The Journal of the American Dental Association
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

J Am Dent Assoc, Vol 134, No 3, 317-323.
© 2003 American Dental Association
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by GORDAN, V. V.
Right arrow Articles by WILSON, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by GORDAN, V. V.
Right arrow Articles by WILSON, N.
Related Collections
Right arrow Restoratives

RESEARCH

JADA Continuing Education

Teaching students the repair of resin-based composite restorations

A survey of North American dental schools



VALERIA V. GORDAN, D.D.S., M.S., IVAR A. MJÖR, B.D.S., M.S.D., M.S., Dr.Odont., IGOR R. BLUM, D.D.S., Ph.D., M.Sc. and NAIRN WILSON, Ph.D., M.Sc., B.D.S., F.D.S., D.R.D.


   ABSTRACT
TOP
 ABSTRACT
MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 CONCLUSION
 REFERENCES
 
Background. The purpose of this study was to evaluate whether North American dental schools teach students to repair resin-based composite, or RBC, restorations and to compare the findings with those from similar European surveys.

Materials and Methods. The authors mailed a 15-item questionnaire to 64 dental schools in the United States, Canada and Puerto Rico. The survey asked whether the school taught repair of RBC restorations and inquired about the respondent’s experience with such procedures. Questions also elicited reasons why schools taught or did not teach repair, information in regard to relevant decision-making processes, criteria for deciding whether to perform repairs and the nature of the instruction (theoretical, practical, preclinical or clinical).

Results. Fifty-two (81 percent) of 64 schools participated in the survey. Thirty-seven (71 percent) of the respondents reported that they taught undergraduate students repair techniques as an alternative to replacing failing RBC restorations. Twenty-seven (73 percent) of these 37 schools reported that such teaching was at the clinical level, while only three schools (8 percent) reported that it was included in formal lectures as part of preclinical courses. The major reasons given for teaching students how to repair RBC restorations were tooth structure preservation and reduction of potentially harmful effects on the pulp. Indications included the correction of marginal defect and marginal discoloration.

Conclusions. More than one-half of the respondents reported that they taught repair of RBC restorations and that patients were willing to accept such treatment. Most schools considered the repair of RBC restorations to be a definitive measure and reported that, on average, they expected a repaired RBC restoration to have a longevity of four years.

Despite advancements in dental adhesive technology, the replacement of resin-based composite, or RBC, restorations is a continuing problem in restorative dentistry.1 Several factors determine the longevity of RBC restorations. Polymerization shrinkage, coefficients of thermal expansion that are different from those of tooth tissues and wear resistance still limit the longevity of RBC materials. Other generally accepted contributing factors in restoration failure are inadequate operator technique and poor patient compliance (primarily poor oral hygiene).2

More than one-half of the respondents reported that they taught repair of resin-based composite restorations.

Apart from problems that are inherent to the properties of RBC material, the clinical diagnosis of secondary caries is the most common reason for replacing restorations in general dental practice.3 This diagnosis is ill-defined and subjective4 and invariably leads to replacement of the entire restoration.

Laboratory and clinical studies have shown a significant increase in the size of cavity preparations when Class I5 and Class V RBC restorations are replaced.6,7 The main difficulty when replacing RBC restorations is differentiating sound tooth structure from restorative material at the interface between the restoration and the tooth. The excellent color-matching and light-transmitting properties of present-day RBC materials are appealing characteristics; however, they also pose a challenge for dentists trying to identify the cavity margins at the time of replacement, especially in areas distant from the site of failure. Replacing RBC restorations consistently results in loss of tooth structure in locations that are distant from the site of restoration failure. Removing only the defective part of an otherwise acceptable restoration (that is, a repair) is an effective alternative to replacing the entire restoration (Figures 1Go and 2Go).



View larger version (100K):
[in this window]
[in a new window]
  		Figure 1. Preoperative view of stained margins of a resin-based composite restoration on an upper right premolar (arrows).

 


View larger version (83K):
[in this window]
[in a new window]
  		Figure 2. Postoperative view of a repaired resin-based composite restoration on the upper right premolar shown in Figure 1Go.

 
Previous surveys conducted in German, British, Irish and Scandinavian dental schools reported diversity in regard to teaching repair of RBC restorations.8 The purpose of this study was to investigate whether North American dental schools taught students how to repair RBC restorations and to compare some of the findings with those from similar surveys conducted in European dental schools.


   MATERIALS AND METHODS
TOP
 ABSTRACT
 MATERIALS AND METHODS
RESULTS
 DISCUSSION
 CONCLUSION
 REFERENCES
 
In August 2001, we mailed a 15-item questionnaire to 64 dental schools in the United States, Canada and Puerto Rico; a cover letter addressed to a known faculty member (either a department chairman or professor) in the operative/restorative department also was included. Recipients were given six weeks to complete the two-page survey. In September 2001, we sent a reminder letter, including a copy of the questionnaire, to schools that had not responded. No further responses were received after October 2001.

We used forms that were similar to those used in the survey administered in Europe.8 The survey consisted of several questions that could be answered by "yes" or "no" responses, by multiple-choice answers or in a descriptive format. We encouraged respondents to use the back of the questionnaire to illustrate and describe any special procedure or technique used.

The survey inquired about the respondent’s experience in repairing RBC restorations and in teaching such techniques. We also sought reasons for teaching or not teaching repair of RBC restorations, information regarding relevant decision-making processes, the criteria for deciding whether to undertake repairs (including limitations and contraindications) and information about the nature of the instruction (that is, theoretical, practical, preclinical and clinical). In addition, the survey sought information about the anticipated longevity of repaired RBC restorations, the patient’s reaction to the treatment and arrangements for recall appointments. Responses were calculated as percentages based on the number of schools that responded to the questions.


   RESULTS
TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
DISCUSSION
 CONCLUSION
 REFERENCES
 
Fifty-two (81 percent) of 64 schools completed and returned the questionnaire. Forty-nine (94 percent) of these respondents stated that they had repaired RBC restorations. Forty-five (92 percent) of these 49 respondents reported that the treatment had been successful.

Thirty-seven (71 percent) of the 52 responding dental schools stated that they taught undergraduate students repair techniques as an alternative to replacing failing RBC restorations. Fifteen schools that did not teach students how to repair RBC restorations reported that they did not intend to teach such techniques within the next three years. The major reason given for not teaching this procedure was the lack of clinical evidence. Seventy-three percent of the schools that did teach students how to repair RBC restorations reported that this instruction was provided at the clinical level only. Only 8 percent of the schools reported that the instruction was part of formal lectures linked to preclinical courses.

Below are some of the findings from the 37 schools that reported that they taught students how to repair RBC restorations:

– Thirty-six of the 37 schools reported that clinical experience influenced their decision to teach repair of RBC restorations.
– The major reasons given for teaching students how to repair RBC restorations were preservation of tooth structure and reduction of the potential harmful effects on the pulp (Table 1Go). Indications included the need to correct marginal defects and discoloration, surface discoloration and partial loss of the restoration (Table 2Go).
– All schools reported that patients were receptive to undergoing repair of RBC restorations.
– Most schools (81 percent) considered the repair of RBC restorations to be a definitive measure (that is, expected to last more than 12 months) (Table 3Go).
– The schools reported that, on average, the acceptable longevity for a repaired RBC restoration was four years.
– Sixty percent of the schools had recall arrangements in place to monitor the repair treatment.
– The majority of schools (70 percent) used diamond finishing burs and acid-etching with phosphoric acid (81 percent) to treat the tooth surface before the repair. Eighty-seven percent of the schools preferred small-particle (hybrid) RBC material to complete a repair.
– Although 19 (51 percent) of 37 respondents reported that using a resin sealant was an acceptable alternative to restoring defective margins of RBC restorations, only three (8 percent) of the schools actually used this technique (Table 4Go).
– Sixty-two percent of the schools reported that they taught students how to repair amalgam restorations.


View this table:
[in this window]
[in a new window]
  		TABLE 1 REASONS FOR TEACHING STUDENTS HOW TO REPAIR RESIN-BASED COMPOSITE RESTORATIONS IN NORTH AMERICAN DENTAL SCHOOLS.

 

View this table:
[in this window]
[in a new window]
  		TABLE 2 INDICATIONS FOR TEACHING STUDENTS HOW TO REPAIR RESIN-BASED COMPOSITE RESTORATIONS IN NORTH AMERICAN DENTAL SCHOOLS.

 

View this table:
[in this window]
[in a new window]
  		TABLE 3 EXPECTED LONGEVITY OF A REPAIRED RESIN-BASED COMPOSITE RESTORATION BY NORTH AMERICAN AND EUROPEAN DENTAL SCHOOLS.

 

View this table:
[in this window]
[in a new window]
  		TABLE 4 ALTERNATIVE TREATMENTS USED TO CORRECT A DEFECTIVE RESIN-BASED COMPOSITE RESTORATION IN NORTH AMERICAN DENTAL SCHOOLS.

 
Fifteen (100 percent) of the British and Irish dental schools, 24 (75 percent) of 32 German schools and nine (82 percent) of 11 Scandinavian schools responded to the European survey, for an overall response rate of 83 percent,8 which is similar to the North American response rate of 81 percent.


   DISCUSSION
TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
CONCLUSION
 REFERENCES
 
Inherent problems with RBC materials. Although the use of RBC materials has increased markedly in recent years, inherent problems with these materials still exist. Restoration replacement invariably leads to enlargement of the cavity preparation, even for intact areas not directly related to the defect that caused the failure.6,7,9–11 The loss of tooth structure may be greater with tooth-colored restorations5 than with amalgam restorations, because it often is difficult for dentists to demarcate the area between the tooth and the restoration. Repair, therefore, is an important alternative to replacing aged restorations, but it is most important in cases of recently placed restorations with localized marginal defects identified after delayed finishing procedures.

Reasons for repairing restorations. Thirty-seven of the responding schools stated that they taught students how to repair RBC restorations, and 34 (92 percent) of them considered such treatment to have been successful. The major reasons for teaching students to repair RBC restorations were preservation of tooth structure and reduction of potential harmful effects on the pulp. These reasons are in agreement with opinions expressed in other studies,12,13 and are validated by investigations that have shown a significant loss of healthy tooth structure when RBC restorations are replaced.5–7

Traditional teaching has maintained that RBC restorations do not meet the standards set for amalgam restorations and, therefore, when evidence exists of deterioration that may lead to failure, the RBC restoration should be replaced. The concept of repairing RBC restorations is not recognized by all dental schools despite numerous laboratory studies showing that the use of surface treatments and bonding agents provides bond strengths of up to 80 percent of the cohesive strength of the material.14–19 However, 37 (71 percent) of 52 respondents stated that their schools provided instruction in the repair of RBC restorations.

Clinical instruction should be based on scientific evidence; nevertheless, many procedures in contemporary operative dentistry are based on experience rather than scientific evidence. The repair of a partially lost fissure sealant is an established technique.20,21 In contrast, repairing RBC restorations has not been recognized as an acceptable procedure despite many laboratory studies showing that it can achieve favorable clinical results.17–19,22–25

Fifteen (29 percent) of 52 schools reported that they did not teach repair of RBC restorations. In these schools, replacing RBC restorations is the treatment of choice for defective margins. Considering that studies have shown a significant loss of tooth structure when complete replacement of RBC restorations takes place,5–7 one could conclude that some schools are not yet committed to the concept of minimal operative intervention in managing failing restorations. Of even greater concern is that these schools reported that they did not plan to teach such repairs within the next three years.

The major reason given for not teaching this procedure was the lack of supporting clinical evidence. However, since most defects leading to replacement are local in nature and of limited extent (including clinically localized secondary caries),3 removing the entire restoration may not be justified when there is no evidence of, for example, active residual or recurrent caries beneath the restoration. Almost all of the respondents who reported that they taught repairs stated that their clinical experience influenced their decision to teach it. Thus, a so-called experience base had apparently been established. More research is needed to convert the experience base into an evidence base. As Figure 3Go shows, the percentage of schools that taught restoration repair was much higher in Scandinavia, Britain and Ireland than it was in Germany.8 The results for North American schools were between those for Anglo-Scandinavian schools and German schools.



View larger version (25K):
[in this window]
[in a new window]
  		Figure 3. North American and European dental schools8 that reported teaching undergraduate dental students how to repair resin-based composite restorations.

 
Marginal defects and discoloration. The majority of North American dental schools reported marginal defects (84 percent) and marginal discoloration (73 percent) as the most common indications for repairing RBC restorations. In these clinical situations, active caries tends not to be present, and, consequently, the complete replacement of an RBC restoration is not justified. However, one-third of the schools reported secondary caries as a reason for repairing the restoration. Mjör and Toffenetti3 reported that secondary caries is the most common reason for replacing restorations in general dental practice. Secondary caries is a localized defect. Therefore, it is appropriate for future studies to focus on the clinical investigation of repair as an alternative to replacing RBC restorations. In addition, more well-defined clinical criteria need to be developed to facilitate the diagnosis of secondary caries.4

Although no consensus exists within dentistry as to the best repair protocol, the results of several laboratory studies conducted in the late 1970s and 1980s demonstrate that acceptable RBC repairs can be achieved.14–19 In the current study, most schools considered the repair to be a definitive treatment. These results are consistent with the findings from Scandinavian dental schools (Table 3Go). However, fewer than half of the German dental schools considered repair to be a definitive treatment.8

Although undercuts may be preferred in the remaining restoration, successful resin repair depends more on the development of an adequate interfacial bond between the old and new RBC material. Previous studies have shown that the highest bond strength for repaired restorations is achieved when some type of mechanical treatment (such as roughening the surface, preparing undercuts deep enough to provide additional retention, sandblasting) is applied to the surface of the old RBC material26–30 and when this surface receives a low-viscosity resin before the addition of new RBC material.14,17,23,31,32 Factors that can influence the interfacial bond strength are the viscosity of the bonding resin, mechanical roughening of the substrate surface, age of the substrate resin, filler concentrations and types, voids and resin formulation.33–35 Use of different cutting instruments is likely to generate differences in smearing, roughness and matrix cracking of the old composite. These differences influence the micromechanical retention and bond strength of new composite bonded to old composite.24

The results of this survey show that more clinical research is needed regarding the repair of resin-based composite restorations.

Similar to European dental schools, the majority of North American dental schools use diamond finishing burs and acid-etching with phosphoric acid as surface treatment before performing the repair procedure8 (Figure 4Go), even though laboratory studies have demonstrated that superior bond strength can be achieved when the surface is sandblasted with aluminum oxide or silicate ceramic particles.36–38 The majority of responding dental schools preferred a small-particle (hybrid) composite material for repairing RBC restorations. These results are consistent with findings from European dental schools.8



View larger version (29K):
[in this window]
[in a new window]
  		Figure 4. Surface preparations used by North American and European dental schools8 in the repair of resin-based composite restorations.

 
Although more than half of the respondents stated that a resin sealant would be an acceptable material to repair degraded margins, only three schools reported actually using a resin sealant to repair RBC restorations (Table 4Go). Similarly, more respondents considered repair to be an appropriate measure for correcting a defective RBC restoration than the number who actually performed such repairs in their dental clinics.

The results of this survey show that more clinical research is needed regarding the repair of RBC restorations. Future studies could establish consistent guidelines for repairing RBC restorations and provide clinical evidence, the lack of which some schools claim to be the major reason for not teaching repair of restorations. Therefore, clinical studies could serve as validation and encouragement for dental schools to teach repairs of RBC restorations. In addition, future studies should focus on the quality of restorations being placed, on improving the properties of restorative materials and on patient education in regard to maintenance of restorations.


   CONCLUSION
TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 CONCLUSION
REFERENCES
 
Thirty-seven (71 percent) of 52 responding dental schools in North America reported that they taught undergraduate dental students repair techniques for RBC restorations. The majority of dental schools that responded to the survey considered the repair of defective RBC restorations to be a definitive measure and reported that, on average, the acceptable longevity of repaired restorations is four years.



View larger version (121K):
[in this window]
[in a new window]
  		Dr. Gordan is an associate professor, University of Florida, College of Dentistry, Department of Operative Dentistry, Health Science Center, P.O. Box 100415, Gainesville, Fla., 32610-0415, e-mail "vgordan{at}dental.ufl.edu". Address reprint requests to Dr. Gordan.

 


View larger version (135K):
[in this window]
[in a new window]
  		Dr. Mjör is a professor and Academy 100 Eminent Scholar, University of Florida, College of Dentistry, Department of Operative Dentistry, Gainesville.

 


View larger version (79K):
[in this window]
[in a new window]
  		Dr. Blum is a research fellow, University Dental Hospital of Manchester, England.

 


View larger version (113K):
[in this window]
[in a new window]
  		Dr. Wilson is a professor, Guy’s, King’s, and St. Thomas’ Dental Institute, King’s College University of London.

 


   FOOTNOTES
 

This research project was funded in part by the University of Florida, Division of Sponsored Research grant 01042678.


The authors thank Drs. Anette Schriver and Detlef Heidemann, J.W. von Goethe University of Frankfurt, for gathering the European data and permitting them to be compared with North American findings.


Copies of the North American survey can be obtained from Dr. Gordan.


   REFERENCES
TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 CONCLUSION
 REFERENCES
 

  1. Mjör IA, Moorhead JE, Dahl JE. Selection of restorative materials in permanent teeth in general dental practice. Acta Odontol Scand 1999;57:257–62.[Medline]

  2. Burke FJT, Wilson NHF, Cheung SW, Mjör IA. Influence of method of funding on the age of failed restorations in general dental practice in the UK. Br Dent J 2002;192:699–702.[Medline]

  3. Mjör IA, Toffenetti F. Secondary caries: a literature review with case reports. Quintessence Int 2000;31:165–79.[Medline]

  4. Clark TD, Mjör IA. Current teaching of cariology in North American dental schools. Oper Dent 2001;26:412–8.[Medline]

  5. Gordan VV, Mondragon E, Shen C. Replacement of resin-based composite: evaluation of cavity design, cavity depth, and shade matching. Quintessence Int 2002;33:273–8.[Medline]

  6. Gordan VV. In vitro evaluation of margins of replaced resin-based composite restorations. J Esthet Dent 2000;12:209–15.[Medline]

  7. Gordan VV. Clinical evaluation of replacement of class V resin based composite restorations. J Dent 2001;29:485–8.[Medline]

  8. Blum I, Schriever A, Heidemann D, Mjör IA, Wilson NHF. The repair of direct composite restorations: an international survey of the teaching of operative techniques and materials. Eur J Dent Educ 2003;7(1):41–8.[Medline]

  9. Elderton RJ. An in vivo morphological study of cavity and amalgam margins on the occlusal surfaces of human teeth [doctoral thesis]. London: University of London; 1975.

  10. Elderton RJ. The quality of amalgam restorations. In: Allred H, ed. A series of monographs on the assessment of the quality of dental care. London: Experimental Dental Care Project, The London Hospital Medical College, University of London; 1977:45–81.

  11. Mjör IA, Reep RL, Kubilis PS, Mondragon BE. Change in size of replaced amalgam restorations: a methodological study. Oper Dent 1998;23:272–7.[Medline]

  12. Mjör IA. Repair versus replacement of failed restorations. Int Dent J 1993;43:466–72.[Medline]

  13. Wilson NHF, Setcos JC, Brunton PA. Repair versus replacement of restorations. In: Wilson NHF, Roulet JF, Fuzzi M, eds. Advances in operative dentistry. Vol 2. Challenges of the future. Chicago: Quintessence; 2001:105–15.

  14. Boyer DB, Chan KC, Torney DL. The strength of multilayer and repaired composite resin. J Prosthet Dent 1978;39:63–7.[Medline]

  15. Lloyd CH, Baigrie DA, Jeffrey IW. The tensile strength of composite repairs. J Dent 1980;8:171–7.[Medline]

  16. Marshall TD, Murry AJ, Norling BK. Shear bond strength of additions to composite resin (abstract 1115). J Dent Res 1982;61.

  17. Boyer DB, Chan KC, Reinhardt JW. Build-up and repair of light-cured composites: bond strength. J Dent Res 1984;63:1241–4.[Abstract/Free Full Text]

  18. Pounder B, Gregory WA, Powers JM. Bond strengths of repaired composite resins. Oper Dent 1987;12:127–31.[Medline]

  19. Chiba K, Hosoda H, Fusayama T. The addition of an adhesive composite resin on the same material: bond strength and clinical techniques. J Prosthet Dent 1989;61:669–75.[Medline]

  20. Simonsen RJ. Potential uses of pit-and-fissure sealants in innovative ways: a review. J Public Health Dent 1982;42:305–11.[Medline]

  21. Houpt M, Fuks A, Eidelman E, Shey Z. Composite/sealant restoration: 61/2-year results. Pediatr Dent 1988;10:304–6.[Medline]

  22. Lloyd CH, Dhuru VB. Effect of a commercial bonding agent upon the fracture toughness (K’IC) of repaired heavily filled composite. Dent Mater 1985;1(3):83–5.[Medline]

  23. Söderholm KJ. Flexure strength of repaired dental composites. Scand J Dent Res 1986;94:364–9.[Medline]

  24. DeSchepper EJ, Tate WH, Powers JM. Bond strength of resin cements to microfilled composites. Am J Dent 1993;6:235–8.[Medline]

  25. Swift EJ, Cloe BC, Boyer DB. Effect of a silane coupling agent on composite repair strengths. Am J Dent 1994;7:200–2.[Medline]

  26. Söderholm KJ, Roberts MJ. Variables influencing the repair strength of dental composites. Scand J Dent Res 1991;99:173–80.[Medline]

  27. Turner CW, Meiers JC. Repair of an aged, contaminated indirect composite resin with a direct, visible-light-cured composite resin. Oper Dent 1993;18:187–94.[Medline]

  28. Farid MR, Abdel-Mawla EA. Fracture resistance of repaired Class II composite resin restorations. Egypt Dent J 1995;41:1507–12.[Medline]

  29. Shahdad SA, Kennedy JG. Bond strength of repaired anterior composite resins: an in vitro study. J Dent 1998;26:685–94.[Medline]

  30. Yap AU, Quek CE, Kau CH. Repair of new-generation tooth-colored restoratives: methods of surface conditioning to achieve bonding. Oper Dent 1998;23:173–8.[Medline]

  31. Miranda FJ, Duncanson MG Jr, Dilts WE. Interfacial bonding strengths of paired composite systems. J Prosthet Dent 1984;51:29–32.[Medline]

  32. Azarbal P, Boyer DB, Chan KC. The effect of bonding agents on the interfacial bond strength of repaired composites. Dent Mater 1986;2:153–5.[Medline]

  33. Gregory WA, Pounder B, Bakus E. Bond strengths of chemically dissimilar repaired composite resins. J Prosthet Dent 1990;64:664–8.[Medline]

  34. Powers JM, Pratten DH, Collard SM, Cowperthwaite GF. Spreading of oligomers on polymers. Dent Mater 1991;7:88–91.[Medline]

  35. Puckett AD, Holder R, O’Hara JW. Strength of posterior composite repairs using different composite/bonding agent combinations. Oper Dent 1991;16:136–40.[Medline]

  36. Swift EJ, LeValley BD, Boyer DB. Evaluation of new methods for composite repair. Dent Mater 1992;8:362–5.[Medline]

  37. Stokes AN, Tay WM, Pereira BP. Shear bond of resin cement to post-cured hybrid composites. Dent Mater 1993;9:370–4.[Medline]

  38. Bouschlicher MR, Reinhardt JW, Vargas MA. Surface treatment techniques for resin composite repair. Am J Dent 1997;10:279–83.[Medline]




This article has been cited by other articles:


Home page
 Journal of the American Dental AssociationHome page
V. V. Gordan
Author's response
J Am Dent Assoc, September 1, 2009; 140(9): 1079 - 1079.
[Full Text] [PDF]

Home page
 Journal of the American Dental AssociationHome page
C. D. Lynch, R. J. McConnell, and N. H.F. Wilson
Teaching the placement of posterior resin-based composite restorations in U.S. dental schools
J Am Dent Assoc, May 1, 2006; 137(5): 619 - 625.
[Abstract] [Full Text] [PDF]

Home page
 Journal of the American Dental AssociationHome page
I. A. MJOR
Clinical diagnosis of recurrent caries
J Am Dent Assoc, October 1, 2005; 136(10): 1426 - 1433.
[Abstract] [Full Text] [PDF]

Home page
 J Dent EducHome page
S. Tubert-Jeannin, S. Domejean-Orliaguet, P. J. Riordan, I. Espelid, and A. B. Tveit
Restorative Treatment Strategies Reported by French University Teachers
J Dent Educ., October 1, 2004; 68(10): 1096 - 1103.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by GORDAN, V. V.
Right arrow Articles by WILSON, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by GORDAN, V. V.
Right arrow Articles by WILSON, N.
Related Collections
Right arrow Restoratives

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS