Comparison of resin modified glass ionomer cement and composite resin in class II primary molar restorations: a 2-year parallel randomised clinical trial

AIM To compare the 2-year success rates of a Resin Modified Glass Ionomer Cement (RMGIC) with a composite resin in class II primary molar restorations. METHODS Healthy, cooperative children aged 4-7.5 years with at least one carious primary molar requiring a class II restoration were included in this parallel randomised trial and allocated on a 1:1 basis to composite resin (Z250, 3M ESPE) or RMGIC (Vitremer, 3M ESPE). Restorations were assessed semiannually up to 2 years clinically and radiographically using modified United States Public Health Service criteria, with the primary outcome being all-cause failure. Data were analysed per protocol by binomial linear regression with Relative Risks (RR) and their 95% confidence intervals (CI). RESULTS 55 patients were randomly allocated to either group and 44 analysed at 2 years; with 49 teeth in the Z250 and 55 teeth in the Vitremer group. The all-cause failure rate for both materials was 3% after 1 year (4 and 2% for Z250 and Vitremer, respectively) and 16% after 2 years (16% for both Z250 and Vitremer). Overall, no difference between materials could be found at 2 years (RR = 1.4; 95% CI 0.8, 2.4; P = 0.30). However, Vitremer was associated with more favourable gingival health compared to composite (RR = 0.2; 95% CI 0.1, 0.9; P = 0.03), but also occlusal wear, which was observed exclusively for Vitremer. CONCLUSION No significant difference was found in the overall performance of the two materials, making them suitable for class II primary molar restorations, although RMGIC presented more pronounced occlusal wear of limited clinical importance after 2 years

The Effect of a Needs-Related Caries Preventive Program in Children and Young Adults – Results after 20 Years

The risk for caries development in children varies significantly for different age groups, individuals, teeth, and surfaces. Thus from a cost-effectiveness point of view, caries preventive measures must be integrated and based on predicted risk from age group down to individual tooth surfaces. Based on this philosophy and experiences from continuously ongoing research on evaluating and reevaluating separate and integrated caries preventive measures, as well as methods for prediction of caries risk, a needs-related caries preventive program was introduced for all 0–19-year-olds in the county of Värmland, Sweden, in 1979. The goals for the subjects following the program from birth to the age of 19 years were

Comparison of four different treatment strategies in teeth with molar-incisor hypomineralization-related enamel breakdown–A retrospective cohort study

Background There is little information available on the longevity of non-invasive glass ionomer cement (GIC) and composite restorations as well as conventional composite and ceramic restorations placed on permanent teeth with enamel breakdowns due to molar-incisor hypomineralization (MIH). Aim To compare the longevity of the abovementioned treatment procedures. Design Of 377 identified MIH patients, 118 individuals received restorative treatment and were invited for clinical examination, including caries and MIH status. Finally, survival data from 204 MIH-related restorations placed on 127 teeth were retrospectively collected from 52 children, monitored between 2010 and 2018. Descriptive and explorative analyses were performed, including Kaplan-Meier estimators and the Cox regression model. Results The mean patient observation time was 42.9 months (SD = 35.1). The cumulative survival probabilities after 36 months—7.0% (GIC, N = 28), 29.9% (non-invasive composite restoration, N = 126), 76.2% (conventional composite restoration, N = 27) and 100.0% (ceramic restoration, N = 23)—differed significantly in the regression analysis. Conclusions Conventional restorations were associated with moderate-to-high survival rates in MIH teeth. In contrast, non-invasive composite restorations, which were predominately used in younger or less cooperative children, were linked to lower survival rates

Direct pulp capping versus pulpotomy with MTA for carious primary molars: a randomised clinical trial

Aim: Aim of this randomised clinical trial was to compare the outcome of direct pulp capping (DPC) versus pulpotomy, both with MTA, for carious primary molars. Methods: Healthy, cooperative children aged 3-9 years with at least one deep carious primary molar requiring vital pulp therapy were included. Data on the primary outcome (all-cause failure) and secondary outcomes (clinical or radiographic failure) were collected blindly semi-annually for a minimum of 1 year up to 3 years and analysed with survival analysis and generalised linear regression at alpha = 5%. Results: A total of 74 children were randomly allocated on 1:1 basis to DPC (35 children; 40 teeth) or pulpotomy (39 children; 57 teeth). Survival from all-cause failure was 79.7% [95% confidence interval (CI) 69.3-86.9%] at 12 months and 66.0% (95% CI 53.4-76.0%) at 24 months which remained stable up to 36 months, with no differences between groups (P > 0.05). No significant difference was found in the survival rate of the two groups for all-cause [hazard ratio (HR) = 0.95; 95% CI 0.45-2.01; P = 0.88], clinical (HR = 0.74; 95% CI 0.0.19-2.92; P = 0.66), or radiographic failure (HR = 0.80; 95% CI 0.0.36-1.82; P = 0.60) throughout the 3-year follow-up. Regression analysis indicated that needing a second attempt for haemorrhage control was associated with higher clinical failure rate. All-case failure was significantly different for class II versus occlusal cavities and in the latter cavities pulpotomy performed better (P < 0.001). Conclusion: The results of the current trial indicate that both DPC and pulpotomy can be reliable options for the treatment of deep carious primary molars in cooperative children, in carefully selected cases. Keywords: Direct pulp capping; MTA; Primary molars; Pulpotomy; Randomised clinical trial

Three-year performance of a nano-filled resin-modified glass ionomer cement in class II primary molar restorations

PURPOSE To compare the clinical failure rate of two resin-modified glass ionomer cements (RMGICs) used for Class II primary molar restorations over a 3-year period. METHODS Healthy, cooperative children aged 4-8 years with carious, asymptomatic primary molars requiring class II restorations received either nano-filled (Ketac Nano, 3 M ESPE) or regular (Vitremer, 3 M ESPE) RMGIC restorations. These were blindly assessed semiannually for 3 years using the modified USPHS criteria with all-cause failure as primary outcome and failure for each criterion as secondary outcome. Data was analysed with Fisher's exact tests and survival analysis with robust standard errors at 5%. RESULTS Outcome assessment included 159 teeth at 12 months, 141 teeth at 24 months, and 98 teeth at 36 months. No difference in all-cause failure was found between regular and nano-filled RMGIC at 12 (8.6% versus 14.1%), 24 (9.0% versus 14.9%) or 36 months (7.4% versus 20.5%) (P > 0.05). The nano-filled RMGIC retained better its anatomical form and the regular RMGIC likewise its marginal integrity (P < 0.05), but only in the acceptable range (Alpha-Bravo). Overall, survival analysis found no significant difference for all-cause failure [hazard ratio (HR) 0.58; 95% confidence interval (CI) 0.25-1.31; P = 0.19] or any secondary outcomes other than contact point integrity. Finally, subgroup analysis by jaw indicated that the regular RMGIC performed better than the nano-filled RMGIC for mandibular molars (HR 0.36; 95% CI 0.13-0.96; P = 0.04), but further data are needed. CONCLUSION Nano-filled RMGIC showed less occlusal wear but more mild marginal defects than regular RMGIC, but these findings were of limited clinical significance and both materials performed favourably for 3 years

Reliability and validity of the Greek version of the Children&apos;s Fear Survey Schedule-Dental Subscale

Background. The Children&apos;s Fear Survey Schedule-Dental Subscale (CFSS-DS) is a commonly used questionnaire which measures children&apos;s dental fear. Objective. The aim of this study was to gather data to evaluate the psychometric properties of a Greek version of the CFSS-DS. Methods. A sample of 260 children aged 4-12 completed the Greek version of the CFSS-DS while in the waiting room of a paediatric dentist. The dentist, who was unaware of the children&apos;s scores, rated the children&apos;s behaviour during the dental appointment using the Frankl scale. Children who returned for a second dental appointment during the study period completed the CFSS-DS a second time. Results. The mean CFSS-DS score was 24.80 (standard deviation = 9.17). Age and gender were not related to mean scores. Invasiveness of dental treatment was not related to mean scores. Children who were most uncooperative/fearful on the Frankl had the highest mean scores (Kruskal-Wallis χ2 = 9.48; d.f. = 2; P = 0.009). The internal consistency (Cronbach&apos;s alpha) was 0.85, and the test-retest reliability (intraclass correlation) was 0.74. Conclusions. The Greek version of the CFSS-DS appears to be reliable and valid. Further samples should include school samples, to include children who may not go to the dentist. © 2008 The Authors

Psychometric properties of Greek versions of the Modified Corah Dental Anxiety Scale (MDAS) and the Dental Fear Survey (DFS)

Background. A growing body of literature describes the performance of dental fear questionnaires in various countries. We describe the psychometric properties of Greek versions of the Modified Dental Anxiety Scale (MDAS) and the Dental Fear Survey (DFS) in adult Greek patients. Methods. Greek versions of the MDAS and DFS were administered to two samples of adult dental patients. In the first sample, 195 patients attending one of three private practice dental offices in a large city in Greece completed the questionnaires in the waiting room before dental treatment. After treatment, their dentists (who did not know how the patients had answered the questionnaire) rated their anxiety during dental treatment. In the second sample, 41 patients attending a Greek university dental school clinic completed the questionnaire twice at two separate visits, in order to provide test-retest data. Cronbach&apos;s alpha was used to compute the internal consistencies, while Spearman&apos;s rho was used to compute the test-retest reliabilities. Construct validity was assessed by correlating the responses to the MDAS and DFS by Spearman&apos;s rho. Spearman&apos;s rho was also used to examine the criterion validities, by comparing the questionnaire responses with the dentists&apos; ratings of anxiety. Results. The internal consistencies for the MDAS were 0.90 and 0.92 in the two samples; for the DFS, the internal consistencies were 0.96 in both samples. The test-retest reliabilities were 0.94 for the MDAS and 0.95 for the DFS. The correlation between the two questionnaires was 0.89. The patients&apos; responses to both questionnaires were significantly related to the dentists&apos; ratings of their anxiety during dental treatment (both p values &lt;0.001). Conclusion. The results indicate that the Greek versions of the MDAS and DFS have good internal consistencies and test-retest reliabilities, as well as good construct and criterion validities. The psychometric properties of the Greek versions of these questionnaires appear to be similar to those previously reported in other countries. © 2008 Coolidge et al; licensee BioMed Central Ltd