Almaeen, Saud;
(2022)
SMART composite restorations of carious primary molar teeth after minimal caries removal.
Doctoral thesis (D.Dent), UCL (University College London).
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Abstract
Background: Placement of high-quality restorations to restore carious primary molars is possible, though technique sensitive. Consequently, Renewal MI composite, which potentially needs no local anaesthesia or drilling, was developed. Aims: First, to assess the ability of the Renewal MI, with and without adhesives, to bond to sound bovine dentine and to inhibit the activity of the matrix metalloproteinase (MMP). Second, to investigate the clinical experience of GDPs to restore carious primary molars and the long-term fate of the used restorative materials. Last, to explore the attitude and willingness of foundation dentists (FDs) to treat child patients and their treatment approaches. Methods: To investigate the ability of the Renewal MI to form resin tags into sound bovine dentine; extracted bovine teeth were used. ISO 29022:2013 instructions were followed to test the Macro-Shear Bond Strength (SBS) of the Renewal MI, with and without adhesives. A fluorescent probe (EnzCheck Collagenase Assay Kit) was used to check the activity of MMPs under Confocal Light Scanning Microscopy (CLSM). To investigate the most common restorations placed and their long-term outcome, a retrospective review of child patients’ records, from eight GDP dentists in London, was undertaken. The willingness of eight dentists to restore carious primary molars and possible barriers in general dental practices was explored through a focus group. Results: SEM of Renewal MI, without adhesives, showed no resin tags formation and large gaps with sound bovine dentine. Furthermore, Renewal MI, without adhesives, failed to achieve proper adhesion to sound dentine. However, with adhesives, it showed statistically significant SBS (16.8MPa), which was comparable to Z250 (18.4 MPa). CLSM images suggested Renewal MI was able to inhibit MMPs activities with or without adhesives. The GDPs’ audit revealed that GIC were most commonly used for carious primary molar teeth (75.8%). On up to three years follow-up, one third of the GIC restorations failed and needed replacement. The FDs were usually happy to offer PMCs as the first treatment option for multi-surface carious primary molars. GIC restoration was their first alternative option. Conclusion: Renewal MI, requires an adhesive to gain bonding to sound dentine. GIC restorations were the treatment of choice for carious primary molars among GDPs surveyed, but had high failure rate on long-term follow-up. In contrast most participating FDs claimed that PMCs would be their first treatment option.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | D.Dent |
| Title: | SMART composite restorations of carious primary molar teeth after minimal caries removal |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2022. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10157695 |
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