1,721,198 research outputs found
Teaching of composite restoration repair: Trends and quality of teaching over the past 20 years
No full textObjectives: Repairs are frequently taught at dental schools around the world. Various studies regarding the teaching of composite repairs were performed over the past 20 years. However, it is unclear if teaching reflects current evidence and if clinical recommendations have changed over time.
Sources: Electronic databases (Embase, Scopus, PubMed) were searched.
Study selection: Studies reporting on teaching concepts (i.e. recommended treatment steps) were included. Teaching was analysed regarding key treatment steps for conditioning of the repair surface (use of (1) diamond burs, (2) air abrasion/silica coating, (3) application of silane or universal primers, and (4) application of adhesives) using random-effects meta-analyses, meta-regressions, and an overall quality score.
Data: 63 records were assessed, and 12 studies having surveyed 331 dental schools were included. The mean (95 % CI) proportion of dental schools teaching the use of diamond burs for roughening of the repair surface amounted to 83.0 % (71.0-90.7 %). Air abrasion / silica coating, the use of silane/universal primers and adhesives was taught by 29.8 % (18.7-44.1 %), 32.4 % (21.1-46.2 %), and 86.4 % (73.5-93.6 %), respectively. In recent years, dental schools more often taught the use of adhesives (padj. = 0.012) and the mean overall quality score of teaching improved (p = 0.007).
Conclusions: Share of dental schools recommending most of the key treatment steps did not significantly increase over the past 20 years. However, the overall quality of teaching improved, and teaching is nowadays more consistent with recently published recommendations.
Clinical significance: Repairs are not only frequently taught, but the mean overall quality score did improve in recent years
Effect of Repairing Endodontic Access Cavities on Survival of Single Crowns and Retainer Restorations
No full textIntroduction: This retrospective study aimed to analyze the effect of repairing endodontic access cavities with composite on the survival of single crowns and retainer restorations of fixed or removable dental prostheses.
Methods: Dental records of patients attending a university dental clinic were retrospectively screened for single crowns and retainer restorations receiving endodontic treatment after crown placement. Survival (no further intervention) and failure (removal, loss or replacement of crown, replacement of access restoration, or recementation of restoration) of crowns and retainers with repaired endodontic access cavities were recorded. The mean annual failure rates were calculated, and the effect of individual-, tooth-, and restoration-related variables on survival was assessed by univariate log-rank tests and multivariate Cox regression analyses with shared frailty (P < .05).
Results: One hundred eighty repaired crowns/retainers placed in 151 patients were included (4.5 ± 3.3 years follow-up). Survival after 2, 5, 7, and 10 years amounted to 82.7%, 71.5%, 67.3%, and 48.8% (mean annual failure rate = 9.0%, 6.5%, 5.5%, and 6.9%), respectively. Although tooth type, kind of restoration, endodontic irrigant, repair conditioning methods, and kind of composite affected survival in the univariate regression analyses, only the kind of restoration (single crown vs retainer restoration) remained significant in the multivariate Cox regression model.
Conclusions: Repairing endodontic access cavities with composite increases the longevity of single crowns and retainer restorations
Dentale Erosionen – Von der Diagnose zur Therapie
No full textIm Bereich der Zahnerhaltung rückten erosive Zahnhartsubstanzdefekte aufgrund des Kariesrückgangs in den letzten Jahrzehnten zunehmend in den Fokus. Ebenfalls begünstigen der zunehmende Konsum saurer Lebensmittel und (Light-)Softdrinks sowie Lifestylefaktoren die Entstehung und Progression erosiver Zahnhartsubstanzdefekte. Dieser Artikel gibt einen Überblick über Ursachen, Diagnostik und Prävention von erosivem Zahnhartsubstanzverlust. Dabei werden sowohl präventive als auch invasive Maßnahmen sowie konkrete Tipps für die Umsetzung in der Praxis vorgestellt
Dentale Erosionen – Von der Diagnose zur Therapie
No full textIm Bereich der Zahnerhaltung rückten erosive Zahnhartsubstanzdefekte aufgrund des Kariesrückgangs in den letzten Jahrzehnten zunehmend in den Fokus. Ebenfalls begünstigen der zunehmende Konsum saurer Lebensmittel und (Light-)Softdrinks sowie Lifestylefaktoren die Entstehung und Progression erosiver Zahnhartsubstanzdefekte. Dieser Artikel gibt einen Überblick über Ursachen, Diagnostik und Prävention von erosivem Zahnhartsubstanzverlust. Dabei werden sowohl präventive als auch invasive Maßnahmen sowie konkrete Tipps für die Umsetzung in der Praxis vorgestellt
Randomised in situ trial on the effect of milk and CPP-ACP on dental erosion
Full text linkOBJECTIVES This randomised in situ study aimed to analyse the effect of milk (with or without 5ppm F) and CPP-ACP pastes (with or without 900ppm F) on dental erosion. METHODS The study was a seven phase (5 days each) crossover design involving 15 participants wearing intraoral appliances with enamel and dentine specimens. Specimens were extraorally eroded (erosive soft drink, 6×90s/day) and brushed (2×30s/day, 2N) using a non-fluoridated toothpaste (negative control). The test products were milk, milk+5ppm F (twice daily, each 100ml/2min), CPP-ACP paste, CPP-ACP paste+900ppm F (3min/day) or a SnCl2/AmF/NaF mouthrinse (positive control, 30s/day), which were applied immediately after erosion with the appliances in the oral cavity. In an additional group, a fluoridated toothpaste was used without any additional test product. Tissue loss was determined profilometrically after 5 days and statistically analysed by linear mixed models methodologies (p<0.05). RESULTS Compared with the negative control (non-fluoridated toothpaste only, enamel: 2.2±1.3μm; dentine: 3.8±2.2μm), enamel and dentine loss was significantly reduced by the use of fluoridated toothpaste (enamel: 1.1±1.0μm; dentine: 2.4±1.7μm) and the SnCl2/AmF/NaF mouthrinse (1.5±1.5μm; dentine: 1.8±1.9μm). CONCLUSIONS Milk and CPP-ACP were not effective in reducing enamel and dentine loss significantly, independently of the presence of fluoride. CLINICAL SIGNIFICANCE Enamel and dentine erosion were significantly reduced by the use of a fluoridated toothpaste or a SnCl2/AmF/NaF mouthrinse, but not by milk or CPP-ACP under the conditions of the present study. CLINICAL TRIALS REGISTRATION NCT01566357
Retrospective analysis on the repair vs. replacement of composite restorations
No full textObjective: Our retrospective study aimed to assess the impact of repairs on the longevity of anterior and posterior direct composite restorations and to compare longevity of repaired and replacement restorations.
Methods: Patient records were retrospectively screened for anterior and/or posterior composite restorations with 2+ surfaces placed in permanent teeth between 2000 and 2015. During follow-up, repaired and replaced restorations were assessed and mean annual failure rates (mAFR) calculated. Outcome was considered in three levels: Success (no further intervention), survival 1 (first repair=survival, second repair=failure) and survival 2 (more than one repair=survival, all surfaces repaired=failure). Statistical analysis was performed using Kaplan-Meier statistics, log-rank tests, and multi-variate Cox-regression analyses with shared frailty (p<0.05).
Results: 8542 initial restorations placed in 3239 patients were included (4.7±4.4 years follow-up, 2.5±0.7 surfaces). Longevity of initial restorations was prolonged by repair(s) (after 10 years: success: 68.3%, mAFR: 3.7%; survival 1: 77.3%, mAFR: 2.5%; survival 2: 80.4%, mAFR: 2.2%; p<0.001). 616 repaired restorations (4.9±4.2 years follow-up, 3.5±1.0 surfaces) and 264 replacement restorations (5.6±4.1 years follow-up, 3.0±0.8 surfaces) were analyzed. Success of repaired restorations amounted to 43.4% after 10 years (mAFR: 8.0%), further repair(s) prolonged survival (survival 1: 65.7%, mAFR: 4.1%; survival 2: 74.8%, mAFR: 2.9%; p<0.001). Success of replacement restorations amounted to 48.6% after 10 years (mAFR: 7.0%), repair(s) prolonged survival (survival 1: 67.4%, mAFR: 3.9%, p=0.044; survival 2: 74.1%, mAFR: 3.0%, p=0.003).
Significance: Repairs are suitable to increase the survival of restorations; repaired restorations last as long as replacements
a review
No full textThis review describes various forms of fluoride applications for reducing dental erosive lesions induced by acidic substances. Fluoride admixtures to acidic solutions in a concentration excluding toxicologically side-effects seem unable to arrest erosive lesions. By contrast, topical fluoride applications of toothpastes, oral rinses, gels or varnishes appear to be an effective agent for reducing demineralization by erosion. In particular, high-concentrated fluoride applications are able to increase abrasion resistance and decrease the development of erosions in enamel and dentin
a review
No full textThis review describes various forms of fluoride applications for reducing dental erosive lesions induced by acidic substances. Fluoride admixtures to acidic solutions in a concentration excluding toxicologically side-effects seem unable to arrest erosive lesions. By contrast, topical fluoride applications of toothpastes, oral rinses, gels or varnishes appear to be an effective agent for reducing demineralization by erosion. In particular, high-concentrated fluoride applications are able to increase abrasion resistance and decrease the development of erosions in enamel and dentin
Cost-effectiveness of repairing versus replacing composite or amalgam restorations
No full textObjectives: Repairing instead of replacing partially defective composite or amalgam restorations might reduce the initial treatment risks and costs, but could be less advantageous long-term due to repeated re-interventions being required. This study aimed to compare the cost-effectiveness of repairing versus replacing composite or amalgam restorations.
Methods: A mixed public-private-payer perspective from the German healthcare setting was adopted. A permanent molar with a three-surfaced partially defective composite or amalgam restoration in need of repair or replacement was modelled. Risks of complications after repair or complete replacement were derived by a rapid systematic literature review. The health outcome measure was tooth retention years. Costs were estimated from the German public and private fee catalogues. Monte-Carlo microsimulations were performed and incremental-cost-effectiveness ratios (ICERs) were used to express cost differences per gain or loss of effectiveness.
Results: Compared with complete composite replacement, composite repairs were marginally more costly and more effective (€326 versus €321; 24.7 versus 24.0 years; ICER: €7.14). Amalgam repairs were more costly and more effective than complete replacement (€467 versus €326; 24.3 versus 23.7 years; ICER: €235). If composite repair costs were €166, composite repair was always cost-effective. This was not the case for amalgam repair. The size of the restoration, the reason for repair/replacement, and patients' age were found to influence the cost-effectiveness.
Conclusions: Repair was found to be more effective, but not necessarily less costly than complete replacement of restorations.
Clinical significance: Repairing instead of replacing partially defective restorations is likely to retain teeth for longer compared with complete replacement. When considering cost-effectiveness, repairing composite can be recommended more strongly than repairing amalgam restorations
Is titanium tetrafluoride (TiF4) effective to prevent carious and erosive lesions? A review of the literature
No full textThe present review summarises the effects of titanium tetrafluoride (TiF(4)) on the development and progression of carious and erosive lesions. The mode of action of TiF(4) is due to the formation of an acid-stable surface layer, which provides mechanical protection to the surface, and to an increased fluoride uptake, which might chemically reduce demineralisation of dental hard tissues. Most in vitro studies showed that TiF(4) is effective in reducing the formation of carious and erosive enamel and dentine lesions. Thereby, TiF(4) was equally or more effective than sodium fluoride (NaF), amine fluoride (AmF) or stannous fluoride (SnF(2)). While clinical data confirm the caries-preventive effect, clinical trials analysing the anti-erosive effect of TiF(4) are lacking. Few data available from in situ studies revealed conflicting results by showing either no effect or a beneficial effect of TiF(4) on enamel erosion. Even though research focused on TiF(4), there is also evidence to show that other metal fluorides, such as zirconium and hafnium tetrafluorides, affect enamel and dentine demineralisation
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