Management of Class I and Class II Amalgam Restorations with Localized Defects: Five-Year Results

Javier Martin, Eduardo Fernandez, Juan Estay, Valeria V Gordan, Ivar Andreas Mjör, Gustavo Moncada, Javier Martin, Eduardo Fernandez, Juan Estay, Valeria V Gordan, Ivar Andreas Mjör, Gustavo Moncada

Abstract

Replacement of dental restorations has been the traditional treatment for defective restorations. This five-year prospective clinical trial evaluated amalgam restorations with localized defects that were treated by means of repair or refurbishing. Fifty-two patients (50% female and 50% male, mean age 28.3 ± 18.1 years, range 18-80) with 160 class I and class II defective restorations were included. The study focused on the application of two minimally invasive treatments for localized restoration defects and compared these with no treatment and total replacement as negative and positive controls, respectively. Restorations were assessed by two calibrated examiners according to modified U.S. Public Health Service criteria, including marginal adaptation, anatomic form, secondary caries, and roughness. At five years, recall was examined in 45 patients with 108 restorations (67.5%). The results suggest that repair treatment is as effective as total replacement of restorations with localized defects, reducing biological costs to the patient and providing new tools to the clinician. Refinishing restoration is a useful treatment for localized anatomic form defects.

Figures

Figure 1
Figure 1
Marginal adaptation curve of all groups, separated by year, expressed as Alfa-rated restorations.
Figure 2
Figure 2
Anatomic form curve of all groups separated by year, expressed as Alfa-rated restorations.
Figure 3
Figure 3
Roughness curve of all groups separated by year, expressed as Alfa-rated restorations.
Figure 4
Figure 4
Secondary caries curve of all groups separated by year, expressed as Alfa-rated restorations.
Figure 5
Figure 5
Median survival time of roughness separated by groups after five years by Kaplan Meiers test.
Figure 6
Figure 6
MST of secondary caries separated by groups.
Figure 7
Figure 7
MST of anatomic form separated by groups.
Figure 8
Figure 8
MST of marginal adaptation separated by groups.
Figure 9
Figure 9
Baseline of a defective amalgam margin of the palatal cusp of a second upper molar. The restoration had served for 17 years. A small cavity was cut initially in the amalgam restoration until sound enamel and dentin could be seen at the pulp floor. The preparation was then repaired with amalgam.
Figure 10
Figure 10
Amalgam restoration immediately after repaired.
Figure 11
Figure 11
Control 1 year after treatment, where the marginal gap remains filled, the surface of the repaired amalgam presented irregularities, related with patient's occlusion.
Figure 12
Figure 12
Control 2 years after, showing roughness modifications similar one year control.
Figure 13
Figure 13
3 years control, with increases of the surface damage including amalgam microfracture, in the disto-palatal edge.
Figure 14
Figure 14
4 years control, showing increases of the surface and marginal damage.
Figure 15
Figure 15
5 years control, showing increases of surface damage, margin fractures of the amalgam and gap appears again, lower than at baseline.

References

    1. Manhart J, García-Godoy F, Hickel R. Direct posterior restorations: clinical results and new developments. Dental Clinics of North America. 2002;46(2):303–339.
    1. Yap AUJ, Teoh SH, Chew CL. Effects of cyclic loading on occlusal contact area wear of composite restoratives. Dental Materials. 2002;18(2):149–158.
    1. Leinfelder KF. Do restorations made of amalgam outlast those made of resin-based composite? The Journal of the American Dental Association. 2000;131(8):1186–1187.
    1. Manhart J, Chen HY, Hamm G, Hickel R. Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentition. Operative Dentistry. 2004;29(5):481–508.
    1. Mjör IA, Moorhead JE, Dahl JE. Reasons for replacement of restorations in permanent teeth in general dental practice. International Dental Journal. 2000;50(5):361–366.
    1. Hickel R, Manhart J. Longevity of restorations in posterior teeth and reasons for failure. Journal of Adhesive Dentistry. 2001;3(1):45–64.
    1. Mjör IA. Amalgam and composite resin restorations: longevity and reasons for replacement. Proceedings of the International Symposium on Criteria for Placement and Replacement of Dental Restorations; October 1989; Lake Buena Vista, Fla, USA.
    1. Friedl KH, Hiller KA, Schmalz G. Placement and replacement of amalgam restorations in Germany. Operative Dentistry. 1994;19(6):228–232.
    1. Mjör IA, Um CM. Survey of amalgam and composite restorations in Korea. International Dental Journal. 1993;43(4):311–316.
    1. Mjör IA, Toffenetti F. Placement and replacement of amalgam restorations in Italy. Operative Dentistry. 1992;17(2):70–73.
    1. Gordan VV, Shen C, Mjor IA. Marginal gap repair with flowable resin-based composites. General Dentistry. 2004;52(5):390–394.
    1. Gordan VV. Clinical evaluation of replacement of class V resin based composite restorations. Journal of Dentistry. 2001;29(7):485–488.
    1. Mjör IA, Dahl JE, Moorhead JE. Age of restorations at replacement in permanent teeth in general dental practice. Acta Odontologica Scandinavica. 2000;58(3):97–101.
    1. Mjör IA. Placement and replacement of restorations. Operative Dentistry. 1981;6:49–54.
    1. Ekstrand KR, Ricketts DNJ, Kidd EAM, Qvist V, Schou S. Detection, diagnosing, monitoring and logical treatment of occlusal caries in relation to lesion activity and severity: an in vivo examination with histologic validation. Caries Research. 1998;32(4):247–254.
    1. Cvar JF, Ryge G. Reprint of criteria for the clinical evaluation of dental restorative materials. 1971 US Public Health Service: San Francisco. Clinical Oral Investigations. 2005;9(4):215–232.
    1. Moncada G, Martin J, Fernández E, Hemnel MC, Mjör IA, Gordan VV. Sealing, refurbishment and repair of Class I and Class II defective restorations A three-year clinical trial. Journal of the American Dental Association. 2009;140(4):425–432.
    1. Murdoch-Kinch CA, McLean ME. Minimally invasive dentistry. Journal of the American Dental Association. 2003;134(1):87–95.
    1. Gordan VV, Garvan CW, Blaser PK, Mondragon E, Mjör IA. A long-term evaluation of alternative treatments to replacement of resin-based composite restorations Results of a seven-year study. Journal of the American Dental Association. 2009;140(12):1476–1484.
    1. Fernández EM, Martin JA, Angel PA, Mjör IA, Gordan VV, Moncada GA. Survival rate of Sealed, Refurbished and repaired defective restorations: 4-year follow-up. Brazilian Dental Journal. 2011;22(2):134–139.
    1. Gordan VV, Mjör IA, Blum IR, Wilson N. Teaching students the repair of resin-based composite restorations: a survey of North American dental schools. Journal of the American Dental Association. 2003;134(3):317–338.
    1. Kidd EA, Toffenetti F, Mjör IA. Secondary caries. International Dental Journal. 1992;42:127–138.
    1. Kidd EAM, Fejerskov O. What constitutes dental caries? Histopathology of carious enamel and dentin related to the action of cariogenic biofilms. Journal of Dental Research. 2004;83:C35–C38.
    1. Kidd EA, Joyston-Bechal S, Beighton D. Microbiological validation of assessments of caries activity during cavity preparation. Caries Research. 1993;27(5):402–408.
    1. Kidd EA, Joyston-Bechal S, Beighton D. Marginal ditching and staining as a predictor of secondary caries around amalgam restorations: a clinical and microbiological study. Journal of Dental Research. 1995;74(5):1206–1211.
    1. Brantley CF, Bader JD, Shugars DA, Nesbit SP. Does the cycle of rerestoration lead to larger restorations? The Journal of the American Dental Association. 1995;126(10):1407–1413.
    1. Özcan M, Koolman C, Aladag A, Dündar M. Effects of different surface conditioning methods on the bond strength of composite resin to amalgam. Operative Dentistry. 2011;36(3):318–325.
    1. Özcan M, Schoonbeek G, Gökçe B, Çömlekoglu E, Dündar M. Bond strength comparison of amalgam repair protocols using resin composite in situations with and without dentin exposure. Operative Dentistry. 2010;35(6):655–662.
    1. Mjör IA. Long term cost of restorative therapy using different materials. Scandinavian Journal of Dental Research. 1992;100(1):60–65.
    1. Setcos JC, Khosravi R, Wilson NHF, Shen C, Yang M, Mjör IA. Repair or replacement of amalgam restorations: decisions at a USA and a UK dental school. Operative Dentistry. 2004;29(4):392–397.
    1. Moncada G, Fernández E, Martín J, Arancibia C, Mjör IA, Gordan VV. Increasing the longevity of restorations by minimal intervention: a two-year clinical trial. Operative Dentistry. 2008;33(3):258–264.
    1. Moncada GC, Martin J, Fernandez E, et al. Alternative treatments for resin-based composite and amalgam restorations with marginal defects: a 12-month clinical trial. General Dentistry. 2006;54(5):314–318.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever