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Quintessence International (Berlin,... 2017With the Minamata Convention the use of mercury will be phased down, and this undoubtedly will have an effect on dental treatment regimens and economic resources.... (Review)
Review
BACKGROUND
With the Minamata Convention the use of mercury will be phased down, and this undoubtedly will have an effect on dental treatment regimens and economic resources. Composite resin restorations are considered viable alternatives to amalgam fillings; however, these will not be covered completely by health insurance systems in many countries. Recently, a high-viscosity glass-ionomer cement (hvGIC) processed with a resinous coating (RC) has been introduced, and has been marketed as a restorative material in load-bearing Class I cavities (and in Class II cavities with limited size), thus serving as a possible alternative to amalgam fillings.
OBJECTIVE
To discuss the outcome based on the evaluation presented in Part I of this paper, and to critically appraise the methodologies of the various studies.
RESULTS
Two of the included studies were industry-funded, and status of the other clinical trials remained unclear. Quality of study reporting was considered perfectible. The use of a light-cured nanofilled resin coating material would seem advantageous, at least when regarding short- and medium term outcomes.
CONCLUSION
Within the respective indications and cavity geometries, the hvGIC/RC approach would seem promising, could merge the phase-down of mercury and the objectives of minimally invasive treatment to some extent, and might be a restorative alternative for patients suffering from allergies or not willing to afford other sophisticated or expensive techniques. These recommendations are based on studies evaluating EQUIA Fil (GC), but are not transferable to clinical perspectives of the glass hybrid successor product (EQUIA Forte; GC).
Topics: Composite Resins; Dental Amalgam; Dental Caries; Dental Restoration, Permanent; Glass Ionomer Cements; Light-Curing of Dental Adhesives; Mercury; Viscosity
PubMed: 28054040
DOI: 10.3290/j.qi.a37211 -
European Archives of Paediatric... Oct 2022To systematically search the available evidence and evaluate the clinical effectiveness of restorative materials for restoration of carious primary teeth. The findings...
PURPOSE
To systematically search the available evidence and evaluate the clinical effectiveness of restorative materials for restoration of carious primary teeth. The findings aimed to support the European Academy of Paediatric Dentistry (EAPD) guidelines development.
METHODS
Literature search was performed by searching 4 electronic databases for eligible randomised controlled clinical trials (RCTs) comparing restorative materials for the restoration of carious primary teeth up to December 28th, 2020. Quality assessment was performed with the revised Cochrane risk-of-bias tool for randomized trials (RoB 2).
RESULTS
Of 1685 identified articles 29 RCTs were finally deemed as eligible for inclusion. Annual failure rates were: Amalgam 1-28%; atraumatic restorative treatment 1.2-37.1%; glass-ionomer cement (GIC) 7.6-16.6%, metal-reinforced GIC 29.9%, resin-modified GIC 1.9-16.9%, high-viscosity GIC 2.9-25.6%; glass carbomer ≤ 46.2%; compomer 0-14.7%; composite resin (CR) 0-19.5%, bulk-fill CR 0-16.9%; zirconia crowns 3.3%, composite strip crowns 15%, and preformed metal crowns (Hall-Technique) 3.1%. Secondary caries, poor marginal adaptation, loss of retention, and fracture of restoration were reported as reasons for failure. Four studies were evaluated at unclear and 25 at high risk of bias. Clinical and methodological heterogeneity, and the diversity of tested materials across included studies did not allow for meta-analyses.
CONCLUSIONS
Within the limitations of this systematic review, namely, the heterogeneity and the overall high risk of bias among included studies, clear recommendations based on solid evidence for the best restorative approach in primary teeth cannot be drawn. There is a need for future thoroughly implemented RCTs evaluating restorations in primary teeth to close this knowledge gap.
Topics: Child; Humans; Composite Resins; Dental Atraumatic Restorative Treatment; Dental Caries; Dental Materials; Dental Restoration Failure; Dental Restoration, Permanent; Glass Ionomer Cements; Tooth, Deciduous; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 35819627
DOI: 10.1007/s40368-022-00725-7 -
Dermatitis : Contact, Atopic,...This systematic review summarizes characteristics and treatment outcomes of dental amalgam-associated oral lichenoid lesions (OLLs) and oral lichen planus (OLP). Embase...
This systematic review summarizes characteristics and treatment outcomes of dental amalgam-associated oral lichenoid lesions (OLLs) and oral lichen planus (OLP). Embase and MEDLINE were searched for original studies on OLLs or OLP associated with dental amalgam. Data extraction was completed from 44 studies representing 1855 patients. Removal of amalgam restorations led to complete resolution in 54.2% (n = 423/781), partial resolution in 34.8% (n = 272/781), and no resolution in 11.0% (n = 86/781) of the patients with OLLs, whereas complete resolution occurred in 37.1% (n = 72/194), partial resolution in 26.3% (n = 51/194), and no resolution in 36.6% (n = 71/194) of the patients with OLP. For patients with OLLs, 91.6% of the patients with positive patch tests and 82.9% with negative patch tests had improvement with removal of amalgam, whereas for patients with OLP, 89.2% of the patients with positive patch tests and 78.9% with negative patch tests had improvement with removal of amalgam. Our results suggest improvement occurs, regardless of patch testing status.
Topics: Dental Amalgam; Dental Restoration, Permanent; Dermatitis, Allergic Contact; Humans; Lichen Planus, Oral; Mercury; Mouth Mucosa; Patch Tests; Treatment Outcome
PubMed: 33273245
DOI: 10.1097/DER.0000000000000703 -
The Cochrane Database of Systematic... Oct 2021Root canal therapy is a sequence of treatments involving root canal cleaning, shaping, decontamination, and obturation. It is conventionally performed through a hole... (Review)
Review
BACKGROUND
Root canal therapy is a sequence of treatments involving root canal cleaning, shaping, decontamination, and obturation. It is conventionally performed through a hole drilled into the crown of the affected tooth, namely orthograde root canal therapy. When it fails, retrograde filling, which seals the root canal from the root apex, is a good alternative. Many materials are used for retrograde filling. Since none meets all the criteria an ideal material should possess, selecting the most efficacious material is of utmost importance. This is an update of a Cochrane Review first published in 2016.
OBJECTIVES
To determine the effects of different materials used for retrograde filling in children and adults for whom retrograde filling is necessary in order to save the tooth.
SEARCH METHODS
An Information Specialist searched five bibliographic databases up to 21 April 2021 and used additional search methods to identify published, unpublished, and ongoing studies. We also searched four databases in the Chinese language.
SELECTION CRITERIA
We selected randomised controlled trials (RCTs) that compared different retrograde filling materials, with the reported success rate that was assessed by clinical or radiological methods for which the follow-up period was at least 12 months.
DATA COLLECTION AND ANALYSIS
Records were screened in duplicate by independent screeners. Two review authors extracted data independently and in duplicate. Original trial authors were contacted for any missing information. Two review authors independently assessed the risk of bias of the included studies. We followed Cochrane's statistical guidelines and assessed the certainty of the evidence using GRADE.
MAIN RESULTS
We included eight studies, all at high risk of bias, involving 1399 participants with 1471 teeth, published between 1995 and 2019, and six comparisons of retrograde filling materials. - Mineral trioxide aggregate (MTA) versus intermediate restorative material (IRM): there may be little to no effect of MTA compared to IRM on success rate at one year, but the evidence is very uncertain (risk ratio (RR) 1.09, 95% confidence interval (CI) 0.97 to 1.22; I = 0%; 2 studies; 222 teeth; very low-certainty evidence). - MTA versus super ethoxybenzoic acid (Super-EBA): there may be little to no effect of MTA compared to Super-EBA on success rate at one year, but the evidence is very uncertain (RR 1.03, 95% CI 0.96 to 1.10; 1 study; 192 teeth; very low-certainty evidence). - Super-EBA versus IRM: the evidence is very uncertain about the effect of Super-EBA compared with IRM on success rate at 1 year, with results indicating Super-EBA may reduce or have no effect on success rate (RR 0.90, 95% CI 0.80 to 1.01; 1 study; 194 teeth; very low-certainty evidence). - Dentine-bonded resin composite versus glass ionomer cement: compared to glass ionomer cement, dentine-bonded resin composite may increase the success rate of the treatment at 1 year, but the evidence is very uncertain (RR 2.39, 95% CI 1.60 to 3.59; 1 study; 122 teeth; very low-certainty evidence). Same result was obtained when considering the root as unit of analysis at one year (RR 1.59, 95% CI 1.20 to 2.09; 1 study; 127 roots; very low-certainty evidence). - Glass ionomer cement versus amalgam: the evidence is very uncertain about the effect of glass ionomer cement compared with amalgam on success rate at one year, with results indicating glass ionomer cement may reduce or have no effect on success rate (RR 0.98, 95% CI 0.86 to 1.12; 1 study; 105 teeth; very low-certainty evidence). - MTA versus root repair material (RRM): there may be little to no effect of MTA compared to RRM on success rate at one year, but the evidence is very uncertain (RR 1.00, 95% CI 0.94 to 1.07; I = 0%; 2 studies; 278 teeth; very low-certainty evidence). Adverse events were not assessed by any of the included studies.
AUTHORS' CONCLUSIONS
Based on the present limited evidence, there is insufficient evidence to draw any conclusion as to the benefits of any one material over another for retrograde filling in root canal therapy. We conclude that more high-quality RCTs are required.
Topics: Adult; Child; Crowns; Glass Ionomer Cements; Humans; Root Canal Therapy
PubMed: 34647617
DOI: 10.1002/14651858.CD005517.pub3 -
Dental Materials : Official Publication... Jun 2024To compare the performance of Cention-N® with direct restorative materials used at the daily practice (e.g., resin-based composites/RBC, glass ionomer cements/GIC,... (Review)
Review
OBJECTIVES
To compare the performance of Cention-N® with direct restorative materials used at the daily practice (e.g., resin-based composites/RBC, glass ionomer cements/GIC, bioactive resins, silver amalgam) via a systematic review study.
METHODS
The review followed the PRISMA-NMA recommendations, and the protocol of the review was published at osf.io/ybde8. The search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, Lilacs, and SciELO databases, as well as in the grey literature (Open Grey, Proquest, and Periódicos CAPES). Studies with an in vitro experimental design evaluating the characteristics and properties of Cention-N in comparison to other restorative materials were included. The risk of bias of included studies was assessed using the RoBDEMAT tool, and meta-analyses were conducted using Review Manager 5.4 and MetaInsight V3 tools.
RESULTS
A total of 85 studies were included in the review, from which 79 were meta-analyzed. Several characteristics of direct restorative materials were analyzed, including physical (color change, degree of conversion, hardness, microleakage, polymerization rate, roughness, water solubility, water sorption), mechanical (bond strength to dentin, compressive strength, diametral tensile strength, flexural modulus, flexural strength, load-to-fracture, wear), and biological (alkalinizing effect, antibacterial activity, calcium and fluoride release) properties.
SIGNIFICANCE
Cention-N presented similar physico-mechanical properties compared to RBCs, but a stronger behavior than GICs. Despite the Alkasite nature of Cention-N, GICs may still demonstrate the greatest fluoride releasing ability from all direct restorative materials. This review confirmed the adequate behavior of Cention-N when compared to several other more traditionally used materials, confirming its applicability for the permanent restoration of decayed or fractured teeth.
PubMed: 38880724
DOI: 10.1016/j.dental.2024.06.014 -
British Dental Journal Oct 1999To conduct a systematic review of the literature on the longevity of routine dental restorations in permanent posterior teeth, and to identify and examine factors... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To conduct a systematic review of the literature on the longevity of routine dental restorations in permanent posterior teeth, and to identify and examine factors influencing its variability.
METHOD
Accepted guidelines were followed. An advisory group oversaw the project. Simple Class I and Class II amalgam, composite resin, glass ionomer and cast gold restorations were covered. Comprehensive searching of electronic databases, hand-searching, and location of 'grey' literature, generated 124 research reports. Those considered relevant were assessed for validity and quality according to agreed criteria. The analysis was descriptive.
RESULTS
Eight of 58 relevant research reports were categorised, according to agreed criteria, as being of satisfactory validity and quality. They suggested that 50% of all restorations last 10 to 20 years, although both higher and lower median survival times were reported. The findings were supported by the totality of studies reviewed. However, variability was substantial. Restoration type, materials, the patient, the operator, the practice environment and type of care system appeared to influence longevity.
CONCLUSIONS
Many studies were imperfect in design. Those considered to be the most appropriate for analysis were too limited to undertake a formal statistical exploration. Therefore there remains a need for definitive randomised controlled trials of restoration longevity, of sound design and adequate power, employing standardised assessments and appropriate methods of analysis.
Topics: Bicuspid; Composite Resins; Dental Amalgam; Dental Cavity Preparation; Dental Materials; Dental Restoration, Permanent; Glass Ionomer Cements; Gold Alloys; Humans; Molar; Reproducibility of Results; Survival Analysis; Time Factors
PubMed: 10716002
DOI: 10.1038/sj.bdj.4800298a1 -
International Endodontic Journal Jul 2015Composite resin is used extensively for restoration of teeth with vital pulps. Although cell culture studies have disclosed harmful effects on pulpal cells, any untoward... (Review)
Review
Composite resin is used extensively for restoration of teeth with vital pulps. Although cell culture studies have disclosed harmful effects on pulpal cells, any untoward clinical effects, manifest as adverse pulpal responses, have yet to be determined. This study comprises a systematic review, designed to address the question of whether the risk of endodontic complications is greater with composite resin restorations than with other restorative materials, such as amalgam. The study methodology involved (i) formulation of the research question, (ii) construction and conduct of an extensive literature search with (iii) interpretation and assessment of the retrieved literature. A search of the medical database PubMed was complemented with a search of the Controlled Trials Register (CENTRAL). The initial search yielded 1043 publications, the abstracts of which were read independently by the authors. After additional searches, 10 studies were included in the review. In all the included studies, the level of evidence was assessed as low. No conclusions could therefore be drawn. The included studies reported few, if any, endodontic complications. Little or no differences emerged between teeth restored with composite resins and those restored with amalgam. To determine whether composite resin restorations of teeth with vital pulps are associated with an increased risk for development of endodontic complications such as apical periodontitis, further evidence is needed, from well-constructed studies with a large number of participants.
Topics: Composite Resins; Dental Cavity Preparation; Dental Pulp Diseases; Dental Restoration, Permanent; Humans; Periapical Diseases
PubMed: 25100025
DOI: 10.1111/iej.12364 -
Quintessence International (Berlin,... Oct 2015For decades, dental restorative treatment of large and deep cavities of posterior teeth has been adequately ensured by amalgam or by indirect gold restorations; with the... (Review)
Review
OBJECTIVE
For decades, dental restorative treatment of large and deep cavities of posterior teeth has been adequately ensured by amalgam or by indirect gold restorations; with the continuing advancements in material technology and clinical techniques, alternative and more esthetic types of restorations have become feasible. Proximal box elevation (PBE) using composite resins has been advocated for relocating subgingival cavity outlines; treatment success and effects of PBE require documentation.
DATA SOURCES
An electronic search was performed on several literature databases to identify relevant articles published in indexed journals until April 2015.
METHOD AND MATERIALS
The authors independently screened the relevant papers found (PBE with composite resins).
RESULTS
This paper compiles the current knowledge about PBE (which is predominantly based on laboratory research, in particular with a focus on microleakage and marginal adaptation), revealing that flowable composites allow for a stepwise elevation of proximal cavity floors, thus simplifying treatment of deep lesions, and broadening the restorative spectrum. A case report revealing an advanced caries lesion and demonstrating the clinical application of the PBE technique together with an indirect computer-aided design/computer-assisted manufacture (CAD/CAM) all-ceramic restoration is presented, assuring the practitioner's familiarity with effective placement techniques.
CONCLUSION
PBE represents a promising two-step treatment regimen, simultaneously encompassing the benefits of immediate dentin sealing and facilitating direct or indirect adhesive restorations of cavities with margins located beneath the gingival tissues. However, high-quality randomized clinical trials are required to confirm the laboratory outcomes.
Topics: Adult; Composite Resins; Computer-Aided Design; Dental Caries; Dental Cavity Preparation; Dental Marginal Adaptation; Dental Restoration, Permanent; Humans; Male; Molar
PubMed: 26159213
DOI: 10.3290/j.qi.a34459 -
Pediatric Dentistry Jan 2022There are several restorative modalities for molar hypomineralization, but there is no consensus on the best approach. The purpose of this review was to describe...
There are several restorative modalities for molar hypomineralization, but there is no consensus on the best approach. The purpose of this review was to describe restorative approaches applied to permanent first molars (PFM) with molar hypomineralization (MH). This review was registered (PROSPERO database CRD42017078336). Searches were conducted in the PubMed, Scopus, Web of Science, LILACS, BBO, and Cochrane Library databases and grey literature. From a total of 1,751 studies, 12 that compared restorative treatments for PFM with MH were included. The risk of bias of the studies was assessed using the Cochrane Collaboration and the Newcastle-Ottawa Scale. The success rate was the primary outcome. The restorative treatment options were direct restorations with amalgam, glass ionomer cement, and resin-based composite as well as indirect restorations with stainless steel, porcelain, ceromer, and gold crowns. The restorative techniques, considering the type of isolation and the removal of caries and hypomineralization, vary between the study. There was also a lack of standard clinical criteria for restorative evaluation. The follow-up period ranged from six to 216 months. The success of direct restorations ranged from 86.3 to 100 percent. For indirect restorations, success ranged from 91.3 to 100 percent. There were multiple clinical protocols for MH. The studies presented heterogeneity in the restoration technique, time, and clinical criteria for restorative follow-up. Direct restorations with glass ionomer cement and resin-based composite could be the first choices for restoration. Further randomized clinical trials on a restorative treatment for MH are needed.
Topics: Composite Resins; Dental Amalgam; Dental Caries; Dental Restoration, Permanent; Glass Ionomer Cements; Humans; Molar; Tooth, Deciduous
PubMed: 35232531
DOI: No ID Found -
Journal of Dentistry Jul 2019While repairs are increasingly recommended to manage partially defective restorations, performing the repair (including bonding to different substrates) can be...
OBJECTIVES
While repairs are increasingly recommended to manage partially defective restorations, performing the repair (including bonding to different substrates) can be challenging, and dentists should adhere to established repair protocols. We aimed to systematically assess the consistency and quality of repair protocols.
DATA
808 records were initially identified and 71 repair protocols based on 84 sources included. The number of published sources over time increased exponentially (p < 0.001). Recommended treatment steps varied widely. Some treatment steps were only recommended by a minority of protocols, while others were consistently recommended (e.g. surface roughening, hydrofluoric acid etching of silicate ceramics, application of an adhesive/bonding agent). The overall quality of included sources was moderate (mean ± SD 3.7 ± 0.9 out of 7 points).
SOURCES
Electronic databases (Medline via PubMed, Embase) were searched, hand searches using Google and Google Scholar conducted, and the reference lists of included full texts screened and cross-referenced.
STUDY SELECTION
(Non-)systematic reviews, working instructions, and textbooks with protocols on direct composite repair restorations for partially defective (1) composite, (2) amalgam, (3) porcelain-fused-to-metal (PFMs) with exposed metal base, (4) ceramic/PFMs without exposed metal base, and (5) full metal restorations were included. Data synthesis was performed by tabulation of recommended treatment steps and descriptive statistics. The quality of included sources was assessed based on a checklist for guideline appraisal (MiChe).
CONCLUSIONS
The main treatment steps were consistently reported across repair protocols.
CLINICAL SIGNIFICANCE
Dentists may want to adopt widely recommended treatment steps when performing repairs of different restoration materials in their daily practice.
Topics: Ceramics; Composite Resins; Dental Materials; Dental Porcelain; Dental Restoration Failure; Dental Restoration, Permanent
PubMed: 31108118
DOI: 10.1016/j.jdent.2019.05.021