Can a single composite resin serve all purposes?

Managing the phase-down of amalgam: part I. Educational and training issues

“…[6][7][8] Fundamental to the increasing use of tooth-coloured restorative systems in the restoration of posterior teeth is the realisation that these systems must be applied and placed by alternative means and according to different principles. 9 If a tooth-coloured restorative material is viewed and used/handled as 'white amalgam', the clinical outcomes and performance will be poor. 10,11 Posterior composites, when applied and placed in ways that favour the clinical performance of resin composites, offer many important advantages over amalgam restorations, which they have been shown capable of matching in terms of longevity.…”

State-of-the-art techniques in operative dentistry: contemporary teaching of posterior composites in UK and Irish dental schools

“…Patients more favourable than those for dental amalgams, in particular, once practitioners become more familiar and comfortable practising minimally invasive dentistry than traditional techniques. 4,18 The transition occurs when practitioners stop using composites as 'white amalgam' and adopt approaches and techniques found to maximise the benefi ts and life expectancies of composites in the restoration of posterior teeth. Drivers for change include moving on from traditional concepts, including Black's principles for cavity preparation, the adoption of modern approaches to the art and science of operative dentistry and, above all else, a change to thinking more about maintaining healthy rather than treating disease, notably in respect of failing restorations and, in particular, secondary caries, which is much less common than indicated by, for example, studies on reasons for the replacement of restorations.…”

“…These extensions may fracture under subsequent repeated occlusal loading and, as a consequence, will result in steps along the cavosurface margin. 4 Also, the presence of occlusal bevels may cause confusion as to the extent of the restoration during its refurbishment, repair or eventual transmitting wedge (given its rigidity and inability to adapt the matrix band to the fl oor of the proximal box) result in an increased number of proximal overhangs, fl at proximal surfaces, and open proximal contacts. 36 Happily since the time of the last surveys, there have been positive developments in techniques for the protection of operatively exposed dentine, with a greater emphasis on the use of 'total-etch' approaches for managing dentine in all but the deepest of cavities.…”

“…1,2 The management of such lesions should be by means of a minimally invasive approach, avoiding unnecessary removal of intact dental tissues. [1][2][3][4] Historically, dental amalgam has been the material of choice for the restoration of posterior teeth affected by caries. While this material suffers from several negative attributes, such as its unaesthetic appearance and lingering, albeit unfounded, concerns regarding its safety, its main disadvantage lies in the fact that it does not adhere to remaining tooth tissue, and the bonding of amalgam offers no tangible benefi ts.…”

Teaching of direct posterior resin composite restorations in UK dental therapy training programmes

“…Modern approaches to the use of composites in preference to dental amalgam underpin the muchneeded adoption of minimally invasive dentistry. 8,21,22 This in turn is anticipated in the medium to long term to reduce the economic burden on patients and healthcare providers, notably the NHS, as the need for more complex and expensive treatments, such as repeated total replacement of restorations of increasing size and complexity, root canal treatments and crowns will be reduced over the lifetime of the patient. Indeed, to help give momentum to the drive in the NHS for enhanced quality, innovation, prevent and productivity, it is suggested that the rate of change to minimally interventive dentistry and, as a consequence, increased use of composites in the restoration of posterior teeth, should be accelerated, thereby limiting the further growth of the so-called 'heavy metal generation' of patients highlighted in the recent review of the dental services provided by the NHS.…”