To evaluate the 5-yr clinical performance of a resin-modified glass-ionomer cement and a polyacid-modified resin composite in restoring non-carious cervical lesions.
Non-carious cervical lesions in 46 incisors, canines, and premolars were restored either with Fuji II LC (n=18) or with Dyract (n=28) in 16 healthy patients. The lesions were restored without cavity preparation strictly according to the manufacturer's instructions. The restorations were clinically evaluated single blind after 5 yrs using modified USPHS criteria.
The percentage of Alfa ratings were as follows (Dyract/Fuji II LC): color match 81.3%/28.6%, surface texture 93.8%/21.4%, anatomic form 75.0%/28.6%, marginal integrity (enamel) 62.5%/42.9%, marginal integrity (dentin) 68.8%/28.6%, marginal discoloration (enamel) 56.3%/42.9%, marginal discoloration (dentin) 68.8%/21.5%. Five-yr data revealed a significant difference between the clinical ratings of Dyract and Fuji II LC for all criteria except marginal integrity and marginal discoloration in enamel. A total of five Dyract restorations and four Fuji II LC restorations failed within the study period.
A considerably high and almost similar overall failure rate was found for both restorative materials in restoring non-carious cervical lesions. However, retained Dyract restorations presented superior clinical performance compared to Fuji II LC restorations.
"There is a significant body of literature, which documents the influence of filling material type on the longevity of cervical restorations. Clinical studies have shown repeatedly that restorations of NCCL have inadequate retention rates, with higher percentages of failure at the cervical, compared with the occlusal margins      . To circumvent the existing shortcomings and improve the clinical longevity of cervical restorations, modified or unmodified preparations , layered restorative techniques   and improvements in the adhesion of the materials  have been suggested. "
[Show abstract][Hide abstract] ABSTRACT: It is still largely unknown as to what material parameter requirements would be most suitable to minimise the fracture and maximising the retention rate of the restoration of cervical non-carious lesions (NCCL). The present paper, as a first of its kind, proposes a radical approach to address the problems of material improvement, namely: numerical-based, fracture and damage mechanics materials optimisation engineering. It investigates the influence of the elastic modulus (E) on the failure of cervical restorative materials and aims to identify an E value that will minimise mechanical failure under clinically realistic loading conditions.
The present work relies on the principle that a more flexible restorative material would partially buffer the local stress concentration. We employ a "most favourable" parametric analysis of the restorative's elastic modulus using a fracture mechanics model embedded into finite element method. The advanced numerical modelling adopts a Rankine and rotating crack material fracture model coupled to a non-linear analysis in an explicit finite element framework.
The present study shows that the restorative materials currently used in non-carious cervical lesions are largely unsuitable in terms of resistance to fracture of the restoration and we suggest that the elastic modulus of such a material should be in the range of 1GPa. We anticipate that the presented methodology would provide more informative guidelines for the development of dental restorative materials, which could be tailored to specific clinical applications cognisant of the underlying mechanical environment.
"In this case report, to restore cervical lesions a hybrid (compomer) material was selected due to its favorable clinical characteristics which are (i) color stability, (ii) biocompatibility, (iii) less plaque accumulation, (iv) flour releasing and esc.15 From various studies, it has been clearly understood that when compared the composite and/or amalgam restorations adjacent to the gingiva, hybrid materials show less adverse effect on gingival margin, clinical attachment level, pocket depth, width and thickness of the keratinized gingival;16 possess significantly lower plaque-gingival index, bleeding scores;17 and produce fewer crevicular fluid.18 Also, in an in vivo study, Dragoo19 aimed the clinical and histological responses of the subgingivally placed hybrid-ionomer restorations in 50 cases, and concluded that these restorations could successfully be used to restore subgingival defects in where periodontal health is crucial, yielding an ideal epithelial and connective tissue adherence to these materials. "
[Show abstract][Hide abstract] ABSTRACT: A case of uncommon occupational dental erosion was reported in an individual who had worked in the war industry for twenty years. This occupation involved daily, at least 8 hours, inhalation of chromic acid being used for cleaning of barrel of cannons. The erosion manifested as dental sensitivity with excessive cervical erosion even with pulpal exposure in certain teeth. Moreover, due to the adverse effect of the chemical against to gingival and/or periodontal tissues, the lesions were extremely harmful with respect to the exposed root-cementum. After proper periodontal therapy, cervical lesions were treated conservatively with a compomer based restorative material without cavity preparation. Although today it is not common due to the well-controlled working conditions, occupational combined dental and medical problems via airborne fumes and/or elements can be seen at workers in chemical factories. A cumulative biohazardous effect is generally seen as not only medical but also dental disorders.
European journal of dentistry 05/2007; 1(2):119-22.
[Show abstract][Hide abstract] ABSTRACT: This study evaluated the 5-year clinical performance of polyacid-modified resin composite, Dyract (DeTrey/Dentsply, Konstanz,
Germany), restorations in class V carious lesions. Ninety-two class V carious lesions in 28 patients were restored with Dyract.
Restorations were clinically evaluated at baseline, 1-, 2-, 3-, 4-, and 5-year recalls and were evaluated according to the
modified Ryge criteria by two experienced calibrated examiners in regard to color match, marginal discoloration, wear or loss
of anatomical form, caries, marginal adaptation, and surface texture. The retention rate after 5years compared to baseline
in class V carious restorations was 84%, with only 12 restorations failing. Color change and marginal discoloration in restorations
were found to be statistically significant (p = 0.0238 and p < 0.0001, respectively) at the end of the 5years, but did not require replacement of any of the restorations. The results
of this study revealed that at the end of 5years, Dyract exhibited a clinically acceptable success rate but had significant
color changes and marginal discoloration in class V carious lesions.
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