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Two-year clinical evaluation of three restorative materials in primary molars. Meyer-Lueckel H, Bitter, K, Paris S. Randomized controlled clinical trial on proximal caries infiltration: Three-year follow-up. 87. van’t Hof MA, Frenecken JE, van Palenstein Helderman WH, Holmgren CJ. Pediatric Dentistry is the practice of dentistry concerned with the dental problems of children, proper maintenance, and treatment. Clinical performance of resin-modified glass ionomer cement restorations in primary teeth. Chicago, Ill.: American Academy of Pediatric Dentistry; 1991:57-9. Restorative Resin. Two-year clinical per-formance of a nanofiller vs a fine-particle hybrid resin composite. Atieh M. Stainless steel crown versus modified open-sandwich restorations for primary molars: A 2-year randomized clinical trial. Helping your child achieve a healthy, beautiful smile sometimes requires additional cosmetic or restorative dental treatment. We discussed potential preventive/restorative alternatives and disagreed on the kind of restorative material to use, since amalgam has been criticized and composites dominate restorative dentistry. J Am Med Assoc 2006;295(15):1775-83. Community dental officers’ use and knowledge of restorative techniques for primary molars: An audit of two trusts in Wales. Caries Res 2013;47(2):103-9. They are used more frequently in patients whose treatment is performed under sedation or general anesthesia.97-99, There are very few prospective RCTs comparing outcomes for preformed metal crowns to intra-coronal restorations.100,101 A Cochrane review and two systematic reviews conclude that the majority of clinical evidence for the use of preformed metal crowns has come from nonrandomized and retrospective studies.16,97-99 However, this evidence suggests that preformed metal crowns showed greater longevity than amalgam restorations,16 despite possible study bias of placing SSCs on teeth more damaged by caries.98,99,102 Five studies which retrospectively compared Class II amalgam to preformed metal crowns showed an average five year failure rate of 26 percent for amalgam and seven percent for preformed metal crowns.98, A two-year RCT regarding restoration of primary teeth that had undergone a pulpotomy procedure found a non-significant difference in survival rate for teeth restored with preformed metal crowns (95 percent) versus resin modified glass ionomer/composite restoration (92.5 percent).100 In another prospective study, significantly fewer restoration failures and improved calcium hydroxide pulpotomy success were found with preformed metal crowns (79.7 percent) versus amalgam restorations (60 percent) after one year.103 However, a systematic review did not show strong evidence that preformed metal crowns were superior over other restorations for pulpo-tomized teeth.104, With regards to gingival health adjacent to preformed metal crowns, a one year RCT showed no difference in gingival inflammation between preformed metal crowns and composite restorations after pulpotomy.99 Yet, a two year randomized clinical study showed more gingival bleeding for preformed metal crowns vs. composite/glass ionomer restorations.100 Inadequately contoured crown and residues of set cement remaining in contact with the gingival sulcus aresuggested as reasons for gingivitis associated with preformed metal crowns, and a preventive regime including oral hygiene instruction is recommended to be incorporated into the treatment plan.98. Restorative Materials in Pediatric Dentistry S.Lal, DDS Course Director Preventive Materials 1. Federal Register 75: Issue 112 (Friday, June 11, 2010). Due to the young age of children treated and associated behavior guidance difficulty, it is sometimes impossible to isolate teeth for the placement of composite restorations. Understfanding dentists’ restorative treatment decisions. Sheiham A. Innes NP, Ricketts D, Evans DJ. Therefore, use of SSCs is supported on high-risk children with large or multi-surface cavitated or non-cavitated lesions on primary molars, especially when children require advanced behavioral guidance techniques126 including general anesthesia for the provision of restorative dental care. However, a high dropout rate was observed in this study limiting its significance.83 In general, there is insufficient evidence to support the use of RMGIC as long-term restorations in permanent teeth. 9. Welbury RR, Shaw AJ, Murray JJ, Gordon PH, McCabe JF. Pediatr Dent 2002;24(5):511-6. 1. Dent Mater 1994;10(2):78-82. Minguez N, Ellacuria J, Soler JI, Triana R, Ibaseta G. Advances in the history of composite resins. Kupietzky A, Waggoner WE, Galea J. 113. Community Dent Oral Epidemiol 2013;41(1):79-96. Community Dent Health 2012;29(2):173-8. Dr. Jeff Johnson Division of Pediatric Dentistry Department of Oral Health Science University of Kentucky Pulp Therapy in Pediatric Dentistry --A Review- Despite the modern advances in prevention of dental caries and an increased understanding of the importance of maintaining the natural dentition, many teeth are still lost prematurely. J Am Dent Assoc 2001;132(8):1153-61. Evidence from a meta-analysis shows enamel and dentin bonding agents decrease marginal staining and detectable margins for the different types of composites. Hutcheson C, Seale NS, McWhorter A, Kerins C, Wright J. Multi-surface composite vs stainless steel crown restorations after mineral trioxide aggregate pulpotomy: A randomized controlled trial. Recommendation: There is strong evidence that dental amalgam is efficacious in the restoration of Class I and Class II cavity restorations in primary and permanent teeth. There are many challenges for the physical properties of the ideal dental restorative material. 21. 125. 54. Commercial Supporter: Volume 40 eBook 4. 121. The major advantage of this technique is the avoidance of aspects that commonly solicit anxiety in pediatric patients, such as noise, vibration, and lo… Trends in Restorative Dentistry February 20, 2019. The risks of restorative therapy include reducing the longevity of teeth by making them more susceptible to fracture, recurrent lesions, restoration failure, pulp exposure during caries excavation, future pulpal complications, and iatrogenic damage to adjacent teeth.14,15 Primary teeth may be more susceptible to restoration failuresthan permanent teeth.16 Additionally, before restoration of primary teeth, one needs to consider the length of time re-maining prior to tooth exfoliation. Pediatr Dent 2016;38(7):519-22. Tellez M, Gomez J, Kaur S, Pretty IA, Ellwood R, Ismail AI. 64. Mandari GJ, Frencken JE, van’t Hof MA. Color stability of esthetic restorative materials used in pediatric dentistry: An in vitro study J Indian Soc Pedod Prev Dent . 26. Bisphenol A and related compounds in dental materials. 41. Bazargan H, Chopra S, Gatonye L, Jones H, Kaur T. Permanent restorations on pulpotomized primary molars: An evidence-based review of the literature. Pediatric restorative dentistry involves the use of many materials. Clinical decision-making for caries management of primary teeth. Pediatr Dent 2016;38(1):42-6. Cochrane Database Syst Rev 2015;(11):CD010431. Tyas MJ. 3. Cildir SK, Sandalli N. Fluoride release/uptake of glass-ionomer cements and polyacid-modified composite resins. The chronic recommendation of pediatric drugs could exhibit erosive and cariogenic problems. Br Dent J 2004;197 (11):697-701. Based on the need of restorative treatments due to dental caries in young patients, this chapter deals with the characterization of dental materials used for restorative techniques in primary … Preformed metal crowns Preformed metal crowns also known as SSCs are prefabricated crown forms that are adapted to individual teeth and cemented with a biocompatible luting agent. 109. Br Dent J 2005;199(7):435-5. Bjørndal L, Reit C, Bruun G, et al. Direct Esthetic Adhesive Restorative Materials Susana Ferreira, DDS; Gerard Kugel, DMD, MS, PhD; Stephen Martin, DMD; Jack Ferracane, PhD. Dent Mater 2013;29 (2):191-8. 111. Lula EC, Monteiro-Neto V, Alves CM, Ribeiro CC. Pediatr Dent 2001;23(1):28-31. Restorative dentistry is the study, practice and treatment of diseases of the teeth in order to bring it back to its original healthy state. The assessment of evidence for each topic was based on a modification of the American Dental Association’s grading of recommendations: strong evidence (based on well-executed RCTs, meta-analyses, or systematic reviews); evidence in favor (based on weaker evidence from clinical trials).4, When to restore Historically, the management of dental caries was based on the belief that caries was a progressive disease that eventually destroyed the tooth unless there was surgical and restorative intervention.5 It is now recognized that restorative treatment of dental caries alone does not stop the disease process,6 and restorations have a finite lifespan. 96. 6 Describe the use of tooth-whitening products in the esthetic aspect of restorative dentistry. Dental amalgam is an old material of choice for restoration of primary and permanent teeth and is still being used in many countries. Full evaluation and abstraction included examination of the clinical efficacy on specific restorative dentistry topics, research methods, and potential for study bias (e.g., patient recruitment, randomization, blinding, subject loss, sample size estimates, conflicts of interest, statistics). These products showed improvement in handling characteristics, decreased setting time, increased strength, and improved wear resistance.69,70 All glass ionomers have several properties that make them favorable for use in children including: chemical bonding to both enamel and dentin; thermal expansion similar to that of tooth structure; biocompatibility; uptake and release of fluoride; and decreased moisture sensitivity when compared to resins. American Academy of Pediatric Dentistry. J Am Dent Assoc 1998; 129(1):55-66. restorative materials - Free download as Powerpoint Presentation (.ppt), PDF File (.pdf), Text File (.txt) or view presentation slides online. J Evid Based Dent Pract 2012;12(2):110-2. This moisture can trigger a reaction that releases fluoride and buffers acidic environments.91,92 Considering the ability to release fluoride, esthetic value, and simple handling properties of compomer, it can be useful in pediatric dentistry.90, Based on a recent RCT, the longevity of Class I compomer restorations in primary teeth was not statistically different compared to amalgam, but compomers were found to need replacement more frequently due to recurrent caries.46 In Class II compomer restorations in primary teeth, the risk of developing secondary caries and failure did not increase over a two-year period in primary molars.54,93 Compomers also have reported comparable clinical performance to composite with respect to color matching, cavo-surface discoloration, anatomical form, and marginal integrity and secondary caries.94,95 Most RCTs showed that compomer tends to have better physical properties compared to glass ionomer and resin modified glass ionomer cements and in primary teeth, but no significant difference was found in cariostatic effects of compomer compared to these materials.49,93,96. 127. ITR: Interim therapeutic restoration. 1. Minimally invasive resin infiltration of arrested white-spot lesions. 85. The remaining evidence is case reports and expert opinion concerning indications for use of preformed metal crowns on permanent molars. Ismail AI, Sohn W, Tellez M, et al. 50. In cases where isolation or patient cooperation is in question, resin-based composite may not be the restorative material of choice.61, Bisphenol A (BPA) and its derivatives are components of resin-based dental sealants and composites. Fluoride is released from glass ionomer and taken up by the surrounding enamel and dentin, resulting in teeth that are less susceptible to acid challenge.71,72 One study has shown that fluoride release can occur for at least one year.73 Glass ionomers can act as a reservoir of fluoride, as uptake can occur from dentifrices, mouth rinses, and topical fluoride applications.74,75 This fluoride protection, useful in patients at high risk for caries, has led to the use of glass ionomers as luting cement for SSCs, space maintainers, and orthodontic bands.76, Regarding use of conventional glass ionomers in primary teeth, one RCT showed the overall median time from treatment to failure of glass ionomer restored teeth was 1.2 years.49 Based on findings of a systematic review and meta-analysis, conventional glass ionomers are not recommended for Class II restorations in primary molars.77,78 Conventional glass ionomer restorations have other drawbacks such as poor anatomical form and marginal integrity.79,80 Composite restorations were more successful than GICs where moisture control was not a problem.78, Resin-modified glass-ionomer cements (RMGICs), with the acid-base polymerization supplemented by a second resin light cure polymerization, have been shown to be efficacious in primary teeth. 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