Faculty Bibliography

PURPOSE/OBJECTIVE:This study evaluated bond strengths of six one-bottle bonding agents and a control (primer plus unfilled resin) to moist enamel. MATERIALS AND METHODS/METHODS:One-hundred and five bovine teeth were randomly assigned to seven groups of 15. Enamel was etched for 15 seconds with 35% phosphoric acid. Etched enamel was rinsed, and excess water was blotted with tissue paper. Following application of the adhesive, composite resin was bonded using a gelatin capsule technique. Shear bond strengths to enamel were determined using a universal testing machine (Instron Corp., Canton, Massachusetts). RESULTS:Mean bond strengths ranged from 21.9 MPa for OptiBond Solo (Kerr Corp., Orange, California) to 29.6 MPa for Prime & Bond 2.1 (Dentsply/Caulk, Milford, Delaware). Prime & Bond 2.1 had a significantly higher mean bond strength than the other adhesives. CLINICAL SIGNIFICANCE/CONCLUSIONS:The results of this study suggest that all of the one-bottle systems tested should provide clinically acceptable bonding to moist enamel.

OBJECTIVE:The purpose of this investigation was to evaluate the influence of finishing and polishing procedures on the decision to replace existing amalgam restorations. METHOD AND MATERIALS/METHODS:Twenty Class I and Class II amalgam restorations, free from obvious defects, were selected in 6 patients. The restorations were photographed before and after being submitted to a standard finishing and polishing procedure. In the first phase, the preoperative slides were examined by 27 clinicians and senior dental students, who were instructed to inspect each restoration and answer a questionnaire indicating if and why the restoration needed to be replaced. Two weeks later, the postoperative slides were presented to the same examiners, who were asked to answer the same questionnaire as before. RESULTS:At the first phase, there were 236 decisions (44%) to replace existing amalgam restorations. Following the finishing and polishing procedures, 114 decisions (21%) were made to replace existing amalgam restorations. This difference was statistically significant. Secondary caries was the most common reason for replacement. CONCLUSION/CONCLUSIONS:The finishing and polishing procedure reversed the decision to replace old amalgam restorations.

OBJECTIVE:The purpose of this project was to evaluate the performance of a dentin adhesive system on carious and noncarious primary dentin in vivo. METHOD AND MATERIALS/METHODS:Forty-eight primary molars with carious lesions were randomly assigned to 2 different treatments: group 1 (control, n = 24)--All identifiable, irreversibly infected dentin was removed prior to the application of the bonding agent and restorative material; group 2 (experimental, n = 24)--Irreversibly infected dentin was partially removed prior to the application of the bonding agent and restorative material. The control and experimental teeth were clinically monitored every 3 months and evaluated 12 months after restoration. The teeth were extracted around the time of exfoliation and processed for scanning electron microscopy. RESULTS:Retention rate, marginal integrity, and pulpal symptoms were identical in both groups. Radiographically, the radiolucent area associated with the experimental restorations did not increase with time in 75% of the cases. For the control group, the adhesive system formed a hybrid layer. In the experimental group, there was morphologic evidence of the formation of an acid-resistant "altered hybrid layer." An acid-resistant tissue, resulting from the interdiffusion of adhesive resin within the area of carious dentin, was observed adjacent to and under the altered hybrid layer. CONCLUSION/CONCLUSIONS:Application of an adhesive restorative system to irreversibly infected dentin did not affect the clinical performance of the restoration.

Due to the development of sound clinical procedures and evolution of advanced restorative materials, composite resins are being used with increasing frequency for direct posterior applications. When the clinical protocol for the use of composite resin is performed properly, this material can be utilized with success and predictability. This article presents the advantages and limitations of this restorative modality. It also reviews the characteristics of contemporary composite resin materials and demonstrates the treatment protocol that is utilized to achieve aesthetic restorations in the posterior segment.