Research Summaries in Focus
Summarized & Presented by:
Mohammad Adnan Abu Khalifeh – BDS
• Assistant Editor, Smile Dental Journal
• e-communication Committee Vice President, JDA
• Health Editor, UMEN MAGAZINE
• Co-Owner, Dental Lounge/Smile Studio,
Amman – Jordan | email@example.com
A Retrospective Study of the 3-Year Survival
Rate of Resin-Modified Glass-Ionomer Cement
Class II Restorations in Primary Molars
Webman M, Mulki E, Roldan R, Arevalo O, Roberts JF, Garcia-
J Clin Pediatr Dent. 2016 Winter;40(1):8-13
To determine the three-year survival rate of Class II resin-modified glass-ionomer cement (RMGIC), Vitremer, restorations in primary molars and to compare these results with measurements of survival of Class II restorations of standard restorative materials.
Data on Class II restorations placed in primary molars during a six-year period were collected through a chart review and radiographic evaluation in the office of a board-certified pediatric dentist. A radiograph showing that the restoration was intact was required at least 3 years after placement to qualify as successful. If no radiograph existed, the restoration was excluded. If the restoration was not found to be intact radiographically or was charted as having been replaced before three years it was recorded as a failure. The results of this study were then compared to other standard restorative materials using normalized annual failure rates.
Of the 1,231 Class II resinmodified glass-ionomer cement restorations placed over six years 427 met the inclusion criteria. There was a 97.42% survival rate for a 3-year period equivalent to an annual failure rate of 0.86%.
A novel approach comparing materials showed that in this study Vitremer compared very favorably to previously published success rates of other standard restorative materials (amalgam, composite, stainless steel crown, compomer) and other RMGIC studies.
Clinical Procedures for Revitalization:
Int Endod J. 2015 Dec 30. doi: 10.1111/iej.12606.
[Epub ahead of print]
The purpose of this study is to report retrospectively the Revitalization or regenerative treatment approaches in teeth with incomplete root formation and pulp necrosis have become part of the therapeutic endodontic spectrum and should be considered as an alternative to conventional apexification. Ideally, regenerative endodontic procedures allow not only for a resolution of pain, inflammation and periapical lesions, but also for the formation of an immunocompetent tissue inside the root canal which can reconstitute the original biological structure and function of dental pulp and thus lead to an increase of root length, and thickness and strength of previously thin, fracture-prone dentine walls. Common features of regenerative procedures performed in immature teeth with pulp necrosis include 1) minimal or no instrumentation of the dentinal walls, 2) disinfection with irrigants, 3) application of an intracanal medicament, 4) provocation of bleeding into the canal and creation of a blood clot, 5) capping with calcium silicate and 6) coronal seal. Although case reports and case series provide promising results, the protocol for regenerative endodontic treatment is not fully established; questions remain regarding the terminology, patient selection and informed consent as well as procedural details, especially on the choice of irrigants, intracanal medicaments and materials for cavity sealing. Animal studies document repair rather than regeneration, which opens the discussion on prognosis and outcome, especially the biological versus the patient-based outcome. This review will provide an overview of the current state of regenerative endodontic therapies, discuss open questions and provide recommendations based on the recent literature.
Cuspal Deflection of Premolars Restored
with Bulk-Fill Composite Resins
Behery H, El-Mowafy O, El-Badrawy W, Saleh B, Nabih S
J Esthet Restor Dent. 2016 Mar;28(2):122-30
This in vitro study compared cuspal deflection of premolars restored with three bulk-fill composite resins to that of incrementally-restored ones with a low-shrinkage silorane-based restorative material.
MATERIALS AND METHODS
Forty freshly-extracted intact human upper premolars were used. Reference points at buccal and palatal cusp tips were acid-etched and composite rods were horizontally bonded to them (TPH-Spectra-HV, Dentsply). Two acrylic resin guiding paths were made for each premolar to guide beaks of a digital micrometer used for cuspal deflection measurements. Standardized MOD cavities, 3 mm wide bucco-lingually and 3.5 mm deep, were prepared on each premolar. Prepared teeth were then equally divided into four groups (n = 10) and each group was assigned to one of four composite resin (QuiXX, Dentsply; X-tra fil, Voco; Tetric EvoCeram Bulk Fill, Ivoclar Vivadent; low-shrinkage Filtek LS, 3M/ESPE). Adper Single Bond-Plus, 3M/ESPE was used with all bulk-fill restoratives. LS-System Adhesive, 3M/ESPE was used with Filtek LS. For each prepared premolar, cuspal deflection was measured in microns as the difference between two readings between reference points before and after restoration completion. Means and SDs were calculated and data statistically-analyzed using One-way ANOVA and Tukey’s test.
Filtek LS showed the lowest mean cuspal deflection value 6.4(0.84)μm followed by Tetric EvoCeram Bulk Fill 10.1(1.2) μm and X-tra fil 12.4(1.35)μm, while QuiXX showed the highest mean 13(1.05)μm. ANOVA indicated significant difference among mean values of groups (p < 0.001). Tukey’s test indicated no significant difference in mean values between QuiXX and X-tra fil (p = 0.637).
Tetric EvoCeram Bulk Fill had significantly lower mean cuspal deflection compared with the two other bulkfill composite resins tested. Filtek LS had the lowest significant mean cuspal deflection in comparison to all tested bulk-fill restoratives.
The use of Tetric EvoCeram Bulk fill composite resin restorative for class II MOD cavities resulted in reduced cuspal deflection in comparison to the two other bulkfill composite resins tested. The silorane-based Filtek LS restorative resulted in the least cuspal deflection in comparison to all tested bulk-fill composite restoratives.