Restorations In Molars Research Articles

Marginal Integrity of Class-I Restorations, Restored with Amalgam and Bonded Amalgam; A Comparative Study

Objective: To compare the marginal integrity of Class-I amalgam and bonded amalgam restorations in maxillary and mandibular molars at seven days, three, six and twelve-months intervals.
 Study Design: Comparative prospective study.
 Place and Duration of Study: Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi Pakistan,from Jul 2017 to Jul 2018.
 Methodology: A total number of 114 patients of either gender with an age range of 14-45 years having Class-I cavities in first and second maxillary and mandibular molars on both sides were equally distributed in two groups. Group-A received conventional Amalgam, and Group-B received bonded amalgam restorations. All the fillings were placed and carved using routine instruments used for amalgam restorations, and the restorations were polished after 24 hours. The patients were initially evaluated for marginal ditching around restorations with the help of a dental mirror and explorer at seven days,followed by inspection at 3, 6 and 12 months.
 Results: Of the 114 participants, all showed excellent marginal integrity at seven-days intervals regardless of the restorative material used. However, marginal integrity deteriorated swiftly with time among those 57(50%) participants who acquired conventional Amalgam. Marginal integrity at 3, 6 and 12-months period was 51(89.5%), 35(61.4%) and 17(29.8%), respectively.Bonded amalgam restorations performed superiorly with 100%, 56(98.2%) and 43(75.4%) successful marginal integrity at 3, 6 and 12-months, respectively.
 Conclusion: Bonded amalgams can be a better substitute than non-bonded amalgam restorations with superior longevity in marginal integrity.Keywords: Amalgam, Bonded amalgam, Marginal integrity, Micro-leakage, Marginal deterioration, Restoration longevity.

Posterior Dahl: A Minimally Invasive Method for the Treatment of Localized Posterior Tooth Wear.

This retrospective case series of 9 patients aimed to describe clinical outcomes and patient satisfaction following the implementation of the posterior Dahl concept to manage localized posterior tooth wear. Localized occlusal space was created in the posterior dentition. Supra-occluding direct restorations were placed bilaterally for the restoration of molars. Intraoral scans were taken at the pre-treatment stage, immediately post-restoration, and during follow-up appointments. Scans were used to undertake analysis of any occlusal changes and re-establishment of the occlusion. A questionnaire was used to assess patient satisfaction, alleviation of any pre-treatment concerns, and evaluation of post-treatment complaints. Immediately post-treatment, all patients showed an increase in the vertical dimension. Opening of the bite in the untreated areas following restoration of worn posterior molars resulted either in a tendency towards or the actual reestablishment of the occlusion. One patient completely lacked compensatory vertical tooth movement in the untreated areas, culminating in the persistence of a vertical open bite. One restoration displayed cohesive fracture after 4 months. Pre-treatment problems (eg, sensitivity) were fully resolved amongst all patients after 6 months. Post-treatment complaints were minor and demonstrated resolution within a relatively short period of time. Eight patients reported being "very satisfied" with their treatment outcomes. Application of the posterior Dahl concept appears to offer a promising, relatively simple, minimally invasive and effective approach for the management of localized posterior tooth wear, which is well accepted by patients.

Fracture Resistance and Failure Mode of Endocrown Restorations with Different Remaining Walls and Finish Lines

Objective: Endocrown is a conservative treatment plan for endodontically treated teeth. The aim of this study was to evaluate the fracture resistance of four different preparation designs of endocrown restorations in mandibular molars. Methods: Thirty-six endodontically treated molars were divided into two groups (L, MD). In group L, the lingual wall and in group MD, mesial and distal walls were removed up to 1 mm above the CEJ. For each group, 2 subgroups (n=9) were considered: B) 2mm occlusal reduction with but joint finish line, S) axial reduction with radial shoulder finish line, in addition to 2mm occlusal reduction. Digital impression was performed, followed by designing and milling the lithium disilicate blocks. After cementation of the restorations and thermocycling, fracture resistance and failure mode were investigated. Results: Groups LB and LS, showed significantly higher fracture resistance compared to groups MDB and MDS (P=0.02). However, the type of finish line did not have a significant effect on the fracture resistance in the experimented groups (P=0.232). Conclusion: Unlike the finish line type, the number of remaining axial walls had a significant effect on fracture resistance. Although most of the fractures were catastrophic, they occurred due to forces much greater than usual.

Survival Rate of Single Implant When Replacing the Mandibular Second Molars: Importance of Implant Length

Purpose: Restoration of the mandibular second molar with single implants has many limitations. This includes poor bone quality, reduced alveolar bone, large occlusal force, and difficulty in surgical approach. The purpose of this study was to analyze the survival rate of single implants in second molar restoration and evaluate the effect of associated factors regarding implant length, diameter, and guided bone regeneration (GBR). Materials and Methods: Altogether, 137 patients (77 males and 60 females; age range: 19 to 81 years; mean age 53.6 years) were treated with 147 single implants in the mandibular second molar region by an experienced surgeon between 2006 and 2019. The cumulative survival rate (CSR) was analyzed using a life-table analysis and the effect of associated factors on the survival was compared using Log Rank Test. Results: Four of the 147 implants failed. Thus, the five-year cumulative survival rate was 97.1%. In three out of four cases, implant failed after the 4th, 6th, and 8th year of implantation. In one of the four cases, the implant failed within four months of implantation. A significant change was observed in CSR with respect to the implant length. However, no difference was observed in CSR with respect to the implant diameter and GBR.Conclusion: This study reveals that replacing the mandibular second molar with a single implant is an effective and reliable treatment. However, the implant length over 10mm is recommended for successful result if there is sufficient residual alveolar bone.

Fracture resistance of defective amalgam restorations repaired with a resin-based composite material

BackgroundRepair is used to increase the longevity of defective restorations, such as large amalgams. The aim of this study was to investigate the fracture resistance and fracture modes of mesio-occlusodistal (MOD) amalgam molar restorations with extensive cuspal fracture repaired or replaced using a bulk-fill resin-based composite material. MethodsAmalgam restorations were placed in 84 permanent extracted molars and randomly assigned (n = 14) to groups: (1) MOD amalgam, (2) composite repair of 1-cusp fracture and adjacent proximal box, (3) composite repair of 1-cusp fracture, (4) composite repair of 2-cusp fracture, (5) replacement of 1-cusp defect and existing MOD amalgam, (6) replacement of 2-cusp defect and MOD amalgam. Each molar was prepared to simulate the assigned fracture and either repaired or replaced. Specimens were aged and then loaded to fracture. Fracture resistance and fracture modes were recorded. ResultsThe authors found significant differences (P < .001) between group 4 (1,652.3 N) and groups 5 (3,095.0 N), 1 (2,669.8 N), 6 (2,658.6 N), and 2 (2,442.9 N) as well as between group 3 (2,133.5 N) and group 5 (3,095.0 N). The results of the Fisher exact test showed differences among groups (P < .001), with group 5 having the highest number of nonrestorable fractures as well as higher fracture resistance on average. ConclusionsComposite material is a viable option for the repair and replacement of cuspal defects, especially in the case of a 1-cusp fracture and 1-cusp fracture involving the adjacent proximal box. Practical ImplicationsWithin the limitations of this study, the repair of cusp fractures in existing MOD amalgam–restored molars is an appropriate treatment option, although replacement of the defect and existing restoration with resin-based composite will withstand higher forces.

Survival Analysis and Cost Effectiveness of Silver Modified Atraumatic Restorative Treatment (SMART) and ART Occlusal Restorations in Primary Molars: a randomized controlled trial

ObjectiveTo evaluate and compare the clinical performance and cost effectiveness of Silver Modified Atraumatic Restorative Treatment (SMART) and Atraumatic Restorative Treatment (ART) restorations in primary molars over 12 months follow up period. Materials and methodsSixty-seven children, aged 5-9 years old having at least one asymptomatic primary molar with active caries, were randomly assigned to either the test arm (SMART) or the control arm (ART). Clinical performance was assessed after 6 and 12-months using the modified United States Public Health Services criteria. The trial was registered at Clinical Trial.gov with a registration number (NCT03881020). Treatment time for each restoration was recorded, Kaplan-Meier survival analysis and the log-rank test were performed (p<0.05) and cost effectiveness was measured at the end of the study. ResultsBoth techniques showed comparable clinical performance and the mean survival time was 11.8 and 11.6 months for SMART and ART restorations respectively with no detected significant differences (p=0.416). Mean treatment time for SMART restorations (7.8 min.), however, was significantly lower than ART (15 min.) (p < 0.001). SMART technique, also, showed statistically significant lower mean total cost per restoration (p <0.001). ConclusionsThough SMART and ART have comparable clinical performance and survival in single-surface occlusal restorations in primary molars, SMART is less time consuming and more cost effective. Clinical significanceUsing SMART technique could change paradigms in caries management. Being a patient friendly and cost-effective approach, it could be adopted as a superior treatment option when dealing with young children, those with behavioral and medical challenges and for promoting access to oral care among the underprivileged.

The advancement of adhesive dentistry with the endocrown technique and its diffusion among professionals: a literature review

Introduction: In the decades with the advancement of materials fabrication, such as restorations with the latest improvements in their dental fabrication process, or as restorations with improvements in their dental fabrication process, or as the latest restorations in their dental fabrication process, dentistry, or as the latest restorations in their restorative materials manufacturing process. Objective: This work aims to demonstrate through a literature review the use of the endocrown technique. Methods: The research was carried out from January to May 2022 and was developed based on PubMed, Scielo, and Google Scholar. Results: There were 11 a total of 13 articles on Endocrowns. In total, 47 articles were complete and 19 were included in this study. Dentistry, contributing to a better resolution of cases, presents little interocclusal space, so the indirect endocrown restoration technique becomes an excellent option, presenting a good alternative and less dental wear for making. Conclusion: It was concluded that the use of the endocrown technique has shown, for the most part, employing clinical results that it is an excellent restorative option for the restoration of molars with great coronary destruction, and its clinical survival rate was comparable to the use of intraradicular posts of fiber.

Comparative Evaluation of Two Different Fiber-Reinforced Composite Materials in Class 1 Post-Endodontic Restorations in Molars-A Randomized Clinical Study.

This study aimed to evaluate and compare two different fiber-reinforced composite materials in class I post-endodontic restoration in molars. A total of 50 patients were randomly assigned into two groups (n = 25 for each group); group A: everX Posterior (packable composite) with a top layer of solareX (nano-hybrid composite) and group B: everX Flow (flowable composite) with a top layer of G-aenial universal injectable (flowable composite). Patients were evaluated immediately after the procedure (baseline), at 6 months, and at 1 year time intervals based on the modified USPHS criteria. The statistical analysis using a chi-square test showed no statistically significant difference in the clinical performance of group A and group B. Clinical performance of the combination of everX Flow with overlying G-aenial universal injectable composite proved to be comparable with everX Posterior with overlying solareX composite as post-endodontic restorations in class I lesions in permanent molars.

Use of rubber dam versus cotton roll isolation on composite resin restorations’ survival in primary molars: 2-year results from a non-inferiority clinical trial

BackgroundThis non-inferiority randomised clinical trial aimed to evaluate the survival of direct bulk fill composite resin restorations in primary molars using different methods of moisture control: rubber dam isolation (RDI—local anaesthesia and rubber dam) and cotton roll isolation (CRI—cotton roll and saliva ejector). Secondary outcomes included baseline and 2-year incremental cost, self-reported child’s pain scores and patient behaviour during the restorative procedure.MethodsA total of 174 molars (93 children) with dentine caries lesions were randomly allocated to study groups (RDI or CRI) and restored with bulk fill composite resin by trained operators. Two blinded examiners assessed the restorations for up to 24 months. Wong-baker faces and Frankl's behaviour rating scales were used for accessing the child's pain and behaviour, respectively. The primary outcome (restoration survival) was analysed using the two-sample non-inferiority test for survival data using Cox Regression (non-inferiority/alternative hypothesis HR > 0.85; CI = 90%). Bootstrap Linear regression was used for cost analysis and logistic regression for pain and behaviour analysis (α = 5%).ResultsAfter 2-years, 157 restorations were evaluated (drop-out = 9.7%). The survival rate was RDI = 60.4% and CRI = 54.3%. The non-inferiority hypothesis was accepted by the Cox Regression analysis (HR = 1.33; 90% CI 0.88–1.99; p = 0.036). RDI was 53% more expensive when compared to the CRI group. No differences were found between the groups regarding pain (p = 0.073) and behaviour (p = 0.788).ConclusionCotton roll isolation proved to be non-inferior when compared to rubber dam for composite restorations longevity in primary molars. Furthermore, the latest presented the disadvantage of higher cost and longer procedure time.Clinical Significance The moisture control method does not influence the longevity of composite restorations in primary molars. Cotton roll isolation proved to be non-inferior to rubber dam isolation and is a viable option for restoring primary molars.Clinical trial registration registered NCT03733522 on 07/11/2018. The present trial was nested within another clinical trial, the CARies DEtection in Children (CARDEC-03-NCT03520309).

Novel 3D Printed Resin Crowns for Primary Molars: In Vitro Study of Fracture Resistance, Biaxial Flexural Strength, and Dynamic Mechanical Analysis.

This study evaluated the fracture resistance, biaxial flexural strength (BFS), and dynamic mechanical analysis (DMA) of three-dimensional (3D) printing resins for the esthetic restoration of primary molars. Two 3D printing resins, Graphy (GP) and NextDent (NXT), and a prefabricated zirconia crown, NuSmile (NS), were tested. GP and NXT samples were 3D printed using the workflow recommended by each manufacturer. Data were collected and statistically analyzed. As a result of the fracture resistance test of 0.7-mm-thick 3D printed resin crowns with a thickness similar to that of the NS crown, there was no statistically significant difference among GP (1491.6 ± 394.6 N), NXT (1634.4 ± 289.3 N), and NS (1622.8 ± 323.9 N). The BFS of GP was higher for all thicknesses than that of NXT. Both resins showed high survival probabilities (more than 90%) when subjected to 50 and 150 MPa. Through DMA, the glass transition temperatures of GP and NXT were above 120 °C and the rheological behavior of GP and NXT according to temperature and frequency were analyzed. In conclusion, GP and NXT showed optimum strength to withstand bite forces in children, and 3D printed resin crowns could be an acceptable option for fixed prostheses of primary teeth.

CARIES ASSOCIATED WITH RESTORATIONS IN PRIMARY MOLARS –AN 18-MONTHS FOLLOW-UP STUDY

Objective: To investigate the occurrence of caries associated with restorations in primary molars. Methods: Resin-modified glass ionomer cement (n=50) and compomer (n=50) restorations of primary molars were made in 100 children. The restorations were clinically evaluated on the 3rd, 6th, 12th and 18th month with the FDI criteria. Results: On the 3rd month recall, all restorations showed excellent clinical assessment scores for all FDI criteria. In regard to secondary caries, on the 6th month, clinically unacceptable was only one restoration. In the 12th month, 19.00% of the restorations were diagnosed with caries adjacent to the restoration. The relative share of secondary caries lesions assessed in restorations from glass ionomer cement (27.27%) was higher than that from compomer material (14.28%), as well as the restorations on the occlusal surface (38.46%), compared to those on the proximal surfaces (7.40%). Caries associated with restorations was diagnosed more frequently in relation to the caries lesions assessed as active at the first visit (29.62%) compared to the inactive lesions (7.69%). At the 18th month recall, the relative share of restorations diagnosed with secondary caries was lower (8.00%). Conclusion: The type of restorative material, type of affected surface and the activity of the carious lesion are factors that may influence the occurrence of caries associated with restorations in primary molars. Our study showed that a critical moment for the clinical condition of the followed restorations is the 12th month of the treatment.

The Effect of External Cold and Vibration on Infiltration-Induced Pain in Children: A Randomized Clinical Trial.

Introduction Children's fear of and anxiety about dental treatments are important problems in maintaining health. The anesthetic injection is the main cause of dental fear. One of the methods to reduce the infiltration-induced pain is to use external cold or vibration using the gate control system. Various devices have been used to apply cold and vibration, including the BUZZY device (BUZZY Company, Arizona). Studies have shown contradictory results for the effectiveness of cold and vibration. This study aimed to investigate the effect of cold and vibration versus cold alone on maxillary infiltration-induced pain and stress. Methods Thirty children aged 6–12 years who required profound restoration of deciduous or permanent first molars were recruited in this randomized double-blind clinical trial. The anesthetic gel and BUZZY device were used in half of the children's jaws, and the anesthetic gel and the cold alone were used in the other half of the jaws. To measure stress from the heart rate, the Wong–Baker scale was used as the subjective scale, and the face, legs, activity, cry, consolability (FLACC) scale was used as the objective scale. Results The FLACC score was significantly lower in the BUZZY group than in the cold-alone group, but the Wong–Baker scale and heart rate did not show a significant difference between the two groups. Conclusions The BUZZY device can be effective in reducing infiltration-induced dental pain.

A Randomised Clinical Trial Evaluating the Clinical Performance of Compomer and Composite Materials in Class II Primary Molar Restorations: 24-Month Results

A Randomised Clinical Trial Evaluating the Clinical Performance of Compomer and Composite Materials in Class II Primary Molar Restorations: 24-Month Results

Marginal integrity of classical and bulk-fill composite restorations in permanent and primary molars

Bulk-fill composites enable timesaving and less technical-sensitive application of restorations. This study investigated and compared the marginal integrity of classical and bulk-fill composite restorations in primary and permanent molars before and after thermo-mechanical loading (TML). Two Class II cavities were prepared in each of 20 primary and 20 permanent molars. The molars were randomised in four groups for each molar type. Groups 1 and 5 were restored with a high-viscous bulk-fill composite (Tetric PowerFill), groups 2 and 6 were restored with a flowable bulk-fill composite (Tetric PowerFlow), groups 3 and 7 were restored with a high-viscous classical composite (Tetric Prime), and groups 4 and 8 were restored with a flowable classical composite (Tetric EvoFlow). In permanent molars, the flowable composites were covered with a 2-mm layer of high-viscous composite (groups 6 and 8). The restorations were subjected to TML in a custom-made chewing machine (5–50 °C, 2 min dwelling time, × 1000; 400 ,000 loading cycles, 1.7 Hz, 49 N), and quantitative marginal analysis was conducted using scanning electron microscopy. Marginal integrity of each restoration was calculated as a percentage of continuous margins before and after TML. The tested high-viscous bulk-fill restoration showed similarly high marginal integrity in primary and permanent molars as the classical restoration. The tested flowable bulk-fill restoration showed the lowest marginal integrity compared to all other restorations after TML. In contrast to flowable bulk-fill restorations, high-viscous bulk-fill restorations show similar marginal integrity as classical hybrid composite restorations after TML, in both primary and permanent molars.

Randomized Clinical Trial of Heated High Viscosity Glass Ionomer Class II Restorations in Deciduous Molars: 12 Months Follow Up

Objective: New generation High Viscosity Glass Ionomer Cements (HVGICs) have enhanced physical and mechanical properties. By effectively closing the restoration margin, it ensures that the restorations will last longer. The aim of this study was to investigate the clinical performances of heat-cured versus non heated HVGIC in class II restorations of deciduous molars. Methods: This randomized, split mouth, multicentre study was performed in four different centres. A total of 250 deciduous molars from 88 individuals were randomly allocated to one of the following groups: 1) non-heated (n = 125) 2) heated (n = 125) and restored with a HVGIC using LED light for heat application. Restorations were clinically evaluated according to the modified USPHS at the baseline, 6 months and 12 months. The survival analysis was performed by Kaplan Meier and Life Tables. This study was retrospectively registered to the ClinicalTrials.gov with the ID number of NCT04291872 at 2nd March 2020. Results: No statistically significant differences were found between the groups regarding to modified USPHS criteria (p&amp;gt;0.05). Success rate in retention criteria was 94.1% of the heat-cured and 92.6% of the non-heated restorations after 12 months. The mean survival time was 11.8 ±0.1 months in the heated group, while 11.9±0.1 months in the non-heated group. Conclusion: The heat treated HVGIC for Class II restorations did not show any significant differences in 12 months’ follow-up compared with the conventional technique.

Clinicoradiographic evaluation of different intracoronal and extracoronal restorative materials for the restoration of carious primary molars: a twelve month follow-up study

Background: To assess clinical and radiographic efficacy of conventional GIC, stainless steel crown (HT), and Alkasite restoration (Cention N) as management options for cavitated primary molars and to evaluate their success clinico-radiographically in terms of survival, patient’s acceptance and parental satisfaction over a minimum period of 12 months. Methods: IOPAs were taken to assess the extent of caries. Cavitated primary teeth were subjected to following procedures randomly: GROUP I- (GIC) - Isolation followed by soft caries removal, then restoration of cavity with GIC. Patient recalled after 24 hours for finishing and polishing of restoration. GROUP II- (SSC) - Proper isolation followed by soft caries removal. Appropriately sized prefabricated SSC fit and cemented by luting GIC. GROUP III- (AK) - Isolation followed by soft caries removal, restoration of cavity with Alkasite and light cured for setting and finished.Results: In terms of pain, secondary caries and pulpal involvement, 10% cases failed in group I and group III while 100% success was seen in group II. In terms of longevity, maximum dislodgement was seen in group I (30%) followed by group III (10%) while 100% success was seen in group II. In terms of patient and parent acceptance, group III was most widely accepted by patients at baseline while parents were satisfied with group II at the end of the study. Conclusions: All restorative materials were clinically and radiographically successful in restoration of primary molars in terms of survival, patient acceptance and parental satisfaction, however Stainless-Steel crowns proved to be most efficacious.

Clinical Evaluation of Stainless Steel Crown versus Zirconia Crown in Primary Molars: An In Vivo Study.

AimThe objective of this clinical trial was to evaluate and compare two full-coronal restoration [stainless steel crowns (SSCs) and zirconia crown] in carious primary posterior teeth.Materials and methodsForty endodontically treated primary teeth in children within the age-group of 3-9 years were selected and divided into two equal groups (20 SSCs and 20 zirconia crown). The two crowns were evaluated for retentivity of crown, temporomandibular joint (TMJ) problem, gingival response, plaque accumulation, and tooth wear in opposing teeth after 1st and 3rd month follow-up.ResultsBoth the crowns showed 100% results regarding TMJ problems, but SSCs performed better in terms of retention of crown, gingival response, plaque accumulation, and tooth wear in opposing teeth. The statistics showed significant result by using Mann-Whitney U test and Wilcoxon signed-rank test.ConclusionStainless steel crowns performed better among both the full-coronal restoration for posterior primary teeth.Clinical significanceStainless steel crowns remain “Gold Standard”, for posterior full coverage restorations in primary molars as compared to zirconia crowns.How to cite this articleAgrawal R, Khanduja R, Singhal M, et al. Clinical Evaluation of Stainless Steel Crown versus Zirconia Crown in Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(1):15-19.

3-Year Survival of direct composite resin restorations of permanent first molars with excessive material loss in children

Aim: The aim of this retrospective study was to determine survival rates of direct composite resin (DCR) restorations of permanent first molars (PFMs) with excessive material loss at the end of 3 years. Material and methods: Children between the ages of 7-14 whose PFMs had 3-surfaced DCR restoration were included in the study. In restorations Ionofil Molar glass ionomer cement (VOCO,Cuxhaven,Germany) as base material, Clearfil SE Bond adhesive agent and Clearfil Majesty Posterior composite resin (Kuraray Noritake Dental Inc.,Okayama,Japan.) were used. Survival rates of the restorations after 3 years were evaluated using The United States Public Health Service criteria and the presence of symptoms indicating irreversible pulp damage and the need for root canal treatment such as provoked or spontaneous pain, percussion, abscess, fistula in the related teeth were examined clinically and radiographically. Chi-square and Kruskal Wallis analyzes were used for the statistical analysis. Results: Totally 58 DCR restorations of PFMs of 34 patients who agreed to come for the control visit at the end of 3 years were examined. The survival rate of restorations was 70.69% and findings indicating irreversible pulp damage were found in 15.5% of the restorations examined. Conclusion: Survival rate of DCR restorations applied to PFMs with excessive material loss is not satisfactory after 3 years, however it is thought that DCR applications will continue in PFMs with excessive material loss thanks to the developments in adhesive systems and composite resins. Therefore, long-term randomized controlled clinical studies on this subject should be continued.

One-year clinical results of restorations using a novel self-adhesive resin-based bulk-fill restorative

This prospective study assessed the dual-curing self-adhesive bulk-fill restorative Surefil one. The restorations were placed and reviewed by dental practitioners who are members of a practice-based research network in the United States. Seven practitioners filled 60 cavities (20 class I, 19 class II and 21 class V) in 41 patients with Surefil one without adhesive, according to the manufacturer’s instructions. The restorations were evaluated using modified USPHS criteria at baseline, 3 months, and 1 year. Patients were also contacted to report postoperative hypersensitivity one to four weeks after placement. The only patient that showed moderate hypersensitivity after 1 year had previously reported symptoms that were unlikely associated to the class I molar restoration. One class II restoration in a fractured maxillary molar was partially lost. The remaining restorations were found to be in clinically acceptable condition resulting in an annual failure rate of 2%. Color match showed the lowest number of acceptable scores (88%) revealing significant changes over time (P = 0.0002). No significant differences were found for the other criteria (P > 0.05). The novel self-adhesive bulk-fill restorative showed clinically acceptable results in stress-bearing class I and II as well as non-retentive class V cavities at 1-year recall.

Evaluation of composite restorations in primary molars subjected to selective caries removal associated with antimicrobial photodynamic therapy: A randomized controlled trial.

Antimicrobial photodynamic therapy (aPDT) has been used as an adjunct treatment of deep caries lesions; however, studies on the effects of aPDT on the longevity of restorations are still limited. To evaluate the clinical performance of composite restorations in primary molars subjected to selective caries removal (SCR) associated with aPDT. A randomized clinical trial was designed. Primary molars of patients (mean age 6.15years) with deep caries lesions without signs and symptoms of pulpal involvement were selected. A total of 64 teeth were randomly divided into groups G1 (SCR, 32 teeth) and G2 (SCR+aPDT, 32 teeth) for treatment, restored with composite, and evaluated after a week (T0 ), 6months (T1 ), and 12months (T2 ) according to the criteria of FDI. Groups were compared using the Rao-Scott chi-squared test and the logistic regression analysis for complex designs to account for multiple observations per subject (alpha=0.05). From all FDI criteria evaluated, the marginal adaptation for the SCR+aPDT group was significantly better in comparison with the SCR group at T0 and T2 in the logistic regression analysis (T0: OR=0.151; 95% CI=0.03-0.068, P=.015; and T2: OR=0.201; 95% CI=0.05-0.79, P=.022). The marginal adaptation of primary molar resin restorations was positively affected by aPDT after 12months of follow-up.