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. The longevity of different restorations in primary teeth. Efficacy of conventional treatment with composite resin and atraumatic restorative treatment in posterior primary teeth: study protocol for a randomised controlled trial Longevity and Cariostatic Effects of Everyday Conventional Glass-ionomer and Amalgam Restorations in Primary Teeth: Three-year Results Dentists' molar restoration choices and longevity: a web-based survey. Two-year clinical performance of sonic-resin placement system in posterior restorations. Dental restoration longevity: survival functions and statistical indices in low and high failure rate groups. A prospective evaluation of zirconia posterior fixed dental prostheses: three-year clinical results. Risk factors for secondary caries in direct composite restorations in primary teeth. Clinical investigation of a high-strength glass ionomer restorative used with the ART technique in Wuhan, China: one-year results. The effects of two cavity preparation methods on the longevity of glass ionomer cement restorations: an evaluation after 12 months. Comparison of Conventional versus Colored Compomers for Class II Restorations in Primary Molars: A 12-Month Clinical Study Clinical Investigation of Two Glass–Ionomer Restoratives Used with the Atraumatic Restorative Treatment Approach in China: Two–Years Results
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 AND AIM This paper review s three published papers and adds results from a fourth study which aim ed to determine which restorative material would be the best alternative(s ) to amalgam ( AM )  in primary teeth . DESIGN All studies had a practice -based design and were part of the routine treatment of children and adolescents . The clinicians were assigned which material s to use in a r and omised matter in the first three studies which lasted for 7 - 8 years . In the fourth study conducted 4 years after the initial studies , the clinicians were free to select the restorative material s. RESULTS AND CONCLUSIONS Resin modified glass ionomer ( RMGI ) and compomer ( COM ) restorations showed similar longevity compared with AM , whereas conventional GI restorations showed significantly shorter longevity . The studies indicated that the ' new and improved ' material s based on in vitro tests did not always show enhanced clinical properties . In the last study , where clinicians freely selected the restorative material s they used in their practice s , seven used COM , one used conventional GI material s and one used a combination of the two types of material 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 The aim of this study was to compare the longevity and cariostatic effects of everyday  conventional glass-ionomer and amalgam restorations in primary teeth . The material s consisted of  515 Ketac-Fil glass-ionomer restorations and 543 Dispersalloy amalgam restorations prepared in 666 children , from 3 to 13 years of age , by 14 dentists within the Danish Public Dental Health Service in the municipalities of Vaerlose and Hillerød . The restorations , of which 79 % were of the Class II type , were in contact with 593 unrestored surfaces in adjacent primary and permanent teeth . After 3 years , 6 % of the patients had dropped out of the study , and 33 % of the teeth were exfoliated with the restoration in situ . A further 37 % of the glass-ionomer and 18 % of the amalgam restorations were recorded as failed ( p < 0.001 ) . The frequency of failures was highest for Class II glass-ionomer restorations , which showed a 50 % median survival time of only 34½ months , because of many fractures , while the 75 % survival time for Class II amalgam restorations just exceeded the actual 36 months ( p < 0.001 ) . Caries progression was most often recorded in surfaces adjacent to amalgam restorations , and 21 % of these surfaces needed restorative treatment vs. 12 % of the surfaces adjacent to glass-ionomer restorations ( p < 0.01 ) . The three-year results indicated that conventional glass ionomer is not an appropriate alternative to amalgam for all types of restorations in primary teeth . In particular , the short longevity of Class II glass-ionomer restorations could not be compensated for by the reduced caries progression and need for restorative therapy of adjacent surfaces STATEMENT OF PROBLEM The increasing trend toward esthetics has led to controversy as to the longevity of esthetic restorations and the wisdom of having traditional restorations replaced for esthetic reasons . With the assumption that the way dentists treat their own teeth may be a good indication of the accumulated wisdom of the profession , knowledge of dentists ' own restorative choices may provide guidance in selecting the most appropriate restorations . PURPOSE The purpose of this article was to determine restorative choices of dentists for personal molars and estimate restoration longevity . MATERIAL AND METHODS Information about dentists ' molars was obtained from a Web-based survey design ed to receive dentists ' demographic data and charting of 8 molar teeth with estimated longevity . Approximately 12,000 e-mails asking to access the website were sent to dentists ' addresses r and omly selected from a commercial data base . Nonrespondents received 1 reminder . The responses were statistically analyzed with a chi-square analysis ( alpha=.05 ) . RESULTS Seven hundred fifty-seven valid replies provided information for 6,034 teeth ( 22 % unrestored , 75 % restored , 2 % missing ) . Restorations reported included amalgam ( 36 % ) , gold inlay/onlay ( 13 % ) , complete veneer crown ( CVC ) ( 10 % ) , metal-ceramic crown ( MCC ) ( 8 % ) , and composite ( 7 % ) . Other esthetic options accounted for less than 3 % . Restorations with more than 20 years longevity included amalgam restorations ( 58 % ) , gold inlays/onlays ( 48 % ) and crowns ( 23 % ) . Fifty-six percent of esthetic restorations and 5 % of amalgams were placed in the last 5 years . The following restorations were placed in the last year ( n=186 ) : 38 % esthetic , 29 % crowns ( 18 % MCC ; 11 % CVC ) , and 17 % gold inlay/onlay or amalgam . Significant differences ( P<.001 ) were identified for dentist 's gender , year of graduation and practice location . CONCLUSIONS Most dentists have not replaced traditional metallic restorations with esthetic alternatives . Dentists still choose nonesthetic options for significant numbers of their own restorations OBJECTIVE The objective of this split-mouth r and omized controlled study was to compare the 2-year clinical performance of two restorative techniques and material s for posterior permanent carious teeth . METHOD AND MATERIAL S After signing informed consent , 30 patients aged between 7 and 16 received two Class 1 restorations on cavities on permanent first or second molar teeth performed with one of two systems : incrementally placed conventional posterior composite resin ( Herculite Ultra , Kerr ) , and sonic-resin placement system ( SonicFill , Kerr ) with single-component self-etch adhesive system ( Kerr ) according to the manufacturers ' directions . Two blinded observers evaluated the restorations at three times ( baseline , and after 1 and 2 years ) according to the US Public Health Service modified criteria . Kruskal-Wallis test and Mann-Whitney U-test were used to compare the clinical performance of the restorative systems . RESULTS The restorative systems showed similar clinical performance at 2 years . At the end of 2 years in both groups , one restoration 's marginal staining Alpha ratings decreased . In the same period , two restorations in the conventional group and one in the SonicFill group received Bravo ratings for color match and surface roughness scorings . CONCLUSION The sonic-resin placement system demonstrated similar results to incrementally placed conventional composite resin in terms of clinical success . Considering the advantages of providing up to 5 mm in a single layer , and the adjustability of the viscosity , bulk-fill composite restorations seem to be a good alternative to posterior Class 1 composite restorations . CLINICAL RELEVANCE This study suggests that a new dental material for bulk-fill technology exhibits similar clinical success to incrementally placed composite resin 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 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 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 OBJECTIVE To evaluate the safety and effectiveness of a new glass ionomer restorative , ChemFlex , and to compare its clinical performance and wear to another popular material , Fuji IX GP , when used with the atraumatic restorative treatment ( ART ) approach in posterior teeth in school children . METHODS Ninety-two subjects aged between 6 and 14 years who had bilateral matched pairs of carious posterior teeth were selected . A split-mouth experimental design was used in which the two restorative material s were r and omly placed on contralateral sides . The restorations were assessed directly and also indirectly from color transparencies and die replicas . RESULTS After one year , the success rates of ART restorations  in the primary teeth were 96.6 % for ChemFlex restorations and 89.7 % for Fuji IX GP restorations placed in the Class I cavity preparations , whereas only 46.2 % ( ChemFlex ) and 61.5 % ( Fuji IX GP ) of Class II restorations were assessed as clinical ly satisfactory . In the permanent dentition , the success rates were 94.6 % and 98.2 % for ChemFlex and Fuji IX GP , respectively ; however , there was no statistically significant difference between the two restoratives for either the permanent or primary teeth . The mean occlusal wear after one year in the permanent teeth was 53.2 microns for ChemFlex and 56.3 microns for Fuji IX GP . Again , there were no statistically significant differences in wear between the two material s ( P > 0.05 ) . CONCLUSION The clinical performance of both ChemFlex and Fuji IX GP over a 12-month period was highly satisfactory and completely adequate for the ART technique , particularly in Class I cavities BACKGROUND The authors undertook a study to evaluate the effect of two cavity preparation methods on the initial survival of two more-viscous glass ionomer cements , or GICs , placed in the occlusal surfaces of permanent molar teeth . METHODS Three dentists placed 149 restorations in 68 adult patients in a hospital clinic . They used either atraumatic restorative treatment , or ART , or conventional cavity preparation methods to place two encapsulated esthetic conventional GICs : Fuji IX GP ( GC International Corp. , Tokyo ) and Ketac-Molar Aplicap ( 3 M ESPE , Seefeld , Germany ) . For comparison , they used high-copper-content GK Amalgam Alloy ( Advanced Technology & Material s Co. Ltd. , Beijing ) in conventional preparations . They evaluated the restorations using both direct and indirect observation methods . RESULTS Cavity preparations for which the authors used ART h and instruments took approximately twice as long to complete as did those for which they used conventional rotary instruments . After 12 months , no restorations had failed , but restorations comprising both GICs showed early losses of adjacent sealant material . Both GICs also showed relatively high restoration wear . At 12 months , the mean cumulative net occlusal wear for Fuji IX GP was 77 + /- 47 micrometers , and for Ketac-Molar 83 + /- 51 microm , without statistical significance ( P > .05 ) . Color matching improved significantly with time ( P < .001 ) , without significant differences in color between the two GICs by 12 months ( P = .09 ) . The amalgam alloy had minor surface tarnishing and marginal discrepancies increased with time ( P < .00 1 ) . CONCLUSIONS All of the occlusal restorations were rated as satisfactory after 12 months . The method of cavity preparation did not affect the restoration performance of the GICs . However , their deterioration requires long-term monitoring . Clinical Implication s. The more viscous GICs appear initially suitable for restricted use in clinical practice when placed using either of two cavity preparation methods in the occlusal surfaces of permanent molar teeth in adults Objective : To evaluate the 12-month clinical performance of conventional ( Compoglass F ) and colored ( Twinky Star ) compomer restorative material s in class II restorations of primary molars . Material s and Methods : A total of 196 restorations were placed in 98 children aged between 5 and 10 years ( mean age : 7.43 ± 1.31 years ) who had bilateral matched pairs of carious posterior class II primary molars . A split-mouth design was used in which 2 material s ( Compoglass F , Twinky Star ) were r and omly placed on contralateral sides by 3 dentists . At baseline , after 6 and after 12 months , the restorations were evaluated using modified US Public Health Service criteria for : secondary caries , marginal integrity , marginal discoloration , anatomic form and surface texture . The Alpha and Bravo scores were considered as clinical success . The data were subjected to statistical analysis by the Wilcoxon and McNemar tests ( p < 0.05 ) . The Kaplan-Meier survival method was applied to estimate survival percentages . Results : No significant difference was found among the groups at all recalls regarding marginal integrity , marginal discoloration , anatomic form , secondary caries and surface texture . The 12-month mean cumulative survival rate  of Compoglass F was 95.7 % , while in the Twinky Star group , the survival rate was 93 % in class II restorations with no significant difference between the groups for either material . Conclusion : Both conventional and colored compomer material s are suitable restorative material s for primary teeth for at least 12 months . Colored compomers could also be a good alternative to tooth-colored compomers in the restoration of primary molars Objective : To compare the clinical performance of two glass – ionomer cements , ChemFlex ( Dentsply DeTrey ) and Fuji IX GP ( GC ) , when used with the atraumatic restorative treatment ( ART ) approach in China . Methods : Eighty – nine school children aged between 6 and 14 years who had bilateral matched pairs of carious posterior teeth were included . A split – mouth design was used in which the two material s were r and omly placed on contralateral sides . The performance of the restorations was assessed directly and also indirectly from die – stone replicas at baseline and after 6 , 12 , and 24 months . Results : The 24–month cumulative survival rates of ART restorations  in the primary teeth were 93 and 90 % for the ChemFlex and Fuji IX GP class I restorations , respectively , while 40 and 46 % of class II restorations placed with the respective material s were satisfactory . In the permanent dentition , only class I restorations were involved and the cumulative survival rates were 95 and 96 % for ChemFlex and Fuji IX GP . For the primary teeth after 24 months , net mean occlusal wear was 87 µm for ChemFlex and 85 µm for Fuji IX GP . The occlusal wear in the permanent teeth was 75 µm for ChemFlex and 79 µm for Fuji IX GP . Conclusion : The clinical performance of both material s over a 24–month period was similar and the survival rates of class I ART restorations  in both primary and permanent teeth were high
Restorations of primary molars with conventional glass ionomer cement showed increased risk of failure than compomer , resin-modified glass ionomer cement , amalgam , and composite resin .
This study aim ed to compare the longevity of different conventional restorative material s placed in posterior primary teeth .