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The Cochrane Database of Systematic... May 2021The effective control of moisture and microbes is necessary for the success of restoration procedures. The rubber dam, as an isolation method, has been widely used in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The effective control of moisture and microbes is necessary for the success of restoration procedures. The rubber dam, as an isolation method, has been widely used in dental restorative treatments. The effects of rubber dam usage on the longevity and quality of dental restorations still require evidence-based discussion. This review compares the effects of rubber dam with other isolation methods in dental restorative treatments. This is an update of the Cochrane Review first published in 2016.
OBJECTIVES
To assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients.
SEARCH METHODS
Cochrane Oral Health's Information specialist searched the following electronic databases: Cochrane Oral Health's Trials Register (searched 13 January 2021), Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 12) in the Cochrane Library (searched 13 January 2021), MEDLINE Ovid (1946 to 13 January 2021), Embase Ovid (1980 to 13 January 2021), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 13 January 2021), and SciELO BIREME Virtual Health Library (1998 to 13 January 2021). We also searched Chinese BioMedical Literature Database (CBM, in Chinese) (1978 to 13 January 2021), VIP database (in Chinese) (1989 to 13 January 2021), and China National Knowledge Infrastructure (CNKI, in Chinese) (1994 to 13 January 2021). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform, OpenGrey, and Sciencepaper Online (in Chinese) for ongoing trials. There were no restrictions on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (including split-mouth trials) over one month in length assessing the effects of rubber dam compared with alternative isolation methods for dental restorative treatments.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened the results of the electronic searches, extracted data, and assessed the risk of bias of the included studies. Disagreement was resolved by discussion. We strictly followed Cochrane's statistical guidelines and assessed the certainty of the evidence using GRADE.
MAIN RESULTS
We included six studies conducted worldwide between 2010 and 2015 involving a total of 1342 participants (of which 233 participants were lost to follow-up). All the included studies were at high risk of bias. Five studies compared rubber dam with traditional cotton rolls isolation. One study was excluded from the analysis due to inconsistencies in the presented data. Of the four remaining trials, three reported survival rates of the restorations with a minimum follow-up of six months. Pooled results from two studies involving 192 participants indicated that the use of rubber dam isolation may increase the survival rates of direct composite restorations of non-carious cervical lesions (NCCLs) at six months (odds ratio (OR) 2.29, 95% confidence interval (CI) 1.05 to 4.99; low-certainty evidence). However, the use of rubber dam in NCCLs composite restorations may have little to no effect on the survival rates of the restorations compared to cotton rolls at 12 months (OR 1.38, 95% CI 0.45 to 4.28; 1 study, 30 participants; very low-certainty evidence) and at 18 months (OR 1.00, 95% CI 0.45 to 2.25; 1 study, 30 participants; very low-certainty evidence) but the evidence is very uncertain. At 24 months, the use of rubber dam may decrease the risk of failure of the restorations in children undergoing proximal atraumatic restorative treatment in primary molars but the evidence is very uncertain (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97; 1 study, 559 participants; very low-certainty evidence). None of the included studies mentioned adverse effects or reported the direct cost of the treatment.
AUTHORS' CONCLUSIONS
This review found some low-certainty evidence that the use of rubber dam in dental direct restorative treatments may lead to a lower failure rate of the restorations compared with cotton roll usage after six months. At other time points, the evidence is very uncertain. Further high-quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.
Topics: Bias; Dental Atraumatic Restorative Treatment; Humans; Randomized Controlled Trials as Topic; Rubber Dams; Treatment Outcome
PubMed: 33998662
DOI: 10.1002/14651858.CD009858.pub3 -
British Dental Journal Mar 2005
Topics: Dental Instruments; Foreign Bodies; Humans; Practice Guidelines as Topic; Radiography, Abdominal; Radiography, Thoracic; Radiology; Root Canal Preparation; Rubber Dams
PubMed: 15789099
DOI: 10.1038/sj.bdj.4812229 -
Evidence-based Dentistry Mar 2017Data sourcesCochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, LILACS, SciELO, Chinese BioMedical...
Data sourcesCochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, LILACS, SciELO, Chinese BioMedical Literature Database, VIP, China National Knowledge Infrastructure, ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, OpenGrey and Sciencepaper Online databases. Handsearches in a number of journals.Study selectionRandomised controlled trials, including split-mouth studies assessing the effects of rubber dam isolation for restorative treatments in dental patients.Data extraction and synthesisTwo review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies.ResultsFour studies involving a total of 1,270 patients were included. The studies were at high risk of bias. One trial was excluded from the analysis due to inconsistencies in the presented data. Restorations had a significantly higher survival rate in the rubber dam isolation group compared to the cotton roll isolation group at six months in participants receiving composite restorative treatment of non-carious cervical lesions (risk ratio (RR) 1.19, 95% confidence interval (CI) 1.04 to 1.37, very low-quality evidence). The rubber dam group had a lower risk of failure at two years in children undergoing proximal atraumatic restorative treatment in primary molars (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97, very low-quality evidence). One trial reported limited data showing that rubber dam usage during fissure sealing might shorten the treatment time. None of the included studies mentioned adverse effects or reported the direct cost of the treatment, or the level of patient acceptance/satisfaction. There was also no evidence evaluating the effects of rubber dam usage on the quality of the restorations.ConclusionsWe found some very low-quality evidence, from single studies, suggesting that rubber dam usage in dental direct restorative treatments may lead to a lower failure rate of the restorations, compared with the failure rate for cotton roll usage. Further high quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.
Topics: Dental Atraumatic Restorative Treatment; Dental Care; Humans; Pit and Fissure Sealants; Rubber Dams; Tooth, Deciduous
PubMed: 28338026
DOI: 10.1038/sj.ebd.6401221 -
BMC Oral Health Oct 2022This non-inferiority randomised clinical trial aimed to evaluate the survival of direct bulk fill composite resin restorations in primary molars using different methods... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
This non-inferiority randomised clinical trial aimed to evaluate the survival of direct bulk fill composite resin restorations in primary molars using different methods of moisture control: rubber dam isolation (RDI-local anaesthesia and rubber dam) and cotton roll isolation (CRI-cotton roll and saliva ejector). Secondary outcomes included baseline and 2-year incremental cost, self-reported child's pain scores and patient behaviour during the restorative procedure.
METHODS
A total of 174 molars (93 children) with dentine caries lesions were randomly allocated to study groups (RDI or CRI) and restored with bulk fill composite resin by trained operators. Two blinded examiners assessed the restorations for up to 24 months. Wong-baker faces and Frankl's behaviour rating scales were used for accessing the child's pain and behaviour, respectively. The primary outcome (restoration survival) was analysed using the two-sample non-inferiority test for survival data using Cox Regression (non-inferiority/alternative hypothesis HR > 0.85; CI = 90%). Bootstrap Linear regression was used for cost analysis and logistic regression for pain and behaviour analysis (α = 5%).
RESULTS
After 2-years, 157 restorations were evaluated (drop-out = 9.7%). The survival rate was RDI = 60.4% and CRI = 54.3%. The non-inferiority hypothesis was accepted by the Cox Regression analysis (HR = 1.33; 90% CI 0.88-1.99; p = 0.036). RDI was 53% more expensive when compared to the CRI group. No differences were found between the groups regarding pain (p = 0.073) and behaviour (p = 0.788).
CONCLUSION
Cotton roll isolation proved to be non-inferior when compared to rubber dam for composite restorations longevity in primary molars. Furthermore, the latest presented the disadvantage of higher cost and longer procedure time. Clinical Significance The moisture control method does not influence the longevity of composite restorations in primary molars. Cotton roll isolation proved to be non-inferior to rubber dam isolation and is a viable option for restoring primary molars. Clinical trial registration registered NCT03733522 on 07/11/2018. The present trial was nested within another clinical trial, the CARies DEtection in Children (CARDEC-03-NCT03520309).
Topics: Child; Composite Resins; Dental Caries; Dental Restoration, Permanent; Humans; Molar; Pain; Rubber Dams
PubMed: 36217147
DOI: 10.1186/s12903-022-02449-y -
British Dental Journal Aug 2020
Topics: Practice Patterns, Dentists'; Rubber Dams; Surveys and Questionnaires
PubMed: 32811914
DOI: 10.1038/s41415-020-2011-y -
Journal of Esthetic and Restorative... Jan 2023To evaluate the effect of rubber dam isolation on shear bond strength of two different adhesive systems to enamel.
OBJECTIVE
To evaluate the effect of rubber dam isolation on shear bond strength of two different adhesive systems to enamel.
MATERIALS AND METHODS
The mesial, distal, lingual, and vestibular enamel surfaces of thirty human third molars were prepared (total n = 120). A custom splint was made to fit a volunteer's maxilla, holding the specimens in place in the oral cavity. Four composite resin cylinders were bonded to each tooth with one of two bonding agents (OptiBond FL and Prime&Bond active) with or without rubber dam isolation. Shear bond strength was tested in a universal testing machine and failure modes were assessed. Significance level for statistical analyses was set at 5%.
RESULTS
All pairwise comparisons revealed statistical differences (p < 0.05). The highest mean shear bond strength values were obtained in rubber dam experimental groups, regardless of the adhesive system. Group OptiBond FL with rubber dam presented the highest mean bond strength values. Fracture modes for specimens bonded without rubber dam isolation were adhesive and cohesive within enamel, while rubber dam experimental groups revealed only cohesive fractures.
CONCLUSIONS
Absolute isolation with rubber dam increases bond strength to enamel, independent of the adhesive system. The three-step total-etch system OptiBond FL provided significantly higher bond strength values than Prime&Bond active under both experimental conditions.
CLINICAL SIGNIFICANCE
Rubber dam isolation has a significant effect on bond strengths to enamel, independent of the adhesive system. Its application is, therefore, advised whenever adhesive procedures are performed. A filled three-step etch-and-rinse adhesive performed superiorly, with or without rubber dam isolation, when bonding to enamel compared to an isopropanol-based universal adhesive.
Topics: Humans; Dental Bonding; Rubber Dams; Resin Cements; Composite Resins; Dental Enamel; Materials Testing; Dentin-Bonding Agents
PubMed: 36325593
DOI: 10.1111/jerd.12979 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2022The aim: To assess the actual prevalence of rubber dam usage among general dentists.
OBJECTIVE
The aim: To assess the actual prevalence of rubber dam usage among general dentists.
PATIENTS AND METHODS
Materials and methods: Surveyed participants were offered a questionnaire containing 14 questions about gender, country of origin, clinical experience, time and place of acquisition of skills of rubber dam, as well as the frequency of its usage.
RESULTS
Results: 30.69% of dentists always use rubber dams for direct restorations; 74.26% always use rubber dams during root canals treatment; 36.3% always use rubber dam for bonding indirect restorations.
CONCLUSION
Conclusions: The prevalence of rubber usage among general dentists shows positive growth dynamics, but the frequency is still considered insufficient.
Topics: Humans; Rubber Dams; Practice Patterns, Dentists'; Prevalence; Surveys and Questionnaires; Dentists
PubMed: 36378704
DOI: 10.36740/WLek202209213 -
British Dental Journal Mar 1998In a busy dental practice the many advantages of the routine use of dental dam for day-to-day procedures are often not appreciated. Many general dental practitioners...
In a busy dental practice the many advantages of the routine use of dental dam for day-to-day procedures are often not appreciated. Many general dental practitioners (GDPs) are unaware of the simple and rapid techniques for placement that exist and the important role that rubber dam plays in infection control.
Topics: Air Microbiology; Air Pollutants, Occupational; Air Pollution; Dentistry, Operative; Equipment Contamination; General Practice, Dental; Humans; Latex; Rubber Dams
PubMed: 9581036
DOI: 10.1038/sj.bdj.4809584 -
Journal of the American Dental... May 2016
Topics: Practice Patterns, Dentists'; Rubber Dams
PubMed: 27126314
DOI: 10.1016/j.adaj.2016.03.009 -
British Dental Journal Jan 2009
Topics: Humans; Rubber Dams
PubMed: 19165245
DOI: 10.1038/sj.bdj.2009.18