Proximal Restorations Research Articles

Microinfiltração em dentes decíduos em função de materiais restauradores e condicionamento ácido

A pesquisa teve como objetivo avaliar a microinfiltração em restaurações de quatro materiais (Dyract, Vitremer, Z100 e Fuji II LC), em dentes decíduos, realizando ou não condicionamento ácido. Foram feitas dez restaurações (5 OM e 5 OD) para cada condição experimental. As cavidades tinham as dimensões (mm): 4 de altura, 3 de largura e 2 de profundidade. Os materiais foram manipulados conforme instruções dos fabricantes. Os dentes restaurados, após sete dias de armazenagem foram submetidos à ciclagem térmica (700 ciclos a 5 e 55ºC, com um minuto em cada banho). Em seqüência os corpos-de-prova foram preparados para a imersão em azul de metileno a 0,5%, pH 7,2, por quatro horas, após o que foram preparados para a avaliação do grau de infiltração. Os resultados permitiram concluir que: foi grande a diferença de escores entre materiais (de infiltração nula, 0, a 4 máxima); médias de 0,1 (Dyract) a 4,0 (Fuji II LC); os materiais Vitremer e Z100 não diferiram entre si e se encontraram com valores entre os outros dois; o condicionamento ácido influiu apenas com o material Fuji II LC.

Comparison between the sequential and simultaneous approaches for the restoration of adjacent proximal cavities

summary The clinical situation in which several proximal carious lesions have to be treated is frequently encountered. The need to provide a cost‐effective and time‐effective treatment often compels the clinician to perform multiple adjacent proximal restorations simultaneously, at the same treatment session. Alternatively, such treatments may be performed sequentially in successive sessions. The different possible treatment modalities and their clinical sequel are described. Examination of the clinical results suggests that the preferred restorative procedure is the sequential one, enabling an optimal restoration of the original anatomical form, which is important for the proper health and function of the teeth and the surrounding periodontal tissues.

Observations in Australia of the use of glass ionomer cement restorative material.

The aim of this study was to evaluate, with the aid of a questionnaire distributed to selected groups of dentists, the use of glass ionomer cement in different types of proximal restorations and further to evaluate any complications observed with the use of GIC. Few dentists responded in the 'Often' category regarding the observation of secondary caries or gingival inflammation in association with GIC fillings compared with about three-quarters of the dentists who reported on posterior composite resin restorations. Tunnel cavities had been prepared and restored by 54 per cent of the dentists, simple proximal restorations in primary molars by 89 per cent and 'sandwich' restorations by 69 per cent. Few dentists with at least two years experience with tunnel restorations observed biological complications, but fracture of the marginal ridge was reported in the 'Often' category by 12 per cent. Among the dentists with at least five years experience with proximal restorations in primary molars 59 per cent of the operators mentioned more complications with these than with amalgam restorations. Biological complications were not a great problem with glass ionomer/composite laminates but wear or dissolution of the proximal GIC surface was recorded in the 'Often' section by 14 per cent of those placing them.

Periodontal healing in teeth with periapical lesions

The purpose of the present investigation was to compare clinical periodontal healing in periodontally involved teeth with and without pulpal pathosis. The investigation was conducted as a retrospective study on a consecutive referral population. The periapical conditions in endodontically involved single-rooted teeth from a selected patient sample were evaluated and correlated with their periodontal healing pattern. Multiple regression analysis of the registered variables showed that initial mean pocket depth and time elapsed after treatment significantly influenced change in pocket-depth. Non-surgical treatment of periodontal pockets exceeding 2.5 mm in teeth with horizontal marginal defects, over the observation period, showed significantly reduced mean pocket depth reduction in teeth with periapical pathology compared to teeth without periapical pathology. It was, furthermore, evident that proximal restorations, abutments for fixed bridges and root fillings with and without dowels did not significantly influence pocket depth reduction in the present material. It was concluded, based on the present results, that a root-canal infection, evident as a periapical radiolucency, if left untreated may in the long term perspective result in retarded or impaired periodontal healing following periodontal therapy and, consequently, should be given appropriate consideration when coordinating endodontic therapy and periodontal treatment.

Wedges in restorative dentistry: principles and applications

Overhanging margins of proximal restorations are a well-known, iatrogenic cause of periodontal pathology. The high incidence of such findings in Western societies should arose the concern of the dental community. However, overhanging margins represent only part of the iatrogenic problem created by the misuse of wedges in restorative procedures. Other causes include incorrect proximal contouring, inadequate contact points and under- or overfilling the restorative material. The understanding of the variables associated with wedge selection and positioning has a major role to play in the prevention of iatrogenic periodontal pathology associated with restorative procedures. It is concluded that: (i) the occlusion of the matrix band to the remaining healthy tooth structure of the gingival cavosurface line angle should be achieved solely by the correct application of the wedges; (ii) the effect of the wedges on the proximal contour and contact area should be carefully re-evaluated prior to insertion of the restorative material; (iii) various sizes and shapes of wedges and a sharp knife for carving must be readily available.

A hybrid matrix retainer for two-surface proximal restorations

A hybrid matrix combines the rigid and flexible properties of two different thicknesses of matrix bands for use in restoring the proximal surfaces of teeth.

Management of the endodontically treated tooth. Part I: concept for restorative designs.

The first premise is that not all teeth treated endodontically will require posts, cores, or crowns (Fig. 1). Despite small proximal restorations, most pulpless anterior teeth with sound coronal tooth structure can be conservatively restored with lingual composite restoration. The concept that all anterior teeth that have received root canal therapy require posts and crowns is not supported by recent studies. Trabert et a1.14 concluded that there is no appreciable difference in the resistance to fracture between untreated anterior teeth and endodontically treated anterior teeth. Guzy and Nicholls3 compared failure loads on intact endodontically treated maxillary central incisors and maxillary and mandibular cuspids with and without posts. They concluded that there was no

A radiographic study of chronic periodontitis in 15 year old Queensland children.

A retrospective study was carried out to determine the frequency of early periodontal bone loss in 15 year olds as seen in bite-wing radiographs. A total of 468 radiographs of 15 year olds was examined, 246 from 1970-74 and 222 from 1978-80. The alveolar bone crest on the mesial and distal of the first permanent molar teeth was examined for radiographic evidence of early chronic periodontitis. The condition of the adjacent proximal tooth surfaces was also recorded. No significant difference was found between the two groups; 39% of the 1978-80 and 43% of the 1970-74 group showed radiographic evidence of early chronic periodontitis (P less than 0.05). Males and females showed a similar frequency of periodontal disease levels. The mesial interproximal space of the first molars had significantly higher frequencies of radiographic evidence of chronic periodontitis than the distal interproximal spaces in the two groups examined. Fewer proximal restorations with overhangs were noted in the 1978-80 group, however more proximal subgingival calculus was found in this group than the 1970-74 group.

Esthetic considerations for the placement of anterior crown margins

2. Renggli, H. H., and Regolati, B.: Gingival inflammation and plaque accumulation by well-adapted supragingival and subgingival proximal restorations. Helv Odont Acta 16:99, 1972. 3. Silness, J.: Periodontal conditions in patients treated with dental bridges, Part II. The relationship between the location of the crown margin and the periodontal condition. J Periodont Res 5:225, 1970. 4. Silness, J.: Periodontal conditions in patients treated with dental bridges. J Periodont Res 5:60, 1970. 5. Waerhaug, J.: Histologic considerations which govern where the margins of restorations should be located in relation to the gingiva. Dent Clin North Am 4:161, 1960. 6. Newcomb, G. M.: The relationship between the location of subgingival crown margins and gingival inflammation. J Periodontol 45:151, 1974. 7. Richter, W. A., and Ueno, H.: Relationship of crown margin placement to gingival inflammation. J PROSTHET DERT 30:156, 1973. 8. Donaldson, D.: The etiology of gingival recession associated with temporary crowns. J Periodontol 45:468, 1974. 9. Waerhaug, J.: Tissue reactions around artificial crowns. J Periodontol 24: 172, 1953. 10. Karlsen, K.: Gingival reactions to dental restorations. Acta Odontol Stand 28:896, 1970. 11. Crispin, B. J., and Caputo, A. A.: Color stability of temporary restorative materials. J PROSTHET DENT 42:27, 1979. 12. Barghi, N., and Simmons, E. W.: The marginal integrity of the temporary acrylic resin crown. J PROSTHET DENT 36:274, 1976.

Marginal fit of dental restorations in a 35-year-old Norwegian urban population.

The quality of proximal surface dental restorations in posterior teeth was diagnosed from the interproximal radiographs of 100 persons constituting a random sample of 35 year old citizens in Oslo. Defective margins were found in 41.4 percent of the restored surfaces examined. Approximately two thirds of the surfaces with defective margins were classified as medium or large overhangs. Only a small part of the surfaces showed deficits.