Conservative Dentistry Research Articles

Pilot study to evaluate a novel measure of self-perceived competencies among dental students

BackgroundPRISM is a novel approach to support self-reflection and learning appraisal in dental students, based on a visual metaphor. The aim of this study was to evaluate whether PRISM measurments would be reproducible and sensitive to detect learning progress in undergraduate dental students in their clinical years.MethodsVoluntarily participating dental students were included. To evaluate reproducibility, a mixed cohort of 10 students each in 3rd, 4th and 5th year (total n = 30) was recruited and received three identically structured PRISM interviews within one week without any other teaching events. To assess perceived learning progress, 29 volunteer 3rd year students participated in three interviews during their clinical simulation course (beginning, middle, end). Distances between Subject and Objects was measured in millimeter; objects were classified into close or branched clusters depending on their distance from each other on the PRISM board.ResultsValues for perceived competencies within PRISM interviews during one week were comparable between the three time points in the mixed cohort (n = 30; p > 0.05). Comparing the three subgroups (3rd, 4th and 5th year, each n = 10), PRISM indicated that 3rd year students perceived their competencies are significantly lower than the 4th and 5th year students (p < 0.01). 3rd year students had less often a branched cluster of objects than the other two groups (p < 0.05).PRISM showed that over time, 3rd year students perceived a gain in their competencies in conservative dentistry and its sub-disciplines (p ≤ 0.01). The PRISM data indicated that by the end of the simulation course, the students appeared to show higher discrimination of their self-perceptions between sub-topics in conservative dentistry than at the start of the course (p = 0.01).ConclusionPRISM yields a reproducible measure of individual students' learning progress. It is a promising novel approach for appraisal in dental education. Further work is needed to confirm the generalisability of the findings.

Comparitive evaluation of antimicrobial effectiveness of titanium oxide coatings on different types of ceramic brackets against Streptococcus mutans

Nanomaterials are widely used in modern clinical dentistry. They improve various properties, such as antimicrobial properties, durability of materials. These particles do not exceed 100 nm, due to they obtain a better ratio between the surface and mass. Nanomaterials are used in many areas of dentistry, such as conservative dentistry, endodontics, oral, and maxillofacial surgery, periodontics, orthodontics, and prosthetics. One of the most important complications of fixed orthodontic treatment is enamel demineralization. Brackets and orthodontic accessories facilitate plaque accumulation and compromise oral hygiene maintenance which lead to an increase in oral bacteria count during orthodontic treatment. 30 MBT 0.022’’ monocrystalline ceramic brackets and 30 MBT 0.022’’ polycrystalline ceramic brackets (Metro Orthodontics) which are randomly divided into 4 groups: 2 control groups (group-1=15 uncoated monocrystalline and group-2=15 uncoated polycrystalline) and 2 experimental groups (group-3=15 silver oxide coated monocrystalline and group-4=15 silver oxide coated polycrystalline). S.mutans counts were significantly less in the experimental groups than control groups. Titanium oxide coatings on ceramic brackets reduced the colony forming units of S. mutans. Reduced number of colony forming units was seen in both the monocrystalline and polycrystalline coated brackets than their control groups.

Impact of the COVID-19 pandemic on graduating dental interns: the students' perspective.

BackgroundCOVID 19 pandemic has caused an unprecedented change in the way of life of the individual as well as of the society globally. Medical and healthcare education has become virtual, complex, and challenging with minimal real-time experience. Dental education has faced major impacts affecting the skills and preparedness of the graduates. This study aimed to assess the overall impact of the COVID 19 pandemic on graduating dental interns.MethodsThis cross-sectional survey was conducted among the graduating dental interns from various states across India. A specially designed questionnaire was used in our study which consisted of multiple-choice, Likert scale, dichotomous response, open-ended response questions. The 15 item questionnaire focused on 5 domains (i) demographic details (ii) perceptions regarding disrupted academic schedule and switch to E-education (iii) perceptions on its impact on the career (iv) items concerning the mental health and stress (v) potential solutions suggested by the interns.Results316 dental interns responded to this survey. Only 13.6% of them felt that the e-platforms were useful tools for learning. The dental interns felt that Conservative Dentistry and Oral Surgery postings had the maximum impact on clinical skills. Less than one-fourth (23.1%) of them agreed with the fact that they were under parental pressure; 43.4% agreed that the pandemic had affected the confidence and preparedness to start their clinical practice.ConclusionIt was observed that the interns faced major challenges due to the missed hours of clinical practice, which affected them in terms of preparedness and confidence in facing their future.

Management of periapical cyst (radicular cyst): A non-surgical endodontic approach

A periapical cyst (Radicular cyst) is most common odontogenic cyst of oral cavity which arises from epithelial remnants which form by an inflammatory process originating from pulpal necrosis of a non-vital tooth. This cyst associated with non-vital tooth and generally visible on radiographs. Radiographic interpretation of the lesion is a round or oval, well circumscribed radiolucency involving the apex of the tooth. A 14-year-old female patient reported to department of conservative dentistry and endodontics with chief complain of discoloured tooth since one year and mobility in maxillary left anterior teeth (#22) since 3 months. Clinical and radiological findings were suggestive of periapical radicular cyst. Non-surgical endodontic therapy was performed using 5% sodium hypochlorite, 2% chlorhexidine and normal saline and Calcium hydroxide intra canal medicament. A 3 months follow-up radiographic examination revealed progressive involution of periapical radiolucency without any clinical symptoms. Periapical cysts respond favourably to non-surgical endodontic treatment.

Perception of dental anatomy among dental students, dental practitioners, and dental academicians: A questionnaire-based cross-sectional study

Objectives: The subject of dental anatomy is basically very important both from academic and practical points of view in dentistry. The present study was designed to determine the extent of variations in the perception of dental anatomy among dental students, dental practitioners, and dental academicians. Material and Methods: The questionnaire consisted of 15 closed-ended questions related to dental anatomy. There were 11 dichotomous questions with “yes” and “no” options and four multiple-choice questions. The questions were validated by experts and the questionnaire was submitted in Google form to the targeted respondent’s groups through WhatsApp and Emails. The responses received over 2 months were considered for statistical analysis. The Kruskal–Wallis non-parametric test was performed to test the difference in the responses between the groups of respondents. Results: The results of the study revealed that nearly 62–92% of the respondents gave an affirmative response to the dichotomous questions (Q. No. 1–11). The digital Vernier caliper was the most preferred instrument to measure the tooth dimensions and the FDI system was the most preferred nomenclature system among the respondents (66.7%) followed by the Palmer-Zsigmondy system (18.2%). Almost 50% of the respondents opted for conservative dentistry and endodontics as the clinical specialty in dentistry, where the knowledge of dental anatomy has its greatest application. Conclusion: There was no significant difference in the opinion about dental anatomy between the undergraduate dental students and the professionals except for their opinion regarding the course curriculum.

The 3D printed teeth models intended for hands-on practice in conservative dentistry.

Designing and printing out a 3D model of a mandible, including the teeth with replicated carious lesions, to be fitted into the Dental Patient Simulator. Students assessed the 3D teeth models against the extracted teeth and the standard models, identifying specific restorative dentistry procedures where they might be applied as the teaching aids. A 3D tooth model was printed out against a patient's Cone Beam Computed Tomography scan. The study was attended by 22, 5th-year students, who, having prior removed the caries, filled in the cavities of different classes and trepanned the pulp chamber in the 3D models, subsequently rating them against a questionnaire. Over 95% of students recommended introducing the 3D models into teaching conservative dentistry with endodontics at the pre-clinical stage to enhance manual skills in cavity preparation and filling. The replication of tissue hardness and anatomical characteristics in the 3D models was rated significantly higher, as compared to the standard ones (p <0.05). Over 90% of students also asserted that working on the 3D models would enhance their pulp chamber trepanation skills, and rated overall replication of the anatomical characteristics significantly higher, in comparison with the standard teeth models (p <0.05). In pre-clinical education, the 3D teeth models offer a viable alternative, as there is an appreciable potential for different types of teeth to be printed out, in full consideration of their anatomical diversity. Further design refinements in the 3D teeth models are required, though, particularly the ones regarding true-to-life replication of the soft tissues.

Środki fluorkowe w zapobieganiu i leczeniu próchnicy i erozji zębów u dzieci, młodzieży i dorosłych – rekomendacje Polskich Ekspertów. Aktualizacja zaleceń: Indywidualna profilaktyka fluorkowa u dzieci, młodzieży – rekomendacje Polskich Ekspertów

Introduction. Fluoride-containing agents have a wide range of uses that have dental maintenance in line with the principles of minimal dentistry. They are effective in reducing the risk and progression of caries and erosion of deciduous and permanent teeth, and these pathologies are non-invasive. The safety condition and the base point of the fluoride device is the knowledge of various methods and patterns in accordance with the principle of their application. The common setting of measures for the establishment of preventive measures is termed “fluoride prophylaxis”, although some of them do so far dictate the recognition of tooth decay. Aim. As part of the activities of the Working Group on Fluoride Prevention of the Polish Division of the Alliance for a Caries-Free Future (ACFF PL) and the Polish Society of Pediatric Dentistry (PTSD), experts in the field of pediatric dentistry, team dentistry and pediatrics were appointed to update consensus statement of Polish experts on individual caries prevention with fluoride in children, adolescents and adults in Poland. Material and methods. We reviewed the literature of the equilibrium at the service level on the provision of technical assistance in the field of work performance and their application to people in the system and by people in Poland. The analysis covers measures to complement fluoride safety measures and recommendations for fluoride prevention and scientific workshops in different countries around the world. The last version of the document discussed and approved by experts in the field of pediatric dentistry, conservative dentistry and paediatrics on April 4, 2019. The update is planned no later than 5 years after its publication. Results. The documents contain basic information on educational needs and educational profiles in the field of tooth decay and erosion in Poland, the mechanism of anti-caries effect of fluoride, protective devices and different individual methods as well as imposed measures regulating issues related to regulations and provisions regarding restrictions on the prevention of caries and erosion in regulations from age and the risk of these pathologies. Conclusions. The effectiveness of agents containing fluorine compounds in the prevention and treatment of tooth decay and erosion of teeth is not in doubt at present, and their use in accordance with the developed principles is safe for patients. Compared to using only fluoride toothpaste, the combination of fluoride toothpaste with another method increases the chance of reducing tooth decay: with fluoride varnish – 48%, with fluoride gel – 14%, with rinsed – 7%. In addition to proper diet and oral hygiene, the use of agents containing fluoride compounds remains the basic method of preventing tooth decay. Highly concentrated, acidic pH formulations containing polyvalent fluorine compounds are the most preferred for erosion prophylaxis. It is recommended to use toothpastes and mouthwashes that contain fluoride or tin chloride. The protective potential increases with long-term use of the tin fluoride toothpaste. An effective form of erosion prophylaxis is the daily application of an AmF / NaF gel containing 1.23% F at low pH and a gel containing tin (II) fluoride.

COVID-19 Contraction Among Dental Healthcare Workers in the Department of Conservative Dentistry and Endodontics - A Retrospective Analysis During the Pandemic.

IntroductionThe COVID-19 pandemic has led to major challenges for the healthcare sector across the globe including dental healthcare workers (DHCWs) due to the increased risk of transmission of virus during aerosol-generating procedures. We conducted the present retrospective analysis determining the risk of contraction of COVID-19 infection among DHCWs since the outbreak of the pandemic for a year (March 2020 through March 2021) in Mumbai.MethodsIn total, 18,058 patients visited the Nair Hospital Dental College for dental treatment related to the Department of Conservative Dentistry and Endodontics during the assessed year. All the patients were subjected to intensive triage, which included recording their body temperature, oxygen saturation level, travel, and COVID-19 exposure history.ResultsA total of 26 DHCWs were responsible for attending and treating the patients with all the standard infection control measures. Seventy-four (0.40%) patients out of 18058 were referred for a nasal rapid antigen test (RAT) on giving a positive affirmation about COVID-19 like symptoms when screened at the triage. Of those 74 patients referred, 20 reported a positive nasal rapid antigen test and the infection was confirmed by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Among 26, 9 (34,7%) DCHWs were found to have contracted the infection during the assessed year.ConclusionThe analysis found that the risk of COVID-19 infection contraction amongst the DHCWs is considerably less. This could be attributed to the intensive triage and the preventive measures taken while rendering treatment.

Alternative aesthetic treatment of dental agenesis: a case report

Objective: To restore the self-esteem of an adolescent patient with dental agenesis through an alternative conservative aesthetic treatment. Methodology: A case report. Demarcation of the gingival plasty area and determination of bleeding points for gingivoplasty with a periodontal probe, incision using the internal bevel technique with a 15c scalpel blade and Kirkland's gingivotome. Composite resin increment technique by conditioning the enamel with 37% phosphoric acid for 30 seconds, washing with water for 1 minute and drying with absorbent paper. Application of the Adhesive System Adapter Single Bond 2 and light curing for 20 seconds. Soon after, with the aid of a Uvenner matrix, the resin Z350xt filtek supreme color B1 enamel was used for a thin veneer, photoactivated 3 times for 20 seconds. Interproximal excesses were removed with sandpaper. Results: The treatment, based on a gingivoplasty and reanatomization in composite resin, restored the patient's smile and self-esteem directly and quickly. Conclusion: A multidisciplinary planning based on the principles of conservative restorative dentistry is capable of restoring the aesthetic patterns of the smile, thus restoring the patient's self-esteem and social well-being.

Undergraduate dentistry student’s perception on objective structured practical examination (OSPE): A cross-sectional study

Assessment for practical skills in dental education needs improvement from subjective methods to objective ones. An OSPE has been considered as one such method. This study is an attempt to evaluate the feasibility of OSPE as a tool for the formative assessment of undergraduate medical education in Dental Material. Thirty-two students of Second BDS, at the end of the first term, were assessed by both the conventional practical examination (CPE) and OSPE. A five-station question based &amp; practical skill evaluation based OSPE was conducted one week after the conventional examination in Department of Conservative Dentistry and Endodontics of our institute. The scores obtained in both exams by these thirty-two students were compared. Feedback of participating students was evaluated in this interventional study. The steps involved were Sensitization of faculty and students; Preparation of five OSPE stations; Preparation phase and content validation of questionnaire for students. Feedback was given to students which will be useful to them in their subsequent and final university exams. The difference in marks was insignificant when paired t test was applied. Regarding the students’ perceptions of OSPE when compared to CPE, 78% responded that OSPE could partially or completely replace CPE. OSPE was judged as an objective and unbiased assessment as compared to CPE, by 84% of the students.

Comparative Evaluation of Anaesthetic Efficacy of Ropivacaine and Articaine with Epinephrine for Buccal Infiltration Anaesthesia in Maxilla Central Incisor and their Effect on Cardiovascular Parameters – A Randomized Control Trial

Aim: To compare the effectiveness, latency time and onset of pulpal anaesthesia with 0.5% plain ropivacaine and 4% articaine with epinephrine 1:100 000 and to determine their probable effect on cardiovascular parameters.&#x0D; Place and Duration of Study: Department of Conservative Dentistry and Endodontics, NPDCH, Visnagar, Gujarat between January 1st 2022 and January 31st 2022.&#x0D; Methodology: 20 patients (10 male, 10 females) age range of 18-36 years were inserted 1.8 mL of the anaesthetic solution for buccal infiltration anaesthesia of maxillary central incisors deprived of caries, restorations or signs of pulpitis. The latency time, onset of pulpal anaesthesia and duration of pulp anaesthesia were assessed with an electric pulp tester. Heart rate and blood pressure were measured before, Immediate and after the onset of pulpal anaesthesia of the solutions. Data was sent for statistical analysis.&#x0D; Results: The efficacy of anaesthesia of central incisors was 100% for both anaesthetics. The comparison of latency time and onset of pulpal anaesthesia were statistically significant for ropivacaine and articaine. Mean duration was less in Articaine group (206.50 ± 9.34) than Ropivacaine group (318.30 ± 43.21). Ropivacaine caused significant increases in blood pressure and heart rate.&#x0D; Conclusion: Ropivacaine (0.5%) achieved effective and long duration of pulp anaesthesia. Ropivacaine could be beneficial for long lasting operative procedures without the need for a vasoconstrictor.

Low-Shrinkage Resin Matrices in Restorative Dentistry-Narrative Review.

Dimethacrylate-based resin composites restorations have become widely-used intraoral materials in daily dental practice. The increasing use of composites has greatly enhanced modern preventive and conservative dentistry. They have many superior features, especially esthetic properties, bondability, and elimination of mercury and galvanic currents. However, polymeric materials are highly susceptible to polymerization shrinkage and stresses that lead to microleakage, biofilm formation, secondary caries, and restoration loss. Several techniques have been investigated to minimize the side effects of these shrinkage stresses. The primary approach is through fabrications and modification of the resin matrices. Therefore, this review article focuses on the methods for testing the shrinkage, as well as formulations of resinous matrices available to reduce polymerization shrinkage and its associated stress. Furthermore, this article reviews recent cutting-edge developments on bioactive low-shrinkage-stress nanocomposites to effectively inhibit the growth and activities of cariogenic pathogens and enhance the remineralization process.

Effect of antibacterial intracanal medicaments mixed with different vehicle used in inter-appointment flare-up patients

Background: Post-operative pain is a common finding after endodontic treatment, its incidence ranges from 3% to 58%. It may be due to microbial, mechanical or chemical injury to the periapical tissues. Calcium hydroxide has been recommended for use as an intracanal medicament based on its antibacterial, antiresorptive and tissue dissolving properties. The use of chlorhexidine gluconate as an intracanal medicament has been suggested either in the form of 2% gel or solution placed in a sustained release device or active points. Aim of the study: To evaluate and compare the effect of antibacterial intracanal medicaments mixed with different vehicle and used in inter-appointment flare-up patients. Materials and methods: The present study was conducted in the Department of Conservative Dentistry and Endodontic of the dental institute. This study was conducted on 45 permanent single-rooted mandibular premolars with acute apical periodontitis. Results: It is evident that the preoperative pain in Group 1, 2 and 3 patients was 3.56, 3.88 and 3.41 respectively. The post-operative pain for Group 1, 2 and 3 patients decreased significantly from 6 to 48 hours. However, on comparing the pain intensity for Group 1, 2 and 3, results were non-significant.

APEXIFICATION FOLLOWED BY DIRECT COMPOSITE VENEER ON ELLIS CLASS IV FRACTURE: A CASE REPORT

Introduction: Traumatized immature permanent teeth can cause pulp necrosis, leading to imperfect root formation, and thus resulting an open apex. The apical opening of the immature teeth is mostly large and thus may lead to difficulties in performing a root filling. In such cases, apexification is mandatory before doing root canal treatment. The aim of this case report was to inform that apexification and direct veneer was suitable to treat Ellis class IV fracture with necrotic pulpCase Report: 21-year-old female came to the Dental Conservation Clinic RSGM Prof. Soedomo Faculty of Dentistry UGM with chief complaint of right central incisive maxilla fracture and tooth discoloration. Radiographic examination showed an open apex of tooth 11 with a diffuse apical radiolucent area. Root canal treatment and apexification were carried out using circumferential technique and Mineral Trioxide Aggregate (MTA). Vertical warm obturation was performed, followed by intra coronal bleaching in the next visit. Final restoration was carried out using direct composite veneer. Post treatment radiographic showed a 1 mm diameter of radiolucent area at the apex in a good healing process.Conclusion: Apexification using MTA can be used to treat an open apex tooth. 1Student of Specialist Programme in Conservative Dentistry, Dentistry Faculty, Gadjah Mada University 2Department of Conservative Dentistry, Dentistry Faculty, Gadjah Mada University

The Lipstick.

1L. Rapp is PhD student, Maintain Aging Research team, and researcher, INSERM Centre for Epidemiology and Population Health Research, Université Toulouse III Paul Sabatier; member, Cancer Ageing and Rejuvenation (CARe) Graduate School; and doctor of dental surgery, Conservative and Restorative Dentistry Department, Geriatric Dentistry, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; e-mail: [email protected]; ORCID: 0000-0003-0908-694X. 2J.-N. Vergnes is full professor, Maintain Aging Research team, INSERM Centre for Epidemiology and Population Health Research, Université Toulouse III Paul Sabatier, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; and adjunct professor, Oral Health and Society Division, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada; ORCID: 0000-0001-7322-6551; Twitter:@JnVergnes. Acknowledgments: The authors are attached to the Inspire Platform, which is supported by grants from the Region Occitanie/Pyrénées-Méditerranée (Reference number: 1901175) and the European Regional Development Fund (ERDF) (Project number: MP0022856); the Inspire Chairs of Excellence are funded by grants from the Alzheimer Prevention in Occitania and Catalonia (APOC), EDENIS, KORIAN, Pfizer, and Pierre-Fabre and to the CARe Graduate School, which is funded through the grant EUR CARe N°ANR-18-EURE-0003 in the framework of the Programme des Investissements d'Avenir.

Commentary on "The Lipstick".

1L. Rapp is a PhD student, Maintain Aging Research team, and researcher, INSERM Centre for Epidemiology and Population Health Research, Université Toulouse III Paul Sabatier, member, Cancer Ageing and Rejuvenation (CARe) Graduate School, and doctor of dental surgery, Conservative and Restorative Dentistry Department, Geriatric Dentistry, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; email: [email protected]; ORCID: 0000-0003-0908-694X. 2J.-N. Vergnes is full professor, Maintain Aging Research team, INSERM Centre for Epidemiology and Population Health Research, Université Toulouse III Paul Sabatier, Centre Hospitalier Universitaire de Toulouse, Toulouse, France, and adjunct professor, Oral Health and Society Division, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada; Twitter: @JnVergnes; ORCID: 0000-0001-7322-6551. See facing page for “The Lipstick,” by Lucie Rapp, DDS, and Jean-Noel Vergnes, DDS, PhD. Commentary first published online March 29, 2022.

Huia Masters (Pick) Pickard (1909-2002): a pioneer of restorative dentistry.

Huia Masters Pickard was a leading dental teacher of conservative and restorative dentistry in the 1950s, 1960s and early 1970s. After war service and some general practice, he devoted himself to teaching undergraduates and training junior staff at the Royal Dental Hospital of London.

The Influence of Preventive Regimens Containing Different Toothpastes on Caries Risk of High-Risk Patients: A Randomized Clinical Trial

BACKGROUND: The main objective of conservative dentistry is maintaining the health of the dentition and restored teeth free from dental caries. The prevention of dental caries can be achieved by personal prevention programs at home, dental health care professional, and public health application programs. Based on knowledge related to the etiology and pathogenesis of dental caries, this provides a chance for application of effective prevention program for the prevention of dental caries. AIM: This study aimed to evaluate the effect of different preventive regimens using different toothpastes on caries risk using cariogram and decayed, missing, and filled (DMF) scores of high caries risk patients. MATERIALS AND METHODS: The study was conducted on 66 participants with high caries risk. Participants were divided into three groups, 22 participant each. According to the test regimen, where (A1) participants were exposed to a regimen including dual zinc plus arginine-based toothpaste (Colgate total), (A2) participants were exposed to a regimen including zinc-based toothpaste (Crest complete), and (A3) control group was participants that were exposed to a regimen including fluoride-based toothpaste (Signal). The study was carried for 1 year, assessment of cariogram and DMF scores was done in four intervals: T0: baseline, T3: after 3 months, T6: after 6 months, and T12: after 12 months. RESULTS: According to cariogram, there was a statistically significant difference between Groups A1, A2, and A3, where p &lt; 0.001. However, DMF scores of all groups showed no statistically significant difference between the three groups. CONCLUSIONS: Dual zinc plus arginine-based toothpaste is a superior caries preventive regimen in high caries risk patients. CLINICAL SIGNIFICANCE: The benefits of preventive regimen to the practitioner will be providing a non-invasive, and cost-efficient method to prevent dental caries. Benefits to the patient will be an improvement of oral hygiene, prevention of dental caries, and maintain healthy dental supporting structures.

Role of laser in conservative dentistry and endodontics

With dentistry in the high tech era, we are fortunate to have many technological innovations to enhance treatment, including intraoral video cameras, CAD-CAM units, RVGs and Air-abrasive units. However, no instrument is more representative of the term high-tech than the Laser. The rapid development of laser technology, as well as a better understanding of laser interaction with biological tissues, has widened the spectrum of possible applications of lasers in Conservative dentistry and Endodontics. This article reviews the basic mechanism and applications of each laser in conservative dentistry and endodontics.

Low Prevalence of Amalgam-Associated Lichenoid Lesions in the Oral Cavity: A Prospective Study.

Introduction: Amalgam has been the restoration of choice for years, but its popularity has declined due to concerns about aesthetics, mercury toxicity and lichenoid lesions associated with it. Lichenoid reaction is considered to be a delayed hypersensitivity type of reaction and it has been associated with dental materials in general and amalgam in particular.Materials and Methodology: Two thousand patients having at least one amalgam restoration were examined for signs of lichenoid lesions when visiting the OPD of Conservative Dentistry and Endodontics at the Nair Hospital Dental College in Mumbai, India. Indirect spatial correlation to the amalgam restoration and the same were recorded. Descriptive analysis was used.Results: Three (0.15%) out of 2000 patients with amalgam-associated lichenoid lesions showed complete resolution of lesions after the replacement of the restorations.Conclusion: Amalgam associated lichenoid lesions have a low prevalence and should not be a contraindication to its use in routine restorative dental practice. Patch tests and biopsies have questionable diagnostic and prognostic value. Identification of the lesions should be made after the elimination of all other causative factors for the presenting symptoms. A close spatial association of the lesion to amalgam and the regression of symptoms after its removal should be considered as confirming the diagnosis.