The Class IV resin composite restoration: results of a national survey

Various aspects and principles of the Class IV acid-etched direct resin composite restoration are reviewed through an examination of the literature and a national survey. The purpose of the survey was to determine what is being taught and relate it to literature on the subject. The general conclusion is that responding dental schools in the United States teach the most currently accepted concepts of material selection, tooth preparation, and clinical technique associated with this treatment service. Among respondents: (1) 73 percent report that they teach use of a liner before placement of the resin composite; (2) two include instruction for a total-etch technique; (3) 15 percent regularly teach use of DBAs; (4) 21 percent teach placement of a microfilled resin composite veneer, while 69 percent teach placement of a single resin composite restoration; (5) all use visible light-cured resin composite systems exclusively; (6) all indicate that some type of preparation is required, and circumferental preparation was preferred most (95 percent); types of margins taught most frequently are the long bevel (33 percent), chamfer (26 percent), and either the long bevel or chamfer (14 percent); one school prefers porcelain laminate veneers as the restoration for larger Class IV lesions; and. 74 percent prefer incremental addition of resin composite layers as their placement technique. In most cases, the literature and survey findings agree, but there are a number of areas (liners, DBAs, and occlusion) for which further research is indicated to determine an optimal direction for dental school instruction. This article will be useful if it improves clinical performance or spurs answers to those items for which consensus is lacking.