Extensive Amalgam Restorations Research Articles

Do non-clinical subjective factors influence the treatment decisionmaking of Brazilian dentists?

The literature contains little information on several non-clinical factors such as the association between graduate residency programs and the application of minimally invasive dentistry, or on dentists' clinical decision-making processes for replacing restorations for esthetic reasons. This study evaluated whether non-clinical subjective factors influence the treatment decisions made by Brazilian dentists regarding technical and esthetic matters. Dentists were invited to participate in a cross-sectional survey by answering an electronic questionnaire containing clinical cases, regarding what treatment they would select for: T1 - a molar tooth with significant crown destruction and spontaneous pain, and T2 - premolar teeth with extensive amalgam restorations and no carious lesion or associated complaint. The survey also included questions about subjective variants (sociodemographic and professional). Chi Square test and Fischer's Exact test were used toanalyzetheanswers to T1, and one-factor analysis of variance and post-hoc Tamhane were applied to T2. The significance level was set at 5% for all analyses. A total 302 professionals participated in the study. For T1, it was found that clinical decision-making was influenced by the Brazilian region of clinical practice (p=0.005). For T2, a significant association was found between increased loss of patient tooth tissues and whether the professional had completed a residency program in Operative Dentistry (p=0.035), worked in a private practice (p=0.033), or if most of his/her patients belonged to a high estimated socioeconomic level (household income above $4350) (p=0.002). In conclusion, the clinical decision-making of Brazilian dentists varies according to professional profile, mainly with relation to the replacement of restorations due to esthetic concerns.

Amalgam allergy and Burning Mouth Syndrom: treatment and 25 years recall

Background: Burning mouth syndrome (BMS) is a non-neuropathic chronic orofacial pain condition, characterizedby the presence of burning/warm sensation without specific mucosal lesions. Objective: The aim of the presentclinical case report is to describe the positive outcome of dental treatment of a patient with BMS and followedup for 25 years. Data Treatment: This report describes the case of a 50-year-old black woman sought treatmentfor burning, and persistent swelling of tong (24h/day) occurring over years. Clinical evaluation of the oralenvironment revealed the tongue with cracking, darkened points areas, surrounded by whitish areas. Twelveteeth presented extensive amalgam restorations. Patch testing revealed a very strong hypersensitivity to Amalgam.All amalgam restorations were substituted by composite resin restorations. Results and Conclusion: Burningsensation disappeared completely after these restorations had been changed. After 25-year follow-up period, it wasobserved that burning sensation has never been felt anymore. Clinical Significance: Burning mouth syndromeis a chronic orofacial pain, usually without specific mucosal lesions. The etiology is complex and multifactorialand the treatment should be made specifically for each pacient.KEYWORDSBurning mouth syndrome; Composite resin; Dental amalgam.

Fracture Resistance of Extensive Amalgam Restorations Retained by Pins, Amalgapins and Amalgam Bonding Agents

This in-vitro study compared the resistance of extensive amalgam restorations retained by either four Regular TMS Link Plus pins, four amalgapins, Amalgambond Plus, Amalgambond Plus with HPA, Scotchbond Multi-Purpose Plus, PQ Amalgam, Panavia F 2.0, All-Bond 2 or Resinomer. Ninety caries-free third molars were embedded in acrylic resin and their occlusal surfaces reduced to within 2 mm of their CEJ. Tytin amalgam alloy was hand-condensed into copper band matrices reinforced with modeling compound after placement of mechanical retention or application of the amalgam bonding agents. Modeling compound and copper bands were removed after 24 hours, and the restorations were adjusted to produce specimens 5 mm in height with a 1 mm bevel on the occlusal-axial surface. The specimens were stored in 100% humidity for one month followed by immersion in de-ionized water for 24 hours at 37 degrees C. The specimens were loaded in compression at a 45 degrees angle in an Instron Universal Testing Machine at a crosshead speed of 0.02 inches/minute. The mean failure loads and standard deviations recorded in Newtons were as follows: Amalgambond Plus with HPA 2160N (380), Scotchbond Multi-Purpose Plus 1900N (380), four Amalgapins 1770N (340), PQAmalgam 1660N (270), Panavia F 2.0 1620N (440), Amalgambond Plus 1570N (390), four Regular TMS Link Plus Pins 1325N (406), All-Bond 2 1300N (390) and Resinomer 1245N (310). A one-way ANOVA and Tukey post hoc analysis indicated all amalgam bonding agents were statistically equal to either four Regular TMS Link Plus pins orfour amalgapins.

Long-term evaluation of extensive restorations in permanent teeth

Objectives. The present prospective, longitudinal study assessed the outcome of posterior extensive restorations and identified risk factors for failure of the restorations. Materials and methods. The sample consisted of 722 amalgam restorations, 115 composite resin restorations and 89 crowns placed in 428 adults by one dentist from 1982 to 1999 in Belgium. Well-defined criteria were used for cavity preparation design, type of retention and selection of restorative material. Results. At the closure of the study 48% of the restorations were well functioning, 24% were lost to lack of follow-up, and 28% had failed. The most frequent reasons for failure were fracture of restoration (8%), secondary caries (6%) and fracture of cusp (5%). Failures were more often found in premolar teeth (34%) than in molars (27%) ( P=0.05) and occurred in 28% of the amalgam restorations, 30% of the resin restorations and 24% of the crowns ( P=0.55). Molar restorations were more frequently repaired than replaced in contrast to premolar restorations. The highest percentage of extractions was related to complete amalgam restorations in premolars. The Kaplan–Meier median survival times were 12.8 years for amalgam restorations, 7.8 years for resin restorations, and more than 14.6 years for crowns, considering all retreatment as failures ( P=0.002). The survival was influenced by extension of restoration, age of patient, pulpal vitality, 3-year period of treatment, use of base material and dentinal retentive pins. Conclusion. Within the limits of the study the data support the view that extensive amalgam restorations but not composite resin restorations can be used as an appropriate alternative to crowns, with due consideration to the longevity of the restorations.

Long-term survival of extensive amalgams and posterior crowns

Objectives: There is very little information available from private dental practices on the comparative survivals of extensive posterior amalgam restorations and posterior crowns placed in the same patient population. Therefore, the present retrospective study examined the performance of such restorations at three long-established Adelaide city practices. Methods: Life-table survival estimates were generated for 160 extensive amalgams, 96 cast gold crowns and 174 ceramometal crowns. The restorations were placed by 20 dentists at various times in 100 patients who attended the practices on a regular basis for around 25 years on average. Results: There were no significant differences found in the survival times for both types of crowns, with around 70% still being present at 20 years. However, the median survival time for the extensive amalgams was much lower, at 14.6 years. Despite these differences in survival times, the extensive amalgam restorations survived for longer than is usually expected. Conclusion: In this present study, the survival findings have implications for the most cost-effective dental treatments of large lesions in posterior teeth.

Treatment time analysis for extensive amalgam restorations

The treatment times for the fabrication of Extensive Amalgam Restorations (EAR) as recorded in a longitudinal clinical trial at the Dental School in Nijmegen were analyzed. 269 EAR's with different retention methods were made on molars by three operators. A mean total treatment time of 60 min was found. The factor operator had a significant influence on all treatment phases resulting in a 26% difference in total treatment time between operators. Also significant influences were found in some treatment phases for the factor retention, side location of the tooth and extension of the restoration. The results of this study with regard to treatment times must be considered from the perspective of the quality of the care provided.

In vitro resistance of extensive amalgam restorations using various retention methods

In vitro resistance of extensive amalgam restorations using various retention methods

Effects of topical fluorides on five low-fusing dental porcelains

Samani, S. 1. A.: A procedure for repairing fractured post-core restorations. J PRCXTHET DENT 39:6, 1978. Johnson, J. I<.: I)wrl form and tcmsilc force. J PRCWHET [ILTInd rlesiqn. J PROSTXET DEN,~ 39:4. 10’8. l%rcz hloll, ,J. p.. (:;M gold post and tort rind pin-retained wrnpositc resirl hasrs A comparatiw ~tudv in strength. ,J PRO';THI.T DIXT 40:6. 197% il Vujimoto, J.. . comparison of pin-retained amalgam and composite resin core. J PROSTHET DENT 39:5, 1978. 7 Outhwaite, W. C. Pin vs. slot retention in extensive amalgam restorations. J PROSTHET DENT 41:4, 1979. h \Vrlk, D. A: Influencr of pins on the compressive and transverse strength of dental amalgam and retention of pins in amalgam. ,J :Zm Dent Rssoc 78:lOl. 1969.

A Clinical Comparison of Dentinal Slot Retention with Metallic Pin Retention

Twenty-two pairs of extensive amalgam restorations were placed in 19 patients. One amalgam of each pair had self-threading pin retention, and the other had dentinal slot retention. Evaluations were done at baseline, at one, and two years. After two years, 17 pairs of amalgams were available for evaluations. The data obtained can be summarized as follows: 100% (17) of the slot-retained amalgams were clinically acceptable, whereas 94.1% (16) of the pin-retained amalgams were acceptable. It can be concluded that, in clinical usage, dentinal slot retention is as effective as self-threading pin retention in extensive amalgam restorations.

Pin vs. slot retention in extensive amalgam restorations

Pin vs. slot retention in extensive amalgam restorations