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Sartori CHM, Mazzetti T, Júnior FAV, Daneris ÂP, Cenci MS, van de Sande FH, Montagner AF. Methodological quality of evidence-based clinical practice guidelines in cariology. Clin Oral Investig 2023; 28:66. [PMID: 38159154 DOI: 10.1007/s00784-023-05429-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The present study aimed to appraise the methodological quality of evidence-based Clinical Practice Guidelines (CPGs) in the cariology field. MATERIALS AND METHODS A systematic search on electronic databases (MEDLINE/Pubmed, EMBASE, DARE and Epistemonikos), websites, and guideline organizations were undertaken. Evidence-based CPGs including at least one recommendation for clinical prevention and/or management of dental caries, developed for any clinical setting, were included. The quality of each guideline was evaluated using the AGREE II tool. Descriptive analysis was performed and the average overall score for each domain was calculated. RESULTS Thirty-two guidelines were included. Most of the CPGs achieved higher scores for the domains of clarity of presentation (66.7%, 95% IC 37.3-52.2) and scope and purpose (59.6%, 95% IC 53.7-65.5) domains; and lower scores for editorial independence (46.1%, 95% IC 37.8-55.7) and applicability domain (44.7%, 95% IC 37-55.3). The reviewers assessed 12 CPGs (37.5%) as recommended for use, 15 (46.9%) recommended with modifications, and 5 (15.6%) as not recommended. CONCLUSION The overall methodological quality of evidence-based CPGs in the cariology field is moderate, and there is a need for improvements in reporting related to most domains. The poorest reporting was found in the description of the domains' applicability of its recommendations and editorial independence. CLINICAL RELEVANCE Clinical Practice Guidelines provide guidance to patients, healthcare professionals, and stakeholders. The quality of these documents is essential for establishing trust in their recommendations.
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Affiliation(s)
| | - Thais Mazzetti
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, Ottawa, Canada
| | | | | | - Maximiliano Sérgio Cenci
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Françoise Hélène van de Sande
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil
| | - Anelise Fernandes Montagner
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil.
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Al-Saeed EJ, AlMarhoon ZW, Al-Eid ZAA, AlAhmari TA, AlJamed SH, AlSarhan R, AlShehri A, Al-Debasi YT, Badaoud OM, AlHussain BS. Properties, Success, and Applications of Resin Infiltration for Minimal Invasive Restoration: A Scoping Review. ARCHIVES OF PHARMACY PRACTICE 2022. [DOI: 10.51847/nabhjpaqo7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Tavares MI, Saraiva J, do Vale F, Coelho AS, Amaro IF, Marto CM, Francisco I, Ferreira MM, Paula AB, Carrilho EV. Resin infiltration in white spot lesions caused by orthodontic hypomineralisation: a minimally invasive therapy. Br Dent J 2021; 231:387-392. [PMID: 34625686 DOI: 10.1038/s41415-021-3476-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/17/2021] [Indexed: 01/11/2023]
Abstract
Objective White spot lesions are characterised by the presence of clinically detectable opaque lesions due to enamel demineralisation. These frequently present in patients following fixed orthodontic treatment, mostly due to the prolonged accumulation of bacterial plaque on the dental surface. When remineralisation is not achieved through good oral hygiene and prophylaxis with fluoride products, the infiltration of lesions with low-viscosity photopolymerised resin has proved to be a valid micro-invasive alternative compared to traditional conservative therapy.Clinical considerations A case series will be presented, where the chosen approach was resin infiltration, a micro-invasive and aesthetic technique.Clinical significance Infiltrative resin therapies are single-session procedures that reduce the need for more invasive therapies such as the use of rotary instruments for greater patient comfort. The need for periodic fluoride applications is also avoided. This approach increases the durability of the infiltrated lesion without compromising its mechanical properties and impedes the development of recurrent or secondary caries.Conclusions Resin infiltration might be considered as a routine procedure in the treatment of post-eruptive hypomineralised lesions. This follows the line of thought of minimally invasive dentistry, is an excellent treatment option and prevents the lesion's progression.
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Affiliation(s)
- Maria Inês Tavares
- University of Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, 3000-075 Coimbra, Portugal
| | - José Saraiva
- University of Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, 3000-075 Coimbra, Portugal
| | - Francisco do Vale
- University of Coimbra, Institute of Orthodontics, Faculty of Medicine, 3000-075 Coimbra, Portugal
| | - Ana Sofia Coelho
- University of Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, 3000-075 Coimbra, Portugal; University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal; University of Coimbra, Centre for Innovative Biomedicine and Biotechnology (CIBB), 3000-548 Coimbra, Portugal; Clinical Academic Centre of Coimbra (CACC), 3004-561 Coimbra, Portugal
| | - Inês Flores Amaro
- University of Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, 3000-075 Coimbra, Portugal
| | - Carlos Miguel Marto
- University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal; University of Coimbra, Centre for Innovative Biomedicine and Biotechnology (CIBB), 3000-548 Coimbra, Portugal; Clinical Academic Centre of Coimbra (CACC), 3004-561 Coimbra, Portugal; University of Coimbra, Institute of Experimental Pathology, Faculty of Medicine, 3000-548 Coimbra, Portugal
| | - Inês Francisco
- University of Coimbra, Institute of Orthodontics, Faculty of Medicine, 3000-075 Coimbra, Portugal
| | - Manuel Marques Ferreira
- University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal; University of Coimbra, Centre for Innovative Biomedicine and Biotechnology (CIBB), 3000-548 Coimbra, Portugal; Clinical Academic Centre of Coimbra (CACC), 3004-561 Coimbra, Portugal; University of Coimbra, Institute of Endodontics, Faculty of Medicine, 3000-075 Coimbra, Portugal
| | - Anabela Baptista Paula
- University of Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, 3000-075 Coimbra, Portugal; University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal; University of Coimbra, Centre for Innovative Biomedicine and Biotechnology (CIBB), 3000-548 Coimbra, Portugal; Clinical Academic Centre of Coimbra (CACC), 3004-561 Coimbra, Portugal.
| | - Eunice Virgínia Carrilho
- University of Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, 3000-075 Coimbra, Portugal; University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal; University of Coimbra, Centre for Innovative Biomedicine and Biotechnology (CIBB), 3000-548 Coimbra, Portugal; Clinical Academic Centre of Coimbra (CACC), 3004-561 Coimbra, Portugal
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Moradi S, Sabbagh S, Timms L, Ravaghi V. Teaching Minimally Invasive Interventions in Paediatric Dentistry: A Cross-Sectional Survey of Dental Schools in Iran. BMC Oral Health 2021; 21:368. [PMID: 34301216 PMCID: PMC8298961 DOI: 10.1186/s12903-021-01735-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dental caries is a significant public health problem in Iran. Teaching minimally invasive interventions in paediatric dentistry may facilitate the provision of treatment for untreated dental caries in children. We evaluated the teaching of such interventions in both undergraduate dental curriculum and Paediatric Dentistry Specialty Training Programme (PDSTP) in Iran. METHODS This was a cross-sectional questionnaire-based survey. Participants in this study were the directors of 40 undergraduate programmes and 15 PDSTPs in all Iranian dental schools (response rate = 100%). Descriptive statistics were reported. RESULTS The most commonly taught methods were preventive fissure sealant and preventive resin restoration (PRR), which were taught 'both didactically and clinically' in all undergraduate dental programmes. The least commonly taught methods were silver diamine fluoride (SDF), the Hall technique and resin infiltration, which were taught 'both didactically and clinically' in less than 5% of dental schools. The same three methods were the least commonly approaches taught in PDSTP, further, they were less often perceived to be 'essential'. CONCLUSIONS There was a notable variation in the teaching of the management of dental caries in Iran's dental education. Some minimally invasive approaches including SDF, the Hall technique and resin infiltration are not being commonly taught in Iranian dental schools despite the evidence base for these techniques.
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Affiliation(s)
- S Moradi
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - S Sabbagh
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - L Timms
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - V Ravaghi
- School of Dentistry, University of Birmingham, Birmingham, UK
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Chen Y, Chen D, Lin H. Infiltration and sealing for managing non-cavitated proximal lesions: a systematic review and meta-analysis. BMC Oral Health 2021; 21:13. [PMID: 33413327 PMCID: PMC7791990 DOI: 10.1186/s12903-020-01364-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background Infiltration and sealing are micro-invasive treatments for arresting proximal non-cavitated caries lesions; however, their efficacies under different conditions remain unknown. This systematic review and meta-analysis aimed to evaluate the caries-arresting effectiveness of infiltration and sealing and to further analyse their efficacies across different dentition types and caries risk levels. Methods Six electronic databases were searched for published literature, and references were manually searched. Split-mouth randomised controlled trials (RCTs) to compare the effectiveness between infiltration/sealing and non-invasive treatments in proximal lesions were included. The primary outcome was obtained from radiographical readings. Results In total, 1033 citations were identified, and 17 RCTs (22 articles) were included. Infiltration and sealing reduced the odds of lesion progression (infiltration vs. non-invasive: OR = 0.21, 95% CI 0.15–0.30; sealing vs. placebo: OR = 0.27, 95% CI 0.18–0.42). For both the primary and permanent dentitions, infiltration and sealing were more effective than non-invasive treatments (primary dentition: OR = 0.30, 95% CI 0.20–0.45; permanent dentition: OR = 0.20, 95% CI 0.14–0.28). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.20, 95% CI 0.14–0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01–8.27), there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.24, 95% CI 0.08–0.72; low to moderate risk: OR = 0.38, 95% CI 0.18–0.81; moderate to high risk: OR = 0.17, 95% CI 0.10–0.29; and high risk: OR = 0.14, 95% CI 0.07–0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01–8.27), infiltration was superior (low risk: OR = 0.24, 95% CI 0.08–0.72; low to moderate risk: OR = 0.38, 95% CI 0.18–0.81; moderate to high risk: OR = 0.20, 95% CI 0.10–0.39; and high risk: OR = 0.14, 95% CI 0.05–0.37). Conclusion Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.
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Affiliation(s)
- Yuanyuan Chen
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, Guangzhou, China
| | - Dongru Chen
- Department of Orthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, Guangzhou, China
| | - Huancai Lin
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China. .,Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China. .,Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, Guangzhou, China.
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Kielbassa AM, Leimer MR, Hartmann J, Harm S, Pasztorek M, Ulrich IB. Ex vivo investigation on internal tunnel approach/internal resin infiltration and external nanosilver-modified resin infiltration of proximal caries exceeding into dentin. PLoS One 2020; 15:e0228249. [PMID: 31990942 PMCID: PMC6986723 DOI: 10.1371/journal.pone.0228249] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 01/11/2020] [Indexed: 02/08/2023] Open
Abstract
This ex vivo proof-of-concept study aimed to investigate the effect of nanosilver particles (AgNP) added to a conventional infiltrant resin (Icon) on external penetration into natural proximal enamel caries exceeding into dentin after internal tunnel preparation and internal infiltration. Carious lesions (ICDAS codes 2/3) of extracted human (pre-)molars revealing proximal caries radiographically exceeding into dentin (E2/D1 lesions) were preselected. Then, 48 of those specimens showing demineralized areas transcending the enamel-dentin border as assessed by means of near-infrared light transillumination (DIAGNOcam) were deproteinized (NaOCl, 5%). Using an internal tunnel approach, occlusal cavities central to the marginal ridge were prepared. Excavation of carious dentin, total etch procedure (H3PO4, 40%), and internal resin infiltration (FITC-labeled) followed, along with final restorations (flowable composite resin). Outer lesion surfaces were etched (HCl, 15%) prior to external infiltration (RITC-labeled). Group 1 (control; n = 24) used non-modified infiltrant, while an infiltrant/AgNP mixture (20 nm; 5.5 wt%) was used with experimental Group 2 (n = 24). Non-infiltrated pores of cut lesions were stained (Berberine), and specimens were analyzed using confocal laser scanning microscopy. Compared to the non-filled infiltrant, incorporation of AgNP had no effect on the resin's external penetration. Between the groups, no significant differences regarding internal or external infiltration could be detected, and non-infiltrated lesion areas did not differ significantly (p>0.109; t-test). The internal tunnel preparation in combination with both an internal resin infiltration and an additional external infiltration approach using a nanosilver-modified infiltrant resin leads to increased infiltrated lesion areas, thus occluding and adhesively stabilizing the porous volume of the demineralized enamel. While exerting antimicrobial effects by the nanosilver particles, this approach should have the potential as a viable treatment alternative for proximal lesions extending into dentin, thus avoiding the sacrifice of sound enamel, postponing the frequently inevitable restoration/re-restoration cycle of conventional proximal caries treatment, and improving dental health.
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Affiliation(s)
- Andrej M. Kielbassa
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University, Krems, Austria
- * E-mail:
| | - Marlene R. Leimer
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University, Krems, Austria
| | - Jens Hartmann
- Department for Biomedical Research, Danube University, Krems, Austria
| | - Stephan Harm
- Department for Biomedical Research, Danube University, Krems, Austria
| | - Markus Pasztorek
- Department for Biomedical Research, Danube University, Krems, Austria
| | - Ina B. Ulrich
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University, Krems, Austria
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Effect of diphenyliodonium hexafluorophosphate salt on experimental infiltrants containing different diluents. Odontology 2018; 107:202-208. [DOI: 10.1007/s10266-018-0391-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
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