Faculty Bibliography

PURPOSE/OBJECTIVE:To compare the clinical performance of a self-etching adhesive with that of a popular etch-and-rinse adhesive in Class I posterior composite restorations. METHODS:60 Class I resin composite restorations (30 per group) were placed in matched pairs using either the self-etch adhesive Xeno III and the microhybrid resin composite Esthet-X or the etch-and-rinse adhesive OptiBond Solo Plus and Point 4 microhybrid resin composite. Subjects were interviewed via telephone 1 week after restoration placement to assess early post-operative sensitivity. In addition, the restorations were evaluated clinically for post-operative sensitivity, marginal quality, wear, and other characteristics immediately after placement and at 6, 12, 18, and 36 months from baseline. RESULTS:During the first week after placement, subjects reported that 23% of restorations in each group had post-operative sensitivity. Sensitivity decreased greatly with time, and differences between the two groups were never statistically significant. Marginal integrity and discoloration were similar for each group at each recall evaluation. Wear of both resin composites increased over time, but mean wear remained at less than 100 microm for each resin composite at 3 years.

BACKGROUND:One approach to controlling dental unit waterline (DUWL) contamination by microorganisms is the addition of chemical cleaners to the treatment water. Yet, there is concern that these cleaners might affect the bonding of resin-based composites to enamel and dentin. The authors evaluated the influence of DUWL cleaners on composite-to-dentin bond strengths. METHODS:The authors tested the strength of resin-based composite bonded to dentin in specimens treated with distilled water (control) or one of four cleaners. They tested a total-etch adhesive, a self-etching primer/adhesive and an experimental self-etching primer/ adhesive. The authors stored the specimens for 24 hours at 37 C and tested them to determine their bond strengths. RESULTS:The mean shear bond strengths (SBSs) varied according to the cleaner and adhesive used, ranging from 14.7 to 21.9 megapascals. However, the authors found no statistically significant differences and/or interactions between mean SBSs of specimens treated with the various DUWL cleaners and adhesives (P > or = .05). CONCLUSIONS:The tested DUWL cleaners did not significantly influence composite-to-dentin bond strengths for the total-etch adhesive and self-etching primer/adhesives used in this study. CLINICAL IMPLICATIONS. The conclusions imply that bonding of resin-based composites to dentin is not affected by the cleaners tested when they are used to treat DUWL contamination.

This randomized clinical trial compared the performance of an all-in-one adhesive (iBond) applied in sclerotic and non-sclerotic non-carious cervical lesions with that of a three-step etch-prime-bond adhesive (Gluma Solid Bond, SB). One-hundred and five lesions were randomly assigned to four groups according to adhesive, sclerosis scale and technique: 1) SB applied to lesions with sclerosis scale 1 and 2 (n=26); 2) iBond applied to lesions with sclerosis scale 1 and 2 (n=28); 3) iBond applied to lesions with sclerosis scale 3 and 4 (n=25) and 4) iBond applied with prior acid-etching to lesions with sclerosis scale 3 and 4 (n=26). A microfilled composite (Durafill VS) was used as the restorative material. The restorations were evaluated for retention, color match, marginal adaptation, anatomic form, cavosurface margin discoloration, secondary caries, pre- and post-operative sensitivity, surface texture and fracture at insertion (baseline), 6, 18 months and at 3 years using modified USPHS evaluation criteria (Alfa=excellent; Bravo=clinically acceptable; Charlie=clinically unacceptable). There was a high percentage of Bravo scores for marginal adaptation (4%-32%) and marginal discoloration (18%-60%) in Groups 2, 3 and 4, but all groups had <5% Charlie scores at 6 months and <10% Charlie scores at 18 months for retention and marginal discoloration, respectively. However, it should be noted that 13% of the restorations in Group 4 were not retained at three years.

UNLABELLED:Coronal fractures of the anterior teeth are a common form of dental trauma that mainly affects children and adolescents. One of the options for managing coronal tooth fractures when the tooth fragment is available and there is no or minimal violation of the biological width is the reattachment of the dental fragment. Reattachment of fractured tooth fragments can provide good and long-lasting esthetics (because the tooth's original anatomic form, color, and surface texture are maintained). It also restores function, provides a positive psychological response, and is a relatively simple procedure. Patient cooperation and understanding of the limitations of the treatment is of utmost importance for good prognosis. This article reports on two coronal tooth fracture cases that were successfully treated using tooth fragment reattachment. CLINICAL SIGNIFICANCE/CONCLUSIONS:Reattachment of fractured tooth fragments offers a viable restorative option for the clinician because ot restores tooth function and esthetics with the use of a very conservative and cost-effective approach.

In the previous Journal of Esthetic and Restorative Dentistry's Talking with Patients, we defined occlusion and malocclusion and discussed when and why malocclusion is a concern. In this issue we will discuss the diagnosis and treatment of malocclusions.