ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title For Patients Who Need Posterior Composite Restorations, Instrument Lubrication Decreases the Strength of the Composite When Compared to Not Using Instrument Lubrication
Clinical Question For patients who need posterior composite restorations, what is the effect of using resin adhesives for instrument lubrication on the strength of composite, compared to not using adhesive resin lubricants?
Clinical Bottom Line The strength of posterior composite restorations decreases when using an instrument lubricated with resin adhesive compared to using no instrument lubrication.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 27746333Patel/2017300 posterior composite cylindrical specimens (n=60 for ethanol, 3-step, 2-step, and 1-step bonding agent adhesive system and n=60 with no lubricant [control])Laboratory study
Key resultsThe mean diametral tensile strength (MPa) between the controls (no instrument lubricant) and the specimens (four different adhesive resins) were statistically different at week 0, week 1, and week 12 (p < 0.05). Group 1 (week 0) was tested immediately after fabrication while Group 2 and Group 3 were tested after immersion in phosphate-buffered saline for 1 week (Group 2) and 12 weeks (Group 3). The adhesive resin from a 3-step adhesive systems decreased the MPa the least compared to the other adhesive resin lubricants.
Evidence Search posterior[All Fields] AND composite[All Fields] AND ("lubricants"[Pharmacological Action] OR "lubricants"[MeSH Terms] OR "lubricants"[All Fields] OR "lubricant"[All Fields]) AND instrument[All Fields]
Comments on
The Evidence
Validity: All the specimens were prepared by two operators. One placed the composite and the other light polymerized the composite. The specimens were then randomly separated into the three groups. In an effort to simulate the environment of the mouth, Groups 2 and 3 (week 1 and week 12) were submerged in phosphate-buffered saline. The specimens’ diametric tensile strength was tested at all three time-points using a Universal Testing Machine. The groups were similar at the start, treated the same, and the researchers had no competing interests. Perspective: Several resins marketed specifically as instrument lubricants are available to clinicians, and further research is needed to determine their effect, if any, on composite strength. In-vivo research in this area would be beneficial but would be difficult to perform.
Applicability Many people have posterior composite restorations. Composite restorations are becoming increasingly popular in this day and age where esthetics is more important and longevity of the restorations is comparable. Composite strength should not be decreased in an effort to decrease composite placement time. Evidence supports the discontinuance of resin adhesives as instrument lubricant when placing resin composites.
Specialty/Discipline (General Dentistry) (Pediatric Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords Dental materials, dental composite, material properties, instrument lubricant, lubricant, diametral tensile strength, sticky, strength, composite, strength
ID# 3163
Date of submission: 03/22/2017spacer
E-mail elliotts2@livemail.uthscsa.edu
Author Steven Elliott
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author James Summitt, DDS, MS
Faculty mentor/Co-author e-mail SUMMITT@uthscsa.edu
Basic Science Rationale
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