The longevity of amalgam versus compomer/composite restorations in posterior primary and permanent teeth: findings From the New England Children's Amalgam Trial. Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial. Risk factors for secondary caries in direct composite restorations in primary teeth. Dental restoration longevity: survival functions and statistical indices in low and high failure rate groups. Predictors of root canal treatment in teeth with full coverage restorations. Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement. Efficacy of conventional treatment with composite resin and atraumatic restorative treatment in posterior primary teeth: study protocol for a randomised controlled trial A prospective evaluation of zirconia posterior fixed dental prostheses: three-year clinical results. Five-year performance of high-copper content amalgam restorations in a multiclinical trial of a posterior composite. Endodontic complications after plastic restorations in general practice. Implant loading protocols for the partially edentulous posterior mandible. Longevity and Cariostatic Effects of Everyday Conventional Glass-ionomer and Amalgam Restorations in Primary Teeth: Three-year Results The longevity of different restorations in primary teeth. Relationship between number of proximal contacts and survival of root canal treated teeth. Survival characteristics of 771 resin-retained bridges provided at a UK dental teaching hospital The Hall Technique 10 years on: its effect and influence Direct Contra Naïve-Indirect Comparison of Clinical Failure Rates between High-Viscosity GIC and Conventional Amalgam Restorations: An Empirical Study Dental Composites and Amalgam and Physical Development in Children Two-year clinical performance of sonic-resin placement system in posterior restorations. Design and Validity of Randomized Controlled Dental Restorative Trials Relationship between crown placement and the survival of endodontically treated teeth. The FiCTION dental trial protocol – filling children’s teeth: indicated or not? Clinical study of indirect composite resin inlays in posterior stress-bearing cavities placed by dental students: results after 4 years.
BACKGROUND Limited information is available from r and omized clinical trials comparing the longevity of  amalgam and resin-based compomer/composite restorations . The authors compared replacement rates of these types of restorations in posterior teeth during the five-year follow-up of the New Engl and Children 's Amalgam Trial . METHODS The authors r and omized children aged 6 to 10 years who had two or more posterior occlusal carious lesions into groups that received amalgam ( n=267 ) or compomer ( primary teeth)/composite ( permanent teeth ) ( n=267 ) restorations  and followed them up semiannually . They compared the longevity of restorations placed on all posterior surfaces using r and om effects survival analysis . RESULTS The average+/-st and ard deviation follow-up was 2.8+/-1.4 years for primary tooth restorations and 3.4+/-1.9 years for permanent tooth restorations . In primary teeth , the replacement rate was 5.8 percent of compomers versus 4.0 percent of amalgams ( P=.10 ) , with 3.0 percent versus 0.5 percent ( P=.002 ) , respectively , due to recurrent caries . In permanent teeth , the replacement rate was 14.9 percent of composites versus 10.8 percent of amalgams ( P=.45 ) , and the repair rate was 2.8 percent of composites versus 0.4 percent of amalgams ( P=.02 ) . CONCLUSION Although the overall difference in longevity was not statistically significant , compomer was replaced significantly more frequently owing to recurrent caries , and composite restorations required seven times as many repairs as did amalgam restorations . CLINICAL IMPLICATION S Compomer/composite restorations on posterior tooth surfaces in children may require replacement or repair at higher rates than amalgam restorations , even within five years of placement BACKGROUND Failure of dental restorations is a major concern in dental practice . Replacement of failed restorations constitutes the majority of operative work . Clinicians should be aware of the longevity of , and likely reasons for the failure of , direct posterior restorations . In a long-term , r and omized clinical trial , the authors compared the longevity of  amalgam and composite .  SUBJECTS , METHODS AND MATERIAL S : The authors r and omly assigned one-half of the 472 subjects , whose age ranged from 8 through 12 years , to receive amalgam restorations in posterior teeth and the other one-half to receive resin-based composite restorations .  Study dentists saw subjects annually to conduct follow-up oral examinations and take bitewing radiographs . Restorations needing replacement were failures . The dentists recorded differential reasons for restoration failure . RESULTS Subjects received a total of 1,748 restorations at baseline , which the authors followed for up to seven years . Overall , 10.1 percent of the baseline restorations failed . The survival rate of the amalgam restorations was 94.4 percent ; that of composite restorations was 85.5 percent . Annual failure rates ranged from 0.16 to 2.83 percent for amalgam restorations and from 0.94 to 9.43 percent for composite restorations .  Secondary caries was the main reason for failure in both material s. Risk of secondary caries was 3.5 times greater in the composite group . CONCLUSION Amalgam restorations performed better than did composite restorations . The difference in performance was accentuated in large restorations and in those with more than three surfaces involved . CLINICAL IMPLICATION S Use of amalgam appears to be preferable to use of composites in multisurface restorations of large posterior teeth if longevity is the primary criterion in material selection BACKGROUND Secondary caries or caries adjacent to restorations is the most frequent reason for replacement of dental restorations . Though , limited data is available on variables influencing the development of secondary caries in primary teeth . AIM To investigate risk factors for the development of secondary caries adjacent to direct composite restorations in primary teeth . DESIGN For this retrospective study , data of 2417 composite restorations , which were placed due to primary carious lesions , were considered . A total of 212 restorations failed due to secondary caries within a maximum observation period of 8 years . A control group was r and omly selected . Mann-Whitney U-test , binomial logistic regression with backward elimination and Cox regression with frailty model were performed ( P < 0.05 ) . RESULTS The overall caries experience amounted to 6.3 dmft and 13.3 dmfs . 72.5 % of restorations failed within the first 2 years . Older children and children from families with a higher socio-economic status showed a lower risk for secondary caries . Further , the dentist and the adhesive had a significant influence on the longevity . Posterior restorations had a higher risk to fail in comparison with anterior restorations . CONCLUSIONS Within the limitation of this study , it is concluded that the development of secondary caries is influenced by several factors . Nevertheless , the secondary caries rate was found to be relatively low in this high-risk population A group of 71 patients was examined to determine the longevity of restorations placed at the University of North Carolina School of Dentistry . Patients with an overall restorations failure rate of equal to or greater than 40 per 1000 restoration-yr were categorized as having a " high failure rate " and those below that were considered " low failure rate " . An investigation was made to determine statistical differences between these two groups of patients using survival analysis and various statistical indices . Time of exposure and age of patients for both groups were similar . High rate patients had a greater number of anterior restorations and anterior teeth restored . In addition , the number of restorations per tooth was significantly greater in anterior and posterior teeth of the high failure rate group . No single variable was found to account for the differences in the failure rates in the two groups of patients . A prospect i ve study is needed in order to examine possible causes for restoration failures This case-control study sought to identify variables predictive of subsequent root canal therapy ( RCT )  in teeth receiving full coverage restorations . The University of North Carolina School of Dentistry 's computerized treatment data base was used to identify all patients receiving a single-unit crown on a nonendodontically treated permanent tooth from January 1 , 1998 through December 31 , 2002 . These patients then were classified either as cases ( those whose crowned teeth received RCT before July 1 , 2004 ) or controls ( those whose crowned teeth did not ) . Computerized data , chart entries , and dental radiographs were examined to determine pre- , intra- , and postoperative factors of interest . In the final multivariable logistic regression model that included 66 cases and 71 controls , younger age ( p = 0.005 ) and greater extent of coronal and root destruction ( p = 0.020 ) remained statistically significant predictors of case status , though many potentially important predictors were unavailable through chart review . Patients could benefit if prospect i ve studies were conducted to identify factors predictive of subsequent endodontic involvement in newly crowned teeth UNLABELLED Several recent studies have demonstrated the success of the ART ( atraumatic restorative treatment ) technique under field conditions in developing countries . The ART technique involves removal of caries using only h and instruments , and placing a glass ionomer cement ( GIC ) restoration . OBJECTIVES To estimate the longevity of Fuji II GIC ART restorations placed in permanent teeth by dental nurse students under field conditions in rural Cambodia . DESIGN Clinical field trial . SETTING One high school in rural Cambodia . SAMPLE AND METHODS 53 subjects between the ages of 12 and 17 who had dental caries were selected to participate . Subjects were r and omly assigned to a dental nurse student for cavity preparation and placement of ART restorations ( without cavity conditioning ) . RESULTS 92.1 % of the carious lesions required class I or class V restorations , and 85.4 % were in the lower molars . 89 teeth were filled . At 1 and 3 years 86.4 % and 79.5 % of restorations were still present . Restorations were assessed by one dentist according to st and ard criteria . 76.3 % of the restorations were judged to be successful at 1 year , and 57.9 % at 3 years . CONCLUSIONS Factors which may have affected the success rates included : the material used , technical factors , failure to condition the cavity prior to restoration , and inexperience of the operators . The results suggest that ART restorations in permanent teeth using Fuji II GIC are only moderately successful after 3 years . Better results could be expected by using a dentine conditioner in conjunction with one of the newer stronger glass ionomer cements Introduction Despite the widespread acceptance of conventional treatment using composite resin in primary teeth , there is limited evidence that this approach is the best option in paediatric clinics .  Atraumatic restorative treatment ( ART ) using high-viscosity glass ionomer cement has gradually become more popular because it performs well in clinical studies , is easy to h and le and is patient friendly . Therefore , the aim of this r and omised clinical trial study is to compare the restoration longevity of conventional treatment using composite resin with that of ART in posterior primary teeth . As secondary outcomes , cost-efficacy and patient self-reported discomfort will also be tested . Methods and analysis Children aged 3–6 years presenting with at least one occlusal and /or occlusal-proximal cavity will be r and omly assigned to one of two groups according to the dental treatment : ART ( experimental group ) or composite resin restoration ( control group ) . The dental treatment will be performed at a dental care trailer located in an educational complex in Barueri/SP , Brazil . The unit of r and omisation will be the child . A sample size of 240 teeth with occlusal cavities and 188 teeth with occlusal-proximal cavities has been calculated . The primary outcome will be restoration longevity , which will be clinical ly assessed after 6 , 12 , 18 and 24 months by two examiners . The duration of the dental treatment and the cost of all material s used will be considered when estimating the cost-efficacy of each treatment . Individual discomfort will be measured after each dental procedure using the Facial Scale of Wong-Baker . Ethics and dissemination This clinical trial was approved by the local ethics committee from the Faculty of Dentistry of the University of São Paulo ( registration no. 1.556.018 ) . Participants will be included after their legal guardians have signed an informed consent form containing detailed information about the research . Trial registration number www . clinical trials.gov , NCT02562456 ; Pre- results STATEMENT OF PROBLEM Although the favorable mechanical properties of zirconium oxide-based ceramics have increased the acceptance of fixed dental prostheses for use in the posterior regions of the mouth in recent years , there are few clinical studies documenting the longevity of these restorations . Furthermore , certain complications must be resolved before the material is used more extensively . PURPOSE The purpose of this r and omized prospect i ve study was to evaluate the clinical performance of zirconia ( Lava ) 3-unit posterior fixed dental prostheses . MATERIAL AND METHODS Twenty 3-unit fixed dental prostheses were placed in 17 participants to replace a second premolar or a first molar . Eleven were placed in the maxilla and 9 in the m and ible . All abutment teeth were prepared with a chamfer finish line of 0.8 to 1 mm , and frameworks were prepared with the Lava system . Restorations were cemented with a resin cement . Two calibrated examiners independently evaluated the fixed dental prostheses 1 week ( baseline ) and 1 , 2 , and 3 years after placement with the California Dental Association quality evaluation system . The periodontal parameters : the gingival index , plaque index , margin index , and the probing depths of abutment teeth and contralateral teeth were assessed . Data were analyzed by using descriptive statistics and the Wilcoxon signed-rank test ( α=.05 ) . RESULTS All fixed dental prostheses were rated satisfactory after 3 years , and no fracture of the framework was observed during the observation period . One fixed dental prostheses was lost because of a biological complication at the 3-year examination , and a small degree of chipping of the veneering ceramic was observed in 2 participants . No significant differences among the periodontal parameters of the test and control teeth were observed except for the margin index . CONCLUSIONS The results of a 3-year evaluation suggest that posterior zirconia 3-unit fixed dental prostheses are a reliable treatment PURPOSE This paper reports the 5-year performance of the restorations of the high-copper content dental amalgam alloys included in the worldwide programme of clinical trials of Occlusin , including unique data on wear . METHODS The methods employed are common to those previously reported for the multi clinical evaluation of Occlusin . Analysis of the data is limited to simple statistical procedures . RESULTS The findings lend support to existing knowledge concerning the favourable performance of restorations of high-copper content dental amalgam alloys  , notably in relation to restorations in moderate- to large-sized Class II preparations in permanent molar teeth . Analysis of the data sheds new light on the influences of variables , including type of tooth restored , size and class of restoration and the presence or absence of occlusal contact(s ) on performance . CONCLUSION Conclusions are drawn regarding ways in which protocol s for future evaluations of the type reported should be exp and ed , and , together with suggestions for further work , it is concluded that this paper is a timely reminder of the value of existing dental amalgam alloys AIM To test the hypothesis that dentine and pulp protection by conditioning- and -sealing is no less effective than using a conventional calcium hydroxide lining . METHODOLOGY A cohort of healthy adults requiring a new or replacement restoration in a posterior tooth was recruited in six general practice s. All procedures received local Ethics Committee approval . Exclusion criteria included signs and symptoms of pulp necrosis or inflammation , and patients unable to commit to a long-term trial . Cavity preparations were r and omized to receive a calcium hydroxide lining or conditioning- and -sealing with a smear-removing bonding system . Choice of bulk restorative material ( composite resin or amalgam ) was at the discretion of the dentist . The key outcome measure was evidence of pulpal breakdown identified at unscheduled ( emergency ) or scheduled recall examinations . Postoperative sensitivity was recorded on 100 mm VAS at 24 h , 4 days and 7 days . Pulp status was assessed at 6 , 12 , 24 and 36 month recall , and at any emergency recall appointment . The relationship between pre-treatment and treatment variables and pulp breakdown was assessed by logistic regression ( P = 0.05 ) . RESULTS A total of 602 teeth were recruited , with comparable numbers of cavities lined ( 288 , 47.8 % ) or conditioned and sealed ( 314 , 52.2 % ) . The majority ( 492 , 81.7 % ) were replacement restorations , and amalgam was the most common bulk restorative material ( 377 , 62.6 % ) . A total of 390 ( 64.8 % ) restored teeth were review ed at 6 months , 307 ( 51 % ) at 12 months , 363 ( 60.3 % ) at 24 months , and 279 ( 46.3 % ) at 36 months post-restoration . Sixteen cases of pulp breakdown were identified within 36 months of restoration placement , 11 presenting as emergencies and five detected at routine recall examination . Logistic regression showed that preoperative pain , cavity treatment by lining or conditioning- and -sealing and the use of rubber dam isolation had no association with pulp breakdown . Pulp breakdown was associated with deep or pulpally exposed cavities ( P < 0.001 , odds ratio 7.8 ) and with composite rather than amalgam restorations ( P = 0.001 , odds ratio 2.13 ) . Re-coding to identify teeth with pulp exposures revealed that pulpal exposure was the key determinant of adverse pulp outcomes ( P < 0.0001 , odds ratio 28.4 ) and that composite resin restorations were again more likely to be associated with pulp breakdown than amalgam ( P = 0.017 , odds ratio 3.92 ) . CONCLUSIONS Considered within the context of routine primary dental care : Dentists can be confident that pulps will be equally well protected from post-restorative breakdown up to 36 months by calcium hydroxide lining and conditioning- and -sealing with adhesive resins .  Residual dentine thickness appears to be a key determinant of pulp responses after restorative dental treatment . In deep and pulpally exposed cavities in posterior teeth , composites were associated with more pulpal breakdown than amalgams PURPOSE To evaluate the predictability of early and immediate loading protocol s of  implants in the posterior m and ible and to investigate whether there is a difference in success rates , survival rates , and peri-implant parameters , including marginal bone level changes , between loading protocol s. MATERIAL S AND METHODS A comprehensive systematic review of the literature was conducted . The selection of publications reporting on human clinical studies was based on predetermined inclusion criteria and was agreed upon by two review ers . RESULTS A total of 19 papers were selected : 8 on early loading , 9 addressing immediate loading , and 2 comparing immediate and early loading . Of the 19 studies , 5 were r and omized clinical trials and 14 were prospect i ve studies . CONCLUSIONS Existing literature supports the early loading of  microroughened dental implants in the partially edentulous posterior m and ible at 6 to 8 weeks in the absence of modifying factors . Therefore , loading within this time frame can be considered routine for the majority of clinical situations in the posterior m and ible , either with single crowns or fixed dental prostheses . Immediate loading of microroughened dental implants in the partially edentulous posterior m and ible proved to be a viable treatment alternative . Caution is necessary when interpreting published outcomes for immediate loading , as the inclusion exclusion criteria are inconsistent and many subjective confounding factors are evident . Additional studies with longer follow-ups , specifically r and omized clinical trials , are needed to consoli date the data for immediate loading . Priority should be given to trials testing immediate loading The aim of this study was to compare the longevity and cariostatic effects of everyday  conventional glass-ionomer and amalgam restorations in primary teeth . The material s consisted of  515 Ketac-Fil glass-ionomer restorations and 543 Dispersalloy amalgam restorations prepared in 666 children , from 3 to 13 years of age , by 14 dentists within the Danish Public Dental Health Service in the municipalities of Vaerlose and Hillerød . The restorations , of which 79 % were of the Class II type , were in contact with 593 unrestored surfaces in adjacent primary and permanent teeth . After 3 years , 6 % of the patients had dropped out of the study , and 33 % of the teeth were exfoliated with the restoration in situ . A further 37 % of the glass-ionomer and 18 % of the amalgam restorations were recorded as failed ( p < 0.001 ) . The frequency of failures was highest for Class II glass-ionomer restorations , which showed a 50 % median survival time of only 34½ months , because of many fractures , while the 75 % survival time for Class II amalgam restorations just exceeded the actual 36 months ( p < 0.001 ) . Caries progression was most often recorded in surfaces adjacent to amalgam restorations , and 21 % of these surfaces needed restorative treatment vs. 12 % of the surfaces adjacent to glass-ionomer restorations ( p < 0.01 ) . The three-year results indicated that conventional glass ionomer is not an appropriate alternative to amalgam for all types of restorations in primary teeth . In particular , the short longevity of Class II glass-ionomer restorations could not be compensated for by the reduced caries progression and need for restorative therapy of adjacent surfaces BACKGROUND AND AIM This paper review s three published papers and adds results from a fourth study which aim ed to determine which restorative material would be the best alternative(s ) to amalgam ( AM )  in primary teeth . DESIGN All studies had a practice -based design and were part of the routine treatment of children and adolescents . The clinicians were assigned which material s to use in a r and omised matter in the first three studies which lasted for 7 - 8 years . In the fourth study conducted 4 years after the initial studies , the clinicians were free to select the restorative material s. RESULTS AND CONCLUSIONS Resin modified glass ionomer ( RMGI ) and compomer ( COM ) restorations showed similar longevity compared with AM , whereas conventional GI restorations showed significantly shorter longevity . The studies indicated that the ' new and improved ' material s based on in vitro tests did not always show enhanced clinical properties . In the last study , where clinicians freely selected the restorative material s they used in their practice s , seven used COM , one used conventional GI material s and one used a combination of the two types of material AIM The present study tested the hypothesis that having two proximal contacts ( PCs ) at access is associated with improved survival of root canal treated ( RCT ) teeth  , controlling for important presenting conditions , endodontic variables and restorative factors . METHODOLOGY A treatment data base at the University of Iowa College of Dentistry was used to identify permanent teeth undergoing obturation between 1 July 1985 and 31 December 1987 . The list was restricted to teeth of patients with at least one dental visit in each two-year interval from 1985 to 1996 , and a simple r and om sample of 280 patients ( n = 400 teeth ) was selected . Dental charts , radiographs , and computerized data bases were examined to ascertain variables of interest and to verify study inclusion criteria . Kaplan-Meier survival estimates were generated for the 221 teeth satisfying study inclusion criteria . Multivariate Cox models were developed , with st and ard errors adjusted to account for clustering of teeth within patients . RESULTS The final Cox model showed that teeth with < or = 1 PC at access were lost at a rate three times that of teeth with 2 PCs ( hazard ratio = 3.1 ; 95 % confidence interval = 1.9 - 5.1 ) , controlling for tooth type , presence of radiographic caries at access , and presence of a crown before or after obturation . CONCLUSIONS Because RCT teeth with two PCs at access experienced substantially better survival than teeth with fewer than two PCs , the influence of PCs on prognosis should be recognized during treatment planning . Future research should employ prospect i ve study design s , capture additional variables , and provide data to support endodontic treatment decisions Objective To analyse the factors affecting the clinical performance and those influencing the survival of  resin-retained bridgework provided at a UK dental teaching hospital between 1994 and 2001 . Design A prospect i ve analysis of restorations provided at a single centre using case notes with all patients invited for review to corroborate findings . Setting Department of Restorative Dentistry , University of Bristol Dental Hospital and School , Bristol , United Kingdom . Subjects and methods Between January 1994 and December 2001 , data regarding 1,000 consecutive resin-retained bridges provided at Bristol Dental Hospital and School were recorded . Data was available for 805 patients at the time of the study . Following invitation , 621 patients attended for a review appointment . Life table and Kaplan-Meir survival analysis were carried out for all restorations provided . Results The five-year and ten-year survival rates estimated by the life-table method are 80.8 % ( 95 % confidence interval 78.0–83.6 % ) and 80.4 % ( 95 % confidence interval 77.6–83.2 % ) respectively . The median survival can not be estimated for this study as the survival probability remains above 80 % even at the longest follow-up . Analysis of clinical variables influencing survival revealed that design of the restoration and experience of the operator providing the restoration were significant factors . Resin-retained bridges made with minimal tooth preparation are shown to be superior in terms of longevity than those for which other types of tooth preparation is made . Patient satisfaction with their treatment was high Dental caries in early childhood can have a very significant effect not only on the oral health of young children but on their quality of life and that of their families . Added to this are the long-term infective risks to the host of untreated caries in primary teeth but also the risk of damage to successor permanent teeth . Traditional restoration of damaged primary teeth has been shown to have only moderate outcomes depending on the techniques and material s used and the ability of children to cooperate because of age or other factors . The Hall technique has outperformed other techniques in r and omised clinical trials . In this Opinion Article I will take a look back at the Innes et al. paper , first published in this Journal in 2006 , that introduced the Hall Technique and the subsequent scientific literature which provided us with high quality scientific evidence of the efficacy of the technique . I will evaluate how this new technique has affected the management of early childhood caries  and hence its influence on wider oral and general health Background Naïve-indirect comparisons are comparisons between competing clinical interventions ’ evidence from separate ( uncontrolled ) trials . Direct comparisons are comparisons within r and omised control trials ( RCTs ) . The objective of this empirical study is to test the null-hypothesis that trends and performance differences inferred from naïve-indirect comparisons and from direct comparisons/ RCTs regarding the failure rates of  amalgam and direct high-viscosity glass-ionomer cement ( HVGIC ) restorations in permanent posterior teeth have similar direction and magnitude . Methods A total of 896 citations were identified through systematic literature search . From these , ten and two uncontrolled clinical longitudinal studies for HVGIC and amalgam , respectively , were included for naïve-indirect comparison and could be matched with three out twenty RCTs . Summary effects sizes were computed as Odds ratios ( OR ; 95 % Confidence intervals ) and compared with those from RCTs . Trend directions were inferred from 95 % Confidence interval overlaps and direction of point estimates ; magnitudes of performance differences were inferred from the median point estimates ( OR ) with 25 % and 75 % percentile range , for both types of comparison . Mann-Whitney U test was applied to test for statistically significant differences between point estimates of both comparison types . Results Trends and performance differences inferred from naïve-indirect comparison based on evidence from uncontrolled clinical longitudinal studies and from direct comparisons based on RCT evidence are not the same . The distributions of the point estimates differed significantly for both comparison types ( Mann – Whitney U = 25 , nindirect = 26 ; ndirect = 8 ; p = 0.0013 , two-tailed ) . Conclusion The null-hypothesis was rejected . Trends and performance differences inferred from either comparison between HVGIC and amalgam restorations failure rates in permanent posterior teeth are not the same . It is recommended that clinical practice guidance regarding HVGICs should rest on direct comparisons via RCTs and not on naïve-indirect comparisons based on uncontrolled longitudinal studies in order to avoid inflation of effect estimates Resin-based composite dental restoration material s may release bisphenol-A , an endocrine-disrupting chemical . Using secondary analysis of a r and omized clinical safety trial of amalgam vs. composites , we tested the hypothesis that dental restoration material s affect children ’s growth . Children ( N = 218 boys , N = 256 girls ) aged 6 to 10 yrs at baseline with ≥ 2 decayed posterior teeth were r and omized to amalgam or composites ( bisphenol-A-diglycidyl-dimethacrylate composite for permanent teeth , urethane-dimethacrylate compomer for primary teeth ) for treatment of posterior caries throughout follow-up . Primary outcomes for this analysis were 5-year changes in BMI -for-age z-scores , body fat percentage ( BF% ) , and height velocity ; exploratory analyses ( n = 113 ) examined age at menarche . Results showed no significant differences between treatment assignment and changes in physical development in boys [ ( composites vs. amalgam ) BF% , 4.9 vs. 5.7 , p = 0.49 ; ( BMI -z-score ) 0.13 vs. 0.25 , p = 0.36 ] or girls ( 8.8 vs. 7.7 , p = 0.95 ; 0.36 vs. 0.21 , p = 0.49 ) . Children with more treatment on primary teeth had greater increases in BF% regardless of material type . Girls assigned to composites had lower risk of menarche during follow-up ( hazard ratio = 0.57 , 95 % CI 0.35 - 0.95 ) . Overall , there were no significant differences in physical development over 5 years in children treated with composites or amalgam . Additional studies examining these restoration material s in relation to age at menarche are warranted ( clinical trials.gov number NCT00065988 ) OBJECTIVE The objective of this split-mouth r and omized controlled study was to compare the 2-year clinical performance of two restorative techniques and material s for posterior permanent carious teeth . METHOD AND MATERIAL S After signing informed consent , 30 patients aged between 7 and 16 received two Class 1 restorations on cavities on permanent first or second molar teeth performed with one of two systems : incrementally placed conventional posterior composite resin ( Herculite Ultra , Kerr ) , and sonic-resin placement system ( SonicFill , Kerr ) with single-component self-etch adhesive system ( Kerr ) according to the manufacturers ' directions . Two blinded observers evaluated the restorations at three times ( baseline , and after 1 and 2 years ) according to the US Public Health Service modified criteria . Kruskal-Wallis test and Mann-Whitney U-test were used to compare the clinical performance of the restorative systems . RESULTS The restorative systems showed similar clinical performance at 2 years . At the end of 2 years in both groups , one restoration 's marginal staining Alpha ratings decreased . In the same period , two restorations in the conventional group and one in the SonicFill group received Bravo ratings for color match and surface roughness scorings . CONCLUSION The sonic-resin placement system demonstrated similar results to incrementally placed conventional composite resin in terms of clinical success . Considering the advantages of providing up to 5 mm in a single layer , and the adjustability of the viscosity , bulk-fill composite restorations seem to be a good alternative to posterior Class 1 composite restorations . CLINICAL RELEVANCE This study suggests that a new dental material for bulk-fill technology exhibits similar clinical success to incrementally placed composite resin Background : The evidence stemming from trials on restorative material s is shaped not only by trial findings , but also trial design and validity . We aim ed to evaluate both aspects in r and omized controlled dental restorative trials published from 2005–2015 . Methods : Using systematic review methodology , we retrieved trials comparing  restorative or adhesive dental material s. Two authors independently assessed design , risk of bias , registration status , and findings of trials . Descriptive and regression analyses were performed . Results : 114 studies on 15,321 restorations placed mainly in permanent teeth of 5232 patients were included . Per trial , the median number of patients was 37 ( 25th/75th percentiles : 30/51 ) . Follow-up was 24 ( 20/48 ) months . Seventeen percent of trials reported on sample size calculations , 2 % had been registered . Most trials ( 90 % ) used US Public Health Service ( USPHS ) criteria , and had a high risk of bias . More recent trials were more likely to have been registered , to have reported on sample size calculations , to be of low risk of bias , and to use other than USPHS- criteria . Twenty-three percent of trials yielded significant differences between groups . The likelihood of such differences was significantly increased in older studies , studies with potential reporting bias , published in journals with high impact factor ( > 2 ) , longer follow-up periods , and not using USPHS- criteria . Conclusions : The majority of dental restorative trials published from 2005–2015 had limited validity . Risk of bias decreased in more recent trials . Future trials should aim for high validity , be registered , and use defined and appropriate sample sizes , follow-up periods , and outcome measures STATEMENT OF PROBLEM Crowns have been considered the restoration of choice for endodontically treated teeth , but their selection has been based primarily on anecdotal evidence . PURPOSE This study tested the hypothesis that crown placement ( coronal coverage ) is associated with improved survival of endodontically treated teeth when preaccess , endodontic , and restorative factors are controlled . MATERIAL AND METHODS A University of Iowa College of Dentistry treatment data base was used to identify permanent teeth that had undergone initial obturation between July 1 , 1985 , and December 31 , 1987 . Study patients were restricted to persons with at least 1 dental visit in each 2-year interval from 1985 to 1996 ; a simple r and om sample of 280 patients ( n = 400 teeth ) was selected . Dental charts , radiographs , and computerized data bases were examined to ascertain variables of interest and to verify study inclusion criteria . Kaplan-Meier survival estimates were generated for the 203 teeth that satisfied study inclusion criteria . Multivariate Cox proportional hazards regression models were developed , with st and ard errors adjusted to account for clustering of teeth within patients . RESULTS When tooth type and radiographic evidence of caries at access were controlled , the final Cox model showed that endodontically treated teeth not crowned after obturation were lost at a 6.0 times greater rate than teeth crowned after obturation ( 95 % confidence interval : 3.2 to 11.3 ) . CONCLUSION Within the limitations of this study , a strong association between crown placement and the survival of endodontically treated teeth was observed . These results may impact treatment planning if long-term tooth retention is the primary goal Background There is a lack of evidence for effective management of  dental caries ( decay ) in children ’s primary ( baby ) teeth and an apparent failure of conventional dental restorations ( fillings ) to prevent dental pain and infection for UK children in Primary Care . UK dental schools ’ teaching has been based on British Society of Paediatric Dentistry guidance which recommends that caries in primary teeth should be removed and a restoration placed . However , the evidence base for this is limited in volume and quality , and comes from studies conducted in either secondary care or specialist practice s. Restorations provided in specialist environments can be effective but the generalisability of this evidence to Primary Care has been question ed . The FiCTION trial addresses the Health Technology Assessment ( HTA ) Programme ’s commissioning brief and research question “ What is the clinical and cost effectiveness of restoration caries in primary teeth , compared to no treatment ? ” It compares conventional restorations with an intermediate treatment strategy based on the biological ( sealing-in ) management of caries and with no restorations . Methods / Design This is a Primary Care-based multi-centre , three-arm , parallel group , patient-r and omised controlled trial . Practitioners are recruiting 1461 children , ( 3–7 years ) with at least one primary molar tooth where caries extends into dentine . Children are r and omized and treated according to one of three treatment approaches ; conventional caries management with best practice prevention , biological management of caries with best practice prevention or best practice prevention alone . Baseline measures and outcome data ( at review /treatment during three year follow-up ) are assessed through direct reporting , clinical examination including blinded radiograph assessment , and child/parent question naires . The primary outcome measure is the incidence of either pain or infection related to dental caries . Secondary outcomes are ; incidence of caries in primary and permanent teeth , patient quality of life , cost-effectiveness , acceptability of treatment strategies to patients and parents and their experiences , and dentists ’ preferences . Discussion FiCTION will provide evidence for the most clinical ly-effective and cost-effective approach to managing caries in children ’s primary teeth in Primary Care . This will support general dental practitioners in treatment decision making for child patients to minimize pain and infection in primary teeth . The trial is currently recruiting patients .Trial registration Protocol ID : NCTU : IS RCT OBJECTIVES This longitudinal r and omized controlled clinical trial evaluated the longevity of composite resin inlays in single- or multi-surface cavities up to 4 years . METHODS 21 dental students placed 75 Artglass and 80 Charisma composite resin inlays in class I and II cavities in posterior teeth ( 89 adult patients ) luted with dual-curing resin cements .  Clinical evaluation was performed up to 4 years using modified USPHS criteria . RESULTS 87.2 % of Artglass and 76.6 % of Charisma inlays were assessed to be clinical ly excellent or acceptable . Up to the 4-year recall 5 Artglass and 11 Charisma inlays failed mainly because of postoperative symptoms , bulk fracture , and loss of marginal integrity . No significant differences between both composite resin material s could be detected at 4 years for all clinical criteria ( Mann-Whitney U-test , p>0.05 ) . The comparison of restoration performance with time yielded a significant increase in marginal discolouration and postoperative symptoms ( p<0.05 ) , deterioration of surface texture quality , marginal and restoration integrity ( p<0.05 ) for both inlay systems . However , the changes were mainly effects of scoring shifts from alfa to bravo . Small inlays compared to large inlays and premolar restorations compared to molar restorations showed significant better outcome for some of the tested clinical parameters for the Artglass inlays ( p<0.05 ) . For Charisma inlays no such influences were revealed . CONCLUSIONS Clinical assessment of Artglass and Charisma composite resin inlays exhibited an annual failure rate of 3.2 % and 5.9 % that is within the range of published data . Within the limitations of this study indirect composite inlays are a competitive restorative procedure in stress-bearing preparations
However , variability was substantial .
Restoration type , material s , the patient , the operator , the practice environment and type of care system appeared to influence longevity .
Objective To conduct a systematic review of the literature on the longevity of routine dental restorations in permanent posterior teeth , and to identify and examine factors influencing its variability .