Longevity of extensive class II open-sandwich restorations with a resin-modified glass-ionomer cement.
Several new techniques have been introduced for use in the esthetic restoration of posterior cavities to substitute for the presumed toxicity of amalgam. Composite-laminated glass-ionomer cement restorations, the sandwich technique, have been recommended for caries-risk patients. Clinical evaluation of the use of conventional glass-ionomer cements in the open-sandwich restoration has shown a high failure rate. The aim of this study was to evaluate the durability and cariostatic effect of a modified open-sandwich restoration utilizing a resin-modified glass-ionomer cement (RMGIC) in large cavities. The materials consisted of 274 mostly extensive Class II Vitremer/Z100 restorations performed by four dentists in 168 adults. Six experimental groups were investigated. In four groups a thick and in two groups a thin layer of cement was placed. Cavity conditioning before application of the RMGIC self-etching primer was done in 3 groups with polyacrylic acid and in one group with maleic acid; in two groups, only water rinsing was performed. The restorations were evaluated at baseline and after 6, 12, 24, and 36 months according to modified USPHS criteria (van Dijken, 1986). After 3 years, 239 restorations were evaluated. Twelve (5%) were estimated as non-acceptable. Two were replaced, and seven were repaired with resin composite. Tooth fractures were observed in 2.5%. Slight erosion of the RMGIC part was seen in 4%, and in one case operative treatment was indicated. Post-operative sensitivity was reported for 9 teeth. Forty-three percent of the patients were considered as caries-risk patients. Only one restoration showed secondary caries. The three-year results indicated that the modified open-sandwich restoration is an appropriate alternative to amalgam including extensive restorations.
Institution of Oral Biology, Dental School, Umeå University, Sweden.
J W
JW
van Dijken
C
C
Kieri
M
M
Carlén
D000134:Acid Etching, Dental; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002327:Cariostatic Agents; D003188:Composite Resins; D001840:Dental Bonding; D003731:Dental Caries / Q000517:prevention & control; D003733:Dental Caries Susceptibility; D003738:Dental Cements; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000009:adverse effects / Q000145:classification / Q000379:methods*; D003807:Dentin Sensitivity / Q000209:etiology; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012822:Silicon Dioxide; D013997:Time Factors; D014082:Tooth Fractures / Q000209:etiology; D015040:Zirconium
D002327:Cariostatic Agents; D003188:Composite Resins; D003738:Dental Cements; D005899:Glass Ionomer Cements; C084550:Vitremer; C083568:Z100 composite resin; D012822:Silicon Dioxide; D015040:Zirconium