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Biomimetics (Basel, Switzerland) Jan 2023Dentin hypersensitivity (DH) is a very common dental problem that can have a negative impact on the quality of life and can lead to invasive dental procedures.... (Review)
Review
Dentin hypersensitivity (DH) is a very common dental problem that can have a negative impact on the quality of life and can lead to invasive dental procedures. Prevention of DH and control of symptoms are highly desirable. Hydroxyapatite (HAP) has been shown in vitro to block dentinal tubules and in vivo to be a safe and effective additive in oral care products that reduce DH clinically. This study's aim was to conduct a systematic review and meta-analysis of the current evidence that HAP-containing oral care products reduce DH. Databases were searched, and only clinical trials in humans were included; studies conducted in vitro or on animals were not included. Publications in a foreign language were translated and included. We found 44 published clinical trials appropriate for systematic analysis. More than half of the trials had high-quality GRADE scores. HAP significantly reduced dentin hypersensitivity compared to placebo (39.5%; CI 95% [48.93; 30.06]), compared to fluoride (23%; CI 95% [34.18; 11.82]), and with a non-significant tendency compared to other desensitizing agents (10.2%; CI 95% [21.76; -19.26]). In conclusion, the meta-analysis showed that HAP added to oral care products is a more effective agent than fluoride in controlling dentin hypersensitivity and may be superior to other desensitizers.
PubMed: 36648809
DOI: 10.3390/biomimetics8010023 -
The Journal of Prosthetic Dentistry Apr 2024The clinical complications, success, and survival rates of indirect restorations delivered with the immediate dentin sealing protocol are unclear. (Review)
Review
STATEMENT OF PROBLEM
The clinical complications, success, and survival rates of indirect restorations delivered with the immediate dentin sealing protocol are unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to find and collect evidence on the clinical complication, success, and survival rates of indirect restorations delivered with immediate dentin sealing.
MATERIAL AND METHODS
Electronic databases were searched for clinical studies on immediate dentin sealing up to December 2023, without language or time limitations. The records were included if they were clinical trials evaluating the clinical complication and survival rates of indirect restorations bonded to tooth substrate sealed immediately after preparation with suitable resin bonding. The extracted data were analyzed via Review Manager 5.4 for meta-analysis (α=.05).
RESULTS
A total of 11 studies were included in this review. The clinical complication rate was lower for immediately sealed dentin than for protocols without dentin sealing. The survival rate of restorations luted with the immediate dentin sealing protocol was higher (96.4% to 100%) than that of immediate dentin sealing (81.8% to 96.7%), negatively correlated with the observation time. The intensity and incidence of postoperative sensitivity were statistically significantly lower for restorations with immediate dentin sealing than for those without dentin sealing or conventionally cemented (P<.05).
CONCLUSIONS
Immediate dentin-sealed indirect restorations had fewer clinical complications and higher success and survival rates than those delivered without dentin sealing. To avoid postoperative sensitivity or reduce its intensity, dentin surfaces should be sealed immediately after preparation. More long-term randomized clinical trials are recommended to confirm these evidence-based conclusions.
PubMed: 38570282
DOI: 10.1016/j.prosdent.2024.03.014 -
International Journal of Dentistry 2023To compare the effectiveness of cyanoacrylate to other treatments or placebo in the management of dentin hypersensitivity (DH). (Review)
Review
OBJECTIVE
To compare the effectiveness of cyanoacrylate to other treatments or placebo in the management of dentin hypersensitivity (DH).
MATERIALS AND METHODS
The present review was organized based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. The search aimed to answer the following question: is cyanoacrylate effective in the treatment of DH when compared to other treatments or placebo? The following databases were used: PubMed/MEDLINE, Scopus, BVS, Web of Science, Cochrane, Clinicaltrials.gov, Portal Periódicos Capes, Google Scholar, and manual search. The evaluation process started with the information collected from the selected articles according to the Consolidated Standards of Reporting Trials (CONSORT).
RESULTS
Two randomized and five nonrandomized clinical trials were analyzed in the qualitative synthesis. The studies presented different cyanoacrylate formulations, different scales for evaluating pain, and different methods for provoking a painful stimulus. Cyanoacrylate-based products reduce DH in shorter follow-up periods and this reduction persisted throughout the study. The results varied according to the methods used to stimulate the pain. Only two articles showed a low risk of bias and a high level of scientific evidence.
CONCLUSION
Although there is a limited number of studies in the scientific literature with appropriate methodological quality, the available evidence proves the effectiveness of cyanoacrylate in the treatment of DH. . Cyanoacrylate is easy to access, effective, easily applicable, and a low-cost product with satisfactory results.
PubMed: 37663787
DOI: 10.1155/2023/1465957 -
PloS One 2018A systematic quantitative evaluation of the available evidence of the treatment for caries lesions in primary teeth that considers how different caries progressions lead... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A systematic quantitative evaluation of the available evidence of the treatment for caries lesions in primary teeth that considers how different caries progressions lead to the need for distinct interventions might provide additional useful information for clinical evidence-based decision making. The aim of this systematic review and network meta-analysis was to verify the effect of the treatments on caries lesion arrestment (CLA) or the success rate (SR) of dentin caries lesion treatments in the primary teeth.
METHODS
A search was conducted using the MEDLINE/PubMed, Web of Science and Scopus databases through December 2017. The primary search terms used in combination were primary teeth, caries lesion and restoration. The grey literature was also screened, as were the reference lists of eligible studies. A search of prospective studies with at least 12 months of follow up that compared different techniques was performed. The exclusion criteria were the absence of a comparison group; no evaluation of different restorative techniques; the evaluation of other outcomes unrelated to this review; and the recruitment of specific patient. The risk of bias was evaluated by the tools: the Cochrane Handbook for Systematic Reviews of Interventions and ROBINS-I. A network meta-analyses and meta-analyses were conducted considering CLA or SR as outcomes according to the surface involved and the depth of progression.
RESULTS
Of the 1671 potentially eligible studies, 15 were included. For occlusal surfaces, only two studies presented data regarding the outer half of the dentin, with conventional restorative treatment (CRT) using composite resin showing superior results; five studies presented data regarding the depth of caries lesions, and CRT with compomer resulted in the best results. Seven studies considered occlusoproximal surfaces, and the Hall technique showed the best SR among the evaluated treatments. Finally, two annual applications of silver diamine fluoride showed the best nonrestorative approach to arrest caries lesions on occlusal and smooth surfaces.
DISCUSSION/CONCLUSIONS
The treatments for dentin caries lesions in primary teeth depend on the depth of progression and the surface involved. However, few of the included studies provided evidence to strongly recommend the best treatment option.
OTHER
Funding: FAPESP; Systematic review registration number-PROSPERO CRD42016037784.
Topics: Dental Caries; Dentistry; Disease Progression; Humans; Pediatrics
PubMed: 30462676
DOI: 10.1371/journal.pone.0206296 -
Journal of Dental Research May 2017Current evidence supports noninvasive/nonrestorative treatment of "early" carious lesions: those confined to enamel or reaching the enamel-dentin junction. The extent... (Meta-Analysis)
Meta-Analysis Review
Current evidence supports noninvasive/nonrestorative treatment of "early" carious lesions: those confined to enamel or reaching the enamel-dentin junction. The extent that dentists' thresholds for intervening restoratively have changed with this evidence is unknown. This systematic review aimed to determine dentists' and therapists' current lesion threshold for carrying our restorative interventions in adults/children and primary/permanent teeth. Embase, Medline via PubMed, and Web of Science were searched for observational studies, without language, time, or quality restrictions. Screening and data extraction were independent and in duplicate. Random-effects meta-analyses with subgroup and meta-regression analysis were performed. Thirty studies, mainly involving dentists, met the inclusion criteria. There was heterogeneity in sampling frames, methods, and scales used to investigate thresholds. The studies spanned 30 y (1983-2014), and sample representativeness and response bias issues were likely to have affected the results. Studies measured what dentists said they would do rather than actually did. Studies represented 17 countries, focusing mainly on adults ( n = 17) and permanent teeth ( n = 24). For proximal carious lesions confined to enamel (not reaching the enamel-dentin junction), 21% (95% confidence interval [CI], 15%-28%) of dentists/therapists would intervene invasively. The likelihood of a restorative intervention almost doubled (risk ratio, 1.98; 95% CI, 1.68-2.33) in high caries risk patients. For proximal lesions extending up to the enamel-dentin junction, 48% (95% CI, 40%-56%) of dentists/therapists would intervene restoratively. For occlusal lesions with enamel discoloration/cavitation but no clinical/radiographic dentin involvement, 12% (95% CI, 6%-22%) of dentists/therapists stated they would intervene, increasing to 74% (95% CI, 56%-86%) with dentin involvement. There was variance between countries but no significant temporal trend. A significant proportion of dentists/therapists said they would intervene invasively (restoratively) on carious lesions where evidence and clinical recommendations indicate less invasive therapies should be used. There is great need to understand decisions to intervene restoratively and to find implementation interventions that translate research evidence into clinical practice.
Topics: Decision Making; Dental Caries; Dental Enamel; Dental Restoration, Permanent; Dentin; Humans; Practice Patterns, Dentists'
PubMed: 28195749
DOI: 10.1177/0022034517693605 -
Journal of Dentistry Jun 2021A better understanding of the microstructure and mechanical properties of enamel and dentine may enable practitioners to apply the current adhesive dentistry protocols... (Review)
Review
OBJECTIVES
A better understanding of the microstructure and mechanical properties of enamel and dentine may enable practitioners to apply the current adhesive dentistry protocols to clinical cases involving dentine disorders (dentinogenesis imperfecta or dentine dysplasia).
DATA/SOURCES
Publications (up to June 2020) investigating the microstructure of dentine disorders were browsed in a systematic search using the PubMed/Medline, Embase and Cochrane Library electronic databases. Two authors independently selected the studies, extracted the data in accordance with the PRISMA statement, and assessed the risk of bias with the Critical Appraisal Checklist. A Mann-Whitney U test was computed to compare tissues damage related to the two dentine disorders of interest.
STUDY SELECTION
From an initial total of 642 studies, only 37 (n = 164 teeth) were included in the present analysis, among which 18 investigating enamel (n = 70 teeth), 15 the dentine-enamel junction (n = 62 teeth), and 35 dentine (n = 156 teeth). Dentine is damaged in cases of dentinogenesis imperfecta and osteogenesis imperfecta (p = 2.55E-21 and p = 3.99E-21, respectively). These studies highlight a reduction in mineral density, hardness, modulus of elasticity and abnormal microstructure in dentine disorders. The majority of studies report an altered dentine-enamel junction in dentinogenesis imperfecta and in osteogenesis imperfecta (p = 6.26E-09 and p = 0.001, respectively). Interestingly, enamel is also affected in cases of dentinogenesis imperfecta (p = 0.0013), unlike to osteogenesis imperfecta (p = 0.056).
CONCLUSIONS
Taking into account all these observations, only a few clinical principles may be favoured in the case of adhesive cementation: (i) to preserve the residual enamel to enhance bonding, (ii) to sandblast the tooth surfaces to increase roughness, (iii) to choose a universal adhesive and reinforce enamel and dentine by means of infiltrant resins. As these recommendations are mostly based on in vitro studies, future in vivo studies should be conducted to confirm these hypotheses.
Topics: Dental Cements; Dental Enamel; Dentin; Hardness; Tooth
PubMed: 33798638
DOI: 10.1016/j.jdent.2021.103654 -
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 -
Photodiagnosis and Photodynamic Therapy Mar 2023The objective of this systematic review and meta-analysis (SRMA) was to investigate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The objective of this systematic review and meta-analysis (SRMA) was to investigate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of endodontic sealers to intraradicular dentin.
METHODS
This SRMA followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42022319856). A population, intervention, control, and outcome (PICO) question was formulated: "Does antimicrobial photodynamic therapy decrease the bond strength of root canal sealers?". A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases until July 2022. Joanna Briggs Institute Critical Assessment Guidelines for Quasi-Experimental Studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (p<0.05).
RESULTS
Out of an initial 345 articles, 8 in vitro studies were included, published between 2013 and 2022. The studies were qualitatively analyzed; two studies showed a positive effect, two studies a negative effect, and the other studies showed no effect on bond strength of endodontic sealers to intraradicular dentin. Seven of the studies were included in the SRMA, which indicated that there was no significant difference in bond strength when using aPDT (P = 0.90; MD: -0.03; 95% CI: -0.46 to -0.41). There was a high level of evidence for each meta-analysis outcome.
CONCLUSION
It can be concluded that the use of aPDT as a method of root canal disinfection does not negatively influence the bond strength of endodontic sealers in the root canal.
Topics: Root Canal Filling Materials; Photochemotherapy; Dentin; Photosensitizing Agents; Anti-Infective Agents; Materials Testing
PubMed: 36596331
DOI: 10.1016/j.pdpdt.2022.103270 -
Critical Reviews in Biomedical... 2021One aspect of special concern in endodontics is the effect of irrigating solutions on the biomechanical properties of dentine. A systematic review of in vitro studies... (Meta-Analysis)
Meta-Analysis
One aspect of special concern in endodontics is the effect of irrigating solutions on the biomechanical properties of dentine. A systematic review of in vitro studies was conducted to analyze and systematize the effect of endodontic irrigating solutions on biomechanical properties in noninstrumented dentine, according to published in vitro studies. A literature review was conducted on different databases including papers from 2009 to 2019. Two researchers identified in vitro studies on permanent teeth root dentine that reported control group, featured nonmechanical preparation, and sample size ≥ 10. An instrument was designed for bias assessment in three categories (High-Uncertain-Low), applying 17 criteria. Using the PRISMA tool, an electronic search found 9,026 titles. From these, 28 were subjected to full-text analysis and 9 were chosen for qualitative analysis. It was identified that chelates decrease microhardness and stiffness. It was also inferred that the proteolytic effect of NaOCl reduces the elasticity modulus and flexural strength. The heterogeneity analysis, with a value I2:92% for microhardness and I2:81% for roughness, revealed high heterogeneity among the included studies. The random effect model identified with 95% confidence that NaOCl and EDTA significantly decrease microhardness: -3.00[-4.22, -1.78]; EDTA 17% at 15 min being on average the lowest value: -6.66[-8.32, -5.00]. For roughness, all the proposed solutions increased significantly: 2.37[1.67, 3.08]; the highest, 3.94[2.84, 5.04], was recorded by NaOCl2.5%-15 min. In contrast, CLX registered a high roughness value: 3.33[1.88, 4.77]. Dentinal microhardness reduction associated to chelates is a concentration and time- dependent variable. Collagen degradation by NaOCl is a time and concentration-dependent variable.
Topics: Dentin; Humans; Root Canal Irrigants; Sodium Hypochlorite
PubMed: 34936315
DOI: 10.1615/CritRevBiomedEng.2021038065 -
The Journal of Evidence-based Dental... Sep 2019The aim of the present systematic review was to evaluate if epoxy resin-based root canal sealers present superior push-out bond strength compared to calcium... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of the present systematic review was to evaluate if epoxy resin-based root canal sealers present superior push-out bond strength compared to calcium silicate-based root canal sealers.
METHODS
The inclusion criteria consisted of in vitro studies that compared the push-out bond strength of epoxy resin-based and calcium silicate-based sealers. A systematic search was performed in the following databases for articles published until February 2018: PubMed, ScienceDirect, Scopus, Web of Science, and OpenGrey. The quality assessment and data extraction of the selected articles were performed. A meta-analysis of the pooled data and the subgroups according to the root thirds was carried out using the RevMan software (P < .05).
RESULTS
The search resulted in 2292 studies. After the duplicate studies were removed and the title and abstract were read, 20 studies were selected and 17 were considered as having a low risk of bias. The pooled meta-analysis comparing epoxy resin-based (n = 467) and paste-to-paste calcium silicate-based root canal sealers (n = 467) demonstrated higher mean push-out bond strength values (P < .001) for the epoxy resin-based root canal sealers; the heterogeneity among studies was 85% (I). The comparisons between epoxy resin-based (n = 358) and premixed ready-to-use calcium silicate-based root canal sealers (n = 358) also demonstrated a significant difference between the sealers (P < .05), with an I of 95%. The subgroup analysis showed that only in the middle third, were increased bond strength values for epoxy resin-based sealer observed (P < .001), with an I of 94%.
CONCLUSIONS
The epoxy resin-based sealer demonstratedhigher push-out bond strength than paste-to-paste calcium silicate-based root canal sealer regardless of the root third assessed. In addition, the epoxy resin-based sealer exhibited increased push-out bond strength in comparison with premixed ready-to-use calcium silicate-based root canal sealer when evaluating the middle third.
Topics: Calcium Compounds; Dental Bonding; Dentin; Epoxy Resins; Humans; Materials Testing; Root Canal Filling Materials
PubMed: 31732099
DOI: 10.1016/j.jebdp.2019.04.004