©Operative Dentistry, 2007, 32-1, 3-10 N Akimoto• M Takamizu • Y Momoi Clinical RelevanceThis 10-year clinical evaluation of a self-etching adhesive system showed only slight marginal change of some restorations; however, these changes were not severe. Consequently, these clinical conditions did not require replacement, since no recurrent caries were present. Clinically, these data demonstrate that this self-etching adhesive system is acceptable for placement of a long-term adhesive restoration in human teeth. SUMMARYThis study evaluated the long-term clinical performance of a self-etching adhesive system, Clearfil Liner Bond 2. Two operators placed a total of 87 restorations among 42 patients. Carious dentin was identified with the help of Caries Detector and was removed using only a low speed round bur. Clearfil Liner Bond 2 was applied following the manufacturer's directions, and the resin composite was then placed. The number of restorations placed by cavity classification were: 8-Class I, 11-Class II, 21-Class III, 2-Class IV and 45-Class V. The restorations were evaluated in 5 categories according to modified USPHS criteria: pulpal response, marginal integrity, marginal discoloration, retention and secondary caries. Assessments were done at baseline, immediately after placement and at 6-months and 1, 5, 7 and 10 years. Recall rates at each assessment period were 83.9% (6-months), 82.8% (1 year), 59.8% (5 years), 77.0% (7 years) and 50.6% (10 years). In terms of assessment categories, there were no recorded sensitivity, retention loss or secondary caries at any of the five recall periods. At the 10-year assessment, 40 out of 44 restorations (90.9%) were rated Bravo for marginal integrity and 39 restorations (88.6%) were rated Bravo for marginal discoloration (Wilcoxon signed-ranks test p<0.05). This data demonstrates the retention rate and pulpal response of the self-etching adhesive system Clearfil Liner Bond 2 was excellent at 10 years. Most cases showed slight marginal changes during clinical function; however, these changes were not clinically severe by USPHS criteria. These data demonstrate that placement of the Clearfil Liner Bond 2 self-etching adhesive system was demonstrated to be acceptable for the clinical restoration of human teeth following 10 years of clinical function.
The questionnaires used in this study are useful for measuring patient satisfaction in the dental school hospital setting.
This historical treatise follows the documented timeline of tooth decay into today's understanding, treatment, and teaching of caries biology. Caries has been attributed to many different causes for several millennia, however, only since the late 1900s has research revealed its complex multifactorial nature. European writers of the 1600s to 1700s held views that general health, mechanical injuries, trauma, and sudden temperature changes all caused caries—holding a common belief that decay was due to chemical agents, faulty saliva, and food particles. Until the early 1800s most writers believed that caries was due to inflammation from surrounding diseased alveolar bone. Today's science has demonstrated that caries is caused by indigenous oral microorganisms becoming a dynamic biofilm, that in the presence of fermentable sugars produce organic acids capable of dissolving inorganic enamel and dentin followed by the proteolytic destruction of collagen leaving soft infected dentin. As bacteria enter the pulp, infection follows.
This study evaluated the clinical performance of a fluoride releasing restorative system (FL-Bond II & Beautifil II) in posterior restorations after 18-month placement. IRB forms were submitted with each patient approving by signing their acceptance. Seven Class I and 46 Class II restorations were placed by three clinicians in 38-patients. Each FL-Bond II & Beautifil II restoration was placed under rubber dam isolation according to manufacture's instruction. Clinical evaluation was assessed at baseline, 6 and 18-months using modified USPHS criteria. No post-operative sensitivity was reported in any restored tooth at each patient assessment. Only slight color change with some surface staining was noted. Slight marginal changes were observed in 12 of 53-restorations -seen as step irregularities when a sharp explorer was drawn across the tooth from the enamel toward the restoration interface. Utilizing USPHS evaluation criteria, the clinical performance of each (FL-Bond II & Beautifil II) posterior fluoride releasing system was clinically acceptable at 18-month.
The purpose of this study was to determine if adhesion between various resin composites can occur by a chelation reaction of elemental ions. The surface composition of four commercially available resin composites (Beautifil II, Clearfil AP-X, Estelite Σ Quick and Solare) were measured by X-ray fluorescence analysis. Composite-to-composite adhesion with conventional silane coupling treatment was compared to self-etching primer treatment and evaluated by conventional shear bond strength testing. Our results detected Strontium and Barium (alkaline metallic earth ions) on the surface of Beautifil II and Clearfil AP-X resins. The shear bond strength values of self-etching primer treatments of Beautifil II and Clearfil AP-X was significantly higher than Estelite Σ Quick and Solare. Our data suggest that self-etching primer treatment is effective for adhesion of resin composites, depending on their filler composition, due to the chelation adhesion reaction between the acidic monomer and incorporated alkaline metal ions.
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