Abstract:A survey was conducted of 100 dental schools worldwide to investigate the current teaching of posterior resin composite restorations. A 20 multi-part question questionnaire was emailed to the selected schools. Schools were selected by ability to understand and respond in English. The questionnaire consisted of four open-ended questions and 16 closed questions on topics such as material selection for restoring posterior teeth, preclinical teaching of resin composite for posterior teeth, restoration size, contra… Show more
“…Resin-based composite restorative materials are a cornerstone in modern-day dental practice because of their excellent esthetics and chemo-mechanical properties [1,2,3]. Dentine hybridization through polymeric agents represents a considerable innovation in dentistry, which has become clinically feasible [4].…”
Objective: To evaluate the effect of a new application method of bulk-fill flowable composite resin material on bond-strength, nanoleakage, and mechanical properties of dentine bonding agents. Materials and methods: Sound extracted human molars were randomly divided into: manufacturerâs instructions (MI), manual blend 2 mm (MB2), and manual blend 4 mm (MB4). Occlusal enamel was removed and flattened, dentin surfaces were bonded by Prime & Bond universal (Dentsply and Optibond FL, Kerr). For the MI group, adhesives were applied following the manufacturerâs instructions then light-cured. For MB groups, SDR flow+ bulk-fill flowable composite resin was applied in 2- or 4-mm increment then manually rubbed by a micro brush for 15 s with uncured dentine bonding agents and the mixture was light-cured. Composite buildup was fabricated incrementally using Ceram.X One, Dentsply nanohybrid composite resin restorative material. After 24-h water storage, the teeth were sectioned to obtain beams of about 0.8 mm2 for 24-h and thermocycled micro-tensile bond strength at 0.5 mm/min crosshead speed. Degree of conversion was evaluated with micro-Raman spectroscopy. Contraction gaps at 24 h after polymerization were evaluated and atomic force microscopy (AFM) nano-indentation processes were undertaken for measuring the hardness across the interface. Depth of resin penetration was studied using a scanning electron microscope (SEM). Bond strength data was expressed using two-way ANOVA followed by Tukeyâs test. Nanoindentation hardness was separately analyzed using one-way ANOVA. Results: Factors âstorage F = 6.3â and âapplication F = 30.11â significantly affected the bond strength to dentine. For Optibond FL, no significant difference in nanoleakage was found in MI/MB4 groups between baseline and aged specimens; significant difference in nanoleakage score was observed in MB2 groups. Confocal microscopy analysis showed MB2 Optibond FL and Prime & Bond universal specimens diffusing within the dentine. Contraction gap was significantly reduced in MB2 specimens in both adhesive systems. Degree of conversion (DC) of the MB2 specimens were numerically more compared to MS1 in both adhesive systems. Conclusion: Present study suggests that the new co-blend technique might have a positive effect on bond strengths of etch-and-rinse adhesives to dentine.
“…Resin-based composite restorative materials are a cornerstone in modern-day dental practice because of their excellent esthetics and chemo-mechanical properties [1,2,3]. Dentine hybridization through polymeric agents represents a considerable innovation in dentistry, which has become clinically feasible [4].…”
Objective: To evaluate the effect of a new application method of bulk-fill flowable composite resin material on bond-strength, nanoleakage, and mechanical properties of dentine bonding agents. Materials and methods: Sound extracted human molars were randomly divided into: manufacturerâs instructions (MI), manual blend 2 mm (MB2), and manual blend 4 mm (MB4). Occlusal enamel was removed and flattened, dentin surfaces were bonded by Prime & Bond universal (Dentsply and Optibond FL, Kerr). For the MI group, adhesives were applied following the manufacturerâs instructions then light-cured. For MB groups, SDR flow+ bulk-fill flowable composite resin was applied in 2- or 4-mm increment then manually rubbed by a micro brush for 15 s with uncured dentine bonding agents and the mixture was light-cured. Composite buildup was fabricated incrementally using Ceram.X One, Dentsply nanohybrid composite resin restorative material. After 24-h water storage, the teeth were sectioned to obtain beams of about 0.8 mm2 for 24-h and thermocycled micro-tensile bond strength at 0.5 mm/min crosshead speed. Degree of conversion was evaluated with micro-Raman spectroscopy. Contraction gaps at 24 h after polymerization were evaluated and atomic force microscopy (AFM) nano-indentation processes were undertaken for measuring the hardness across the interface. Depth of resin penetration was studied using a scanning electron microscope (SEM). Bond strength data was expressed using two-way ANOVA followed by Tukeyâs test. Nanoindentation hardness was separately analyzed using one-way ANOVA. Results: Factors âstorage F = 6.3â and âapplication F = 30.11â significantly affected the bond strength to dentine. For Optibond FL, no significant difference in nanoleakage was found in MI/MB4 groups between baseline and aged specimens; significant difference in nanoleakage score was observed in MB2 groups. Confocal microscopy analysis showed MB2 Optibond FL and Prime & Bond universal specimens diffusing within the dentine. Contraction gap was significantly reduced in MB2 specimens in both adhesive systems. Degree of conversion (DC) of the MB2 specimens were numerically more compared to MS1 in both adhesive systems. Conclusion: Present study suggests that the new co-blend technique might have a positive effect on bond strengths of etch-and-rinse adhesives to dentine.
“…(22/1-23) It is established that the teaching of alternatives to amalgam restorations, especially treatment of posterior teeth with use of resin composite, has increased worldwide 12,28,30,[37][38][39] and that institutional approaches to the teaching of tooth-coloured materials varies significantly. 30,40,41 Ben-Gal and Weiss 37 suggested 'convenience and long experience' are primary factors in the decision-making process and clinical teachers' use of resin composite was influenced mainly by the 'prevailing trend' and not evidence-based -a conclusion being these teachers were not aware of current appropriate alternatives to amalgam.…”
“…Comparisons to dental amalgam contained in these studies have been minimal but consistent in their findings that the inclusion of dental amalgam as part of curricula has steadily decreased . It is established that dental schoolsâ teaching of dental amalgam varies, with some planning its removal from, and others not containing it in, the curriculum.…”
Objective
To ascertain dental educatorsâ attitudes towards the teaching of dental amalgam at dental schools in Australia and identify preferred curricular approaches in a potentially âamalgamlessâ profession.
Methods
A mixed methods analysis was employed based on an openâended response survey followed by a closedâended questionnaire. Identification of key issues from the survey helped frame the questionnaire. Participants included those with expertise in operative and restorative dentistry, with direct involvement in curriculum development or delivery, at Australian dental schools.
Results
Participants numbered fifteen and represented seven of the nine dental schools in Australia. Key themes identified and explored included the following: (in)consistency of approach to teaching restorative dentistry; a perceived disconnect between undergraduate study and the âreal worldâ; a need for a focus on teaching of alternatives to dental amalgam (80 per cent (strongly) agreeing); the contradictory nature of the evidence base and literature that is not readily understood; the need for more postâgraduate education relating to adhesive restorative materials (86 per cent (strongly) agreeing); the need for dental amalgam to continue to be available; formal understandings (guidelines) as to the use of dental amalgam; dental schools in Australia being heard on these issues; and the relevance of this issue (100 per cent (strongly) agreeing the issue is topical and important).
Conclusion
There is a broad consensus of dental educators at Australian dental schools as how best to approach the teaching of amalgam if a phaseâdown is to occur and the issues any such approach may face.
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