Cork University Dental School and Hospital - Journal Articles

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    A randomised controlled study on the effects of different surface treatments and adhesive self-etch functional monomers on the immediate repair bond strength and integrity of the repaired resin composite interface
    (Elsevier Ltd, 2019) Martos, Renata; Hegedüs, Viktória; Szalóki, Melinda; Blum, Igor R.; Lynch, Christopher D.; Hegedüs, Csaba; European Regional Development Fund; Hungarian Government
    Objectives: To evaluate the effects of different surface conditioning methods on the immediate repair bond strength and integrity of the repaired composite interface. Methods: One hundred and five resin composite blocks made of a nanohybrid resin composite were randomly assigned to one of the following surface conditioning groups (n = 15/group): Group 1: Gluma Self Etch™ adhesive system, Group 2: Tokuyama Bond Force II™ adhesive system, Group 3: non-roughened and non-conditioned surfaces, Group 4: sandblasting and Gluma Self Etch™, Group 5: sandblasting and Tokuyama Bond Force II™, Group 6: sandblasting only. A positive control group was also used. Resin composite identical to the substrate was applied and the repaired specimens were subjected to shear bond strength (SBS) testing. Representative samples from all groups were subjected to scanning electron microscopy and surface profilometry to determine their mode of failure. The data were analysed statistically using Analysis of Variance (ANOVA) and two independent sample t-test (α = 0.05). Results: The mean SBS of all test groups ranged between 1.92 and 5.40 MPa and varied with the degree of composite surface roughness and the type of adhesive system employed. Significantly highest SBS values (5.40 ± 0.36 MPa) were obtained in Group 5 (p = 0.017) which were comparable to the coherent strength of the resin composite in the positive control group (p > 0.05). Conclusions: Under the tested conditions, significantly greater SBS of repaired resin composite was achieved when the substrate surface was conditioned by sandblasting followed by the application of the Tokuyama Bond Force II™ adhesive system. Clinical significance: Effecting a repair of a nanohybrid composite restoration with sandblasting and the application of TBF II would seem to enhance the interfacial bond strength and integrity of the repaired resin composite interface. Clinical trials are necessary to determine the usefulness of this technique. © 2019 Elsevier Ltd
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    An RCT of atraumatic restorative treatment for older adults: 5 year results
    (Elsevier Ltd, 2019) da Mata, C.; McKenna, G.; Anweigi, L.; Hayes, M.; Cronin, M.; Woods, N.; O'Mahony, D.; Allen, P. F.
    Objectives: to compare the survival of ART and a conventional restorative technique (CT) for restoring carious lesions in older adults after 5 years. Methods: In this parallel randomised controlled clinical trial, 219 independently-living adults were recruited from a dental hospital/community and a geriatric day hospital. Ninety-nine patients who met the inclusion criteria and presented with carious lesions were randomly allocated to receive either ART or conventional restorations (anaesthesia, rotary instruments and resin-modified glass ionomer). The status of restorations was assessed 6 months, 1, 2 and 5 years after restoration placement. Estimates of cumulative survival were calculated for each interval between assessments and a Cox Proportional Hazards (PH) model was fitted to the interval-censored survival time. Results: Three hundred restorations (ART n=142; CT n=158) were placed on 99 patients, 46 males and 53 females, with a mean age of 73.2, SD: 6.8 (65–90 yrs). After 5 years, ART and CT presented cumulative probability of survival of 85% and 79% (p=0.8095), respectively. Conclusions: ART presents survival rates comparable to a conventional technique, when treating older adults after 5 years. The ART approach could be a useful tool to provide dental care for older adults particularly in the nonclinical setting. (Trial Registration number: ISRCTN 76299321). Clinical Relevance: This study shows that ART presents survival rates comparable to conventional techniques to treat carious lesions in older patients after 5 years. It is well accepted by this age cohort, and therefore could be an alternative to treat the elderly, especially those who are homebound or cannot attend the dentist. © 2019 Elsevier Ltd
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    Atraumatic vs conventional restorative treatment for root caries lesions in older patients: Meta‐ and trial sequential analysis
    (John Wiley & Sons, Inc., 2019-05-24) Göstemeyer, Gerd; da Mata, Cristiane; McKenna, Gerald; Schwendicke, Falk
    Objectives: We aimed to appraise the comparative clinical efficacy of atraumatic restorative treatment (ART) versus conventional restorative treatment (CT) using a meta-analysis, and assessed the robustness of evidence by trial sequential analysis (TSA). Background: Due to its simplified clinical approach, ART may be advantageous over CT for restoration of root caries lesions in institutionalised older patients. Methods: Three electronic databases (PubMed, Embase and Cochrane CENTRAL) were screened, and hand searches and cross-referencing performed to identify randomised controlled trials reporting on survival of ART vs CT for restoration of root caries in older patients. Trial selection, data extraction and risk of bias assessment were performed by two independent reviewers. ART and CT were compared using fixed- or random-effects pairwise meta-analysis for per-protocol (PP), intention-to-treat (ITT) and best-case scenarios. TSA was used to control for risk of random errors. Results: A total of 235 studies were identified, and three trials involving 130 patients (463 restorations) were included. Risk of bias was high or moderate in all but one trial. ART was associated with a significantly increased risk of failure (OR [95% CI] 2.06 [1.06/4.00]) in PP- but not in ITT analysis (1.36 [0.92/2.02]). Analyses for best-case scenarios found great uncertainty introduced by attrition. No firm evidence was reached according to TSA. Conclusions: For restoration of root caries, there is insufficient data to clearly rule out whether differences between ART and CT exist. Limited available data indicate there might be an increased risk of failure for ART.
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    Consumption frequency of added sugars and UK children's dental caries
    (John Wiley & Sons, Inc., 2018-08-20) Hong, Jialan; Whelton, Helen; Douglas, Gail; Kang, Jing
    Objectives: To examine the association between consumption frequency of foods and drinks with added sugar and dental caries experience in the permanent teeth of 12- and 15-year-old children in England, Wales and Northern Ireland, using the Children's Dental Health Survey 2013 (CDHS) data. Methods: Four thousand nine hundred and fifty children aged 12 and 15 have the following information available: daily consumption frequency of foods and drinks with added sugar, tooth-brushing frequency, dental attendance, and water-drinking frequency. The children's dental caries experience was available as a DMFT score (number of decayed, missing, filled permanent teeth). A zero-inflated negative binomial model (ZINB) was used to fit the DMFT score. Results: Lower socioeconomic status (SES), nonregular dental check-ups, and low water-drinking frequency were associated with higher consumption frequency of added sugar (all P < 0.05). The consumption frequency of both drinks and foods with added sugar also differed by region (P < 0.001), and children who more frequently consumed foods with added sugars also consumed drinks with added sugars more often (P < 0.001). Using the Zero-Inflated Negative Binomial model, DMFT scores were not associated with consumption frequency of added sugars for children with caries (DMFT > 0), but the chance of being free of obvious caries (DMFT = 0) was lower for children with high frequency (≥4) of sugar-added foods than for children reported to have a sugar-free diet (OR = 0.5, 95% CI [0.3, 0.8]). Conclusions: Consumption frequency of added sugars was associated with dental caries and a number of child demographic and lifestyle characteristics. Children who consume foods and drinks with added sugar more frequently are more likely to develop dental caries, but higher consumption frequency of drinking water in fluoridated areas might reduce dental caries. The findings add to the evidence for the association between children's dental caries and added sugar consumption.
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    Resin-modified glass ionomer cement vs composite for orthodontic bonding: A multicenter, single-blind, randomized controlled trial
    (Elsevier Inc., 2019-01) Benson, Philip E.; Alexander-Abt, Jonathan; Cotter, Stephen; Dyer, Fiona M. V.; Fenesha, Fatma; Patel, Anjli; Campbell, Ciara; Crowley, Niamh; Millett, Declan T.; Sheffield Hospitals Charity
    Introduction: In this study, we aimed to compare the incidence of new demineralized lesions and bond failures between 2 groups of participants wearing fixed orthodontic appliances bonded with either light-cured resin-modified glass ionomer cement or light-cured composite. Methods: This trial was a multicenter (6 centers: 2 teaching hospitals, 4 specialist orthodontic practices), single-blinded, randomized controlled trial with 2 parallel groups. Patients aged 11 years or older, in the permanent dentition, and about to start fixed orthodontic treatment in these 6 centers were randomly allocated to have either resin-modified glass ionomer cement or light-cured composite for bonding brackets, forward of the first molars. Pretreatment and day-of-debond digital photographic images were taken of the teeth and assessed by up to 5 clinical and 3 lay assessors for the presence or absence of new demineralized lesions and the esthetic impact. The assessors were masked as to group allocation. Results: We randomized 210 participants, and 197 completed the trial. There were 173 with complete before-and after-digital images of the teeth. The incidence of new demineralized lesions was 24%; but when the esthetic impact was taken into account, this was considerably lower (9%). There was no statistically significant difference between the bracket adhesives in the numbers with at least 1 new demineralized lesion (risk ratio,1.25; 95% confidence interval, 0.74-2.13; P = 0.403) or first-time bracket failure (risk ratio,0.88; 95% confidence interval, 0.67-1.16; P = 0.35). There were no adverse effects. Conclusions: There is no evidence that the use of resin modified glass ionomer cement over light-cured composite for bonding brackets reduces the incidence of new demineralized lesions or bond failures. There might be other reasons for using resin modified glass ionomer cement.