Class II composite restoration technique teaching: A randomised controlled crossover laboratory‐based trial involving a novel ringless sectional matrix technique (original) (raw)
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Clinical Oral Investigations, 2019
Objective This prospective study evaluated the clinical performance of large class II restorations made with different techniques over 24 months. Materials and methods Thirty patients received two class II restorations (n = 60) using a nanohybrid composite and different restorative techniques (direct (DT), semidirect (SDT)), in a split-mouth randomized design. The same adhesive system was applied for all restorations. For DT, the restorative material was applied directly inside the tooth preparation. For SDT, a tooth preparation impression was obtained using alginate and a silicone flexible die was prepared. The restoration was made chairside on the model and additionally light cured. After that, it was cemented in preparation using resinous cement. All restorations were evaluated using the FDI criteria after 7 days, 6, 12, and 24 months postoperatively. Results After 24 months, 24 patients attended the recall and 48 restorations were evaluated. Fisher's statistical analysis (5%) showed no difference between the techniques. Nevertheless, Friedman's test showed significant differences for some criteria after 12 months of evaluation for both techniques. Postoperative sensitivity was reported in one DT restoration. Also, after 24 months, one SDT restoration presented marginal fracture, which was deemed unsatisfactory. Conclusions After a 24-month follow-up, no significant difference between the tested techniques was detected. The restorations performed with both techniques produced clinically acceptable restorations. Clinical relevance This study demonstrated the viability of applying two different operatory techniques (direct and semidirect) for class II resin composite restorations.
Operative Dentistry, 2013
A literature review was conducted on adhesive Class I and II restorations and nondestructive in vitro tests using the PubMed/Medline database for the 1995-2010 period. The first part of this review has presented and critically appraised selected literature dealing with the quality and in vitro behavior of adhesive Class II restorations using photoelasticity, finite element analysis, and microleakage study protocols. This second part reviews additional parameters, which are deformation and fracture resistance to cyclic loading, shrinkage stress and tooth deformation following restoration placement, bond strength (microtensile, tensile, and shear tests), and marginal and internal adaptation. In addition, a "relevance score" has been proposed that aims to classify the different study protocols according, firstly, to the resulting quality, quantity, and consistency of the evidence and then, secondly, to their potential clinical relevance, as estimated by their ability to simulate oral and biomechanical strains. The highest clinical relevance was attributed to marginal and internal adaptation studies, following cyclic loading in a moist environement. However, a combination of in vitro protocols will have an even greater predictive potential and has to be considered as a crucial preclinical research approach with which to investigate the numerous restorative configurations that cannot be efficiently and rapidly tested in vivo.
International Journal of Bio-Medical Informatics and e-Health, 2023
This systematic review of 112 RCTs (n=89,712) compared incremental versus bulk-fill placement techniques for direct Class II composite restorations in permanent posterior teeth over ≥6 months. Meta-analyses found no significant differences between groups for retention, recurrent caries, marginal adaptation, fracture, postoperative sensitivity, surface roughness, color match, or anatomic form (p>0.05 for all). Bulk-fill had less marginal staining (p=0.01). Clinical performance correlated more with materials and protocols than placement technique. Challenges like microleakage and wear persisted long-term. Neither incremental nor bulk-fill demonstrated clear superiority across clinical outcomes over up to 7 years. Both can provide durable posterior restorations. Practitioners should use professional judgment in technique selection based on clinical factors. Further long-term RCTs are warranted to reinforce these conclusions that neither placement technique showed superior clinical performance for direct Class II composite restorations.
Journal of dentistry, 2017
To evaluate the teaching and operative techniques for the repair and/or replacement of direct resin-based composite restorations (DCRs) in dental schools in Oceania. A 14-item questionnaire was mailed to the heads of operative dentistry in 16 dental schools in Oceania (Australia, New Zealand, Fiji and Papua New Guinea). The survey asked whether the repair of DCRs was taught within the curriculum; the rationale behind the teaching; how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability, expected longevity and recall systems. All 16 schools participated in the study. Thirteen (81%) reported the teaching of composite repairs as an alternative to replacement. Most schools taught the theoretical and practical aspects of repair at a clinical level only. All 13 schools (100%) agreed on tooth substance preservation being the main reason for teaching repair. The main indications for repair were marginal defects (100%), followed by seco...
Journal of Dentistry, 2005
The study evaluated the clinical performance and marginal adaptation of direct and semi-direct class II composite restorations in a split-mouth design over 3.5 years. Design. 44 upper posterior teeth in 11 adults with primary carious lesions were treated with 22 direct and 22 semi-direct restorations. Conventional cavities were prepared for both types of restorations. A fine fine hybrid composite (APH) and a multifunctional adhesive system (Prisma universal bond 3) were used for all restorations. The incremental '3-sited light curing' technique was applied to direct restorations. Semi-direct inlays were prefabricated on silicone casts and post-cured using light and heat. Clinical performance was evaluated using modified USPHS parameters, while marginal adaptation was judged on replicas, using SEM and a standardized evaluation technique. Results. Clinical results after 3.5 years revealed a 100% retention rate with no fractures, sensitivity or recurrent caries for both types of restorations. SEM-evaluation of the occlusal margins showed at the tooth-restoration interface relatively low rates of marginal openings over the observation period (4-8%). Marginal restoration fractures ranged between 1 and 2%, marginal tooth fractures between 3 and 9%. Differences between the restorative techniques and after the different time observation periods were not statistically significant. Proportions of marginal fractures and openings at the restoration-luting composite interface were less than 10% after 3.5 years. Conclusion. The results indicated no significant differences for direct and semi-direct fine hybrid composite restorations in medium size cavities in posterior teeth with respect to clinical performance and marginal adaptation over 3.5 years.
Techniques in Direct Composite Restoration
Modern Approaches in Dentistry and Oral Health Care
Composite restorations have made their presence felt and also have solidified their position in the field of dentistry because of their esthetic varieties, longer life and their capability to provide an instant result which may sometimes be almost equivalent to ceramic restorations. However, there are many disadvantages like technique sensitive, polymerization shrinkage, inadequate dry area to work causing failure and inadequate light curing (time and depth) being some of them.
The stamp technique for direct Class II composite restorations: A case series
Journal of conservative dentistry : JCD
Background: "Stamp" technique is a new method for placing large composite restorations with accurate occlusal topography. It was introduced mainly to restore Class I cavities and erosively damaged teeth. This technique is indicated when the preoperative anatomy of the tooth is intact and not lost due to the carious lesion. A precise tooth-like filling an accurate functional occlusion is obtained when the stamp technique is applied. However, using this technique to restore Class II cavities is not established yet. Aim: To introduce modifications of the stamp technique that make it applicable to restore Class II composite restorations. Materials and Methods: The traditional materials and tools used for direct composite restorations are needed with no additional instruments. Clinical illustrations and step-by-step description are provided in this paper. Results and Conclusion: Using the stamp technique to restore Class II cavities is achievable, simple and practical, and result in a very accurate anatomical restoration.