American Journal of Dentistry 1992 Oct;5(5):277-9 AB - The consequence of using either rubber dam or cotton roll isolation on the subsequent clinical deterioration of 546 polished amalgam and 148 anterior enamel-bonded resin composite restorations was evaluated over periods of up to 15 and 10 years, respectively. Double-blind assessments for several clinical factors or parameters of the restorations were made using both direct and indirect observation methods. The transformed rating scores obtained were evaluated using a mixed model analysis of variance. With very few exceptions, all restoration placements were of high quality, and there were relatively few unsatisfactory rating scores given for any of the clinical factors assessed over the study. The low mean deterioration scores for most of the clinical factors assessed were also fairly similar, irrespective of the isolation method used. Therefore, although a statistically significant difference was found between the two isolation methods for marginal fracture of the composites, the clinical relevance of this difference is questionable. <26> UI - 93228924 AU - Wendt SL Jr AU - Leinfelder KF IN - UCONN Health Center, School of Dental Medicine, Department of Restorative Dentistry and Endodontology, Farmington, CT 06032. TI - Clinical evaluation of a heat-treated resin composite inlay: 3-year results. SO - American Journal of Dentistry 1992 Oct;5(5):258-62 AB - The purpose of this study was to evaluate a resin composite inlay system in clinical trials involving human subjects. A total of 60 restorations were inserted equally in Class I and II preparations and in premolars and molars. A glass ionomer liner was applied to the dentin. Light-cured direct inlays were fabricated in the oral environment. Thirty inlays were heat-treated for 7.5 minutes at 125 degrees C in a dry heat oven. Enamel margins of the preparations were etched with 37% phosphoric acid gel. All inlays were cemented with a light-cured enamel bonding resin. Restorations were evaluated using the USPHS system and M-L indirect scale. Six, 12, 24 and 36-month recalls were compared to baseline. Color, interfacial staining, secondary caries, and wear were unchanged from baseline for all restorations. Marginal integrity and surface texture show a differential change from baseline and with respect to restoration type. Indirect wear was not significantly different between restoration types (P < 0.05). Wear resistance was not significantly improved with heat treatment, but marginal integrity and surface characteristics showed marked improvement in the heat-treated group at 24 and 36-month recalls. <27> UI - 93228921 AU - Powell LV AU - Gordon GE AU - Johnson GH IN - Department of Restorative Dentistry, University of Washington, Seattle 98195. TI - Clinical comparison of Class V resin composite and glass ionomer restorations. SO - American Journal of Dentistry 1992 Oct;5(5):249-52 AB - Three techniques for restoring abrasion/erosion lesions were evaluated over a 2-year period: 1) glass ionomer restoration (Ketac-Fil); 2) composite restoration with a dentin bonding agent (Silux Plus, Scotchbond 2); 3) composite restoration with glass ionomer liner and a dentin bonding agent (Silux Plus, Vitrebond, Scotchbond 2). There were 116 lesions restored and 115 evaluated for color match, cavosurface discoloration, surface texture, caries development, and retention. Most restorations were rated clinically acceptable for color match, cavosurface discoloration, surface texture, and caries development when measured at 2 years. Glass ionomer restorations and composite restorations with a glass ionomer liner and a dentin bonding agent demonstrated better retention rates, 97.4% and 100% respectively, than the composite restorations with a dentin bonding agent only (86.8%) (Cochrane Q test, P = 0.07). <28> UI - 93178749 AU - Smales RJ AU - Gerke DC IN - Department of Dentistry, University of Adelaide, South Australia. TI - Clinical evaluation of four anterior composite resins over five years. SO - Dental Materials 1992 Jul;8(4):246-51 AB - Four hundred and thirty nine chemical-cured composite resin restorations were placed in the anterior teeth of 86 patients treated in a private dental practice. Four anterior resins were used, and placement was performed with acid etching and appropriate enamel bonding resins. Assessments were made of the handling characteristics, condition of the gingiva, surface staining, marginal staining, color deterioration, and of the longevity of the four materials. Clinical deterioration rates and failures of the different types of composites were evaluated over periods of up to five years. Although all the assessed clinical factors deteriorated with time, there were very few unsatisfactory rating scores. Most of the composite restorations performed well over the study. Eight per cent of the restorations failed during the study. Class IV preparations showed the highest restoration failure rates. <29> UI - 93178369 AU - Rykke M IN - Department of Operative Dentistry, University of Oslo, Norway. TI - Dental materials for posterior restorations. [Review] [96 refs] SO - Endodontics & Dental Traumatology 1992 Aug;8(4):139-48 AB - Assessment of the quality of dental restorations by the Ryge system is described. Generally, the quality of dental restorations is shown to be dependent on the technique sensitivity of the restorative material as well as the skill and experience of the dentist. Concerning biocompatibility, adverse reactions related to amalgam restorations are unlikely or scarce, due to small amounts of released mercury. Resin based restorative materials contain a large number of organic compounds and, as such, the toxic and allergenic potentials are unknown. Gold and ceramics turn out to be the most biotolerable dental materials. Based on studies on longevity, data indicate that the median age of amalgam restorations is 10-12 years, of gold castings 13-14 years and more, and of composite restorations 4 years. Data on longevity of ceramic restorations are sparse. Secondary caries appears to be the most frequent cause for replacement of the different restorations, followed by marginal degradation. Secondary caries account for more failures among the resin based restorations than among amalgam. Reviewing the literature, it appears that amalgam is the best and most economic dental material for routine posterior restorations with reasonable durability. Gold is recommended for complex restorations. Resin based composites may be limited to small restorations where cosmetics is the main aspect, as wear and recurrent caries are main problems. Ceramic restorations comprise aesthetic restorations with excellent biocompatibility, however, data on longevity and marginal adaptation are not encouraging. [References: 96] <30> UI - 93176362 AU - Smales RJ AU - Gerke DC IN - Department of Dentistry, University of Adelaide, South Australia. TI - Clinical evaluation of light-cured anterior resin composites over periods of up to 4 years. SO - American Journal of Dentistry 1992 Aug;5(4):208-12 AB - Seven hundred light-cured anterior restorations were placed in the permanent teeth of 161 patients by one researcher and evaluated over 4 years. One microfilled and two hybrid resins were assessed for their handling and for gingivitis adjacent to them, surface staining, marginal staining, and color mismatch. Restorative failures were related to the material, patient age, tooth site, and class of preparation. The different handling properties of the three resins did not affect their clinical behavior. There were only 10 unsatisfactory instances from 1626 restoration observations for the four clinical parameters assessed, and no clinically significant differences were found between the three materials, apart from the initial lighter shade mismatches of the microfilled resin. There was no obvious clinical deterioration recorded for most of the restoration observations, although all restorations deteriorated slightly over the study. There were no significant failure differences between the three resins, but significantly more failures occurred in elderly patients, restored (Class V) premolar teeth, and Class IV and V preparations. Of the 43 restoration failures, 81% were from Class V preparations, which reflected undue reliance on a dentin-bonding resin system for restoration retention in premolar cervical abrasion-erosion lesions. <31> UI - 93178744 AU - Freilich MA AU - Goldberg AJ AU - Gilpatrick RO AU - Simonsen RJ IN - University of Connecticut, School of Dental Medicine, Farmington. TI - Three-year occlusal wear of posterior composite restorations. SO - Dental Materials 1992 Jul;8(4):224-8 AB - The specific aims of this study were to: 1) measure the occlusal wear of four different dental composite materials placed in the posterior teeth of adults; and 2) evaluate the effect of the clinical parameters, cavity class and tooth type on occlusal wear. Four different visible light-cured composite materials were used to make the restorations in this study. The restorations placed for this randomized clinical trial were scored through the use of an indirect evaluation system (M-L scale). The total sample size per recall ranged from 90 to 142 restorations from baseline to 36 months. The mean wear at 36 months for Heliomolar, J&J Experimental (Adaptic II) and P-30 was 45-54 microns, which is rather low compared to the recently reported wear of other composite materials. Marathon exhibited significantly greater wear with a mean of 174 microns at 36 months. The data also showed that cavity class and tooth type had no significant effect on the occlusal wear of the restorations made with the three low wear-rate materials, while restorations composed of the high wear-rate material exhibited more wear in molars than premolars; this effect was again not statistically significant. These data support the hypothesis that the overall wear of a composite restoration is more dependent on the material's properties than clinical parameters such as cavity class and tooth type. <32> UI - 93183291 AU - Mjor IA IN - College of Dentistry, University of Florida, Gainesville 32610. TI - Problems and benefits associated with restorative materials: side-effects and long-term cost. [Review] [59 refs] SO - Advances in Dental Research 1992 Sep;6:7-16 AB - The paper reviews data on biological side-effects of dental materials on patients and also on personnel who routinely handle the materials. The incidence of adverse effects is low--in one study indicated to be 1:700 for all types of treatments. For individual types of materials, it will be significantly lower, and for restorative materials, probably in the 1:10,000 to 1:20,000 range. Allergic reactions are the most common type of adverse effect of dental materials. Lichenoid reactions on the oral mucous membrane adjacent to amalgam restorations are the most frequently encountered side-effects for a specific group of restorative materials. Cost analyses were based on reports of longevity of different restorations and the cost of restorations at the time of placement. Amalgam restorative therapy was more cost-effective than composite restorations and gold castings. [References: 59] <33> UI - 93201336 AU - Su HL AU - Chen PS IN - Department of Dentistry, Chang Gung Memoria Hospital, Taipei, Taiwan, R.O.C. TI - A clinical evaluation of comprehensive dental treatment for children under general anesthesia. SO - Chang-Keng i Hsueh Tsa Chih 1992 Dec;15(4):188-92 AB - The purpose of this study is to evaluate the comprehensive dental treatment for children under general anesthesia. From 1989 to 1991, 57 children with mean age of 3 years 2 months were treated, followed up with a minimal of 1 year. This procedure allows the dentition to be restored in one visit. Further care including preventive options and behavior shaping was provided on a 3-6 months recall schedule. The reasons for general anesthesia are that these children were either unable to accept treatment because of handicaps, extreme fear or young age. Their mean number of decayed tooth was 15 (Standard Deviation, SD = 5) and nearly three quarters of the children were under 6 years old. The most frequent treatment procedures were the extraction of teeth, composite resin restoration and Ni-Cr crown restoration. The Ni-Cr crown (1.7% failure rate) was more successful than the amalgam and composite resin restoration (9.7% failure rate). Pedo-strip crown had the highest failure rate (22%) for anterior teeth restoration. Nineteen children needed retreatment with conventional behavior guide. Six children had new caries and required further treatment. Thirty eight children returned for regular recall during the minimal 1 year follow-up period. <34> UI - 93173788 AU - Johnson GH AU - Bales DJ AU - Powell LV IN - Department of Restorative Dentistry, University of Washington, School of Dentistry, Seattle 98195. TI - Effect of admixed indium on the clinical success of amalgam restorations. SO - Operative Dentistry 1992 Sep-Oct;17(5):196-202 AB - The purpose of this study was to clinically evaluate two formulations of a dispersed-phase, high-copper dental amalgam alloy (Indisperse), which contained admixed indium. One alloy tested contained 5% indium, and the second alloy contained 10% indium. A similar alloy without indium, Dispersalloy, was also placed for comparison. Over the course of the five-year study, there were no differences clinically or statistically regarding texture and luster. The margins of the restorations containing indium incurred slightly less fracture than the non-indium-containing restorations; however, these differences were not clinically significant. It can be concluded that the admixture of 5-10% indium as well as the increased ratio of eutectic spheres to lathe-cut particles found in the indium alloys enhance the clinical performance of amalgam restorations. <35> UI - 93168425 AU - Isenberg BP AU - Essig ME AU - Leinfelder KF IN - University of Alabama, Birmingham School of Dentistry 35294. TI - Three-year clinical evaluation of CAD/CAM restorations. SO - Journal of Esthetic Dentistry 1992 Sep-Oct;4(5):173-6 AB - This study dealt with the clinical evaluation of 121 inlays and onlays generated from both Dicor ceramics and Vita porcelains. These two different types of ceramic materials were cemented using three different duo-cured composite resin luting agents, which differed in particle size. At the end of 3 years, no difference could be detected between the clinical performance of the Dicor and Vita restorations. Both exhibited the same degree of color matching characteristics, marginal integrity, and general clinical performance; however, seven of the restorations exhibited fracture through the isthmus, which was shown to be due to insufficient cavity depth. The balance of the restorations exhibited excellent clinical performance when evaluated against the United States Public Health Service System. <36> UI - 93168420 AU - Croll TP IN - Department of Pediatric Dentistry, University of Pennsylvania School of Dental Medicine, Philadelphia. TI - Class I composite resin restoration. SO - Journal of Esthetic Dentistry 1992 Sep-Oct;4(5):148-53 AB - Composite resin materials and methods for their use have improved to the extent that long lasting Class I carious lesions on stress-bearing surfaces can be restored with predictable results. This article demonstrates a step-by-step clinical technique for placement of a Class I composite resin restoration lined with a light-hardened glass-ionomer dentin replacement foundation. Emphasis is placed on tooth isolation, thoughtful handling of the respective materials, and the importance of final sealing of the resin/enamel margins. <37> UI - 93155923 AU - Burgess JO AU - Summitt JB AU - Robbins JW IN - Department of Restorative Dentistry, University of Texas Health Science Center, San Antonio. TI - The resistance to tensile, compression, and torsional forces provided by four post systems. SO - Journal of Prosthetic Dentistry 1992 Dec;68(6):899-903 AB - This study measured the force required to displace four different endodontic posts (an experimental, Para-Post, Flexi-Post, and V Lock) when tensile, torsion, or compressive forces were applied. Extracted mandibular premolars were decoronated at the cementoenamel junction, the roots were divided into groups of similar size, and the pulpal tissue was removed. The canals were enlarged, cleaned, and filled with gutta percha. Post preparations were made, and the posts were cut and cemented into the post spaces with resin cement. The roots were notched with a separating disc and lowered into a metal tube filled with acrylic resin. Two Minim pins were placed into the coronal dentin paralleling the post. Composite resin cores were made around the coronal 4 mm of the posts and the two pins for 10 specimens from each group. The specimens were placed into a standardized fixture and a load applied until failure. The tensile load required to pull the experimental post and resin was significantly less than the load required to remove the threaded posts. Flexi-Posts provided the greatest resistance to torsion and tensile loading. The compressive load required to fracture the core over the V-Lock post was significantly greater than the other post systems. <38> UI - 93147334 AU - Weerheijm KL AU - Gruythuysen RJ AU - van Amerongen WE IN - Department of Pediatric Dentistry ACTA, Amsterdam, The Netherlands. TI - Prevalence of hidden caries. SO - ASDC Journal of Dentistry for Children 1992 Nov-Dec;59(6):408-12 AB - Clinical evaluations of the first and second permanent molars were compared with radiographic evaluations of the same teeth, for 359 patients (between six and eighteen years old) of the pediatric department of the Academic Centre for Dentistry Amsterdam (ACTA). The teeth were professionally cleaned and dried before the clinical evaluation. Despite the thorough examination, taking into account the fact that all discolorations and/or decalcifications were noted, 15 percent of the teeth that did not show signs of enamel caries clinically, showed a dentine lesion on the bitewing radiograph. These 15 percent of teeth with hidden caries were found in 7.5 percent of the population studied. The absence of clinical signs of occlusal enamel caries or dentine caries does not guarantee a sound dentition. Sealant treatment of teeth that are sound (both clinically and radiographically) is justified, therefore, soon after tooth eruption. <39> UI - 93118467 AU - Granath L AU - Schroder U AU - Sundin B IN - Department of Pedodontics, Lund University, School of Dentistry, Malmo, Sweden. TI - Clinical evaluation of preventive and class-I composite resin restorations. SO - Acta Odontologica Scandinavica 1992 Dec;50(6):359-64 AB - This study was initiated in 1986 in response to increased interest in restorative procedures favoring preservation of tooth substance and in the search for alternatives to dental amalgams. Eighty-seven preventive resin restorations in permanent molars and 35 occlusal composite resin restorations in primary molars (limited size) and 13 in premolars were followed up for 2 years. They were placed by a large number of operators, mainly dental students under supervision, and rated by five calibrated instructors in accordance with an internationally accepted system for the evaluation of the clinical performance of dental materials. One composite resin (Occlusin) was used. A survival model was used to calculate the cumulative theoretical number of successful treatments of children who had dropped out. For none of the 6 clinical variables was the success rate lower than 91%, and only 3 of 26 failures were of a nature requiring remake or correction. The failures occurred, with a few exceptions, during the 1st year of observation. The two types of restoration have thus proved to be efficient treatments fulfilling all reasonable requirements in modern operative dentistry. <40> UI - 93119315 AU - Tyas MJ IN - School of Dental Science, University of Melbourne. TI - One-year clinical performance of PMDM-based dentine bonding agents. SO - Australian Dental Journal 1992 Dec;37(6):445-8 AB - Two PMDM-based dentine bonding agents and a microfilled composite were used to restore a total of forty non-undercut caries-free cervical abrasion lesions without enamel etching. Restorations were evaluated over one year and the loss rate calculated using a life table analysis. Marginal staining was assessed from colour photographs on a continuous linear rating scale. After one year, 5 per cent of Tenure bonded restorations were lost compared with 52 per cent of Mirage bonded restorations. Slight marginal staining was evident around Tenure bonded restorations after one year. <41> UI - 93107488 AU - Summitt JB AU - Osborne JW IN - Department of Restorative Dentistry, University of Texas Health Science Center Dental School, San Antonio 78284-7890. TI - Initial preparations for amalgam restorations: extending the longevity of the tooth-restoration unit [see comments]. [Review] [46 refs] CM - Comment in: J Am Dent Assoc 1993 Feb;124(2):10-11, 13, Comment in: J Am Dent Assoc 1993 Feb;124(2):13, 15 SO - Journal of the American Dental Association 1992 Nov;123(11):67-73 AB - Tradition has dictated cavity preparation and tooth restoration since the turn of the century. The authors discuss material and technique options that challenge tradition and extend the longevity of restorations. [References: 46] <42> UI - 93105457 AU - Dijkman GE AU - Arends J IN - Laboratory for Materia Technica, Groningen, The Netherlands. TI - Secondary caries in situ around fluoride-releasing light-curing composites: a quantitative model investigation on four materials with a fluoride content between 0 and 26 vol%. SO - Caries Research 1992;26(5):351-7 AB - In the literature, secondary caries around composite restorations is reported often. Fluoridated composites are therefore interesting materials because they might reduce or inhibit secondary caries. In this article an in situ model investigation is presented in which the effect of F-releasing composites on enamel demineralisation around an artificial gap of 200 microns width was quantified after 1 month. The fluoride content of the composites varied between 0 and 26 vol%. The beneficial effect of the fluoride released was larger in the gap than at the outer enamel surface. In the gap, all fluoridated composites reduced the enamel demineralisation statistically significantly with respect to the non-fluoridated control. Microradiography showed a reduction of lesion depth values of 27-45%, and a reduction of mineral loss values of 25-56%. At the outer enamel surface next to the artificial gap, a beneficial fluoridation effect was measurable only near the most fluoridated composite. The results indicate that fluoridated composites may play a role in the future prevention of secondary caries. <43> UI - 93088181 AU - Hoglund C AU - van Dijken J AU - Olofsson AL IN - Department of Cariology, Dental School, Umea University, Sweden. TI - A clinical evaluation of adhesively luted ceramic inlays. A two year follow-up study. SO - Swedish Dental Journal 1992;16(4):169-71 AB - Fired porcelain inlays were cemented in class II cavities with either a dual cured composite or a glass ionomer luting cement. Clinically evaluation according to modified USPHS criteria was done at baseline and after 6, 12 and 24 months. Inlays bonded with the composite resin showed a 2% failure rate, while 15% of the inlays cemented with the glass ionomer were lost or fractured during the evaluation period. The failures were in most cases due to an adhesive bond failure at the cement-porcelain interface. <44> UI - 93081107 AU - Paterson AJ AU - Stewart F AU - Tulloch EN AU - Hughes AM IN - Department of Conservative Dentistry, Glasgow Dental Hospital and School. TI - Self-inflicted mutilation of the dentition in a schizophrenic patient. SO - British Dental Journal 1992 Nov 21;173(9):314-6 AB - A case is presented in which a patient performed mechanical self-mutilation of her dentition during an episode of psychotic illness. The management of this case is described and discussed. <45> UI - 93057225 AU - Frank AL AU - Glick DH AU - Patterson SS AU - Weine FS IN - School of Dentistry, University of Southern California, Los Angeles. TI - Long-term evaluation of surgically placed amalgam fillings. SO - Journal of Endodontics 1992 Aug;18(8):391-8 AB - The coauthors of this article had developed the clinical impression that whereas surgically placed amalgam fillings are successful on a short-term basis, the long-term prognosis for these cases may not be nearly as favorable. In order to test this hypothesis, as many patients as could be contacted, either directly or indirectly, who had been treated before 1981 were evaluated. Excluded from this study were cases for which failure could be attributed to any reason other than failure from the amalgam reverse filling. Therefore, all cases included had to demonstrate periapical healing prior to ultimate breakdown. On this basis, 60 of 104 teeth (57.7%) were considered to be successful and 44 teeth (42.3%) were determined to be failures. <46> UI - 93065554 AU - Mjor IA AU - Toffenetti F IN - NIOM Scandinavian Institute of Dental Materials. TI - Placement and replacement of amalgam restorations in Italy. SO - Operative Dentistry 1992 Mar-Apr;17(2):70-3 AB - The reasons for placement and replacement and the longevity of amalgam restorations were recorded by 62 Italian private practitioners. The survey compiled 1935 amalgam restorations inserted due to primary caries (59%) and failed restorations (41%). The clinical diagnosis of secondary caries constituted 59% of failures of amalgam restorations. The age of 46% of the restorations needing replacement was noted. The median longevity was 4.7 years. <47> UI - 93065559 AU - Mjor IA AU - Toffenetti F IN - NIOM Scandinavian Institute of Dental Materials. TI - Placement and replacement of resin-based composite restorations in Italy. SO - Operative Dentistry 1992 May-Jun;17(3):82-5 AB - The use of resin-based composite restorations, the reasons for failure, and the longevity of these restorations have been surveyed in 62 Italian private practices. Almost two-thirds of the 1025 restorations inserted were class 3 and 5 restorations, while 18% were class 1 and 2 restorations. Secondary caries was the most common reason reported for replacement of resin-based composite restorations (44%), followed by discoloration (21%), and bulk and margin fracture (14%). The age of restorations needing replacement was reported for 53% of the sample. The median longevity in this sample was calculated to be 3.3 years. <48> UI - 93067963 AU - Hansen EK IN - Department of Dental Materials and Technology, Royal Dental College, Copenhagen, Denmark. TI - Five-year study of cervical erosions restored with resin and dentin-bonding agent. SO - Scandinavian Journal of Dental Research 1992 Aug;100(4):244-7 AB - The cumulative retention rate of a microfilled resin in non-undercut cervical abrasion/erosion lesions was studied over a 5-yr period. The enamel was etched and the dentin was pretreated with either Gluma (n = 75) or the first marketed version of Scotchbond (n = 30). The cumulative 5-yr retention rate of the Gluma fillings was 90% and that of the Scotchbond fillings 47% (the 95% confidence limits were 83-98% for Gluma fillings and 27-67% for Scotchbond fillings). The retention rate with both bonding agents was significantly higher in the maxillary arch than in the mandibular arch. <49> UI - 93046447 AU - Svanberg M IN - Department of Public Dental Health, Kronoberg County Council, Vaxjo, Sweden. TI - Class II amalgam restorations, glass-ionomer tunnel restorations, and caries development on adjacent tooth surfaces: a 3-year clinical study. SO - Caries Research 1992;26(4):315-8 AB - Eighteen caries-active adolescents, each having both a class II conventional amalgam (Dispersalloy) and a glass-ionomer (Ketac Silver) tunnel restoration of the same age placed on a contralateral tooth, were part of a 3-year clinical study. At the 1- and 2-year examinations all test restorations were assessed as acceptable in all patients. At the 3-year assessment three amalgam restorations failed due to recurrent caries, and one glass-ionomer restoration failed due to marginal ridge fracture. During the entire study period, the requirement of restorative therapy because of primary proximal caries was significantly reduced (p < 0.05) on tooth surfaces adjacent to the glass-ionomer restorations as compared with that on tooth surfaces adjacent to the amalgam restorations. <50> UI - 93046445 AU - Weerheijm KL AU - Groen HJ AU - Bast AJ AU - Kieft JA AU - Eijkman MA AU - van Amerongen WE IN - Department of Pediatric Dentistry, Academic Centre for Dentistry, Amsterdam, The Netherlands. TI - Clinically undetected occlusal dentine caries: a radiographic comparison. SO - Caries Research 1992;26(4):305-9 AB - The occlusal bite-wing radiograph evaluations of 131 14-year-old and of 123 17- and 20-year-old Dutch persons were compared with the clinically collected observations. The clinical observations and the bite-wing radiographs were collected as part of a longitudinal epidemiological survey conducted in 1987 and 1990. Comparison of the evaluations of the first and second molar teeth showed significantly more radiolucencies in all three age groups than expected clinically. Of the clinically judged 'sound' surfaces, 26% in the 14-, 37.5% in the 17- and 50% in the 20-year-old group showed a radiolucency on the bite-wing radiograph. In the 14-, 17- and 20-year-old age group a radiolucency was noticed on the bite-wing radiograph in 32, 44 and 58% of the sealed teeth, respectively. The radiolucencies below the occlusal enamel of sealed teeth were most likely due to the problems in diagnosing occlusal dentine lesions correctly with the clinical diagnostic methods. Therefore not only approximal but also occlusal bite-wing radiograph judgement before sealant application seems to be advisable now. Because of the numbers of clinically undetected lesions it may be advisable to reconsider the criteria for occlusal diagnosis in epidemiological surveys and to judge not only the approximal but also the occlusal surfaces in epidemiological surveys when bite-wing radiographs are available. <51> UI - 93000739 AU - Wendt SL Jr AU - Leinfelder KF IN - UCONN Health Center, Farmington, CT. TI - Clinical evaluation of Clearfil photoposterior: 3-year results. SO - American Journal of Dentistry 1992 Jun;5(3):121-5 AB - The purpose of this study was to evaluate a new resin composite/bonding restorative system in clinical trials involving human subjects. Sixty restorations were inserted in Class I and Class II preparations in premolars and molars. The enamel margins of the preparations were etched for 60 seconds with 37% phosphoric acid gel. The dentinal surfaces of cavity preparations were etched for 40 seconds with 37% phosphoric acid in glycerine (K-etchant gel) and bonding agent (Clearfil Photo Bond) applied. A resin composite (Clearfil Photoposterior) was placed in three increments with a 20 second light cure of each increment and a 60 second light cure of the final increment. All the restorations were evaluated using the USPHS system and M-L indirect scale. At 36 month recalls, compared to baseline, surface texture for essentially all the restorations was rated Bravo, while all other characteristics were rated Alpha. Secondary caries was reported for one restoration during the third year of clinical use. Wear showed an adjusted mean value of 14.6 microns at 36 months or 4.9 microns per year. No cases of clinical post-operative sensitivity to hot, cold, percussion and foods were reported during the length of the study. Clearfil Photoposterior resin composite system has exhibited remarkable wear resistance and no post-operative sensitivity throughout the length of the study. <52> UI - 93001403 AU - Wood M AU - Litkowski LJ AU - Thompson VP AU - Church T IN - Baltimore College of Dental Surgery. TI - Repair of porcelain/metal restoration with resin bonded overcasting. SO - Journal of Esthetic Dentistry 1992 Jul-Aug;4(4):110-3 AB - Porcelain occasionally fractures from ceramometal fixed partial dentures following final cementation. Repair of these porcelain fractures can be a challenging task. When the problem occurs on anterior teeth, it is especially difficult because the repair must not only be durable, but esthetically pleasing as well. Although composite resins can be used for some repairs, it is often difficult to match the color and texture to the surrounding intact porcelain. In addition, the bonding between the resin and porcelain is susceptible to margin leakage, which may ultimately cause an esthetic failure. Techniques involving a cemented porcelain-fused-to-metal overcasting have often been successful in restoring the fixed partial denture to form and function. Although the esthetic result of a porcelain/metal overcasting can be quite successful, retention of the overcasting is sometimes poor. The compromised retention and resistance form is due to lack of interproximal walls on the underlying fractured unit. To improve the retention of the overcasting, the following technique of tin plating the overcasting and fractured unit prior to cementing with a composite resin cement is presented. <53> UI - 93012131 AU - Sivers JE AU - Johnson WT IN - Department of Adult Restorative Dentistry, University of Nebraska Medical Center College of Dentistry, Lincoln. TI - Restoration of endodontically treated teeth. [Review] [42 refs] SO - Dental Clinics of North America 1992 Jul;36(3):631-50 AB - Criteria have been presented for the evaluation of and treatment planning for endodontically treated teeth for final restoration. The dentist must consider the advantages and disadvantages of saving teeth according to their eventual role in restoring occlusal function, arch integrity, and esthetics. The prognosis is dependent on successful endodontic therapy, the presence of sound periodontal support, and an acceptable restorative effort. Currently accepted post and core systems and materials have been reviewed. [References: 42] <54> UI - 93014283 AU - Huysmans MC AU - Peters MC AU - Plasschaert AJ AU - van der Varst PG IN - Dental School, University of Nijmegen, The Netherlands. TI - Failure characteristics of endodontically treated premolars restored with a post and direct restorative material. SO - International Endodontic Journal 1992 May;25(3):121-9 AB - Ninety-one extracted maxillary premolar teeth were restored with a prefabricated post and amalgam, composite resin or glass-cermet core. Each group was again divided into three groups of 9-13 teeth to be subjected to an increasing load in one of three standardized directions (10, 45 and 90 degrees to the long axis of the tooth). Failure load and characteristics of failure were recorded. The glass-cermet-restored teeth had a lower strength than the other groups for every load direction (Student's t-test: P less than 0.01). Amalgam and composite resin groups showed a significant difference only for the 10 degrees loading condition (Student's t-test: P less than 0.02). Teeth restored with amalgam cores displayed a higher mean failure load, in combination with a 46% occurrence of root fracture. <55> UI - 93017292 AU - Magbool G IN - King Faisal University, College of Medicine and Medical Sciences, Dammam, Saudi Arabia. TI - Prevalence of dental caries in school children in Al-Khobar, Saudi Arabia. SO - ASDC Journal of Dentistry for Children 1992 Sep-Oct;59(5):384-6 AB - The author collected base-line data on the prevalence of dental caries in Al-Khobar. He submits that examination of children's teeth should be part of clinical examinations by pediatricians. <56> UI - 93020454 AU - Bex RT AU - Parker MW AU - Judkins JT AU - Pelleu GB Jr IN - Naval Dental School, National Naval Dental Center, Bethesda, Md. TI - Effect of dentinal bonded resin post-core preparations on resistance to vertical root fracture. SO - Journal of Prosthetic Dentistry 1992 Jun;67(6):768-72 AB - An in vitro study was conducted to compare the resistance to failure of two restorative protocols for endodontically treated teeth. Half of 24 specimens received cemented cast post-core restorations and the other half were restored with dentin-bonded composite resin using the ferric oxalate, NTG-GMA, and the PMDM system developed by Bowen. The dentin-bonded resin post-core restorations provided significantly less resistance to failure than the cemented custom cast post-core. The dentin-bonded resin post-core fractured in every instance before the root fractured. A greater force was required to cause failure of the resin post as the cross-sectional area of the post increased. <57> UI - 93020478 AU - Guenzel PJ AU - Knight GW IN - Office of Educational Resources, University of Michigan, School of Dentistry, Ann Arbor. TI - Long-term outcomes for remedial students. [Review] [18 refs] SO - Journal of Prosthetic Dentistry 1992 Jun;67(6):865-9 AB - A recent survey of dental schools concluded that current efforts toward remediation are inadequate. A remedial waxing course providing recognition training before production attempts, emphasis on formative self- and peer-evaluation of projects, and application of a highly structured format for ensuring relevant practice had been developed and favorably evaluated previously. The current report follows the progress of two differently trained remedial groups and the remainder of the class in two courses following remediation. On the five subsequent practical examinations analyzed, the experimental group continued to perform at the class mean. On one practical examination, the experimental group significantly outperformed the traditional group (p less than 0.02). For three of the five examinations, the traditional group was significantly outperformed by the class. One of the six students in the experimental group required additional remediation. Of the seven in the traditionally remediated group, one left school and four required additional remediation. An apparent changing remediation pattern in the preclinical training period is described and possible reasons for the change are explored. [References: 18] <58> UI - 93020534 AU - Kovarik RE AU - Breeding LC AU - Caughman WF IN - Department of Oral Health Practice, University of Kentucky College of Dentistry, Lexington. TI - Fatigue life of three core materials under simulated chewing conditions. SO - Journal of Prosthetic Dentistry 1992 Oct;68(4):584-90 AB - There has been an increase in the use of prefabricated post systems to restore endodontically treated teeth. Various restorative materials are being used as core buildups on these posts. The purpose of this study was to compare three core materials that are used with prefabricated stainless steel posts. Two types of prefabricated posts were placed in extracted teeth, followed by core buildups in amalgam, composite resin, or glass ionomer. The teeth were prepared for full cast crowns with the margins of the crown preparation extending 0.5 to 1.0 mm below the margins of the core buildup. Crowns were fabricated and cemented with zinc phosphate cement. A custom-designed chewing machine was used to cyclically load the teeth with vertical and horizontal forces for one million cycles or until failure occurred. Results indicated highly significant differences in the survival of the post-core-crown restorations depending on which core buildup material was used. Amalgam cores had the lowest failure rate, followed by composite resin cores. All teeth restored with crowns over glass-ionomer core buildup failed. The type of prefabricated post used had no effect on the survival of the post-core-crown restorations regardless of the core buildup used. <59> UI - 93020538 AU - Simon JF AU - Gartrell RG AU - Grogono A IN - Department of Operative Dentistry, University of the Pacific School of Dentistry, San Francisco, Calif. TI - Improved retention of acid-etched fixed partial dentures: a longitudinal study. SO - Journal of Prosthetic Dentistry 1992 Oct;68(4):611-5 AB - Debonding of acid-etched fixed partial dentures has been a problem since their introduction. A study was conducted to determine whether this problem could be resolved by modifying the mechanical retention of tooth preparations. Retentive grooves were prepared at the line angles to create mechanical locks for the resin bonded fixed partial denture. The 4-year retention of posterior resin-bonded fixed partial dentures improved from 60% to 95% by the placement of the proximal grooves. This study was conducted in a dental school clinic during a period of 10 to 52 months. The results demonstrated that design modifications were necessary to improve clinical longevity so that the restoration could be considered "permanent" in the traditional sense. The less-experienced dentist may be more confident of the treatment with the recommended modifications and projected longevity. <60> UI - 93029224 AU - Saleh N AU - Peretz B AU - Rehany Al AU - Zyskind D AU - Hirschfeld Z AU - Stark M IN - Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel. TI - One-year clinical evaluation of an anterior composite resin. SO - Quintessence International 1992 Aug;23(8):559-67 AB - An anterior composite resin was evaluated in a clinical study of 93 Class III and Class IV restorations placed in patients aged 12 to 50 years. The restorations were evaluated at baseline, 6 months, and 1 year. Sixty-four (79%) of the 81 restorations examined at the 1-year recall were unchanged. Marginal discoloration and changes in surface appearance and marginal adaptation accounted for most of the changes. All changes appeared in patients younger than 14 years, which may indicate that the patients had problems in oral hygiene. Replicas of randomly selected restorations showed smooth surfaces and well-sealed margins with a smooth transition from restoration to enamel. Some restorations showed marginal breakdown and a pitted irregular surface. <61> UI - 92407163 AU - Coker HB Jr TI - A protocol for successful posterior composite restorations. SO - Journal - Alabama Dental Association 1992 Winter;76(1):16-20 <62> UI - 92389073 AU - Rees JS AU - Jacobsen PH IN - Department of Conservative Dentistry, University of Wales College of Medicine, Cardiff, U.K. TI - Stresses generated by luting resins during cementation of composite and ceramic inlays. SO - Journal of Oral Rehabilitation 1992 Mar;19(2):115-22 AB - The present study used the finite element method to model the stresses generated by a composite luting cement around a class I composite restoration and a ceramic inlay. In many cases maximum tensile stresses of greater than 20 MPa were found, and failure of the restoration-dentine and restoration-glass ionomer interfaces was predicted. <63> UI - 92398719 AU - Kern M AU - Schwarzbach W AU - Strub JR IN - School of Dentistry, Albert-Ludwigs University. TI - Stability of all-porcelain, resin-bonded fixed restorations with different designs: an in vitro study. SO - International Journal of Prosthodontics 1992 Mar-Apr;5(2):108-13 AB - The strength of resin-bonded, all-ceramic fixed partial dentures with different framework and prosthesis designs was evaluated. Metal dies were fabricated from a cast of a patient missing the left central incisor and the adjacent teeth were prepared to receive an all-ceramic, resin-bonded prosthesis. Framework designs were standardized and at least 10 samples were made for testing each design. Labial veneering of the pontic with Vitadur-N significantly decreased the stability compared with that of the unveneered In-Ceram framework. Circumferential veneering of the pontic and additional proximal box preparation yielded the strongest units. <64> UI - 92394387 AU - Sakaguchi RL AU - Cross M AU - Douglas WH IN - University of Minnesota, School of Dentistry, Minneapolis. TI - A simple model of crack propagation in dental restorations. SO - Dental Materials 1992 Mar;8(2):131-6 AB - Although natural teeth often exhibit microcracks, they rarely demonstrate bulk fracture. However, conventional full-crown restorations periodically exhibit failure due to fracture. Presented here is evaluation of a simple model of crack propagation that estimates crack growth during cyclic loading. A finite element model of a premolar tooth provides the tensile stresses adjacent to cusp loading. If the crack propagation rates for natural teeth, porcelain-fused-to-metal crowns and composite crowns are compared with the wear rates of their respective materials as determined in an artificial mouth, it is evident that the low wear rate of composites may predispose them to fracture. Natural teeth disperse occlusal stresses throughout the dentin so that the effect of high occlusal stress is minimized. Porcelain tends to wear the opposing dentition, which reduces areas of high occlusal stress. Composite, however, demonstrates crack propagation rates higher than those of either natural teeth or porcelain. This, in addition to its low wear rate, might predispose the material to fracture. This model should be used only as a qualitative indicator of fracture tendency. The high calculated crack propagation rates in composites may explain the observed clinical failures and microchipping at the area of occlusal contact, as noted in SEM analysis. <65> UI - 92394379 AU - Freilich MA AU - Goldberg AJ AU - Gilpatrick RO AU - Simonsen RJ IN - University of Connecticut, School of Dental Medicine, Farmington. TI - Direct and indirect evaluation of posterior composite restorations at three years. SO - Dental Materials 1992 Jan;8(1):60-4 AB - The purpose of this study was to compare the use of direct (USPHS) and indirect (M-L) systems of evaluating the occlusal wear of posterior composite restorations. Additionally, this study has utilized the USPHS method to compare the in vivo performance of posterior resin composite restorations made from four different visible-light-cured materials. Of the 202 restorations placed for this randomized clinical trial, only those restorations that were scored by both direct and indirect evaluation systems were included in these comparisons. Restorations were evaluated by two calibrated examiners from baseline to 36 months. While there were some differences noted among the four materials, the majority (99%) of the restorations evaluated in this study received "alpha" or "bravo" scores for all USPHS parameters, indicating acceptable in vivo performance. The results of this study also indicate that there was a consistent relationship between the direct (USPHS) and indirect (M-L scale) scoring systems. For those restorations that changed anatomic form scores, the mean wear at the alfa/bravo transition was 100 +/- 80 microns. By the 24-month recall examination, the use of the USPHS evaluation system category of anatomic form enabled examiners to differentiate restorations and materials that had experienced little occlusal wear from those that had experienced greater amounts of wear. <66> UI - 92350867 AU - Mormann W AU - Krejci I IN - University of Zurich, Dental Institute, Switzerland. TI - Computer-designed inlays after 5 years in situ: clinical performance and scanning electron microscopic evaluation. SO - Quintessence International 1992 Feb;23(2):109-15 AB - Eight mesio-occlusodistal adhesive inlays, fabricated from ceramic blocks using a computer-aided design/machining method, were reexamined after 5 years of clinical service. The inlays wre evaluated according to modified US Public Health Service criteria. The results indicated excellent clinical performance, with eight Alfa ratings for wear, recurrent caries, and color match, and five Alfa and three Bravo for marginal discoloration and marginal integrity. Under scanning electron microscope, 81.0% of the tooth-cement interfaces and 84.1% of the cement-inlay interfaces were rated continuous at the occlusal margin. Axially, 73.6% of the tooth-cement interfaces and 87.0% of the cement-inlay interfaces were rated continuous. Although this long-term investigation revealed good clinical performance of the inlays, improvements in the ceramic structure and its properties, the cavosurface design, and the luting composite resin were recently introduced to further optimize quality. <67> UI - 92350870 AU - Serra MC AU - Cury JA IN - Dentistry School of Piracicaba, University of Campinas, Sao Paulo, Brazil. TI - The in vitro effect of glass-ionomer cement restoration on enamel subjected to a demineralization and remineralization model. SO - Quintessence International 1992 Feb;23(2):143-7 AB - The purpose of this in vitro study was to evaluate differences in initiation and progression of carieslike lesions around restorations in enamel. A demineralization/remineralization cycling model was used to induce experimental secondary caries around cavities restored with glass-ionomer cement or composite resin. The effects of these materials were compared by microhardness profiles. The results indicated that glass-ionomer cement showed potential value as a restorative material for the prevention or reversal of caries in enamel adjacent to restorations, even in situations of high cariogenic challenge. <68> UI - 92358405 AU - Ostlund J AU - Moller K AU - Koch G IN - Department of Pediatric Dentistry, Linkoping, Sweden. TI - Amalgam, composite resin and glass ionomer cement in Class II restorations in primary molars--a three year clinical evaluation. SO - Swedish Dental Journal 1992;16(3):81-6 AB - Amalgam (ANA 2000), composite resin (Occlusin), and glass ionomer cement (ChemFil) were compared in conventional Class II restorations in second primary molars. Twenty-five restorations of each material were placed by two dentists in 50 patients. The restorations were evaluated during a three year period using the USPHS criteria. Great differences could be found between the materials. The failure rate (USPHS ratings Charlie) was after three years 8 per cent for the amalgam, 16 per cent for the composite resin and 60 per cent for the glass ionomer cement restorations. <69> UI - 92373600 AU - McMaster DR AU - House RC AU - Anderson MH AU - Pelleu GB Jr IN - Comprehensive Dentistry Department, Naval Dental School, National Naval Dental Center, Bethesda, Md. TI - The effect of slot preparation length on the transverse strength of slot-retained restorations. SO - Journal of Prosthetic Dentistry 1992 Apr;67(4):472-7 AB - An in vitro study was conducted (1) to compare fracture strength of amalgam restorations retained with retentive slots of different lengths when stressed with a transverse force, (2) to determine if beveling the slot preparation resulted in an increase in fracture resistance to a transverse force, and (3) to evaluate the incidence of unrestorable tooth fracture as it relates to slot preparation length. Six groups of 10 specimens were prepared with slots of increasing length, with each specimen receiving four slots of equal length. Slot preparations in group 6 were beveled. Results showed that shorter slot preparations provided statistically equal amounts of resistance to a transverse force as did the longer preparations. Beveling the slot preparation did not significantly increase fracture strength. Specimens restored with longer slot preparations failed unrestorably more often than restorations retained with shorter slot preparations. <70> UI - 92366405 AU - Bimstein E IN - Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel. TI - Frequency of alveolar bone loss adjacent to proximal caries in the primary molars and healing due to restoration of the teeth. SO - Pediatric Dentistry 1992 Jan-Feb;14(1):30-3 AB - The frequency of alveolar bone loss adjacent to extensive proximal caries, and the effect of dental restorations on alveolar bone loss and healthy alveolar bone were examined in human primary molars. Proximal caries, contact loss, mesial drift and the presence of alveolar bone loss were recorded from 190 bite-wing radiographs from 60 boys and 46 girls. Proximal caries was evident in 297 quadrants. In 63.0% of quadrants, both primary molars had proximal caries. Contact loss was evident in 38.4% of the quadrants with proximal caries. Bone loss was found in 12.1% of the quadrants with proximal caries or 31.6% of those with contact loss. Analysis of variance for the presence of bone loss indicated statistically significant values (P less than 0.05) for one or two teeth with caries by quadrant, the presence or absence of contact loss, and age. A second examination was available for 41 children. Among these, eight out of the 36 bone defects disclosed at the first examination were present. At the second examination, after tooth restoration, healing of five bone defects was evident. These findings indicate a connection between the presence and treatment of extensive proximal caries and alveolar bone health in the primary dentition. <71> UI - 92366704 AU - Ripa LW AU - Wolff MS IN - State University of New York at Stony Brook, School of Dental Medicine 11794. TI - Preventive resin restorations: indications, technique, and success. SO - Quintessence International 1992 May;23(5):307-15 AB - Although preventive resin restorations have been reported since 1977, there is little uniformity concerning the indications for this procedure, nor is there a standard technique. This article proposes diagnostic criteria for pit and fissure occlusal caries and diagnosis-related considerations for treatment planning for preventive resin restorations. A step-by-step "laminate" technique, which includes, successively, a glass-ionomer cement liner, a posterior composite resin, and a sealant, is described. The success rates reported for several clinical studies of preventive resin restorations are presented, although the criteria for this restoration, treatment methodology, and the determinates of success vary from study to study. <72> UI - 92366723 AU - Catovic AM IN - University of Zagreb, Croatia. TI - Comparative investigation of dynamic loading of prepared and intact human premolars. SO - Quintessence International 1992 Jun;23(6):435-8 AB - The aim of this study was to obtain some data on the dynamic strength of premolar teeth. Experiments were performed on three groups of human premolars: intact teeth, teeth prepared for partial veneer crowns with flat occlusal surfaces, and teeth prepared for partial veneer crowns with rounded occlusal surfaces. The loading procedure was performed in a modified Amslers high-frequency pulsator. The greatest dynamic strength was exhibited by the intact specimens. The highest continual (unlimited number of loading cycles) dynamic stress withstood by all three groups of premolars was about 300 N. A statistically significant negative correlation was found between Fmax and the number of cycles in all three tested groups. <73> UI - 92336747 AU - Nordbo H AU - Lyngstadaas SP IN - Department of Preclinical Techniques and Material Sciences, Faculty of Dentistry, University of Oslo, Norway. TI - The clinical performance of two groups of functioning class-II cast gold inlays. SO - Acta Odontologica Scandinavica 1992 Jun;50(3):189-92 AB - The length of service and the clinical performance of two groups of functioning class-II cast gold inlays in patients attending a private practice were assessed by conventional clinical and radiographic examination. In one group all inlays were older than 25 years (median age, 34 years), and they had an extended outline form. The impression technique was based on a thermoplastic material in a copper ring. In the other group, comprising inlays inserted during the past 25 years (median age, 16.5 years), the outline form was minimal and an elastic impression material in a copper ring was used. The inlays in the older group appeared to perform better than those in the younger group. In both groups recurrent caries appeared to be the predominant reason for repair. <74> UI - 92332854 AU - Qvist V AU - Johannessen L AU - Bruun M IN - Department of Cariology and Endodontics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark. TI - Progression of approximal caries in relation to iatrogenic preparation damage. SO - Journal of Dental Research 1992 Jul;71(7):1370-3 AB - The aim of the present study was to evaluate the effect of iatrogenic preparation damage on the need for operative caries treatment of approximal surfaces, adjacent to Class II amalgam restorations. The material was collected by 77 dentists from the Public Dental Child Health Service in Denmark. It consisted of die-stone models of 187 first-time Class II preparations, adjacent to 190 unfilled approximal surfaces of 58 primary and 132 permanent teeth. The cavity preparations were performed in children between 4 and 17 years of age. They were all filled with amalgam. Information about operative treatment and exfoliation or extraction of the preparation teeth and the adjacent teeth during the following seven years was obtained from the patients' records. Stereomicroscopic examination of the models revealed preparation damage on 64% of the unfilled approximal surfaces in primary teeth and on 69% of the corresponding test surfaces in permanent teeth. During the observation period, operative treatment was performed on 10% of the undamaged test surfaces in primary teeth and on 35% of the damaged ones (p less than 0.05). The corresponding figures for test surfaces in permanent teeth were 6% and 15% (p less than 0.05). It is concluded that iatrogenic preparation damage is a frequent side-effect of operative intervention with approximal caries lesions, and represents a dental health problem, since the damage increases caries progression and the perceived need for restorative therapy of the adjacent teeth. <75> UI - 92331087 AU - Sonju Clasen AB AU - von der Fehr FR AU - Kant van Daal JM IN - Department of Public Dental Health, Salzgitter, FRG. TI - Caries prevalence of kindergarten children in Salzgitter and Oslo. SO - Caries Research 1992;26(3):201-4 AB - In a comparable epidemiological study of kindergarten children, 455 4- and 5-year-olds in Salzgitter (FRG) and 171 4- and 5-year-olds in Oslo (Norway) were examined. Caries was scored at the cavitation level according to WHO criteria. The percentage of caries-free children was higher and the dmfs scores were lower in Oslo than in Salzgitter. It is postulated that this was the result of different levels of fluoride exposure, nutritional habits and dental treatment provision. <76> UI - 92317521 AU - Ferracane JL IN - Department of Dental Materials Science, School of Dentistry, Oregon Health Sciences University, Portland 97201-3097. TI - Using posterior composites appropriately. SO - Journal of the American Dental Association 1992 Jul;123(7):53-8 AB - The success rates of posterior composite restorations vary depending on whether they are used in clinical studies or by practitioners. This article offers a guide to determining when to use these materials. <77> UI - 92299734 AU - Huysmans MC AU - van der Varst PG AU - Schafer R AU - Peters MC AU - Plasschaert AJ AU - Soltesz U IN - Department of Cariology & Endodontology, TRIKON, Nijmegen, The Netherlands. TI - Fatigue behavior of direct post-and-core-restored premolars. SO - Journal of Dental Research 1992 May;71(5):1145-50 AB - Evaluation of long-term mechanical behavior of new types of restorations in clinical trials is time-consuming. A partial alternative can be found in experimental fatigue-testing, which simulates accelerated mechanical deterioration. The aim of this study was to determine the feasibility of using fatigue-testing of a complex dental restoration and to evaluate the mechanical fatigue behavior of premolar teeth restored with a titanium alloy post and an amalgam or composite core. Eighty-seven human upper premolar teeth were decoronated, embedded, and restored with a prefabricated post of 1 mm diameter. The teeth were randomly assigned to one of two groups corresponding with a core build-up of amalgam or chemically-cured core composite, respectively. Five to 21 days after restoration, the specimens were subjected to cyclic loading (frequency, 5 Hz), at an angle of 45 degrees to the long axis of the tooth. The boundary technique was used for determination of the mean fatigue strengths of the restorations at 10(4), 10(5), and 10(6) cycles, simulating up to 1-3 years of clinical functioning. Mean fatigue strength was expressed in percentage of initial strength: For 10(4), 10(5), and 10(6) cycles, the results were 66%, 58%, and 52%, respectively, for the amalgam and 62%, 62%, and 53% for the composite group. It is concluded that fatigue-testing of more complex systems is possible, if a suitable testing method is selected. The restorations showed a comparable strength reduction after 10(6) cycles of about 50% of their initial strength. The composite core build-up showed a behavior less predictable than that of the amalgam, which might be attributed to handling parameters. <78> UI - 92273380 AU - Temple-Smithson PE AU - Causton BE AU - Marshall KF IN - Maurice Wohl GDP Centre, KCSMD, Camberwell, London. TI - The adhesive amalgam--fact or fiction?. SO - British Dental Journal 1992 Apr 25;172(8):316-9 AB - Forty molar and premolar teeth had non-retentive cavities prepared and restored with amalgam using (1) copal varnish (control), (2) a pin, (3) Amalgambond or (4) Panavia-Ex. The forces and energy required to dislodge the restorations were recorded and compared, and the mode of failure noted for each group. Although the pinned restorations required significantly higher loads to dislodge them, the mode of failure and energy required to dislodge the restorations in the Amalgambond and Panavia-Ex groups indicated that these types of restorations had significant advantages over pinned restorations, particularly where the pulp might be compromised. The film thickness of the retentive systems in these two groups, however, indicated a substantial operator or technique sensitivity. <79> UI - 92260310 AU - Yontchev E AU - Carlsson GE IN - Department of Prosthetic Dentistry, Faculty of Odontology, University of Goteborg, Sweden. TI - Long-term follow-up of patients with orofacial discomfort complaints. SO - Journal of Oral Rehabilitation 1992 Jan;19(1):13-9 AB - To a group of 113 patients who exhibited wide variation in orofacial and general complaints, which they related to the effects of dental material, a new questionnaire was sent 8-10 years after the first examination. Eight patients had died, and 23 individuals could not be contacted. Of the remaining 82 patients, 62 (76%) individuals completed the questionnaire. Almost two-thirds (29%) of the responding patients reported that they were now free from the previous symptoms, or that these symptoms were alleviated (35%). Dryness of the mouth and smarting tongue were the most frequent symptoms at the follow-up. Half of the patients (52%) thought they still needed treatment for their complaints, and several of them had visited many other therapists after the end of the treatment period at the Department. The treatment outcome and symptom development may be regarded as acceptable with regard to the severity and long duration of the original complaints. However, the prognosis was poor in a substantial proportion of the patients, and this group continued to be a high consumer of health-care resources. <80> UI - 92208761 AU - Roth AG AU - Conry JP IN - Division of pediatric dentistry, University of Minnesota. TI - A retrospective cohort evaluation of preventive resin restorations. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1992 Mar;58(3):223-6 AB - This study measured the longevity and clinical success of preventive resin restorations (PRRs) placed in permanent teeth by multiple operators in the Pediatric Dentistry Clinic at the University of Minnesota. A retrospective chart audit identified patients who had one or more PRRs placed. Only restorations of the occlusal surfaces of the first or second permanent molars were included. Each patient was given a dental examination. On completion, the patient's chronological record of treatment was reviewed for the following information: experience of the operator, type of isolation used, bonding material, liner type, composite resin, and sealant type. Teeth were examined with a front surface dental mirror and a sharp No. 23 dental explorer. Evaluations were made according to criteria developed by Cvar and Ryge, but modified to include a sealant evaluation. Independent measurements were made by each of the two examiners and a consensus was obtained. One hundred restorations were examined in 64 patients. The mean duration of service was 27 +/- 13 months. Sealant was evaluated as alfa (complete) 26 per cent, bravo (incomplete/adequate) 48 per cent, charlie (incomplete/inadequate) 21 per cent and delta (lost) five per cent. Cavosurface discoloration was evaluated as alfa (none) 87 per cent, bravo (margin only) 12 per cent, and charlie (margin/proceeding toward pulp) one per cent. Anatomical form was evaluated as alfa (well contoured) 89 per cent, bravo (under contoured/dentin not exposed) 11 per cent. Marginal adaptation was evaluated as alfa (no visible crevice) 85 per cent, bravo (visible crevice/no dentin exposed) 12 per cent, charlie (visible crevice/dentin exposed) two per cent and delta (restoration missing) one per cent.(ABSTRACT TRUNCATED AT 250 WORDS) <81> UI - 92208756 AU - McConnachie I IN - Children's Hospital of Eastern Ontario. TI - The preventive resin restoration: a conservative alternative. [Review] [31 refs] SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1992 Mar;58(3):197-200 AB - With the proven results of etched resin techniques, there has been renewed interest in conservative cavity design with a view to the preservation of healthy tooth material. Among the newer techniques showing long-term success are preventive resin restorations. This treatment has several distinct advantages over traditional amalgam restorations, but it requires excellent isolation from salivary and moisture contamination. Three types of preventive resin restorations, with high rates of retention over a seven-year period, have been described. Minimal exploratory openings in enamel are filled with pit and fissure sealants, whereas isolated carious lesions are removed without any extension into the surrounding healthy tooth. The cavity is obturated with filled resin and the unaffected pits and fissures are protected with pit and fissure sealant. The success rate of these conservative restorations can be enhanced by paying strict attention to technique, thereby ensuring a noncontaminated surface. A number of suggestions are offered on how this success rate can be increased. [References: 31] <82> UI - 92225665 AU - Shi Y AU - Barmes D AU - Bratthall D AU - Leclercq MH IN - Beijing Medical University, People's Republic of China. TI - WHO pathfinder caries survey in Beijing extended with data for prevalence of mutans streptococci. SO - International Dental Journal 1992 Feb;42(1):31-6 AB - A pathfinder caries survey was carried out in Beijing, People's Republic of China, using WHO standard methodologies, in order to estimate the trend by comparing the results with the 1981 caries survey, performed in the same area. Simultaneously, the levels of mutans streptococci in the group were estimated in order to define the proportion of children with high and low mutans levels. Twelve-year-old children were randomly selected from schools in five districts within the city limits. Examinations for caries were performed according to 'WHO Oral Health Surveys' by two calibrated examiners. A total of 178 children were examined for caries and 156 of them were randomly selected for saliva sampling of mutans streptococci, using the 'Strip mutans' method. The number of colonies adhering to the strips were compared with a chart, supplied by the manufacturer, and given a score between 0 and 3, indicating low to very high saliva mutans counts, respectively. The results showed a mean DMFT of 1.87 (1.61-0.06-0.20, for decayed, missing and filled teeth respectively); 66.3 per cent of the children were affected. Fourteen per cent had mutans class 0, 28 per cent class 1, 35 per cent class 2 and 23 per cent class 3. The mean DFT, for each mutans class was 0.82, 1.48, 2.09 and 2.69, respectively. The differences were statistically significant (P = 0.0015). In the lowest mutans class, 50 per cent had caries and the mean number of teeth requiring conservative care was 0.68. For the high mutans group, the corresponding values were 72 per cent and 2.11 teeth.(ABSTRACT TRUNCATED AT 250 WORDS) <83> UI - 92230442 AU - Witt MC IN - Department of Periodontology, Dental Faculty, University of Oslo, Norway. TI - Pattern of caries experience in a 12-year-old Brazilian population related to socioeconomic background. SO - Acta Odontologica Scandinavica 1992 Feb;50(1):25-30 AB - The aim of this work was to study the pattern of DMFT, DMFS, and DMFS components in groups of poor (91) and rich (89) 12-year-old children in Porto Alegre, Brazil. The results showed similar DMFT scores for the groups; however, the poor had a higher DMFS score than the rich. Filled surfaces comprised 96% (rich) and 50% (poor) of the DMFS values, and caries experience for the first molars were similar in the groups. Prevalence of interproximal caries was higher among the poor. It is concluded that the unequal access to dental care in the two populations may have influenced the DMFT values and concealed differences in the true disease experience. <84> UI - 92193505 AU - Plasmans PJ AU - van't Hof MA AU - Creugers NH IN - Department of Oral Function and Prosthetic Dentistry, TRIKON, Nijmegen, The Netherlands. TI - Fabrication times for indirect composite resin restorations. SO - Journal of Dentistry 1992 Feb;20(1):27-32 AB - Fabrication times for indirect posterior composite resin restorations were recorded in a prospective clinical efficacy study. Four operators completed 132 one-visit inlays and onlays utilizing a new indirect posterior composite resin system (ICS). The mean time needed for the fabrication of one ICS restoration was 90 min, including the 'laboratory time'. When two restorations were provided simultaneously, the overall mean fabrication time was 120 min. The fabrication times were significantly influenced by the operator and the number of restorations. In several clinical phases a 40 per cent difference in mean fabrication time could be identified between operators. The extent of the restoration had no influence on mean fabrication time. The results of this study are considered to provide some indication of the cost-effectiveness of ICS restorations. <85> UI - 92191524 AU - Raadal M AU - Espelid I IN - Department of Pedodontics, University of Bergen, Norway. TI - Caries prevalence in primary teeth as a predictor of early fissure caries in permanent first molars. SO - Community Dentistry & Oral Epidemiology 1992 Feb;20(1):30-4 AB - The study aimed to examine the validity of employing the caries experience of the primary dentition for predicting early caries in the permanent first molar fissures. Subjects consisted of 192 children who were followed for 2 yr, 91 of whom were pursued for a further year, all receiving semiannual check-ups. The caries prevalence in the primary dentition (dmft), excluding incisors, was recorded at baseline, which was the year the children became 6. Fissure caries in the permanent first molars was recorded as being confined to enamel or dentin, based on findings during cavity preparation. The correlation between dmft and the number of intact permanent first molars was -0.368 and -0.337 after 2 and 3 yr observation respectively. When the children were grouped according to their dmft, a statistically significant relationship was found between the dmft and the number of intact molars in each individual. The positive and negative predictive values as well as the sensitivity and specificity of different dmft values were calculated, and the relationship between them illustrated by the use of ROC curves. Even if there are no specific dmft values which seem obviously favorable for the purpose, these data give information relevant in planning for large scale use of fissure sealing in preventing early fissure caries in permanent first molars. <86> UI - 92191522 AU - Grondahl HG AU - Lith A AU - Jonsson G AU - Persson Y IN - Department of Oral Radiology, University of Goteborg, Sweden. TI - Approximal caries and frequency of bitewing examinations in Swedish children and adolescents. SO - Community Dentistry & Oral Epidemiology 1992 Feb;20(1):20-4 AB - The aim of this study was to assess the number of, and time intervals between, bitewing examinations performed on a group of Swedish patients between 3 up to and including 18 yr of age and to relate them to the accumulated posterior approximal caries experience of the patients as found in the last bitewing examination before age 19. The patients showed a marked variability in approximal caries experience. 25% accounted for about 1% of the total number of carious lesions and restorations accumulated up to age 19 while 25% accounted for 60%. From age 9 up to age 18 more than 75% of the patients were subjected to at least one bitewing examination annually. Between 10 and 15 yr of age more than 90% received annual radiographic examinations. Mean number of bitewing examinations was 10.4 and the average time interval between bitewing examinations was 11.5 months. 11% of the variation in the number of bitewing examinations and 8% of the variation in average time intervals between bitewing examinations could be explained by the number of lesions and restorations in the approximal surfaces of the patients accumulated up to age 19. <87> UI - 92153519 AU - Knibbs PJ IN - Department of Operative Dentistry, Dental School, Newcastle upon Tyne. TI - The clinical performance of a glass polyalkenoate (glass ionomer) cement used in a 'sandwich' technique with a composite resin to restore Class II cavities. SO - British Dental Journal 1992 Feb 8;172(3):103-7 AB - The use of glass polyalkenoate (GPA) cement in conjunction with composite resin using an acid etch technique is now well known and a 'sandwich' of tooth/GPA cement/composite resin has been recommended to form the cervical seal at the base of approximal boxes in Class II cavities. This paper reports on the 2-year results of a controlled clinical trial using a commercial GPA lining cement. The trial was designed to evaluate the efficacy of this 'sandwich' technique. Sixty-four restorations in the mouths of 22 patients were evaluated during the 2.5 year period of the trial. The composite resin component of the restorations performed well. Five restorations failed, all in the region of the approximal box. Four failures were related to the exposed GPA cement component of the 'sandwich'. Failure was probably related to placement difficulties of the technique. The use of GPA cement laminated with composite resin when the GPA cement was enclosed within the final restoration appeared to be a successful technique. <88> UI - 93182976 AU - Martin FE IN - Department of Operative Dentistry, University of Sydney. TI - Recognition and prevention of failures in clinical dentistry. Aesthetic dental materials--posterior. [Review] [46 refs] SO - Annals of the Royal Australasian College of Dental Surgeons 1991 Oct;11:178-88 AB - Despite the widespread use of posterior composite resins and the availability of porcelain and composite resin inlays to restore posterior teeth, clinical researchers express caution regarding their use. Two main concerns include: the technique sensitive nature of the procedures involved and limitations in the performance of these restorations due to the physical properties of the materials. Composites are prone to wear, fracture and a lack of marginal seal; whilst porcelain is brittle, difficult to manipulate and has the ability to wear opposing enamel. Longevity of the newer systems has not yet been determined and as such they should be regarded as experimental. Patients who request these restorations need to be provided with a thorough explanation of the advantages and disadvantages of each type of restoration; following this, careful clinical judgment and conservative use of these materials is recommended for optimum results. [References: 46] <89> UI - 93182975 AU - Boland TW TI - Recognition and prevention of failures in clinical dentistry. Success with anterior restorative material--an overview. [Review] [37 refs] SO - Annals of the Royal Australasian College of Dental Surgeons 1991 Oct;11:167-77 AB - Advances in materials and techniques have still not provided the ideal anterior restoration. This paper gives an overview which outlines and discusses the materials available, their pertinent characteristics and those factors which contribute to determining a satisfactory outcome. [References: 37] <90> UI - 92305626 AU - Pecora JD AU - Saquy PC AU - de Souza JE AU - Sousa Neto MD IN - Faculdade de Odontologia de Ribeirao Preto, Universidade de Sao Paulo. TI - Endodontic treatment of a maxillary lateral incisor presenting dens invaginatus and transposition to the region of the canine--case report. SO - Brazilian Dental Journal 1991;2(1):5-8 AB - Endodontic treatment was performed in a maxillary lateral incisor presenting two different types of anomalies: dens invaginatus and transposition to the region of the canine. The two transposed teeth were subsequently restored with light-cured composite, bringing dental esthetics to normal in a single session. <91> UI - 92279064 AU - Smales RJ IN - Department of Dentistry, University of Adelaide, Australia. TI - Long-term deterioration of composite resin and amalgam restorations. SO - Operative Dentistry 1991 Nov-Dec;16(6):202-9 AB - Previous long-term longitudinal studies of two different methods of placing an auto-cured conventional anterior composite resin, and of a low- and a high-copper amalgam alloy, had shown similar restoration survivals despite the different resin treatment methods used or the types of amalgam alloy placed. Therefore, the aim of the present study was to assess several clinical factors or characteristics of these restorations that were believed to affect the survival of the restorative materials. The 950 composite resin and the 1042 amalgam restorations examined were placed by many operators in numerous patients attending a dental hospital. The composite resin restorations were placed using unetched- and etched-enamel-bonding treatment methods, and the amalgam restorations were polished after insertion. Clinical ratings supplemented by color transparencies were used for the assessment of four factors for the resin, and four factors for the amalgam restoration. Significant deterioration differences were found for several of the clinical factors assessed for both the two different composite resin treatment methods, and for the two different amalgam alloys, which were not directly related to the restoration survivals. <92> UI - 92285846 AU - van Dijken JW IN - Department of Cariologi, Faculty of Odontology, University of Umea, Sweden. TI - A six year follow-up of three dental alloy restorations with different copper contents. SO - Swedish Dental Journal 1991;15(6):259-64 AB - Class II restorations of three amalgam alloys, with 6%, 12% and 23% copper content, respectively, were evaluated and compared intraindividually during a six year follow-up. In total 10.3% of the restorations were replaced during the test period. The reasons for replacement were bulk fracture (5.6%), tooth fracture (2.4%), marginal ridge fracture (0.8%), and secondary caries (1.6%). The intraindividual ranking of the three alloys, including evaluation of anatomical form, marginal adaptation and secondary caries, showed significantly better results for the two high copper alloys than for the conventional low copper alloy. No difference was seen between the two high copper containing alloys. <93> UI - 92249721 AU - Kaurich M AU - Kawakami K AU - Perez P AU - Munn T AU - Hasse AL AU - Garrett NR IN - Veterans Administration Medical Center, Sepulveda, California. TI - A clinical comparison of a glass ionomer cement and a microfilled composite resin in restoring root caries: two-year results. SO - General Dentistry 1991 Sep-Oct;39(5):346-9 <94> UI - 92253675 AU - Duke ES AU - Robbins JW AU - Snyder DS IN - Department of General Practice, University of Texas, Health Science Center at San Antonio, Dental School 78284. TI - Clinical evaluation of a dentinal adhesive system: three-year results. SO - Quintessence International 1991 Nov;22(11):889-95 AB - The dentinal adhesive Scotchbond 2 was evaluated with the microfilled composite resin Silux in cervical and root caries lesions for up to 3 years. Clinical criteria evaluated included retention, marginal integrity, marginal discoloration, color match, anatomic form, recurrent caries, gingival response, and postoperative sensitivity. Overall, the adhesive demonstrated improved performance over earlier dentinal adhesive systems. Retention was greatest at 3 years when available enamel margins had been etched (93%) and when root caries lesions (97%) had been restored. Other criteria were reported as generally favorable. Early findings suggest that the level of development of sclerotic dentin may influence behavior of the adhesive. The greatest difficulty was noted in lesions presenting with heavy sclerotic dentin. <95> UI - 92248174 AU - Neuenschwander D TI - Overlay bit restorer as a Phase 1 orthotic. [Review] [12 refs] SO - Cranio Clinics International 1991;1(2):185-92 AB - Phase 1 (reversible) orthotic therapy is often complicated by missing teeth or the fragile nature of the materials used to construct appliances that must function under the pressures of mastication. The bite restorer combines the strength of Vitallium with the occlusal acceptability of Anodyne to produce an esthetic and functional orthotic without the ill effects of cast metallic overlays. The author uses his experience as a certified dental technician to discuss arch and tooth preparation, clasping, and proper impression technique. [References: 12] <96> UI - 92267269 AU - Barr-Agholme M AU - Oden A AU - Dahllof G AU - Modeer T IN - Department of Pedodontics, Karolinska Institutet, Huddinge, Sweden. TI - A two-year clinical study of light-cured composite and amalgam restorations in primary molars. SO - Dental Materials 1991 Oct;7(4):230-3 AB - The object of this prospective study was to compare the clinical behavior of composite and amalgam restorations with respect to anatomical form, marginal adaptation, caries adjacent to margin, and post-operative sensitivity. We selected children (n = 43) with an average age of 6.4 yr exhibiting proximal caries lesions in primary molars distributed on both left and right sides. In each child, one amalgam and one composite side were randomly chosen, resulting in 64 fillings for composite and 55 for amalgam. After a two-year period, significantly (p less than 0.05) more composite fillings (88%) were clinically classified as satisfactory compared with amalgam fillings (68%). No significant relationship was found between the success rate of proximal filling