- Email: [email protected]
Adhesive performance
and the effectiveness of these interventions. Most patients can continue to take their medications throughout dental procedures and recovery periods. Dentists must be aware of the possible drug-drug interactions as well as physical, cognitive, and behavioral manifestations that accompany the patient’s mental health condition.
McCann KJ: Assessment and management of dental patients with mental health issues. Oral Health J June, 2012 Reprints not available
Restorative Dentistry Adhesive performance Background.—The success of direct resin composite restorations depends on adhesion to the underlying tooth using adhesive systems. These systems facilitate a more conservative approach to cavity preparation that does not demand the excessive removal of tooth structure for mechanical retention and resistance form. The mechanism of adhesion requires etching the tooth, application of a primer, and then use of the adhesive resin, comprising the conventional three-step etch-and-rinse approach. Although the efficacy of this approach is well documented, some clinicians believe it is highly sensitive to the technique used. As a result, simplified systems have been developed. The two-step etch-and-rinse systems use a primer and adhesive in one bottle but maintain a separate etching step to remove the smear layer and demineralize the surface layer of enamel and dentin. Self-etch systems penetrate through the smear layer and incorporate it into the hybrid layer. They have either a self-etching primer plus an adhesive resin applied in a later step, or a self-etch adhesive with no separate primer. These systems have been faulted for not producing sufficient bonding performance and durability. Most studies of the clinical effectiveness of bonding systems measure the longevity of restorations in noncarious cervical lesions (NCCLs) as the outcome. Reports on the various bonding strategies were compared for the efficacy of the systems in restorations of NCCLs, with the primary outcome of restoration retention and the secondary outcomes of marginal integrity and discoloration. Methods.—The four bonding strategies investigated were the three-step etch-and-rinse, the two-step etch-andrinse, the two-step self-etch, and the one-step self-etch. The databases used were the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE. Hand searching of selected journals was also done. A total of 26 studies met the criteria for inclusion.
Results.—In general, none of the studies were of sufficient quality to fully address the study’s objectives. The worst clinical performance with respect to marginal integrity was with One-Step, with just 51% of the restorations considered clinically acceptable after 36 months. One Coat Bond had the poorest recorded clinical performance in terms of marginal discoloration. Only 86% of restorations with One Coat Bond were clinically acceptable after 18 months. However, there were no significant differences between the performance of the various adhesives. Discussion.—The evidence in the selected studies was insufficient to make firm recommendations for the use of a specific adhesive system or bonding strategy. Studies with low overall risk of bias noted good clinical performance for adhesives with all the bonding strategies. Future research should study the clinical effectiveness of adhesives.
Clinical Significance.—The studies evaluated showed wide variations in the performance of adhesives in the same categories. Overall, none of the adhesives or bonding systems was shown to be clearly better than the others. Future research should focus on better methods of standardization and reporting of randomized controlled trials studying adhesive performance.
Chee B, Rickman LJ, Satterthwaite JD: Adhesives for the restoration of non-carious cervical lesions: A systematic review. J Dent 40:443-452, 2012 Reprints available from B Chee, Colgate Australian Clinical Dental Research Ctr, 2nd Flr, Adelaide Dental Hosp, Frome Rd, Adelaide, SA 5001, Australia; e-mail: [email protected]
Volume 58
Issue 6
2013
319
McCann KJ: Assessment and management of dental patients with mental health issues. Oral Health J June, 2012 Reprints not available
Restorative Dentistry Adhesive performance Background.—The success of direct resin composite restorations depends on adhesion to the underlying tooth using adhesive systems. These systems facilitate a more conservative approach to cavity preparation that does not demand the excessive removal of tooth structure for mechanical retention and resistance form. The mechanism of adhesion requires etching the tooth, application of a primer, and then use of the adhesive resin, comprising the conventional three-step etch-and-rinse approach. Although the efficacy of this approach is well documented, some clinicians believe it is highly sensitive to the technique used. As a result, simplified systems have been developed. The two-step etch-and-rinse systems use a primer and adhesive in one bottle but maintain a separate etching step to remove the smear layer and demineralize the surface layer of enamel and dentin. Self-etch systems penetrate through the smear layer and incorporate it into the hybrid layer. They have either a self-etching primer plus an adhesive resin applied in a later step, or a self-etch adhesive with no separate primer. These systems have been faulted for not producing sufficient bonding performance and durability. Most studies of the clinical effectiveness of bonding systems measure the longevity of restorations in noncarious cervical lesions (NCCLs) as the outcome. Reports on the various bonding strategies were compared for the efficacy of the systems in restorations of NCCLs, with the primary outcome of restoration retention and the secondary outcomes of marginal integrity and discoloration. Methods.—The four bonding strategies investigated were the three-step etch-and-rinse, the two-step etch-andrinse, the two-step self-etch, and the one-step self-etch. The databases used were the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE. Hand searching of selected journals was also done. A total of 26 studies met the criteria for inclusion.
Results.—In general, none of the studies were of sufficient quality to fully address the study’s objectives. The worst clinical performance with respect to marginal integrity was with One-Step, with just 51% of the restorations considered clinically acceptable after 36 months. One Coat Bond had the poorest recorded clinical performance in terms of marginal discoloration. Only 86% of restorations with One Coat Bond were clinically acceptable after 18 months. However, there were no significant differences between the performance of the various adhesives. Discussion.—The evidence in the selected studies was insufficient to make firm recommendations for the use of a specific adhesive system or bonding strategy. Studies with low overall risk of bias noted good clinical performance for adhesives with all the bonding strategies. Future research should study the clinical effectiveness of adhesives.
Clinical Significance.—The studies evaluated showed wide variations in the performance of adhesives in the same categories. Overall, none of the adhesives or bonding systems was shown to be clearly better than the others. Future research should focus on better methods of standardization and reporting of randomized controlled trials studying adhesive performance.
Chee B, Rickman LJ, Satterthwaite JD: Adhesives for the restoration of non-carious cervical lesions: A systematic review. J Dent 40:443-452, 2012 Reprints available from B Chee, Colgate Australian Clinical Dental Research Ctr, 2nd Flr, Adelaide Dental Hosp, Frome Rd, Adelaide, SA 5001, Australia; e-mail: [email protected]
Volume 58
Issue 6
2013
319