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Journal of Dentistry Mar 2024This systematic review and network meta-analysis (NMA) aimed to establish a clinically relevant hierarchy of the different adhesive and/or restorative approaches to... (Meta-Analysis)
Meta-Analysis
AIM
This systematic review and network meta-analysis (NMA) aimed to establish a clinically relevant hierarchy of the different adhesive and/or restorative approaches to restore cavitated root caries lesions through the synthesis of available evidence.
MATERIALS AND METHODS
A systematic search was conducted in Medline/Web of Science/Embase/ Cochrane Library/Scopus/grey literature. RCTs investigating ≥2 restorative strategies (restorative /adhesive materials) for root caries lesions in adult patients were included. Risk of bias within studies was assessed (Cochrane_RoB-2) and the primary outcome was survival rate of restorations at different follow-up times (6-/12-/24-months). Network meta-analyses were conducted using a random effects model stratified by follow-up times. I-statistics assessed the ratio of true to total variance in the observed effects. All available combinations of adhesives (1-SE: one-step self-etch; 2-3ER: two-/three-step etch-and-rinse) and restorative materials (conventional composite (CC) as well as conventional and resin-modified glass ionomer cements (GIC, RMGIC)) were included. Risk of bias across studies and confidence in NMA (CINeMA) were assessed.
RESULTS
547 studies were identified and nine were eligible for the NMA. In total, 1263 root caries lesions have been restored in 473 patients in the included clinical trials. Patients involved were either healthy (n = 6 trials), living in nursing homes (n = 1 trial) or received head-and-neck radiotherapy (n = 2 trials). There was statistically weak evidence to favour either of material/material combination regarding the survival rate. A tendency for higher survival rate (24-months) was observed for 2-3ER/CC (OR 2.65; CI=1.45/4.84) as well as RMGIC (OR 2.05; CI=1.17/3.61) compared to GIC. These findings were though not statistically significant and confidence of the NMA was low.
CONCLUSION
An evidence-based choice of restorative strategy for managing cavitated root caries lesions is currently impossible. There is a clear need for more standardised, well-designed RCTs evaluating the retention rate of root caries restoration approaches.
Topics: Adult; Humans; Root Caries; Dental Cements; Network Meta-Analysis; Dental Restoration, Permanent; Dental Materials; Dental Caries; Glass Ionomer Cements; Composite Resins
PubMed: 37977410
DOI: 10.1016/j.jdent.2023.104776 -
Journal of the American Dental... Nov 2014Hemostatic agents have been used clinically in dentistry for many years to control bleeding. The authors reviewed scientific publications in which researchers... (Review)
Review
BACKGROUND
Hemostatic agents have been used clinically in dentistry for many years to control bleeding. The authors reviewed scientific publications in which researchers investigated the effects of hemostatic agents on dentin and enamel surfaces and on bonding of adhesive systems and resin cements.
TYPES OF STUDIES REVIEWED
The authors screened PubMed and Scopus databases for studies in English published from 1980 to 2013. They read the titles and abstracts to identify literature that fulfilled the inclusion criteria. The authors included studies in which researchers evaluated the hemostatic action on the dentin and enamel surfaces or its influence on the bond strength of adhesive systems or resin cements. They used cross-referencing to identify more articles.
RESULTS
Twenty in vitro studies met the inclusion criteria. Investigators in 12 of these studies evaluated the bond strength to contaminated dentin. Investigators in 10 of these studies reported a significant decrease in bond strength. Those in two studies evaluated the influence of a hemostatic agent on the dental enamel and reported decreases in bond strength. Researchers also reported significant increases in microleakage of self-etching adhesives on contaminated dentin. Scanning electron microscopy revealed partial removal of the smear layer or an etching effect of dentin as a result of the application of hemostatic agents on dentin.
PRACTICAL IMPLICATIONS
Adhesive procedures may be affected adversely when performed on dentin and enamel contaminated by hemostatic agents. Hemostatic agents may induce changes in the dentin surface morphology. The results of this review indicate that the bond strength of self-etching adhesive systems is affected more negatively than is that of etch-and-rinse systems. The authors found that a 60-second application of ethylenediaminetetraacetic acid followed by a water spray restored the bond strength of a self-etching adhesive to dentin; use of phosphoric acid for 15 seconds followed by a water spray also was an effective cleaning method. Direct comparison of selected studies was not possible, however, mainly because of methodological differences hampering definitive conclusions.
Topics: Acid Etching, Dental; Composite Resins; Dental Bonding; Dental Cements; Dental Enamel; Dental Stress Analysis; Dentin; Dentin-Bonding Agents; Hemostatics; Microscopy, Electron, Scanning; Surface Properties
PubMed: 25359643
DOI: 10.14219/jada.2014.84 -
Journal of Prosthodontics : Official... Jan 2014To systematically evaluate the survival and success of screw- versus cement-retained implant crowns. (Review)
Review
PURPOSE
To systematically evaluate the survival and success of screw- versus cement-retained implant crowns.
MATERIALS AND METHODS
The authors performed an electronic search of nine databases using identical MeSH phrases. Systematic evaluation and data extraction of the articles from 1966 through 2007 were completed by three reviewers and two clinical academicians. The major outcome variable was implant or crown loss, and the minor outcome variables were screw loosening, decementation, and porcelain fracture. Random effects Poisson models were used to analyze the failure and complication rates.
RESULTS
The initial search produced 26,582 articles. Of these, 577 titles and subsequently 295 abstracts were available for evaluation, with 81 full texts meeting the criteria for review. Data were extracted from 23 level one and two research studies. Fleiss' kappa interevaluator agreement ranged from almost perfect to moderate. Major failures included 0.71 screw-retained and 0.87 cement-retained failures per 100 years. Minor failures included 3.66 screw loosenings, 2.54 decementations, and 0.46 porcelain fractures per 100 years.
CONCLUSION
There is no significant difference between cement- and screw-retained restorations for major and minor outcomes with regard to implant survival or crown loss. This is important data, as clinicians use both methods of restoration, and neither is a form of inferior care.
Topics: Cementation; Crowns; Dental Porcelain; Dental Prosthesis Design; Dental Prosthesis Retention; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Humans
PubMed: 24382004
DOI: 10.1111/jopr.12128 -
Quintessence International (Berlin,... 2016With 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 evaluate the literature on this treatment approach, and to focus particularly on the clinical performance of the hvGIC/RC combination.
SEARCH STRATEGY
The Cochrane Library as well as Ebsco, Embase, PubMed, and Scopus databases were screened. Moreover, relevant abstracts published with dental meetings were reviewed.
SELECTION CRITERIA
All available randomized clinical trials focusing on the hvGIC/RC approach (published either as full-texts or abstracts until June 2016) were selected. Moreover, single-group studies using hvGIC/RC were included.
DATA COLLECTION AND ANALYSIS
Screening of titles and abstracts, data extraction, and quality assessments of full-texts according to Oxford scoring were performed.
RESULTS
Regarding failure rates, minor differences between hvGIC/RC and GIC or composite resins as comparators could be observed in seven clinical studies. The hvGIC/RC combination showed high survival rates (with only few catastrophic failures) of up to 6 years.
CONCLUSION
Class I retention rates of hvGIC/RC seem promising, but further high-quality clinical studies are clearly warranted.
Topics: Composite Resins; Dental Amalgam; Dental Caries; Dental Restoration, Permanent; Glass Ionomer Cements; Humans; Mercury; Viscosity
PubMed: 27757445
DOI: 10.3290/j.qi.a36884 -
International Journal of Clinical... 2021Knowledge of the cytotoxicity and bioactivity of endodontic materials may assist in understanding their ability to promote dental pulp stem cell activity and pulp... (Review)
Review
BACKGROUND
Knowledge of the cytotoxicity and bioactivity of endodontic materials may assist in understanding their ability to promote dental pulp stem cell activity and pulp healing in primary teeth.
MATERIALS AND METHODS
This systematic review was carried out by searching the electronic databases such as PubMed, Google Scholar, and Cochrane reviews for the articles published between January 2000 and December 2018 using the appropriate MeSH keywords. An independent investigator evaluated the abstracts and titles for possible inclusion, as per the stipulated inclusion and exclusion criteria. The topics considered for extracting data from each study were: cell lineage, cytotoxicity assay used, and type of material tested.
RESULTS
Seven eligible studies were selected for assessing the quality of evidence on the bioactivity of bioactive endodontic cements (BECs) (1 human cell line, 2 animal cell lines, and 4 , animal, and human studies) and 13 studies were selected for reviewing the quality of evidence on cytotoxicity (7 human cell lines, 4 animal cell lines, and 2 animal model studies). Very limited studies had been conducted on the bioactivity of materials other than mineral trioxide aggregate (MTA). With regards to cytotoxicity, the studies were diverse and most of the studies were based on MTT assay. Mineral trioxide aggregate is the most frequently used as well as studied root-end filling cement, and the literature evidence corroborated its reduced cytotoxicity and enhanced bioavailability.
CONCLUSION
There was a lack of sufficient evidence to arrive at a consensus on the ideal material with minimal cytotoxicity and optimal bioactivity. More focused human/cell line-based studies are needed on the available root filling materials.
CLINICAL SIGNIFICANCE
The present systematic review provides an update on the available literature evidence on the cytotoxicity and bioactivity of various BECs including MTAs and their influence on the different cells with respect to their composition and strength.
HOW TO CITE THIS ARTICLE
Maru V, Dixit U, Patil RSB, Cytotoxicity and Bioactivity of Mineral Trioxide Aggregate and Bioactive Endodontic Type Cements: A Systematic Review. Int J Clin Pediatr Dent 2021;14(1):30-39.
PubMed: 34326580
DOI: 10.5005/jp-journals-10005-1880 -
Journal of Oral Rehabilitation Jun 2015The aim was to make an inventory of the current literature on the clinical performance of tooth- or implant-supported zirconia-based FDPs and analyse and discuss any... (Review)
Review
The aim was to make an inventory of the current literature on the clinical performance of tooth- or implant-supported zirconia-based FDPs and analyse and discuss any complications. Electronic databases, PubMed.gov, Cochrane Library and Science Direct, were searched for original studies reporting on the clinical performance of tooth- or implant-supported zirconia-based FDPs. The electronic search was complemented by manual searches of the bibliographies of all retrieved full-text articles and reviews, as well as a hand search of the following journals: International Journal of Prosthodontics, Journal of Oral Rehabilitation, International Journal of Oral & Maxillofacial Implants and Clinical Oral Implants Research. The search yielded 4253 titles. Sixty-eight potentially relevant full-text articles were retrieved. After applying pre-established criteria, 27 studies were included. Twenty-three studies reported on tooth-supported and 4 on implant-supported FDPs. Five of the studies were randomised, comparing Y-TZP-based restorations with metal-ceramic or other all-ceramic restorations. Most tooth-supported FDPs were FDPs of 3-5 units, whereas most implant-supported FDPs were full arch. The majority of the studies reported on 3- to 5-year follow-up. Life table analysis revealed cumulative 5-year survival rates of 93.5% for tooth-supported and 100% for implant-supported FDPs. For tooth-supported FDPs, the most common reasons for failure were veneering material fractures, framework fractures and caries. Cumulative 5-year complication rates were 27.6% and 30.5% for tooth- and implant-supported FDPs, respectively. The most common complications were veneering material fractures for tooth- as well as implant-supported FDPs. Loss of retention occurred more frequently in FDPs luted with zinc phosphate or glass-ionomer cement compared to those luted with resin cements. The results suggest that the 5-year survival rate is excellent for implant-supported zirconia-based FDPs, despite the incidence of complications, and acceptable for tooth-supported zirconia-based FDPs. These results are, however, based on a relatively small number of studies, especially for the implant-supported FDPs. The vast majority of the studies are not controlled clinical trials and have limited follow-up. Thus, interpretation of the results should be made with caution. Well-designed studies with large patient groups and long follow-up times are needed before general recommendations for the use of zirconia-based restorations can be provided.
Topics: Dental Materials; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Partial, Fixed; Humans; Time Factors; Treatment Outcome; Zirconium
PubMed: 25580846
DOI: 10.1111/joor.12272 -
Stomatologija 2020A significant loss of dental structures during endodontic treatment increases the probability of tooth cracks, fractures or even tooth loss. The objective of this...
INTRODUCTION
A significant loss of dental structures during endodontic treatment increases the probability of tooth cracks, fractures or even tooth loss. The objective of this systematic review was to assess the influence of temporary filling material on dental cracks and fractures during endodontic treatment.
MATERIALS AND METHODS
The literature was digitally searched for in vivo and in vitro studies using Pubmed, ScienceDirect and Wiley Online Library databases. A total of 38 potentially relevant records were identified in the literature search after duplicates were removed. After screening, full-text analysis of selected studies was done. Two reviewers independently selected the studies, extracted the data which was structured and summarized.
RESULTS
Five publications met the selection criteria. Ten temporary filling materials were evaluated in this review. The analysis demonstrated that non-eugenol chemically hardening temporary filling materials significantly increase filling and dental fractures and have the lowest fracture and tooth fracture resistance. Glass ionomer cements (GIC) presented the higher hermetic, tightness and fracture resistance features.
CONCLUSIONS
A temporary filling material during endodontic treatment may influence dental cracks and fractures. Highest impact for dental cracks and fractures has ready-to-use, eugenol-free temporary filling materials, whereas the least impact has GIC.
Topics: Glass Ionomer Cements; Humans; Root Canal Filling Materials; Tooth Fractures
PubMed: 33821811
DOI: No ID Found -
The Journal of Evidence-based Dental... Dec 2018Direct pulp capping therapies use biomaterials to protect exposed tissues, inducing repair through the production of a mineralized barrier. The purpose of this study was... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Direct pulp capping therapies use biomaterials to protect exposed tissues, inducing repair through the production of a mineralized barrier. The purpose of this study was to compare the effectiveness of biomaterials and techniques by means of a systematic review and meta-analysis.
METHODS
The PubMed, Cochrane, and Embase databases were used to search the literature published from January 1, 1980 until August 31, 2017. Studies that met inclusion criteria were screened by 2 authors individually. The meta-analysis was performed on mineral trioxide aggregate (MTA) cement vs calcium hydroxide cement, tricalcium silicate cement vs MTA cement, and adhesive systems vs CaOH cement and evaluated the success rate, inflammatory response, and dentin bridge formation.
RESULTS
Forty-six studies were included in the systematic review, while 22 studies were included in the meta-analysis. There was no significant heterogeneity between the studies. MTA cements showed a significantly higher success rate, in all parameters, compared with calcium hydroxide cements (odds ratio = 2.72; 95% confidence interval [CI] = 1.90-3.90; P = 0.000). However, when compared with the tricalcium silicate cements, there were no statistically significant differences (odds ratio = 1.18; 95% CI = 0.53-2.65; P = 0.672). Adhesive systems showed a significantly lower success rate, in all parameters, compared with calcium hydroxide cements (odds ratio = 0.062; 95% CI = 0.024-0.157; P = 0.000).
CONCLUSIONS
MTA cements have a higher success rate, with a lower inflammatory response and a more predictable hard dentin barrier formation than calcium hydroxide cements. However, there were no differences, in these parameters, when MTA cement was compared with tricalcium silicate cements. Dental adhesives systems showed the lowest success rates.
Topics: Dental Cements; Dental Pulp Capping; Humans; Root Canal Therapy
PubMed: 30514444
DOI: 10.1016/j.jebdp.2018.02.002 -
The Journal of Adhesive Dentistry Mar 2022To evaluate through a systematic review and meta-analysis the bonding performance of adhesive materials to silver diamine fluoride (SDF)-treated dentin. (Meta-Analysis)
Meta-Analysis
PURPOSE
To evaluate through a systematic review and meta-analysis the bonding performance of adhesive materials to silver diamine fluoride (SDF)-treated dentin.
MATERIALS AND METHODS
Studies located in PubMed, Web of Science, LILACS, and Scopus up to September 2020, which compared the bond strength of adhesives (AD) or glass-ionomer cement (GIC) to SDF-treated and untreated (control) dentin were included. Mean differences were estimated separately by material and dentin condition (sound or caries-affected), with a random-effects model, at a 5% significance level.
RESULTS
Twenty-two studies, including 11 new studies not included in our previous systematic review, met the eligibility criteria, and 21 studies were considered in the meta-analyses. SDF dentin pretreatment did not influence the bonding of GIC (Z = 0.53; p = 0.60), independent of dentin condition. SDF treatment significantly impaired the bonding of AD (Z = 2.43; p = 0.01). A rinsing step after SDF eliminated this effect in sound dentin (Z = 1.82; p = 0.07) and increased the bond strength to caries-affected dentin (Z = 2.14; p = 0.03).
CONCLUSION
SDF pretreatment does not influence the bond strength of GIC. A rinsing step after SDF application can improve the bond strength of AD to caries-affected dentin.
Topics: Dental Bonding; Dental Cements; Dentin; Fluorides, Topical; Glass Ionomer Cements; Materials Testing; Quaternary Ammonium Compounds; Silver Compounds
PubMed: 35227044
DOI: 10.3290/j.jad.b2701679 -
Journal of Biomedical Materials... Apr 2018To systematically review the literature to analyze the current trends and future perspectives of dental pulp capping materials through an analysis of scientific and...
To systematically review the literature to analyze the current trends and future perspectives of dental pulp capping materials through an analysis of scientific and technological data. This study is reported in accordance with the PRISMA Statement. Nine databases were screened: PubMed (MedLine), Lilacs, IBECS, BBO, Web of Science, Scopus, SciELO, Google Scholar, and The Cochrane Library. Additionally, the following patent applications were searched online in Questel Orbit (Paris, France), USPTO, EPO, JPO, INPI, and Patentscope databases. A total of 716 papers and 83 patents were included. Calcium hydroxide was the main type of material studied, especially for direct pulp capping, followed by MTA. Patents related to adhesives or resins increased from 1998 e 2008, while in the last years, a major increase was observed in bioactive materials (containing bioactive proteins), materials derived from MTA (calcium silicate, calcium phosphate and calcium aluminate-based cements) and MTA. It was possible to obtain a scientific and technological overview of pulp capping materials. MTA has shown favorable results in vital pulp therapy that seem to surpass the disadvantages of calcium hydroxide. Recent advances in bioactive materials and those derived from MTA have shown promising results that could improve biomaterials used in vital pulp treatments. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1358-1368, 2018.
Topics: Animals; Biocompatible Materials; Dental Materials; Dental Pulp Capping; Humans
PubMed: 28561919
DOI: 10.1002/jbm.b.33934