Teaching posterior composite resin restorations in the United Kingdom and Ireland: consensus views of teachers

Managing the phase-down of amalgam: part I. Educational and training issues

“…21 National and international surveys on the teaching of posterior composite restorations over the past 25 years have demonstrated a progressive increase in the teaching and clinical experience in the field of posterior composite restorations. [22][23][24][25][26][27][28][29][30][31][32][33][34][35] In UK dental schools, undergraduate students have for a number of years gained, on average, more experience in the placement of posterior composite restorations than in the placement of dental amalgams (on average 55% posterior composite:45% amalgam), 28 with much of the remaining use of dental amalgam being the replacement of dental amalgams in older patients belonging to the 'heavy metal generation' .…”

“…[22][23][24][25][26][27][28][29][30] This shift has been supported by consensus guidance from the British Association of Teachers of Conservative Dentistry, who recommended in 2007 that composite be considered the 'material of choice' for the restoration of posterior teeth affected by initial lesions of caries. 36 Nowadays, students in UK and Ireland dental schools gain more experience in the placement of posterior composites than amalgam, with a strong emphasis on minimally interventive dentistry (55% posterior composite:45% amalgam). 28 Furthermore, the first preclinical skills (formerly 'phantom head') experience in the restoration of posterior teeth for the majority of students is now posterior composite rather than amalgam.…”

State-of-the-art techniques in operative dentistry: contemporary teaching of posterior composites in UK and Irish dental schools

“…19 Contrary to this expert opinion, recent surveys on the use of restorative materials in posterior teeth in clinical practice indicate that within the UK amalgam still predominates over posterior composites. [20][21][22] The reasons for the apparent disconnect between clinical practice and expert opinion are considered to be multifactorial, including custom and practice being perpetuated, issues in respect of costs and fees, a failure of the profession at large to embrace minimally interventive dentistry, and the long lag time between changes in teaching and impact on clinical practice.…”

“…Concerns were expressed that dental school teaching programmes in respect of posterior composites were 'lagging behind' developments in clinical practice, with an implication that dental students were graduating with a lack of competence in relevant, albeit emerging techniques. 11,12 Surveys of the teaching of posterior composites in 2004/2005 found that this element of teaching had increased from the time of the surveys in 1998, with approximately 30% of posterior restorations placed by dental students of that time being of composite, with most of the remainder of amalgam. [13][14][15][16] Studies examining the survival of posterior restorations, such as a review of clinical outcome studies published in the period 1990-2004, demonstrated an aggregate annual failure rate of 2.2% for posterior direct composites, in comparison to 3.0% for amalgam restorations.…”

Longevity of conventional and bonded (sealed) amalgam restorations in a private general dental practice

“…Although, to certain recollection, cavity design was not radically different between the groups, it is acknowledged that, as the operator's experience with the bonding technique developed, it could have decreased the level of emphasis placed upon mechanical cavity preparation features. Although the use of rubber dam has been advocated to improve the longevity of dental restorations, 42,43 it was not applied for any restorations placed in this study. It is acknowledged that, had scrupulous cotton wool roll isolation and the use of high volume aspiration not been in place, this could have affected longevity.…”