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Title: The Best Dental Restorative Option is Prevention
Source: [None]
URL Source: http://boards.medscape.com/forums?1 ... DSRagFDf5X@.2a338929!comment=1
Published: Jul 20, 2012
Author: Margaret Scarlett
Post Date: 2012-07-20 04:50:41 by Tatarewicz
Keywords: None
Views: 23

Evidence suggesting that preserving the patient's own tooth structure is best just got a boost from a recent publication. This week, Medscape reported on the Pediatrics article, "Dental Composite Restorations and Psychosocial Function in Children," by Nancy N. Maserejian et al. For some time, scientific evidence has shown that resin-based dental materials can release chemical components and bisphenol A (BPA) intraorally. This has been an issue of investigation by the Food and Drug Administration for several years.

In a randomized trial, the New England Children's Amalgam Trial found that children in the arm using only amalgam for posterior tooth restorations had better psychosocial outcomes than the study arm of children assigned to composites for posterior tooth restorations. The analysis compared behavioral outcomes of children from amalgam restorations arm with the composite arm. The composite arm used either bisphenol A-glycidyl methacrylate (bisGMA)-based composite or urethane dimethacrylate-based polyacid-modified composite (compomer). The study of 534 children aged 6 to 10 years used a psychometric measure, the Behavior Assessment System for Children (BASC-SR) and parent-reported Child Behavior Checklist (CBCL). The researchers found that greater exposure to bisGMA-based dental composite restorations was associated with impaired psychosocial function in children. No effect was shown with compomer or amalgam.

While the study did not assess likely confounding factors and the effect size was relatively small, the research provides more evidence of the value of preventing loss of tooth structure. No restoration appears to be the best, as this research suggests. How are you performing caries risk assessments in your practice and how you are providing prevention practices in your office? Are you using remineralizing agents for early caries? Tell Medscape what you think about the implications of this study on your restorative practice. How are you providing combination therapies to prevent tooth decay in your practice?

Poster Comment:

Restored teeth have a limited lifetime. Information which needs to be emphasized in the school curriculum.

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