Anatomic Form Research Articles

Determination of an estimate point of rupture for intracranial aneurysms using mathematical models applied to fluids dynamics

BackgroundIntracranial aneurysms represent a potential risk factor for various comorbidities, mainly associated with its rupture. Available information for aneurysms intervention is changing a paradigm and now, the decision of operating or not, varies in co‐dependence with the patient. We present the preliminary results of a potential tool that shows high rupture probability areas, predicting early rupture risk, also as an alternative for surgical planning.ObjectiveTo describe the mathematical models that best characterize the blood flow in an aneurysm and implement them through computational simulations to define the hemodynamic properties in terms of pressure, velocity and shear rate in artery walls.Materials/MethodsUsing the software ITK snap, an angioscanography of a patient from the Fundación Santa Fe de Bogotá was segmented. This program implements the methodology of snake evolution to obtain a 3D model by creating an estimated anatomical form and calculating internal forces of the image gradient inside of a closed curve. This gradient is determined by the pixel intensity on every point of the closed curve, which can be enhanced by contrast made previously to the volume. Secondly, with the purpose of having a non‐restriction model, the software Meshlab was used. This software edits and processes a model that is composed of triangular meshes. For this, a three Laplacian smooth was implemented in the final model. Finally, the blood flow within an aneurysm was modeled using the Comsol Multiphysics software assuming that blood behaves like Newtonian fluid with laminar flow, density of 1000 kg/m3 and a dynamic viscosity of 0.0035 Pa * s, governed by conservation of momentum and mass equations. For the simulation, a free tetrahedral mesh was used, with refinement at the edges of the geometry, whose size was defined by the previously established fluid dynamics.ResultsFor our first model, the highest stress levels were found at two points of an aneurysm: at the entrance and at the wall, where the highest velocity of blood flow was present. As for the velocity of the blood, it was reduced in the model, meaning that recirculation was present which is to be expected when dealing with aneurysms. Lastly, the shear rate was highest at the neck of the aneurysm and its lowest degree inside the aneurysm.DiscussionThe mathematical models describe the behavior of different variables. The simulation of blood flow within an aneurysm model obtained from diagnostic images of a real patient generates a good approximation to the behavior of blood flow in real life.ConclusionPressure, speed and shear stress on the arterial wall are the main factors involved in the development and possible rupture of an aneurysm. The mathematical models of this preliminary study will be implemented on a larger database. By doing so, a method capable of predicting the point in which there is a greater probability of rupture in an aneurysm can be developed, based on its hemodynamic properties.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Comparison of retention of two proximal sealants in mandibular first molars of 12-year-old school children - A split-mouth randomized trial

Aim: This study was done to assess and compare the retention properties of a proximal sealant made of polyurethane dimethacrylate and a resin-based adhesive system for sealing proximal surfaces of permanent mandibular first molars in 12-year-old children over a period of 6 months. Methodology: A split-mouth randomized trial was conducted among 50 school children. Pre-operative and post-operative bitewing radiographs were taken bilaterally prior at baseline and the end of the sixth month. Separators were placed for those children who did not have physiological spacing. The interventions were delivered on the left and right sides after randomization as per the manufacturer’s instructions, and post-operative instructions were given to the participants. The interventions were assessed for retention primarily and other criteria such as color match, marginal discoloration, marginal adaptation, anatomic form, caries formation (using bitewing radiographs), post-operative sensitivity, and surface roughness at the end of the 1st, 3rd, and 6 months using United States Public Health Service Modified Ryge Criteria for Direct Clinical Evaluation of Restorations proposed by Cvar and Ryge, 1980. The data were compiled, analyzed using SPSS and results were generated. Conclusions: The study results revealed that the resin-based adhesive system was better than the adhesive patch in terms of retention over a period of 6 months. Hence, the feasibility of including proximal sealants as a part of the preventive regimen for caries risk children should be positively considered.

Retrospective evaluation of the clinical performance and longevity of porcelain laminate veneers 7 to 14 years after cementation

Statement of problemStudies on the long-term clinical assessment and longevity of porcelain laminate veneers (PLVs) are lacking. PurposeThe purpose of this clinical study was to assess the clinical performance and longevity of PLVs after 7 to 14 years of clinical service. Material and methodsPatients with PLVs placed 7 to 14 years earlier were recalled for clinical evaluation. At the recall visit, clinical parameters such as margin integrity, margin discoloration, porcelain surface, anatomic form, and secondary caries were evaluated according to the Ryge criteria. Standardized photographs of veneers were made for each participant. Data were tabulated for all descriptive criteria and analyzed statistically. The Cohen Kappa assessment was carried out to determine interrater agreement, the Kaplan-Meier survival analysis for survival probability, and the Cox regression for significance between the arches. ResultsOne hundred and fourteen veneers (83 maxillary and 31 mandibular) were evaluated in 26 participants, including 19 women restored with 87 veneers and 7 men restored with 27 veneers. Distribution of the veneers included 37 central incisors, 41 laterals, and 36 canines. The Alfa ratings for the veneers were as follows: porcelain surface (85%), anatomic form (87%), and secondary caries (96%). For margin integrity, 37% rated Alfa, 60% Bravo, and 3% Charlie. For margin discoloration, 56% rated Alfa and 44% Bravo. The overall Cohen Kappa interrater agreement was 0.7023 with an agreement rate of 88.3%. Clinical deficiencies included fracture rate of 4.35% (n=5); porcelain chipping 5.26% (n=6); caries 4% (n=4); debonding 2% (n=2); crack/craze lines 5.26% (n=6); loss of vitality 2% (n=2); and replaced veneers 4.38% (n=5). The main reason for failure was porcelain fracture. The survival rate for the veneers was 98%. The Kaplan-Meier success probability was 0.976 at 7 years and 0.882 at 14 years. ConclusionsWithin the limitations of this clinical study, PLVs exhibited an estimated survival probability of 0.976 over 7 years and 0.882 over 14 years, a high survival rate of 98%, and a low failure rate of 4.38%.

Arteriovenous forms of congenital vascular malformations of extremities: aspects of pathogenesis

The aim — to improve the results of treatment of patients with arterio‑venous forms (AVF) of congenital vascular malformation (CVM) of extremities based on the study of etiopathogenetic aspects of pathology. Materials and methods. Work is based on data of complex clinical research and surgical treatment of 155 patients with the arteriovenous forms of congenital vascular malformation of extremities. There were 65 (42 %) men, 90 (58 %) women, average age — 25.1 ± 10.4 years. The children’s age group (up to 18 years old) is formed of 53 (34 %) persons. The analysis of clinical material is viewed depending on the clinical‑anatomical forms of CVM, which were subdivided into 11 groups on the basis of «working» classification scheme «VASC +T»: I—VII — macrofistulous forms (trunkular, extratrunkular, combined), VIII — IX — micrоfistulous forms, X—XI — mixed or combined forms (with predominance of venous component and presence of single microfistulas). Distribution by prevalence: diffuse forms — groups I — IV, VIII, X; localized forms — groups V—VII, IX, XI. Assessment of chronic arterial and venous insufficiency for each patient was carried out. Results and discussion. Diffuse macrofistulous AVF of CVM are hemodynamically more severe, causing the hypertrophy of soft tissues and more expressed clinical displays of chronic arterial (26 (17 %)) and cardiac (25 (16 %)) insufficiency. Diffuse microfistulous CVM (group VIII) and mixed forms with existence of microfistulas (group X) are characterized by more severe manifestations of chronic venous hypertension (88 (56.8 %)) and vascular‑bone syndrome (56 (36 %)). The most severe manifestations of systemic hemodynamic disorders were revealed in diffuse macrofistulous forms, although, according to most parameters, disturbances in diffuse macro‑ and microfistulous AVF of CVM are comparable and of the same type. Pathomorphological (66 (45.8 %)) and immunohistochemical studies (10.7 %) revealed the presence of proliferative activity of angiomatous tissues and degenerative changes in the walls of the angiodysplastic vessels both due to developmental defects and pathological disorders of hemodynamics. The source of progression of AVF of CVM is vessels of the microvasculature (capillaries) and microfustulas, proceeding from the level of VEGF and Ki‑67. Conclusions. The study of hemodynamic and pathomorphological aspects of the pathogenesis of AVF of СVM is necessary for planning of an individual differentiated approach in diagnosis and treatment, depending on the clinical and anatomical form of the disease.

Correlation Between Postoperative Morphologic Changes of Ankle Mortise and Ankle Joint Function After Pilon Fracture

Objectives: We aimed to explore the correlation between the postoperative morphologic changes of ankle mortise and ankle joint function after Ruedi-Allgower type III pilon fracture. Methods: A retrospective analysis was performed for 60 patients with Ruedi-Allgower type III pilon fractures receiving surgical treatment. The height, width, depth, coronal angle, and sagittal angle of ankle mortise were measured based on X-ray films during the last follow-up. The ankle joint function on the injured side was scored according to the Mazur ankle grading scale, and the patients were divided into an excellent group (n = 41), a good group (n = 12), and a mediocre + poor group (n = 7). Results: The correlation between the morphologic changes of ankle mortise and function was analyzed by comparing the five indices of ankle mortise on injured and healthy sides. The injured and healthy sides had significantly different widths, depths, and coronal and sagittal angles of ankle mortise. The differences between the indices of ankle mortise on injured and healthy sides, except for that between heights, were negatively correlated with scores. The differences increased with decreasing score. Effective treatment of the width and depth, together with coronal and sagittal angles of ankle mortise, was significantly correlated with postoperative ankle joint function. Conclusions: Anatomical reduction for the width, depth, and coronal and sagittal angles of ankle mortise of patients with Ruedi-Allgower type III pilon fractures exerts significant positive effects on ankle joint function. Thus, the anatomical form of ankle mortise should be restored as much as possible during surgery.

A randomized, prospective clinical study evaluating effectiveness of a bulk-fill composite resin, a conventional composite resin and a reinforced glass ionomer in Class II cavities: one-year results.

Bulk-fill restorative materials such as bulk-fill composite resins and high viscous glass ionomer cements have become very popular materials in operative dentistry because their application is easy and time-saving.Objectives:The aim of this clinical study was to evaluate the clinical performance of a highly viscous reinforced glass ionomer material, a bulk-fill composite resin and a micro hybrid composite resin in Class II restorations.Methodology:In total, 109 Class II restorations were performed in 54 patients using three different restorative materials: Charisma Smart Composite (CSC); Filtek Bulk Fill Posterior Restorative (FBF); Equia Forte Fil (EF). Single Bond Universal adhesive (3M ESPE, Germany) was used with composite resin restorations. The restorations were evaluated using modified USPHS criteria in terms of retention, color match, marginal discoloration, anatomic form, contact point, marginal adaptation, secondary caries, postoperative sensitivity and surface texture. The data were analyzed using Chi-Square, Fischer's and McNemar's tests.Results:At the end of one year, 103 restorations were followed up. No changes were observed during the first 6 months. At the end of one year, there were small changes in composite restorations (FBF and CSC) but no statistically significant difference was observed between the clinical performances of these materials for all criteria (p>0.05). However, there was a statistically significant difference between EF, FBF and CSC groups in all parameters except marginal discoloration, secondary caries and postoperative sensitivity in one-year evaluation (p<0.05).Conclusion:Bulk-fill composite resins and conventional composite resins showed more successful clinical performance than highly viscous reinforced glass ionomers in Class II cavities.

A randomized controlled clinical trial of glass carbomer restorations in Class II cavities in primary molars: 12-month results.

To evaluate the clinical performance of Glass Carbomer (GC) (GCP Dental) in restoring Class II cavities in primary molars in comparison with resin-modified glass-ionomer cement (RMGIC) and composite resin (CR) restorations. Healthy children aged between 4 and 8 years with a proximal lesion in at least one primary molar were recruited from the Pediatric Dental Clinics. A sample of 162 molars was randomly assigned to one of the following restoration types: GC, RMGIC, and CR. The restorations were evaluated clinically using the Cvar and Ryge criteria at 6 and 12 months postoperatively. At 12 months, the success rates of anatomical form and marginal adaptation were 67% and 54% for GC, 98% and 93% for RMGIC, and 98% and 98% for CR, respectively. The GC restorations were significantly less successful than RMGIC and CR restorations in terms of anatomical form (P < .001) and marginal adaptation (P < .001). Secondary caries formation was not observed in any of the restorations in the three restorative material groups. The 12-month clinical performance of the GC restorative material was not satisfactory in restoring Class II cavities in primary molars. RMGIC and composite resin restorations performed significantly better. The use of GC cannot be recommended for restoring Class II cavities in primary molars.

Seeing with Sound: How Ultrasound Is Changing the Way We Look at Anatomy.

Ultrasound uses high frequency sound waves and their rebounding echoes to capture live images of the structures beneath the skin. Thanks to recent technological advances, contemporary ultrasound machines offer excellent image resolution packaged in smaller, highly portable devices, which has allowed ultrasound to expand into new areas, both within the hospital as well as across non-traditional settings. Ultrasound is an incredibly powerful visualization tool in medicine, allowing physicians to safely see and interrogate the most relevant parts of their patient's internal anatomy instantly. Point-of-care ultrasound, a focused ultrasound evaluation performed at the patient's bedside, is now common across medical specialties, encompassing a vast array of diagnostic, procedural and screening applications. The impressive expansion of point-of-care ultrasound has resulted in an increased demand for ultrasound training earlier during medical school. As a non-invasive and non-destructive way to see inside the living body, ultrasound is an ideal tool to teach anatomy. It allows both medical and non-medical students the ability to improve their understanding and retention of anatomical form and function. The widespread and still expanding use of ultrasound in healthcare today, as well as its adoption into the anatomy classroom, is a testament to the power of ultrasound for achieving real-time visualization of the hidden aspects of our bodies.

Восстановление анатомической формы боковых зубов с применением окклюзионной матрицы и отечественных пломбировочных материалов

Восстановление анатомической формы боковых зубов с применением окклюзионной матрицы и отечественных пломбировочных материалов

ÇÜRÜKSÜZ SERVİKAL BÖLGE DİŞ SERT DOKU KAYIPLARININ RESTORASYONUNDA UNIVERSAL DENTİN BAĞLAYICI AJAN KULLANILARAK FDI KRİTERLERİNE GÖRE DEĞERLENDİRİLMESİ

Aim: This study aimed to compare the different application modes of universal bonding agents on non-carious cervical lesions. Material and method: Twenty-five patients without any systemic disease and with good oral hygiene, having at least 20 teeth and 6 non-carious cervical lesions treated using a universal adhesive and nano hybrid composite material were selected among the patients who were treated at Department of Restorative Dentistry, Eskişehir Osmangazi University between January 2015-March 2015. The 246 restorations included in the study were evaluated according to FDI criteria at 18-month follow-up. Each bonding mode was analyzed by Friedman analysis and Dunn’s binary comparison test. Relation between the categorical mode variate and the scores were analyzed by Pearson Chi-square analysis (p=0.05). Results: There was no significant difference between the application modes at 18-month period regarding surface luster, surface staining, color match and translucency, esthetic anatomical form, marginal adaptation, post operative sensitivity, caries recurrence, erosion, abfraction, tooth integrity and periodontal response. Marginal discoloration, fracture and retention, and the patient's view criterias showed a significant difference in terms of the application modes at 18-month follow-up. Esthetic anatomic form, patient's view, and tooth integrity were not significantly different between evaluation periods (p&amp;gt;0.05). Conclusion: SE mode showed significantly worse scores than that of TE and SLE modes. Further studies are needed to evaluate the clinical performance of universal adhesives.

Literary bioinformatics studies: The genetic code mystique

What is life and what does it mean to be in the living political universe of entitiness without rhyme or reason? Flappy exudate, a bag in a bag, corpuscles of corporeality, worms (or flesh tubes) with appendages, even the cult of first involution – these are our body pods and the hunger and thirst of being-in. How can the situation of anatomical form be analysed without the illusion of instrumentalized reflection? Perhaps by amalgamating the categories and their issues. The issuance of taxonomy is the actual fine muck of excrement, which every brick of ordered life leaks as exudence and decay. Deep thoughts leave a mucal snail trail of what was tabular-seeming about our bodily situation, our environs, our friends, our experiments and our nourishment. Especially in this current age of 露 露 and 娜娜 (Lulu and Nana), our first officially public transgenic kindred, the question becomes, ‘who are these free-living divergences and what does it mean to be the uber-ding beyond geoengineering’s capabilities?’.

Influence of the anatomical form of the posterior maxilla on the reliability of superior maxillary repositioning by Le Fort I osteotomy

Certain patients with facial deformities require superior repositioning of the maxilla via Le Fort I osteotomy; however, the magnitude of superior repositioning of the maxilla is often less than expected. In this study, the correlation between the accuracy of superior repositioning of the maxilla and the anatomical form of the maxillary posterior region was examined. Seventy-five patients who underwent Le Fort I osteotomy without forward movement of the maxilla but with superior repositioning of the maxilla were included in this study. The bone volume around the descending palatine artery (DPA), the angle of the junction between the pterygoid process and the tuberosity, and the distance between the upper second molar and the pterygoid process were measured via three-dimensional analysis. A significant negative correlation (r=−0.566) was found between the bone volume around the DPA and the ratio of repositioning (actual movement divided by expected movement). It is possible that the superior repositioning of the maxilla expected prior to surgery was not sufficiently attained because of the large volume of bone around the DPA. The results of this study show that in some patients, superior repositioning was not achieved at the expected level because of bone interference attributable to the anatomical form of the maxillary posterior region.

MODERN APPROACHES TO THE SURGICAL TREATMENT OF BILIARY ATRESIA

The review of literature deals with the current classification of the biliary atresia, presents the authors’ opinion considering a technique of theKasaiprocedure, and displays modern modifications of portoenteroanastomosis estimating their effectiveness. PubMed database and Google Scholar search system were used to search for primary terms. Survival of children with this pathology was analyzed depending on theKasaitechnique, anatomical form, terms of portoenteroanastomosis and importance of early diagnosis of this pathology.

Maxillofacial prosthetic rehabilitation: A survey on the quality of life

Statement of problemMaxillofacial prostheses, especially those supported by endosseous implants, are regarded as a viable, secure treatment for the reconstruction of facial defects to restore quality of life. The long-term quality of life of patients treated with facial prostheses with different retentive systems is unclear. PurposeThe purpose of this clinical study was to assess the long-term quality of life of patients treated with facial prostheses with different retentive systems over a 14-year period at a Dutch oral and maxillofacial surgery unit. Material and methodsA total of 66 patients with facial prostheses were inventoried and categorized based on anatomic location and type of retention. A 62-item questionnaire was designed to survey the daily prosthetic use, care, quality, durability, longevity, and reliability of retention. Furthermore, issues relating to general satisfaction, self-image, and socialization frequency were addressed. ResultsCompleted validated questionnaires were returned by 52 patients. Of the prosthetic replacements, 23% (n=12) were orbital, 33% (n=17) nasal, and 44% (n=23) auricular prostheses. The survey showed that a prosthetic reconstruction led to high satisfaction scores with regard to wearing comfort, anatomic fit, color, and anatomic form. A significant difference was shown for implant-retained facial prostheses, which provided enhanced retention and increased ease of placement and removal (Fisher exact test P=.01 and P=.04). Patients with nasal prostheses were less satisfied with the junction of their prostheses to the surrounding soft tissue and more aware of others noticing their prosthetic rehabilitation. Patients with auricular defects were less embarrassed (P=.01) by their prostheses. Although auricular prostheses were less frequently cleaned (P=.01), no significant difference was found in minor soft tissue complications between different anatomic locations and the various retentive systems. ConclusionsImplant-retained prostheses have advantages over adhesive-retained prostheses in terms of ease of handling. However, improvements in prosthetic material properties, including color stability and durability, are needed to increase the longevity of facial prostheses.

Hybrid Treatment of the Lusoria Subclavian Artery

Lusoria subclavian artery (LSA) is a rare anatomical anomaly. It generally remains asymptomatic but can become complicated and require surgical treatment which is complex in case of association with a Kommerell diverticulum (KD) and/or an anomaly of the aortic arch. The treatment of reference was only surgical until the appearance of endovascular techniques. The objective of this retrospective and multicentric study was to analyze the results of the hybrid endovascular and surgical treatment of symptomatic LSA, whatever the anatomical form.

One Year -Randomized Clinical Trial to Evaluate Packable Bulk fill and Nano Resin Composite in Children and Adolescents

Purpose: To evaluate the one- year clinical performance of the packable bulk fill and nano resincomposite in class I restorations in children and a adolescents.Materials & Methods: (33) pairs of first permanent molars had class I restorations wereplaced in (33) children were selected from Outpatient Clinic, Pediatric Dentistry Department,Faculty of Dentistry, Suez Canal University, each patient received two class I restorations thatwere similar as possible . In all cavities, single bond adhesive (Xeno V+) was applied. One cavity ofeach pair was randomly assigned to be restore with packable bulk fill resin composite (Quixfil) inincrement up to 4 mm . Another cavity was restored with Nano hybrid resin composite (Esthet-Xflow) placed in 2 mm increments. All restorations were evaluated at one week baseline and then onemonth, 3 months, 6 months , 9 months and 12 months . using slightly modified USPHS .Results: At all periods of evaluation, no statistically significant differences were detectedbetween packable bulk fill composite resin and Nano hybrid composite resin in marginal adaptation,surface roughness and caries detection ,whereas statistically significant differences between bothmaterials in anatomical form and marginal discoloration parameters in favor with packable bulkfill. Sensitivity was not reported during all evaluation periods Performance at one week base line, 1month, 3 months, 6 months, 9 months and 12 months for all criteria.Conclusions: The packable bulk- fill composite resin showed highly clinical performance whencompared with Nano hybrid composite resin restorations at one- year follow up. Further studiesnecessary for long term clinical evaluation of these materials.

Development and validation of the Maxillary Canine Aesthetic Index.

Aesthetic appraisal is rarely included in the objective assessment of outcome studies of impacted maxillary canines treatment. The present study aimed to validate a new index for assessing the aesthetic appearance of maxillary canines and adjacent soft tissues. The Department of Oral and Maxillofacial Surgery at University Hospitals Leuven. Four oral‐maxillofacial surgeons, two orthodontists, two prosthodontists, and two lay persons rated 11 maxillary canines and adjacent soft tissues according to the new index. Each of the examiners repeated the examination three times with a 2‐week interval. Twelve relevant aesthetic variables were selected on the basis of the anatomic form, color, and surface characteristics of the canine crown and on the basis of the anatomic form, color, and surface characteristics of the adjacent soft tissues. Intraclass correlation (ICC) coefficient and Fleiss' kappa statistics were performed to analyze the intrarater and interrater agreement. The index proofed to be a reliable assessment tool. Considering the cumulative assessment of the Maxillary Canine Aesthetic Index (MCAI), the mean ICC value for the interrater agreement of the 10 examiners was 0.71, representing a good agreement. Intrarater agreement ranged from 0.10 to 0.91. Interrater agreement (Fleiss' kappa statistics) calculated for each variable ranged from 0.08 to 0.98. The MCAI is a tool in rating aesthetic outcome of impacted canine treatment and adjacent soft tissues. The MCAI can be used to evaluate the aesthetic outcome after surgical exposure or transalveolar transplantation of maxillary canines.

Combined Effect of Enamel Deproteinization and Intermediate Bonding in the Retention of Pit and Fissure Sealants in Children: A Randomized Clinical Trial.

This manuscript shows if enamel deproteinization along with an intermediate layer of bonding enhances the retention of pit and fissure sealants.. Two hundred six mandibular first permanent molars were allocated to Group I (n=103) and Group II (n=103). Group I underwent deproteinization, acid etching, bonding agent application and pit & fissure sealant placement while Group II treated with acid etching followed by pit & fissure sealant application only. Clinical analysis of all the teeth in the two groups was performed at 1, 3, 6, 9 and 12 months respectively. Pearson's chi - square test was utilized to evaluate the success of both treatment procedures (p<0.05). At 12 months follow up the differences between the groups pertaining to Marginal integrity, Marginal discoloration and Anatomical form were statistically significant suggesting enhanced retention in Group I. Enamel deproteinization along with the use of intermediate bonding layer significantly enhances the retention of pit and fissure sealants in terms of enhanced marginal integrity, decreased marginal discoloration and preserving the anatomical form.

Clinical performance of class I occlusal composite resin restorations: a multicenter double-blinded randomized clinical trial

Objective: The objective of this study was to evaluate the 6-month clinical performance of class I occlusal composite resin restorations through a multicenter, randomized, double-blind, clinical trial. Material e Métodos: Two hundred and eighty class I occlusal restorations were performed in 70 patients (aged between 17 to 50 years). The restorations were divided into four groups: G1 (Filtek P60/3M ESPE); G2 (Rok/SDI); G3 (Filtek™ P90/3M ESPE); G4 (Evolux/Dentsply). Two pre-calibrated dental practitioners performed and evaluated the restorative procedures regarding to color match, marginal discoloration, recurrent caries, wear (anatomic form) and marginal integrity according to the USPHS criteria. Resultados: In 85.8% of the evaluated restorations was observed the ideal score (A) for color match; 91.4% for marginal discoloration; 100% for recurrent caries; 87.7% for wear (anatomic form) and 99.3% for marginal integrity. Conclusion: The composite resins used in this study presented satisfactory and similar clinical performance in a 6-month clinical evaluation.KeywordsDentistry; Composite resins; Permanent dental restoration; Molar; Bicuspid.

Clinical and Micromorphologic 29-year Results of Posterior Composite Restorations

Prospective clinical studies of composite restorations revealed their safety and longevity; however, studies did not elucidate the dynamic mechanisms of deterioration caused by fractures and secondary caries. Therefore, the aims of this 29-y controlled study were 1) to follow up on the clinical behavior of posterior composite restorations annually and 2) to compare clinical outcomes with micromorphologic scanning electron microscopy features. After ethical approval, the single-arm study commenced in 1987 with 194 class I or II primary posterior composite restorations with glass ionomer cement providing pulp protection. Each restoration was evaluated annually for 15 y and then again at 29 y per the US Public Health Service–compatible Clinical, Photographic and Micromorphologic coding index, with clinical and photographic criteria for anatomic form, color matching, surface quality, wear, marginal integrity, secondary caries, and clinical acceptability. Parallel micromorphologic criteria were applied at baseline and after 1, 3, 5, 7, 10, 15, and 29 y to assess surface roughness, texture, marginal integrity, fractures, ledges, and marginal gaps with semiquantitative coding and with quantitative 3-dimensional scanning electron microscopy profilometric measurements of marginal grooves next to the enamel, grooves within the bonding zone, and ledges. Statistical analysis included the calculation of the annual failure rate and the use of Kaplan-Meier methodology and nonparametric tests. The cumulative survival rates were 91.7% (6 y), 81.6% (12 y), and 71.4% (29 y). The mean annual failure rate was 1.92%. Significant changes in the restoration-tooth interface from baseline to 5 y resulted in functional masticatory equilibrium. Clinical deterioration year by year, including micromorphologic microfractures and wear, reflected unique dynamic changes in long-term surviving restorations with very low secondary caries and fracture risks (German Network for Health Care Research VfD 29 99 003924).