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Dental Materials : Official Publication... May 2020This systematic literature review and meta-analysis compared the clinical retention of primed or adhesively bonded sealants to that of conventional sealant materials. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This systematic literature review and meta-analysis compared the clinical retention of primed or adhesively bonded sealants to that of conventional sealant materials.
METHODS
A search of the MEDLINE, EMBASE and CENTRAL databases identified 3707 abstracts published prior to 12/31/2017, of which 335 clinical publications were analysed in detail. A total of 67 studies included information about sealant retention after 24, 36, or 60 months of follow-up. A meta-analysis using a random effects model was conducted to calculate the pooled estimate of the retention rates for the five groups of sealants. Subgroup moderator analysis was performed to compare the pooled retention rate estimate (RRE) of primed sealants against those of the other groups.
RESULTS
Primed sealants had a 2-year pooled RRE of 43.2% (95% CI: 30.5-55.8), which was significantly inferior to those of auto-polymerizing (80.8%, 95% CI: 72.2-89) and light-polymerizing sealants (68.4%, 95% CI: 60.2-76.7). Fluoride-releasing and light-polymerizing sealants had the highest 3-year pooled RREs (86.4%, 95% CI: 73.4-99.3 and 83.1%, 95% CI: 75.6-90.7, respectively).
SIGNIFICANE
The results of this meta-analysis suggest that primed sealants cannot be fully recommended for clinical practice due to their moderate survival rates. Auto-polymerizing, light-polymerizing and fluoride-releasing sealants continue to be considered the reference standards for pit and fissure sealants. However, future generations and developments of primed sealant materials may change this position.
Topics: Dental Caries; Fluorides; Humans; Pit and Fissure Sealants
PubMed: 32061445
DOI: 10.1016/j.dental.2020.02.001 -
Scientific Reports Feb 2020The high prevalence and heavy socio-economic burden for caries of first permanent molars (FPMs) make the prevention of this disease a major public health goal. Current... (Meta-Analysis)
Meta-Analysis
The high prevalence and heavy socio-economic burden for caries of first permanent molars (FPMs) make the prevention of this disease a major public health goal. Current guidelines recommend a preference of fissure sealant (FS) over fluoride varnish (FV) based on two recent systematic reviews. However, evidences of these two studies are weak because of scarce data and some limitations. Besides, an up-to-date large scale randomized controlled trial (RCT) reported commensurate effectiveness of these two techniques. Thus, in order to more accurately compare the clinical efficacy between FS and FV on caries prevention for FPMs, we carried out this systematic review and meta-analysis. A total of 8 RCTs involving 3289 participants and 6878 FPMs fulfilled the inclusion criteria. Our meta-analysis for the first time showed that there was no statistical difference on caries incidence or occlusal DMFS increment between sealant group and fluoride varnish group at 2~3 years' follow-up. In that sense, biannual applications of FV or FS may be equally effective on caries prevention for FPMs. These results do not support routine recommendation of FS over FV, thus shedding light on current conceptions. Our findings endow clinicians with a window to reconsider the choice between these two techniques.
Topics: Dental Caries; Fluorides, Topical; Guidelines as Topic; Humans; Molar; Pit and Fissure Sealants
PubMed: 32055001
DOI: 10.1038/s41598-020-59564-5 -
Dentistry Journal Sep 2019This systematic review appraises studies conducted with layered double hydroxides (LDHs) for fluoride release in dentistry. LDH has been used as antacids, water... (Review)
Review
This systematic review appraises studies conducted with layered double hydroxides (LDHs) for fluoride release in dentistry. LDH has been used as antacids, water purification in removing excess fluoride in drinking water and drug delivery. It has great potential for controlled fluoride release in dentistry, e.g., varnishes, fissure sealants and muco-adhesive strips, etc. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed with two reviewers performing a literature search using four databases: PubMed, Web of Science, Science Direct and Ovid Medline with no date restrictions. Studies including any LDH for ion/drug release in dentistry were included, while assessing the application of LDH and the value of the methodology, e.g., ion release protocol and the LDH production process. Results: A total of 258 articles were identified and four met the inclusion criteria. Based on two in vitro studies and one clinical study, LDH was previously studied in dental materials, such as dental composites and buccal muco-adhesive strips for fluoride release, with the latter studied in a clinical environment. The fourth study analysed LDH powder alone (without being incorporated into dental materials). It demonstrated fluoride release and the uptake of volatile sulphur compounds (VSC), which may reduce halitosis (malodour). Conclusion: LDHs incorporated in dental materials have been previously evaluated for fluoride release and proven to be clinically safe. LDHs have the potential to sustain a controlled release of fluoride (or other cariostatic ions) in the oral environment to prevent caries. However, further analyses of LDH compositions, and clinical research investigating any other cariostatic effects, are required.
PubMed: 31480648
DOI: 10.3390/dj7030087 -
BMC Oral Health Sep 2019This systematic review aimed to assess the clinical effects of laser preparation compared to other types of chemical or mechanical preparation of tooth surfaces used in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This systematic review aimed to assess the clinical effects of laser preparation compared to other types of chemical or mechanical preparation of tooth surfaces used in fissure sealant placement.
METHODS
A systematic literature search was conducted up to January 2019, through Pubmed, Scopus, Medline/EMBASE via OVID and the Cochrane library. Only randomized clinical trials were included.
RESULTS
Five studies were included in the systematic review and three were included in the meta-analysis. All the studies used acid-etching as a comparator to lasers. All the included studies were rated as having an overall high risk of bias introduced by performance bias. Three studies assessed the clinical effects of fissure sealants placed by acid or laser etching, one compared acid etching versus laser combined with acid etching and one investigated the influence of lasers on the objective and subjective parameters of stress during sealant application in children. The meta-analysis showed no significant difference between laser preparation and conventional acid-etching preparation at 3- (P = 0.08), 6- (P = 0.49), and 12-month (P = 0.87) follow-ups. One study reported that laser preparation as an adjunct to acid-etching enhanced the retention rate. No significant difference in the incidence of caries was reported. And no significant differences were found in heart rates, oxygen saturation or degree of the patient dental anxiety between acid-etching and laser preparation.
CONCLUSION
The present limited evidence suggests that lasers could be an effective pretreatment method. The retention rate was similar to that of conventional acid etching. However, the included studies had an overall high risk of bias and more rigorously designed research is needed.
Topics: Acid Etching, Dental; Child; Dental Anxiety; Dental Caries; Humans; Lasers, Solid-State; Pit and Fissure Sealants
PubMed: 31477081
DOI: 10.1186/s12903-019-0892-4 -
Australian Endodontic Journal : the... Apr 2020The purpose of this systematic review was to qualify and quantify the evidence regarding the effect of extruded sealers on endodontic treatment outcomes. Two reviewers... (Meta-Analysis)
Meta-Analysis
The purpose of this systematic review was to qualify and quantify the evidence regarding the effect of extruded sealers on endodontic treatment outcomes. Two reviewers independently conducted a comprehensive literature search. The EMBASE, MEDLINE, Cochrane, PubMed databases, bibliographies, grey literature of all relevant articles and textbooks were searched. Six articles met the inclusion criteria with a moderate risk of bias and were analysed for qualitative and quantitative synthesis. There was moderate-certainty evidence that sealer extrusion can contribute to non-healing outcomes, 95% confidence interval, risk ratio 1.32 (1.12-1.54) and P < 0.05. This indicates that the current authors are somewhat confident the true effect is likely to be close to the estimate of the effect. Sealer extrusion had a 32% higher risk of contributing to a non-healing outcome than no extrusion. However, well-conducted research would need to be conducted to confirm this causality claim.
Topics: Endodontics; Humans; Pit and Fissure Sealants; Treatment Outcome
PubMed: 31449355
DOI: 10.1111/aej.12370