Clinical Evaluation of a Compomer and an Amalgam in Primary Teeth C lass II Restorations: A 2 year Comparative Study

Department of Pediatric Dentistry
Resident’s Name: Murphy Program: Lutheran Medical Center - Providence
Article title: Clinical Evaluation of a Compomer and an Amalgam in Primary Teeth C lass II Restorations: A 2 year Comparative Study
Author(s): Katerina Kavvadia, DDS, MDent Sc, Dr Odont. Et al
Journal: Pediatric Dentistry
Year. Volume (number). Page #’s: 2004. Vol 26 no 3. 245-251
Major topic: The purpose of this study was to compare the clinical performance between the compomer f2000 and amalgam Dispersalloy in class II restorations in primary molars over a 2 year period.

Overview of method of research: 75 amalgam and 75 comps were placed in 75 children in two separate pediatric dentistry private practices. In each child, an amalgam and a composite were placed in contra-lateral sides. The restorations were evaluated at 1 week, and then 6, 12, and 24 months by two independent calibrated evaluators. The rests were evaluated clinically, radiographically (bitewings), and under scanning electron microscope. The clinical exams were performed according to the Ryge criteria, including
1. Retention, bulk fracture, and presence (or not) of secondary caries. Ranked as either Yes or NO
2. Surface texture, marginal adaptation, marginal discoloration, contact area, and anatomic form. Ranked as either Alpha (ideal), Bravo (Acceptable) or Charlie (Unacceptable).

Findings:
Clinically
One amalgam was lost, and one comp had secondary caries. No bulk fractures in either group. None graded as “Charlie”. Many comps. Were rated as “Bravo”, while many Amals. Were rated as “Alpha”.

Radiographically
Five Amals and four Comps had cervical defects. These defects did not progress after 24 months.

SEM
Amals demonstrated marginal microfractures leading to ditching, leading to loss of anatomic form. Comps exhibited generalized wear, leading to loss of anatomic form and exposure of the cavity walls (although no marginal integrity was lost).

Key points/Summary:
Eventhough comps exhibited significantly higher “Bravo” scores regarding marginal adaptation and anatomic form, there is not an increased risk for secondary caries and failures… over a 2 year period!

Assessment of Article: Good article, Skeptical about how they continually reviewd how amazing the results were, and how awesome the comps were, but then quietly mentioned it was only with regards to the 2 year time frame. Shenanigans? Maybe.