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Aim It is the aim of this paper to consider whether overall patient treatment history per se and what length of patient history, matters in predicting future treatment need.Methods This study used a data set (SN7024, available from UKDataService), consisting of treatment records for General Dental Services' (GDS) patients, this being obtained from all items of service payment records for patients treated in the GDS of England and Wales between 1990 and 2006. For the purpose of this study, the GDS dataset for patients attending in 2003 was restricted to adult patients (aged 18 or over on 31 December 1990; that is, year of birth earlier than 1973) who attended in both two-year periods 1991/2 and 2004/5. Each course of treatment was classified as 'active' (eg restoration, extraction, prosthesis) or 'not active' (eg prevention, diagnosis). Treatment costs for 2001-2005 (outcome), 2000 (one-year history), 1999-2000 (two-year history) and so on until 1991-2000 (ten-year history) were determined, and history and outcome correlated.Results A total of 455,844 patients met the inclusion criteria, namely adults with a full history. They received 9,341,583 courses of treatment, of which 49% were classified as 'active' and 51% as 'not active'. The analysis indicated that both total costs and active treatment costs are positively correlated with their historical values, with the correlation coefficients increasing from 0.24 and 0.25 with one year of history to 0.42 and 0.44 with ten years of history. Overall, therefore, future treatment cost is correlated with past treatment costs.Conclusions Treatment history may provide an important correlate of future dental treatment needs and the more history the better, at least up to five years. However, active treatment is the important component and should be distinguished from preventive and diagnostic treatments.

For more than 40 years dentists worldwide have been using directly placed resin-bonded composite to restore damaged anterior teeth. While such techniques are invariably more conservative of tooth tissue than indirect procedures, operative techniques using direct composite can be challenging and are considered technique sensitive. Clinicians require both technical and artistic skill to provide composite restorations that restore function and aesthetics to blend seamlessly with the residual dentition. This paper provides an update on the aesthetic considerations involved in the restoration of anterior teeth with directly placed composite and outlines the contemporary materials, equipment and techniques that are available to optimize every clinical stage. Clinical Relevance: Successful restoration of anterior teeth with direct composite is an integral component of contemporary clinical practice.

This paper evaluates the five year clinical evaluation of restorations formed in a low shrinkage stress resin composite material (3M ESPE Filtek Silorane, Seefeld, Germany) and placed in the general dental practices of five members of the PREP Panel, a group of UK practice-based researchers. Results indicated satisfactory performance of the material under evaluation, other than for marginal staining, which affected 60% of the restorations evaluated after five years, albeit with less than 10% of the circumference of the restorations being affected.The low shrinkage stress material, Filtek Silorane™, demonstrated good clinical performance in the majority of parameters which were assessed at five years.

To evaluate the handling, by a group of practice-based researchers, of a recently introduced bulk fill resin-based composite restorative material, Filtek Bulk Fill Restorative (3M ESPE).The twelve selected evaluators were sent explanatory letters, a pack of the material under investigation to use for 8 weeks, and a questionnaire.The evaluators rated the ease of use of the bulk fill restorative the same as the previously used posterior composite material. The provision of one shade only for evaluation may have compromised the score for aesthetic quality. No post-operative sensitivity was reported.The bulk fill material was well received as indicated by the high number of evaluators who would both purchase the material and recommend it to colleagues.A recently introduced bulk fill restorative material achieved a rating for handling which was similar to the evaluators' previously used resin composite, although there were some concerns regarding the translucency of the material.

Use a low shrinkage stress composite but, if not, use incremental placement and a layer of flowable at the gingival box; Ensure good bonding to dentine and enamel and avoid (over) etching the dentine; Ensure good adaptation at the gingival floor of a Class II box; Make sure that the restoration has received sufficient light; Provide good isolation; Use reliable and tested materials throughout.

There is anecdotal evidence that sales of 'own-label' (OL) or 'private label' dental products is increasing, as dentists become more cost conscious in times of economic downturn. However, the purchase of such (less expensive) products could be a false economy if their performance falls below accepted standards. So, while the examination of a resin-based product under research conditions alone may not guarantee success, it could be considered that a material which has been subjected to testing under research conditions will demonstrate its effectiveness under laboratory conditions or reveal its shortcomings; either of these being better than the material not being examined in any way. It was therefore considered appropriate to determine the materials on which research was carried out, with particular reference to OL brands.To determine whether there is a research base behind OL resin-based restorative dental materials.

The porcelain laminate veneer is an elective restoration, often placed in the absence of disease for purely esthetic reasons. As such, it would appear desirable that the success rate of the technique was 100%. It is therefore the purpose of this paper to review the literature on porcelain laminate veneer survival by searching dental databases containing clinical trials of porcelain veneer restorations. References of selected trials were also screened to identify relevant studies. Each paper that was included was examined to ascertain if preparation into dentin affected survival. A total of 24 papers were included in the review. It was concluded that survival rates of porcelain laminate veneers are rarely 100%, and there is reasonable evidence indicating that a veneer preparation into dentin adversely affects survival.A review of the literature has indicated that porcelain laminate veneer survival is rarely 100%. Accordingly, patients should be made aware of this before embarking on this elective restorative technique. Clinicians should also be aware that the ideal preparation for porcelain veneers remains within enamel.

Previous laboratory studies have demonstrated satisfactory fracture resistance of all-ceramic crowns placed using a resin-composite luting material and a dentine bonding system. This study investigated the fracture resistance of teeth restored using CAD/CAM technology, namely, Zirconia Based crowns and Cerec produced feldspathic porcelain crowns, both luted with a self adhesive resin luting material (RelyX Unicem Clicker 3M ESPE). Standardized preparations were carried out on two groups often sound, unrestored, maxillary premolar teeth. Ceramic crowns were constructed to have a thickness of 2mm at their midline fissure. Compressive fracture resistance was determined for each group using a Universal Testing Machine. The failure modes were also examined visually and interpreted according to a chosen scale. Mean Compressive fracture resistance of 746 (147)N and 1630 (175)N were recorded for the Cerec and Lava groups respectively; differences were statistically significant (p0.001). The fracture resistance of teeth restored with Lava crowns is significantly greater than a similar group of teeth restored with Cerec crowns.

Bond strength testing of resin-based materials to dentine may provide evidence as to the potential effectiveness of a dentine-bonding agent in producing adhesion and minimising microleakage. The purpose of this analysis was to analyse the methods used in 102 recently-published investigations on bond strength tests of resin composite to dentine. One hundred and two papers, published during the years 1998 to 2002 on the subject of bond strength measurement of resin composite to dentine were identified from a literature search. These papers were assessed for their inclusion of the following variables: type of test, thermal cycling regime, tooth notation, storage medium, preparation of dentine surface, rate of load application, type of dentine, film thickness, dimensions of surface area contact and time of testing. Shear testing was the most common type of test, used in 46% (n=47) of the papers analysed, human dentine was used in 77% (n=79) of the investigations, and 24 h post-placement was the predominant time of specimen testing (67%, n=68). Surface area of contact, or specimen diameter, was stated in 65% (n=66) of the papers analysed. A number of variables were not stated in a majority of papers. There was little standardization of test methods and a number of potentially significant variables may not be reported or recorded in bond strength determinations which limit the overall standardization between different test centres.