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  • 1.
    Addi, Simon
    et al.
    Umeå University, Faculty of Medicine, Odontology, Dental Materials Science.
    Hedayati-Khams, Arjang
    Umeå University, Faculty of Medicine, Odontology, Dental Materials Science.
    Poya, Amin
    Umeå University, Faculty of Medicine, Odontology, Dental Materials Science.
    Sjögren, Göran
    Umeå University, Faculty of Medicine, Odontology, Dental Materials Science.
    Interface gap size of manually and CAD/CAM-manufactured ceramic inlays/onlays in vitro.2002In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 30, no 1, p. 53-58Article in journal (Refereed)
    Abstract [en]

    Objectives : To determine the fit of ceramic inlays manufactured using a recently introduced CAD/CAM-system (Decim) and of two types of laboratory-made heat-pressed ceramics (IPS Empress and Opc).

    Materials and methods : Extracted human premolars were prepared to receive mesio-occlusodistal (MOD) ceramic inlays, for which 10 Denzir, 10 IPS Empress, and 10 Opc were fabricated. The Denzir restorations were produced by the manufacturer of the CAD/CAM-system, and the IPS Empress and Opc by student dental technicians. Before luting the internal fit on the diestone models and on the premolars was determined using replicas. After luting on the premolars with a resin composite the marginal and internal fit were measured. The values were analyzed statistically using ANOVA and Scheffe's test at a significance level of p<0.05.

    Results : Before luting there were no significant differences ( p>0.05) in the internal gap width between the three systems studied when placed on their matching diestone models. When placed on the premolars a significant difference ( p<0.01) in the internal fit was seen between Empress and Opc before luting, whereas there were no significant differences ( p>0.05) between Empress and Denzir and between Opc and Denzir. Between the diestone models and the premolars there were significant differences ( p<0.01) in the internal fit, except for IPS Empress. After luting there were no significant differences ( p>0.05) between IPS Empress and Denzir, whereas the marginal gap width was significantly wider ( p<0.001) for Opc than for IPS Empress and Denzir. The internal fit was significantly ( p<0.001) wider for Opc than for IPS Empress, whereas there were no significant differences ( p>0.05) between IPS Empress and Denzir or between Opc and Denzir.

    Conclusion : After luting there were only slight differences in the fit between the restorations fabricated using the three different manufacturing techniques and ceramics. Therefore, long-term follow-up studies are needed to assess the clinical significance of the slight differences between the three systems.

  • 2.
    André, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Kou, Wen
    Umeå University, Faculty of Medicine, Department of Odontology.
    Sjögren, Göran
    Umeå University, Faculty of Medicine, Department of Odontology.
    Sundh, Anders
    Research and Development, Cad.esthetics AB, Skellefteå, Sweden.
    Effects of pretreatments and hydrothermal aging on biaxial flexural strength of lithium di-silicate and Mg-PSZ ceramics2016In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 55, p. 25-32Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate the effect of specimen thickness, pretreatment and hydrothermal aging on the biaxial flexural strength (BFS) of lithium di-silicate glass (e.max Cad) and magnesia-stabilized zirconia (ZirMagnum) ceramic discs. Methods: The e.max Cad discs was studied: i) crystallized, ii) crystallized and glazed and iii) crystallized, glazed and unglazed side etched with hydrofluoric acid. The ZirMagnum discs were studied: i) as delivered, ii) after sandblasting and iii) after heat treatment similar to veneering. Hydrothermal aging was simulated by autoclave treatment. Results: The BFS of all the ZirMagnum specimens was superior (p < 0.001) to all the e.max Cad specimens. Glazing the 0.4 mm e.max Cad discs reduced (p < 0.05) their BFS compared with the unglazed 0.8 mm specimens, whereas glazing of 0.8 mm discs had no influence (p > 0.05) on the strength. Etching and autoclaving of e.max Cad did not affect (p > 0.05) the BFS. For ZirMagnum sandblasting with 0.2 MPa or 0.6 MPa did not influence the biaxial flexural strength (p > 0.05), whereas heat treatment reduced (p < 0.01) the BFS of 0.6 MPa sandblasted ZirMagnum. Autoclaving reduced the strength (p < 0.05) compared with ZirMagnum as delivered, whereas autoclaving of the 0.6 MPa sandblasted and heat treated specimens did not influence (p > 0.05) the BFS. Glazing, etching and sandblasting increased (p < 0.05) surface roughness. Conclusions: The effects of glazing, heat treatment, aging and mechanical treatment of the materials evaluated should be considered since their strength could be affected. Clinical significance: Mechanical properties of restorations made from prefabricated ceramic blocks could be affected of various treatments and could change over time.

  • 3. Astvaldsdottir, Alfheidur
    et al.
    Dagerhamn, Jessica
    van Dijken, Jan W. V.
    Umeå University, Faculty of Medicine, Department of Odontology, Dental Hygiene.
    Naimi-Akbar, Aron
    Sandborgh-Englund, Gunilla
    Tranaeus, Sofia
    Nilsson, Mikael
    Longevity of posterior resin composite restorations in adults: A systematic review2015In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 43, no 8, p. 934-954Article, review/survey (Refereed)
    Abstract [en]

    Objective: To conduct a systematic review of the literature on the longevity of posterior resin composite restorations in adults. Material and methods: A systematic literature search was conducted according to predetermined criteria for inclusion and exclusion. The studies selected were prospective clinical trials with a minimum follow-up time of 4 years, 40 restorations per experimental group and an annual attrition rate of less than 5%. Initially, abstracts and full-text articles were assessed independently and the assessment was subsequently agreed on by five reviewers. The methodological quality of the studies was assessed according to the Swedish Council on Health Technology Assessment (SBU) standard checklist for determining the extent to which studies meet basic quality criteria. Results: In all, the literature search identified 4275 abstracts and 93 articles were read in fulltext. There were eighteen studies which met the criteria for inclusion, eight of which were included in the analysis. There were 80 failures of restorations with a total follow-up time at risk for failure of 62,030 months. The overall incidence rate for all causes of failure was 1.55 lost restorations per 100 restoration years. The most common biological reason for failure (a total of 31 restorations) was secondary caries, with or without fracture of the restoration. The quality of the evidence was low. Conclusions: In an efficacy setting, the overall survival proportion of posterior resin composite restorations is high. The major reasons for failure are secondary caries and restoration fracture which supports the importance of adequate follow-up time. Clinical significance: The overall survival proportion of posterior composite restorations was high, but the results cannot be extrapolated to an effectiveness setting. The importance of adequate follow-up time is supported by the finding that secondary caries often occurred after 3 years or later.

  • 4.
    Johansson, Elisabeth
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Dental Hygiene.
    Claesson, Rolf
    Umeå University, Faculty of Medicine, Department of Odontology, Oral Microbiology.
    van Dijken, J W V
    Umeå University, Faculty of Medicine, Department of Odontology, Dental Hygiene.
    Antibacterial effect of ozone on cariogenic bacterial species.2009In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 37, no 6, p. 449-453Article in journal (Refereed)
    Abstract [en]

    Objective: The aim was to evaluate the antibacterial effect of ozone on cariogenic bacterial species with and without the presence of saliva and a possible effect on the salivary proteins.

    Methods: Suspensions of Actinomyces naeslundii (ACTCC 12104T), Lactobacilli casei (N CTC 151) and Streptococcus mutans (NCTC 10449), in salt buffer or in saliva, were exposed to ozone gas delivered by the ozone generator Healozone™ 2130C. Aliquots of the suspensions were taken after 10, 30 and 60s ozone exposures and cultivated on agar plates. Initial number of bacteria per ml was 8.0×107 (SD 2.2×107) (A. naeslundii), 1.0×108 (SD 3.1×106) (L. casei) and 1.0×108 (SD 7.0×105) (S. mutans), respectively. The proteins were separated by SDS electrophoresis and visualized by silver staining.

    Results: In salt buffer 92%, 73% and 64% of the initial numbers of A. naeslundiiS. mutans and L. casei, respectively, were killed already after 10s ozone exposure, while approximately 99.9% of the bacteria were dead after a 60s exposure. After 10 and 30s, but not after 60s exposure to ozone, S. mutans and L. casei were less efficiently killed in saliva compared to the salt buffer. Various saliva proteins were degraded by ozone after a 60s exposure.

    Conclusions:The cariogenic species S. mutansL. casei and A. naeslundii were almost eliminated following 60s of ozone treatment. This killing was reduced in the presence of saliva although increasing the ozone application time to 60s overcame these reductants in saliva. Detection of altered salivary proteins indicates that saliva components constitute additional targets for ozone.

  • 5.
    Lindberg, Anders
    et al.
    Umeå University, Faculty of Medicine, Odontology.
    van Dijken, Jan
    Umeå University, Faculty of Medicine, Odontology, Dental Hygiene.
    Lindberg, Marianne
    Nine-year evaluation of a polyacid-modified resin composite/resin composite open sandwich technique in Class II cavities2007In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 35, no 2, p. 124-129Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to evaluate in an intraindividual comparison the durability of a polyacid-modified resin composite/resin composite open sandwich restoration in a 9 years follow-up. A polyacid-modified resin composite (PMRC; compomer, Dyract) was placed as an intermediate layer and covered with resin composite (RC, Prisma TPH). A direct RC restoration was used as control. METHODS: Each of 57 patients, received at least one pair of Class II restorations, one open sandwich and one resin composite control. In total 75 pairs of Class II restorations, 68 premolars and 82 molars, all in occlusion, were placed by two dentists. Most of the cavities were surrounded by enamel. The restorations were evaluated at baseline, 6, 12, 24, 36 months and 9 years by slightly modified USPHS criteria. Survival of restorations grouped on the two different techniques was determined using Kaplan-Meier survival curves. RESULTS: After 9 years, 14 of 135 evaluated restorations were estimated as unacceptable, 6 in the sandwich group and 8 in the control group. Over all annual failure rate during the 9-year period was 1.1%. The survival rate was not significant different between the two techniques (p=0.604). Reasons of failure were: secondary caries (8), fracture of tooth (1), fracture of restoration (2), endodontic treatment (3). CONCLUSIONS: Both restorative techniques showed good durability during the 9-year period. No clinical advantage was observed for the sandwich technique.

  • 6. Pallasen, Ulla
    et al.
    van Dijken, Jan
    Umeå University, Faculty of Medicine, Department of Odontology.
    Halken, Jette
    Hallonsten, Anna-Lena
    Höigaard, Ruth
    Longevity of posterior resin composite restorations in permanent teeth in Public Dental Health Service: A prospective 8 years follow up2013In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 41, no 4, p. 297-306Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate in a prospective follow up the longevity of posterior resin composites (RC) placed in permanent teeth of children and adolescents attending Public Dental Health Service.

    Methods: All posterior RC placed, in the PDHS clinics in the cities of Copenhagen and Frederiksberg in Denmark between November 1998 and December 2002, in permanent teeth of children and adolescents up to 18 years, were evaluated in an up to 8 years follow up. The endpoint of each restoration was defined, when repair or replacement was performed. Survival analyses were performed between subgroups with Kaplan–Meier analysis. The individual contribution of different cofactors to predict the outcome was performed with Cox regression analysis.

    Results: Totally 2881 children with a mean age of 13.7 years (5–18) received 4355 RC restorations placed by 115 dentists. Eighty percent were placed in molars and 49% were Class I. Two percent of restorations with base material and 1% of the restorations without base material showed postoperative sensitivity (n.s.). Replacements were made in 406 and repairs in 125 restorations. Kaplan–Meier analysis showed a cumulative survival at 8 years of 84.3%, resulting in an annual failure rate of 2%. Lower patient age, more than one restoration per patient, placement of a base material and placement of RC: in molars, in cavities with high number of surfaces, in lower jaw teeth, showed all significant higher failure rates. Five variables had significant importance for the end point, replacement/repair of the resin composite restorations: age of patient, age of operator, jaw, tooth type and cavity size.

    Significance: Posterior RC restorations placed in children and adolescents in Public Dental Health clinics showed an acceptable durability with annual failure rates comparable with those of randomized controlled RC studies in adults.

  • 7. Pallesen, Ulla
    et al.
    van Dijken, Jan W V
    Umeå University, Faculty of Medicine, Department of Odontology.
    A randomized controlled 27 years follow up of three resin composites in Class II restorations2015In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 43, no 12, p. 1547-1558Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the durability of three conventional resin composites in Class II restorations during 27 years.

    METHODS: Thirty participants, 25 female and 5 male (mean age 38.2 yrs, range 25-63), received at least three (one set) as similar as possible Class II restorations of moderate size. The three cavities were chosen at random to be restored with a chemical-cured (Clearfil Posterior) and two visible light-cured resin composites (Adaptic II, Occlusin). A chemical-cured enamel bonding agent (Clearfil New Bond) was applied after Ca(OH)2 covering of dentin and enamel etch. Marginal sealing of the restorations was performed after finishing. One operator placed 99 restorations (33 sets). Evaluation was performed with slightly modified USPHS criteria at baseline, 2, 3, 10 and 27 years.

    RESULTS: Postoperative sensitivity was observed in 5 patients. Three participants with 11 restorations (11%) could not be evaluated at the 27 year recall. Thirty-seven restorations failed (13 AII, 10CP and 14 O). The overall success rate after 27 years was 56.5% (AII 55.2%, CP 63.0%, O 51.7%; p=0.70), with an annual failure rate of 1.6%. The main reason for failure was secondary caries (54.1%), followed by occlusal wear (21.6%) and material fracture (18.9%). Non-acceptable color match was seen in 24 (28.3%) of the restorations (AII 2, CP 16, O 6). Cox regression-analysis showed significant influence of the covariates tooth type, caries risk, and bruxing activity of the participants.

    CONCLUSIONS: Class II restorations of the three conventional resin composites showed an acceptable success rate during the 27 year evaluation.

  • 8. Pallesen, Ulla
    et al.
    van Dijken, Jan W. V.
    Umeå University, Faculty of Medicine, Department of Odontology, Dental Hygiene.
    Halken, Jette
    Hallonsten, Anna-Lena
    Hoigaard, Ruth
    Longevity of posterior composite restorations in permanent teeth in Public Dental Health Service: A prospective 8 years follow up (vol 41, pg 297, 2013)2013In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 41, no 11, p. 1132-1133Article in journal (Refereed)
  • 9.
    Sunnegårdh-Grönberg, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Dijken, Jan W. V. van
    Umeå University, Faculty of Medicine, Department of Odontology.
    Funegård, Ulrika
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lindberg, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Nilsson, Mats
    Futurum, County Hospital Ryhov, 551 85 Jönköping, Sweden.
    Selection of dental materials and longevity of replaced restorations in Public Dental Health clinics in northern Sweden.2009In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, no 37, p. 673-678Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the selection of direct restorative materials and longevity of replaced restorations in relation to operator and patients characteristics. METHODS: A cross-sectional study of treatment in practice, recording all new placements and replacements of direct restorations was performed during 2 weeks comprising all dentists within the Public Dental Health clinics in the county council of Västerbotten. RESULTS: A total of 2834 data collection sheets, one for each placed restoration, were received with a dropout of 10%. Restorations analyzed in the study were placed in permanent teeth in patients older than 15 years. First restorations placed due to primary caries were 671 and replacements 1536. Class II was the most frequently treated cavity followed by class I. The median longevity of replaced restorations was for amalgam, resin based composite and glass ionomer 16, 6 and 11 years, respectively. High caries risk patients showed shorter longevity for resin based composite restorations than low or moderate risk patients. Secondary caries as reason for failure for class II resin based composite restorations occurred significantly later than loss or fracture. Significantly longer longevity was observed for replaced restorations executed by more experienced dentists. CONCLUSIONS: The use of amalgam was negligible and the material was predominantly replaced by resin based composites in first and replaced restorations. Class II was the most frequent placed and replaced restorations. Caries risk and experience of operator influenced longevity of replacements.

  • 10.
    van Dijken, Jan
    Umeå University, Faculty of Medicine, Odontology, Dental Hygiene.
    Retention of a resin-modified glass ionomer adhesive in non-carious cervical lesions. A 6-year follow-up.2005In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 33, no 7, p. 541-547Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this study was to evaluate the clinical retention of a new resin-modified glass ionomer cement based adhesive combined with a hybrid resin composite or a poly-acid modified resin composite in non-carious cervical lesions during a 6-year period. METHODS: The resin-modified glass ionomer adhesive (Fuji Bond LC), was placed in 73 cervical lesions, 36 with a universal hybrid resin composite (Tetric Ceram) and 37 with a poly-acid modified resin composite (Hytac). Fifty-one in lesions with sclerotic dentin and 22 in non-sclerotic ones. Of the sclerotic lesions 38 were slightly roughened with a diamond bur before conditioning. The restorations were evaluated with slightly modified USPHS criteria every six months during a 6-year period. RESULTS: All except six restorations were evaluated during the 6 years. Twelve (17.9%) were lost, four Tetric Ceram (11.8%) and eight Hytac (24.2%) (p<0.05). Four were found in non-sclerotic lesions (20.0%) and eight in sclerotic lesions (17.0%). The differences between the sclerotic and non-sclerotic and the roughened and non-roughened lesions were not significant. CONCLUSIONS: The resin-modified glass adhesive showed a superior clinical retention combined with the resin composite material, with an annual failure rate of 2%.

  • 11.
    van Dijken, Jan
    et al.
    Umeå University, Faculty of Medicine, Odontology, Dental Hygiene.
    Sunnegårdh-Grönberg, Karin
    Umeå University, Faculty of Medicine, Odontology, Cariology.
    Fiber-reinforced packable resin composites in Class II cavities2006In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 34, no 10, p. 763-769Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the 6-year performance of two glass fiber-reinforced packable resin composites in Class II cavities. METHODS: Sixty-three participants received 87 medium to large, cervically dentin bordered, Class II restorations of two fiber-reinforced resin composites, 42 Nulite F (N) and 45 Alert (A). The restorations were evaluated clinically, according to slightly modified USPHS criteria at baseline, after 6 months, and yearly during 6 years. RESULTS: At 2 years the cumulative failure frequencies for N and A were 4.8% and 2.2%, respectively, which increased at 6 years to 25.0% and 12.8%. Reasons for failure were secondary caries, material and cusp fracture. The majority of the failures occurred after 3 years. Secondary caries occurred between 4 and 6 years. The incorporation of fibers resulted in very rough surface characteristics. CONCLUSIONS: A rather high failure rate was observed for one of the fiber-reinforced resin composites, while the other fulfilled the ADA criteria. The occurrence of most failures after 3 years indicated the necessity of long-term evaluations of new materials.

  • 12.
    van Dijken, Jan W V
    Umeå University, Faculty of Medicine, Department of Odontology.
    Durability of resin composite restorations in high C-factor cavities: A 12-year follow-up2010In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 38, no 6, p. 469-474Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Polymerization shrinkage and shrinkage stress has been considered as one of the main disadvantages of resin composite restorations. Cavities with high C-factors increase the risk for interfacial failures. Several restorative techniques have been suggested to decrease the shrinkage stress. The purpose of this study was to evaluate the durability of techniques as oblique layering, indirect curing and/or a laminate with a poly-acid modified resin composite in direct Class I resin composite restorations in a 12-year follow-up. METHODS: Each of 29 patients received one or two pair(s) rather extensive Class I restorations. The first restoration was a poly-acid modified resin composite/resin composite sandwich restoration and the second a direct resin composite restoration. Both restorations, except for the laminate layer, were placed with oblique layering and two-step curing technique. 90 restorations were evaluated annually with slightly modified USPHS criteria during 12 years. RESULTS: At 12 years, 38 pairs were evaluated. Two cases of slight post-operative sensitivity were observed in one patient. A cumulative failure rate of 2.4% was observed for both the resin composite and the laminate restorations. One laminate restoration showed non-acceptable color match, but was not replaced and one resin composite restoration showed a chip fracture. Five restorations were replaced due to primary proximal caries. CONCLUSIONS: The high failure rate expected in the high C-factor Class I cavity, associated with polymerization shrinkage and shrinkage stress, were not observed. The techniques used resulted in an excellent durability for the Class I resin composite restorations.

  • 13.
    van Dijken, Jan W V
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Pallesen, Ulla
    A 7-year randomized prospective study of a one-step self-etching adhesive in non-carious cervical lesions. The effect of curing modes and restorative material.2012In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 40, no 12, p. 1060-7Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to evaluate the clinical retention of a one-step self-etching adhesive system (Xeno III) in Class V non-carious cervical lesions and the effect of restorative material and curing techniques on longevity of the restorations.

    MATERIALS AND METHODS: A total of 139 Class V restorations were placed with the self-etching primer Xeno III and a resin composite (Tetric Ceram) or a poly-acid modified resin composite (Dyract AP) in non-carious cervical lesions without intentional enamel involvement. The materials were cured with a conventional continuous light, a soft-start or a pulse-delay curing mode. The restorations were evaluated at baseline, 6, 12, 18 and 24 months and then yearly during a 7 year follow-up with modified USPHS criteria. Dentine bonding efficiency was determined by the percentage of lost restorations.

    RESULTS: During the 7 years, 135 restorations could be evaluated. No post-operative sensitivity was reported by the participants. Overall relative cumulative loss rate frequencies for the adhesive system at 6 and 18 months and 7 years, independent of curing technique and restorative material, were 0.8%, 6.9% and 23.0%, respectively. The self-etching adhesive fulfilled at 18 months the full acceptance ADA criteria. Tetric Ceram showed at 7 years a 20.9% loss of retention and Dyract AP a 25.0% loss rate (Log rank p=0.48). The loss rates for the 3 curing techniques: continuous, soft start and pulse delay were 17%, 27.9% and 24.4%, respectively (Log rank p=0.52). No secondary caries was observed.

    SIGNIFICANCE: The single-step self-etching adhesive showed acceptable clinical long-time retention rates to dentine surfaces independent of restorative material and curing technique used.

  • 14.
    van Dijken, Jan W V
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Pallesen, Ulla
    Institute of Odontology, Faculty of Health Science, University of Copenhagen, Denmark.
    Four-year clinical evaluation of Class II nano-hybrid resin composite restorations bonded with a one-step self-etch and a two-step etch-and-rinse adhesive2011In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 39, no 1, p. 16-25Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The objective of this prospective clinical trial was to evaluate the 4-year clinical performance of an ormocer-based nano-hybrid resin composite (Ceram X; Dentsply/DeTrey) in Class II restorations placed with a one-step self-etch (Xeno III; Dentsply/DeTrey) and two-step etch-and-rinse adhesive (Ivoclar Vivadent).

    METHODS: Seventy-eight participants received at random at least two, as similar as possible, Class II restorations of the nano-hybrid resin composite bonded with either a single step self-etch adhesive or a control 2-step etch-and-rinse adhesive. The 165 restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 4 years.

    RESULTS: 162 restorations were evaluated at 4 years. Postoperative sensitivity was observed in 6 patients (3 Xeno III, 3 Exite) between 1-3 weeks. Eleven failed restorations (6.8%) were observed during the follow up. Seven in the one-step self-etch adhesive group (7.7%) and four in the 2-step etch-and-rinse group (5.6%). This resulted in non-significant different annual failure rates of 1.9% and 1.4%, respectively. Fracture of restoration was the main reason for failure.

    CONCLUSION: The ormocer-based nano-hybrid resin composite showed a good clinical performance in Class II cavities during the 4 year evaluation. No significant difference was seen in overall clinical effectiveness between the two adhesives.

  • 15.
    van Dijken, Jan W V
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Pallesen, Ulla
    Posterior bulk-filled resin composite restorations: a 5-year randomized controlled clinical study2016In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 51, p. 29-35Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate in a randomized controlled study the 5-year clinical durability of a flowable resin composite bulk-fill technique in Class I and Class II restorations.

    MATERIAL AND METHODS: 38 pairs Class I and 62 pairs Class II restorations were placed in 44 male and 42 female (mean age 52.4 years). Each patient received at least two, as similar as possible, extended Class I or Class II restorations. In all cavities, a 1-step self-etch adhesive (Xeno V+) was applied. Randomized, one of the cavities of each pair received the flowable bulk-filled resin composite (SDR), in increments up to 4mm as needed to fill the cavity 2mm short of the occlusal cavosurface. The occlusal part was completed with the nano-hybrid resin composite (Ceram X mono+). In the other cavity, the resin composite-only (Ceram X mono+) was placed in 2mm increments. The restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 5 years. Caries risk and bruxing habits of the participants were estimated.

    RESULTS: No post-operative sensitivity was reported. At 5-year 183, 68 Class I and 115 Class II, restorations were evaluated. Ten restorations failed (5.5%), all Class II, 4 SDR-CeramX mono+ and 6 CeramX mono+-only restorations. The main reasons for failure were tooth fracture (6) and secondary caries (4). The annual failure rate (AFR) for all restorations (Class I and II) was for the bulk-filled-1.1% and for the resin composite-only restorations 1.3% (p=0.12). For the Class II restorations, the AFR was 1.4% and 2.1%, respectively.

    CONCLUSION: The stress decreasing flowable bulk-fill resin composite technique showed good durability during the 5-year follow-up.

    CLINICAL SIGNIFICANCE: The use of a 4mm incremental technique with the flowable bulk-fill resin composite showed during the 5-year follow up slightly better, but not statistical significant, durability compared to the conventional 2mm layering technique in posterior resin composite restorations.

  • 16. van Noort, R
    et al.
    Gjerdet, NR
    Schedle, A
    Björkman, L
    Berglund, Anders
    Umeå University, Faculty of Medicine, Odontology, Dental Technology/Dental Materials Science.
    An overview of the current status of national reporting systems for adverse reactions to dental materials.2004In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 32, no 5, p. 351-358Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Since all dental materials pose a potential risk to patients and members of the dental team, the post-market monitoring of adverse reactions caused by dental materials should be considered essential. This article reviews the current status of post-market monitoring of adverse reactions to dental materials and highlights some of the issues that arise in trying to establish an evidence base on the characteristics of adverse reactions to dental materials. METHODS: Norway, Sweden and more recently the UK have sought to monitor adverse reactions to dental materials systematically and proactively in an effort to add to the evidence base on the safety of dental materials. Their experiences in undertaking post-market surveillance have been combined in preparing this article. RESULTS: To date the Norwegian, Swedish and the UK projects has received 1268 reports over 11 years, 848 reports over 5.5 years and 1117 reports over 3 years, respectively, relating to adverse reactions seen or experienced by dental personnel and patients. Presently, there are no harmonized criteria for what can be classified as an adverse reaction related to dental materials. Under reporting is a recognised problem and lack of awareness and lack of clarity as to what constitutes an adverse reaction may be contributory factors. A pro-active reporting system takes a considerable time to become established, but can generate a lot of potentially useful information. CONCLUSIONS: There is a need to raise the awareness among dental professionals of the potential for adverse reactions due to dental materials and to develop an internationally accepted system of data gathering that can produce the evidence that reflect the extent, severity and incidence of adverse reactions to dental materials.

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