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. Clinical behaviour of glass ionomer restorations in primary teeth. Dental restoration longevity: survival functions and statistical indices in low and high failure rate groups. Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement. Longevity and Cariostatic Effects of Everyday Conventional Glass-ionomer and Amalgam Restorations in Primary Teeth: Three-year Results Effect of cavity form on the durability of glass ionomer cement restorations in primary teeth: a three-year clinical evaluation. Efficacy of conventional treatment with composite resin and atraumatic restorative treatment in posterior primary teeth: study protocol for a randomised controlled trial Survival of Fuji IX ART fillings in permanent teeth of primary school children in Tanzania. The survival of resin modified glass ionomer and stainless steel crown restorations in primary molars, placed in a specialist paediatric dental practice Atraumatic Restorative Treatment with Resin-Modified Glass Ionomer Material: Short-Term Results of a Pilot Study Long-term clinical evaluation of fracture and pulp injury following glass-ionomer cement or composite resin applied as a base filling in teeth restored with amalgam. Rigid versus flexible dentine-like endodontic posts--clinical testing of a biomechanical concept: seven-year results of a randomized controlled clinical pilot trial on endodontically treated abutment teeth with severe hard tissue loss. Survival characteristics of composite restorations in primary teeth Dentists' molar restoration choices and longevity: a web-based survey. Risk factors for secondary caries in direct composite restorations in primary teeth. Clinical evaluation of the ART approach and materials in peri-urban farm schools of the Johannesburg area. Comparison of Resilon and Gutta-Percha Filling Materials on Root Canal Fracture Resistance Following Restoring with Quartz Fiber Posts Randomized controlled clinical trial of the 24-months survival of composite resin restorations after one-step incomplete and complete excavation on primary teeth. One-year evaluation of two hybrid composites placed in a randomized-controlled clinical trial. Clinical performance of a self-etching and a total-etch adhesive system - 2-year results. The longevity of amalgam versus compomer/composite restorations in posterior primary and permanent teeth: findings From the New England Children's Amalgam Trial. Clinical investigation of a high-strength glass ionomer restorative used with the ART technique in Wuhan, China: one-year results. A 3-year longitudinal, controlled clinical study of a gallium-based restorative material Influence of proximal box elevation on the marginal quality and fracture behavior of root-filled molars restored with CAD/CAM ceramic or composite onlays Clinical evaluation of a polyacid-modified resin composite (compomer) in Class II restorations of primary teeth: a two-year follow-up study. Bilayer technique and nano-filled coating increase success of approximal ART restorations: a randomized clinical trial.
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 OBJECTIVE To compare a silver-reinforced glass ionomer material ( cermet ) with a resin-modified glass ionomer in minimal Class II preparations in primary teeth . METHODS Matched pairs of primary molars with approximal caries that required operative treatment were used . Each cavity was filled with either Vitremer or Ketac-Silver . The restorations were followed for at least 36 months and examined annually using bitewing radiographs and clinical inspections . Impressions were taken at each recall and models were examined microscopically . RESULTS After 36 months , one of the resin-modified glass ionomer ( RMGI ) restorations and 13 ( 26.5 % ) of the silver cermet restorations had failed . The RMGI failed because of secondary caries , while most of the failures of the silver cermet fillings were marginal defects alone or in combination with secondary caries . The median survival time ( MST ) for the silver cermet restorations was 37 months . The RMGI restorations had a MST exceeding 42 months , but MST could not be calculated exactly because of the low failure rate during the study period . CONCLUSIONS The resin-modified glass ionomer had the overall best performance of the two material s under comparison . The silver cermet material can not be recommended for Class II restorations in primary teeth 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 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 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 The effect of cavity form on the durability of  glass ionomer cement restorations in primary molars was studied in a clinical , intraindividual , three-year longitudinal study . Proximal restorations were placed in either a microcavity or a modified Black 's Class II cavity with rounded internal and external angles . A total of twenty-eight pairs were assessed . After two years the cumulative failure rate was 16 percent for each of the cavity types and after three years 25 percent for the microcavity and 32 percent for the modified Black 's Class II cavity . No statistical difference was found in the longevity of the restorations placed in the two different types of cavities 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 OBJECTIVE To evaluate the clinical performance of atraumatic restorative treatment ( ART ) fillings using Fuji IX as a filling material in field conditions . DESIGN Longitudinal study of the ART fillings in permanent teeth of primary school children aged eight to fifteen years . SETTING Primary schools in Morogoro municipality , Tanzania . SUBJECTS AND METHODS St and ard 3 and 4 children in five primary schools r and omly selected from a list of 36 primary schools of Morogoro municipality were examined for dental caries and periodontal conditions . All 296 carious lesions that were indicated for restoration were treated using ART approach according to the instructions given in the manual for ART approach for the control of dental caries . Essential measurements for treated teeth and cavity were taken . The cavities were filled with Fuji IX glass ionomer cement as per manufacturer 's instructions . After one year , 238 restorations were evaluated using the criteria for evaluating ART restorations . MAIN OUTCOME MEASURE Clinical appearance of the surface of the restorations . RESULTS Ninety four per cent of the restorations evaluated were rated as good and intact , while 1.7 % were rated as having slight defects that needed no repair , giving a one year survival rate of 96.1 % . Mean working time was 14.5 minutes . CONCLUSIONS AND RECOMMENDATIONS The one-year survival rate of 96.1 % is high enough to recommend wide use of ART in Tanzania . Town and municipal councils should be encouraged to adopt ART in their school oral health programmes Aims To prospect ively report on the survival of resin-modified glass ionomer cement ( RMGIC ) , photac-fil and pre-formed stainless steel crown ( SSC ) restorations in primary molar teeth placed over a seven-year period in a specialist paediatric dental practice under private contract of remuneration . Method All primary molar restorations placed by a specialist paediatric dentist over a seven-year period were review ed and the outcome results recorded . Data were recorded at review visits until June 30 , 2003 . Data recorded included Class I restorations , Class II restorations and SSC . The Class II cavities were either mesial or distal , with or without buccal/palatal extensions . If both proximal surfaces were decayed or if after cavity preparation the result ant outline form was significantly larger than the minimal classical form , RMGIC was not used ; an SSC was placed instead . Stainless steel crown preparation followed conventional guidelines . The crowns were cemented with reinforced zinc oxide and eugenol ( Kalzinol ) . The status was recorded as satisfactory restoration , tooth exfoliated , tooth extracted for orthodontic reasons with the date of extraction , or needing replacement . If replaced then the reason for replacement was also recorded . Results A total of 544 Class I RMGICs , 962 Class II RMGICs , and 1,010 SSCs  were placed . At the last review of each restoration , 98.3 % of Class I , 97.3 % of Class II RMGICs and 97.0 % of SSCs were either satisfactory or withdrawn intact . Conclusion Under the conditions of private specialist practice -based study SSCs continued to prove very successful for the restoration of larger cavities and for pulp-treated primary molar teeth . For the smaller cavities RMGIC were also very successful Objectives : The aim of this study was to assess the feasibility of the resin-modified glass ionomer ( RMGI ) material in atraumatic restorative treatment ( ART ) approach and compare RMGI with the high-strength traditional glass ionomer cement ( GIC ) in permanent teeth with one or more surface-carious cavities . Material s and Methods : This study was conducted in a village school in rural southeastern Anatolia , Turkey . The RMGI and GIC restorations with the ART technique were placed r and omly employing a split mouth design . In addition , the ART approach was used when necessary for both primary and /or permanent teeth with no pulpal involvement and no perceived pain before treatment . Ninety-one fillings were placed on contralateral molar pairs of 37 children . Baseline and 6-month evaluation of the fillings were made with the classic ART , modified Ryge and USPHS criteria . Results : Based on the ART criteria , 100 % of RMGI and 92.4 % of GIC restorations were classified as successful after 6 months , and the difference between the 2 groups was statistically significant ( p = 0.009 ) . While marginal discoloration was the commonest failure in the RMGI group according to both the modified Ryge and USPHS criteria , unsatisfactory surface texture and low anatomic form were the commonly seen failures in the ART technique . Conclusion : Generally , for each rating system , RMGI exhibited better clinical performance than GIC in all categories , except for marginal discoloration . Results based on the 6-month evaluation show that RMGI can be an alternative material to the GIC The aim of this research was to analyse the long-term clinical behaviour of two dental material s applied as filling under  silver amalgam restorations  : glass-ionomer cement ( GIC ) and composite resin with adhesive system ( CR ) . In this study , 117 posterior teeth ( 29 premolars and 88 molars ) were selected with carious lesions which result ed in great loss of dentin and cusps with unsupported enamel . After caries removal , cavities were prepared and totally filled with GIC or with CR . In a following visit , new cavities were prepared , leaving the employed filling material as a base and support for the enamel , which were then restored with silver amalgam . Restorations were evaluated periodically after 6 months and up to 5 years . Both fracture and pulpal involvement rates were low . Although differences could be observed in the behaviour of the material s , statistical survival estimation showed that the performances of GIC and CR as filling material were similar . There was a significant association both between kind of tooth ( molar or premolar ) and long-term survival of the restorations ; and between degree of unsupported enamel and the same long-term survival . Our results confirmed that the technique in which GIC or CR are used as filling under  silver amalgam restorations is clinical ly acceptable INTRODUCTION This is the first clinical long-term pilot study that tested the biomimetic concept of using more flexible , dentine-like ( low Young modulus ) glass fiber-reinforced epoxy resin posts ( GFREPs ) compared with rather rigid , stiff ( higher Young modulus ) titanium posts ( TPs ) in order to improve the survival rate of severely damaged endodontically treated teeth . METHODS Ninety-one subjects in need of postendodontic restorations in teeth with 2 or less remaining cavity walls were r and omly assigned to receive either a tapered TP ( n = 46 ) or a tapered GFREP ( n = 45 ) . The posts were adhesively luted using self-adhesive resin cement . The composite core build-ups were prepared ensuring a circumferential 2-mm ferrule . The primary endpoint was a loss of restoration for any reason . To study group differences , the log-rank test was calculated ( P < .05 ) . Hazard plots were constructed . RESULTS After 84 months of observation ( mean = 71.2 months ) , 7 restorations failed ( ie , 4 GFREPs and 3 TPs ) . The failure modes were as follows : GFREP : root fracture ( n = 3 ) , core fracture ( n = 1 ) and TP : endodontic failure ( n = 3 ) . No statistical difference was found between the survival rates ( GFREPs = 90.2 % , TPs = 93.5 % , P = .642 ) . The probability of no failure was comparable for both post material s ( risk ratio ; 95 % confidence interval , 0.965 - 0.851/1.095 ) . CONCLUSIONS When using self-adhesive luted prefabricated posts in severely destroyed abutment teeth with 2 or less cavity walls and a 2-mm ferrule , postendodontic restorations achieved high long-term survival rates irrespective of the post material used ( ie , glass fiber vs titanium ) Objectives This retrospective study analyzed restoration survival of  composite fillings in children with at high caries risk in relation to age , sex , operator , tooth type , filling extension , and material used . Material s and methods Among 667 children treated in 2004–2012 in a university setting without sedation or general anesthesia , 2388 composite fillings were included . Relevant data from regular recall intervals were retrieved from patients ’ records . Either total-etch or a self-etch adhesive combined with flowable and /or (nano)hybrid composite was used . The Kaplan-Meier estimator and Cox proportional hazard analysis with backward elimination model were applied for survival analysis . Results For the observation period of 8 years ( mean 1.7 years ) , the cumulative failure rate was 17.2 % with annual failure rates of 10.0 % . In 8.8 % of the cases , fillings failed due to secondary caries . In 8.3 % technical failure due to total filling loss , loosening , marginal gaps , or tooth fracture occurred . Tooth type , filling extension , age , operator , dental dam , and type of adhesive were significant for survival ( p < 0.05 ) . Conclusions Filling survival was comparably lower to composite restorations observed in prospect i ve clinical studies on permanent teeth and other tooth-colored restoratives used in primary teeth . Due to the very high caries risk and young age of the population , frequent loss due to secondary caries was observed . With respect to the high caries risk , composite restorations can be used to treat carious primary teeth , though a strict caries prevention regimen should be followed to minimize restoration failure . Clinical relevance Filling loss of composites in the primary dentition is associated with secondary caries on the long term 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 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 In this study , 1,325 school children from 7 farm schools were examined . Their mean age ( + /- SD ) was 10.5 + /- 3.0 ( range 6 - 11 ) years . At baseline , the mean DMFT score was 1.1 + /- 1.7 and 36.4 % of the children had caries . The prevalence of fluorosis among the children was 12.6 % . Curative treatment was offered to all the children . A total of 113 children ( 8.5 % ) with one-surface cavities on permanent teeth and without fluorosis were treated using the atraumatic restorative treatment ( ART ) approach . A total number of 163 cavities were included in the study , of which 82 were treated with Fuji IX glass-ionomer cement and 81 with Ketac-MOLAR ( h and mix ) . One year after treatment , restoration and sealant parts of ART fillings were examined . Caries status was also determined . The placing of the ART fillings and their evaluation were performed by different practitioners . A total number of 108 restorations  ( 58 with Fuji IX , 50 with Ketac-MOLAR ) were evaluated . Results of ART fillings showed a survival rate of 93.1 % with Fuji and 94.0 % with Ketac-MOLAR .  Retention of the sealant parts of ART fillings  was observed in 81 % of restorations with Fuji IX and 76 % with Ketac-MOLAR , not connected to the filled cavity . Caries was absent on all teeth restored with Fuji IX and noted in only one tooth restored with Ketac-MOLAR , not connected to the filled cavity . The retention rate after a 12-month period was acceptable and ART approach proved to be an appropriate technique for restoring teeth in this population group . There were no statistically significant differences between the survival rates of the two glass-ionomer restorative material s ( P > 0.05 ) Objective : Bacterial leakage and root fractures are the most important reasons of root canal treatment failure . Due to the lack of adhesion of gutta percha to the canal walls , Resilon has been introduced as a root-filling material able to bond to the root walls . Metal posts may predispose the tooth walls to oblique and vertical fracture which usually leads to tooth loss ; whereas , fiber posts may reinforce the remaining tooth structure . The purpose of this study was to compare the effect of Resilon and gutta-percha on the fracture resistance of root canal following restoring with quartz fiber posts . Material s and Methods : Forty-four maxillary incisor root canals were chemo-mechanically prepared , then r and omly divided into three groups : 1-Control group ( n=20 ) , 2-Experimental group ( n=20 ) and a negative control group ( n=4 ) . Root filled teeth were restored with quartz fiber posts and composite resin cores .  Four teeth with a conservative prepared access cavities and without any further post preparation were used as a negative control group . After simulating the clinical situation , specimens were loaded in the Universal Testing Machine for compressive strength test . All data were statistically analyzed by the T-test . Results : The mean compressive strengths for group 1 was 535.8 ± 155.23 N and 645.93 ± 182.98N for group 2 , which were statistically significant ( p-value= 0.047 ) . Conclusion : Root canals filled with Resilon were significantly more resistant than that of gutta-percha , following restoration with quartz fiber posts OBJECTIVE This r and omized clinical trial aim ed to compare the 24-months survival of  composite restorations in primary molars after partial caries removal ( PCR ) and total caries removal ( TCR ) . METHODS Forty-eight children aged 3 - 8 years with at least one molar with a deep carious lesion were included ( PCR ; n=66 ; TCR ; n=54 ) . For PCR , excavation was stopped when dentine with a leathery consistency was achieved ; in the TCR group , total absence of carious tissue was confirmed using a blunt-tipped probe . Pulpotomy was performed in cases of pulp exposure . Success was assessed by modified USPHS criteria with Alpha and Bravo scores recorded as success . RESULTS Pulp exposure occurred in 1 and 15 of the teeth treated with PCR and TCR respectively ( p<0.01 ) . The restorations survival rate after 24 months was 66 % ( PCR ) and 86 % ( TCR ) ( p=0.03 ) . When teeth that received pulpotomy were analyzed separately , the survival rate was 92 % ( p=0.09 ) . PCR performed in occlusoproximal restorations demonstrated the lowest success rate ( p=0.002 ) . PCR increases 2.90 times the probability of having a restorative failure compared to TCR ( p=0.03 ) , after adjusting for cavity type . When pulp exposure and restoration failure were considered as the outcome , there was no significant difference between the two groups ( p=0.10 ) with success rates of 64 % ( PCR ) and 61 % ( TCR ) . CONCLUSION Collectively , deciduous teeth su bmi tted to PCR prevented pulp exposure and , consequently , more invasive treatments ; otherwise , PCR yielded lower longevity for composite restoration compared to TCR , suggesting that PCR restorations need to be followed over time , especially when multi-surface restorations are involved . CLINICAL SIGNIFICANCE Composite restorations on carious remaining tissue require monitoring over time , especially those performed in more than one surface . Even if the restorations present shortcomings over the time , the majority of them are subject to repair , allowing more conservative approaches for teeth with deep caries lesions OBJECTIVE The aim of this prospect i ve r and omized-controlled clinical trial is to assess the long-term performance of two direct composite resins in posterior teeth . This study provides a survey of the one-year results . MATERIAL S AND METHODS A total of 1805 restorations were placed by students in stress-bearing Class I/II cavities ( including cuspal-coverage ) in molars and premolars in 456 patients . Clinical evaluation was performed at baseline and after one year using modified USPHS criteria . The restorations in each patient were performed either with Ceram X/Prime&Bond NT or Tetric Ceram/Optibond Solo Plus . RESULTS After one year 528 fillings with Ceram X and 580 with Tetric Ceram were available for evaluation of substance loss , contact point , color match , marginal staining , marginal adaptation , secondary caries and radiographic examination ( if necessary ) . This represents a recall rate of 61.18 % ( 279 patients ) . The failure rate per material was 5.3 % in the Ceram X group and 6.1 % in the Tetric Ceram group . Most of the failures were associated with marginal adaptation/integrity of the filling . A significant influence on the occurrence of a failure was observed for the number of treated teeth per patient , the age of the patient , the mesio-distal extension of the restoration and the tooth position . Gender , material , a previous root canal treatment , the bucco-lingual extension of the filling or cuspal-coverage did not significantly influence the failure rate . Patients attending the first recall were significantly older and had more fillings than patients not attending . CONCLUSIONS In a group of Class I/II restorations ( including cuspal-coverage ) , there was no significant difference in failure rates between ormocer-based and bis-GMA-based restorative systems after one year . A previous root canal treatment had no negative influence on the failure rate . A longer observation period is indicated to get clear evidence of the long-term performance of these composite resin systems The purpose of this controlled prospect i ve clinical study was to compare the clinical performance of the self-etching adhesive system AdheSE and the established total-etch adhesive system Excite in classes I and II cavities for a period of 2 years . Fifty patients participated in this study . Each received two restorations , one with AdheSE , one with Excite by one calibrated , non-blinded operator . The resin composite used to restore the teeth was Tetric Ceram HB . One calibrated , blinded clinician re-evaluated the restorations at baseline , after 6 , 12 and 24 months after placement using the modified Ryge criteria . For this , vitality , post-operative sensitivity , visible marginal irregularity , marginal discolouration , secondary caries , surface texture , anatomic form and filling defect were considered . After 2 years , 67 restorations were review ed in 34 patients . None of the teeth showed signs of secondary caries . Two teeth , one of each group , had to receive endodontic treatment because of pulp inflammation . All other teeth remained vital . Slight marginal discolourations were observed in six AdheSE restorations and three Excite restorations . These restorations were scored as Beta . After 2 years , an overall clinical success rate , summing up all the Alpha and Beta scores , of 97 % was found , viewing both adhesive systems together . Statistic analysis using log-rank test showed no statistic differences in the overall survival rate between the two material s tested within the observation period . It can be concluded that both adhesive systems tested demonstrated very good clinical performance in the restoration of classes I and II cavities at the end of 2 years 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 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 Aim The aim of this three-year longitudinal controlled study was to compare the clinical performance of Galloy versus a high copper , mercury based Dispersalloy filling material . Methods Moderate to large class I and class II cavities or replacement restorations were selected and 25 Galloy ® restorations and 25 Dispersalloy controls were placed in 14 adult patients by a single operator . Restorations were photographed and a silicone impression recorded at baseline , 6 months , 1 year , 2 years and 3 years . Results At 3 years all 22 Dispersalloy restorations but only 4 Galloy restorations were still in situ . Three Dispersalloy restorations were lost to follow – up . Tooth fracture was observed in 15 ( 60 % ) of the Galloy restorations by the end of the 3 years , compared to one ( 4 % ) Dispersalloy restoration , which failed due to tooth fracture . A further six Galloy restorations had to be removed due to complaints of persistent pain . Four teeth restored with Galloy  required endodontic treatment but none of the Dispersalloy restored teeth required endodontics . Of the four Galloy restorations remaining in situ , three were relatively small restorations and the fourth a moderate sized restoration required a marginal repair . Conclusion The clinical performance of Galloy restorations was so grossly inferior to the Dispersalloy controls that Galloy can not be recommended for clinical use in moderate to large or multi-surface cavities Objectives This study investigated the influence of proximal box elevation ( PBE ) with composite resin when applied to deep proximal defects in root-filled molars with mesio-occluso-distal ( MOD ) cavities , which were subsequently restored with computer-aided design ed/computer-aided manufacturing ( CAD/CAM ) ceramic or composite restorations . Material s and method  Root canal treatment was performed on 48 human m and ibular molars . St and ardized MOD cavities were prepared with the distal box located 2 mm below the cemento-enamel junction ( CEJ ) . The teeth were r and omly assigned to one of four experimental groups ( n = 12 ) . In groups G1 and G2 , the distal proximal box was elevated up to the level of the CEJ with composite resin ( PBE ) . No elevation was performed in the remaining two groups ( G3 , G4 ) . CAD/CAM restorations were fabricated with feldspathic ceramic ( Vita Mark II , CER ) in groups G1 ( PBE-CER ) and G3 ( CER ) or with resin nano-ceramic blocks ( Lava Ultimate , LAV ) in groups G2 ( PBE-LAV ) and G4 ( LAV ) . Replicas were taken before and after thermomechanical loading ( TML ; 1.2 Mio cycles ; 49 N ; 3,000 thermocycles between 50 ° C and 5 ° C ) . Following TML , load was applied until failure . Fracture analysis was performed under a stereomicroscope ( ×16 ) . Marginal quality before and after TML ( tooth restoration , composite restoration ) was evaluated using scanning electron microscopy ( ×200 ) . Results After TML , lower percentages of continuous margins were observed in groups G1–G3 compared with pre-TML assessment s ; however , the differences were not statistically significant . For group G4-LAV , the marginal quality after TML was significantly better than in any other group . The highest mean fracture value was recorded for group G4 . No significant difference was found for this value between the groups with PBE compared with the groups without PBE , regardless of the material used . The specimens restored with ceramic onlays exhibited fractures that were mainly restricted to the restoration while , in teeth restored with composite onlays , the percentage of catastrophic failures ( fractures beyond bone level ) was increased . Conclusion PBE had no impact on either the marginal integrity or the fracture behavior of root canal-treated m and ibular molars restored with feldspathic ceramic onlays . CAD/CAM-fabricated composite onlays were more favorable than ceramic onlays in terms of both marginal quality and fracture resistance , particularly in specimens without PBE . Clinical relevance Composite onlays with or without PBE may be a viable approach for the restoration of root-filled molars with subgingival MOD cavities PURPOSE The aim of the study was to assess the clinical performance of a compomer restorative material ( Dyract , DeTrey/Dentsply ) for the restoration of Class II cavities , extended into dentin in primary teeth . METHODS The sample of the study consisted of 25 patients with 68 restored cavities . The restorations were evaluated with the modified Ryge criteria at baseline and after 6 , 12 and 24 months . Examination was clinical , radiographic , and observation of cast replicas under scanning electron microscope ( SEM ) . RESULTS After 24 months , 100 % of the restorations were retained , 3 % presented bulk fractures , and 6 % developed secondary caries at cervical margins . After 24 months , there was a significant reduction in marginal integrity while there was only slight change in anatomic form . Proximal contact was defective in 6 % of the restorations and 8 % showed marginal discoloration . SEM evaluation revealed a generalized occlusal and scattered marginal wear with no marginal gaps . CONCLUSION The compomer presented acceptable clinical performance in Class II restorations of primary teeth after 24 months in service BACKGROUND The high-viscosity consistency of glass ionomer cement ( GIC ) may lead to its incorrect adaptation into the cavity and therefore to restoration failure . AIM To compare two different insertion techniques for GIC in approximal atraumatic restorative treatment ( ART ) restorations and two different surface protection material s. DESIGN Approximal caries lesion in primary molars from 208 schoolchildren was r and omly assigned into four groups : G1 , conventional GIC insertion protected with petroleum jelly ( PJ ) ; G2 , bilayer technique protected with PJ ; G3 conventional GIC insertion protected with nano-filled particles coating for GIC ( NPC ) ; G4 , bilayer technique protected with NPC . Restorations were evaluated after 1 , 6 , 12 , 18 , 24 , and 36 months . Kaplan-Meier survival analysis and log-rank test were performed . Cox regression analysis ( α = 5 % ) was used to verify the influence of clinical factors . RESULTS Restoration survival was 52.8 % . Log-rank test indicated a better survival of the bilayer technique restorations , compared to conventional restorations ( P = 0.005 ) , whereas the coated conventional restorations presented higher survival than the uncoated ones ( P = 0.035 ) . Cox regression analysis showed no influence of any clinical tested variables . CONCLUSION The survival rate of the approximal ART restorations is positively influenced by the bilayer technique , and the application of nano-filled coating increases the longevity of the conventional approximal ART restorations
Class I restorations and restorations placed using rubber dam presented better AFR .
An elevated number of failures were observed due to recurrent caries , highlighting the need for professionals to work with a health-promoting approach .
BACKGROUND Several restorative material s with specific indications are used for filling cavities in primary teeth .
AIM To systematic ally review the literature in order to investigate the longevity of primary teeth restorations  and the reasons for failure .