Abstract
Objective: To evaluate the influence of cavosurface vestibular bevel (CSVB) application on the clinical success (CS) of class IV restorations of traumatized permanent teeth, the influence of the number of fracture angles and dental trauma recurrence (DTR) on the restorations retention rate (RRR) and incidence of pulp necrosis (PN). Material and Methods: Fifty-seven children and adolescents with enamel and dentin fractures requiring C-IV restorations were randomly allocated in groups with CSVB and without CSVB. The primary outcomes were the CS of restorations, evaluated using modified USPHS criteria, and the incidence of PN after a 6-months follow-up. As secondary outcomes, the influence of the number of fractured angles and the DTR on the RRR and on the incidence of PN were evaluated (p>0.05). Results: Of 57 children and adolescents, 74 teeth were restored, and 71 completed the six-month follow-up analysis. Teeth restored with and without CSVB displayed similar CS as well as the same incidence of PN (p>0.05). The number of fractured angles did not influence the RRR and DTR was not associated with PN (p>0.05). DTR was associated with a lower RRR (p<0.001). Conclusion: Cavosurface vestibular bevel did not influence the clinical success of Class IV restorations or incidence of PN after 6-months follow-up. DTR did not influence the incidence of pulp necrosis, but did negatively influence the restorations retention rate. The number of fracture angles did not influenced in the restorations retention rate.
Highlights
Dental trauma (DT) is a common health problem in the child and adolescent population
Cavosurface vestibular bevel did not influence the clinical success of Class IV restorations or incidence of pulp necrosis (PN) after 6-months follow-up
Previous authors evaluated the clinical performance of anterior restorations through a systematic review: upon isolating the eight studies that evaluated class IV restorations, it was noticed that the majority of studies were carried out between 1977 and 1997, using many materials that are no longer available on the market and techniques that are not widely in use currently [7]
Summary
Dental trauma (DT) is a common health problem in the child and adolescent population. In cases where fragment bonding cannot be performed, restoration using composite resin is considered the more conservative treatment for teeth with enamel and dentin fractures, requiring minimal dental preparation [2]. The influence of this technique on the clinical performance of previous restorations remains debatable [4,5,6]. Previous authors evaluated the clinical performance of anterior restorations through a systematic review: upon isolating the eight studies that evaluated class IV restorations, it was noticed that the majority of studies were carried out between 1977 and 1997, using many materials that are no longer available on the market and techniques that are not widely in use currently [7]. None of the included studies evaluated the direct influence of the bevel on restoration clinical performance since they did not adopt the enamel preparation as a single variable to be studied [7]
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