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Materials (Basel, Switzerland) Jun 2020In the era of biology-driven endodontics, vital pulp therapies are regaining popularity as a valid clinical option to postpone root-canal treatment. In this sense, many... (Review)
Review
Cytotoxicity and Bioactivity of Dental Pulp-Capping Agents towards Human Tooth-Pulp Cells: A Systematic Review of In-Vitro Studies and Meta-Analysis of Randomized and Controlled Clinical Trials.
In the era of biology-driven endodontics, vital pulp therapies are regaining popularity as a valid clinical option to postpone root-canal treatment. In this sense, many different materials are available in the market for pulp-capping purposes. The main aim of this systematic review and meta-analysis was to examine literature regarding cytotoxicity and bioactivity of pulp-capping agents by exposure of human dental pulp cells of primary origin to these materials. A secondary objective was to evaluate the inflammatory reaction and reparative dentin-bridge formation induced by the different pulp-capping agents on human pulp tissue. A literature search strategy was carried out on , and the databases. The last search was done on 1 May 2020. No filters or language restrictions were initially applied. Two researchers independently selected the studies and extracted the data. In vitro studies were included when human dental pulp cells of primary origin were (in)directly exposed to pulp-capping agents. Parallel or split-mouth randomized or controlled clinical trials (RCT or CCT) were selected to investigate the effects of different pulp-capping agents on the inflammation and reparative bridge-formation capacity of human pulp tissue. Data were synthesized via (95% confidence interval) with fixed or random effects models, depending on the homogeneity of the studies. The (95% confidence interval) were presented for the sake of interpretation. In total, 26 in vitro and 30 in vivo studies were included in the systematic review and meta-analysis, respectively. The qualitative analysis of data suggested that resin-free hydraulic calcium-silicate cements promote cell viability and bioactivity towards human dental pulp cells better than resin-based calcium-silicate cements, glass ionomers and calcium-hydroxide cements. The meta-analysis of the in vivo studies indicated that calcium-hydroxide powder/saline promotes reparative bridge formation better than the popular commercial resin-free calcium-silicate cement Pro-Root MTA (Dentsply-Sirona), although the difference was borderline non-significant ( = 0.06), and better than calcium-hydroxide cements ( < 0.0001). Moreover, resin-free pulp-capping agents fostered the formation of a complete reparative bridge better than resin-based materials ( < 0.001). On the other hand, no difference was found among the different materials tested regarding the inflammatory effect provoked at human pulp tissue. Calcium-hydroxide (CH) powder and Pro-Root MTA (Dentsply-Sirona) have shown excellent biocompatibility in vitro and in vivo when tested on human cells and teeth. Their use after many years of research and clinical experience seems safe and proven for vital pulp therapy in healthy individuals, given that an aseptic environment (rubber dam isolation) is provided. Although evidence suggests that most modern hydraulic calcium-silicate cements promote bioactivity when exposed to human dental pulp cells, care should be taken when these new materials are clinically applied in patients, as small changes in their composition might have big consequences on their clinical efficacy. Pure calcium-hydroxide powder/saline and the commercial resin-free hydraulic calcium-silicate cement Pro-Root MTA (Dentsply-Sirona) are the best options to provide a complete reparative bridge upon vital pulp therapy. CRD42020164374.
PubMed: 32545425
DOI: 10.3390/ma13122670 -
Journal (Canadian Dental Association) Mar 2008To investigate the evidence for sealants as a means to prevent caries in children and adolescents and, in the presence of suitable supporting evidence, to develop a... (Review)
Review
OBJECTIVES
To investigate the evidence for sealants as a means to prevent caries in children and adolescents and, in the presence of suitable supporting evidence, to develop a protocol for the application of sealants.
METHODS
Previous systematic reviews on this topic were used as the basis for the current review. Ovid MEDLINE, CINAHL and several other relevant bibliographic databases were searched for English-language articles, with human subjects, published from 2000 to 2007.
RESULTS
A total of 303 articles were identified by the literature search; relevance was determined by examining the title and abstract of the articles. Thirty-eight original research studies met the inclusion criteria. These articles were read in full and scored independently by 2 reviewers, and evidence was extracted for development of recommendations.
RECOMMENDATIONS
The following recommendations are based on the evidence gathered in this review: 1. Sealants should be placed on all permanent teeth without cavitation (i.e., teeth that are free of caries, teeth that have deep pit and fissure morphology, teeth with "sticky" fissures or teeth with stained grooves) as soon after eruption as isolation can be achieved. 2. Sealants should not be placed on partially erupted teeth or teeth with cavitation or caries of the dentin. 3. Sealants should be placed on the primary molars of children who are susceptible to caries (i.e., those with a history of caries). 4. Sealants should be placed on first and second molars within 4 years after eruption. 5. Resin-based sealants should be preferred, until such time as glass ionomer cements with better retention capacity are developed. 6. Sealants should be placed as part of an overall prevention strategy based on assessment of caries risk.
Topics: Adolescent; Child; Composite Resins; Cost-Benefit Analysis; DMF Index; Dental Caries; Dental Caries Susceptibility; Glass Ionomer Cements; Humans; Pit and Fissure Sealants; Practice Guidelines as Topic; Vulnerable Populations
PubMed: 18353204
DOI: No ID Found -
Brazilian Oral Research 2015This study aimed to identify factors that can affect the retention of glass fiber posts to intra-radicular dentin based on in vitro studies that compared the bond... (Review)
Review
This study aimed to identify factors that can affect the retention of glass fiber posts to intra-radicular dentin based on in vitro studies that compared the bond strength (BS) of GFPs cemented with resin cements. Searches were carried out in PubMed and Scopus until December 2013. Bond strength values and variables as type of tooth, presence of endodontic treatment, pretreatment of the post, type of bonding agent (if present), type of cement and mode of cement application were extracted from the 34 included studies. A linear regression model was used to evaluate the influence of these parameters on BS. The presence of endodontic treatment decreased the BS values in 22.7% considering the pooled data (p = 0.013). For regular cement, cleaning the post increased BS when compared to silane application without cleaning (p = 0.032), considering cleaning as ethanol, air abrasion, or phosphoric acid application. Applying the cement around the post and into root canal decreased the resistance compared to only around the post (p = 0.02) or only into root canal (p = 0.041), on the other hand, no difference was found for self-adhesive resin cement for the same comparisons (p = 0.858 and p = 0.067). Endodontic treatment, method of cement application, and post pretreatment are factors that might significantly affect the retention of glass-fiber posts into root canals mainly when cemented with regular resin cement. Self-adhesive resin cements were found to be less technique-sensitive to luting procedures as compared with regular resin cements.
Topics: Analysis of Variance; Animals; Cattle; Cementation; Dental Prosthesis Retention; Dentin Desensitizing Agents; Glass; Humans; Post and Core Technique; Resin Cements; Treatment Outcome
PubMed: 26083089
DOI: 10.1590/1807-3107BOR-2015.vol29.0074 -
Journal of Conservative Dentistry : JCD 2023The purpose of this systematic review was to analyze the effect of commercially available calcium silicate-based bioactive endodontic cement (BEC) on treatment outcome... (Review)
Review
OBJECTIVES
The purpose of this systematic review was to analyze the effect of commercially available calcium silicate-based bioactive endodontic cement (BEC) on treatment outcome when used as root repair material in human permanent teeth and to compare it with traditional materials.
METHODS
PubMed, Embase, and Cochrane Library were searched until June 2020. Randomized clinical studies and observational studies with a minimum 1-year follow-up and sample size of at least 20 were included. Risk of bias (ROB) was assessed using Cochrane's ROB tool and the National Institutes of Health Quality Assessment Tool.
RESULTS
Thirty-nine studies were included in the systematic review. Majority of the studies used mineral trioxide aggregate. The pooled success rate for BEC was estimated by a random-effects method as 90.49% (95% confidence interval [CI]: 88.4992.34, = 54%). Eleven studies comparing BEC with traditional materials were included in the meta-analysis. The use of BEC significantly improved the treatment outcome when compared to traditional materials with odds ratio (OR) = 2.15 (95% CI: 1.57-2.96, = 0.8%, = 0.433).
CONCLUSION
Very low-to-moderate-quality evidence suggests that the use of BEC as root repair material enhanced the treatment outcome. High-quality studies are required for the newer BEC to establish their clinical performance. Registration: PROSPERO CRD42020211502.
PubMed: 37205900
DOI: 10.4103/jcd.jcd_498_22 -
Journal of Conservative Dentistry and... Feb 2024The aim of this study was to systematically compare the bond strength of self-adhesive and self-etch or total-etch resin cement to zirconia. The PubMed, ISI (all), and... (Review)
Review
The aim of this study was to systematically compare the bond strength of self-adhesive and self-etch or total-etch resin cement to zirconia. The PubMed, ISI (all), and Scopus databases were searched for the selected keywords up to November 1, 2021, without date or language restrictions. In vitro studies comparing the bond strength of self-adhesive and self-etch or total-etch resin cement to zirconia were eligible for inclusion in the study. The selected articles were divided into four groups based on the type of resin cement and the storage time. Statistical analysis was performed using the Biostat Comprehensive Meta-Analysis Software version 2 ( = 0.05). The effect of conventional cement ( Glass Ionomer (GI), Resin Modified Glass Ionomer (RMGI) and zinc phosphate) was analyzed using descriptive analysis. The initial search yielded 376 articles, of which 26 were selected after a methodological assessment. Two reviewers independently extracted data and assessed the risk of bias. The results showed that the immediate or delay bond strength of the self-adhesive resin cement to zirconia has no significant difference with the bond strength of self-etch resin cement to zirconia. The immediate and delay bond strength of total-etch cement-zirconia was significantly lower than that of self-adhesive cement-zirconia ( = 0.00). A descriptive analysis of the selected articles showed that the bond strength of self-adhesive resin cement to zirconia was significantly higher than total-etch cement. The results of the meta-analysis showed that both self-adhesive and self-etch resin cement (if applied according to their manufacturer's instruction) are suitable for bonding to zirconia.
PubMed: 38463466
DOI: 10.4103/JCDE.JCDE_225_23 -
Clinical performance of laminate and non-laminate resin composite restorations: a systematic review.Australian Dental Journal Dec 2015A systematic review was undertaken to determine the clinical outcomes of resin modified glass-ionomer cement or glass-ionomer cement-resin composite (RMGIC/GIC-RC)... (Review)
Review
BACKGROUND
A systematic review was undertaken to determine the clinical outcomes of resin modified glass-ionomer cement or glass-ionomer cement-resin composite (RMGIC/GIC-RC) laminate restorations and flowable resin composite (FRC)-lined RC restorations compared to that of non-laminate RC restorations.
METHODS
Electronic databases were searched and filtered for relevant papers by assessing titles, abstracts and full-text articles. Randomized controlled clinical trials (RCTs) were included, comparing the clinical performance of RMGIC/GIC-RC laminate restorations and FRC-lined restorations with RC restorations as the control. The articles were categorized and critically appraised. Raw data were used for a fixed effects meta-analysis.
RESULTS
Thirteen articles were included in the review. Five evaluated FRC-lined restorations, and eight studies evaluated RMGIC/GIC-RC laminate restorations, comparing with non-laminate RC restorations. Three of eight RMGIC/GIC-RC laminate restorations assessed only postoperative sensitivity. A meta-analysis could only be conducted in three studies with the FRC-lined restorations as the intervention. The meta-analysis found no significant difference in clinical failures between FRC-lined RC restorations and RC restorations with no lining (p > 0.05).
CONCLUSIONS
Based on current clinical evidence, a FRC lining is no more advantageous than RC restorations with no FRC lining. More long-term RCTs are required, particularly for evaluating RMGIC/GIC-RC laminate restorations.
Topics: Acrylic Resins; Composite Resins; Dental Restoration, Permanent; Glass Ionomer Cements; Humans; Polyurethanes
PubMed: 25404178
DOI: 10.1111/adj.12252 -
Stomatologija 2020A significant loss of dental structures during endodontic treatment increases the probability of tooth cracks, fractures or even tooth loss. The objective of this...
INTRODUCTION
A significant loss of dental structures during endodontic treatment increases the probability of tooth cracks, fractures or even tooth loss. The objective of this systematic review was to assess the influence of temporary filling material on dental cracks and fractures during endodontic treatment.
MATERIALS AND METHODS
The literature was digitally searched for in vivo and in vitro studies using Pubmed, ScienceDirect and Wiley Online Library databases. A total of 38 potentially relevant records were identified in the literature search after duplicates were removed. After screening, full-text analysis of selected studies was done. Two reviewers independently selected the studies, extracted the data which was structured and summarized.
RESULTS
Five publications met the selection criteria. Ten temporary filling materials were evaluated in this review. The analysis demonstrated that non-eugenol chemically hardening temporary filling materials significantly increase filling and dental fractures and have the lowest fracture and tooth fracture resistance. Glass ionomer cements (GIC) presented the higher hermetic, tightness and fracture resistance features.
CONCLUSIONS
A temporary filling material during endodontic treatment may influence dental cracks and fractures. Highest impact for dental cracks and fractures has ready-to-use, eugenol-free temporary filling materials, whereas the least impact has GIC.
Topics: Glass Ionomer Cements; Humans; Root Canal Filling Materials; Tooth Fractures
PubMed: 33821811
DOI: No ID Found -
BMC Oral Health Jun 2023This systematic review and network meta-analysis aimed to compare the clinical efficacy of bioactive and conventional restorative materials in controlling secondary... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This systematic review and network meta-analysis aimed to compare the clinical efficacy of bioactive and conventional restorative materials in controlling secondary caries (SC) and to provide a classification of these materials according to their effectiveness.
METHODS
A search was performed in Pubmed, Web of Science, Embase, BBO, Lilacs, Cochrane Library, Scopus, IBECS and gray literature. Clinical trials were included, with no language or publication date limitations. Paired and network meta-analyses were performed with random-effects models, comparing treatments of interest and classifying them according to effectiveness in the permanent and deciduous dentition and at 1-year or 2/more years of follow-up. The risk of bias and certainty of evidence were evaluated.
RESULTS
Sixty-two studies were included in the qualitative syntheses and 39 in the quantitative ones. In permanent teeth, resin composite (RC) (RR = 2.00; 95%CI = 1.10, 3.64) and amalgam (AAG) (RR = 1.79; 95%CI = 1.04, 3.09) showed a higher risk of SC than Glass Ionomer Cement (GIC). In the deciduous teeth, however, a higher risk of SC was observed with RC than with AAG (RR = 2.46; 95%CI = 1.42, 4.27) and in GIC when compared to Resin-Modified Glass Ionomer Cement (RMGIC = 1.79; 95%CI = 1.04, 3.09). Most randomized clinical trials studies showed low or moderate risk of bias.
CONCLUSION
There is a difference between bioactive restorative materials for SC control, with GIC being more effective in the permanent teeth and the RMGIC in the deciduous teeth. Bioactive restorative materials can be adjuvants in the control of SC in patients at high risk for caries.
Topics: Humans; Network Meta-Analysis; Dental Caries Susceptibility; Dental Materials; Dental Caries; Composite Resins; Treatment Outcome; Glass Ionomer Cements; Dental Restoration, Permanent
PubMed: 37322456
DOI: 10.1186/s12903-023-03110-y -
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 -
PloS One 2018Lasers have recently been introduced as an alternative means of conditioning dental ceramic surfaces in order to enhance their adhesive strength to cements and other... (Meta-Analysis)
Meta-Analysis Review
Lasers have recently been introduced as an alternative means of conditioning dental ceramic surfaces in order to enhance their adhesive strength to cements and other materials. The present systematic review and meta-analysis aimed to review and quantitatively analyze the available literature in order to determine which bond protocols and laser types are the most effective. A search was conducted in the Pubmed, Embase and Scopus databases for papers published up to April 2017. PRISMA guidelines for systematic review and meta-analysis were followed. Fifty-two papers were eligible for inclusion in the review. Twenty-five studies were synthesized quantitatively. Lasers were found to increase bond strength of ceramic surfaces to resin cements and composites when compared with control specimens (p-value < 0.01), whereas no significant differences were found in comparison with air-particle abraded surfaces. High variability can be observed in adhesion values between different analyses, pointing to a need to standardize study protocols and to determine the optimal parameters for each laser type.
Topics: Ceramics; Dental Materials; Lasers; Materials Testing
PubMed: 29293633
DOI: 10.1371/journal.pone.0190736