Class II composite restoration technique teaching: A randomised controlled crossover laboratory‐based trial involving a novel ringless sectional matrix technique (original) (raw)
The Art and Science of Class II Composite Restorations
2015
Class II restorations are needed frequently. Their placement requires consideration of material properties in selecting the technique that will be used for an individual patient. Class II composite restorations are esthetic, functional restorations that require careful technique and material selection for successful clinical outcomes. Consideration is given to the patient; size and depth of the carious lesion; use of matrices that aid attainment of a good anatomical form for the final restoration; and which adhesive system, composite or combination of composites, and technique will be used. ABOUT THE AUTHORS January 2012 Lou Graham, DDS, is a graduate of Emory Dental School. He is the past Dental Director at the University of Chicago and currently holds a part-time faculty position there. Dr. Graham is an internationally recognized lecturer involved in continuing education that focuses on incorporating current clinical advancements through conservative dentistry. Dr. Graham practice...
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.
Restorative technique for class IV direct composite restoration
IP Annals of Prosthodontics and Restorative Dentistry, 2021
Fractures and wear tooth, poor dental position, trauma and dissatisfaction with aesthetics are the major causes why patients seek for dental treatment. This work aims to present a technique for treating cases with aesthetic requirements using guides, to restore teeth with a G.V. Black's Class IV restoration. The combination of rising patient aesthetic demands and the desire for conservative dentistry, has resulted in development of intricate direct composite layering techniques. Direct restorations have good predictability, resistance load, longevity and compared with indirect restorations have greater preservation of dental tissues, low cost and fewer clinical sessions. This case report describes a systematic system to rebuild the lost anatomy of a maxillary central incisor with dental composites.
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.
Three-year clinical performance of composite restorations placed by undergraduate dental students
Brazilian dental journal, 2011
This retrospective study evaluated the clinical performance and the reasons for failure of anterior and posterior composite restorations placed by undergraduate dental students over a 3-year period. All cavities were restored using Prime & Bond 2.1 and TPH (Dentsply), according to the manufacturer's indications. One hundred and two patients who had received composite restorations by third and forth year undergraduate students were recalled and examined to analyze the quality of the restorations. The restorations were evaluated using the modified USPHS system. Two hundred and fifty-six composite restorations, 170 in anterior teeth and 86 in posterior teeth, were evaluated. Eighty-five percent of the restorations were considered satisfactory after 3 years. Class II and class IV restorations presented the highest prevalence of failure. Loss of the restoration and deficient marginal adaptation were the main causes of failure. No restoration failed due to secondary caries. Most resto...
Clinical effectiveness of direct class II restorations - a meta-analysis
The journal of adhesive dentistry, 2012
More than five hundred million direct dental restorations are placed each year worldwide. In about 55% of the cases, resin composites or compomers are used, and in 45% amalgam. The longevity of posterior resin restorations is well documented. However, data on resin composites that are placed without enamel/dentin conditioning and resin composites placed with self-etching adhesive systems are missing. The database SCOPUS was searched for clinical trials on posterior resin composites without restricting the search to the year of publication. The inclusion criteria were: (1) prospective clinical trial with at least 2 years of observation; (2) minimum number of restorations at last recall = 20; (3) report on dropout rate; (4) report of operative technique and materials used; (5) utilization of Ryge or modified Ryge evaluation criteria. For amalgam, only those studies were included that directly compared composite resin restorations with amalgam. For the statistical analysis, a linear mi...
Operator Errors In Failed Composite Restoration -A Review Review Article
SciDoc Publishers, 2021
Objective: In this study the literature was reviewed to investigate the operator errors in composite restorations. Data: Clinical studies investigating the survival composite restorations with at least three years of follow-up were screened and main reasons associated with restoration failure due to operator errors were chosen. Sources: PubMed, Scopus, and Cochrane databases were searched without restriction on date or language. Reference lists of eligible studies were hand-searched. Conclusion: Composite restorations fail for a variety of reasons, and the operator should do everything possible to avoid this, from case selection to finishing and polishing.
Dental Materials, 1990
The aim of this study was to evaluate conservative preparation designs for therestoration of Class II lesions with posterior resin composite. Fourteen primary and 14 permanent molars were obtained. Consenvative modified MO and DO preparations were placed in half the teeth; conventional MO and DO preparations were placed in the remaining teeth. Randomly, a glass-ionomer liner was placed over the exposed dentin in one preparation of each tooth; a calcium hydroxide liner was placed in the remaining preparations. Posterior resin composite was placed in all teeth, and the teeth were loaded with a 17-kg force. Teeth were thermocycled, stored in 37°C water, then immersed in 50% silver nitrate solution and placed in developer. The teeth were sectioned and photographed. Microleakage was calculated according to the depth of dye penetration, on a 6-degree scale. Results demonstrated the conservative modified restorations and conventional restorations, when glass-ionomer liner was used, to have less marginal microleakage, in both primary and permanent teeth, than their calcium hydroxide counterparts.
56-month clinical performance of Class I and II resin composite restorations
Journal of applied oral science : revista FOB
This study evaluated the 56-month clinical performance of Class I and II resin composite restorations. Filtek P60 was compared with Filtek Z250, which are both indicated for posterior restorations but differ in terms of handling characteristics. The null hypothesis tested was that there is no difference in the clinical performance of the two resin composites in posterior teeth. Thirty-three patients were treated by the same operator, who prepared 48 Class I and 42 Class II cavities, which were restored with Single Bond/Filtek Z250 or Single Bond/Filtek P60 restorative systems. Restorations were evaluated by two independent examiners at baseline and after 56 months, using the modified USPHS criteria. Data were analyzed statistically using Chi-square and Fisher's Exact tests (a=0.05). After 56 months, 25 patients (31 Class I and 36 Class II) were analyzed. A 3% failure rate occurred due to secondary caries and excessive loss of anatomic form for P60. For both restorative systems, ...