-
The Cochrane Database of Systematic... Dec 2017Dental caries is a sugar-dependent disease that damages tooth structure and, due to loss of mineral components, may eventually lead to cavitation. Dental caries is the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Dental caries is a sugar-dependent disease that damages tooth structure and, due to loss of mineral components, may eventually lead to cavitation. Dental caries is the most prevalent disease worldwide and is considered the most important burden of oral health. Conventional treatment methods (drill and fill) involve the use of rotary burs under local anaesthesia. The need for an electricity supply, expensive handpieces and highly trained dental health personnel may limit access to dental treatment, especially in underdeveloped regions.To overcome the limitations of conventional restorative treatment, the Atraumatic Restorative Treatment (ART) was developed, mainly for treating caries in children living in under-served areas of the world where resources and facilities such as electricity and trained manpower are limited. ART is a minimally invasive approach which involves removal of decayed tissue using hand instruments alone, usually without use of anaesthesia and electrically driven equipment, and restoration of the dental cavity with an adhesive material (glass ionomer cement (GIC), composite resins, resin-modified glass-ionomer cement (RM-GICs) and compomers).
OBJECTIVES
To assess the effects of Atraumatic Restorative Treatment (ART) compared with conventional treatment for managing dental caries lesions in the primary and permanent teeth of children and adults.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 22 February 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 1), MEDLINE Ovid (1946 to 22 February 2017), Embase Ovid (1980 to 22 February 2017), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 22 February 2017) and BBO BIREME Virtual Health Library (Bibliografia Brasileira de Odontologia; 1986 to 22 February 2017). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) with at least six months' follow-up that compared the effects of ART with a conventional restorative approach using the same or different restorative dental materials to treat caries lesions.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened search results, extracted data from included studies and assessed the risk of bias in those studies. We used standard methodological procedures expected by Cochrane to evaluate risk of bias and synthesise data. Where pooling was appropriate we conducted meta-analyses using the random-effects model. We assessed the quality of the evidence using GRADE criteria.
MAIN RESULTS
We included a total of 15 eligible studies randomising 3760 participants in this review. The age of participants across the studies ranged from 3 to 101 years, with a mean of 25.42 years. 48% of participants were male. All included studies were published between 2002 and 2016. Two of the 15 studies declared that the financial support was from companies that manufacture restorative material. Five studies were individually randomised parallel-group studies; six were cluster-randomised parallel-group studies; and four were randomised studies that used a split-mouth design. Eleven studies evaluated the effects of ART on primary teeth only, and four on permanent teeth. The follow-up period of the included studies ranged from 6 months to 36 months. We judged all studies to be at high risk of bias.For the main comparison of ART compared to conventional treatment using the same material: all but two studies used high-viscosity glass ionomer (H-GIC) as the restorative material; one study used a composite material; and one study used resin-modified glass ionomer cement (RM-GIC)).Compared to conventional treatment using H-GIC, ART may increase the risk of restoration failure in the primary dentition, over a follow-up period from 12 to 24 months (OR 1.60, 95% CI 1.13 to 2.27, five studies; 643 participants analysed; low-quality evidence). Our confidence in this effect estimate is limited due to serious concerns over risk of performance and attrition bias. For this comparison, ART may reduce pain during procedure compared with conventional treatment (MD -0.65, 95% CI -1.38 to 0.07; 40 participants analysed; low-quality evidence)Comparisons of ART to conventional treatment using composite or RM-GIC were downgraded to very low quality due to indirectness, imprecision and high risk of performance and attrition bias. Given the very low quality of the evidence from single studies, we are uncertain about the restoration failure of ART compared with conventional treatment using composite over a 24-month follow-up period (OR 1.11, 95% CI 0.54 to 2.29; one study; 57 participants) and ART using RM-GIC in the permanent teeth of older adults with root caries lesions over a six-month follow-up period (OR 2.71, 95% CI 0.94 to 7.81; one study; 64 participants).No studies reported on adverse events or costs.
AUTHORS' CONCLUSIONS
Low-quality evidence suggests that ART using H-GIC may have a higher risk of restoration failure than conventional treatment for caries lesions in primary teeth. The effects of ART using composite and RM-GIC are uncertain due to the very low quality of the evidence and we cannot rely on the findings. Most studies evaluated the effects of ART on the primary dentition.Well-designed RCTs are required that report on restoration failure at clinically meaningful time points, as well as participant-reported outcomes such as pain and discomfort. Due to the potential confounding effects from the use of different dental materials, a robust body of evidence on the effects of ART compared with conventional treatment using the same restoration material is necessary. We identified four ongoing trials that could provide further insights into this area.
Topics: Adult; Child; Dental Atraumatic Restorative Treatment; Dental Caries; Dental Restoration Failure; Dentition, Permanent; Female; Glass Ionomer Cements; Humans; Male; Randomized Controlled Trials as Topic; Tooth, Deciduous; Toothache
PubMed: 29284075
DOI: 10.1002/14651858.CD008072.pub2 -
British Dental Journal Jan 2018Objectives The aim of this systematic review and meta-analysis was to evaluate fissure sealant retention in clinical studies in which investigators used flowable... (Meta-Analysis)
Meta-Analysis Review
Objectives The aim of this systematic review and meta-analysis was to evaluate fissure sealant retention in clinical studies in which investigators used flowable composites as pit and fissure sealants compared with conventional resin-based pit and fissure sealants.Data sources and data selection The authors conducted a literature search (all articles published until April 13, 2017) to identify studies for inclusion in this systematic review. They assessed the quality of the evidence provided by using the modified Jadad scale and performed meta-analyses by using a random-effects model.Data extraction and data synthesis The authors found 11 studies that met the inclusion criteria for the systematic review and nine studies that could be used for the meta-analysis. Of the 11 studies identified in the systematic review, four scored as having a low risk of bias, and seven scored as having a medium risk of bias. Our meta-analysis showed a significant positive effect of using flowable composites as a fissure sealant material (odds ratio, 2.387 [95% CI, 1.047, 5.444; P = 0.039]).Conclusion It seems that the use of flowable composite as a fissure sealing material can slightly increase the retention rate of sealants compared with conventional resin-based sealants.
Topics: Composite Resins; Dental Caries; Pit and Fissure Sealants
PubMed: 29372708
DOI: 10.1038/sj.bdj.2018.40 -
The Journal of Adhesive Dentistry Feb 2015Currently, no consensus exists regarding the best adhesion protocol for zirconia used in dentistry; this is important particularly for restorations where mechanical... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Currently, no consensus exists regarding the best adhesion protocol for zirconia used in dentistry; this is important particularly for restorations where mechanical retention is deficient. This systematic review analyzed the adhesion potential of resin-based and glass-ionomer luting cements to zirconia and aimed to highlight the possible dominant factors affecting the bond strength results to this substrate.
MATERIALS AND METHODS
Original scientific papers on adhesion to zirconia published in the MEDLINE (PubMed) database between 01/01/1995 and 01/06/2011 were included in this systematic review. The following MeSH terms, search terms, and their combinations were used: "Dental bonding", "Zirconium", "Zirconia", "Y-TZP", "Y-TZP ceramic", "Materials Testing/methods", "Test", "Cement", and "Resin bonding". Two reviewers performed screening and data abstraction. Descriptive statistics were performed and the frequencies of the studied parameters, means, standard deviations, confidence intervals (95% CI; uncorrected and corrected), median values, and interquartile ranges (IQR) were calculated for the bond strength data reported for different factor levels: surface conditioning methods (control, physicochemical, physical, chemical), cements (bis-GMA-, MDP-, and 4-META-based resin cements, self-adhesive cements, glass ionomer), aging with and without thermocycling (TC), and test methods (macroshear, microshear, macrotensile, and microtensile).
RESULTS
The final search provided 177 titles with abstracts. Further abstract screening yielded 72 articles, out of which 54 were found potentially appropriate to be included. After full text evaluation, 2 of these were eliminated. The selection process resulted in the final sample of 52 studies. In total, 169 different surface conditioning methods, mainly combinations of air-abrasion protocols and adhesive promoters (primers or silanes), were investigated. Altogether, the use of 5 types of cements and 4 testing methods was reported. While 26 studies were performed without TC as aging, 26 of them employed thermocycling at varying number of cycles. This review highlighted that adhesion of the luting cements is significantly influenced by the surface conditioning method (p = 0.044), cement type (p = 0.018), test method (p = 0.017) and aging condition (p = 0.003). In nonconditioned control groups without thermocycling, mean bond strength values ranged between 1.15 (IQR = 3.54) and 8.93 (IQR = 9), and 6.9 (IQR = 0) and 8.73 (IQR = 13.93) MPa for macroshear and macrotensile tests, respectively. After physical conditioning method, MDP monomer based cement presented the highest bond values compared to those of other resin cements using either the macrotensile (no TC: 34.2; IQR = 24.18 MPa, TC: 42.35; IQR = 0 MPa) or microtensile (no TC: 37.2; IQR = 41.5 MPa, TC: 17.1; IQR = 31.15 MPa) test method.
CONCLUSION
Based on the results of this systematic review, increased adhesion could be expected after physicochemical conditioning of zirconia. MDP-based resin cements tend to present higher results than those of other cements types when tested using macro- and microtensile tests. Adhesion studies on zirconia and reporting of data require more standardization.
Topics: Ceramics; Dental Bonding; Dental Materials; Glass Ionomer Cements; Humans; Resin Cements; Surface Properties; Yttrium; Zirconium
PubMed: 25646166
DOI: 10.3290/j.jad.a33525 -
European Journal of Oral Implantology 2017The impact of prosthetic material selection on implant survival is not clear. The current criteria for choosing a prosthetic material seem to be based on clinician... (Meta-Analysis)
Meta-Analysis Review
AIM
The impact of prosthetic material selection on implant survival is not clear. The current criteria for choosing a prosthetic material seem to be based on clinician preferences. This systematic review aims to evaluate the impact of restorative materials on the mid- and long-term survival of implants supporting single crowns and fixed partial dentures.
MATERIALS AND METHODS
Hand and MEDLINE searches were performed to identify relevant literature for single crowns (SC) and fixed partial dentures (FPD). Further inclusion criteria were a mean follow-up period of at least 3 years, the inclusion of at least 10 patients in a relevant study cohort, and a clear description of prosthesis type and prosthetic material.
RESULTS
A total of 63 studies for the SC group and 11 studies for the FPD group were included. Full arch restorations were not included. The materials utilised in the SC group were metal-ceramic (precious and non-precious), lithium-disilicate, veneered zirconia, veneered alumina, and nanoceramics. The materials used in the FPD group were metal-ceramic (precious), veneered titanium, metal-resin (precious), and veneered zirconia. No significant impact on the prosthetic material relating to mid- or long-term implant survival was identified. Furthermore, there were no statistically significant differences between the survival rates of the dental prostheses made from different materials (SC and FPD group). Single crowns made of nanoceramics showed a higher risk for decementation relative to other materials (0.80, 95% CI [0.67; 0.89]; P < 0.0001), whereas metal-resin FPDs showed a higher risk for chipping (0.36, 95% CI [0.23; 0.52]; P = 0.0072).
CONCLUSION
The current evidence suggests that prosthetic material selection has no influence on mid- and long-term survival of implants restored with single crowns and fixed partial dentures. Similarly, the prosthetic material seems to have no significant impact on prosthetic survival rates. Further research is required to provide more evidence regarding the impact of the prosthetic material on long-term outcome. Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Topics: Crowns; Dental Materials; Dental Prosthesis Design; Dental Restoration Failure; Denture Design; Denture, Partial, Fixed; Humans
PubMed: 28944368
DOI: No ID Found -
BMC Oral Health Aug 2023Large cavity designs and access cavities impair endodontically treated tooth fracture resistance. As the tooth's strength is known to reduce significantly after the root...
BACKGROUND
Large cavity designs and access cavities impair endodontically treated tooth fracture resistance. As the tooth's strength is known to reduce significantly after the root canal treatment, occlusal loading as a result of functions such as chewing, biting and certain parafunctional tendencies makes the endodontically treated tooth vulnerable to fracture. Hence, after endodontic treatment, it is vital to give adequate and appropriate restorative material to avoid tooth fractures. Accordingly, the choice of such restorative material should be dictated by the property of fracture resistance.
OBJECTIVE
The goal of this study was to conduct a systematic review and critical analysis of available data from in vitro studies examining the fracture resistance of endodontically treated posterior teeth restored with fiber-reinforced composites.
METHODOLOGY
The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRIS-MA) Statement was used to guide the reporting of this systematic review A comprehensive literature search was performed using MEDLINE (via PubMed), Scopus, ScienceDirect, Google Scholar, and LILACS. A manual search of the reference lists of the articles was also performed. The databases provided a total of 796 studies from the electronic systematic search. The databases provided a total of 796 studies from the electronic systematic search. Two reviewers scrutinized the papers for eligibility based on inclusion/exclusion criteria and extracted data. The studies were assessed for their potential risk of bias. Based on modified JBI & CRIS (checklist for reporting in vitro studies) guidelines, along with the methodology and treatment objective, we have formulated 13 parameters specifically to assess the risk of bias. A total of 18 studies met the inclusion criteria and were included for qualitative analysis. Considering the high heterogeneity of the studies included, a meta-analysis could not be performed.
RESULTS
The majority of the included studies had a moderate or high risk of bias. When compared to traditional hybrid composites, fiber-reinforced composites showed increased fracture resistance of endodontically treated teeth in the majority of investigations. On the other hand, limited evidence was found for the bulk fill composites. Moreover, moderate evidence was found for the fracture resistance of inlays and fiber posts with fiber-reinforced composites for core build-up in endodontically treated teeth. No evidence could be found comparing the fracture resistance of endo crowns and fiber-reinforced composites in endodontically treated teeth.
CONCLUSION
According to the research, using fiber-reinforced composites instead of conventional hybrid composites improves the fracture resistance of endodontically treated teeth. However, there was a high risk of bias in the research considered. No judgments could be reached about the superiority of one material over another based-on comparisons between other core restorations.
Topics: Humans; Tooth, Nonvital; Dental Materials; Crowns; Tooth Fractures; Composite Resins; Dental Stress Analysis
PubMed: 37574536
DOI: 10.1186/s12903-023-03217-2 -
The Journal of Prosthetic Dentistry Mar 2012Evidence is limited on the efficacy of zirconia-based fixed dental prostheses. (Review)
Review
STATEMENT OF PROBLEM
Evidence is limited on the efficacy of zirconia-based fixed dental prostheses.
PURPOSE
The purpose of this systemic review was to assess zirconia-based FDPs in terms of survival and complications.
MATERIAL AND METHODS
Searches performed in PubMed databases were enriched by hand searches to identify suitable publications. The keywords used were: "zirconia" and "fixed dental prosthesis," "zirconia" and "crown," "zirconia" and "fixed partial denture" and "humans," "zirconia" and "crown" and "humans," "crown" and "all-ceramics," and "fixed partial denture" and "all-ceramics". Titles and abstracts were read to identify literature that fulfilled the inclusion criteria. Only peer reviewed clinical studies published in the English language from January 1999 through June 2011 were included.
RESULTS
Twelve clinical studies based on zirconia, framework design, and porcelain veneering technique met the inclusion criteria. Of the studies identified, 1 was a randomized clinical study with 3-year follow-up results; the others were cohort prospective studies. Clinical complications included chipping of veneering porcelain, abutment failure, and framework fracture. One study investigated pressed ceramics as the veneering material and found no chipping of veneering porcelain after 3 years.
CONCLUSIONS
Short term clinical data suggest that zirconia-based fixed dental prostheses may serve as an alternative to metal ceramic fixed dental prostheses in the anterior and posterior dentition.
Topics: Crowns; Dental Materials; Dental Porcelain; Dental Restoration Failure; Dental Veneers; Denture, Partial, Fixed; Humans; Survival Analysis; Zirconium
PubMed: 22385693
DOI: 10.1016/S0022-3913(12)60051-1 -
Acta Stomatologica Croatica Mar 2021Ion-incorporated zeolite is a widely used antimicrobial material studied for various dental applications. At present, there is no other systematic review that evaluates... (Review)
Review
OBJECTIVE
Ion-incorporated zeolite is a widely used antimicrobial material studied for various dental applications. At present, there is no other systematic review that evaluates the effectiveness of zeolite in all dental materials. The purpose of this study was to review all available literature that analyzed the antimicrobial effects and/or mechanical properties of zeolite as a restorative material in dentistry.
MATERIAL AND METHODS
Following PRISMA guidelines, an exhaustive search of PubMed, Ovid Medline, Scopus, Embase, and the Dentistry & Oral Sciences Source was conducted. No language or time restrictions were used and the study was conducted from June 1, 2020 to August 17, 2020. Only full text articles were selected that pertained to the usage of zeolite in dental materials including composite resin, bonding agents, cements, restorative root material, cavity base material, prosthesis, implants, and endodontics.
RESULTS
At the beginning of the study, 1534 studies were identified, of which 687 duplicate records were excluded. After screening for the title, abstract, and full texts, 35 articles remained and were included in the qualitative synthesis. An Inter-Rater Reliability (IRR) test, which included a percent user agreement and reliability percent, was conducted for each of the 35 articles chosen.
CONCLUSION
Although ion-incorporated zeolite may enhance the antimicrobial properties of dental materials, the mechanical properties of some materials, such as MTA and acrylic resin, may be compromised. Therefore, since the decrease in mechanical properties depends on zeolite concentration in the restorative material, it is generally recommended to add 0.2-2% zeolite by weight.
PubMed: 33867540
DOI: 10.15644/asc55/1/9 -
Clinical Oral Investigations Dec 2020To perform a review on the influence of preheating and/or heating of resinous and ionomeric materials on their physical and mechanical properties and to discuss the...
OBJECTIVES
To perform a review on the influence of preheating and/or heating of resinous and ionomeric materials on their physical and mechanical properties and to discuss the benefits and methods of preheating/heating that have been used.
MATERIAL AND METHODS
A search was performed in the Pubmed, Scopus, Scielo, and gray literature databases. In vitro studies published from 1980 until now were searched using the descriptors "composite resins OR glass ionomer cements OR resin cements OR adhesives AND heating OR preheating." Data extraction and quality of work evaluation were performed by two independent evaluators.
RESULTS
At the end of reading the search titles and abstracts, 74 articles were selected. Preheating of composite resins reduces viscosity, facilitates adaptation to cavity preparation walls, increases the degree of conversion, and decreases the polymerization shrinkage. Preheating of resin cements improves strength, adhesion, and degree of conversion. Dental adhesives showed good results such as higher bond strength to dentin. However, unlike resinous materials, ionomeric materials have an increase in viscosity upon heating.
CONCLUSIONS
Preheating improves the mechanical and physical properties. However, there is a lack of clinical studies to confirm the advantages of preheating technique.
CLINICAL RELEVANCE
Preheating of dental restorative materials is a simple, safe, and successful technique. In order to achieve good results, agility and training are necessary so the material would not lose heat until the restorative procedure. Also, care is necessary to avoid bubbles and formation of gaps, which compromises the best restoration performance.
Topics: Composite Resins; Dental Bonding; Dental Cements; Dental Materials; Dentin; Glass Ionomer Cements; Heating; Materials Testing; Resin Cements
PubMed: 33083851
DOI: 10.1007/s00784-020-03637-2 -
The Journal of Prosthetic Dentistry Mar 2022How the performance of dental implants is related to their occlusogingival placement, crestal or subcrestal, is unclear. (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
How the performance of dental implants is related to their occlusogingival placement, crestal or subcrestal, is unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate marginal bone loss, implant survival rate, and peri-implant soft tissue parameters between implants placed at the crestal and subcrestal bone level.
MATERIAL AND METHODS
Two independent reviewers searched the PubMed/MEDLINE, Embase, and Cochrane Library databases for randomized clinical trials published up to September 2020. The meta-analysis was based on the Mantel-Haenszel and the inverse variance methods (α=.05).
RESULTS
The search identified 928 references, and 10 studies met the eligibility criteria. A total of 393 participants received 709 implants, 351 at crestal bone levels and 358 at subcrestal bone levels. Meta-analysis indicated that crestal bone level implants showed similar marginal bone loss to that seen with subcrestal bone level implants (mm) (P=.79), independent of the subcrestal level (P=.05) and healing protocol (P=.24). The bone level implant placement did not affect the implant survival rate (P=.76), keratinized tissue (mm) (P=.91), probing depth (mm) (P=.70), or plaque index (%) (P=.92).
CONCLUSIONS
The evidence suggests that both approaches of implant placement are clinically acceptable in terms of peri-implant tissue parameters and implant-supported restoration survival.
Topics: Alveolar Bone Loss; Dental Implantation, Endosseous; Dental Implants; Humans; Wound Healing
PubMed: 33358610
DOI: 10.1016/j.prosdent.2020.11.003 -
The Journal of Prosthetic Dentistry Dec 2016Radiotherapy has been considered a contraindication for rehabilitation with dental implants because it can change the survival rate of implants. Nevertheless, the... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Radiotherapy has been considered a contraindication for rehabilitation with dental implants because it can change the survival rate of implants. Nevertheless, the installation of implants in irradiated patients has been used with varying success.
PURPOSE
The purpose of this systematic review was to compare the success rate of implants placed in irradiated human bone tissue with that of implants placed in nonirradiated areas.
MATERIAL AND METHODS
Searches were performed in the EMBASE, Cochrane, and PubMed/Medline databases up to December 2013 to identify clinical trials addressing the subject. This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The relative risks of implant failure and survival curves were calculated considering a confidence interval of 95%. Heterogeneity was analyzed by using a funnel chart.
RESULTS
A total of 40 studies involving 2220 participants and 9231 dental implants were selected. The survival curve of the studies indicated a survival rate of 84.3% for implants installed in irradiated bone tissue. The meta-analysis indicated statistically significant differences (P<.001) between item success rates of implants placed in irradiated areas and those of implants placed in nonirradiated areas.
CONCLUSIONS
Dental implants installed in the irradiated area of an oral cavity have a high survival rate, but strict monitoring is needed to prevent complications, thereby reducing possible failures.
Topics: Dental Implants; Dental Restoration Failure; Equipment Failure Analysis; Head and Neck Neoplasms; Humans; Jaw; Kaplan-Meier Estimate
PubMed: 27460315
DOI: 10.1016/j.prosdent.2016.04.025