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Journal of Esthetic and Restorative... Jan 2022Several systematic literature reviews have assessed the scientific evidence on resin bonding protocols to conventional 3 mol% ytrria-stabilized zirconia (3Y-TZP)... (Review)
Review
OBJECTIVES
Several systematic literature reviews have assessed the scientific evidence on resin bonding protocols to conventional 3 mol% ytrria-stabilized zirconia (3Y-TZP) ceramics. It has been widely discussed, however, that the differing composition and physical properties of new high-translucent zirconia generations (4Y-TZP and 5Y-TZP) may require alternative bonding materials and procedures. This paper reviewed in vitro studies on the success and durability of bonding protocols to high-translucent zirconia.
MATERIAL AND METHODS
A systematic search of PubMed and Cochrane Library for in vitro studies on bonding to new zirconia generations published until November 2020 was conducted and complemented by a manual search. Studies selected for review fulfilled the applied inclusion and exclusion criteria. The quality of the included studies was assessed with the Cochrane risk-of-bias tool for randomized trials.
RESULTS
Of 629 screened articles, 18 were included in this review. They investigated different surface pretreatment methods, primers, resin cements, aging procedures, and bond strength test protocols. The limited number of the identified studies and the heterogeneity of the extracted data did not allow to conduct a meta-analysis.
CONCLUSIONS
The available evidence suggests that resin bonding protocols successfully applied to conventional zirconia are also the most successful for high-translucent zirconia. Airborne particle abrasion and special phosphate monomer-containing primers or composite resin cements provide long-term durable resin bonds.
CLINICAL SIGNIFICANCE
Durable bonds can be established between high-translucent zirconia and resin cements. The bonding materials and procedures applied do not compromise their physical properties.
Topics: Ceramics; Dental Bonding; Dental Stress Analysis; Materials Testing; Resin Cements; Surface Properties; Zirconium
PubMed: 35072329
DOI: 10.1111/jerd.12876 -
International Dental Journal Jun 2022The aim of this review was to evaluate the most used suture materials with regards to their inflammatory response, their bacterial adhesion, and their physical... (Review)
Review
BACKGROUND
The aim of this review was to evaluate the most used suture materials with regards to their inflammatory response, their bacterial adhesion, and their physical properties when used to close oral wounds.
METHODS
Four databases (PubMed, Scopus, Dentistry & Oral Sciences, and OVID) were searched to retrieve relevant studies from January 1, 2000, to January 31, 2020.
RESULTS
Out of the 269 articles, only 13 studies were selected as they were relevant and met the systematic review's protocol. These studies showed that almost all suture materials studies (catgut, polyglycolic acid [PGA] sutures, nylon, expanded polytetrafluoroethylene, and silk sutures) caused bacterial adherence and tissue reaction. In nylon and chromic catgut, the number of bacteria accumulated was lowest. Silk and nylon were found to be more impacted than catgut and PGA in terms of physical characteristics such as tensile strength. PGA, on the other hand, was said to be the most susceptible to knot unwinding.
CONCLUSIONS
Following an oral surgical operation, all sutures revealed varied degrees of irritation and microbial accumulation. Nonresorbable monofilament synthetic sutures, however, exhibited less tissue response and less microbial accumulation.
Topics: Humans; Nylons; Oral Surgical Procedures; Polyglycolic Acid; Sutures
PubMed: 35305815
DOI: 10.1016/j.identj.2022.02.005 -
Dental Materials : Official Publication... Oct 2021The purpose of this systematic review and meta-analysis was to analyze the literature on the bond strength of self-etching (SE) adhesives containing 10-MDP or other... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The purpose of this systematic review and meta-analysis was to analyze the literature on the bond strength of self-etching (SE) adhesives containing 10-MDP or other acidic functional monomers, comparing the bonding performance of both compositions.
METHODS
This study is registered in PROSPERO (CRD42020175715) and it followed the PRISMA Statement. The literature search was performed in PubMed, Web of Science, SciELO, Scopus, LILACS, IBECS, and BBO from the starting coverage date through 30 June 2021. Study eligibility criteria consisted of in vitro studies that evaluated the bond strength (microtensile, microshear, tensile or shear testing) to sound dentin/enamel of a minimum of two distinct SE systems, with at least one material containing 10-MDP and one other being comprised of a distinct acidic composition. Statistical analyses were carried out with RevMan 5.3.5 and using random-effects models with the significance level at p < 0.05. Also, Bayesian network meta-analysis (NMA) was conducted using MetaInsight V3 tool.
RESULTS
From 740 relevant studies evaluated in full-text analysis, 210 were incorporated to the systematic review and 206 in meta-analysis. The majority of studies was classified as having medium risk of bias (56.7%), followed by low (35.2%) and high (8.1%) risk of bias. Data from a total of 64 adhesive systems were collected, which favored the 10-MDP-based group at both dentin (overall effect: 6.98; 95% CI: 5.61, 8.36; p < 0.00001) and enamel (overall effect: 2.79; 95% CI: 1.62, 3.96; p < 0.00001) substrates. Microtensile testing was more frequently used (73.4%) in the included studies. Adhesives based on 10-MDP showed greater bonding performance than adhesives comprised of monomers such as PENTA, 6-MHP, 4-META, 4-MET, pyrophosphate esters, mixed composition or monomers derived from sulfonic acid (p ≤ 0.01); whereas similar bond strength values were verified between 10-MDP-based materials and those containing PEM-F, acrylamide phosphates, 4-AET, MAC-10, or monomers derived from polyacrylic and phosphonic acids (p ≥ 0.05). Adhesives based on GPDM were the only ones that resulted in greater bonding potential than the 10-MDP-based group (p = 0.03). Dental bonds in dentin were favored with the application of 2-step 10-MDP-based adhesives; whereas in enamel the dental bonds were favored for both 2-steps versions of adhesives, regardless of the presence of 10-MDP. Indirect evidence from NMA revealed that 1-step 10-MDP-free and universal 10-MDP-free adhesives seemed to perform worst in dentin and enamel, respectively.
SIGNIFICANCE
Adhesives containing 10-MDP showed higher bonding performance than materials formulated with other acidic ingredients, although this result relied on the type of mechanical testing, type of the substrate, acidic composition of the adhesive, and the application category of the SE system. This review summarized the effects of the foregoing factors on the adhesion to dental substrates.
Topics: Bayes Theorem; Dental Bonding; Dental Cements; Dentin; Dentin-Bonding Agents; Materials Testing; Methacrylates; Resin Cements; Tensile Strength
PubMed: 34456050
DOI: 10.1016/j.dental.2021.08.014 -
Journal of Esthetic and Restorative... Jan 2022This study comprehensively reviewed clinical trials that investigated the effect of immediate dentin sealing (IDS) technique on postoperative sensitivity (POS) and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study comprehensively reviewed clinical trials that investigated the effect of immediate dentin sealing (IDS) technique on postoperative sensitivity (POS) and clinical performance of indirect restorations.
MATERIALS AND METHODS
The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses statement, and was guided by the PICOS strategy. Clinical trials in which adult patients received at least one indirect restoration cemented with IDS approach and one restoration cemented following the delayed dentin sealing (DDS) were considered.
RESULTS
Following title screening and full-text reading, four studies met the inclusion criteria and were included for qualitative synthesis, while two studies were selected for quantitative synthesis. According to Risk of bias-2 tool, two studies were classified as "some concerns" for the outcome POS. No statistically significant differences were found between teeth restored with indirect restorations using the IDS and DDS approach for POS (p > 0.05), neither at the baseline (very low certainty of evidence according to GRADE) nor after 2 years of follow-up (low certainty of evidence according to GRADE).
CONCLUSION
There is low-certainty evidence that IDS does not reduce POS in teeth restored with indirect restorations.
CLINICAL SIGNIFICANCE
There is no clinical evidence to favor IDS over DDS when restoring teeth with indirect restorations.
Topics: Adult; Composite Resins; Dentin; Humans; Molar
PubMed: 34859939
DOI: 10.1111/jerd.12841 -
The Journal of Prosthetic Dentistry Jul 2022A fiber post is indicated when there is a significant loss of tooth structure and additional support for the restoration is needed. However, whether the use of a glass... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
A fiber post is indicated when there is a significant loss of tooth structure and additional support for the restoration is needed. However, whether the use of a glass fiber post affects the fracture susceptibility of the restored anterior teeth is unknown.
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate the fracture resistance of endodontically treated and restored anterior teeth and to answer the research question, "Does the use of a fiber post influence the fracture resistance of endodontically treated and restored anterior teeth compared with alternative restorative treatments?"
MATERIAL AND METHODS
A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and Embase databases without date and/or language restrictions (updated in July, 2020). In vitro studies comparing the fracture strength of endodontically treated and restored anterior teeth with and without fiber posts were included. The risk of bias was evaluated by using the previous meta-analyses of in vitro studies. The results were presented as standardized mean difference with a 95% confidence interval. Statistical heterogeneity of treatment effects between studies was assessed using the Cochran Q test and the I2 inconsistency test, and values greater than 50% were considered indicative of substantial heterogeneity.
RESULTS
After the removal of duplicates and title and abstract screening, 31 studies remained. Seventeen were considered low risk of bias, 10 were medium risk of bias, and 4 were high risk of bias. Meta-analysis comparing control and experimental groups favored the use of a fiber post in endodontically treated teeth with some types of restoration to improve fracture resistance (standardized mean difference= 0.5 [0.08; 0.92]); a glass fiber post was also favored (standardized mean difference=0.92 [0.43; 1.42]); for veneer preparations and teeth with cervical cavities, a fiber post increases the fracture strength (standardized mean difference= 0.74 [0.01; 1.47]; 1.18 [0.35; 2.02], respectively).
CONCLUSIONS
The use of glass fiber posts increases the fracture resistance of endodontically treated and restored teeth.
Topics: Composite Resins; Dental Stress Analysis; Humans; Post and Core Technique; Tooth Fractures; Tooth, Nonvital
PubMed: 33546858
DOI: 10.1016/j.prosdent.2020.12.013 -
Journal of Dentistry Nov 2016The aim of this systematic review and meta-analysis was to assess the differences in clinical performance in direct and indirect resin composite restorations in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this systematic review and meta-analysis was to assess the differences in clinical performance in direct and indirect resin composite restorations in permanent posterior teeth.
SOURCES
PubMed, the Cochrane Library, Web of Science, Scopus, LILACS, BBO, ClinicalTrials.gov and SiGLE were searched without restrictions.
STUDY SELECTION
We included randomized clinical trials (RCTs) that compared the clinical performance of direct and indirect resin composite restorations in Class I and Class II cavities in permanent teeth, with at least two years of follow-up. The risk of bias tool suggested by Cochrane Collaboration was used for quality assessment.
DATA
After duplicate removal, 912 studies were identified. Twenty fulfilled the inclusion criteria after the abstract screening. Two articles were added after a hand search of the reference list of included studies. After examination, nine RCTs were included in the qualitative analysis and five were considered to have a 'low' risk of bias. The overall risk difference in longevity between direct and indirect resin composite restorations in permanent posterior teeth (p>0.05) at five-year follow-up was 1.494 [0.893-2.500], and regardless of the type of tooth restored, that of molar and premolars was 0.716 [0.177-2.888] at three-year follow-up.
CONCLUSIONS
Based on the findings, there was no difference in longevity of direct and indirect resin composite restorations regardless of the type of material and the restored tooth.
CLINICAL SIGNIFICANCE
Contemporary dentistry is based on minimally invasive restorations. Any indication of a less conservative technique must have unquestionable advantages. In vitro and in vivo studies reveal contradictory evidence of the clinical performance of direct and indirect resin composite restorations in posterior teeth. Thus this study clarified this doubt.
Topics: Composite Resins; Dental Caries; Dental Restoration, Permanent; Dentition, Permanent; Humans; Molar
PubMed: 27523636
DOI: 10.1016/j.jdent.2016.08.003 -
The Journal of Adhesive Dentistry 2018The primary objective of this systematic review was to compare treatment outcomes of direct and indirect permanent restorations in endodontically treated teeth, and... (Meta-Analysis)
Meta-Analysis
PURPOSE
The primary objective of this systematic review was to compare treatment outcomes of direct and indirect permanent restorations in endodontically treated teeth, and provide clinical suggestions for restoring teeth after endodontic treatment.
MATERIALS AND METHODS
Electronic databases (Medline, EMBASE, CENTRAL) and gray literature were screened for articles in English that reported on prospective and retrospective clinical studies of direct or indirect restorations after endodontic treatment with an observation period of at least 3 years. Primary outcomes were determined to be short-term (≤ 5 years) and medium-term (> 5 and ≤ 10 years) survival. Secondary outcomes included restorative and endodontic success of restored teeth. The quality of included studies and risk of bias were assessed using Cochrane Collaboration's tool for RCTs (randomized controlled trials), the Newcastle-Ottawa Scale for cohort studies, and the Agency for Healthcare Research and Quality (AHRQ) methodology checklist for cross-sectional studies. The GRADE system was used for assessing collective strength of the overall body of evidence.
RESULTS
Of 2547 screened articles, only 9 (2 RCTs, 3 retrospective cohort studies, 3 cross-sectional studies) met the inclusion criteria, and 8 studies were used in the meta-analysis. In general, indirect restorations (mostly full crowns) showed higher 5-year survival (OR 0.28, 95% CI 0.19-0.43, p < 0.00001) and 10-year survival (OR 0.20, 95% CI 0.12-0.31, p < 0.00001) than direct restorations. However, there was no statistical difference in short-term (≤ 5-years) restorative success (OR 0.32, 95% CI 0.05-2.12, p = 0.24) and endodontic success (OR 0.88, 95% CI 0.72-1.08, p = 0.22).
CONCLUSIONS
Based on current evidence, there is a weak recommendation for indirect restorations to restore endodontically treated teeth, especially for teeth with extensive coronal damage. Indirect restorations using mostly crowns have higher short-term (5-year) and medium-term (10-year) survival than do direct restorations using composite or amalgam (GRADE quality of evidence: low to moderate), but no difference in short-term (≤ 5 years) restorative success (low quality) and endodontic success (very low quality). There is a need for high-quality clinical trials, especially well-designed RCTs.
Topics: Composite Resins; Cross-Sectional Studies; Dental Restoration, Permanent; Endodontics; Humans; Prospective Studies; Retrospective Studies; Tooth, Nonvital
PubMed: 29984369
DOI: 10.3290/j.jad.a40762 -
Odontology Oct 2019Recently, sealers based on calcium silicates were developed as a new class of endodontic sealers. Inspired by the excellent sealing ability and biocompatibility of... (Review)
Review
Recently, sealers based on calcium silicates were developed as a new class of endodontic sealers. Inspired by the excellent sealing ability and biocompatibility of calcium silicate-based cements, these sealers establish a biological point of view on the obturation of root canals. No longer, the bacteria-tight seal against reinfection of the root canal is the only goal of root canal obturation. Antibacterial properties as well as bioactive inducement of periapical healing and hard tissue formation are added to the portfolio of sealers. Ready-to-use sealers consisting of only one component with a need for external water supply from, e.g., body fluid and two components sealers with internal water supply were introduced to the market. Both of these material types have the same setting reactions in common whereby a hydration reaction of the calcium silicate is followed by a precipitation reaction of calcium phosphate. Though the available sealers are all based on calcium silicates, they consist of different compositions. Due to this aspect, differences in their physical and chemical properties as well as in their in vitro characteristics were described. Studies addressing the clinical impact of calcium silicate-based sealers on outcome are still sparse. The bioactive potential of sealers based on calcium silicates is a consequence of the slight solubility of these materials even after setting, but solubility of the sealer might also compromise the quality of sealing a root canal against regrowth and reinfection. Further clinical investigations are required to evaluate the clinical relevance of the gulf between bioactivity and solubility.
Topics: Calcium Compounds; Drug Combinations; Epoxy Resins; Materials Testing; Root Canal Filling Materials; Root Canal Obturation; Silicates
PubMed: 30554288
DOI: 10.1007/s10266-018-0400-3 -
Clinical Oral Investigations Dec 2021The survival rate of indirect partial adhesive restorations on vital versus endodontically treated teeth is still controversial. The hypothesis is that there may be a... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The survival rate of indirect partial adhesive restorations on vital versus endodontically treated teeth is still controversial. The hypothesis is that there may be a difference in the survival rate of partial adhesive restorations performed on non-vital teeth compared to vital teeth.
MATERIALS AND METHODS
This systematic review was conducted following the PRISMA guidelines. The considered clinical studies investigated the outcomes of adhesive inlays, onlays, and overlays conducted over the past 40 years, focusing on Kaplan-Meier survival curves to calculate the hazard ratio (primary objective) and the survival rate (secondary objective) between vital and non-vital teeth. The risk of bias was assessed using the Newcastle-Ottawa Scale. Studies included in the review were identified through bibliographic research on electronic databases ("PubMed," "Scopus," "Cochrane Central Register of Controlled Trial," and "Embase"). The K agreement between the two screening reviewers was evaluated.
RESULTS
A total of 55,793 records were identified on PubMed, Scopus, and other bibliographic sources, and after the application of the eligibility and inclusion criteria, eight articles were included for qualitative analysis and six for quantitative analysis. The meta-analysis of the primary and secondary outcomes demonstrated that hazard ratios (HR = 8.41, 95% CI: [4.50, 15.72]) and survival rates (OR = 3.24, 95% CI: [1.76, 5.82]) seemed more favorable for indirect partial adhesive restorations on vital teeth than for those on endodontically treated teeth.
CONCLUSIONS
Within the limits of this study, these findings suggest that the risk of failure of indirect partial adhesive restorations on endodontically treated teeth is higher than on vital teeth.
CLINICAL RELEVANCE
The use of partial adhesive restorations on vital and endodontically treated teeth showed different long-term clinical outcomes.
Topics: Composite Resins; Dental Restoration Failure; Dental Restoration, Permanent; Humans; Inlays; Kaplan-Meier Estimate; Mass Screening; Tooth, Nonvital
PubMed: 34628547
DOI: 10.1007/s00784-021-04187-x -
The European Journal of Prosthodontics... Nov 2022The objective of this systematic review was to compare the longevity of direct amalgam and composite resin restorations, in posterior teeth, through clinical,...
OBJECTIVES
The objective of this systematic review was to compare the longevity of direct amalgam and composite resin restorations, in posterior teeth, through clinical, prospective or retrospective studies, with at least 5 years of follow-up.
MATERIALS AND METHODS
Studies published in the last 15 years (from 2006 to 2021) were collected using the PubMed and Medline databases.
RESULTS
The search strategy associated with the established inclusion and exclusion criteria resulted in a total of 17 articles. Factors related to failures in the performance of restorations were analyzed together with the clinical performance results of each material over the years of study, according to the methodology of each article.
CONCLUSIONS
Regardless of the restorative material, the successful results over more than 5 years are due much more to the correct application of the technique, the operator's skill/knowledge and factors related to the patient, such as the type of tooth, number of faces involved in the restoration and oral hygiene.
Topics: Humans; Prospective Studies; Retrospective Studies; Composite Resins; Dental Materials
PubMed: 35438266
DOI: 10.1922/EJPRD_2371Maciel09