title: Seal, replacement or monitoring amalgam restorations with occlusal marginal defects? Results of a 10-year clinical trial.
abstract: The aim of this prospective and blind clinical trial was to assess the effectiveness of sealing localized marginal defects of amalgam restoration that were initially scheduled to be replaced. A cohort of twenty six patients with 60 amalgam restorations (n=44Class I and n=16Class II), that presented marginal defects deviating from ideal (Bravo) according to USPHS criteria, were assigned to either sealing or replacement groups: A: sealing n=20, Replacement n=20, and no treatment (n=20). Two blind examiners evaluated the restorations at baseline (K=0.74) and after ten years (K=0.84) according with USPHS criteria, in four parameters: marginal adaptation (MA), secondary caries (SC), marginal staining (MS) and teeth sensitivity (TS). Multiple comparison of restorations degradation/upgrade was analyzed by Friedman test and the comparisons within groups were performed by Wilcoxon test. After 10 years, 44 restorations were assessed (73.3%), Group A: n=14 and Group B: n=16; and Group C: n=14 sealing and replacement amalgam restorations presented similar level of quality in MA (p=0.76), SC (p=0.25) and TS (p=0.52), while in MS (p=0.007) presented better performance in replacement group after 10-years. Most of the occlusal amalgam restorations with marginal gaps showed similar long term outcomes than the restorations were sealed, replaced, or not treated over a 10-year period. Most of the restorations of the three groups were clinically acceptable, under the studied parameters. All restorations had the tendency to present downgrade/deterioration over time.
authors.affiliation: Cariology, Dental School, Universidad Mayor, Santiago, Chile. Electronic address: gmoncada@adsl.tie.cl.
authors.forename: G
authors.initials: G
authors.lastname: Moncada
authors.affiliation: Operative Dentistry, Dental School, Universidad de Chile, Chile.
authors.forename: E
authors.initials: E
authors.lastname: Fernández
authors.affiliation: Operative Dentistry, Dental School, Universidad de Chile, Chile.
authors.forename: K
authors.initials: K
authors.lastname: Mena
authors.affiliation: Operative Dentistry, Dental School, Universidad de Chile, Chile.
authors.forename: J
authors.initials: J
authors.lastname: Martin
authors.affiliation: Operative Dentistry, Dental School, Universidad de Chile, Chile.
authors.forename: P
authors.initials: P
authors.lastname: Vildósola
authors.affiliation: Operative Dentistry, Dental School, Universidade Estatal de São Paulo, UNESP, Araraquara, Brazil.
authors.forename: O B
authors.initials: OB
authors.lastname: De Oliveira Junior
authors.affiliation: Operative Dentistry, Dental School, Universidad de Chile, Chile.
authors.forename: J
authors.initials: J
authors.lastname: Estay
authors.affiliation: Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, University of Florida, Gainesville, FL, USA.
authors.forename: I A
authors.initials: IA
authors.lastname: Mjör
authors.affiliation: Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, University of Florida, Gainesville, FL, USA.
authors.forename: V V
authors.initials: VV
authors.lastname: Gordan
mesh_terms: D000328:Adult; D003723:Dental Amalgam / Q000627:therapeutic use*; D018772:Dental Marginal Adaptation; D003793:Dental Restoration, Permanent / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies
chemical_list: D003723:Dental Amalgam
keywords: Amalgam; Clinical trail; Marginal gaps; Replacement