Compomer Restoration Research Articles

Evaluation of staining potential of Silver Diamine Fluoride, Potassium Iodide, Nanosilver Fluoride: an in vitro study

BackgroundThe black staining effect of silver-containing solutions for use to arrest caries can have a negative aesthetic impact on children and parents. This study aims to assess the staining effects of Silver Diamine Fluoride/Potassium Iodide (SDF/KI), SDF and Nanosilver Fluoride (NSF).Materials and methodsForty-four extracted carious primary molars were collected and randomly divided into four groups (n = 11). The carious tissue in all teeth was removed using a chemo-mechanical caries removal agent with an excavator. After caries removal in all groups, SDF, SDF/KI, and NSF were applied to the different groups, while no solution was applied to the control group. Subsequently, the teeth in all groups were restored with compomer. Color values L*, a* and b* were measured using a spectrophotometer at three time points: immediately after compomer restoration (T0), one week later (T1), and four week later (T2). Changes in brightness (ΔL) and color (ΔE) over time were calculated and comparisons among groups were made.ResultsThe SDF solution induced statistically significant black staining (p = 0.013) and a decrease in L* value (p < 0.001) on the compomer material compared to the other groups over time.ConclusionsIt was observed that SDF/KI has the potential to reduce the black staining effect of SDF, though not entirely. Novel experimental solutions like NSF may offer an alternative to counteract the staining effect of SDF.

The Comparison of Microleakage between Bioactive Composite Resin and Compomer

Background: The ideal restoration material should have endurance, compatible with tooth structure and visible surrounding tissues and must be able to restore the lost tissue. There are various restoration materials such as Compomer and Bioactive Composite Resin. Microleakage is one of the failure in surface sealent, and this may increase the risk of secondary caries. Purpose: The aim of this study was to prove and compare the differences of microleakage between Compomer and Bioactive Composite Resin in class I restoration. Material and Method: Maxilla’s first premolar teeth with class I cavities (diameter: 3mm, depth: 3mm) divided into two groups with 10 samples each group. Group I: Compomer (Dentsply), Group II: Bioactive Composite Resin (Activa Pulpdent USA). All group were immersed in 1% methylene blue solution for 24 hours, rinsed in running water, and section mesial-distal using carborundum disc. Afterward, section were assessed for dye penetration that represent the mickroleakage using scoring method under digital microscope. Finally data were collected and statistically analyzed. Result: There were significant differences between each group (p&lt;0.05). Microleakage in restoration with Bioactive Composite Resin (1.7) shows smaller values than Compomer restoration (4.4). Conclusion: This research show that there is differentiation of microleakage between Compomer and Bioactive Composite Resin. In Bioactive Composite Resin found the smallest microleakage.

Selective vs stepwise removal of deep carious lesions in primary molars: 24\xa0months follow-up from a randomized controlled trial

ObjectivesFor well-defined deep (> 2/3 dentin extension) carious lesions, selective (SE) or stepwise (SW) carious tissue removals have been recommended, while there is limited comparative evidence for both. We compared SE and SW over 24 months in a randomized controlled trial.MethodsA two-arm superiority trial was conducted comparing SW/SE in primary molars without pulpal symptoms but well-defined deep lesions. Seventy-four children (1 molar/child) aged 3–9 years were recruited. In a first step, peripheral carious tissue was removed until hard dentin remained, while in proximity to the pulp, leathery dentin was left. An adhesive compomer restoration was placed and restorations re-examined after 6 months. In SW, re-entry and removal to firm dentin was conducted pulpo-proximally, followed by re-restoration. Molars were re-evaluated for a total of 24 months. Our primary outcome was success (absence of restorative/endodontic complications or pulp exposures). Secondary outcomes included total treatment and opportunity costs and restoration quality, assessed using modified USPHS criteria.ResultsAfter 24 months, 63 molars (31 SE, 32 SW) were re-assessed. Four failures occurred (2 exposures in SW; 2 pulpal complications in SE, 1 of them leading to extraction, p > 0.05). Restoration integrity was satisfying in both groups (USPHS A/B/C in 21/8/0 SE and 23/7/0 SW, p > 0.05). Treatment and opportunity costs were significantly higher in SW than SE (mean 171 ± 51 vs. 106 ± 90; p < 0.001).ConclusionsAfter 2 years, SE and SW showed similar efficacy for managing deep carious lesions in primary molars. The higher costs for SW should be considered during decision-making.Clinical significanceIn primary molars with well-defined deep carious lesions SE was less costly and similarly efficacious like SW. From a cost and applicability perspective, SW may need to be indicated restrictively, e.g., for very deep (> 3/4 dentin extension) lesions only.Trial registrationClinicalTrials.gov Identifier: NCT02232828

Selective vs stepwise removal of deep carious lesions in primary molars: 12-Months results of a randomized controlled pilot trial

ObjectivesFor deep carious lesions, selective or stepwise carious tissue removal (SE, SW) seem advantageous compared with non-selective removal. For primary molars, there is insufficient evidence comparing SE against SW. This randomized pilot trial compared SE and SW over 12 months. MethodsA two-arm superiority trial was conducted comparing SE and SW in primary molars with deep lesions but without pulpal symptoms. We recruited 74 children (one molar/child) aged 3–9 years. In both groups, peripheral carious tissue removal was performed at T1 to hard dentin. In proximity to the pulp, leathery dentin was left followed by an adhesive compomer restoration. Blinded re-examination was performed after six months (T2). Molars allocated to SW were re-entered, removal to firm dentin carried out pulpo-proximally, and again restored. After another 6 months, all molars were re-examined (T3). Our primary outcome was success, defined as no restorative/endodontic complications (including pulp exposure) leading to reinterventions. Secondary outcomes included total treatment and opportunity costs. Patients’, dentists’ and parents’ subjective assessments were recorded. This trial was registered (ClinicalTrials.gov/NCT02232828). ResultsAfter 12 months a total of 72 children (36 SE, 36 SW) were analyzed. Three failures occurred (2 exposures in SW, 1 pulpal complication leading to extraction in SE) (p > 0.05). The subjective evaluation by patients, parents or dentists did not differ significantly. Combined treatment and opportunity costs were significantly higher in SW (mean;SD: 186;61 Euro) than SE (100;59) (p < 0.001). ConclusionsThe significantly increased costs for performing SW instead of SE in deep carious lesions in primary molars may not be justified. Clinical significanceFor primary molars with deep lesions, but vital pulps, SE was less costly at similar efficacy compared with SW. Dentists’ decision-making should consider this alongside further clinical aspects.

Alternative Caries Management Options for Primary Molars: 2.5-Year Outcomes of a Randomised Clinical Trial

Less invasive caries management techniques for treating cavitated carious primary teeth, which involve the concept of caries control by managing the activity of the biofilm, are becoming common. This study aimed to compare the clinical efficacy (minor/major failures) and survival rates (successful cases without any failures) of 3 carious lesion treatment approaches, the Hall Technique (HT), non-restorative caries treatment (NRCT), and conventional restorations (CR), for the management of occlusoproximal caries lesions (ICDAS 3-5) in primary molars. Results at 2.5 years are presented. A total of 169 children (3- to 8-year-olds) were enrolled in this secondary care-based, 3-arm parallel-group, randomised controlled trial. Participants were allocated to: HT (n = 52; sealing caries with stainless-steel crowns without caries removal), NRCT (n = 52; opening up the cavity and applying fluoride varnish), CR (n = 65; control arm, complete caries removal and compomer restoration). Statistical analyses were: non-parametric Kruskal-Wallis analysis of variance, Mann-Whitney U test and Kaplan-Meier survival analyses. One hundred and forty-two participants (84%; HT = 40/52; NRCT = 44/52; CR = 58/65) had follow-up data of 1-33 months (mean = 26). Overall, 25 (HT = 2, NRCT = 9, CR = 14) of 142 participants (17.6%) presented with at least 1 minor failure (reversible pulpitis, caries progression, or secondary caries; p = 0.013, CI = 0.012-0.018; Mann-Whitney U test). Ten (HT = 1, NRCT = 4, CR = 5) of 142 participants (7.04%) experienced at least 1 major failure (irreversible pulpitis, abscess, unrestorable tooth; p = 0.043, CI = 0.034-0.045). Independent comparisons between 2 samples found that NRCT-CR had no statistically significant difference in failures (p > 0.05), but for CR-HT (p = 0.037, CI = 0.030-0.040) and for NRCT-HT (p = 0.011, CI = 0.010-0.016; Kruskal-Wallis test) significant differences were observed. Cumulative survival rates were HT = 92.5%, NRCT = 70.5%, and CR = 67.2% (p = 0.012). NRCT and CR outcomes were comparable. HT performed better than NRCT and CR for all outcomes. This study was funded by the Paediatric Dentistry Department, Greifswald University, Germany (Trial registration No. NCT01797458).

Long-term in-vivo effect of various restorative materials on enamel and dentin of primary molars.

To explore the long-term in-vivo effect of different dental restorative materials on the surrounding enamel and dentin, in primary molars. Sixteen naturally exfoliated primary molars restored with amalgam, compomer, and glass-ionomer cement were collected after 2 to 5 years of function in the mouth. Four intact molars served as control. The teeth were sliced buccolingually and the ion content in the restorative material, the enamel, and the dentin surrounding the restoration was determined using a scanning electron microscopy-energy dispersive x-ray spectroscopy (SEM-EDS) program. Amalgam released copper to the enamel and dentin causing a bluish discoloration. No traces of mercury or other ions were detected in the enamel or dentin. The enamel and dentin surrounding the restoration showed reduced inorganic components and increased organic components. The enamel and dentin surrounding the compomer restoration showed similar to amalgam reduction in inorganic components and increased organic components. Traces of fluoride, aluminum, and silicon were found. The enamel and dentin of teeth restored with glass-ionomer cement showed the least reduction in inorganic components, with higher fluoride content and traces of aluminum, silicon, and strontium. This long-term in-vivo study showed release of copper ions from amalgam material to the enamel and dentin, but no traces of mercury. Amalgam and compomers showed no remineralization effect on the dentin surrounding the restoration. Glass-ionomer restorations showed remineralization effect on the tooth components and migration of inorganic ions from the enamel and dentin to the material.

Caries Management Strategies for Primary Molars

Minimal invasive approaches to managing caries, such as partial caries removal techniques, are showing increasing evidence of improved outcomes over the conventional complete caries removal. There is also increasing interest in techniques where no caries is removed. We present the 1-yr results of clinical efficacy for 3 caries management options for occlusoproximal cavitated lesions in primary molars: conventional restorations (CR; complete caries removal and compomer restoration), Hall technique (HT; no caries removal, sealing in with stainless steel crowns), and nonrestorative caries treatment (NRCT; no caries removal, opening up the cavity, teaching brushing and fluoride application). In sum, 169 children (3-8 yr old; mean, 5.56 ± 1.45 yr) were enrolled in this secondary care–based, 3-arm, parallel-group, randomized clinical trial. Treatments were carried out by specialist pediatric dentists or postgraduate trainees. One lesion per child received CR, HT, or NRCT. Outcome measures were clinical failure rates, grouped as minor failure (restoration loss/need for replacement, reversible pulpitis, caries progression, etc.) and major failure (irreversible pulpitis, abscess, etc.). There were 148 children (87.6%) with a minimum follow-up of 11 mo (mean, 12.23 ± 0.98 mo). Twenty teeth were recorded as having at least 1 minor failure: NRCT, n = 8 (5%); CR, n = 11 (7%); HT, n = 1 (1%) (p = .002, 95% CI = 0.001 to 0.003). Only the comparison between NRCT and CR showed no significant difference (p = .79, 95% CI = 0.78 to 0.80). Nine (6%) experienced at least 1 major failure: NRCT, n = 4 (2%); CR, n = 5 (3%); HT, n = 0 (0%) (p = .002, 95% CI = 0.001 to 0.003). Individual comparison of NRCT and CR showed no statistically significant difference in major failures (p = .75, 95% CI = 0.73 to 0.76). Success and failure rates were not significantly affected by pediatric dentists’ level of experience (p = .13, 95% CI = 0.12 to 0.14). The HT was significantly more successful clinically than NRCT and CR after 1 yr, while pairwise analyses showed comparable results for treatment success between NRCT and CR (ClinicalTrials.gov NCT01797458).

Human Histologic Evaluation of Root Coverage Obtained with Connective Tissue Graft Over a Compomer Restoration

This investigation was designed to evaluate the histologic healing pattern of two Miller Class III recession defects associated with noncarious cervical lesions (NCCLs) treated with a connective tissue graft (CTG) and coronally advance flap (CAF). One patient presenting with two teeth predetermined to be surgically extracted was enrolled and consented to treatment. One month after phase I treatment, a full-thickness flap was reflected and the NCCLs treated with a compomer restoration; at the same time, a CTG was harvested from the palate and positioned over the compomer restoration. The flap was then coronally repositioned. After 4 months of healing, an en bloc biopsy extraction of the two teeth was executed. The teeth were analyzed histologically to assess the periodontal wound healing. A long junctional epithelial attachment was noted throughout the major portion of the restored surface. Only minimal signs of connective adhesion and new bone formation could be seen in the apical portion of the restored area, without signs of root resorption or ankylosis. This report provides evidence that the presence of a compomer restoration allowed the formation of a long juctional epithelium after CTG and CAF treatment.

Effects of chlorhexidine and gaseous ozone on microleakage and on the bond strength of dentin bonding agents with compomer restoration on primary teeth

Background/purposeThe aim of this study was to evaluate microleakage and bond strength in primary tooth dentin after disinfection with chlorhexidine solution or gaseous ozone. Materials and methodsSixty primary first and second molar teeth without caries were collected. Thirty of these teeth were ground to expose the dentin surface and divided into three groups (n = 10 for each group). After the application of materials, the teeth were restored with compomer restorations. Dentin sticks were obtained from these specimens and used for the microtensile bond strength test. The effect on the microleakage of the same materials of compomer restorations was then tested. class V cavities were prepared on the facial surfaces of the remaining 30 sound primary first and second molars to which the materials were applied and that were restored with compomer. The teeth were thermocycled, stained with basic fuchsine, sectioned for microleakage evaluation, and examined under a stereomicroscope. Kruskall-Wallis, Mann-Whitney U, one-way ANOVA, and post hoc Tukey tests were used for statistical analyses. ResultsWhen the bond strength of the groups were compared, the difference between the ozone group and the control group was not significant (P > 0.05); however, the difference between the chlorhexidine group and either of the other two groups was significant (P < 0.05). The chlorhexidine group of teeth showed the lowest bond strength rates. When the occlusal and gingival microleakage rates among the groups were compared, the difference was insignificant (P > 0.05). ConclusionOzone application may be an alternative antibacterial procedure because the bond strength increased after ozone application. Chlorhexidine decreased bonding significantly. There was no significant difference between the microleakage values.

Flowable materials as an intermediate layer could improve the marginal and internal adaptation of composite restorations in Class-V-cavities

The purpose of this in vitro study was to evaluate the marginal and internal adaptation of restorative systems in combination with flowable materials as an intermediate layer in Class-V-cavities. Thirty Class-V-cavities with occlusal margins in enamel and gingival margins in dentin/cementum were prepared and randomly assigned to five groups. The following five restorative systems were used: compomer, composite E, flowable compomer/composite E, composite RF and flowable composite/composite RF. The flowable materials were added between the restorative composites and the cervical margins of the cavities. Marginal and internal adaptation were quantitatively evaluated before and after thermal (2,500 times between 5 and 55 degrees C) and mechanical load cycling (25,000 times 100 N) using standard SEM procedures. Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U-Test. The morphology of the internal restorative interfaces was also evaluated. The present study revealed that the best marginal adaptation in dentin was attained with the compomer restoration (95.8% perfect margin). The marginal adaptation of composite restorative systems was improved by the use of a flowable compomer (45.5% vs. 68.2% perfect margin in dentin) or a flowable composite (46.7% vs. 80.7% perfect margin in dentin, p<0.05) as an intermediate layer. No differences were observed between the used materials for the parameter internal adaptation. In Class-V-cavities compomers showed the best marginal adaptation and the marginal adaptation of composite fillings could be improved by the use of flowable materials as an intermediate layer.

Dentin permeability change according to the process of compomer restoration

Compomer is composed of matrix and filler : matrix is made of the combination of resins and polycarboxylic molecules that are light-cured, and a filler is a glass component which is capable of ion-release. The resin content of compomers produces polymerization shrinkage which can adversely affect marginal adaptation. Pretreatment is a fundamental step which is treated with conditioner or primer in the use of these materials. Microleakage of restorative materials has been investigated mostly by dye penetration method. Dye penetration method was not quantitative and not measured repeatedly. Fluid filtration method, introduced and developed by Pashley's group, has been extensively used for 20 years for research purpose to understand the physiology of dentin, as well as the effects of various restorative treatments on dentin permeability. It permits quantitative, nondestructive measurment of microleakage in a longitudinal manner. The purpose of this study was to evaluate the change of dentin permeability according to the process of compomer restoration. In this study. Cl V cavities were prepared on buccal surface of thirty extracted human molars. The prepared cavities were etched by 37% phosphoric acid. The experimental teeth were randomly divided into three groups. Each group was treated with following materials Group 1 : Prime & Bond NT/Dyract AP, Group2： Single Bond/F2000 compomer, Group 3 : Syntac Single Component/Compoglass. The bonding agent and compomer were applied for each group following manufacturers information. Dentin permeability of each group was measured at each process by fluid filtration method; Step 1 : preparation(smear layer). Step 2 : etching(smear layer removal), Step 3 : applying the bonding agent, Step 4 : filling the compomer. Dentin permeability was expressed by hydraulic conductance ( mincm). The data were analysed statistically using One-way ANOVA and Sheffe's method. The results were as follows : 1. Dentin permeability differences between each process were significant except between step 1 and step 2(p0.05). 5. None of compomers used in this study showed perfect seal at the interface.

Fracture resistance of class II approximal slot restorations

Statement of Problem. Determination of the fracture resistance of various restorative materials in Class II approximal slot restorations has not been studied. Purpose. This study evaluated the effects of retention grooves and different restorative materials in Class II approximal slot restorations. To explore the possibilities for further research, the probable effects of preparation size and loading angle were investigated in a limited manner. Material and Methods. Ninety sound, caries-free human maxillary premolars were divided into 9 groups. The cavities were prepared either by hand or in a computer-controlled CNC machine with or without retention grooves. Four were restored with adhesive amalgam, another 4 with composite, and a single group with Compomer resin. The gingival floor depth was 1.5 mm. The specimens were loaded at an angle of 13.5 degrees to their longitudinal axes by using a computer-controlled material testing machine until failure occurred. For one specific preparation of adhesive amalgam, loading was applied at 0 and 30 degrees to determine the probable effects of the loading angle. For a specific composite, resin application, the effects of the change in gingival floor depth were analyzed by assigning the depth to 2.0 mm. Results. Composite and Compomer resin and composite exhibited better performance than amalgam. The existence of the retention grooves proved to be effective for adhesive amalgam restorations but did not have any advantageous effect in composite and Compomer restoration. Conclusion. For improved fracture resistance in small approximal restorations, the use of composite was the appropriate choice. Compomer also gave satisfactory results. Use of amalgam restoration should be accompanied with retention grooves and an adhesive system to improve its performance. (J Prosthet Dent 2000;84:297-302.)

Compomer versus glass ionomer restorations: which material performs better in primary molars?

Objectives To undertake a clinical trial comparing the efficiency of a compomer restoration with a glass ionomer restoration in the management of caries in primary molar teeth. Design Subjects were admitted to the trial if they required at least one pair of restorations in primary molar teeth. Setting Department of Child Dental Health, Newcastle Dental Hospital and School. Subject Twenty nine children, aged 4–9 years, had 56 pairs of restorations placed between January 1995 and November 1997. Method The durability of the restorations was assessed during a 42-month follow-up period using modified United States Public Health Service criteria. Survival analysis and the McNemar paired test were used to compare the performance of the two restorative materials. Results The compomer restorations had a higher mean survival time (42 months, SE 1.40) compared with 37 months (SE 1.90) for the glass ionomer restorations and this was significant at the 5% level. The compomer also performed significantly better in terms of anatomical form, marginal integrity, cavo surface discoloration and maintenance of interproximal contact. Conclusions The present trial demonstrated that Dyract compomer performed significantly better than Chemfil Superior a glass ionomer cement for all modified United States Public Health Service criteria over a period of 42 months.