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Noncarious cervical lesions in adults: prevalence and occlusal aspects.

BACKGROUND: The factors that induce the formation of noncarious lesions are not understood fully, particularly those that are related to occlusal aspects. The authors conducted a study to evaluate the prevalence of noncarious cervical lesions in adults and their association with occlusal aspects. METHODS: The authors examined 70 people (35 men and 35 women) aged 25 to 45 years to determine the presence and type of noncarious cervical lesions, wear facets, tooth contacts in maximal intercuspal position, and lateral and protrusive movements. The assessment involved a questionnaire and clinical examination. RESULTS: Among the teeth the authors evaluated, 17.23 percent had cervical lesions, 80.28 percent of which had wear facets (P < .01). The authors found a significant difference between the prevalence of noncarious lesions and the presence of wear facets (P = .0484). CONCLUSIONS: The authors found that cervical lesions were related significantly to wear facets. These findings strengthen evidence for the role of occlusal forces as an etiologic factor for noncarious lesions. CLINICAL IMPLICATIONS: The presence of wear facets should be considered in the treatment of noncarious cervical lesions.

Adult↗

Predictors of non-carious loss of cervical tooth tissues.

This Predictor Variables study is designed to determine which one of 11 factors evaluated may be correlated to Non-carious Loss of Cervical Tooth Tissues (NLCTT) using subjects with and without NLCTT. The ultimate objective is to successfully predict the path toward risky behaviors and reduce the incidence of NLCTT.

Acids↗

1-year clinical evaluation of Compoglass and Fuji II LC in cervical erosion/abfraction lesions.

PURPOSE: This study was undertaken to compare the clinical performance of a polyacid-modified resin-based composite and a resin-modified glass-ionomer restorative material over 1 year. MATERIALS AND METHODS: Thirty-four pairs of restorations of Compoglass (C) and Fuji II LC (F) were placed in 31 patients, with no patient receiving more than two pairs, and with materials assigned at random within the pairs. Caries-free cervical erosion/abfraction lesions of the facial surface were restored without tooth preparation according to manufacturers' instructions, except that tooth structure to be restored was etched with 37% phosphoric acid prior to placement of Compoglass. Restorations were clinically evaluated by two blinded examiners at baseline, 6 months, and 1 year, using modified Ryge/USPHS criteria. Restorations receiving a score of "Charlie" in either retention or secondary caries were classified as failed restorations. The incidence of failures was statistically analyzed as a pairwise comparison, using an exact binomial test. RESULTS: Thirty-one pairs of restorations were available for recall at 1 year. The percentage of Alfa scores for each material in each category were: Retention (C = 84%, F = 100%), Color match (C = 81%, F = 100%), Marginal discoloration (C = 78%, F = 97%), Secondary caries (C = 88%, F = 100%), Anatomic form (C = 92%, F = 100%), and Marginal adaptation (C = 26%, F = 46%). Except for the failed restorations, no other Charlie scores were assigned. A significant difference in the incidence of failed restorations was found between the materials (P = 0.01).

Adult↗

Evaluation of esthetic parameters of resin-modified glass-ionomer materials and a polyacid-modified resin composite in Class V cervical lesions.

OBJECTIVE: The purpose of this study was to compare the esthetics of 3 resin-modified glass-ionomer materials and 1 polyacid-modified resin composite to the esthetics of a conventional glass-ionomer control material. METHOD AND MATERIALS: One hundred eighty-seven Class V cervical restorations were observed clinically over 18 months. The esthetic index system that was used evaluated color match, translucency or opacity, and surface roughness. RESULTS: The tested materials behaved very dissimilarly and inconsistently. In general, the esthetic results of the resin-modified glass-ionomer materials and the polyacid-modified resin composite were far from optimal. The esthetic appearance of restorations seriously deteriorated during clinical service, mainly because of discoloration of margins, changes in translucency and opacity, and rapidly appearing roughness or dullness on the surface. Both the resin-modified glass-ionomer materials and the polyacid-modified resin composite evaluated in this study performed better esthetically than did the conventional glass-ionomer material. CONCLUSION: Indications for these combination materials are limited to areas where esthetics is not a primary concern but where their ease of application may guarantee a more durable functional result.

Acrylic Resins↗

Two-year clinical performance of a polyacid-modified resin composite and a resin-modified glass-ionomer restorative material.

This study compared the clinical performance of a polyacid-modified resin composite and a resin-modified glass-ionomer restorative material over two years. Thirty-four pairs of restorations of Compoglass and Fuji II LC were placed in caries-free cervical erosion/abfraction lesions without tooth preparation. Restorations were clinically evaluated at baseline, 6, 12, 18 and 24 months using modified Ryge/USPHS criteria. A significantly higher incidence of failed restorations was found with the polyacid-modified resin composite (p < 0.05).

Adult↗

Two-year clinical performance of Class V resin-modified glass-lonomer and resin composite restorations.

While a one-year report had been previously published, this study was undertaken to evaluate the clinical performance and appearance of a resin-modified glass ionomer and a resin composite over two years. Thirty-seven pairs of restorations of FujI II LC and Z 250/Single Bond were placed in caries-free cervical erosion/abfraction lesions without tooth preparation. Restorations were clinically evaluated at baseline, 6, 12, 18 and 24 months using modified Ryge/USPHS criteria. No statistically significant difference (p = 0.13) was observed in the overall performance of the materials. Retention was 96% for the resin-modified glass ionomer and 81% for the resin composite, with no additional restorations of either material lost after one year. As previously reported, retention of the Z 250 restorations at six months was below the minimum specified in the ADA Acceptance Program for Dentin and Enamel Adhesives. The resin composite restorations generally had a better appearance, with a 100% alpha rating in color match, versus 85% for the resin-modified glass ionomer.

Adult↗

Effect of resin viscosity and enamel beveling on the clinical performance of Class V composite restorations: three-year results.

This study evaluated the effect of the elastic modulus and margin configuration on the clinical performance of resin-based composite restorations in Class V non-carious defects. One hundred and five cervical non-carious defects on buccal surfaces of canines and premolars were included in this study. Defects were randomly divided into three Groups and restored according to the following techniques: Group 1--no enamel bevel was placed and the defect was restored with a microfilled resin-based composite (Durafill VS); Group 2--the enamel margin was beveled and the defect restored as in Group 1; Group 3-the enamel margin was beveled and the defect was restored with a flowable resin-based composite (Natural Flow). Each group comprised 35 lesions. A total-etch, one-bottle adhesive (One-Step) was used in all groups. Retention rate, pre- and post-operative sensitivity, marginal discoloration and secondary caries were determined over a three-year period and the data were analyzed statistically. At six months post-insertion, the restorations placed with beveled enamel margins resulted in 100% retention regardless of the composite used compared to a 66% retention of the non-beveled margins. At two and three years, no significant difference in retention rate was found among the three groups. Post-operative sensitivity, marginal discoloration and secondary caries were not affected by enamel beveling and restorative material. Beveled enamel margins resulted in significantly better clinical retention in the first six months only. Enamel beveling and composite viscosity appeared to not significantly affect the clinical performance of Class V non-retentive composite restorations after three years.

Adult↗

Five-year double-blind randomized clinical evaluation of a resin-modified glass ionomer and a polyacid-modified resin in noncarious cervical lesions.

PURPOSE: The aim of this double-blind randomized study was to compare the clinical performance of a resin-modified glass ionomer (Vitremer, 3M) and a polyacid-modified resin (Dyract, Dentsply DeTrey) in noncarious Class V restorations after 5 years. MATERIALS AND METHODS: Twelve patients, having at least one pair of equal-sized noncarious cervical lesions under occlusion and a mean age of 40 years (range 19 to 63 years; median 41), were enrolled in this study. A total of 32 restorations (16 with each material) were placed according to the manufacturers' instructions by two calibrated operators. Two other independent examiners evaluated the restorations at baseline and after 5 years according to the USPHS criteria. The assessment criteria were: retention, anatomical form, marginal adaptation and marginal discoloration, color match, surface texture, and secondary caries. Statistical analysis was conducted using Fisher's exact test (alpha = 0.05). RESULTS: No secondary caries was detected with either material. The retention rate for Vitremer (93%) and for Dyract (78.5%) did not differ significantly (p > 0.05). Regarding anatomical form, only two restorations of each material were recorded as bravo. In terms of marginal adaptation, 38.5% of Dyract restorations were rated alpha and 61.5% bravo, while 84.6% of Vitremer restorations were rated alpha and only 15.4% bravo (p < 0.05). For marginal discoloration, 18.2% of Dyract restorations and 84.6% of Vitremer restorations were rated alpha, with the remaining rated bravo. 86% of Vitremer restorations were rated as bravo and 23% alpha for both surface texture and color match. All Dyract restorations were classified as alpha regarding surface texture, and only two Dyract restorations (18.2%) were classified as bravo in the color match item. CONCLUSION: The marginal adaptation of the RMGIC (Vitremer) was significantly better, the marginal discoloration lower, and the retention rate higher (though not significantly) than that of the PMRC (Dyract) after 5 years in situ. Dyract performed better in terms of surface texture and color match in noncarious Class V restorations after 5 years.

Adult↗

Durability of three simplified adhesive systems in Class V non-carious cervical dentin lesions.

PURPOSE: To investigate the durability of three simplified systems in Class V non-carious abrasion/erosion lesions. METHODS: 144 non-carious cervical dentin lesions were restored either with Clearfil Liner Bond 2, a 2-step self-etching primer (n = 46), One Coat Bond, a one bottle total-etch system applied with one coat (n = 46), or Prompt-L-Pop, a 1-step self-etching primer ("all-in-one") (n = 52), in 90 individuals. Ninety-eight of the lesions showed sclerotic dentin and 46 were non-sclerotic. Sixty-one were slightly roughened with a diamond bur before conditioning. The restorations were evaluated every 6 months during a 2-year period with slightly modified USPHS criteria. RESULTS: All except three restorations were evaluated over 2 years. The cumulative loss rates for Clearfil Liner Bond 2, One Coat Bond and Prompt-L-Pop were at 6 months: 4.3, 2.2 and 3.9%, at 18 months: 4.3, 10.9 and 15.4% and at 24 months: 8.7, 13.0 and 21.2%, respectively. The cumulative loss rates of the materials in sclerotic lesions (15.7%) versus non-sclerotic lesions (14.0%) were not significanty different. Restorations placed with a diamond bur-roughened lesions showed a loss rate of 14.5%, while for the non-roughened lesions the frequency was 14.8%.

Aged↗

Noncarious cervical lesions among a non-toothbrushing population with Hansen's disease (leprosy): initial findings.

OBJECTIVE: The purpose of this preliminary investigation was to examine the presence of noncarious cervical lesions (NCCLs) among a convenience sample of non-toothbrushing subjects with Hansen's disease (leprosy). METHOD AND MATERIALS: A cross-sectional sample of 102 non-toothbrushing subjects (20 to 77 years of age) was examined. The clinical parameter of interest for this study was the presence or absence of NCCLs and their probable etiology as it relates to the subjects' diet, occlusion, and use of medication. Subjects were examined clinically and interviewed according to study protocol. RESULTS: NCCLs were found in 48 subjects (47% of the studied sample). Widespread consumption of acidic foods and beverages acting as corrodents, signs of parafunction, and use of medication that causes xerostomia were also noted. Thus, all may be contributing factors in the etiology of NCCLs in this population. CONCLUSION: This preliminary report suggests that toothbrush/dentifrice abrasion was not a factor in the etiology of NCCLs in the population studied. The authors intend to expand their study among these non-toothbrushing

Adult↗

One-year clinical evaluation of two resin composites, two polymerization methods, and a resin-modified glass ionomer in non-carious cervical lesions.

AIM: The aim of this study was to examine clinically relevant data on four restorative procedures for non-carious cervical lesions using United States Public Health Service (USPHS)-compatible clinical and photographic criteria and to compare different methods of analyzing clinical data. METHODS AND MATERIALS: Fourteen patients with at least one or two pairs of non-carious lesions under occlusion and a mean age of 50 were enrolled in this study. A total of 56 restorations (14 with each material) were placed by three experienced, calibrated dental practitioners. Two other experienced and calibrated practitioners, under single-blind conditions, followed up on all restorations for a period of one year. Three materials were randomly placed: a micro-hybrid composite with two polymerization methods (G1 and G2), a flowable micro-hydrid composite (G3), and a resin-modified glass ionomer (G4). Statistical analysis was performed using the Kruskall-Wallis test (p<0.05) and a Mann-Whitney U modified test with a corrected significance level. RESULTS: At the one year evaluation time, there were no restorations with secondary caries and the retention rates in G1 (IntenS with a hard polymerization), G2 (IntenS with a soft polymerization), G3 (Filtek flow), and G4 (Fuji II LC) were 85.7% (two losses), 92.8% (one loss), 100%, and 100%, respectively. The total visual comparison of the results at baseline (15 days later) showed significant differences only with the clinical acceptance criterion: G1 was different from G2, with a soft polymerization device (p<0.05). In terms of surface quality at one year, G1, G2, and G3 exhibited a statistically significant difference from G4, p<0.05. The digital analysis at baseline showed significant differences only with the clinical acceptance criterion: G1=G2 was different from G3=G4, p<0.05. At one year, only the microporosity criterion showed any statistical differences: G1=G2=G3 was different from G4, p<0.05. CONCLUSIONS: The resin-modified glass ionomer was easier to use and had a high retention rate, but it failed in terms of surface quality (visual mode) and porosity (digital mode) criteria compared to the others groups. Overall results showed no difference between groups G1 (hard-polymerized) and G2 (soft-polymerized), and only G1 was affected by the marginal edge (p<0.03) and integrity criteria (p<0.02) at one year.

Bisphenol A-Glycidyl Methacrylate↗

[Disorders of vaginal biocenosis in women with risk of genital cancer].

473 women 38-71 years old were examined. 55 women with physiologic biocenosis of the vagina were included into control group. In remaining (418) there were detected: erosions, cancers of the cervix, hyperplasias and cancers of the endometrium of the uterine body, inflammations, leukoplakia and cancers of the vulva. Microbiological examinations consisted if indirect examinations of vaginal content and of artificial cultures on different media. Disturbances in vaginal biocenosis was diagnosed in the greater part of examined women. There were concluded that in praeneoplasie disease and in neoplasms of female genital organ inflammatory process has been. The authors suggests about necessity of prophylaxis of inflammations by microbiological examinations and treatment of women with the threat of female genital organ neoplasms.

Adult↗

[Ionization of the cervix uteri].

A procedure of copper ionization of the cervix uteri performed in 1054 cases of chronic cervicitis is described. This way of treatment resulted in the reduction of exaggerated cervical discharge, the volume of the cervix was diminished, and erosions became smaller. Slight bleeding after this therapy was recorded as complication in two cases. In 85% of cases only one ionization is needed to reach the optimal therapeutic effect.

Chronic Disease↗

Non-carious cervical tooth loss: Part 1.

Non-carious cervical tooth loss is not always attributable to a single causative factor, as evidenced by the numerous terminologies used. In this, the first of two articles, the aetiology and prevalence of non-carious tooth loss are discussed. Guidelines are suggested as to how it may be diagnosed, prevented and monitored. A further article will cover the restorative management.

Adult↗

3-year clinical evaluation of modified Gluma adhesive systems in cervical abrasion/erosion lesions.

PURPOSE: To study the clinical performance of two candidates for improvement of the original Gluma bonding system. MATERIALS AND METHODS: Eight teeth with cervical buccal abrasion/erosion lesions were identified in 40 patients. The lesions were conditioned with an oxalic acid solution followed by either a HEMA-glutaraldehyde bonding agent or a formamide-containing bonding agent. The lesions were restored with a hybrid composite. Each patient received the same number of restorations with the two different bonding formulations. All restorations were made by the same operator (JK). Evaluations were based on the USPHS system. RESULTS: No difference between the two groups as to retention, marginal adaptation and discoloration was observed after 3 years. Eight restorations were lost and a slight increase in marginal discoloration was seen during the observation period.

Adult↗