 he
first compomer, Dyract, was a phenomenal
success. The second generation of compomer
Dyract ®AP is specially designed for all
classes of restorations in both anterior
and posterior teeth.
There are now more than 4 years of superb
clinical results from the placement of more
than 40 million
restorations throughout the world.
Dyract ®AP has excellent physical strength
and wear resistance comparable to a hybrid
composite.
Not only has the fluoride release of Dyract
®AP been increased by 50%, its long-term
fluoride release
has also been demonstrated
Clinicians worldwide like the simplicity
of technique and ease of handling of Dyract ®AP
to achieve highly aesthetic and functional
restorations in all classes of restorations.
With the introduction of the No Rinse
Conditioner (NRC) and Prime & Bond ®NT,
clinicians now can enjoy even simpler procedures
and achieve greater bond strengths and marginal
integrity of their restorations.
Numerous clinical studies on compomers
have shown that they are superior substitutes
for dental amalgams. As an example, Figure 6A
shows the severe and unsightly early childhood
caries. Figure 6B shows the beautiful aesthetics
that can be accomplished using Dyract ®AP with
Pedodontic Strip Crowns.
Dyract ®AP has also numerous uses in
geriatric dentistry where the poorly maintained
dentitions in the elderly, frequently present
clinicians with most difficult challenges.
Dyract ®AP has been found to be the restorative
material of choice for cavities where they are
difficult to access and minimal mechanical
retention is available and where optimal
adhesion is desired.
From our range of restoratives, Dyract?
AP is best suited for cost-effective, essential
caries treatment. 3-year clinical data from the
Universities of Munich and Liverpool (Table 1)
prove the safety and efficacy of the formulation
and the recommended placement technique. Up to
now, for reasons of precaution we have
recommended an acid etch procedure for large
occlusal stress-bearing restorations. The 3-year
results show that the conditioning step may be
omitted.
| Dyract?AP 3-year
results at a glance |
Overall success rate
Munich/Liverpool |
97%/100% |
Clinical evidence of wear
Munich/Liverpool |
0/0 |
Indirect instrumental analysis of wear
Liverpool |
53 |
| Signs
or symptms of pulp irritation/necrosis
Munich/Liverpool |
0/0 |
Table 1
Clinical
Performance of Dyract AP
Compomer:
2-year Results
Y.Luo,
E.C.M. Lo, D.T.S. Fang, R.J. Smales and
S.H.Y. Wei
Glass-ionomer - Resin Composite Continuum
- Conventional
Glass-ionomer Cement cariostatic effects
- Resin-modified
Glass-ionomer Cement
- Polyacid-modified
Resin Composite (Compomer)
- Resin
Composite: Physical propeties, Esthetics,
Clinical manipulation
Restorative
Compomer
- Physical
propeties inferior to those of resin
composites
- Wear
resistance lower than that of resin
composite and amalgam
- Restricted
use in non-stress-bearing areas
in permanent teeth
|
|
- Dyract
DeTrey [Dentsply, Konstanz,
Germany]
- Compoglass
[Vivadent, Schaan, Liechtenstein]
- Hytac
[Espe, Seefeld, Germany]
- Variglas
[Caulk Dentsply, Milford,
USA]
- Luxat
[DMG, Hamburg, Germany
|
|
Dyract AP Restorative Compomer
- Universal
compomer restorative material
- Improved
physical strength and abrasion resistance
- Indicated
for al cavity classes in anterior
and poterior teeth
|
 |
NRC, Prime&Bond NT
|
- Self-priming
conditioning liquid, no need to
rinse after one-coat application
- Self-priming
dental adhesive
|
Objectives
To
evaluate the clinical behavior of Dyract
AP, in combination with the NRC and
Prime&Bond NT, when used for occlusal
stress-bearing restorations in posterior
permanent teeth.
Study
Design
- Clinical
trial
- Guidelines
of the American Dental Association
- Class
I and II cavities of permanent teeth
- Must
be in occlusion
- Evaluation
at baseline, 6 months, 1 year and 2 years
Materials
and Methods
Subjects
- 39
subjects, 15 males and 24 females
- Aged
18-54 years, mea 29 years
- Ethics
Committee approval
- Patient
informed consent form
- 41
Class I and 50 Class II at baseline
Clinical
Performance of Dyract AP Compomer
 |
 |
 |
|
45Mo,
pre-operation
|
45Mo,
cavity preparation
|
45MO,
after insertion
|
Evaluation
- Recalls
at baseline, 6 months, 1 year, 2 years
- Clinical
evaluation according to Ryge-USPHS
- Indirect
evaluation on dental replicas, clinical
color photographs, bitewing radiographs
Vinyl
polysiloxane impression, die-stone replicas
Results
Restorations
Available for Evaluation
| Recall |
Subjects |
Restorations |
Drop
out (%) |
| Baseline |
39
|
91
|
0
|
| 6
Months |
36
|
84
|
7.7
|
| 12
Months |
35
|
82
|
9.9
|
| 24
Months |
33
|
76
|
16.5
|
Distribution of Restorations
|
Baseline
|
24
Months
|
|
Class
I
|
Class
II
|
Class
I
|
Class
II
|
| Maxillary
premolars |
0
|
33
|
0
|
27
|
| Maxillary
molars |
12
|
8
|
10
|
7
|
| Mandibular
premolars |
0
|
6
|
0
|
6
|
| Mandibular
molars |
29
|
3
|
23
|
3
|
| Total |
41
|
50
|
33
|
43
|
Evaluation Results After 2 Years
| Ryge
ratings |
%A
|
%B
|
%C
|
%D
|
| Color
Match |
96
|
4
|
0
|
0
|
| Marginal
Discoloration |
50
|
50
|
0
|
0
|
| Marginal
Integnity |
27
|
71
|
1
|
1
|
| Surface
Texture |
95
|
5
|
0
|
0
|
| Recurrent
Caries |
96
|
4
|
-
|
-
|
| Gingival
Status |
SBI=0
|
SBI=1
|
-
|
-
|
| (Class
II only) |
98
|
2
|
|
|
Failure Rates
| Reason |
6
Months
|
12
Months
|
24
Months
|
|
n
|
%
|
n
|
%
|
n
|
%
|
| Bulk
Fracture |
-
|
-
|
1
|
1.2
|
1
|
1.3
|
| Recurrent
Caries |
-
|
-
|
3
|
3.6
|
-
|
-
|
| Cumulatie
Failure* |
-
|
-
|
4
|
4.8
|
5
|
6.3
|
*Cumulative
failure rate= (previous failures + current
failures)/
(previous failures + currently recalled
restorations) x 100
Color
Match
Clinical
Performance of Dyract AP Compomer
 |
 |
| 45DO,
at baseline |
45DO,
after 6 months |
 |
 |
| 45DO,
after 1 year |
45DO,
after 2 years |
Marginal
Discoloration
Clinical
Performance of Dyract AP Compomer
 |
 |
 |
| 14DO,
at 6 months |
14DO,
after 1 year |
14DO,
after 2 years |
Marginal
Integriy
Clinical Performance of Dyract AP Compomer
 |
 |
| 15DO,
after 1 year |
15DO,
after 2 years |
Surface
Texture
Clinical Performance of Dyract AP Compomer
 |
 |
| 25MO,
12 months |
25MO,
12 months |
 |
 |
| 25MO,
12 months |
25MO,
24 months |
Net
Occlusal Wea
- Mean
Wear (um):
- 6
Months:18.5¡Ó11.7
12 Months: 35.7¡Ó13.6
24 Months: 55.9¡Ó21.9
|
|
Discussion
- Simplified
application technique with the use of
the dental bonding system
- Outstanding
surface characteristics and color-matching
ability
- l
2-year wear rate: Dyract AP 56 um, Dyract
(113 um), Prisma TPH (64 um)* Dyract (190
um)**
*Hse
KMY, Leung Sk, Wei Sh=HY. Resin-ionomer
restorative materials for cildren: Areview.
Aust Dent J 1999; 4: 1-11.
**Peters MCRB, Roeters FJM, Frahkenmolen
FWA. Clinical evaluation of Dyract in
primary molars. Am J Dent 196; 9: 83-88. |
- Marginal quality of restorative compomer
remains problematic
- Bond
strengths not strong enough without
acid etching*
- Significantly
improved marginal quality
when using phosphoric acid in vitro
study**
|
*Cehreli
ZC Altay N. Three-year clinical evaluation
of a polyacid-modified resin composite
in minimally-invasive occlusal cavities.
J Dent 2000; 28: 117.
**Luo Y, Tay FR, Lo ECM, Wei SHY. Margina
adaptation of a new compomer under different
conditioning methods. J Dent 2000; 28:
399. |
Conclusions
l
Survival rate over 93% after 2 years; most
of the restorations performed satisfactorily
l Improved wear resistance supports its
use in stress-bearing posterior teeth
|
|
|
