Seal, replacement or monitoring amalgam restorations with occlusal marginal defects? Results of a 10-year clinical trial
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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. (C) 2015 Elsevier Ltd. All rights reserved.
Artículo de publicación ISI
DOI: doi: 10.1016/j.jdent.2015.07.012
Quote ItemJournal of Dentistry 43 (2015) 1371–1378
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