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Title Limited Evidence to Compare of Bond Strength of Composite Resin to Sclerotic Dentin and Normal Dentin
Clinical Question In a adult patient population (>18 years) with severe acid erosion of the occlusal surfaces, do direct composite restorations bond as well to sclerotic dentin when compared to normal dentin.
Clinical Bottom Line The bond of composite resin is weaker when bonded to sclerotic dentin when compared to normal dentin, however, the bond is sufficient enough to protect the tooth structure from further erosion. The evidence is only a narrative literature review.
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) 15140178Sundaram/2004Adult populationNarrative Literature Review
Key resultsBond strengths of 16–19 Mpa have been reportedly achieved to sclerotic dentine compared with 22–30 Mpa to normal dentine. Which is sufficient enough for a sufficient bond clinically.
Evidence Search "Dental Bonding"[Mesh]Search "Tooth Erosion"[Mesh]Search "Composite Resins"[Mesh] ...view in PubMed
Comments on
The Evidence
The study is listed as a literature review, but no further designation is made. There is no indication of what selection/exclusion criteria were used for the articles researched. This article may be valid, but due to lack of methods section it is difficult to determine.
Applicability This study is applicable to all patients with permanent dentition presenting with cavitated erosion lesions.
Specialty/Discipline (Restorative Dentistry)
Keywords Composite resins, tooth erosion, dental bonding
ID# 952
Date of submission: 05/24/2011spacer Revised: 10/03/2011
E-mail mayen@livemail.uthscsa.edu
Author Steven Mayen
Co-author(s) e-mail
Faculty mentor/Co-author Erica Teixeira, DDS, PhD
Faculty mentor/Co-author e-mail TeixeiraE@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
Comments and Evidence-Based Updates on the CAT
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by Lauren Bierschwale, Anthony Mendez (San Antonio, TX) on 12/01/2017
The Pubmed and TRIP databases were searched for related topics of CAT 952 in November 2017. A more recent and higher level of evidence was found in an article (PMID18666493) published in 2008. Ritter et al. conducted a randomized clinical trial comparing the bond of two adhesives using microfilled composite on different levels of sclerotic dentin. There was a slight advantage in retention at 18 months and 3 years for restorations placed on lower sclerosis scales, however this was not statistically significant and all groups met clinical requirements under ADA guidelines for retention. Although this clinical trial was not comparing scerlotic to non-sclerotic dentin, the results published include information that can be used to further conclude that dentin with a lower level of sclerosis will have greater bond strength, but with little to no clinical significance.

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