The longevity of amalgam versus compomer/composite restorations in posterior primary and permanent teeth: findings From the New England Children's Amalgam Trial. Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial. Risk factors for secondary caries in direct composite restorations in primary teeth. Dental restoration longevity: survival functions and statistical indices in low and high failure rate groups. Predictors of root canal treatment in teeth with full coverage restorations. Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement. Efficacy of conventional treatment with composite resin and atraumatic restorative treatment in posterior primary teeth: study protocol for a randomised controlled trial A prospective evaluation of zirconia posterior fixed dental prostheses: three-year clinical results. Five-year performance of high-copper content amalgam restorations in a multiclinical trial of a posterior composite. Endodontic complications after plastic restorations in general practice. Implant loading protocols for the partially edentulous posterior mandible.
BACKGROUND Limited information is available from r and omized clinical trials comparing the longevity of  amalgam and resin-based compomer/composite restorations . The authors compared replacement rates of these types of restorations in posterior teeth during the five-year follow-up of the New Engl and Children 's Amalgam Trial . METHODS The authors r and omized children aged 6 to 10 years who had two or more posterior occlusal carious lesions into groups that received amalgam ( n=267 ) or compomer ( primary teeth)/composite ( permanent teeth ) ( n=267 ) restorations  and followed them up semiannually . They compared the longevity of restorations placed on all posterior surfaces using r and om effects survival analysis . RESULTS The average+/-st and ard deviation follow-up was 2.8+/-1.4 years for primary tooth restorations and 3.4+/-1.9 years for permanent tooth restorations . In primary teeth , the replacement rate was 5.8 percent of compomers versus 4.0 percent of amalgams ( P=.10 ) , with 3.0 percent versus 0.5 percent ( P=.002 ) , respectively , due to recurrent caries . In permanent teeth , the replacement rate was 14.9 percent of composites versus 10.8 percent of amalgams ( P=.45 ) , and the repair rate was 2.8 percent of composites versus 0.4 percent of amalgams ( P=.02 ) . CONCLUSION Although the overall difference in longevity was not statistically significant , compomer was replaced significantly more frequently owing to recurrent caries , and composite restorations required seven times as many repairs as did amalgam restorations . CLINICAL IMPLICATION S Compomer/composite restorations on posterior tooth surfaces in children may require replacement or repair at higher rates than amalgam restorations , even within five years of placement BACKGROUND Failure of dental restorations is a major concern in dental practice . Replacement of failed restorations constitutes the majority of operative work . Clinicians should be aware of the longevity of , and likely reasons for the failure of , direct posterior restorations . In a long-term , r and omized clinical trial , the authors compared the longevity of  amalgam and composite .  SUBJECTS , METHODS AND MATERIAL S : The authors r and omly assigned one-half of the 472 subjects , whose age ranged from 8 through 12 years , to receive amalgam restorations in posterior teeth and the other one-half to receive resin-based composite restorations .  Study dentists saw subjects annually to conduct follow-up oral examinations and take bitewing radiographs . Restorations needing replacement were failures . The dentists recorded differential reasons for restoration failure . RESULTS Subjects received a total of 1,748 restorations at baseline , which the authors followed for up to seven years . Overall , 10.1 percent of the baseline restorations failed . The survival rate of the amalgam restorations was 94.4 percent ; that of composite restorations was 85.5 percent . Annual failure rates ranged from 0.16 to 2.83 percent for amalgam restorations and from 0.94 to 9.43 percent for composite restorations .  Secondary caries was the main reason for failure in both material s. Risk of secondary caries was 3.5 times greater in the composite group . CONCLUSION Amalgam restorations performed better than did composite restorations . The difference in performance was accentuated in large restorations and in those with more than three surfaces involved . CLINICAL IMPLICATION S Use of amalgam appears to be preferable to use of composites in multisurface restorations of large posterior teeth if longevity is the primary criterion in material selection BACKGROUND Secondary caries or caries adjacent to restorations is the most frequent reason for replacement of dental restorations . Though , limited data is available on variables influencing the development of secondary caries in primary teeth . AIM To investigate risk factors for the development of secondary caries adjacent to direct composite restorations in primary teeth . DESIGN For this retrospective study , data of 2417 composite restorations , which were placed due to primary carious lesions , were considered . A total of 212 restorations failed due to secondary caries within a maximum observation period of 8 years . A control group was r and omly selected . Mann-Whitney U-test , binomial logistic regression with backward elimination and Cox regression with frailty model were performed ( P < 0.05 ) . RESULTS The overall caries experience amounted to 6.3 dmft and 13.3 dmfs . 72.5 % of restorations failed within the first 2 years . Older children and children from families with a higher socio-economic status showed a lower risk for secondary caries . Further , the dentist and the adhesive had a significant influence on the longevity . Posterior restorations had a higher risk to fail in comparison with anterior restorations . CONCLUSIONS Within the limitation of this study , it is concluded that the development of secondary caries is influenced by several factors . Nevertheless , the secondary caries rate was found to be relatively low in this high-risk population A group of 71 patients was examined to determine the longevity of restorations placed at the University of North Carolina School of Dentistry . Patients with an overall restorations failure rate of equal to or greater than 40 per 1000 restoration-yr were categorized as having a " high failure rate " and those below that were considered " low failure rate " . An investigation was made to determine statistical differences between these two groups of patients using survival analysis and various statistical indices . Time of exposure and age of patients for both groups were similar . High rate patients had a greater number of anterior restorations and anterior teeth restored . In addition , the number of restorations per tooth was significantly greater in anterior and posterior teeth of the high failure rate group . No single variable was found to account for the differences in the failure rates in the two groups of patients . A prospect i ve study is needed in order to examine possible causes for restoration failures This case-control study sought to identify variables predictive of subsequent root canal therapy ( RCT )  in teeth receiving full coverage restorations . The University of North Carolina School of Dentistry 's computerized treatment data base was used to identify all patients receiving a single-unit crown on a nonendodontically treated permanent tooth from January 1 , 1998 through December 31 , 2002 . These patients then were classified either as cases ( those whose crowned teeth received RCT before July 1 , 2004 ) or controls ( those whose crowned teeth did not ) . Computerized data , chart entries , and dental radiographs were examined to determine pre- , intra- , and postoperative factors of interest . In the final multivariable logistic regression model that included 66 cases and 71 controls , younger age ( p = 0.005 ) and greater extent of coronal and root destruction ( p = 0.020 ) remained statistically significant predictors of case status , though many potentially important predictors were unavailable through chart review . Patients could benefit if prospect i ve studies were conducted to identify factors predictive of subsequent endodontic involvement in newly crowned teeth UNLABELLED Several recent studies have demonstrated the success of the ART ( atraumatic restorative treatment ) technique under field conditions in developing countries . The ART technique involves removal of caries using only h and instruments , and placing a glass ionomer cement ( GIC ) restoration . OBJECTIVES To estimate the longevity of Fuji II GIC ART restorations placed in permanent teeth by dental nurse students under field conditions in rural Cambodia . DESIGN Clinical field trial . SETTING One high school in rural Cambodia . SAMPLE AND METHODS 53 subjects between the ages of 12 and 17 who had dental caries were selected to participate . Subjects were r and omly assigned to a dental nurse student for cavity preparation and placement of ART restorations ( without cavity conditioning ) . RESULTS 92.1 % of the carious lesions required class I or class V restorations , and 85.4 % were in the lower molars . 89 teeth were filled . At 1 and 3 years 86.4 % and 79.5 % of restorations were still present . Restorations were assessed by one dentist according to st and ard criteria . 76.3 % of the restorations were judged to be successful at 1 year , and 57.9 % at 3 years . CONCLUSIONS Factors which may have affected the success rates included : the material used , technical factors , failure to condition the cavity prior to restoration , and inexperience of the operators . The results suggest that ART restorations in permanent teeth using Fuji II GIC are only moderately successful after 3 years . Better results could be expected by using a dentine conditioner in conjunction with one of the newer stronger glass ionomer cements Introduction Despite the widespread acceptance of conventional treatment using composite resin in primary teeth , there is limited evidence that this approach is the best option in paediatric clinics .  Atraumatic restorative treatment ( ART ) using high-viscosity glass ionomer cement has gradually become more popular because it performs well in clinical studies , is easy to h and le and is patient friendly . Therefore , the aim of this r and omised clinical trial study is to compare the restoration longevity of conventional treatment using composite resin with that of ART in posterior primary teeth . As secondary outcomes , cost-efficacy and patient self-reported discomfort will also be tested . Methods and analysis Children aged 3–6 years presenting with at least one occlusal and /or occlusal-proximal cavity will be r and omly assigned to one of two groups according to the dental treatment : ART ( experimental group ) or composite resin restoration ( control group ) . The dental treatment will be performed at a dental care trailer located in an educational complex in Barueri/SP , Brazil . The unit of r and omisation will be the child . A sample size of 240 teeth with occlusal cavities and 188 teeth with occlusal-proximal cavities has been calculated . The primary outcome will be restoration longevity , which will be clinical ly assessed after 6 , 12 , 18 and 24 months by two examiners . The duration of the dental treatment and the cost of all material s used will be considered when estimating the cost-efficacy of each treatment . Individual discomfort will be measured after each dental procedure using the Facial Scale of Wong-Baker . Ethics and dissemination This clinical trial was approved by the local ethics committee from the Faculty of Dentistry of the University of São Paulo ( registration no. 1.556.018 ) . Participants will be included after their legal guardians have signed an informed consent form containing detailed information about the research . Trial registration number www . clinical trials.gov , NCT02562456 ; Pre- results STATEMENT OF PROBLEM Although the favorable mechanical properties of zirconium oxide-based ceramics have increased the acceptance of fixed dental prostheses for use in the posterior regions of the mouth in recent years , there are few clinical studies documenting the longevity of these restorations . Furthermore , certain complications must be resolved before the material is used more extensively . PURPOSE The purpose of this r and omized prospect i ve study was to evaluate the clinical performance of zirconia ( Lava ) 3-unit posterior fixed dental prostheses . MATERIAL AND METHODS Twenty 3-unit fixed dental prostheses were placed in 17 participants to replace a second premolar or a first molar . Eleven were placed in the maxilla and 9 in the m and ible . All abutment teeth were prepared with a chamfer finish line of 0.8 to 1 mm , and frameworks were prepared with the Lava system . Restorations were cemented with a resin cement . Two calibrated examiners independently evaluated the fixed dental prostheses 1 week ( baseline ) and 1 , 2 , and 3 years after placement with the California Dental Association quality evaluation system . The periodontal parameters : the gingival index , plaque index , margin index , and the probing depths of abutment teeth and contralateral teeth were assessed . Data were analyzed by using descriptive statistics and the Wilcoxon signed-rank test ( α=.05 ) . RESULTS All fixed dental prostheses were rated satisfactory after 3 years , and no fracture of the framework was observed during the observation period . One fixed dental prostheses was lost because of a biological complication at the 3-year examination , and a small degree of chipping of the veneering ceramic was observed in 2 participants . No significant differences among the periodontal parameters of the test and control teeth were observed except for the margin index . CONCLUSIONS The results of a 3-year evaluation suggest that posterior zirconia 3-unit fixed dental prostheses are a reliable treatment PURPOSE This paper reports the 5-year performance of the restorations of the high-copper content dental amalgam alloys included in the worldwide programme of clinical trials of Occlusin , including unique data on wear . METHODS The methods employed are common to those previously reported for the multi clinical evaluation of Occlusin . Analysis of the data is limited to simple statistical procedures . RESULTS The findings lend support to existing knowledge concerning the favourable performance of restorations of high-copper content dental amalgam alloys  , notably in relation to restorations in moderate- to large-sized Class II preparations in permanent molar teeth . Analysis of the data sheds new light on the influences of variables , including type of tooth restored , size and class of restoration and the presence or absence of occlusal contact(s ) on performance . CONCLUSION Conclusions are drawn regarding ways in which protocol s for future evaluations of the type reported should be exp and ed , and , together with suggestions for further work , it is concluded that this paper is a timely reminder of the value of existing dental amalgam alloys AIM To test the hypothesis that dentine and pulp protection by conditioning- and -sealing is no less effective than using a conventional calcium hydroxide lining . METHODOLOGY A cohort of healthy adults requiring a new or replacement restoration in a posterior tooth was recruited in six general practice s. All procedures received local Ethics Committee approval . Exclusion criteria included signs and symptoms of pulp necrosis or inflammation , and patients unable to commit to a long-term trial . Cavity preparations were r and omized to receive a calcium hydroxide lining or conditioning- and -sealing with a smear-removing bonding system . Choice of bulk restorative material ( composite resin or amalgam ) was at the discretion of the dentist . The key outcome measure was evidence of pulpal breakdown identified at unscheduled ( emergency ) or scheduled recall examinations . Postoperative sensitivity was recorded on 100 mm VAS at 24 h , 4 days and 7 days . Pulp status was assessed at 6 , 12 , 24 and 36 month recall , and at any emergency recall appointment . The relationship between pre-treatment and treatment variables and pulp breakdown was assessed by logistic regression ( P = 0.05 ) . RESULTS A total of 602 teeth were recruited , with comparable numbers of cavities lined ( 288 , 47.8 % ) or conditioned and sealed ( 314 , 52.2 % ) . The majority ( 492 , 81.7 % ) were replacement restorations , and amalgam was the most common bulk restorative material ( 377 , 62.6 % ) . A total of 390 ( 64.8 % ) restored teeth were review ed at 6 months , 307 ( 51 % ) at 12 months , 363 ( 60.3 % ) at 24 months , and 279 ( 46.3 % ) at 36 months post-restoration . Sixteen cases of pulp breakdown were identified within 36 months of restoration placement , 11 presenting as emergencies and five detected at routine recall examination . Logistic regression showed that preoperative pain , cavity treatment by lining or conditioning- and -sealing and the use of rubber dam isolation had no association with pulp breakdown . Pulp breakdown was associated with deep or pulpally exposed cavities ( P < 0.001 , odds ratio 7.8 ) and with composite rather than amalgam restorations ( P = 0.001 , odds ratio 2.13 ) . Re-coding to identify teeth with pulp exposures revealed that pulpal exposure was the key determinant of adverse pulp outcomes ( P < 0.0001 , odds ratio 28.4 ) and that composite resin restorations were again more likely to be associated with pulp breakdown than amalgam ( P = 0.017 , odds ratio 3.92 ) . CONCLUSIONS Considered within the context of routine primary dental care : Dentists can be confident that pulps will be equally well protected from post-restorative breakdown up to 36 months by calcium hydroxide lining and conditioning- and -sealing with adhesive resins .  Residual dentine thickness appears to be a key determinant of pulp responses after restorative dental treatment . In deep and pulpally exposed cavities in posterior teeth , composites were associated with more pulpal breakdown than amalgams PURPOSE To evaluate the predictability of early and immediate loading protocol s of  implants in the posterior m and ible and to investigate whether there is a difference in success rates , survival rates , and peri-implant parameters , including marginal bone level changes , between loading protocol s. MATERIAL S AND METHODS A comprehensive systematic review of the literature was conducted . The selection of publications reporting on human clinical studies was based on predetermined inclusion criteria and was agreed upon by two review ers . RESULTS A total of 19 papers were selected : 8 on early loading , 9 addressing immediate loading , and 2 comparing immediate and early loading . Of the 19 studies , 5 were r and omized clinical trials and 14 were prospect i ve studies . CONCLUSIONS Existing literature supports the early loading of  microroughened dental implants in the partially edentulous posterior m and ible at 6 to 8 weeks in the absence of modifying factors . Therefore , loading within this time frame can be considered routine for the majority of clinical situations in the posterior m and ible , either with single crowns or fixed dental prostheses . Immediate loading of microroughened dental implants in the partially edentulous posterior m and ible proved to be a viable treatment alternative . Caution is necessary when interpreting published outcomes for immediate loading , as the inclusion exclusion criteria are inconsistent and many subjective confounding factors are evident . Additional studies with longer follow-ups , specifically r and omized clinical trials , are needed to consoli date the data for immediate loading . Priority should be given to trials testing immediate loading
However , variability was substantial .
Restoration type , material s , the patient , the operator , the practice environment and type of care system appeared to influence longevity .
Objective To conduct a systematic review of the literature on the longevity of routine dental restorations in permanent posterior teeth , and to identify and examine factors influencing its variability .