Document Detail


Alternative treatments to replacement of defective amalgam restorations: results of a seven-year clinical study.
MedLine Citation:
PMID:  21719808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The authors conducted a prospective cohort clinical study to investigate the effectiveness of alternative treatments to the replacement of defective amalgam restorations.
METHODS: Fifty patients aged 21 through 77 years (mean age, 56 years) with 113 defective amalgam restorations that were diagnosed during treatment planning participated in the study. The authors assigned each tooth to one of five treatment groups: repair with amalgam (n = 20), sealing of defective margins (n = 23), refinishing (n = 23), replacement (n = 22) or no treatment (n = 25). The replacement and no-treatment groups served as comparison groups, and the authors assigned 47 teeth randomly to these groups. Two clinicians examined the restorations before and after the assigned treatment and at subsequent recall visits by using modified U.S. Public Health Service criteria including marginal adaptation, anatomic form, occlusal and proximal contact, postoperative sensitivity and secondary caries.
RESULTS: The clinicians examined 94 restorations (83 percent) at the one-year recall visit, 74 (65 percent) at the two-year recall visit and 54 (48 percent) at the seven-year recall visit. They observed most of the downgraded and failed restorations after the first two years of clinical service.
CONCLUSIONS: The study results show that some degree of degradation occurred in all treatment groups, including the replacement group, at the seven-year recall examination, with no significant failure rate. The results support the repair of defective amalgam restorations as an alternative to replacement. Furthermore, the study findings show that in future controlled clinical trials, all teeth may receive random assignment.
CLINICAL IMPLICATIONS: The study findings support repair rather than replacement of amalgam restorations with localized defects. Randomized controlled trials are needed to confirm these findings.
Authors:
Valeria V Gordan; Joseph L Riley; Paul K Blaser; Eduardo Mondragon; Cynthia W Garvan; Ivar A Mjör
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Dental Association (1939)     Volume:  142     ISSN:  1943-4723     ISO Abbreviation:  J Am Dent Assoc     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-01     Completed Date:  2011-12-07     Revised Date:  2012-04-27    
Medline Journal Info:
Nlm Unique ID:  7503060     Medline TA:  J Am Dent Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  842-9     Citation Subset:  D; IM    
Affiliation:
Dental Practice-Based Research, Department of Restorative Dentistry, Division of Operative Dentistry, College of Dentistry, University of Florida, Health Science Center, Gainesville, FL 32610-0415. vgordan@dental.ufl.edu
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MeSH Terms
Descriptor/Qualifier:
Acid Etching, Dental / methods
Adult
Aged
Bisphenol A-Glycidyl Methacrylate / chemistry
Cohort Studies
Dental Amalgam*
Dental Caries / classification
Dental Marginal Adaptation
Dental Polishing / methods
Dental Prosthesis Repair / methods
Dental Restoration Failure*
Dental Restoration, Permanent*
Dentin Sensitivity / classification
Follow-Up Studies
Humans
Light-Curing of Dental Adhesives / methods
Middle Aged
Patient Care Planning
Prospective Studies
Resin Cements / chemistry
Retreatment
Surface Properties
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Resin Cements; 1565-94-2/Bisphenol A-Glycidyl Methacrylate; 8049-85-2/Dental Amalgam
Comments/Corrections
Comment In:
J Am Dent Assoc. 2011 Dec;142(12):1336; author reply 1336-7   [PMID:  22130429 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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