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Biomedical subjects

R Hickel

Publications and source records attributed to R Hickel.

At least 19 recordsLinked to original sources

Efficacy of intraoral topical anesthetics in children.

OBJECTIVES: The literature reports mixed results regarding the efficacy of intraoral topical anesthetics. Only a few studies have been performed in children. Some non-placebo controlled studies have been carried out to compare the efficacy in reducing children's injection pain between different topical anesthetics METHODS: In a randomized, double blind, placebo controlled study with split-mouth design 104 children were enrolled to evaluate the efficacy of four topical anesthetics (Gingicain Spray, Gingicaine Topical Anesthetic, Legecain-Solution, EMLA Crème) when used prior to buccal injections within the conservative treatment of carious upper primary molars. The heart rate change and a Face Pain Scale were used as primary variables. The Visual Analog Scale, the modified Children's Hospital Pain Scale and the Sound-Eyes-Motor Scale were also evaluated. RESULTS: There was no significant difference between the placebo and any corresponding topical anesthetic with regard to the primary variables (HRC and FPS). A significant difference was found in favour of Gingicain Spray and Gingicaine Topical Anesthetic according to secondary variables (VAS, S(E)MS). CONCLUSION: While the secondary variables point to a benefit of the topical anesthetics Gingicain Spray and Gingicaine Topical Anesthetic compared to placebo, the results of the primary variables showed no differences in effectiveness of topical anesthetics and their corresponding placebos.

Administration, Topical↗

In vitro embryotoxicity assessment with dental restorative materials.

OBJECTIVES: Resin (co)monomers may be released from restorative dental materials and can diffuse into the tooth pulp or the gingiva, and can reach the saliva and the circulating blood. Genotoxic potential of some dental composite components has been clearly documented. The genotoxic effects of xenobiotics can represent a possible step in tumor initiation and/or embryotoxicity/teratogenesis. A modified fluorescent mouse embryonic stem cell test (R.E.Tox) was used to test the embryotoxic potential of following dental restorative materials: Bisphenol A glycidylmethacrylate (BisGMA), urethanedimethacrylate (UDMA), hydroxyethylmethacrylate (HEMA), and triethyleneglycoldimethacrylate (TEGDMA), as well as some of their metabolic intermediates 2,3-epoxy-2-methyl-propionicacid-methylester (EMPME), methacrylic acid (MA), and 2,3-epoxy-2-methylpropionic acid (EMPA). METHODS: Mouse embryonic stem (ES) cells stably transfected with a vector containing the gene for the green fluorescent protein under control of the cardiac alpha-myosin heavy chain promoter were differentiated in the presence of various concentrations of the test compounds for 12 days. Fluorescence was measured using the TECAN Safire and values were expressed as percent of control values. To distinguish between cytotoxic and embryotoxic effects, all compounds were tested in a standard MTT assay. RESULTS: HEMA, TEGDMA and EMPME did not influence the differentiation process of ES cells towards cardiac myocytes. No cytotoxic effects were observed at any of the concentration levels tested. Exposure to BisGMA resulted in a 50% decrease in cell survival and a very strong inhibition of cell differentiation at 10(-5)M (p<0.01). Embryotoxic effects were also present at 10(-6) and 10(-7)M (p<0.05). EMPA induced a decrease in ES cell differentiation at 10(-5)M (p<0.01) without cytotoxic effects. No embryotoxic effects were induced at lower concentrations. Exposure to UDMA resulted in a slight decrease of cell differentiation at 10(-5)M (p<0.05). Exposure of cells to MA resulted in an increase of cardiac differentiation up to 150% (p<0.05) at 10(-5)M without cytotoxic effects. CONCLUSIONS: BisGMA induced a significant high embryotoxic/teratogenic effect over a large range of concentration. Therefore attention should be focused on this dental monomer, which should be investigated further by in vivo experiments.

Animals↗

Accuracy of electronic apex locators in comparison to actual length--an in vivo study.

OBJECTIVES: The measurement precision of four electronic apex locators (Root ZX, Morita, Tokyo, Japan; Endy, Loser, Leverkusen, Germany; Justy II, Hager-Werken, Duisburg, Germany; Endox Lysis, Milan, Italy) was examined in the present in vivo study. METHODS: The root canal length of 40 single-rooted and multi-rooted teeth was determined with the four devices prior to tooth extraction. To determine the actual root canal length, the apical third was longitudinally sectioned, the root canal instrument was positioned and the apex was examined using a microscope. RESULTS: The average measurement deviation (+/-SD) in relation to the apical constriction was 0.3 mm (+/-0.6) for the Root ZX, 0.7 mm (+/-1.0) for the Endy, 0.2 mm (+/-0.7) for the Justy II and 1.3 mm (+/-1.7) for the Endox. The limit of +/-0.5 mm from the apical constriction was attained by the Root ZX in 78%, by the Endy in 67%, by the Justy II in 80% and by Endox in 31% of all measurements. CONCLUSIONS: The latest generation of apex locaters provide the clinician with an accurate and useful adjunct for the determination of root canal length.

Dental Pulp Cavity↗

A new mathematical process for the calculation of average forms of teeth.

STATEMENT OF PROBLEM: Qualitative visual inspections and linear metric measurements have been predominant methods for describing the morphology of teeth. No quantitative formulation exists for the description of dental features. PURPOSE: The aim of this study was to determine and validate a mathematical process for calculation of the average form of first maxillary molars, including the general occlusal features. MATERIAL AND METHODS: Stone replicas of 174 caries-free first maxillary molar crowns from young patients ranging from 6 to 9 years of age were measured 3-dimensionally with a laser scanning system at a resolution of approximately 100,000 points. Then, the average tooth was computed, which captured the common features of the molar's surface quantitatively. This new method adapts algorithms both from computer science and neuroscience to detect and associate the same features and same surface points (correspondences) between 1 reference tooth and all other teeth. In this study, the method was tested for 7 different reference teeth. The algorithm does not involve any prior knowledge about teeth and their features. RESULTS: Irrespective of the reference tooth used, the procedure yielded average teeth that showed nearly no differences (less than +/-30 microm). CONCLUSION: This approach provides a valid quantitative process for calculating 3-dimensional (3D) averages of occlusal surfaces of teeth even in the event of a high number of digitized surface points. Additionally, because this process detects and assigns point-wise feature correspondences between all library teeth, it may also serve as a basis for a more substantiated principal component analysis evaluating the main natural shape deviations from the 3D average.

Algorithms↗

Effectiveness of 4 pulpotomy techniques--randomized controlled trial.

Pulpotomy is the accepted therapy for the management of cariously exposed pulps in symptom-free primary molars; however, evidence is lacking about the most appropriate technique. The aim of this study was to compare the relative effectiveness of the Er:YAG laser, calcium hydroxide, and ferric sulfate techniques with that of dilute formocresol in retaining such molars symptom-free. Two hundred primary molars in 107 healthy children were included and randomly allocated to one of the techniques. The treated teeth were blindly re-evaluated after 6, 12, 18, and 24 months. Descriptive data analysis and logistic regression analysis, accounting for each patient's effect by a generalized estimating equation (GEE), were used. After 24 months, the following total and clinical success rates were determined (%): formocresol 85 (96), laser 78 (93), calcium hydroxide 53 (87), and ferric sulfate 86 (100). Only calcium hydroxide performed significantly worse than formocresol (p = 0.001, odds ratio = 5.6, 95% confidence interval 2.0-15.5). In conclusion, calcium hydroxide is less appropriate for pulpotomies than is formocresol.

Calcium Hydroxide↗

Prevention of oral diseases.

The different types of hard- and soft tissues that are involved in the formation of the oral cavity are subject of numerous diseases. Albeit dental caries and periodontitis comprise the most common oral disease entities, also several premalignant and malignant conditions can occur within the oral cavity. There exists are wide armamentarium for the prevention of both, dental caries and periodontitis. Preventive strategies are even more important regarding oral malignancies since specifically these entities commonly provide only poor prognosis if not treated in early stages. The present contribution aims to present the pathogenic background of the most common oral diseases and the most effective methods for their prevention.

Dental Caries↗

Antioxidative vitamins decrease cytotoxicity of HEMA and TEGDMA in cultured cell lines.

OBJECTIVES AND METHODS: In a previous study it was postulated that toxicity of 2-hydroxyethylmethacrylate (HEMA) and triethleneglycoldimethacrylate (TEGDMA) is based on oxidative metabolites. In this study the influence of antioxidative vitamins (including uric acid) on the toxicity of HEMA or TEGDMA was tested. Toxicity of HEMA and TEGDMA was determined in rat alveolar epithelial L2, human malignant A549, and human fibroblast-like 11Lu cells by inhibition of methionine incorporation (as a marker of protein synthesis inhibition) and by determination of glutathione depletion, as well as by measurement of GSSG increase. RESULTS: Toxicity of the composite components HEMA and TEGDMA was demonstrated by GSH depletion as the most sensitive method. Five hundred micromoles per litre Vitamin C or 250 micromol/l Vitamin E were mostly able to decrease toxicity of HEMA and TEGDMA in the cell lines tested. In addition, 250 micromol/l Vitamin A was only effective in L2 cells impairing HEMA toxicity and 250 micromol/l uric acid impairing TEGDMA toxicity as assessed by decreased GSH depletion. In A549 cells only methionine incorporation inhibition but not GSH depletion was significantly affected. By contrast, in 11Lu cells methionine incorporation inhibition was not significantly changed, but GSH depletion was. CONCLUSIONS: The postulated mechanism of HEMA or TEGDMA toxicity based on radical metabolites is supported by the effectivity of the antioxidative substances tested in mitigating toxicity and by the greater susceptibility of the glutathione redox system as compared to protein synthesis inhibition in assessing toxicity.

Animals↗

Polymerization contraction stress in light-cured compomer restorative materials.

OBJECTIVE: The magnitude and kinetics of polymerization contraction stress build-up may be potential predictors of bond failure of adhesive restorations. The present study determined these properties of seven commercial compomers (Dyract, Dyract AP, F2000 Rasant, Hytac, Compoglass F, Luxat, Glasiosite). METHODS: Polymerization shrinkage was generated by 40 s light curing the test materials (800 mW/cm2). The contraction force induced was recorded for 300 s at room temperature (23-24 degrees C) by means of a Stress-Strain-Analyzer (C factor=0.33). Maximum contraction stress (MPa), coefficient of near linear fit of contraction force/time (gradient) and relative force rate (%/s) of each material were compared with that of two hybrid composites (Tetric Ceram, Prodigy). The statistical analysis was conducted by ANOVA (alpha=0.05) and post hoc Tukey's test. RESULTS: No statistically significant differences in the maximum stress between Glasiosite (2.27+/-0.06 MPa), Hytac (2.31+/-0.07 MPa) and Tetric Ceram (2.21+/-0.11 MPa), and between Compoglass F (2.60+/-0.18 MPa) and Prodigy (2.70+/-0.06 MPa) were found. The contraction stress of F2000 Rasant (3.41+/-0.09 MPa) and Luxat (3.33+/-0.08 MPa) were significantly highest, whilst Dyract exhibited the significantly lowest shrinkage stress (1.27+/-0.08 MPa) among the tested materials. SIGNIFICANCE: High contraction stress, early start of stress build-up and rapid contraction force development may lead to failure of bond to tooth structure. This study suggested that the contraction stress and kinetic behavior of compomers are generally similar to those of hybrid composites in a dry condition. Dyract might be superior in maintaining the bond with cavity walls compared to conventional hybrid composites in view of its low shrinkage stress.

Analysis of Variance↗

In vitro evaluation of novel low abrasive air polishing powders.

AIM OF THE STUDY: Though efficient in stain and plaque removal, air polishing is highly abrasive on root cementum or dentin even if working parameters are adjusted to minimize damage. As abrasiveness is also influenced by the physical properties of the powders used, the aim of the study was to evaluate the safety of novel low abrasive air polishing powders in vitro. MATERIAL AND METHODS: Using four novel air polishing powders (A, B, C and D) and a standard sodium bicarbonate (NaHCO3) powder, roots of 126 extracted teeth were air polished under standardized conditions at various working parameter combinations (distance: 2 mm, 4 mm and 6 mm; powder and water setting: low, medium and high) at an angulation of 90 degrees for 20 s. Instrumentation was performed in triplicate; resulting root defects were quantified laser-optically. RESULTS: Mean defect depths after application of powders A, B, C and D were significantly lower than with standard powder (A: 17.9 +/- 10.9 micro m, B: 48.2 +/- 32.7 micro m, C: 92.5 +/- 57.9 micro m, D: 33.9 +/- 19.6 micro m, NaHCO3: 163.1 +/- 71.1 micro m) (Kruskal-Wallis test). Among the experimental powders, D was transported most reliably in the air polishing unit and allowed complete removal of disclosed plaque as assessed on freshly extracted teeth. CONCLUSION: The novel air polishing powder D is of low abrasiveness to root cementum and dentin while being effective in removing dental plaque. Thus, it may be useful for safe and efficient plaque removal on exposed root surfaces.

Air↗

Root defects following air polishing.

AIM: Air-polishing devices (APDs) are highly effective in removing plaque and extrinsic staining. Their application on root surfaces, however, may result in clinically relevant substance removal, limiting the use in patients with periodontitis, where denuded root surfaces are frequently found. Therefore, the purpose of the study was to assess the influence of different working parameters on root damage and to identify those minimizing root damage. MATERIAL AND METHODS: Defect depth and defect volume after instrumentation of roots with an APD (Dentsply Prophy-Jet) using conventional NaHCO3 powder at instrumentation times of 5, 10 and 20 s, combinations of low, medium and high powder and water settings, distances of 2, 4 and 6 mm, and angulations of 45 degrees and 90 degrees were quantified laseroptically. A total of 297 roots were instrumented and parameter combinations were performed in triplicate. The influence of each working parameter on substance loss was determined by multiple regression analysis. RESULTS: Time had the greatest influence on defect volume and depth (beta-weights 0.6 and 0.57, respectively), when compared with powder setting (beta-weights 0.49 and 0.3) and water setting (beta-weights 0.28 and 0.3). Variations in distance affected defect depth (beta-weight 0.44), but not volume (beta-weight 0.04). No major differences were found at 45 degrees and 90 degrees. Various parameter combinations led to maximal defect depths of 473.5 +/- 26.2 micro m within 20 s. CONCLUSION: Root damage varies among combinations of working parameters. Using the APD with the assessed NaHCO3 powder, all parameter combinations led to substantial root damage. Thus, APDs using NaHCO3 may not be safely utilized on exposed root surfaces.

Air Abrasion, Dental↗

Cytotoxicity of ingredients of various dental materials and related compounds in L2- and A549 cells.

Various ingredients of dental materials and related compounds were tested for cytotoxicity in two alveolar epithelial cell lines (L2 and A549 cells). Release of lactate dehydrogenase (LDH) from cells was measured after incubation with the test substances for time intervals up to 48 h and expressed as percentage of total LDH content of lysed cells. Furthermore, the glutathione content of cells was determined in the nonmalignant L2 cells. Additionally, cell viability was assessed by microscopic examination. The highest cytotoxicity was observed with mercury compounds (methylmercuric chloride and mercury dichloride) in the range of 5-20 micromol/l. The composite components 2-hydroxyethylmethacrylate (HEMA) and triethleneglycoldimethacrylate (TEGDMA) showed time- and concentration-dependent effects of cytotoxicity at high concentrations (about 1-5 mmol/l). A time dependence for GSH decrease was mainly found for the composite components up to 12 h of cellular exposure. L2 cells were more sensitive to both mercury and composite compounds than A549 cells. Gold compounds (sodiumaurothiomalate and gold particles < 1.5 microm) did not produce any sign of toxic reactions. A time-dependent increased toxicity in pulmonary cell lines was found for the composite components HEMA and TEGDMA, but not for mercury and gold compounds.

Animals↗

Evaluation of thermal cycling and mechanical loading on bond strength of a self-etching primer system to dentin.

OBJECTIVE: The aim of this study was to evaluate the in vitro durability and fracture modes of the tooth-resin interface following thermal cycling, fatigue load cycling (FLC) and micro-tensile bond strength testing (MTBS). METHODS: Twenty-four human molars were divided into two groups. In group A, coronal dentin was ground flat with #600-grit SiC paper, Clearfil Linerbond.2V (LB.2V) adhesive was applied and a crown fabricated with Clearfil AP-X resin composite. Samples were loaded in the FLC simulator and thermal cycle device. In group B, Class I cavities were prepared with a diamond bur and the cavity restored with LB.2V/AP-X. Samples were simultaneously subjected to FLC and thermal cycling. After storage of the specimens in water for 1 week, MTBS tests were performed, and fracture modes examined by SEM. RESULTS: For group A, MTBS were approximately 40 MPa with cohesive failures in the bonding resin of all specimens. Neither thermal nor mechanical stressing altered bond strengths on flat dentin surfaces. In group B, MTBS in the unstressed control group was 21 MPa with cohesive failures in the resin. As both thermal and mechanical stresses increased, there was a significant decrease in bond strength (16 MPa, P<0.05) and the fractures were seen in the resin-dentin interface and hybrid layer. SIGNIFICANCE: Surface preparation, C-factor, cavity depth, the dentin substrate and character of the smear layer strongly influence the bond strength values after thermal and fatigue loading. The FLC simulator in combination with MTBS testing provides meaningful in vitro evaluation of dentin bonding durability.

Acid Etching, Dental↗

Biological clearance of HEMA in guinea pigs.

No toxicokinetic data are available about the dental composite component 2-hydroxyethylmethacrylate (HEMA) in vivo in the literature. Therefore, the excretion of HEMA in feces and urine in vivo and, using the pendular perfusion technique with segments of jejunum and colon, in the biliary and enteric excretion in situ were investigated in anesthetized guinea pigs. In the in situ experiments, guinea pigs (n = 4) received HEMA (0.02 mmol/kgbw labelled with a tracer dose 14C-HEMA 0.3 kBq/gbw) injected into the jugular vein. In the in vivo experiments, guinea pigs (n = 4) received HEMA (+ 14C-HEMA, same dose as above) via gastric tube. Urine and feces were collected for 24h. In the in situ experiments, organs from guinea pigs were removed 60 min after the beginning of the experiment, and then the 14C-radioactivity was measured. During the 60 min perfusion period the calculated amount of 14C-activity excreted into the total jejunum and colon was 6.0 +/- 1.0% and 2.7 +/- 0.7% of the dose administered, respectively (mean +/- sem). Of the 14C-HEMA dose, 5.3 +/- 0.3% was found in the bile. Significantly (p < 0.05) higher bile/blood concentration ratios were found at 10-40 min after the injection of HEMA, as compared to the ratio at 60 min. The total 14C-recovery in all organs tested was 20.0 +/- 2.6%. During 24h the amounts of 14C-activity excreted in the feces and urine were 1.1 +/- 0.1% or 17.1 +/- 1.50% of the dose administered, respectively (mean +/- sem). The total 14C-recovery in all organs tested was 11.6 +/- 0.6%. In a second series of in vivo experiments, exhaled air from the animals was captured during the 24h experimental period. 14C was exhaled to 63.6 +/- 2.11% of the administered 14C-HEMA dose (mean +/- sem; n = 4) as 14C-carbondioxide. The results indicate a rapid clearance of 14C-HEMA and/or 14C-HEMA metabolite(s) from the organism, exhalation being the major route of elimination.

Animals↗

Diagnostic features and pedodontic-orthodontic management in dentinogenesis imperfecta type II: a case report.

Dentinogenesis imperfecta type II, also known as hereditary opalescent dentin, is an isolated inherited condition transmitted as an autosomal dominant trait affecting the primary and permanent dentition. The combined pedodontic-orthodontic management of a 4-year-old child is described. Following orthodontic analysis to encourage a favourable growth outcome, treatment comprised restoration of the primary teeth with stainless steel crowns and composite crowns. Differential diagnosis and alternative therapies, including orthodontic considerations, are discussed.

Cephalometry↗

Interdisciplinary rehabilitation and prevention in a case with early and extensive loss of primary teeth.

The oral rehabilitation of a five-and-a-half year old boy is presented, who had an almost complete dental loss due to caries at the age of three years. Partial and complete dentures were provided to restore function and aesthetics, to prevent psychological and speech disorders and to reduce the severity of malocclusion and loss of space in the permanent dentition. The long-term treatment planning objectives are discussed in relation to orthodontic considerations, the establishment of the permanent dentition and the expectations for future growth. This case demonstrates the requirement for interdisciplinary involvement in the treatment planning for children with extensive tooth loss.

Child, Preschool↗

Biological clearance of TEGDMA in guinea pigs.

The excretion of the dental composite component triethylene glycol dimethacrylate (TEGDMA) in feces and urine in vivo and, using the pendular perfusion technique with segments of jejunum and colon, the biliary and enteric excretion in situ were investigated in anesthetized guinea pigs. In the in situ experiments guinea pigs (n = 4) received TEGDMA (0.02 mmol/kg body weight labelled with a tracer dose 14C-TEGDMA 0.7 kBq/g body weight) injected into the jugular vein. In the in vivo experiments guinea pigs (n = 4) received TEGDMA (+14C-TEGDMA; same dose as above) via a gastric tube. Urine and feces were collected for 24 h. In the in situ experiments organs were removed from the guinea pigs 60 min after the beginning of the experiment, and the 14C radioactivity measured. During the 60-min perfusion period the calculated amount of 14C radioactivity excreted into the total jejunum and colon was 0.9 +/- 0.2% and 1.9 +/- 0.1% of the dose administered, respectively (means +/- SEM). Of the 14C-TEGDMA dose, 3.7 +/- 0.2% was found in the bile. A significantly (P < 0.05) higher bile/blood concentration ratio was found 10 min after injection of TEGDMA as compared with the ratios at 20 to 60 min. The following 14C activities (percent of the dose) per total organ were found in guinea pigs (in situ experiment; means +/- SEM): 6.9 +/- 1.7 (muscle), 3.9 +/- 0.5 (kidney), 3.3 +/- 0.1 (skin), 1.4 +/- 0.1 (blood), and 1.2 +/- 0.1 (liver). The 14C activity in all other organs was < 0.4%. The total 14C recovery in all organs tested was 17.5 +/- 1.8%. Over 24 h the amounts of 14C activity excreted in the feces and urine were 0.5 +/- 0.1% and 14.7 +/- 1.8% of the dose administered, respectively (means +/- SEM). The following 14C activities (percent of the dose) per total organ or contents of organs were found (means +/- SEM): 1.4 +/- 0.3 (liver), 0.8 +/- 0.3 (muscle), 0.5 +/- 0.1 (skin), and 0.5 +/- 0.1 (contents of cecum). The 14C activity in all other organs was < 0.2%. The total 14C recovery in all organs tested was 3.9 +/- 0.9%. In a second series of in vivo experiments exhaled air from the animals was captured during the 24-h experimental period. Of the administered dose, 61.9 +/- 4.6% of the 14C (means +/- SEM; n = 4) was exhaled as 14C-carbon dioxide. The results indicate a rapid clearance of 14C-TEGDMA and/or 14C-TEGDMA metabolite(s) from the organism and exhalation is the major route of elimination.

Animals↗

Class V lesions restored with four different tooth-colored materials--3-year results.

The aim of this study was to compare the treatment results using four different types of tooth colored materials for restoring class V lesions. A total of 197 class V restorations (n = 197) were placed by one dentist in 37 patients on incisors, canines and premolars. The fillings were placed due to different indications: erosion/non-carious cervical defects (n = 69), primary carious lesions (n = 57), and for replacing defective existing fillings (n = 71). The teeth were assigned on a random basis to four groups for restoration with either a composite (group 1: n = 36; Tetric, Vivadent), or a polyacid-modified resin composite (group 2: n = 79; Dyract, Dentsply), or one of two different resin-modified glass ionomer cements (group 3: n = 51, Fuji II LC,GC; group 4: n = 31, Photac-Fil, Espe). The restorations were evaluated by a single-blind design, according to a modified USPHS system 36 months following placement. Statistical analysis was completed with the Pearson Chi-square test for comparing the results of the four groups (P < 0.05). Additionally, the survival rates were analyzed with the Kaplan-Meier estimator and the Log-rank test (P < 0.05). The Alpha ratings were as follows (Tetric/Dyract/Fuji II LC/Photac Fil): shade match (86%/77%/58%/40%), surface texture (81%/83%/16%/9%), marginal integrity (enamel) (73%/67%/61%/61%), marginal integrity (dentin) (86%/70%/55%/61%), marginal discoloration (enamel) (59%/44%/58%/52%), marginal discoloration (dentin) (82%/84%/71%/48%), anatomic contours (91%/83%/39%/35%). One Tetric restoration, five Dyract restorations, two Fuji II LC restorations and three Photac restorations were dislodged within the study period. The retention of the restorations showed no significant difference among the four materials. However, the clinical performance of the restorations retained over the 3-year period showed distinct differences for the four materials. The best clinical performance was observed for the resin composite, whereas the quality of the Dyract restorations without enamel etching was worse. The poorest results were obtained for the restorations with the resin-modified glass ionomers.

Adult↗