An evaluation of composite resins and glass polyalkenoate cements in paediatric dentistry
This study comprised five clinical trials in children and young adults, and a series of supporting laboratory investigations. The first trial compared a second generation glass polyalkenoate cement with amalgam as a restorative material in the deciduous dentition. The glass polyalkenoate material underwent a more rapid loss of anatomical form and marginal integrity, and also had a higher failure rate than amalgam. The second trial compared a minimal composite restoration/ fissure sealant technique with a conventional amalgam restoration as treatment for occlusal caries in permanent molars. Although there has been some loss of anatomical form and marginal integrity of the amalgam restorations, and loss of the fissure sealant component of the composite restorations, only 11 amalgam and 8 composites have failed. There was no statistical difference in terms of failure between the two techniques. The third trial involved a study of glass polyalkenoatecomposite resin class II sandwich restorations in premolar and molar teeth. Results showed that a layer of glass polyalkenoate cement brought out to the approximal tooth surface in the box areas was not a reliable method of restoration and certainly not a solution to cervical gap formation found with composite resins alone in the class II cavity. The fourth trial involved a study of a microfilled composite resin veneer technique for improving the aesthetics of anterior teeth. Results showed a low failure rate and high patient satisfaction over a 30 month period. The fifth trial involved the use of a hydrochloric acid—pumice abrasion technique for removal of superficial enamel stains. The technique was quick and easy to perform, and results were impressive. Patient satisfaction and appreciation was very high. Laboratory investigations were largely centred around the use of glass polyalkenoate cements in the sandwich technique. Results showed that etching of glass polyalkenoate cement with acid gave no advantages over a simple wash with water, prior to bonding to composite resin. Also that etching before the manufacturers recommended time, and failure to use an unfilled intermediate resin resulted in a poorer bond between glass polyalkenoate cement and composite resin.