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The International Journal of Esthetic... Jul 2023Important changes have occurred over the last decades in the clinical application of the strategies for posterior restorations - from amalgam to composites in direct... (Review)
Review
Clinical guidelines for posterior restorations based on Coverage, Adhesion, Resistance, Esthetics, and Subgingival management. The CARES concept: Part I – partial adhesive restorations.
Important changes have occurred over the last decades in the clinical application of the strategies for posterior restorations - from amalgam to composites in direct restorations and from traditional resistance form crowns to adhesive partial restorations such as onlays. Despite much evidence available for these advances, there are still very few established guidelines for common clinical questions: When does an indirect restoration present a clinical advantage over a direct one? When should one perform adhesive cusp coverage such as an onlay? When to implement resistance form designs in adhesive restorations? Which conditions create limitations for adhesion so that a resistance form preparation with a stiffer material such as a traditional crown might be more appropriate? In order to provide clinical guidelines, the present authors consider five parameters to support and clarify decisions - Coverage of cusps, Adhesion advantages and limitations, Resistance forms to be implemented, Esthetic concerns, and Subgingival management - the CARES concept. In Part I of this three-part review article, the focus is on clinical decisions for partial adhesive restorations regarding indications for direct versus indirect materials as well as the need for cusp coverage and/or resistance form preparations based on remaining tooth structure and esthetics.
Topics: Humans; Dental Restoration, Permanent; Esthetics, Dental; Tooth; Crowns; Inlays; Composite Resins
PubMed: 37462378
DOI: No ID Found -
British Dental Journal Nov 2023
Topics: Dental Amalgam; Dental Restoration, Permanent
PubMed: 38001180
DOI: 10.1038/s41415-023-6572-4 -
Frontiers in Oral Health 2023This paper set out to investigate the relationship between teaching and clinical practice of direct posterior restoration placement at tertiary dental institutions in...
INTRODUCTION
This paper set out to investigate the relationship between teaching and clinical practice of direct posterior restoration placement at tertiary dental institutions in South Africa.
METHODS
A cross-sectional study using a mixed methods approach was conducted, and all the South African dental schools were invited to participate. The quantitative phase of the study analyzed the Conservative Dentistry department's records of direct restorations at a single dental school. The number of amalgam and tooth-colored restorations placed by students in the fourth and fifth year of the program from 2004 to 2019 were compared. During the qualitative phase, semi-structured interviews were held with staff from the four dental schools involved with the teaching of direct posterior restorations.
RESULTS
The predominant direct posterior restoration placed in student clinics over a 15-year period at a South African dental school was tooth colored (75%). Teaching times do not correspond to a decrease in the placement of dental amalgam restorations for both one-surface and two-surface posterior restorations and a concomitant increase in the tooth-colored restorations.
DISCUSSION
Academic staff involved in teaching identified that South Africa's ratification of the Minamata Convention has consequences for dental education and training. However, all schools reported that dental amalgam would continue to be taught in the absence of an appropriate alternative.
PubMed: 37539092
DOI: 10.3389/froh.2023.1118361 -
Journal of Neuroimaging : Official... 2023When head and neck infection is suspected, appropriate imaging contributes to treatment decisions and prognosis. While contrast-enhanced CT is the standard imaging... (Review)
Review
When head and neck infection is suspected, appropriate imaging contributes to treatment decisions and prognosis. While contrast-enhanced CT is the standard imaging modality for evaluating head and neck infections, MRI can better characterize the skull base, intracranial involvement, and osteomyelitis, implying that these are complementary techniques for a comprehensive assessment. Both CT and MRI are useful in the evaluation of abscesses and thrombophlebitis, while MRI is especially useful in the evaluation of intracranial inflammatory spread/abscess formation, differentiation of abscess from other conditions, evaluation of the presence and activity of inflammation and osteomyelitis, evaluation of mastoid extension in middle ear cholesteatoma, and evaluation of facial neuritis and labyrinthitis. Apparent diffusion coefficient derived from diffusion-weighted imaging is useful for differential diagnosis and treatment response of head and neck infections in various anatomical sites. Dynamic contrast-enhanced MRI perfusion may be useful in assessing the activity of skull base osteomyelitis. MR bone imaging may be of additional value in evaluating bony structures of the skull base and jaw. Dual-energy CT is helpful in reducing metal artifacts, evaluating deep neck abscess, and detecting salivary stones. Subtraction CT techniques are used to detect progressive bone-destructive changes and to reduce dental amalgam artifacts. This article provides a region-based approach to the imaging evaluation of head and neck infections, using both conventional and advanced imaging techniques.
Topics: Humans; Head and Neck Neoplasms; Abscess; Magnetic Resonance Imaging; Diffusion Magnetic Resonance Imaging; Head; Osteomyelitis
PubMed: 36922159
DOI: 10.1111/jon.13099 -
Maxillofacial Plastic and... Oct 2023A range of different chemical interactions can generate an unexpected electronic current in a process called galvanism. Oral galvanism (OG) can also be generated by... (Review)
Review
BACKGROUND
A range of different chemical interactions can generate an unexpected electronic current in a process called galvanism. Oral galvanism (OG) can also be generated by different chemical actions from diverse intraoral rehabilitated metals, including gold, copper, mercury, titanium, and titanium alloy. The main aim of this manuscript is to review OG, particularly focusing on titanium implants and related metallic materials. We searched the MEDLINE (PubMed), Embase, Scopus, and Google Scholar databases for relevant literature published through December 2019. The keywords included "galvanic current", "galvanism", "galvanic corrosion", "oral galvanism", combined with "oral", "oral cavity", "implant", and "saliva."
RESULTS
Out of 343 articles, 126 articles that met the inclusion criteria were reviewed. We examined and summarized research on OG through a division into four categories: definition and symptoms, diagnosis with testing methods, galvanic corrosion, and oral precancerous lesions with OG.
CONCLUSIONS
Patients with OG have high oral energy and current, and although this phenomenon may be due to the patient's mental illness, OG due to amalgam or mercury occurs. It is evident that the difference in electron potential caused by different elemental components such as titanium alloy and pure titanium, which are essential for manufacturing the implant fixture and the abutment, and chrome and nickel, which are essential for manufacturing the upper crown, causes OG. Since the oral cavity is equipped with an environment in which electric current can be transmitted easily due to saliva, it is imperative that clinicians review the systemic and local effects of salivation.
PubMed: 37801180
DOI: 10.1186/s40902-023-00403-8 -
Journal of Yeungnam Medical Science Oct 2023The association between dental amalgam fillings and urine mercury concentrations was investigated in this study to assess the health risks associated with dental...
BACKGROUND
The association between dental amalgam fillings and urine mercury concentrations was investigated in this study to assess the health risks associated with dental amalgams.
METHODS
This cross-sectional study included 99 women in their 20s who visited the dental clinic in Daegu, Korea. The 99 participants were composed of 68 subjects who had dental amalgam fillings (exposure group) and 31 subjects who did not have dental amalgam fillings (nonexposure group). Oral examinations were conducted by a single dental hygienist, sociodemographic features were investigated as confounding variables, and urine mercury concentrations were measured using an automatic mercury analyzer.
RESULTS
The mean±standard deviation of the urine mercury concentrations of the exposure and nonexposure groups were 1.50±1.78 μg/g creatinine and 0.53±0.63 μg/g creatinine, respectively. The exposure group showed significantly higher levels than the nonexposure group (p<0.01). The urine mercury concentration significantly increased with an increase in the number of teeth filled with amalgam, cavity surfaces involved, and number of defective amalgam fillings, and according to the latest exposure time (p<0.001). In the multiple regression analysis of amalgam-related factors and urine mercury concentrations after correction for confounding factors, the urine mercury concentration in the group with six or more amalgam-filled teeth, 11 or more cavity surfaces, and two or more defective amalgams was significantly higher than that in the nonexposure group (p<0.001).
CONCLUSION
According to this study, exposure to dental amalgams was confirmed to significantly affect urine mercury concentrations.
PubMed: 36941777
DOI: 10.12701/jyms.2022.00955 -
The British Journal of Dermatology May 2024Concerns regarding contact allergies and intolerance reactions to dental materials are widespread among patients. Development of novel dental materials and less frequent...
BACKGROUND
Concerns regarding contact allergies and intolerance reactions to dental materials are widespread among patients. Development of novel dental materials and less frequent amalgam use may alter sensitization profiles in patients with possible contact allergy.
OBJECTIVES
To analyse current sensitization patterns to dental materials in patients with suspected contact allergy.
METHODS
This retrospective, multicentre analysis from the Information Network of Departments of Dermatology (IVDK) selected participants from 169 834 people tested in 2005-2019 and registered with (i) an affected area of 'mouth' (and 'lips'/'perioral'), (ii) with the dental material in question belonging to one of three groups (dental filling materials, oral implants or dentures or equivalents) and (iii) with patch-testing done in parallel with the German baseline series, (dental) metal series and dental technician series.
RESULTS
A total of 2730 of 169 834 tested patients met the inclusion criteria. The patients were predominantly women (81.2%) aged ≥ 40 years (92.8%). The sensitization rates with confirmed allergic contact stomatitis in women (n = 444) were highest for metals (nickel 28.6%, palladium 21.4%, amalgam 10.9%), (meth)acrylates [2-hydroxyethyl methacrylate (HEMA) 4.8%] and the substances propolis (6.8%) and 'balsam of Peru' (11.4%). The most relevant acrylates were HEMA, 2-hydroxypropyl methacrylate, methyl methacrylate, ethylene glycol dimethacrylate and pentaerythritol triacrylate. Few men were diagnosed with allergic contact stomatitis (n = 68); sensitization rates in men were highest for propolis (14.9%) and amalgam (13.6%).
CONCLUSIONS
Allergic contact stomatitis to dental materials is rare. Patch testing should not only focus on metals such as nickel, palladium, amalgam and gold, but also (meth)acrylates and the natural substances propolis and 'balsam of Peru'.
Topics: Humans; Female; Male; Retrospective Studies; Dermatitis, Allergic Contact; Adult; Middle Aged; Dental Materials; Patch Tests; Dental Amalgam; Aged; Adolescent; Young Adult; Child; Methacrylates; Balsams; Dental Implants; Stomatitis; Propolis; Dentures; Germany; Allergens; Child, Preschool
PubMed: 38123140
DOI: 10.1093/bjd/ljad525 -
Acta Odontologica Scandinavica May 2024Health complaints attributed to dental amalgam fillings comprise both intraoral and general health complaints. There are data suggesting that patients with medically...
OBJECTIVE
Health complaints attributed to dental amalgam fillings comprise both intraoral and general health complaints. There are data suggesting that patients with medically unexplained physical symptoms (MUPS) attributed to amalgam fillings show improvement in symptoms after removal of all amalgam fillings. However, data indicating changes of specific health complaints are limited. This study evaluated the changes of health complaints after removal of amalgam restorations in patients with health complaints attributed to dental amalgam fillings.
METHOD
Patients with MUPS attributed to dental amalgam (Amalgam cohort) had all their amalgam fillings removed. The participants indicated an intensity of 11 local and 12 general health complaints on numeric rating scales before the treatment and at follow-up after 1 and 5 years. The comparison groups comprising a group of healthy individuals and a group of patients with MUPS without symptom attribution to dental amalgam did not have their amalgam restorations removed.
RESULTS
In the Amalgam cohort, mean symptom intensity was lower for all 23 health complaints at follow-up at 1 year compared to baseline. Statistically significant changes were observed for specific health complaints with effect sizes between 0.36 and 0.68. At the 5-year follow-up, the intensity of symptoms remained consistently lower compared to before the amalgam removal. In the comparison groups, no significant changes of intensity of symptoms of health complaints were observed.
CONCLUSION
After removal of all amalgam restorations, both local and general health complaints were reduced. Since blinding of the treatment was not possible, specific and non-specific treatment effects cannot be separated.
Topics: Humans; Dental Amalgam; Norway; Female; Male; Prospective Studies; Middle Aged; Adult; Dental Restoration, Permanent; Cohort Studies
PubMed: 38699922
DOI: 10.2340/aos.v83.40260 -
Journal of Breath Research May 2024Despite the widespread use of dental restorative materials, little information exists in the literature regarding their potential impact on bad breath. This in vitro...
Despite the widespread use of dental restorative materials, little information exists in the literature regarding their potential impact on bad breath. This in vitro study aims to fill this gap by investigating the influence of different restorative materials on the release of hydrogen sulfide (HS). Thirteen diverse dental restorative materials, including composites, flowable composites, glass ionomer restorative materials, high-copper amalgam, and CAD-CAM blocks, were examined. Cellulose Sponge models were used as negative and positive control. All samples were prepared with a diameter of 5 mm and a height of 2 mm. Except for the negative control group, all samples were embedded into Allium cepa L., and the emitted HS was measured using the Wintact W8802 hydrogen sulfide monitor. Surface roughness's effect on emission was explored by roughening the surfaces of CAD-CAM material samples, and gas emission was measured again. The data were statistically analyzed using the Kruskal-Wallis test and DSCF pairwise comparison tests. Fiber-reinforced flowable composite (EverX Flow), amalgam (Nova 70-caps), and certain composite materials (IPS Empress Direct, Tetric Evoceram, Admira Fusion X-tra) released higher HS concentrations compared to the negative control. The HS release period lasted longer in the same materials mentioned above, along with G-aenial Universal Injectable. Indirectly used materials, such as GC Cerasmart, Vita Enamic, and Vita YZ HT, demonstrated significantly lower emissions compared to other direct restoratives. Importantly, the surface roughness of indirect materials did not significantly affect peak HS concentrations or release times. The study reveals variations in HS release among restorative materials, suggesting potential advantages of indirect restorative materials in reducing HS-induced halitosis. This comprehensive understanding of the relationship between restorative materials and halitosis can empower both dental professionals and patients to make well-informed treatment choices. Notably, there is evidence supporting the enhanced performance of indirect restorative materials for individuals affected by halitosis.
Topics: Humans; Halitosis; Hydrogen Sulfide; Dental Materials; In Vitro Techniques; Dental Restoration, Permanent; Composite Resins; Materials Testing; Dental Amalgam; Surface Properties
PubMed: 38744271
DOI: 10.1088/1752-7163/ad4b57 -
International Dental Journal Dec 2023Dental restorative procedures remain a cornerstone of dental practice, and for many decades, dental amalgam was the most frequently employed material. However, its use... (Review)
Review
Dental restorative procedures remain a cornerstone of dental practice, and for many decades, dental amalgam was the most frequently employed material. However, its use is declining, mainly driven by its poor aesthetics and by the development of tooth-coloured adhesive materials. Furthermore, the Minamata Convention agreed on a phase-down on the use of dental amalgam. This concise review is based on a FDI Policy Statement which provides guidance on the selection of direct restorative materials as alternatives to amalgam. The Policy Statement was informed by current literature, identified mainly from PubMed and the internet. Ultimately, dental, oral, and patient factors should be considered when choosing the best material for each individual case. Dental factors include the dentition, tooth type, and cavity class and extension; oral aspects comprise caries risk profiles and related risk factors; and patient-related aspects include systemic risks/medical conditions such as allergies towards certain materials as well as compliance. Special protective measures (eg, a no-touch technique, blue light protection) are required when handling resin-based materials, and copious water spray is recommended when adjusting or removing restorative materials. Cost and reimbursement policies may need to be considered when amalgam alternatives are used, and the material recommendation requires the informed consent of the patient. There is no single material which can replace amalgam in all applications; different materials are needed for different situations. The policy statement recommends using a patient-centred rather than purely a material-centred approach. Further research is needed to improve overall material properties, the clinical performance, the impact on the environment, and cost-effectiveness of all alternative materials.
PubMed: 38071154
DOI: 10.1016/j.identj.2023.11.004