Caries Treatment of Primary Teeth Using Amalgam and Tooth-colored Restoratives

Objectives: The investigation assessed the clinical effects of a prospective research and quality-developing project concerning operative caries treatment of primary teeth. Methods: It comprised three samples of restorations/adjacent surfaces performed in the Danish Public Dental Health Clinic. Sample '1991' consisted of 398 amalgam (AM) and 349 conventional glass ionomer (GIC) restorations in all cavity types in contact with 416 unrestored proximal surfaces. Sample '1994/95' consisted of 805 resin-modified glass ionomer (RMGIC) and 255 compomer (COMPOMER) class II restorations in contact with 694 unrestored surfaces. Sample '1999' consisted of 57 GIC and 419 COMPOMER restorations in all cavity types in contact with 231 unrestored surfaces. The restorations and surfaces were assessed by specially trained clinicians at regular recalls. The '1991' and '1994/95' samples were followed for 7-8 years and the '1999' sample for 4-5 years concerning quality and longevity of restorations and need for operative treatment of adjacent surfaces. Data were processed by non-parametric statistics and survival analyses. Results: The class of restoration and the type and the brand of restorative material influenced the survival of the restorations (p<0.05). The survival of the adjacent surfaces was influenced by the type of restorative material (p<0.05). The longevity of '1999' restorations in all cavity types corresponded to that of '1991' restorations in AM (p=0.28), but the '1999' surfaces showed a better survival than '1991' surfaces adjacent to AM (p=0.002). Conclusions: The investigation substantiated that everyday caries treatment in the primary dentition can be performed using tooth-colored restoratives as substitutes for amalgam without negative consequences for the dental health.

Support: The investigation was supported by grants from 'TNL', 'Ingeborg and Leo Dannins Legat', and 'Sygekassernes Helsefond', Denmark.