Three high Cu-gamma2 free amalgams and one conventional amalgam were used in a clinical study to evaluate degree of marginal integrity and surface discoloration occurring for time periods of up to two years. Two hundred and seventy restorations were placed in Class I and II cavities in sixty-two paedodontic patients. Amalgams were prepared from conventional alloy, Cu admixed, Dispersalloy and three parts 50Ag-20Sn-30Cu mixed with one part conventional alloy. Restorations were evaluated by three groups of clinicians. Ridit means obtained from all three groups of evaluations were in good agreement. The lower ridits indicate better marginal integrity and less tarnish. Marginal integrity of amalgams prepared from Cu-admix did not differ appreciably (0.41) from the ridit associated with initial placement (0.39). Conventional amalgams had the highest ridit (0.65) for marginal integrity whereas the ternary/conventional and Dispersalloy restorations were intermediate (0.55 and 0.52). The ridit for tarnish and surface discoloration was decidedly higher for the Cu-admix (0.73) than for the other systems investigated which had ridits of the order of 0.50 compared to an initial ridit for tarnish of 0.28.
The American Board of Orthodontics has developed tools to help examinees select patients to be used for the Board examination. The Case Management Form can be used to evaluate aspects of a patient's treatment that cannot be measured by other tools. The Case Management Form is a structured treatment-neutral assessment of orthodontic objectives and outcomes associated with a patient's treatment. Despite the availability of this form, examiners continue to see problems, including lack of attention to finishing details, inappropriate treatment objectives, excessive proclination of mandibular incisors due to treatment mechanics, excessive expansion of mandibular intercanine width, closing skeletal open bite with extrusion of anterior teeth leading to excessive gingival display, and failure to recognize the importance of controlling the eruption or extrusion of molars during treatment. In addition, some examinees exhibit a lack of understanding of proper cephalometric tracing and superimposition techniques, which lead to improper interpretation of cephalometric data and treatment outcomes.
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