Next generation of dentists moving to amalgam‐free dentistry: Survey of posterior restorations teaching in North America

Abstract

Objectives:The dental field is gradually reducing the use of amalgam and moving towards adhesive restoration. This change is in accordance with the advancement and improvement of composite resin materials and adhesion systems. Consequently, posterior cavity preparations teaching should be re-examined to determine whether dental schools are adapting their curriculum to fit the current trends in dentistry and what rationale supports their decisions.Methods: An online questionnaire was constructed to assess the time dedicated to teaching composite materials and amalgam, in addition to the principles of posterior preparations, for composite restorations in North American dental schools. Results:A total 33 schools responded to the questionnaire. A large variation was found in teaching methods and techniques of posterior restorations. The reasoning for teaching amalgam restorations was diverse as were the principles of composite resin preparation taught. Conclusion:No agreed principles of cavity preparation for resin composite restorations were found, as opposed to explicit agreement on amalgam cavity preparations.The results demonstrate a lack of clear guidelines for cavity preparation of resin composite restorations. Dental schools may benefit when a consensus on this topic is achieved. K E Y W O R D Scomposite restoration, dental education, dental material 356 | ZABROVSKY et Al.(a) Access to the carious lesion only from the buccal or lingual aspects, whilst preserving the marginal ridge area, 15,16 (b) A "minibox" or "box-only" type of preparation that includes only a box, with removal of the marginal ridge area. The studies did not show an increased failure rate for this approach compared with standard class II in 2-and 5-year follow-up. 16 An additional classification, different from GV Black's traditional principles, was developed. This classification, compatible with the minimally invasive approach, divides cavities into four types (sizes 1-4) and is based on the progression of the carious lesion and the involvement of enamel and dentin. 17The continuing shift in restoration materials requires dental schools to adapt to the changing reality. 6,9 To understand the present trend in the shift from amalgam to composite materials and the reaction of the dental schools, we decided to review the teaching of this topic in North American dental schools. | MATERIAL S AND ME THODSAn online questionnaire was constructed including 11 multiplechoice questions and five open-ended questions-all requiring a numeric answer (Appendix 1). The questionnaire was directed so as to assess the time dedicated to teaching composite materials and amalgam, in addition to the principles of posterior preparations for composite restorations. It was designed by the head of restorative dentistry course in cooperation with other pre-clinical teachers.

Perceptions of dental therapy students regarding the teaching and training with dental amalgam, in a dental school in KwaZulu-Natal, South Africa

“…This concurred with the study conducted in Israel, which found that today some universities teach composite resin before introducing amalgam. 26 This study's results indicated that dental amalgam is now less than 50% of the total practical time. Similar results were seen in the United Kingdom, where the researchers found that preclinical time for resin composite has increased since 1997.…”

“…An Israeli study had similar results, where the researchers found that, in complex restorations, amalgam was still the material of choice. 26 The majority of the third-year students were aware of the Minamata Convention and its implications, including the phase-down of dental amalgam. Most of the secondyear students had not heard of the Minamata Convention, and just 18% (n= 7) were aware of the phase-down of dental amalgam.…”

Fall of amalgam restoration: a 10‐year analysis of an Australian university dental clinic

“…33 Another problem to consider is the lack of clear guidelines in some countries for tooth preparation for resin composite restorations teaching. 34 This study shows for the first time how steady the decline of the use of amalgam restorations is in a dental school in Australia, using the average annual percentages change (AAPC) method. This method allows the use of a single number to describe the average annual percentage changes (AAPCs) over multiple years.…”

The Development of Filler Morphology in Dental Resin Composites: A Review

“…The excellent mechanical and aesthetic properties of DRCs help them meet the demands of daily chewing and aesthetic appearance in terms of tooth color [ 2 , 3 ]. In addition, with corresponding adhesive systems, the composites bond to tooth tissues without the need for extensive preparation of the dental cavity, avoiding the need for excessive removal of healthy dental tissues, which is common in the case of dental amalgam [ 4 , 5 ]. Thus, DRCs have attracted great interest in both scientific research and clinical practice.…”