Seal, replacement or monitoring amalgam restorations with occlusal marginal defects? Results of a 10-year clinical trial

Artículo de publicación ISIThe aim of this prospective and blind clinical trial was to assess the effectiveness of sealing localized marginal defects of amalgam restoration that were initially scheduled to be replaced. A cohort of twenty six patients with 60 amalgam restorations (n = 44Class I and n = 16Class II), that presented marginal defects deviating from ideal (Bravo) according to USPHS criteria, were assigned to either sealing or replacement groups: A: sealing n = 20, Replacement n = 20, and no treatment (n = 20). Two blind examiners evaluated the restorations at baseline (K = 0.74) and after ten years (K = 0.84) according with USPHS criteria, in four parameters: marginal adaptation (MA), secondary caries (SC), marginal staining (MS) and teeth sensitivity (TS). Multiple comparison of restorations degradation/upgrade was analyzed by Friedman test and the comparisons within groups were performed by Wilcoxon test. After 10 years, 44 restorations were assessed (73.3%), Group A: n = 14 and Group B: n = 16; and Group C: n = 14 sealing and replacement amalgam restorations presented similar level of quality in MA (p = 0.76), SC (p = 0.25) and TS (p = 0.52), while in MS (p = 0.007) presented better performance in replacement group after 10-years. Most of the occlusal amalgam restorations with marginal gaps showed similar long term outcomes than the restorations were sealed, replaced, or not treated over a 10-year period. Most of the restorations of the three groups were clinically acceptable, under the studied parameters. All restorations had the tendency to present downgrade/deterioration over time. (C) 2015 Elsevier Ltd. All rights reserved

Does refurbishing composites lead to short-term effects or long-lasting improvement?

Artículo de publicación ISISin acceso a texto completoPurpose: To evaluate the clinical performance of refurbished resin composite restorations compared to untreated (negative control) restorations over a period of 10 years. Methods: 26 subjects (having a total of 52 composite restorations) were recruited. All restorations in the refurbished group showed clinical features rated bravo according to modified USPHS criteria. Untreated restorations were those that had been deemed acceptable (alpha or bravo rated); these were used as controls. Two examiners performed assessments at baseline and during the 5th and 10th years after the intervention. Wilcoxon tests were performed for within-group comparisons, Friedman tests were used for multiple within-group comparisons, and Mann Whitney tests were used for between-groups comparisons. Kaplan-Meier survival curves were calculated, and the Mantel-Cox test was used to compare curves. P < 0.05 was considered statistically significant. Results: In both groups, 10-year scores were significantly different from baseline scores in all clinical parameters except secondary caries. There were no statistically significant differences in the survival analysis of groups (log-rank test, P = 0.376). Refurbishing treatment improved the anatomy, roughness, luster, and marginal adaptation of restorations with a short term effect, with most properties rated acceptable after 10 years of clinical service. The clinical characteristics were similar for all groups at the 10th year