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The Journal of Contemporary Dental... Aug 2023The present systematic review aimed to report the studies concerning the primers in improving bond strength and identifying pertinent primers for a particular dental... (Meta-Analysis)
Meta-Analysis
AIM
The present systematic review aimed to report the studies concerning the primers in improving bond strength and identifying pertinent primers for a particular dental alloy by adhering to PRISMA precepts.
MATERIALS AND METHODS
PubMed and Semantic Scholar databases were scoured for articles using 10 search terms. studies satisfying the inclusion criteria were probed which were meticulously screened and scrutinized for eligibility adhering to the 11 exclusion criteria. The quality assessment tool for studies (QUIN Tool) containing 12 criteria was employed to assess the risk of bias (RoB).
RESULTS
A total of 48 studies assessing shear bond strength (SBS) and 15 studies evaluating tensile bond strength (TBS) were included in the qualitative synthesis. Concerning SBS, 33.4% moderate and 66.6% high RoB was observed. Concerning TBS, 26.8% moderate and 73.2% high RoB was discerned. Seventeen and two studies assessing SBS and TBS, respectively, were included in meta-analyses.
CONCLUSIONS
Shear bond strength and TBS increased for the primed alloys. Cyclic disulfide primer is best-suited for noble alloys when compared with thiol/thione primers. Phosphoric acid- and phosphonic acid ester-based primers are opportune for base alloys.
CLINICAL SIGNIFICANCE
The alloy-resin interface (ARI) would fail if an inappropriate primer was selected. Therefore, the selection of an appropriate alloy adhesive primer for an alloy plays a crucial role in prosthetic success. This systematic review would help in the identification and selection of a congruous primer for a selected alloy.
Topics: Databases, Factual; Dental Alloys; Disulfides; Thiones; Dental Cements
PubMed: 38193174
DOI: 10.5005/jp-journals-10024-3514 -
Evidence-based Dentistry Mar 2024The research is a systematic review and meta-analysis of randomized controlled trials (RCTs). (Meta-Analysis)
Meta-Analysis
DESIGN
The research is a systematic review and meta-analysis of randomized controlled trials (RCTs).
AIM
The study aimed to compare the clinical outcomes of self-adhesive flowable composite resins (SAFCs) versus conventional flowable composite resins (FCs) used in occlusal cavity restorations in permanent teeth.
METHODS
This research included a search for RCTs. Multiple databases were systematically searched for RCTs with a minimum 1-year follow-up comparing SAFCs to FCs. Outcomes evaluated were retention, secondary caries, marginal adaptation, marginal discoloration, and postoperative sensitivity based on modified USPHS criteria. Risk of bias was assessed using Cochrane RoB 2 tool. Random effects meta-analyses were conducted where applicable. Certainty of evidence was rated using GRADE approach.
RESULTS
Five RCTs (four parallel and one split mouth) comprising 138 patients were included. During 1- and 2-year recalls, there were generally no significant differences in clinical performance between SAFCs and FCs. However, FCs applied using the etch-and-rinse technique demonstrated statistically better marginal adaptation at 2 years (3 studies, RR 3.21, 95% CI 1.50-6.83) and marginal discoloration (4 studies, RR 3.40, 95% CI 1.10-10.48). The overall quality of evidence ranged from low to moderate.
CONCLUSIONS
SAFCs showed comparable short-term outcomes to FCs in treating occlusal cavities. Further high-quality RCTs with longer follow-up are warranted to confirm long-term performance of SAFCs. Use of separate enamel etching may improve marginal adaptation and discoloration with FCs.
Topics: Humans; Dental Cements; Resin Cements; Dental Restoration, Permanent; Dentition, Permanent; Composite Resins; Dental Caries; Resins, Plant
PubMed: 38182663
DOI: 10.1038/s41432-023-00959-4 -
Clinical Oral Investigations Dec 2023To answer the following research question: does the clinical evaluation of restorations on permanent teeth with bioactive materials show greater retention rates than... (Meta-Analysis)
Meta-Analysis Review
Do bioactive materials show greater retention rates in restoring permanent teeth than non-bioactive materials? A systematic review and network meta-analysis of randomized controlled trials.
OBJECTIVES
To answer the following research question: does the clinical evaluation of restorations on permanent teeth with bioactive materials show greater retention rates than those with non-bioactive materials?
MATERIALS AND METHODS
A search strategy was used in the following databases: MEDLINE via PubMed, Scopus, Web of Science, LILACS, BBO, Embase, The Cochrane Library, and OpenGrey. Randomized controlled trials (RCTs), with a minimum of 2-year follow-up and evaluating at least one bioactive material in permanent teeth were included. Risk of bias was detected according to the Cochrane Collaboration tool for assessing the risk of bias (RoB 2.0), and network meta-analysis was performed using a random-effects Bayesian-mixed treatment comparison model.
RESULTS
Twenty-seven studies were included. The success of the restorations was assessed using modified USPHS system in 24 studies and the FDI criteria in 3 studies. Network meta-analysis revealed three networks based on restoration preparations. Resin composites were ranked with higher SUCRA values, indicating a greater likelihood of being the preferred treatment for class I, II, and III restorations. In class V, resin-modified glass ionomer cement was ranked with the highest value.
CONCLUSION
Bioactive restorative materials showed similar good clinical performance in terms of retention similarly to conventional resin composites.
CLINICAL SIGNIFICANCE
The findings must be interpreted with caution because many RCT on restorative materials aim to verify the equivalence of new materials over the gold standard material rather than their superiority. The present systematic review also suggests that new RCT with longer follow-up periods are necessary.
Topics: United States; Network Meta-Analysis; Randomized Controlled Trials as Topic; Composite Resins; Dental Materials; Glass Ionomer Cements
PubMed: 38153565
DOI: 10.1007/s00784-023-05414-3 -
Medicina (Kaunas, Lithuania) Dec 2023Zirconia-reinforced lithium silicate (ZLS) ceramic is a new innovative dental material with unique a chemical composition that is designed to combine harmoniously with... (Review)
Review
Zirconia-reinforced lithium silicate (ZLS) ceramic is a new innovative dental material with unique a chemical composition that is designed to combine harmoniously with the appropriate optical properties of lithium disilicate and the enhanced mechanical strength of zirconia. A thorough understanding of ZLS materials is essential for both clinicians and dental technicians. At present, the mechanical behavior and optical properties of the ZLS ceramic system have not been extensively researched, and there is still a lack of consensus regarding the fabrication process and clinical behavior of ZLS all-ceramic restorations. The aim of the present study was to present a selection of comprehensive information concerning zirconia-reinforced lithium silicate ceramics and their optical and mechanical properties, as well as to assess data regarding cementation procedures and clinical outcomes for ZLS all-ceramic restorations. Three electronic databases (PubMed, Web of Science, and the Cochrane Library) were used for the research by two independent reviewers. The search was limited to articles published in the English language, as well as clinical and in vitro studies of color and studies on mechanical behavior and the cementation procedures of ZLS restorations. The exclusion criteria comprised abstracts, questionnaire-based studies, case reports, literature reviews, and studies that were not available in English. Zirconia-reinforced lithium-silicate-based ceramic presents a unique and complex microstructure that increases mechanical resistance but decreases aesthetic appearance, especially its translucency, due to tetragonal zirconia content. A material's thickness, the color of the underlying tooth structure, and the resin cement shade are important factors that influence the final shade and aesthetic appearance of ZLS restorations. Mechanical properties, which are defined by the fracture toughness, flexural strength, elastic modulus, and hardness of ZLS ceramic are higher compared to feldspathic, lithium disilicate, and hybrid ceramics, as well as resin nanoceramics; however, they are lower than translucent or high-translucency zirconia. Acid etching, sandblasting, and laser etching represent the most used methods to prepare the ZLS restoration surfaces for proper bonding procedures.
Topics: Humans; Ceramics; Dentistry; Lithium; Materials Testing; Silicates; Surface Properties
PubMed: 38138238
DOI: 10.3390/medicina59122135 -
Brazilian Dental Journal 2023The purpose of this article was to Evaluate the influence of sealer on the outcome of non-surgical endodontic treatment or retreatment of permanent teeth with apical...
BACKGROUND
The purpose of this article was to Evaluate the influence of sealer on the outcome of non-surgical endodontic treatment or retreatment of permanent teeth with apical periodontitis (PROSPERO registration: CRD42020205951).
METHODOLOGY
A systematic review of original clinical studies was carried out following PRISMA guidelines to answer whether the type of sealer used in endodontic treatment or retreatment influences the repair of apical periodontitis determined by clinical and radiographic parameters. Electronic searches were performed in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library database, until May 2023. Gray literature and a hand search of reference lists were also performed. The risk of bias was assessed using Cochrane RoB2 for randomized trials and the Newcastle-Ottawa Scale (NOS) for prospective and retrospective cohort and case-control studies.
RESULTS
Among 1046 studies, a total of 819 were selected by title and abstract, resulting in 23 for full-text review. In total, 11 studies met the inclusion criteria (1467 patients/teeth with apical periodontitis). The quality assessment using RoB2 included five randomized control trials, of which four had medium risk and one had a low risk of bias. According to the NOS scale, five studies were classified as low risk and one study was considered as medium risk of bias. The sealer type and obturation techniques varied, and the mean follow-up time was 3.7 years. Most studies used two-dimensional radiographic criteria to assess the treatment outcome sealers and not cements. Eight studies did not find significant differences when comparing cements. The healing rates ranged from 56.7% to 90%.
CONCLUSIONS
The results of this review support that the current endodontic sealers do not seem to influence the treatment outcome of permanent teeth with apical periodontitis. Although the studies had medium and low risk of bias, the results should be interpreted with caution. More randomized studies of long-term outcomes comparing filling materials are needed to strengthen this claim and allow for a meta-analysis.
Topics: Humans; Case-Control Studies; Periapical Periodontitis; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 38133464
DOI: 10.1590/0103-6440202305471 -
Pediatric Dentistry Nov 2023to update the 2016 systematic review evidence for vital pulp therapy (VPT) for primary teeth affected by caries or trauma. The population, intervention, comparison,... (Meta-Analysis)
Meta-Analysis
to update the 2016 systematic review evidence for vital pulp therapy (VPT) for primary teeth affected by caries or trauma. The population, intervention, comparison, outcomes, and study (PICOS) design inclusion/exclusion was used for multiple databases. Risk of bias, meta-analyses using RevMan, and certainty of evidence was created. A total of 299 studies were included; no trauma was found. Indirect pulp treatment (IPT) resulted in 97 percent success. Two calcium silicate cement (CSC) pulpotomies' success using mineral trioxide aggregate (MTA) and Biodentine were 94 percent and 90 percent, respectively, greater than for direct pulp capping (DPC; 86 percent) and other pulpotomies (moderate certainty). The success of IPT versus pulpotomy at 24 months showed no significant difference (P=0.31). Different liners or capping agents did not affect the success of IPT (P=0.79) or DPC at 24 months (P=0.24). The two CSC pulpotomies were not significantly different based on 24-month success (P=0.34). The formocresol pulpotomy success at 24 months was significantly lower than for MTA (P=0.02). Ferric sulfate had a significant lower success at 24 months than MTA pulpotomy (69 percent versus 92 percent; P=0.03). Zinc oxide eugenol, as a singular pulpotomy, had low success (65 percent). Selective/stepwise caries removal did significantly better at avoiding pulp exposures than complete excavation (P<0.001). Complete, selective, and no caries removal (Hall technique [HT], steel crown placement with no caries removal) had no significant difference in pulp vitality success for deep caries at 24 months (P=0.29). For deep caries affecting vital incisors, pulpotomy had significantly greater success than pulpectomy (P=0.002). The following had no significant effect on MTA pulpotomy success: coronal pulp removal methods; irrigation solution; method to control hemorrhage; base over MTA; treatment in one or two visits; and anterior or posterior teeth. Vital pulp therapy success of indirect pulp treatment or two calcium silicate cement pulpotomies demonstrated improved success over direct pulp capping and other pulpotomies based on 24-month evidence with moderate certainty. The Hall technique did not significantly reduce pulp vitality success versus caries removal.
Topics: Humans; Calcium Compounds; Silicates; Dental Care; Dental Cements; Zinc Oxide-Eugenol Cement; Dental Pulp Capping; Pulpotomy; Glass Ionomer Cements; Tooth, Deciduous; Oxides; Drug Combinations; Treatment Outcome; Aluminum Compounds
PubMed: 38129755
DOI: No ID Found -
Zhonghua Kou Qiang Yi Xue Za Zhi =... Dec 2023To systematically assess the durability of the 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) pretreated resin-to-zirconia bonding and conducted a meta-analysis... (Meta-Analysis)
Meta-Analysis
To systematically assess the durability of the 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) pretreated resin-to-zirconia bonding and conducted a meta-analysis to provide clinical guidance on zirconia bonding strategies. A comprehensive search was conducted on PubMed, Scopus, Web of Science, CNKI, and Wanfang database to identify relevant studies on the resin-to-zirconia bonding after surface pretreatment with 10-MDP. Strict inclusion and exclusion criteria were applied to select appropriate literature and extract essential information and data. The included studies were categorized based on aging methods (water storage, thermocycling, or both), 10-MDP application methods (within primer, adhesive, resin cement, or both), and additional surface treatments (alumina sandblasting, tribochemical silica coating, acid etching, laser etching, and plasma treatment) and were analyzed by Review Manager 5.4. The evaluation indicator was the bonding strength of zirconia after surface pretreatment with 10-MDP. A total of 72 studies were included in the systematic review, with 68 studies eligible for the meta-analysis. The bonding strength of zirconia decreased significantly after aging [<0.001; mean difference (): 5.58; 95%: 5.11-6.05]. No significant differences in bonding strength of zirconia were observed after aging when employing various application methods of 10-MDP (all >0.05). The bonding strength of zirconia was significantly enhanced after aging when 10-MDP was applied in conjunction with additional surface treatments, as compared to the application of 10-MDP alone (<0.001; : 10.17; 95%: 8.20-12.14). The bonding strength of zirconia pretreated with 10-MDP exhibited a reduction after undergoing water storage or thermocycling. The application of 10-MDP with additional surface treatments enhanced the bonding strength of zirconia after aging, while the application methods of 10-MDP did not exert an influence.
Topics: Dental Bonding; Shear Strength; Surface Properties; Methacrylates; Resin Cements; Zirconium; Water; Materials Testing
PubMed: 38061871
DOI: 10.3760/cma.j.cn112144-20230915-00158 -
BMC Oral Health Dec 2023The goal behind this study is to answer the question "In tooth-supported fixed partial dentures (FPDs), does the digital impression techniques compared to fabrications... (Meta-Analysis)
Meta-Analysis
PURPOSE OF THE STUDY
The goal behind this study is to answer the question "In tooth-supported fixed partial dentures (FPDs), does the digital impression techniques compared to fabrications using conventional impression methods improve the marginal and internal fit?
BACKGROUND
The incorporation of digital technology in the fabrication of fixed partial dentures (FPDs) has accelerated over the past decade. This study is directed at evaluating the marginal and internal fit of FPDs manufactured using digital approaches compared to conventional techniques. The need for updated data has encouraged this review.
MATERIALS AND METHODS
An electronic search was conducted in PubMed, Scopus, Web of Science, and the Grey Database to identify relevant studies. The Modified Methodological Index for Non-Randomized Studies (MINORS) was used to assess the risk of bias in in vitro experiments. The key results of this meta-analysis were the standard mean differences (SMDs) and 95% confidence intervals (CI) of each main variance, marginal fit, and internal fit between the digital and conventional techniques. Additional analyses were performed to assess the significance of three subgroup parameters: method of digitalization, cement spacer thickness, and span length, and their influence on the fit of the FPDs.
RESULTS
Based on predefined criteria, of the seven articles included in this systematic review, only five were selected for the quantitative data analysis. The marginal fit results were (P = 0.06; SMD: -1.88; 95% CI: - 3.88, 0.11) (P > 0.05) and the internal fit results were (P = 0.02; SMD: -0.80; 95% CI: - 1.49, - 0.10) (P < 0.05). Regarding the subgroup analyses, the method of digitalization subgroup results were (P = 0.35; SMD: -1.89; 95% CI: - 3.89, 0.11) and (P = 0.80; SMD: -0.80; 95% CI: - 1.49, - 0.11) for marginal and internal fit, respectively. The span length results were (P = 0.10; SMD: -1.89; 95% CI: - 3.89, 0.11) for marginal fit and (P = 0.02; SMD: -0.80; 95% CI: - 1.49, - 0.11) for internal fit. The cement spacer thickness (P = 0.01; SMD: -1.89; 95% CI: - 3.89, 0.11) and (P = 0.04; SMD: -0.80; 95% CI: - 1.49, - 0.11) for marginal and internal fit, respectively.
CONCLUSION
Tooth-retained fixed partial dentures FPDs produced by digital scanning and computer-aided design/computer-aided manufacturing (CAD/CAM) systems can significantly enhance the internal fit compared with those manufactured by traditional methods. Intraoral scanners can replace conventional impressions for the fabrication of FPDs because they minimize the operating time and reduce patient pain. Further clinical studies are required to obtain more conclusive results.
SYSTEMATIC REVIEW REGISTRATION
This systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42021261397.
Topics: Humans; Dental Marginal Adaptation; Denture, Partial, Fixed; Computer-Aided Design; Research Design; Dental Prosthesis Design
PubMed: 38049754
DOI: 10.1186/s12903-023-03628-1 -
Photobiomodulation, Photomedicine, and... Feb 2024This systematic review aimed to evaluate the adhesive bond strength of restorative materials to caries-affected dentin (CAD) treated with antimicrobial photodynamic... (Meta-Analysis)
Meta-Analysis Review
This systematic review aimed to evaluate the adhesive bond strength of restorative materials to caries-affected dentin (CAD) treated with antimicrobial photodynamic therapy (aPDT) in comparison with conventional chemical disinfectants. Three databases, including the Web of Science, Scopus, and PubMed, were searched to address the focused question: "What is the effect of aPDT compared to conventional chemical disinfection techniques on the adhesive bond strength of restorative materials to CAD?." Search keywords included "dentin*" "adhes bond*" "caries-affected dentin" "photodynamic "photochemotherapy" "photosensitizing agent" "phototherapy" "photoradiation" "laser" "light activated" "photoactivated." A fixed-effects model was used in each meta-analysis and the inverse variance was used to calculate the standard mean difference (SMD). For evaluating the statistical heterogeneity, the Cochrane's test and the statistics were used. The risk of bias was evaluated based on the Cochrane Collaboration's tool. Fourteen studies were included in the qualitative as well as quantitative analysis. The results of the meta-analyses exhibited an SMD of 2.38% [95% confidence interval (CI): 2.03-2.73; < 0.00001], indicating a statistically significant difference in the shear bond strength scores between the tested group (samples treated with aPDT) and the control group (i.e., favoring the sound dentin and/or conventional chemical disinfectants). Contrarily, an SMD of -1.46% (95% CI: -2.04 to -0.88; < 0.00001) and -0.37% (95% CI: -0.70 to -0.03; = 0.03) was observed, indicating a statistically significant difference in the microtensile bond strength (μTBS), as well as microleakage scores between the tested group (favoring the samples treated with aPDT) and the control group (i.e., sound dentin and/or conventional chemical disinfectants). Adhesive bond strength of restorative materials to CAD treated with conventional chemical disinfectants showed superior outcomes compared to photodynamic therapy (aPDT).
Topics: Dental Caries Susceptibility; Dentin; Resin Cements; Anti-Infective Agents; Photochemotherapy; Disinfectants
PubMed: 38011333
DOI: 10.1089/photob.2023.0037 -
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