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Graziani F, Tinto M, Orsolini C, Izzetti R, Tomasi C. Complications and treatment errors in nonsurgical periodontal therapy. Periodontol 2000 2023; 92:21-61. [PMID: 36591941 DOI: 10.1111/prd.12478] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/14/2022] [Accepted: 10/14/2022] [Indexed: 01/03/2023]
Abstract
Nonsurgical periodontal therapy can be subject to iatrogenesis, which includes all the complications directly or indirectly related to a treatment. These complications include both operator-dependent harms and errors and the consequences and adverse effects of the therapeutic procedures. The complications arising following nonsurgical periodontal treatment can be categorized as intraoperative and postoperative and can affect both soft and hard tissues at an intra-oral and extraoral level. Soft-tissues damage or damage to teeth and restorations can occur while performing the procedure. In the majority of cases, the risk of bleeding associated with nonsurgical therapy is reported to be low and easily controlled by means of local hemostatic measures, even in medicated subjects. Cervicofacial subcutaneous emphysema is not a frequent extraoral intraoperative complication, occurring during the use of air polishing. Moreover, side effects such as pain, fever, and dentine hypersensitivity are frequently reported as a consequence of nonsurgical periodontal therapy and can have a major impact on a patient's perception of the treatment provided. The level of intraoperative pain could be influenced by the types of instruments employed, the characteristics of tips, and the individual level of tolerance of the patient. Unexpected damage to teeth or restorations can also occur as a consequence of procedural errors.
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Affiliation(s)
- Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Manuel Tinto
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Chiara Orsolini
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Rossana Izzetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Derman SHM, Lantwin EM, Barbe AG, Noack MJ. Does a pretreatment with a dentine hypersensitivity mouth-rinse compensate the pain caused by professional mechanical plaque removal? A single-blind randomized controlled clinical trial. Clin Oral Investig 2020; 25:3151-3160. [PMID: 33094406 PMCID: PMC8060178 DOI: 10.1007/s00784-020-03643-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/09/2020] [Indexed: 11/29/2022]
Abstract
Objectives Pain is affecting acceptance of supportive periodontal therapy and primary periodontitis prevention. Our objective was to evaluate the efficacy of a 1-week pre-treatment use of dentinal-hypersensitivity-reducing mouth-rinses (DHM) in periodontal maintenance (SPT) or dental prophylaxis patients. Material and methods One hundred fifty-five participants attending for professional mechanical plaque removal (PMPR) were randomly assigned to use a mouth-rinse twice daily for 1 week prior to their next PMPR. Rinses were containing either potassium oxalate (n = 52), arginine (n = 52), or herbal extracts (n = 51). At baseline and reassessment, procedural pain was assessed by visual analogue scale (VAS) and verbal rating scale (VRS). Self-reported efficacy was documented. Results No inter-group differences were estimated between both test groups and the control for baseline and reassessment means (VAS, VRS). In the SPT group, VAS reduction and self-reported efficacy were found (p < 0.05). Conclusion The 1-week use of DHM failed to show a predictable effect on discomfort during PMPR overall. Around 20% of the patients showed a quantifiable benefit from both test mouth-rinses, whereas more than 50% reported a subjective pain reduction. Focusing patients undergoing supportive periodontal therapy, quantifiable effects were found for both test groups. From a patient’s point of view, DHM might be a suitable adjunct to enhance procedural comfort, especially in patients with a history of periodontitis. Clinical relevance The 1-week use of the dentinal-hypersensitivity-reducing mouth-rinses prior to professional-mechanical-plaque-removal showed to be a suitable adjunct to enhance procedural comfort during instrumentation, especially in patients undergoing supportive periodontal therapy. Registration number: DRKS00010811 Electronic supplementary material The online version of this article (10.1007/s00784-020-03643-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sonja H M Derman
- Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany.
| | - Eva-Maria Lantwin
- Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
| | - Anna Greta Barbe
- Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
| | - Michael J Noack
- Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
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Shi SW, Jiao J, Zhang L, Lu RF, Meng HX, Cao ZQ, Shi D, Song Y. Influence of local anesthesia on the outcomes of non-surgical periodontal treatment. Chin Med J (Engl) 2020; 133:1908-1914. [PMID: 32826453 PMCID: PMC7462207 DOI: 10.1097/cm9.0000000000000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND There is limited evidence of the effects of local anesthesia (LA) on outcomes of non-surgical periodontal treatment (NSPT), in particular among the Chinese. This retrospective cohort study aimed to evaluate the effects of LA on short-term treatment outcomes of NSPT and to determine under what circumstances LA should be prescribed to improve these outcomes. METHODS Data from periodontal examinations of 3980 patients were used. The data were from 3-month re-evaluation records of an electronic periodontal charting record system in the Department of Periodontology of Peking University School and Hospital of Stomatology from June 2008 to January 2015. Descriptive analyses included changes in probing depth (PD) and the Mazza bleeding index (BI). Two-level (patient and tooth) logistic regression models and three-level (patient, tooth, and site) linear regression models were constructed to analyze the influence of LA on PD for all teeth/sites and teeth/sites with an initial PD ≥ 5 mm. Decreases in PD and BI at sites under LA using the initial PD were also compared. RESULTS A significantly higher mean decrease in PD after NSPT was found in the LA group than in the no local anesthesia (NLA) group (0.98 vs. 0.54 mm, t = 24.12, P < 0.001). A significantly higher probability of decreases was found in the LA group in BI (percentages of teeth with BI > 1 and BI > 2) for all teeth (16.7% vs. 13.8%, t = 3.75, P < 0.001; 34.7% vs. 28.1%, t = 6.73, P < 0.001) and PD for teeth with PD ≥ 5 mm (32.3% vs. 17.3%, t = 28.48, P < 0.001). The difference in PD between the LA and NLA groups increased as the initial PD increased. The difference between the two groups was 0.12 to 0.22 mm for sites with a baseline PD < 7 mm; however, it increased to 0.41 to 1.37 mm for sites with a baseline PD ≥ 7 mm. CONCLUSIONS LA improved the decrease in PD after NSPT. Root debridement at sites with initial PD ≥ 7 mm should be performed under routine LA.
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Affiliation(s)
- Shu-Wen Shi
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Jian Jiao
- Department of Periodontology, Peking University Hospital of Stomatology First Clinic Division, Beijing 100034, China
| | - Li Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Rui-Fang Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Huan-Xin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Zhan-Qiang Cao
- Information Center, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Dong Shi
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Malmö 20213, Sweden
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Moraes GS, Santos IBD, Pinto SCS, Pochapski MT, Farago PV, Pilatti GL, Santos FA. Liposomal anesthetic gel for pain control during periodontal therapy in adults: a placebo-controlled RCT. J Appl Oral Sci 2019; 28:e20190025. [PMID: 31778442 PMCID: PMC6882661 DOI: 10.1590/1678-7757-2019-0025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/24/2019] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Periodontal therapy usually requires local anesthesia. If effective, a non-invasive, liposomal anesthetic gel could increase the levels of acceptance of patients in relation to periodontal therapy. OBJECTIVE This study investigated the efficacy of liposomal anesthetic gel for pain control during periodontal therapy. METHODOLOGY Forty volunteers with moderate to severe chronic periodontitis were recruited, of which at least three sextants required periodontal therapy. At least one of the selected teeth had one site with a probing depth of ≥4 mm. The volunteers received the following three gels: a placebo, lidocaine/prilocaine (Oraqix®), or a liposomal lidocaine/prilocaine, which were applied to different sextants. Pain frequency was registered during treatment and the volunteers received a digital counter to register any painful or uncomfortable experiences. At the end of each session, the volunteers indicated their pain intensity using rating scales (NRS-101 and VRS-4). The volunteers had their hemodynamic parameters measured by a non-invasive digital monitor. RESULTS Pain frequency/intensity did not show statistical difference between intervention groups. The tested gels did not interfere with the hemodynamic indices. Dental anxiety, suppuration and probing depth could influence pain during periodontal therapy. CONCLUSION Our results suggest limited indications for the use of non-invasive anesthesia when used for scaling and root planing. Intra-pocket anesthetic gel could be a good option for anxious patients, or those who have a fear of needles.
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Affiliation(s)
- Gustavo Simao Moraes
- Universidade Estadual de Ponta Grossa, Departamento de Odontologia, Ponta Grossa, Paraná, Brasil
| | | | | | - Marcia Thais Pochapski
- Universidade Estadual de Ponta Grossa, Departamento de Odontologia, Ponta Grossa, Paraná, Brasil
| | - Paulo Vitor Farago
- Universidade Estadual de Ponta Grossa, Departamento de Ciências Farmacêuticas, Ponta Grossa, Paraná, Brasil
| | - Gibson Luiz Pilatti
- Universidade Estadual de Ponta Grossa, Departamento de Odontologia, Ponta Grossa, Paraná, Brasil
| | - Fabio Andre Santos
- Universidade Estadual de Ponta Grossa, Departamento de Odontologia, Ponta Grossa, Paraná, Brasil
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Wambier LM, Gonzaga CC, Chibinski A, Wambier DS, Farago PV, Loguercio AD, Reis A. Efficacy of a Light-cured Tetracaine-based Anesthetic Gel for Rubber Dam Clamp Placement: A Triple-blind Randomized Clinical Trial. Oper Dent 2019; 45:E57-E65. [PMID: 31750800 DOI: 10.2341/18-130-c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To evaluate the efficacy of a new light-cured anesthetic gel for pain control in adults undergoing rubber dam isolation for the restorative treatment of noncarious cervical lesions (NCCLs). METHODS AND MATERIALS This study was a randomized, split-mouth, triple-blind, controlled trial. The sample comprised 50 adults with at least one pair of NCCLs located in the same arch but on opposite sides. Simple randomization defined the tooth to receive the light-cured tetracaine-based anesthetic gel or the placebo gel. After cotton roll isolation, the gels were applied in the gingival tissue around the tooth with the aid of the applicator tip of a syringe, left in place for 15 seconds, and light-cured for 15 seconds. Then, a #212 clamp was positioned on the tooth. If the patient reported pain, the clamp was removed, the patient filled out a pain intensity form (a 0-10 visual analog scale [VAS] and a 0-4 verbal rating scale [VRS]) and an injectable anesthetic was applied before rubber dam isolation for the restorative procedure. The absolute risk, intensity of pain, and need for rescue anesthesia were analyzed by the McNemar test and the Wilcoxon signed rank test (α=5%). RESULTS The odds ratio [OR] for pain (OR=3.5; 95% confidence interval [CI]=1.1 to 14.6; p=0.03) showed lower reports of pain for the light-cured anesthetic gel. One in five patients will benefit from placement of the light-cured anesthetic gel. On average, pain intensity was one VAS unit lower in those using the light-cured anesthetic gel than in those using the placebo gel. For the VRS, the pain intensity for the light-cured anesthetic gel was 0.4 units lower than the pain intensity for the placebo gel (95% CI=-0.9 to 0.07). The OR for rescue anesthesia was 2.5 (95% CI=0.7 to 10.9; p=0.18). CONCLUSIONS The light-cured, tetracaine-based anesthetic gel reduced the absolute risk of pain by 20% in NCCLs.
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de Geus JL, Wambier LM, Boing TF, Loguercio AD, Reis A. Effect of ibuprofen on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis: A meta-analysis. AUST ENDOD J 2018; 45:246-258. [PMID: 30295006 DOI: 10.1111/aej.12306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2018] [Indexed: 12/16/2022]
Abstract
The aim of this study was to compare preventive ibuprofen administration to placebo on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis. A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, SIGLE, and grey literature. The risk of bias was evaluated through the Cochrane Collaboration's tool. The quality of evidence was assessed using the GRADE approach. Only seven studies remained for the meta-analysis. Administering ibuprofen before anaesthesia increased the success rate of injectable anaesthesia (RR = 1.79; 95% confidence interval (CI) 1.32-2.42; P = 0.0002) even in cases of symptomatic irreversible pulpitis (RR = 1.55; 95% CI 1.05-2.29; P = 0.03). The intensity of pain was lower for ibuprofen (standardised difference means (SMD) = -3.73; 95% CI -6.43 to -1.04; P = 0.007). Ibuprofen as premedication is beneficial for the success of inferior alveolar nerve block.
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Affiliation(s)
- Juliana L de Geus
- Department of Dentistry. State, University of Ponta Grossa, Ponta Grossa, PR, Brazil.,Department of Dentistry, Paulo Picanço School of Dentistry, Fortaleza, CE, Brazil.,Department of Restorative Dentistry, Guairacá Faculty, Guarapuava, PR, Brazil
| | - Leticia M Wambier
- Department of Pediatric Dentistry, Positivo University, Curitiba, PR, Brazil
| | - Thaynara F Boing
- Department of Restorative Dentistry, Guairacá Faculty, Guarapuava, PR, Brazil
| | | | - Alessandra Reis
- Department of Dentistry. State, University of Ponta Grossa, Ponta Grossa, PR, Brazil
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Effects of Ibuprofen Compared to Other Premedication Drugs on the Risk and Intensity of Postendodontic Pain: A Systematic Review. Eur Endod J 2018; 3:123-133. [PMID: 32161868 PMCID: PMC7006579 DOI: 10.14744/eej.2018.83803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/12/2018] [Accepted: 08/10/2018] [Indexed: 11/20/2022] Open
Abstract
Objective This systematic review aims to evaluate the effects of ibuprofen compared to other drugs on the risk and intensity of postoperative pain resulting from endodontic treatment in adult patients. Methods A systematic search was carried out through Medline databases (Pubmed, Scopus, Web of Science, Cochrane, Lilacs, and BBO). There was no restriction on the publication year or idiom. The gray literature was explored. The Periodicos Capes Theses Databases and ProQuest Dissertations were also searched, as well as the unpublished and ongoing trials registry and the IADR abstracts (1990-2016). Solely randomized clinical trials that compared the risk or intensity of pain resulting from endodontic treatment in adult patients were included in this systematic review. The risk of bias of the articles was evaluated using the Cochrane Collaboration's tool. A random-effect meta-analysis was conducted for ibuprofen versus placebo and ibuprofen versus other drugs at 6, 8, and 24 hours. The GRADE approach was used to assess the quality of the evidence. Results A total of 1132 studies were identified, and only seven meet the eligibility criteria. No difference between the groups was detected in any of the meta-analysis. An exception was observed when one study was removed from the meta-analysis of pain intensity at 24 hours for ibuprofen versus placebo, favoring ibuprofen (SMD -0.67; 95% CI -1.05 to -0.17). The quality of evidence in all meta-analyses was graded as low or very low. Conclusion Results of the present systematic review indicate that there is no clear evidence supporting that preoperative ibuprofen is better than other drugs in reducing the risk and intensity of postendodontic pain.
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Topical intra-pocket anaesthetic gel reduces the risk and intensity of pain during periodontal scaling and root planing and probing. Evid Based Dent 2017; 18:111-112. [PMID: 29269814 DOI: 10.1038/sj.ebd.6401271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Data sourcesMedline, Scopus, Web of Science, LILACS, BBO, Cochrane Library, SIGLE, ProQuest Dissertations and Theses, Periódicos Capes Theses, Current Controlled Trials, International Clinical Trials Registry Platform, the ClinicalTrials.gov, Rebec (www.rebec.gov.br), EU Clinical Trials Register (www.clinicaltrialsregister.eu), abstracts of the annual conference of the International Association for Dental Research (IADR) and its regional divisions. Reference lists of primary studies and related articles from PubMed.Study selectionRandomised controlled trials, parallel, crossover or split-mouth designs comparing intra-pocket anaesthesia with an anaesthetic gel with placebo in patients requiring periodontal probing or SRP were considered.Data extraction and synthesisTwo authors shortlisted 11 final articles based on the inclusion criteria. Data extraction was performed by three authors using customised forms after calibration. The risk of bias in the included studies was evaluated using the Cochrane collaboration tool for assessing risk of bias in randomised controlled trials.1ResultsThe authors used VAS and Heft-Parker scale to measure pain intensity and reported Hedge's g standardised difference in the means. The mean reduction in VAS and Heft-Parker scale were - 0.576 (CI = - 0.94 to - 0.22; p = 0.002) and - 1.814 (CI = - 3.38 to - 0.245; p = 0.023) respectively. This indicates a positive effect of anaesthetic gel in pain intensity reduction. For risk of pain, the authors reported the odds ratio of 0.025 (CI 0.003-0.25; p = 0.002). As far as the need for rescue anaesthesia using the same anaesthetic gel and/or injected anaesthetics, the odds ratio was 0.358 (95% CI 0.174-0.736; p = 0.005). Both these findings show the efficacy of anaesthetic gel in controlling the risk of pain during SRP and probing.ConclusionsThe risk and intensity of pain during probing and SRP as well as the need for additional rescue anaesthesia using the same anaesthetic gel and/or injected anaesthetics is reduced with the application of topical intra-pocket anaesthetic gel.
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Wambier LM, de Geus JL, Boing TF, Chibinski ACR, Wambier DS, Rego RO, Loguercio AD, Reis A. Intrapocket topical anesthetic versus injected anesthetic for pain control during scaling and root planing in adult patients. J Am Dent Assoc 2017; 148:814-824.e2. [DOI: 10.1016/j.adaj.2017.06.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/17/2017] [Accepted: 06/17/2017] [Indexed: 11/27/2022]
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Szesz A, Parreiras S, Martini E, Reis A, Loguercio A. Effect of flowable composites on the clinical performance of non-carious cervical lesions: A systematic review and meta-analysis. J Dent 2017; 65:11-21. [PMID: 28729119 DOI: 10.1016/j.jdent.2017.07.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/07/2017] [Accepted: 07/10/2017] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To answer the following PICO question (participant, intervention, comparator and outcome): Does flowable resin composite restorations compared with regular resin composites improve the marginal adaptation, marginal discoloration and retention rates of restorations placed in non-carious cervical lesions [NCCLs] of adults?, through a systematic review and meta-analysis. SOURCE MEDLINE, Scopus, Web of Science, LILACS, BBO, Cochrane Library and SIGLE were searched without restrictions, as well as the abstracts of the IADR, clinical trials registries, dissertations and theses in May 2016 (updated in April 2017). STUDY SELECTION We included randomized clinical trials (RCTs) that answered the PICO question. RCTs were excluded if cavities other than NCCLs were treated; indirect restorations; polyacid-based resins instead of composite resins were employed, restorations in primary teeth and restorations were placed in carious cervical lesions. The risk of bias tool of the Cochrane Collaboration was applied in the eligible studies and the GRADE tool was used to assess the quality of the evidence. DATA After duplicates removal, 5137 articles were identified. After abstract and title screening, 8 studies remained. Six were at "unclear" risk of bias. The study follow-ups ranged from 1 to 3 years. No significant difference was observed between groups for loss of retention and marginal discoloration in all follow-ups. Better marginal adaptation was observed for restorations performed with flowable composites. At 1-year (risk ratio=0.27 [0.10 to 0.70]) and 3-year (risk ratio=0.34 [0.17 to 0.71]) follow-ups, flowable composites showed a risk 73% and 66% lower than regular composites for lack of adaptation, respectively. The evidence was graded as moderate quality for loss or retention at 3 years due to risk of bias and low and very low for all other outcomes due to risk of bias, imprecision and inconsistency. CONCLUSIONS We have moderate confidence that the resin composite viscosity does not influence the retention rates at 3 years. Similar marginal discoloration and better marginal adaptation was observed for flowable composites but the quality of evidence is doubtful. (PROSPERO CRD42015019560).
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Affiliation(s)
- Anna Szesz
- Department of Dentistry, University of Uberaba-Uniube, MG, Brazil
| | - Sibelli Parreiras
- Department of Restorative Dentistry, State University of Ponta Grossa, Paraná, Brazil
| | - Eveline Martini
- Department of Restorative Dentistry, State University of Ponta Grossa, Paraná, Brazil
| | - Alessandra Reis
- Department of Restorative Dentistry, State University of Ponta Grossa, Paraná, Brazil.
| | - Alessandro Loguercio
- Department of Restorative Dentistry, State University of Ponta Grossa, Paraná, Brazil
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