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European Archives of Paediatric... Oct 2022To systematically review the clinical performance of restorative materials after pulp therapy of carious primary teeth. It is part 2 of a systematic review on the...
PURPOSE
To systematically review the clinical performance of restorative materials after pulp therapy of carious primary teeth. It is part 2 of a systematic review on the clinical effectiveness of restorative materials for the management of carious primary teeth supporting the European Academy of Paediatric Dentistry (EAPD) guideline development.
METHODS
Four electronic databases were systematically searched up to December 28th, 2020. Randomised controlled clinical trials (RCTs) on restorative materials for the restoration of carious primary teeth after pulp therapy were included. Failure rate, annual failure rate (AFR) and reasons for failure were recorded. Studies were sorted by restorative materials. The Cochrane Risk of bias tool for randomised trials (RoB 2.0) was used for quality assessment.
RESULTS
After identification of 1685 articles and screening of 41 papers from EAPD review group 1, 5 RCTs were included. Restored primary molars with pulpotomy presented the following AFRs: composite resin (CR) 0%, preformed metal crowns (PMCs) 2.4-2.5%, resin-modified glass-ionomer cement combined with CR 3.8%, compomer 8.9%, and amalgam 14.3%. Maxillary primary incisors receiving pulpectomy exhibited AFRs of 0-2.3% for composite strip crowns (CSCs) depending on the post chosen. Reasons for failure were secondary caries, poor marginal adaptation, loss of retention and fracture of restoration. All studies were classified as high risk of bias. Meta-analyses were not feasible given the clinical/methodological heterogeneity amongst studies.
CONCLUSION
Considering any limitations of this review, CR and PMCs can be recommended for primary molars after pulpotomy, and CSCs for primary incisors receiving pulpectomy. However, a need for further well-designed RCTs was observed.
Topics: Child; Humans; Tooth, Deciduous; Dental Materials; Dental Caries; Glass Ionomer Cements; Composite Resins; Treatment Outcome; Dental Restoration, Permanent
PubMed: 36056991
DOI: 10.1007/s40368-022-00744-4 -
Journal of Dentistry Oct 2022To investigate the effectiveness of glass ionomer cement (GIC) restorations on preventing new caries in primary or permanent dentitions compared with other types of... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the effectiveness of glass ionomer cement (GIC) restorations on preventing new caries in primary or permanent dentitions compared with other types of restorations.
DATA
Randomized controlled clinical trials evaluating caries experience increment or caries incidence in patients with GIC restorations, including conventional GIC (CGIC) and resin-modified GIC (RMGIC) restorations, were included.
SOURCES
A systematic search of publications in English was conducted in PubMed/Medline, Web of Science, Cochrane, and Scopus databases.
STUDY SELECTION/RESULTS
This review included 10 studies reporting caries preventive effect of GIC restorations and selected 5 studies for meta-analysis. Patients with GIC restorations showed lower caries incidence compared with other restorations in primary and permanent dentition [RR=0.67, 95% CI:0.55-0.82, p < 0.0001]. Patients with CGIC restorations showed lower caries incidence compared with amalgam restorations [RR=0.57, 95% CI:0.43-0.76, p = 0.0001] and RMGIC restorations [RR=0.70, 95% CI:0.56-0.87, p = 0.002], but no statistical difference with composite resin restorations [RR=0.73, 95% CI:0.51-1.04, p = 0.08] in primary dentition. Patients with RMGIC restorations showed no statistical differences of caries incidence compared with composite resin restorations in primary and permanent dentition [RR=0.83, 95% CI:0.56-1.22, p = 0.33].
CONCLUSIONS
GIC restorations presented a better preventive effect on new caries than other restorations did in primary and permanent dentitions. CGIC restorations presented a better caries preventive effect on new caries than RMGIC and amalgam restorations in primary dentitions did. RMGIC restorations showed similar preventing effect on new caries with composite resin restorations in primary and permanent dentitions.
CLINICAL SIGNIFICANCE
This review affirmed the potential of GIC in preventing new caries development in the dentition.
Topics: Acrylic Resins; Composite Resins; Dental Caries; Dental Caries Susceptibility; Dental Restoration, Permanent; Glass Ionomer Cements; Humans; Silicon Dioxide
PubMed: 36038075
DOI: 10.1016/j.jdent.2022.104272 -
Laboratory Fracture Resilience of Hybrid Abutments Used in Oral Rehabilitation: A Systematic Review.Journal of Functional Biomaterials Aug 2022When implants are required in prosthodontics treatment, one of the most important decisions is the choice of the final crown and the type of connection to the implant... (Review)
Review
UNLABELLED
When implants are required in prosthodontics treatment, one of the most important decisions is the choice of the final crown and the type of connection to the implant through the abutment. Hybrid abutments are becoming a primary choice. They are projected and produced with materials whose properties guarantee the required mechanical features (including resistance) and take advantage of the hybrid abutment crown retention between screw and cement. However, a review of the mechanical resistance of the different abutment types and associated materials is still lacking. This review aimed to study the in vitro mechanical efficiency of the hybrid abutments used in oral rehabilitation.
METHODS
A systematic review was conducted using the PubMed, B-on, and Google Scholar databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
75 articles were identified from all databases, and 33 were selected after abstract screening. Thus, 21 studies were included in the review after full-text reading. Among the materials used for crowns, lithium disilicate was, aesthetically, the primary choice for its aesthetic and moderate strength. On the other hand, zirconia showed the best fracture resistance. Regarding the different kinds of abutments, there is still some lack of knowledge about the best design.
CONCLUSIONS
Within the limitations of this systematic review, we can conclude that hybrid pillars are an excellent choice for oral rehabilitation through implants, showing improved resistance when including materials such as zirconia and lithium disilicate.
PubMed: 35997458
DOI: 10.3390/jfb13030120 -
Cells Aug 2022This study aimed to identify the role of crosslinking agents in the resin-dentin bond strength (BS) when used as modifiers in adhesives or pretreatments to the dentin... (Meta-Analysis)
Meta-Analysis Review
This study aimed to identify the role of crosslinking agents in the resin-dentin bond strength (BS) when used as modifiers in adhesives or pretreatments to the dentin surface through a systematic review and meta-analysis. This paper was conducted according to the directions of the PRISMA 2020 statement. The research question of this review was: "Would the use of crosslinkers agents improve the BS of resin-based materials to dentin?" The literature search was conducted in the following databases: Embase, PubMed, Scielo, Scopus, and Web of Science. Manuscripts that reported the effect on the BS after the use of crosslinking agents were included. The meta-analyses were performed using Review Manager v5.4.1. The comparisons were performed by comparing the standardized mean difference between the BS values obtained using the crosslinker agent or the control group. The subgroup comparisons were performed based on the adhesive strategy used (total-etch or self-etch). The immediate and long-term data were analyzed separately. A total of 50 articles were included in the qualitative analysis, while 45 articles were considered for the quantitative analysis. The meta-analysis suggested that pretreatment with epigallocatechin-3-gallate (EGCG), carbodiimide, ethylenediaminetetraacetic acid (EDTA), glutaraldehyde, and riboflavin crosslinking agents improved the long-term BS of resin composites to dentin ( ≤ 0.02). On the other hand, the use of proanthocyanidins as a pretreatment improved both the immediate and long-term BS values ( ≤ 0.02). When incorporated within the adhesive formulation, only glutaraldehyde, riboflavin, and EGCG improved the long-term BS to dentin. It could be concluded that the application of different crosslinking agents such as carbodiimide, EDTA, glutaraldehyde, riboflavin, and EGCG improved the long-term BS of adhesive systems to dentin. This effect was observed when these crosslinkers were used as a separate step and when incorporated within the formulation of the adhesive system.
Topics: Adhesives; Carbodiimides; Collagen; Dentin; Dentin-Bonding Agents; Edetic Acid; Glutaral; Materials Testing; Resin Cements; Riboflavin
PubMed: 35954261
DOI: 10.3390/cells11152417 -
Scientific Reports Jul 2022Strategies aiming to improve the longevity of resin-dentin adhesive interface developed so far have only been able to retard the problem. Different approaches are thus...
Strategies aiming to improve the longevity of resin-dentin adhesive interface developed so far have only been able to retard the problem. Different approaches are thus needed. The objective of this review was to determine whether the use of collagen-depletion strategies after acid-etching procedures may improve the bond strength of resin-based materials to dentin. A systematic review was planned following 2021 PRISMA statement guidelines, with a search strategy performed in five electronic databases: PubMed/Medline, Scopus, EMBASE, SciELO and IADR Abstract Archive (last search: 17/01/2022). Inclusion criteria encompassed studies which evaluated a collagen-depletion strategy in acid-etched human dentin and tensile/shear bond strength tests. Risk of bias assessment was carried out by two reviewers, working independently on an adapted five-domain risk of bias (RoB) checklist for laboratory studies. Results were synthesized qualitatively, as a meta-analysis was not possible due to limited number of studies and their RoB. A total of eight studies were eligible for inclusion in the systematic review after inclusion/exclusion criteria application. Out of these, two evaluated the effect of using NaOCl followed by an antioxidant, and the remaining six evaluated different enzymatic treatments (bromelain, chondroitinase ABC, papain, and trypsin). None of the studies reported a decrease of bond strength when a collagen-depletion strategy was used, in comparison to traditional hybrid layers (control). All enzymatic treatment studies which respected the inclusion criteria improved the bond strength to dentin. Some specific collagen-depletion strategies seem to play a favorable role in improving immediate bond strengths to dentin. Further research with sound methodology is required to consolidate these findings, since limitations in RoB and a low number of studies were found. The assessment of further proteolytic agents and long-term outcomes is also required.
Topics: Collagen; Composite Resins; Dentin; Dentin-Bonding Agents; Humans; Materials Testing; Resin Cements; Tensile Strength
PubMed: 35906302
DOI: 10.1038/s41598-022-17371-0 -
European Archives of Paediatric... Dec 2022Chemical-mechanical caries removal (CMCR) products are in constant evolution and were recommended during the COVID-19 pandemic as substitutes for conventional caries...
BACKGROUND
Chemical-mechanical caries removal (CMCR) products are in constant evolution and were recommended during the COVID-19 pandemic as substitutes for conventional caries removal.
AIM
Characterize the worldwide scientific literature about CMCR products, over the years, by means of a critical review.
DESIGN
Electronic search was performed on Medline/PubMed, Scopus, Web of Science, Cochrane Library, Lilacs, and Embase up to November 2020. Year, journal, country of authors, and type of study were the data extracted from the retrieved studies. Additional data of the clinical studies and systematic reviews were investigated.
RESULTS
2221 records were identified, 397 selected. 2011-2020 period concentrates higher number of publications (n = 169), in the Journal of Dental Research (n = 51), developed in Brazil (n = 45) and India (n = 44). Most studies were in vitro (n = 211) and clinical trials (n = 101). Carisolv™ (n = 48) and Papacarie Duo Gel™ (n = 33) were the most used products, prescript in isolated usage (n = 101), and compared with drills (n = 77). CMCR were more studied in primary teeth (n = 78), receiving glass ionomer cement (GIC) (n = 51) as restorative material. The most evaluated outcomes were time spent (n = 48) and pain (n = 41). Clinical application of CMCR takes more time than other techniques, but can also reduce patient anxiety, pain, and need for anesthesia.
CONCLUSION
In vitro and clinical studies with CMCR products have been increasing, mostly carried out in developing countries, evaluating Carisolv™ and Papacarie Duo Gel™. Clinical studies tend to evaluate the time spent and pain compared to drills for removing caries in primary teeth, posteriorly restored with GIC. CMCR clinical application reduces anxiety, pain, and need for anesthesia, despite increase treatments' time.
Topics: Humans; Tooth, Deciduous; Dental Caries Susceptibility; Pandemics; COVID-19; Dental Caries; Glass Ionomer Cements; Pain
PubMed: 35831699
DOI: 10.1007/s40368-022-00726-6 -
European Archives of Paediatric... Oct 2022To systematically search the available evidence and evaluate the clinical effectiveness of restorative materials for restoration of carious primary teeth. The findings...
PURPOSE
To systematically search the available evidence and evaluate the clinical effectiveness of restorative materials for restoration of carious primary teeth. The findings aimed to support the European Academy of Paediatric Dentistry (EAPD) guidelines development.
METHODS
Literature search was performed by searching 4 electronic databases for eligible randomised controlled clinical trials (RCTs) comparing restorative materials for the restoration of carious primary teeth up to December 28th, 2020. Quality assessment was performed with the revised Cochrane risk-of-bias tool for randomized trials (RoB 2).
RESULTS
Of 1685 identified articles 29 RCTs were finally deemed as eligible for inclusion. Annual failure rates were: Amalgam 1-28%; atraumatic restorative treatment 1.2-37.1%; glass-ionomer cement (GIC) 7.6-16.6%, metal-reinforced GIC 29.9%, resin-modified GIC 1.9-16.9%, high-viscosity GIC 2.9-25.6%; glass carbomer ≤ 46.2%; compomer 0-14.7%; composite resin (CR) 0-19.5%, bulk-fill CR 0-16.9%; zirconia crowns 3.3%, composite strip crowns 15%, and preformed metal crowns (Hall-Technique) 3.1%. Secondary caries, poor marginal adaptation, loss of retention, and fracture of restoration were reported as reasons for failure. Four studies were evaluated at unclear and 25 at high risk of bias. Clinical and methodological heterogeneity, and the diversity of tested materials across included studies did not allow for meta-analyses.
CONCLUSIONS
Within the limitations of this systematic review, namely, the heterogeneity and the overall high risk of bias among included studies, clear recommendations based on solid evidence for the best restorative approach in primary teeth cannot be drawn. There is a need for future thoroughly implemented RCTs evaluating restorations in primary teeth to close this knowledge gap.
Topics: Child; Humans; Composite Resins; Dental Atraumatic Restorative Treatment; Dental Caries; Dental Materials; Dental Restoration Failure; Dental Restoration, Permanent; Glass Ionomer Cements; Tooth, Deciduous; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 35819627
DOI: 10.1007/s40368-022-00725-7 -
Gels (Basel, Switzerland) May 2022Since the adhesion of resin composites to calcium silicate-based cement is considered challenging. Therefore, the best adhesion strategy should be indicated. This review... (Review)
Review
Since the adhesion of resin composites to calcium silicate-based cement is considered challenging. Therefore, the best adhesion strategy should be indicated. This review aimed to assess the effect of different adhesive systems on the bond strength of resin composite to calcium silicate-based cement through a systematic review and meta-analysis. The subsequent PICOS framework used was: population, calcium silicate-based cement; intervention, use of self-etch adhesive systems; control, use of total-etch adhesive systems; outcome, bond strength; study design, in vitro studies. The literature search was conducted independently by two reviewers up to 18 February 2021. Electronic databases (PubMed, ISI Web of Science, SciELO, Scopus, and Embase) were searched for applicable articles. In vitro manuscripts studying the effect of adhesive systems on the bond strength of calcium silicate-based cement were considered. The meta-analyses were performed using Review Manager Software version 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Bond strength comparisons were made considering the type of calcium silicate-based cement (Mineral Trioxide Aggregate (MTA), Biodentine™, or TheraCal LC®). A p-value < 0.05 was considered statistically significant. A total of 7321 studies were retrieved in databases searched. After full-text evaluation, 37 eligible papers were assessed for qualitative analysis, leaving a total of 22 papers for the quantitative analysis. According to the meta-analysis, the bond strength values of resin composite materials to MTA and TheraCal LC® cement were favored when a total-etch adhesive system was used (p ≤ 0.02). On the other hand, the meta-analysis of the bond strength of resin-based materials to Biodentine™ calcium silicate-based cement was similar between both approaches (p = 0.12). The in vitro evidence suggests that the bond strength of resin-based materials to both MTA and TheraCal LC® cement was preferred by using the total-etch adhesive strategy. However, when bonding to Biodentine™, the use of self-etch or total-etch strategies displayed promising results. Given the lack of evidence related to the chemical interaction of self-etch adhesive materials with the bioceramics, if self-etch adhesives are used for bonding resin-based restorations to calcium silicate-based cement, a pretreatment with phosphoric acid could be recommended.
PubMed: 35621609
DOI: 10.3390/gels8050311 -
Arthroplasty (London, England) Feb 2021Methyl methacrylate (MMA) is commonly used in the fields of dentistry and orthopaedic surgery. However, there remain concerns for the occupational hazards of MMA,... (Review)
Review
INTRODUCTION
Methyl methacrylate (MMA) is commonly used in the fields of dentistry and orthopaedic surgery. However, there remain concerns for the occupational hazards of MMA, particularly during pregnancy and breastfeeding.
METHODS
We performed a systematic review of studies on effects that MMA may have in pregnancy in the context of exposure during orthopaedic surgery and dentistry. Review articles, studies lacking statistical data, single case reports and other evidence level V studies were excluded.
RESULTS
Nine studies were included. One basic science study demonstrated an increase in neuronal cell lysis and shrunken cell bodies when neocortical neurons were exposed to MMA monomer. Three animal studies exposed pregnant rodents to MMA via intraperitoneal injection or inhalation. Exposed fetuses in two studies had an increase in gross abnormalities such as hemangiomas, while there was no increase in teratologic effects in the third study. In dental workers exposed to MMA, two retrospective cohort studies did not find a statistically significant increase in birth defects or miscarriage. After exposure to MMA during total joint arthroplasty, two studies found that MMA levels were undetectable in the mothers' serum or breast milk. One study measuring the airborne levels of MMA during simulated joint arthroplasty found that concentrations never exceeded 1% of the recommended limit set forth by the Occupational Safety and Health Administration (OSHA).
CONCLUSIONS
Potential teratologic effects of MMA cannot be excluded by existing evidence. However, the typical MMA exposure levels for dental and orthopaedic personnel appear to be substantially less than currently proposed exposure limits.
PubMed: 35236460
DOI: 10.1186/s42836-020-00059-z -
Clinical and Experimental Dental... Apr 2022The push-out bond strength (POBS) of calcium silicate-based cements (CSCs) to the dentinal wall is considered one of the essential physical properties for clinical... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The push-out bond strength (POBS) of calcium silicate-based cements (CSCs) to the dentinal wall is considered one of the essential physical properties for clinical success. The presence of blood in the treatment area affects the POBS of these types of cement. This study aimed to evaluate the impact of blood contamination on the bond strength of CSCs and dentinal walls.
MATERIAL AND METHODS
This systematic review was performed by searching electronic databases (MEDLINE-PubMed, Scopus, and EMBASE) to include relevant in vitro studies published between 1992 and April 2020. Two reviewers independently evaluated the selected studies and extracted data on the type of studied CSCs, evaluated area of the teeth, sample size, the dimension of a prepared area, slice thickness, storage duration, the setting of the universal testing machine (UTM), effects of blood contamination on POBS of CSCs and their failure modes. The bond strength of evaluated CSCs in studies was used for network meta-analysis.
RESULTS
Initial searches identified 292 articles, while only 13 articles met the inclusion criteria. Full texts of these articles were evaluated, and data extraction was performed. The effect of blood contamination on bond strength to the dentinal wall was assessed in various CSCs such as PMTA, Biodentine, and AMTA. The network meta-analysis results showed that the bond strength of Biodentine was significantly higher than other types of cement in blood presence (p < .05).
CONCLUSIONS
Based on the current systematic review, despite controversies among the result of the different articles and the lack of data for some CSCs like bioaggregate, it could be concluded that the bond strength of Biodentine to the dentinal wall is better than other evaluated CSCs in the presence of blood.
Topics: Calcium Compounds; Dental Bonding; Dental Cements; Silicates
PubMed: 35220692
DOI: 10.1002/cre2.546