Abstract
ObjectivesRemoval of esthetic restorations leads to loss of tooth structure and the extent of the loss is difficult to estimate due to exact-shade matching. This randomized double-blinded in vitro study aimed examining the influence of a white-opaque flowable composite depth marker as an optical removal aid for tooth substance preservation and shortened restoration removal time.Materials and methodsClass II cavities (n = 100) in extracted healthy mandibular molars (n = 50, two runs) were prepared, filled, and the restoration removed. Tooth weight and volume (before and after) and removal time were measured and remnants visually documented. An optimal tooth shade-matched flowable composite liner was used as control.ResultsTooth structure loss was significantly lower using a white-opaque liner. Mean values for volume/weight loss were 0.037 ± 0.030 g and 0.016 ± 0.005 cm3 (p < 0.01) for white-opaque liner; 0.067 ± 0.000 g and 0.028 ± 0.003 cm3 (p < 0.01) for tooth-colored composite. Removal time and number of pulp chamber perforations showed no significant differences (p = 0.80).ConclusionsWithin the limitations of this randomized double-blinded in vitro study, the use of a white-opaque flowable liner as a depth marker may provide the practitioner a visual aid in the replacement of a composite restoration and may protect against tooth structure loss.Clinical relevanceWhen restoration replacement is indicated, removal of esthetic restorations often causes tooth structure loss due to difficult optical color matching. Using a white-opaque flowable liner as a depth marker clinically aids in restoration removal and protects against tooth structure loss.
Highlights
An increased interest in tooth-colored restorations has been noticed and attributed to medical and esthetic reasons [1,2,3,4]
The decision has been made despite the conclusion of the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) at the European Union (EU) Commission, only minor health risks are associated with amalgam as well as other dental restorations [6]
The increased use of composite resin is of concern when one considers the longevity of such restorations [7] compared to amalgam and the common practice of replacement instead of repair of restorations adopted by dental providers
Summary
An increased interest in tooth-colored restorations has been noticed and attributed to medical and esthetic reasons [1,2,3,4]. With modern dentistry’s focus on minimally invasive work, there is a desire to guard against the unnecessary or iatrogenic expansion of preparation dimensions [11], which is extremely difficult today due to optimally color-matched plastic restorations; because of low contrast, confidently differentiating between restoration material and tooth structure is not easy even for dentists with many years of professional experience [12] This in vitro study evaluated the ability of a white-opaque flowable composite resin liner used as a depth marker in class II cavities prior to composite resin placement as a means to preserve tooth structure in case of restoration replacement. The study was designed to test the null hypothesis that a white-opaque flowable composite resin liner would not increase the extension of the preparation with a unnecessary removal of dentin compared to preparations completed using a conventional technique/tooth-colored flowable liner
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