ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Amalgmbond And Threaded Pins Provide Equivalent Rates Of Retention Separately And Greater Retention In Combination
Clinical Question For complex amalgam restorations, does Amalgambond provide greater retention than threaded pins?
Clinical Bottom Line Complex restorations placed with Amalgambond showed no significant increase in retention over those placed with pins. This is supported in vivo studies with clinic patients and in vitro studies with extracted molars. One study showed that restorations placed with Amalgambond and pins offered significantly greater retention than those placed using either method individually.
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) 11480646Summitt/2001n=60RCT
Key results7 of 28 pin-retained amalgams failed at 5 years and 2 of 32 bonded amalgams failed at 5 years. Fisher exact test found no significant difference in failure rates.
#2) 7965897Hadavi/2004n=45RCT
Key resultsBond strength for Amalgambond Plus (6.343 +/- 3.564 MPa) Bond strength for TMS pin (6.868 +/- 0.794 MPa)(P < 0.05)
#3) 9484151Burgess/1997n=30RCT
Key resultsGroup 1 - Amalgambond only Group 2 - Amalgambond with Minim pins Group 3 - Minim pins only(P < 0.05) significantly higher retention in Group 2 than either Group 1 or 3
Evidence Search "Amalgambond" AND "pins"
Comments on
The Evidence
All three studies were conducted with small patient groups. Summitt’s study was conducted on patients presenting for care at clinic with follow up conducted after 5 years. Both Hadavi’s and Burgess’ studies were conducted on extracted molars without follow up.
Applicability Summitt’s study was conducted on clinic patients, and restorations were placed using similar standards of private practice. Hadavi’s and Burgess’ studies conducted shear force tests on extracted molars with occlusal surfaces ground flat for the placement of simulated restorations.
Specialty/Discipline (General Dentistry) (Pediatric Dentistry) (Prosthodontics)
Keywords Amalgam bonding, pins, amalgams
ID# 2264
Date of submission: 04/13/2012spacer
E-mail halberstadt@livemail.uthscsa.edu
Author Kyle Halberstadt
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Robert A. Kaminski, DDS, MS
Faculty mentor/Co-author e-mail kaminskir@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?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Parker Wentz, Jared Hope (San Antonio) on 11/30/2017
A PubMed search was conducted on 11/27/17 looking at retention rates of Amalgambond versus threaded pins in amalgam restorations. Additional support for the original conclusion is provided by Summitt et al. 2007 (PMID: 15195725). This research concluded there was no statistical or clinical difference in the performance of pin-retained amalgam restorations and bonded amalgam restorations. This result is further substantiated by Imrby, et al. 2008( PMID: 19051860) an in vitro study comparing the fracture resistance of ninety caries free third molars treated with either amalgam bonding agents or amalgam pins. This study concluded with a one-way ANOVA and Tukey post hoc analysis indicating all amalgam bonding agents were statistically equal to either four Regular TMS Link Plus pins or four amalgapins, further supporting initial conclusions
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