Restorative dentistry and restorative materials over the next 20 years: A Delphi survey

OBJECTIVES The aim of this study was to forecast trends in restorative dentistry over the next 20 years and to identify treatment goals and corresponding properties of restorative materials. METHODS Using the Delphi method, a panel of 3 experts identified 8 key questions, which were sent to experts in restorative and preventive dentistry. In round 1 of this survey, 15 international experts devised a clearer semantic definition of the key questions and the completion of respective items for two additional rounds. In round 2, 125 experts from 35 countries rated the items developed in round 1 using a Likert scale. In round 3, the same 125 experts received the ratings of round 2 and were asked to agree or disagree to these ratings by re-voting on all key questions and items. A total of 105 experts re-voted and finally took part in the complete survey. Among the 8 key questions, two questions were selected for the present report: (Q1) "What will be the future role of restorative treatment?" and (Q6) "What will be the key qualities for clinical success of restorations?" For both questions and the respective items, the experts were asked to evaluate the importance and the feasibility for later calculation of the scientific value (i.e. the opportunity, where opportunity=importance+[importance-feasibility]). RESULTS The three items of highest importance for Q1 were "preservation of existing enamel and dentin tissue," "prevention of secondary caries," and "maintenance of the pulp vitality," and for Q6 they were "optimization of adhesion," "biocompatibility," and "minimizing technical sensitivity." SIGNIFICANCE Bioactivity toward the pulp-dentin complex and prevention of secondary caries were the items generally rated as having the highest opportunity.

Consensus report of the European Federation of Conservative Dentistry: erosive tooth wear-diagnosis and management

OBJECTIVE Due to an increased focus on erosive tooth wear (ETW), the European Federation of Conservative Dentistry (EFCD) considered ETW as a relevant topic for generating this consensus report. MATERIALS AND METHODS This report is based on a compilation of the scientific literature, an expert conference, and the approval by the General Assembly of EFCD. RESULTS ETW is a chemical-mechanical process resulting in a cumulative loss of hard dental tissue not caused by bacteria, and it is characterized by loss of the natural surface morphology and contour of the teeth. A suitable index for classification of ETW is the basic erosive wear examination (BEWE). Regarding the etiology, patient-related factors include the pre-disposition to erosion, reflux, vomiting, drinking and eating habits, as well as medications and dietary supplements. Nutritional factors relate to the composition of foods and beverages, e.g., with low pH and high buffer capacity (major risk factors), and calcium concentration (major protective factor). Occupational factors are exposition of workers to acidic liquids or vapors. Preventive management of ETW aims at reducing or stopping the progression of the lesions. Restorative management aims at reducing symptoms of pain and dentine hypersensitivity, or to restore esthetic and function, but it should only be used in conjunction with preventive strategies. CONCLUSIONS Effective management of ETW includes screening for early signs of ETW and evaluating all etiological factors. CLINICAL RELEVANCE ETW is a clinical condition, which calls for the increased attention of the dental community and is a challenge for the cooperation with other medical specialities.