Longevity Of Composite Restorations Research Articles

Placement of Posterior Composite Restorations: A Cross-Sectional Study of Dental Practitioners in Libya

Dental practitioner-related factors can influence the quality and longevity of composite restorations. This study aimed to examine the clinical techniques used by dental practitioners (DPs) in Tripoli, Libya, when placing direct posterior composite restorations, with a focus on identifying any associations between clinical practices and years of experience. A questionnaire survey covering aspects of posterior composite placement, including material preference, cavity preparation, adhesive technique, isolation method, and occlusion adjustment, was distributed to 120 DPs in Tripoli. Data were statistically analyzed using Fisher’s exact test to assess associations between years of experience and specific clinical practices. Composite was the preferred material for both small and large posterior cavities across all experience levels. No statistically significant associations were found between years of experience and key clinical practices, including preparation techniques (pulpal depth, p = 0.9005), adhesive choice (p = 0.5679), isolation method (p = 0.2515), and occlusal adjustment (p = 0.7469). The study found that DPs in Tripoli display a standardized approach to posterior composite restorations, with minimal variation in clinical techniques based on experience. These findings suggest the effectiveness of foundational training in establishing consistent practices among Libyan DPs, though further emphasis on specific techniques, such as rubber dam isolation, may be beneficial in education and training.

Longevity of composite restorations in posterior teeth placed by dental students: a 12-year retrospective study.

To evaluate the longevity of resin composite restorations placed in posterior teeth by dental students, using data from electronic records from 2008 to 2019. Demographic (gender and age) and clinical variables (dental group, position in dental arch, and the number of restored surfaces) were evaluated. The 5-year follow-up was assessed according to the day the restoration was placed. Kaplan-Meier curves were generated to calculate the annual failure rate. Data were analyzed by Chi-Square, Kruskal-Wallis, and Mann-Whitney tests (α = 0.05). In total, 3.883 records relative to return periodicity were analyzed. The final sample consisted of 900 restorations from 479 patients. The majority were females, aged between 31 and 60. In total, 256 failures were reported (success rate = 78%), showing an annual failure rate of 2.05%. The main reasons for failures were restoration replacement (55.5%), endodontics (21.9%), prosthetics (14.5%) and extraction (8.2%). There was a higher risk of failure in restorations involving three or more surfaces (p = 0.000) and in patients over 60 years (p < 0.001). In females (p = 0.030), molars (p = 0.044), and maxillary teeth (p = 0.038) failed in a shorter time. Resin composite restorations placed in permanent posterior teeth by dental students had high survival rates. The main reason for failure was the replacement of restorations. The age group and the number of restored surfaces significantly affected the success of the restorations. The electronic health records over 12 years showed that 78% of the resin restorations in posterior teeth placed by dental students were successful for a minimum of five years.

Longevity of composite restorations is definitely not only about materials.

This review study provides an overview of factors that influence the longevity of all types of direct resin composite restorations. A systematic search was performed in PubMed, Scopus, and Web of Science databases for articles reporting data from primary longitudinal clinical studies on composite longevity published 2011-2021. Prospective or retrospective studies with restorations in permanent dentition, with follow-up periods of at least 5 years were included. In total, 33 articles were included with different study designs, practice settings, datasets, countries of origin, and sample sizes. Annual failure rates of restorations ranged from 0.08% to 6.3%. Survival rates varied between 23% and 97.7%, success rates varied between 43.4% and 98.7%. Secondary caries, fractures, and esthetic compromise were main reasons for failures. Risk factors for reduced restoration durability included patient-level factors (e.g., caries risk, parafunctional habits, number of check-ups per year, socioeconomic status), dentist factors (different operators, operator's experience), and tooth/restoration factors (endodontic treatment, type of tooth, number of restored surfaces). Patient gender and the composite used generally did not influence durability. A number of risk factors are involved in the longevity of composite restorations. Differences between composites play a minor role in durability, assuming that materials and techniques are properly applied by dentists. Patient factors play a major role in longevity. The decision-making process implemented by dentists relative to the diagnosis of aging or failed restorations may also affect the longevity of restorations. Clinicians should treat patients comprehensively and promote a healthy lifestyle to ensure longevity.

Shear Bond Strength Of Etch And Rinse Adhesives To Dentin: Comparison Of Bond Strength After Acid And Papacarie Pre-Treatment.

Papacarie pre-treatment of dentin surface has been reported to exhibit good bond strength values between dentin and composites. Its desirable properties like high pH, sites specify and anti-inflammatory response makes it a future material in place acid etching pre-treatment. Acid etching may cause sensitivity and collapse of dentinal matrix. This in-vitro study involved, 60 caries free extracted premolars, randomly divided into three groups. Control Group (Group A) No pre-treatment of dentin prior adhesive application. Experimental Group B acid etchant was applied before adhesive application. Experimental Group C Papacarie was used as a pre-treatment agent. All these specimens were tested for shear bond strength with the help of Universal Testing Machine. All the collected data was entered in SPSS version 20.0. ANOVA was used to determine the mean SBS (Shear Bond strength) values of control and experimental groups. The mean shear bond strength of material was 7.74±0.47 in group A, 17.80±1.43 in group B and 15.11±0.70 in group C. Group B showing better strength than other two groups. The study provides information about longevity of composite restorations and may help in extending the clinical usage of papacarie to avoid harmful effects of acid etching on dentin and pulpal tissue.

Assessment of dentists' opinions on the cause of failure of adhesive composite restorations

Aim of this study was to get an overview of what dentists estimate to be the reason for failure of adhesive composite restorations and to gain knowledge about potential future foci for targeted further education. Therefore, a survey about the fabrication of composite restorations was conducted in the course of seven dental conferences with the main topic tooth-prevention. A total of 577 dentists participated in the survey. The most often called estimated factor for failure of composite restorations was the "dentist" (70.7%), followed by "indication" (32.2%), "material" (8.5%) and "patient" (8.1%). Participants estimated insufficient drying and fluid management (67.9%), incorrect application of the adhesive system (41.8%), insufficient lightpolymerisation (31.2%) and errors in incremental technique (27.6%) to be the main mistakes. The participating dentists claimed to attach great importance to careful drying and fluid management (60.8%), thorough adhesive application (37.3%), adequate incremental technique (32.6%) and sufficient lightpolymerisation (28.8%) while placing their own restorations. According to the survey participants, the treating dentist has the greatest influence on the quality and longevity of composite restorations. Drying and fluid management was the most often called estimated reason for failure but at the same time the step which is given the greatest caution.

Hands-on training based on quantifying radiant exposure improves how dental students cure composites: Skill retention at 2-year follow-up.

The durability and longevity of composite restoration are much dependent on the accurate delivery of the energy required to polymerise the material. This study aimed to investigate the extent to which undergraduate dental students acquire and retain light-curing skills following hands-on training. Hands-on training comprises faculty tutoring for critical aspects of the light-curing procedure, such as distance and angulation of the light-curing tip. Assessments of the students' ability to deliver a specified radiant exposure to class III and I simulated RBCs using a dental simulator (MARC-PS® ) at three different time points after the training. Data were analysed using repeated measure ANOVA. Immediately after the training, students' performance on curing was improved (p<.05). Overall, the radiant exposure increased after training, but the students lost some of the benefits with time. For curing in the anterior section (anterior sensor-class III), the mean radiant exposure values increased by approximately 20% after the training. After 2years, the values were 15% greater than baseline values. For curing in the posterior section (posterior sensor-class I), the mean radiant exposure values increased by approximately 150% after the training. A significant decrease (p<.05) was observed; however, the radiant exposure values were still 82% greater than the baseline after 2years. A hands-on training dedicated to light-curing procedures facilitated acquisition and retention up to a 2-year follow-up of skill on how light cure composite inside the mouth. The training was more relevant for curing in posterior areas, where orientation can significantly impact light-curing. A hands-on training where the radiant exposure can be measure gave objective measurement metrics to guide the curing performance. This approach is an effective means of teaching practical skills to dental students.

Longevity of posterior composite restorations in children suffering from early childhood caries-results from a retrospective study.

This retrospective study aimed to evaluate health status as a new patient risk factor and analyze its influence on the survival of posterior composite restorations in patients with early childhood caries (ECC). Patients who received dental treatment of ECC under general anesthesia (GA) and attended at least one follow-up visit were included in this study. A total of 907 patient records were evaluated retrospectively through patient examination forms and panoramic radiographs. Kaplan-Meier survival probability analysis with log-rank test was used to assess the posterior composite restorations' longevity up to 24 months. Furthermore, risk factors were determined using Cox regression multivariate analysis. A total of 5063 posterior composite restorations were assessed. Following the Cox regression analysis to determine the effect of risk factors on longevity of composite restorations, findings revealed that the survival probability of composite fillings was significantly lower in patients with systemic disease (p = 0.00). Filling materials were compared based on the survival probabilities and results were further discussed. There was no significant relationship between age, gender, and the survival of the restoration; however, the child's health status (p = 0.00) and caries risk status (p = 0.05) significantly affected survival. Moreover, the type of arch and pulp intervention influenced the restoration's survival. Systemic disease has a detrimental influence over longevity of composite restorations. Therefore, considering the reduced survival rates of the composite restorations for children who have systemic disease, alternative non-invasive treatment options should be considered. This study's novelty is the observation of drastically reduced survival of composite restorations in children with systemic disease.

Does the Type of Solvent in Dental Adhesives Influence the Clinical Performance of Composite Restorations Placed in Noncarious Cervical Lesions? A Systematic Review and Meta-analysis.

According to the clinical and scientific evidence presented in this systematic review and meta-analysis, dental adhesives containing either organic solvent (acetone or alcohol) can be used to achieve similar clinical performance and longevity of composite restorations. Objectives: This systematic review and meta-analysis compared the clinical performance and survival rates of composite restorations placed in noncarious cervical lesions (NCCLs) using dental adhesives containing acetone or alcohol-based solvents.Methods and Materials: PubMed, Scopus, Web of Science, Virtual Health Library (VHL) LILACS, Cochrane Library, OpenGrey, Clinical Trials, and Rebec were searched. MeSH terms, supplementary concepts, synonyms, and free keywords were used in the search strategy. All references were crosschecked by two independent investigators following the PICOS strategy (population, NCCLs; intervention, acetone-based bonding agent; comparison, alcohol-based bonding agent; outcome, clinical evaluation parameters and survival rates; study design, randomized controlled clinical trials). Cochrane Collaboration's tool was used to assess risk of bias, and two distinct meta-analyses were performed using the RevMan software. The prevalence of success and the total number of restorations for each group (acetone- or alcohol-based) were used to calculate the risk difference at a confidence interval of 95%. Random-effects models were applied, and heterogeneity was assessed using the I2 index in the pooled and subgrouped meta-analyses. The certainty of evidence was evaluated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.Results: A total of 7876 studies were retrieved, from which 27 studies were selected for the systematic review. Ten studies were classified as "low risk of bias" and included in the meta-analyses. Overall heterogeneity was not significant (I2 = 0.00%). The clinical performance of restorations placed with bonding agents based on both solvents for each of the available parameters presented no statistical significance for any of the meta-analyses (p>0.05).Conclusion: Scientific evidence suggests composite restorations placed with acetone or alcohol-based dental adhesives present similar clinical performance and survival rates in NCCLs.

Effect of alcoholic beverages on shear bond strength of composites to enamel.

Background:Longevity of composite restoration in the oral cavity is dependent on various factors. One such factor is exposure to various foods and beverages which could alter the properties of the material.Aim:The aim of this in vitro study was to evaluate the effect of most widely consumed alcoholic beverages on shear bond strength of composites to enamel.Material and Methods:A total of seventy human premolars were embedded in acrylic resin blocks. Labial enamel surfaces was flattened, etched, bonded, and restored with composite resin (Tetric N Ceram – Ivoclar Vivadent AG, Schaan, Liechtenstein). The specimens were randomly divided into four groups: Group I: beer; Group II: wine; Group III: whiskey, and Group IV: artificial saliva. Group I to Group III were again divided into moderate (Group IA, IIA, and IIIA) and heavy (Group IB, IIB, and IIIB) consumption subgroups. The specimens were soaked in their respective groups for 90 min daily in Group IA, IIA, and IIIA and for 30 min every alternate day in Group IB, IIB, and IIIB until 30 days. Universal testing machine was used to determine the shear bond strength of composite with enamel.Statistical Analysis Used:The values obtained were statistically analyzed using two-way analysis of variance followed by post hoc test with the significant level set at P < 0.05, using GraphPad prism software version 6.01.Results:Group IIB showed the highest reduction in shear bond strength, with a mean value of 6.6 ± 1.2 Mpa in comparison to control with a mean value of 21.8 ± 1.6 Mpa.Conclusion:As the content of alcohol and time of exposure increased along with a decrease in the pH of alcoholic beverages, shear bond strength between composite and enamel decreased.

Polymerization shrinkage stress of composite resins and resin cements - What do we need to know?

Polymerization shrinkage stress of resin-based materials have been related to several unwanted clinical consequences, such as enamel crack propagation, cusp deflection, marginal and internal gaps, and decreased bond strength. Despite the absence of strong evidence relating polymerization shrinkage to secondary caries or fracture of posterior teeth, shrinkage stress has been associated with post-operative sensitivity and marginal stain. The latter is often erroneously used as a criterion for replacement of composite restorations. Therefore, an indirect correlation can emerge between shrinkage stress and the longevity of composite restorations or resin-bonded ceramic restorations. The relationship between shrinkage and stress can be best studied in laboratory experiments and a combination of various methodologies. The objective of this review article is to discuss the concept and consequences of polymerization shrinkage and shrinkage stress of composite resins and resin cements. Literature relating to polymerization shrinkage and shrinkage stress generation, research methodologies, and contributing factors are selected and reviewed. Clinical techniques that could reduce shrinkage stress and new developments on low-shrink dental materials are also discussed.

High precision pycnometer for volumetric measurement of polymerization shrinkage in light cured dental composites

Abstract Due to the many benefits such as excellent aesthetics, biocompatibility, and wear resistance, the use of light cured composite materials in dentistry has grown in the last few decades. However, the main disadvantage of present composite materials is significant volumetric shrinkage during curing, which leads to void and crack formation that is detrimental to the longevity of the restoration. This work presents a gas pycnometer which was re-designed to achieve high precision measurements of polymerization shrinkage while allowing in-situ curing of small size dental composites. Samples of dentin, enamel and body (DEB) shade of conventionally used restorative nanocomposite material with average mass of ∼141.35 mg were in-situ cured at irradiance of ∼370 mW/cm 2 using various exposure time cycles, which totaled the manufacturer recommended 60 s. The proposed system enhancements allowed measurement of time-dependent polymerization shrinkage of in-situ light cured dental composites. Volumetric measurements had reproducibility of ∼0.005% of nominal full-scale sample cell chamber volume; and the shrinkage measurements did not exceed the average relative standard deviation (RSD) of ∼2.8%, which is ∼4 times better when compared with conventional techniques. Overall, this newly developed high precision and C-factor independent technique provides better understanding of time-dependent volumetric polymerization shrinkage aiding in development of better clinical procedures and materials to improve health and longevity of composite restorations.

Comparison of Composite Restoration Techniques

This article briefly presents the classification, and possible ways of application of composites. Our objective was to compare three different restoration technique in class II cavity preparations, with the aim to determine which technique is the most advantageous in practical point of view. Artificial teeth fabricated from self-curing acrylic resin were used as models. Comparison of marginal sealing was performed macroscopically via direct visual inspection and via tactile control. Two parameters were examined on esthetic evaluation, which were the anatomical shape and the optical appearance. The time required to prepare the restorations were also measured. After the evaluation of the results, the bulk-fill technique was demonstrated to require the shortest time to be performed. This was followed by the oblique (Z) technique, whereas the horizontal incremental technique appeared to be the most time-consuming method. Based on the esthetic evaluation, a remarkable difference can be observed between the bulk-fill technique and the other two incremental techniques, while the mean scores for the oblique and the horizontal techniques were comparable. Based on the results of the visual inspection and instrumental examination, there were no differences in terms of marginal sealing between the three applied methods. Based on these, the use of the appropriate incremental technique can reduce the development of secondary caries and increasing the longevity of composite restorations.

Longevity of composite restorations in patients with early childhood caries (ECC)

The aim of this retrospective study was to describe the type and extent of composite fillings in a high risk pediatric caries population and analyze restoration survival probability in relation to severity of decay, Black classification, and composite type. A total of 1,017 fillings in 855 primary teeth performed under general anesthesia from 2004-2007 were included into this study. All 157 patients had early childhood caries after the classification of Wyne and were recalled for at least 6 months. A total etch adhesive system, in combination with flowable and/or packable composites, was used. Failures were evaluated according to clinical criteria. Survival probability was calculated using Kaplan-Meier survival analysis. The mean observation period for restorations was 30.9 months, with a success rate of 81.5 %. In 125 cases, restorations failed after an average retention time of 23.6 months, resulting in an annual failure rate of 4.2 %. The reasons for failure were fracture or partial failure (9.6 %), secondary caries (44 %), or complete restoration loss (46.4 %). Fillings in patients with severe decay had significantly lower survival probabilities. No significant differences were found between flowable and packable composites. Composite fillings are a long lasting, high-quality treatment option in pediatric patients with a high risk of caries who are treated under general anesthesia. A strict caries prevention regimen should be followed to minimize the loss of restorations caused by secondary caries. Composite fillings are a long lasting, high-quality treatment option in children with early childhood caries treated under general anesthesia.