United States Public Health Service Criteria Research Articles

Two-year clinical evaluation of Class I composite resin restorations using three adhesive systems: A double-blind randomized clinical trial

Aim: The purpose of this randomized split-mouth clinical study was to assess the effect of three adhesive systems on the 2-year clinical success of Class I composite resin restorations. Methodology: In the treatment of the Class I carious lesions of 20 participants aged 18–24 years with at least three similar carious lesions, three adhesives—Clearfil SE Bond (CSE; Kuraray, Osaka, Japan), Single Bond 2 (SB2; 3M ESPE, St. Paul, MN, USA), and Tri-S Bond (TSB; Kuraray, Osaka, Japan)—and a Filtek Z550 nanohybrid composite resin (3M ESPE, St. Paul, MN, USA) were cured. The baseline and 2-year results of the restorations were assessed according to the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. The chi-square test was used to analyze the data obtained. Results: There was no loss of restoration in any group at 2 years. No significant differences were observed in any criteria (marginal staining, fracture retention, secondary caries, and postoperative sensitivity) evaluated except marginal adaptation, in accordance with FDI and USPHS criteria (p > 0.05). At 2 years, SB2 showed the best marginal adaptation, followed by CSE and TBS. There was a statistically significant difference between SB2 and TSB (p ˂ 0.05). Conclusion: All three adhesive systems can be used successfully in the restoration of Class I carious lesions. How to cite this article: Çakır Kılınç NN, Demirbuğa S. Two-year clinical evaluation of Class I composite resin restorations using three adhesive systems: A double-blind randomized clinical trial. Int Dent Res 2023;13(2):67-74. https://doi.org/10.5577/idr.2023.vol13.no2.4 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Clinical effectiveness of alkasite versus nanofilled resin composite in the restoration of occlusal carious lesions in permanent molar teeth of children: a randomized clinical trial

PurposeTo evaluate and compare the clinical effectiveness of alkasite with nanofilled resin composite restorations for occlusal caries lesions in permanent molar teeth of children, at one-year follow-up.MethodsIn this randomized controlled clinical trial with parallel design, 38 children aged 7–13 years with occlusal caries lesions on 59 first permanent molars were randomly allocated into two groups, Group 1: Filtek™ Z350XT (nanocomposite) and Group 2: Cention N® (alkasite resin composite). The restorations were evaluated at one year using the United States Public Health Service (USPHS) criteria. Data were analyzed using Chi-square or Fisher’s exact test.ResultsAll restorations had either Alpha or Bravo scores at one-year follow-up. In Group 1, all restorations scored Alpha, while one restoration each (3.6%) in Group 2 scored Bravo for fracture and marginal adaptation. All restorations in both groups scored Alpha for retention, secondary caries, and post-operative sensitivity. For anatomic form, all restorations in Group 1 scored Alpha, while three (10.7%) restorations in Group 2 had Bravo scores. For marginal discolouration, three restorations in both groups scored Bravo (11.5% and 10.7%, respectively). For surface roughness, one restoration (3.8%) in Group 1 and three restorations in Group 2 (10.7%) scored Bravo. The comparative results between the two groups for all the variables in the USPHS criteria were not statistically significantly different.ConclusionsThe performances of the nanofilled composite and alkasite were clinically acceptable and comparable. Alkasite can be an alternative material for the restoration of occlusal caries lesions in permanent molars of children.Clinical trial registrationThe clinical trial was registered at Clinical Trials Registry—India (CTRI Reg no: CTRI/2020/12/029830 Dated: 15/12/2020).

Evaluation of remineralizing effect of zinc-carbonate hydroxyapatite on the reduction of postrestorative sensitivity: A randomized controlled clinical trial.

The adhesive bonding ability of composite resins makes it unnecessary to remove tooth structure for retention, prevention, and convenience. However, postoperative sensitivity after placing composite restoration has been a significant problem experienced by clinicians. The present randomized controlled trial was conducted to assess the role of dentin remineralization in the reduction of postoperative sensitivity after composite placement. Eighty participants with occlusal carious teeth were randomly allocated to one of the four study groups, each having 20 participants, and are as follows: Group A with test group, Group A with control group, Group B with test group, and Group B with control group. Postoperative sensitivity was assessed using the Visual Analog Scale (VAS) and the United States Public Health Service (USPHS) criteria at different time intervals such as baseline, 1 week, 1 month, and 3 months. Data were analyzed using the Kruskal-Wallis ANOVA test, Mann-Whitney U-test, and Wilcoxon matched-pair test. All 80 participants were analyzed at the baseline, 1 week, 1 month, and the end of 3 months for the postoperative sensitivity using the VAS score and USPHS criteria. One restoration in Group A with control group reported mild sensitivity at the end of 1 week and one restoration in Group B with control group reported severe sensitivity at the end of 3 months, necessitating its replacement followed by root canal treatment. No relationship was reported between postoperative sensitivity and tooth type. There was no statistically significant difference in postoperative sensitivity in any of the treatment modalities. Class I restoration using self-etch or selective-etch as well as with or without zinc-carbonate hydroxyapatite is a viable and predictable solution for the reduction of postoperative sensitivity if all the aspects of restorative techniques are considered precisely.

Clinical performance of nano-hydroxyapatite-modified glass ionomer cements in class V cavities: split mouth, randomized controlled trial

BackgroundTo evaluate the effect of modifying conventional glass ionomer (CGIC) and resin-modified glass ionomer (RMGIC) with nano-hydroxyapatite (Nano-HA) on their clinical performance as restorations for class V cavities.MethodsThe wet-chemical precipitation method was utilized to prepare the nano-hydroxyapatite particles. Nano-HA was then characterized using Scanning Electron Microscopy, Elemental Dispersive X-ray and thermal gravimetric analysis. Five wt% of the nano-hydroxyapatite (Nano-HA) was then incorporated into the powder portion of the CGIC and RMGIC. Sixty Class V cavities were prepared in thirty patients with at least two cervical caries lesions. Prepared cavities were restored using the tested materials. Modified United States Public Health Service (USPHS) criteria were used to evaluate the restorations at base line, after three, six and nine months.ResultsRegarding the investigated modified USPHS criteria, the tested restorative materials showed no statistically significant difference throughout the study period. While color match, surface texture and marginal integrity criteria showed a statistically significant change in nano-HA-GIC. Surface texture and marginal integrity showed a significant change with CGIC. A significant change in surface texture was only found with nano-HA-RMGIC.ConclusionsThe investigated restorative materials showed an equivalent clinical performance at the nine months follow-up.

1 - 18-Month Clinical Evaluation of Universal Adhesive Applied in No-Waiting Technique

To evaluate the clinical behavior of a universal adhesive applied in the no-waiting technique in non-carious cervical lesions (NCCLs). Forty-four patients participated in this study. One hundred and seventy-six restorations were assigned to four groups according to the adhesive system in the conditioning strategies and in the waiting time: Prime&Bond Active (PB), applied in the etch-and-rinse strategy (ER) and self-etch (SE) with 20 s application and Clearfil Universal Bond Quick (CQ), applied in the ER and SE strategy), in no-waiting technique. One experienced and calibrated operator made the restorations with (Filtek Z-350 XT) composite resin using the incremental technique. The restorations were evaluated at baseline and after 18 months using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed with Friedman repeated measures analysis of variance by rank and McNemar test for significance in each pair. Ten restorations (2 for PB-ER, 4 for PB-SE, and 4 for CQ-SE) were lost after 18 months. Had a retention rate of 95,45% for PB-ER, 90,9% for PB-SE, 90,9% for CQ-SE and 100% for CQ when using the ER adhesive strategy (p > 0.05 for either criterion). Seventeen restorations showed some discrepancies in marginal adaptation at the 18-month recall using the FDI criteria (2 for PB-ER, 2 for PB-SE, 4 for CQ-ER, and 9 for CQ-SE), but only three restorations were scored as bravo for marginal adaptation in the USPHS criteria (3 for CQ-SE; p > 0.05). The clinical performance of the CQ adhesive in the "no waiting" technique was similar to the PB adhesive in conventional application (20 s), promoting very satisfactory results when applied in the ER or SE strategy, after 18 months of clinical evaluation in non-carious cervical lesions.

COMPARATIVE CHARACTERISTICS OF THE EFFECTIVENESS OF DIRECT AND INDIRECT RESTORATIONS ON TEETH WITH DISCOLORATION

COMPARATIVE CHARACTERISTICS OF THE EFFECTIVENESS OF DIRECT AND INDIRECT RESTORATIONS ON TEETH WITH DISCOLORATION

Critérios clínicos para decisão entre substituição ou reparo de restaurações em resina composta – revisão de literatura

Objetivo: Este estudo objetivou analisar os critérios USPHS e USPHS modificados e oferecer subsídios para a decisão clínica entre o reparo e a substituição das restaurações em resina composta. Material e Métodos: Utilizou-se um levantamento bibliográfico através do Portal de Periódicos CAPES, PubMed, Cochrane e Medline utilizando as seguintes palavras-chave: USPHS, avaliação clínica, resina composta, restauração dental permanente. A partir dessa pesquisa, foram selecionados trabalhos publicados entre 2000 e 2016. Resultados: Os estudos avaliados indicaram que os critérios mais prevalentes nas restaurações insatisfatórias são “cáries secundárias” e “perda da forma anatômica”. Além disso, a maioria dos estudos avaliados indica o reparo de restaurações com falhas pequenas e localizadas como estratégia para o aumento da longevidade das restaurações em resina composta. Conclusão: Os critérios USPHS auxiliam na correta decisão clínica entre substituição ou reparo de restaurações em resina composta. O reparo de compósitos é uma alternativa que deve ser realizada sempre que possível.

A New Universal Simplified Adhesive: 18-Month Clinical Evaluation

To evaluate the 18-month clinical performance of a multimode adhesive (Scotchbond Universal Adhesive, SU, 3M ESPE, St Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. Thirty-nine patients participated in this study. Two-hundred restorations were assigned to four groups: ERm, etch-and-rinse + moist dentin; ERd, etch-and-rinse + dry dentin; Set, selective enamel etching; and SE, self-etch. The composite resin, Filtek Supreme Ultra (3M ESPE), was placed incrementally. The restorations were evaluated at baseline, and at 18 months, using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed using Friedman repeated-measures analysis of variance by rank and McNemar test for significance in each pair (α=0.05). Five restorations (SE: 3; Set: 1; and ERm: 1) were lost after 18 months (p>0.05 for either criteria). Marginal staining occurred in four and 10% of the restorations evaluated (p>0.05), respectively, for USPHS and FDI criteria. Nine restorations were scored as bravo for marginal adaptation using the USPHS criteria and 38%, 40%, 36%, and 44% for groups ERm, ERd, Set, and SE, respectively, when the FDI criteria were applied (p>0.05). However, when semiquantitative scores (or SQUACE) for marginal adaptation were used, SE resulted in a significantly greater number of restorations, with more than 30% of the total length of the interface showing marginal discrepancy (28%) in comparison with the other groups (8%, 6%, and 8%, respectively, for ERm, ERd, and Set). The clinical retention of the multimode adhesive at 18 months does not depend on the bonding strategy. The only differences between strategies were found for the parameter marginal adaptation, for which the FDI criteria were more sensitive than the USPHS criteria.

A New Universal Simplified Adhesive: 6‐Month Clinical Evaluation

Multimode adhesives, which can be used as etch-and-rinse or as self-etch adhesives, have been recently introduced without clinical data to back their use. To evaluate the 6-month clinical performance of Scotchbond Universal Adhesive (SU; 3M ESPE, St. Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-TEm: etch-and-rinse + moist dentin; SU-TEd: etch-and-rinse + dry dentin; SU-SEet: selective enamel etching; and SU-SE: self-etch. The composite resin Filtek Supreme Ultra (3M ESPE) was placed incrementally. The restorations were evaluated at baseline and after 6 months using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed with Friedman repeated measures analysis of variance by rank and McNemar test for significance in each pair (α = 0.05). Only four restorations (SU-SE: 3 and SU-TEm: 1) were lost after 6 months (p > 0.05 for either criteria). Marginal discoloration occurred in one restoration in the SU-SE group (p > 0.05 for either criteria). Only 2/200 restorations were scored as bravo for marginal adaptation using the USPHS criteria (one for SU-SE and one for SU-SEet, p > 0.05). However, when using the FDI criteria, the percentage of bravo scores for marginal adaptation at 6 months were 32%, 36%, 42%, and 46% for groups SU-TEm, SU-TEd, SU-SEet, and SU-SE, respectively (p > 0.05). The clinical behavior of the multimode adhesive does not depend on the bonding strategy at 6 months. The FDI evaluation criteria are more sensitive than the USPHS criteria. At 6 months, the clinical behavior of the new multimode adhesive Scotchbond Universal was found to be reliable when used in noncarious cervical lesions and may not depend on the bonding strategy employed.

Short-term clinical observation of modified resin-bonded fixed partial denture utilizing tooth undercuts

To observe a short-term clinical result of modified resin-bonded fixed partial denture(MRBFPD) utilizing tooth undercuts. One hundred and twenty-nine patients received restoration and totally 196 missing teeth were restored with 148 MRBFPD. According to the positions of abutments in the dental arch, all the MRBFPD were divided into three groups, namely anterior prostheses (40), posterior prostheses (95) and prostheses spanning anterior and posterior (13). The prostheses were examined at 2 weeks, 1 month, 3 months, 6 months, and every year after denture delivery. Retention and marginal integrity of MRBFPD, sensibility, secondary caries and gingival bleeding index were clinically evaluated. The evaluation results were graded as good, acceptable, and bad according to modified United States Public Health service (USPHS) criteria. Survival in this study was defined at two levels: "complete" survival (survival without any debonding), and "functional" survival (survival including loss of retention on one occasion and successful rebonding of the original MRBFPD without further debonding). The average follow-up period was 26 months. Fifteen prostheses failed and were rated as bad with USPHS criteria, and ten prostheses were evaluated as "acceptable" because the gingival bleeding index has been rated as 3 or more at one appointment but reduced to 1 or 0 after treatment. The results of the other 123 prostheses were evaluated as "good". The "complete" survival rates were 80% (32/40) for anterior prostheses, 11/13 for prostheses spanning anterior and posterior, and 95% (90/95) for posterior prostheses, while the "functional" survival rates were 80% (32/40), 11/13 and 99% (93/95) respectively. The "complete" survival rate of posterior prostheses was statistically higher than that of anterior prostheses (χ(2) = 5.433, P < 0.05). The "functional" survival rate of posterior prostheses was not only higher than that of anterior prostheses (χ(2) = 13.179, P < 0.01)but also higher than that of prostheses spanning anterior and posterior (χ(2) = 4.143, P < 0.05) statistically. The results of this preliminary study suggest that short term survival rate of MRBFPD in posterior area was statistically better than that in anterior area. The outstanding advantage of MRBFPD is the minimum need of dental tissue reduction. However, their long-term success needs further investigation.