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Reda SA, Hussein YF, Riad M. The impact of Bis-GMA free and Bis-GMA containing resin composite as posterior restoration on marginal integrity: a randomized controlled clinical trial. BMC Oral Health 2023; 23:1022. [PMID: 38114979 PMCID: PMC10731870 DOI: 10.1186/s12903-023-03759-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND There have been concerns surrounding the utilization of Bis-GMA, a type of bisphenol A (BPA) derivative, within the dental industry. The aim of this study was to compare the performance of bulk fill Bis-GMA-free resin composite class II restorations in respect of its marginal integrity in comparison to bulk fill Bis-GMA-containing resin composite class II restorations over a 12-month period in a parallel clinical trial utilizing a split-mouth, double-blind, randomized strategy. METHODS 20 patients participated in this study. Each patient has received one pair of class II posterior restorations, Bis-GMA-free (Admira fusion x-tra), and Bis-GMA containing (x-tra fil) on each side of the mouth (split-mouth strategy), (n = 40). The restorations' marginal integrity was evaluated based on Ryge's criteria (modified USPHS) at baseline (after 1 week), as well as 1 month, 3 months, 6 months, 9 months, and after 12 months of follow-up by two calibrated examiners. The statistical analyses utilizing the Friedman and Wilcoxon tests, the significance level was adjusted to 0.05. RESULTS Following the 12-month period, all patients attended the recall visits to evaluate the restorations. The Wilcoxon signed-rank and Friedman tests, revealed that both types of bulk fill had 100% of Alpha (A) scores at baseline and after 1 month with no significant statistical differences. After 3, 6, 9, and 12 months, both tested bulk fill restorations showed Bravo (B) score with Bis-GMA free 10% and 5% for Bis-GMA containing with no statistically significant difference (p ≤ 0.05) for clinical marginal integrity parameter in USPHS criteria. CONCLUSIONS Bis-GMA-free resin composites demonstrated satisfactory, marginal integrity compared with Bis-GMA-containing resin composites within 12 months. TRIAL REGISTRATION The protocol of the current study was registered at www. CLINICALTRIALS gov , with the identification number NCT05480852 on 29/07/2022. All procedures involving human participants were performed in accordance with the ethical standards of the Research Ethics Committee of the Faculty of Dentistry, Minia University, Egypt, under the approval number 419 on 27/06/2020.
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Affiliation(s)
- Sara Ahmed Reda
- Operative Dentistry Department, Faculty of Dentistry, Minia University, Minia, Egypt
| | - Yasser Fathi Hussein
- Dental Biomaterials Department, Faculty of Dentistry, Minia University, Minia, 61519, Egypt
| | - Mona Riad
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, 11 El-Saraya St, Manial, Cairo, 11553, Egypt.
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Rezende M, Martins ACR, da Silva JA, Reis A, de Geus JL. Compliance of randomized controlled trials in posterior restorations with the CONSORT statement: a systematic review of methodology. Clin Oral Investig 2021; 26:41-64. [PMID: 34595606 DOI: 10.1007/s00784-021-04198-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aims to investigate the compliance of randomized controlled trials (RCTs) in posterior restorations with the Consolidated Standards of Reporting Trials Statement (CONSORT) statement and to analyze the risk of bias (RoB) of these studies. METHODS A systematic search was performed in PubMed, Scopus, Web of Science, LILACS/BBO, and Cochrane Library. Only RCTs published in peer-reviewed journals were included. The compliance with the CONSORT was evaluated in a 0-2 scale where 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the CONSORT mean score by journal, country, and RoB were performed. The RoB in RCTs was evaluated by using the Cochrane Collaboration's tool version 1.0. RESULTS A total of 15,476 studies were identified after duplicates removal. O only 202 meet the eligibility criteria, among which 31 were follow-up studies. Concerning the overall RoB, only 29 out of 171 were classified as low risk of bias. The overall mean CONSORT score was 19 ± 5.4 points, which means compliance of approximately 59%. Significant differences among countries, publication period, and RoB were observed (p < 0.001). The journal's impact factor was not correlated with the overall CONSORT score (p = 0.36). CONCLUSIONS The adherence of RCTs conducted in posterior restorations to the CONSORT Statement is still low. In addition, most studies were classified as at unclear risk of bias. These results call up an urgent need for improvement. CLINICAL RELEVANCE Most RCTs conducted in posterior teeth have poor reporting and are mainly classified as having an unclear risk of bias.
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Affiliation(s)
- Márcia Rezende
- Department of Dentistry, Paulo Picanço School of Dentistry, Joquim Sá, 900, Fortaleza, Ceará, 60135-218, Brazil
| | | | - Jadson Araújo da Silva
- Department of Dentistry, Paulo Picanço School of Dentistry, Joquim Sá, 900, Fortaleza, Ceará, 60135-218, Brazil
| | - Alessandra Reis
- Department of Dentistry, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Paraná, 84030-900, Brazil
| | - Juliana Larocca de Geus
- Department of Dentistry, Paulo Picanço School of Dentistry, Joquim Sá, 900, Fortaleza, Ceará, 60135-218, Brazil.
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Maran BM, de Geus JL, Gutiérrez MF, Heintze S, Tardem C, Barceleiro MO, Reis A, Loguercio AD. Nanofilled/nanohybrid and hybrid resin-based composite in patients with direct restorations in posterior teeth: A systematic review and meta-analysis. J Dent 2020; 99:103407. [PMID: 32526348 DOI: 10.1016/j.jdent.2020.103407] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/29/2020] [Accepted: 06/07/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE A systematic review and a meta-analysis were performed to answer the following research question: Are there differences in the color match and surface texture of nanofilled/nanohybrid and hybrid composite in patients with direct posterior restorations? DATA Randomized clinical trials that compared nanofilled/nanohybrid and hybrid composite in direct restoration in posterior teeth were included. For the analysis of the bias the risk of bias tool (RoB) was used. Meta-analyses of different pairs (nanofilled vs. hybrid and nanohybrid vs. hybrid composite) were conducted for surface texture and color match and other secondary outcomes at different follow-ups, using a random effects model. Heterogeneity was assessed with the Cochran Q test and I2 statistics. GRADE was used to assess the quality of the evidence. SOURCES A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library and SIGLE, without restrictions. IADR abstracts (2001-2019), unpublished and ongoing trials registries, dissertations and theses were also searched. STUDY SELECTION 28 studies remained. No study was considered to be at low RoB; four studies were judged to have high RoB, and the remaining were judged to have unclear RoB. RESULTS For the primary and secondary outcomes variables no significant differences were detected between nanofilled/nanohybrid restorations and hybrid composite restorations in any of the study follow-ups (p > 0.08). The body of evidence for surface texture and color match was classified as moderate or low. CONCLUSION No evidence of difference was found between nanofilled/nanohybrid and hybrid composite in any of the clinical parameters evaluated.
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Affiliation(s)
- Bianca Medeiros Maran
- Department of Restorative Dentistry, School of Dentistry, State University of West Paraná, Cascavel, Paraná, Brazil; Postgraduate Program in Dentistry, School of Dentistry, North Paraná University, Londrina, Paraná, Brazil
| | - Juliana Larocca de Geus
- Department of Restorative Dentistry, School of Dentistry, Guairacá Faculty, Guarapuava, Paraná, Brazil; Department of Restorative Dentistry, School of Dentistry, Paulo Picanço Faculty, Fortaleza, Ceará, Brazil
| | - Mario Felipe Gutiérrez
- Institute for Research in Dental Sciences, School of Dentistry, University of Chile, Santiago, Chile; Facultad de Odontología, Universidad de los Andes, Santiago, Chile
| | | | - Chane Tardem
- School of Dentistry, Federal Fluminense University, Rio de Janeiro, RJ, Brazil
| | - Marcos O Barceleiro
- School of Dentistry, Federal Fluminense University, Rio de Janeiro, RJ, Brazil
| | - Alessandra Reis
- Department of Restorative Dentistry, State University of Ponta Grossa, PR, Brazil
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Kruly PDC, Giannini M, Pascotto RC, Tokubo LM, Suga USG, Marques ADCR, Terada RSS. Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in comparison to methacrylate composite resin. PLoS One 2018; 13:e0191942. [PMID: 29466366 PMCID: PMC5842874 DOI: 10.1371/journal.pone.0191942] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 01/13/2018] [Indexed: 01/04/2023] Open
Abstract
Polymerization shrinkage of resin composite can compromise the longevity of restorations. To minimize this problem, the monomeric composition of composites have been modified. The objective of this study was to conduct a meta-analysis to assess the clinical behavior of restorations performed with low polymerization shrinkage resin composite in comparison with traditional methacrylates-based resin composite. This systematic review was registered at Prospero data system (CRD42015023940). Studies were searched in the electronic databases PubMed, Web of Science, Scopus, Lilacs and EMBASE according to a predefined search strategy. The inclusion criteria were as follow: (1) randomized controlled clinical trials with at least six months of follow-up; (2) studies investigating composites with monomers designed to reduce polymerization shrinkage; (3) studies conducted with class I or II restorations in the permanent dentition; and (4) studies that assessed at least one of the following criteria: marginal integrity/adaptation, marginal discoloration, recurent caries, retention of composite restorations, and postoperative sensitivity. Two independent reviewers analyzed the articles to determine inclusion and risk of bias. The search conducted in the databases resulted in a total of 14,217 studies. After reviewing the references and citations, 21 articles remained. The longest clinical follow-up time was 60 months. The meta-analysis of the data in the included studies demonstrated that only one variable (marginal adaptation after 12 months) showed statistically significant outcomes, in which methacrylates-based composites presented significantly better results than resin composites containing modified monomers. The good level of the scientific evidence as well as the overall low risk of bias of the included studies indicate that composites with silorane, ormocer or bulk-fill type modified monomers have a clinical performance similar to conventional resin composites.
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Affiliation(s)
| | - Marcelo Giannini
- Department of Restorative Dentistry, State University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Laíse Midori Tokubo
- Department of Dentistry, State University of Maringa, Maringa, Parana, Brazil
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Opdam N, Collares K, Hickel R, Bayne S, Loomans B, Cenci M, Lynch C, Correa M, Demarco F, Schwendicke F, Wilson N. Clinical studies in restorative dentistry: New directions and new demands. Dent Mater 2018; 34:1-12. [DOI: 10.1016/j.dental.2017.08.187] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/24/2017] [Indexed: 10/18/2022]
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Suhasini K, Madhusudhana K, Suneelkumar C, Lavanya A, Chandrababu KS, Kumar PD. Clinical performance of Class I nanohybrid composite restorations with resin-modified glass-ionomer liner and flowable composite liner: A randomized clinical trial. J Conserv Dent 2016; 19:510-515. [PMID: 27994310 PMCID: PMC5146764 DOI: 10.4103/0972-0707.194030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Liners play a vital role in minimizing polymerization shrinkage stress by elastic bonding concept and increase the longevity and favorable outcome for composite restorations. Aims: The aim of this study was to evaluate the clinical performance of nanohybrid composite restorations using resin-modified glass-ionomer and flowable composite liners. Settings and Design: A single-centered, double-blinded randomized clinical trial, with split-mouth design and equal allocation ratio that was conducted in the Department of Conservative Dentistry and Endodontics. Materials and Methods: In forty patients, a total of eighty Class I restorations were placed with resin-modified glass-ionomer cement (RMGIC) liner (FUJI II LC, GC America) in one group and flowable composite liner (smart dentin replacement/SDR, Dentsply Caulk, Milford, DE, USA) in another group. All restorations were clinically evaluated by two examiners, immediately (baseline), 3, 6, and 12 months using US Public Health Service modified criteria. Statistical Analysis Used: Statistical analysis was performed using McNemar's test (P < 0.05). Results: There was no significant difference in the color match, marginal discoloration, surface roughness, and marginal adaptation. Restorations with RMGIC liner group show 20% Bravo scores on anatomic form at 12 months but are still clinically acceptable. Conclusion: Nanohybrid composite restorations with RMGIC (Fuji II LC) and flowable composite liner (SDR) demonstrated clinically acceptable performance after 12 months.
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Affiliation(s)
- Krishtipati Suhasini
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Koppolu Madhusudhana
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Chinni Suneelkumar
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Anumula Lavanya
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - K S Chandrababu
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Perisetty Dinesh Kumar
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
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Gianordoli-Neto R, Padovani GC, Mondelli J, de Lima Navarro MF, Mendonça JS, Santiago SL. Two-year clinical evaluation of resin composite in posterior teeth: A randomized controlled study. J Conserv Dent 2016; 19:306-10. [PMID: 27563176 PMCID: PMC4979274 DOI: 10.4103/0972-0707.186446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Clinical evaluations as fundamental method to prove the efficiency of restorative materials. AIM This study evaluated the clinical performance of restorative systems during 2 years of clinical service. MATERIALS AND METHODS This study assessed the clinical performance of restorative systems (Filtek Z250 and P60), during 2 years of clinical service, using the US Public Health Service system. The randomized and double-blind study comprising thirty volunteers. The restorations were evaluated at baseline, 6, 12, and 24 months. It was used the following criteria: marginal discoloration (MD), marginal integrity (MI), superficial texture (ST), wear (W), postoperative sensitivity (PS) and recurrent caries (RC). RESULTS Statistic analysis was performed using Fisher's and McNemar's exact tests and Pearsons's Chi-square in a significance level of 5%. The results at baseline and 24 months for Group I were: MD - 100, 100%; MI - 100, 88.6%; ST - 100, 94.3%; W - 100, 94.3%; PS - 100, 100%; RC - 100, 100%, of alpha scores; Group II: MD - 100, 97.1%; MI - 100, 91.4%; ST - 100, 94.3%; W - 100, 91.4%; PS - 100, 100%; RC - 100, 100%, of alpha scores. It was observed no statistical difference in the evaluated criteria and period. CONCLUSIONS After 24 months of evaluation, both restorative systems exhibited acceptable clinical performance.
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Affiliation(s)
- Ranulfo Gianordoli-Neto
- Department of Prosthetic Dentistry, Federal University of Espírito Santo, Vitória, ES, Brazil
| | | | - José Mondelli
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Maria Fidela de Lima Navarro
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | | | - Sérgio Lima Santiago
- Department of Operative Dentistry, Federal University of Ceará, Fortaleza, CE, Brazil
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Survival of direct resin restorations in posterior teeth within a 19-year period (1996-2015): A meta-analysis of prospective studies. Dent Mater 2015; 31:958-85. [PMID: 26091581 DOI: 10.1016/j.dental.2015.05.004] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 05/08/2015] [Accepted: 05/08/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The aim of this study is to analyze the survival of posterior composite restorations published within the last 19 years (1996-2015). METHODS In this study only prospective, clinical trials with specification of the failure rate according to Class I/II composite fillings were included. Studies were analyzed according to the observation period (all studies vs. short-term vs. long-term studies). Retrospective studies and/or open laminate studies, tunnel restorations and Class V restorations were excluded. The following variables possibly influencing the failure rate were extracted from the studies: observation period, recall rate, average age of patients, number of patients, ratio of Class I/II fillings, number of restorations, ratio of premolars/molars, operator, method of isolation, bonding generation and filler size. RESULTS A total of 88 studies were included for statistical analysis. The observation period of the studies varied between 1 and 17 years, while most of the studies did not last longer than 5 years. Fracture of the restorations, secondary caries and marginal gap are the main causes for failure in the first 5 years (in descending order), while fracture and secondary caries are similarly distributed in long-term studies. Variables of investigation differed greatly in significance according to the respective observation period. The observation period, the recall rate, the ratio of Class I/II fillings and the number of restorations and patients had a significant influence on the overall failure rate when including all studies (short- and long-term). A linear correlation between the observation period and the failure rate was observed. In long-term studies these variables were not significant any longer. No significant difference in the failure rates between the materials per study was observed. The most common commercial composites investigated were: Tetric Ceram, Surefil, Filtek Supreme (incl. XT), Filtek Z250. The mean annual failure rate was 1.46% (±1.74%) for short-term studies and 1.97% (±1.53) for long-term studies. There is still a big need for clinical studies lasting longer than 5 years, as failure rates of composite restorations in posterior teeth increases with longer observation periods. SIGNIFICANCE A decreasing failure rate with an increasing recall rate as observed in our study suggests a patient selection in regard to availability and dental awareness. Internationally standardized evaluation criteria are mandatory in order to allow comparisons of the outcomes of clinical studies.
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