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Banon R, Vandenbulcke J, Van Acker J, Martens L, De Coster P, Rajasekharan S. Two-year clinical and radiographic evaluation of ACTIVA BioACTIVE versus Compomer (Dyract® eXtra) in the restoration of class-2 cavities of primary molars: a non-inferior split-mouth randomised clinical trial. BMC Oral Health 2024; 24:437. [PMID: 38600533 PMCID: PMC11005273 DOI: 10.1186/s12903-024-04132-w] [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: 06/11/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVES The trial aimed to compare the clinical performance and radiographic success of ACTIVA BioACTIVE versus Compomer in restoring class-II cavities of primary molars. MATERIALS AND METHODS A non-inferior split-mouth design was considered. A pre-calculated sample size of 96 molars (48 per group) with class-2 cavities of twenty-one children whose ages ranged from 5 to 10 years were randomly included in the trial. Pre-operative Plaque Index (PI), DMFT/dmft scores and the time required to fill the cavity were recorded. Over 24 months, the teeth were clinically evaluated every six months and radiographically every 12 months by two calibrated and blinded evaluators using the United States public health service (USPHS)-Ryge criteria. The two-sided 95% confidence interval (CI) for the difference in success rate was considered to assess non-inferiority, and the margin was set at -18%. The linear mixed model and Firth's logistic regression model were used for data analysis (P < 0.05). RESULTS After 24 months, 86 teeth (43 per group) were evaluated. The mean PI score was 1.1(± 0.9), while DMFT/dmft was 0.35 (± 0.74) and 6.55 (± 2.25) respectively. The clinical and radiographic success rate of Dyract vs. ACTIVA was 95.3% and 88.3% vs. 93% and 86%, respectively. The two-sided 95% CI for the difference in success rate (-2.3%) was - 3.2 to 1.3% and didn't reach the predetermined margin of -18% which had been anticipated as the non-inferiority margin. Clinically, ACTIVA had a significantly better colour match (P = 0.002) but worse marginal discolouration (P = 0.0143). There were no significant differences regarding other clinical or radiographic criteria (P > 0.05). ACTIVA took significantly less placement time than Dyract, with a mean difference of 2.37 (± 0.63) minutes (P < 0.001). CONCLUSION The performance of ACTIVA was not inferior to Dyract and both materials had a comparable high clinical and radiographic performance in children with high-caries experience. ACTIVA had a significantly better colour match but more marginal discolouration. It took significantly less time to be placed in the oral cavity. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov on 4 May 2018 (#NCT03516838).
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Affiliation(s)
- Reda Banon
- Paediatric Dentistry, Oral Health Sciences, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University Hospital, Ghent, Belgium.
| | - Jeroen Vandenbulcke
- Paediatric Dentistry, Oral Health Sciences, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University Hospital, Ghent, Belgium
| | - Jakob Van Acker
- Paediatric Dentistry, Oral Health Sciences, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University Hospital, Ghent, Belgium
| | - Luc Martens
- Paediatric Dentistry, Oral Health Sciences, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University Hospital, Ghent, Belgium
| | - Peter De Coster
- Department of Reconstructive Dentistry and Oral Biology, Oral Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Sivaprakash Rajasekharan
- Paediatric Dentistry, Oral Health Sciences, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University Hospital, Ghent, Belgium
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Brum VDS, Borges MLV, Santos NMD, Kaufmann C, Rodrigues JDA. The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial. Braz Oral Res 2024; 38:e009. [PMID: 38198308 DOI: 10.1590/1807-3107bor-2024.vol38.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/09/2023] [Indexed: 01/12/2024] Open
Abstract
This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.
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Affiliation(s)
- Vanessa Dos Santos Brum
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Maria Luiza Vieira Borges
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Nicole Marchioro Dos Santos
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Camila Kaufmann
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Jonas de Almeida Rodrigues
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
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Andaş K, Knorst JK, Bonifácio CC, Kleverlaan CJ, Hesse D. Compomers for the restorative treatment of dental caries in primary teeth: An umbrella review. J Dent 2023; 138:104696. [PMID: 37714452 DOI: 10.1016/j.jdent.2023.104696] [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: 07/20/2023] [Revised: 09/03/2023] [Accepted: 09/08/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVES This umbrella review comprehensively appraised the evidence on the use of compomers in comparison to other dental filling materials for restorative treatment of decayed primary teeth. DATA The literature search was conducted based on the question: "Is the use of compomers as a dental filling material more successful in the restorative treatment of decayed primary teeth than other dental filling materials?" No language restriction was applied and systematic reviews published up to May 2023 were included. The ROBIS tool was used to assess the methodological quality of the included systematic reviews. Data were extracted for narrative synthesis, considering the restoration failure/success outcomes. SEARCH Online search was conducted in three databases (PubMed/Medline, Embase and Cochrane library). STUDY SELECTION The electronic search yielded a total of 779 publications. Finally, 18 systematic reviews were included in this umbrella review. Four systematic reviews presented a low risk of bias, 11 presented an unclear risk of bias and three presented a high risk of bias. Most systematic reviews presenting low risk of bias reported no difference in the success rates of compomers compared to other dental filling materials used for restoration of decayed primary teeth. Studies that found a significant difference or that made clear recommendations towards the use of compomers were commonly rated with a high risk of bias. CONCLUSION Compomers are similar to other dental filling materials for the placement of direct restorations in primary teeth. CLINICAL SIGNIFICANCE The results of this umbrella review indicate a similar clinical performance of compomers compared to other materials containing a resin component for direct restoration in primary teeth. Therefore, the choice of restorative material will depend on multiple factors, such as clinician's skills/preferences, patients' wishes, costs, and cavity type/location.
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Affiliation(s)
- Kübra Andaş
- Department of Paediadtric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, the Netherlands
| | - Jessica Klöckner Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Av. Roraima, 1000, Cidade Universitária - 26F, 97015-340, Santa Maria, RS, Brazil
| | - Clarissa Calil Bonifácio
- Department of Paediadtric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, the Netherlands
| | - Cornelis J Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, the Netherlands
| | - Daniela Hesse
- Department of Paediadtric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, the Netherlands.
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Montagner AF, Angst PDM, Raggio DP, VAN DE Sande FH, Tedesco TK. Methodological quality of network meta-analysis in dentistry: a meta-research. Braz Oral Res 2023; 37:e062. [PMID: 37436290 DOI: 10.1590/1807-3107bor-2023.vol37.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/27/2023] [Indexed: 07/13/2023] Open
Abstract
This meta-research aimed to provide an overview of the methodological quality and risk of bias of network meta-analyses (NMA) in dentistry. Searches for NMA of randomized clinical trials with clinical outcomes in dentistry were performed in databases up to January 2022. Two reviewers independently screened titles/abstracts, selected full texts, and extracted the data. The adherence to PRISMA-NMA reporting guideline, the AMSTAR-2 methodological quality tool, and the ROBIS risk of bias tool were assessed in the studies. Correlation between the PRISMA-NMA adherence and the AMSTAR-2 and ROBIS results was also investigated. Sixty-two NMA studies were included and presented varied methodological quality. According to AMSTAR-2, half of the NMA presented moderate quality (n = 32; 51.6%). The adherence to PRISMA-NMA also varied. Only 36 studies (58.1%) prospectively registered the protocol. Other issues lacking of reporting were data related were data related to the NMA geometry and the assessment of results consistency, and the evaluation of risk of bias across the studies. ROBIS assessment showed a high risk of bias mainly for domains 1 (study eligibility criteria) and 2 (identification and selection of studies). Correlation coefficients between the PRISMA-NMA adherence and the AMSTAR-2 and ROBIS results showed moderate correlation (rho < 0.6). Overall, NMA studies in dentistry were of moderate quality and at high risk of bias in several domains, especially study selection. Future reviews should be better planned and conducted and have higher compliance with reporting and quality assessment tools.
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Affiliation(s)
| | | | | | | | - Tamara Kerber Tedesco
- Univesidade Cruzeiro do Sul - Unicsul, Graduate Program in Dentistry, São Paulo, SP, Brazil
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Conti G, Veneri F, Amadori F, Garzoni A, Majorana A, Bardellini E. Evaluation of Antibacterial Activity of a Bioactive Restorative Material Versus a Glass-Ionomer Cement on Streptococcus Mutans: In-Vitro Study. Dent J (Basel) 2023; 11:149. [PMID: 37366672 DOI: 10.3390/dj11060149] [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: 03/23/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Dental caries management consists of both preventive and restorative approaches. Pediatric dentists can rely on many techniques and materials to restore decayed teeth, but a high failure rate is still observed, mainly due to secondary caries. New restorative bioactive materials combine the mechanical and aesthetic characteristics of resinous materials with the capability to remineralize and the antimicrobial properties of glass ionomers, thus counteracting the occurrence of secondary caries. The aim of this study was to assess the antimicrobial activity against Streptococcus mutans of a bioactive restorative material (ACTIVA™ BioActive-Restorative™-Pulpdent©) and a glass ionomer cement with silver particles added (Ketac™ Silver-3M©), using agar diffusion assay. METHODS Each material was formed into disks of 4 mm in diameter, and four discs of each material were placed on nine agar plates. The analysis was repeated seven times. RESULTS Both materials showed statistically significant growth inhibition properties against S. mutans (p < 0.05). The difference in the effectiveness of the two materials was not statistically significant. CONCLUSION Both ACTIVA™ and Ketac™ Silver can be recommended since both are similarly effective against S. mutans. However ACTIVA™, given its bioactivity and better aesthetics and mechanical properties compared to GICs, may provide better clinical performance.
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Affiliation(s)
- Giulio Conti
- Department of Medicine and Surgery, School of Dentistry, University of Insubria, Via Ravasi 2, 21100 Varese, Italy
| | - Federica Veneri
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, Unit of Dentistry & Oral-Maxillo-Facial Surgery, University of Modena and Reggio Emilia, Via del Pozzo, 41124 Modena, Italy
| | - Francesca Amadori
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
| | - Alba Garzoni
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
| | - Alessandra Majorana
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
| | - Elena Bardellini
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
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Pilcher L, Pahlke S, Urquhart O, O'Brien KK, Dhar V, Fontana M, González-Cabezas C, Keels MA, Mascarenhas AK, Nascimento MM, Platt JA, Sabino GJ, Slayton RL, Tinanoff N, Young DA, Zero DT, Tampi MP, Purnell D, Salazar J, Megremis S, Bienek D, Carrasco-Labra A. Direct materials for restoring caries lesions: Systematic review and meta-analysis-a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2023; 154:e1-e98. [PMID: 36610925 DOI: 10.1016/j.adaj.2022.09.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/26/2022] [Accepted: 09/28/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND The goal of restoring caries lesions is to protect the pulp, prevent progression of the disease process, and restore the form and function of the tooth. The purpose of this systematic review was to determine the effect of different direct restorative materials for treating cavitated caries lesions on anterior and posterior primary and permanent teeth. TYPE OF STUDIES REVIEWED The authors included parallel and split-mouth randomized controlled trials comparing the effectiveness of direct restorative materials commercially available in the United States placed in vital, nonendodontically treated primary and permanent teeth. Pairs of reviewers independently conducted study selection, data extraction, and assessments of risk of bias and certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. The authors conducted pair-wise meta-analyses to summarize the evidence and calculated measures of association and their 95% CIs. RESULTS Thirty-eight randomized controlled trials were eligible for analysis, which included data on Class I and Class II restorations on primary teeth and Class I, Class II, Class III, Class V, and root surface restorations on permanent teeth. Included studies assessed the effect of amalgam, resin composite, compomer, conventional glass ionomer cement, resin-modified glass isomer cement, and preformed metal crowns. Moderate to very low certainty evidence suggested varying levels of effectiveness across restorative materials. CONCLUSIONS AND PRACTICAL IMPLICATIONS Owing to a relatively low event rate across various outcomes indicating restoration failure, there was limited evidence to support important differences between direct restorative materials used in practice.
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Amend S, Seremidi K, Kloukos D, Bekes K, Frankenberger R, Gizani S, Krämer N. Clinical Effectiveness of Restorative Materials for the Restoration of Carious Primary Teeth: An Umbrella Review. J Clin Med 2022; 11:jcm11123490. [PMID: 35743560 PMCID: PMC9225564 DOI: 10.3390/jcm11123490] [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: 04/20/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
Since untreated dental caries remain a worldwide burden, this umbrella review aimed to assess the quality of evidence on the clinical effectiveness of different restorative materials for the treatment of carious primary teeth. A literature search in electronic bibliographic databases was performed to find systematic reviews with at least two-arm comparisons between restorative materials and a follow-up period ≥12 months. Reviews retrieved were screened; those eligible were selected, and the degree of overlap was calculated using the 'corrected covered area' (CCA). Data were extracted and the risk of bias was assessed using the ROBIS tool. Fourteen systematic reviews with a moderate overlap (6% CCA) were included. All materials studied performed similarly and were equally efficient for the restoration of carious primary teeth. Amalgam and resin composite had the lowest mean failure rate at 24 months while high-viscosity and metal-reinforced glass ionomer cements had the highest. At 36 months, high-viscosity glass ionomer cements showed the highest failure rate with compomer showing the lowest. Most reviews had an unclear risk of bias. Within the limitations of the review, all materials have acceptable mean failure rates and could be recommended for the restoration of carious primary teeth.
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Affiliation(s)
- Stefanie Amend
- Department of Paediatric Dentistry, University Medical Centre Giessen and Marburg (Campus Giessen), Medical Centre for Dentistry, Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany;
- Correspondence:
| | - Kyriaki Seremidi
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece; (K.S.); (S.G.)
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland;
| | - Katrin Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University Vienna, Sensengasse 2a, 1090 Vienna, Austria;
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics and Paediatric Dentistry, University Medical Centre Giessen and Marburg (Campus Marburg), Medical Centre for Dentistry, Philipps-University Marburg, Georg–Voigt–Str. 3, 35039 Marburg, Germany;
| | - Sotiria Gizani
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece; (K.S.); (S.G.)
| | - Norbert Krämer
- Department of Paediatric Dentistry, University Medical Centre Giessen and Marburg (Campus Giessen), Medical Centre for Dentistry, Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany;
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da Cunha CMBDL, Wambier LM, Matos TDP, Malaquias P, Reis A, Loguercio AD, Wambier DS, Chibinski ACR. New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial. Int J Clin Pediatr Dent 2022; 15:38-46. [PMID: 35528486 PMCID: PMC9016904 DOI: 10.5005/jp-journals-10005-2173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The clinical performance of new restorative materials must be evaluated before recommending its use in primary teeth. Aim This randomized clinical trial evaluated the survival rates of restorations in single and occluso-proximal cavities of primary teeth performed with a new dual-cure resin-based material in comparison with a resin-modified glass ionomer cement after 12 months of follow-up. Materials and methods A total of 107 restorations were placed in 27 children by one experienced pediatric dentist. Two materials were tested: Vitremer and a dual-cure resin-based material with (CentionN+Adh) and without (Cention N-Adh) adhesive system application. Two calibrated and blinded examiners evaluated the restorations at 3, 6, and 12-month. The longevity of the restorations was analyzed using Kaplan-Meier survival curves and Log-rank test (α = 5%). Results The overall survival rates after 12-month were 81.9% for Vitremer, 70.4% for Cention N+Adh, and 66.7% for Cention N-Adh, which had the poorer performance (HR = 0.54; 95% CI= 0.31-0.95; p = 0.031). When considering the type of the cavities, the difference was significant only for occluso-proximal cavities when Cention N-Adh was used (HR = 0.46; CI = 0.26-0.81; p = 0.008). Conclusion All evaluated materials are suitable for restoring occlusal cavities after selective caries removal. However, Cention N needs to be used with adhesive in occluso-proximal cavities. Clinical significance Cention-N can be used for deciduous teeth restorations, with similar longevity rates as resin modified glass ionomer cements. Trial registration number RBR-9nqszr How to cite this article da Cunha CM, Wambier LM, Paris Matos TD, et al. New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial. Int J Clin Pediatr Dent 2022;15(1):38-46.
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Affiliation(s)
| | - Letícia Maíra Wambier
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | | | - Pamela Malaquias
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Alessandra Reis
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | | | | | - Ana Cláudia Rodrigues Chibinski
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
- Ana Cláudia Rodrigues Chibinski, Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil, Phone: +55 42 999171983, e-mail:
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FONSECA PG, FERNANDES IB, ABREU MHNGD, SOARES MEDC, RAMOS-JORGE ML. Prevalence of unsatisfactory dental restorations in posterior primary teeth and associated factors. Braz Oral Res 2022; 36:e136. [DOI: 10.1590/1807-3107bor-2022.vol36.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 07/04/2022] [Indexed: 12/23/2022] Open
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Cerdán F, Ceballos L, Fuentes MV. Quality of approximal surfaces of posterior restorations in primary molars. J Oral Sci 2021; 63:347-351. [PMID: 34511588 DOI: 10.2334/josnusd.21-0264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE To evaluate the influence of the restorative material and matrix system on proximal contact tightness and morphological characteristics of class II restorations in primary molars. METHODS Occluso-mesial cavities in second primary artificial molars were randomly restored using different materials (Filtek Z500 or Filtek Bulk Fill composites or high-viscosity glass ionomer cement Ketac Universal) and different matrix system (Tofflemire, AutoMatrix, matrix band with ring, contoured sectional matrix) (n = 12). Proximal contact tightness was measured using a custom-made device in an Instron 3345, and proximal surface morphology and marginal adaptation were scored after digital scanning. Two-way ANOVA, Tukey and Fischer's exact tests were performed (P < 0.05). RESULTS Proximal contact tightness values were significantly influenced by the restorative material (P < 0.05), the matrix system (P < 0.001), and their interaction (P < 0.01). Both resin composites showed statistically differences in proximal shape according to the matrix used to restore and exhibited overhanging margins. Ketac Universal restorations showed similar morphology and gaps on the margins regardless of the matrix system. CONCLUSIONS Overall, both composite restorations achieved tighter proximal contact than those restored with the high-viscosity glass ionomer cement. None of the matrix systems tested provided a convex seamless proximal morphology.
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Affiliation(s)
- Fátima Cerdán
- IDIBO Research Group, Nursing and Stomatology Department, Health Sciences Faculty, Rey Juan Carlos University.,European University of Madrid, Villaviciosa de Odón Campus
| | - Laura Ceballos
- IDIBO Research Group, Nursing and Stomatology Department, Health Sciences Faculty, Rey Juan Carlos University
| | - María Victoria Fuentes
- IDIBO Research Group, Nursing and Stomatology Department, Health Sciences Faculty, Rey Juan Carlos University
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Sealing of cavitated occlusal carious lesions in the dentine of deciduous molars: a two-year randomised controlled clinical trial. Clin Oral Investig 2021; 26:1017-1024. [PMID: 34286398 DOI: 10.1007/s00784-021-04085-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This two-arm, parallel-group, tooth-randomised, controlled noninferiority clinical trial aimed to compare survival rates between the sealing and restoring of cavitated occlusal carious lesions in dentine [International Caries Detection and Assessment System (ICDAS) 5] of deciduous molars using resin-modified glass-ionomer cement (RMGIC) and to assess caries progression radiographically. MATERIALS AND METHODS A total of 68 molars with ICDAS 5 occlusal lesions were randomly allocated into two groups, a sealing group (n = 31), in which RMGIC was placed directly over the carious lesion, and a restoration group (n = 37), in which a restoration with the same material was placed after selective caries removal. During the baseline and follow-up visits, dental caries was registered and caries activity was assessed according to a visuotactile criterion. At baseline, patient caries status (dmf-t) and cavity depth and extent (mesiodistal and buccolingual) were measured before RMGIC placement. An independent and blinded examiner evaluated the treated teeth using the USPHS criteria after one and two years. Standardised interproximal radiographs were taken for caries progression assessments. RESULTS During the follow-up period, no lesion progression was observed radiographically. After one year (n = 60; 27 sealed and 33 restored) and two years (n = 48; 23 sealed and 25 restored) of follow-up, the treatment success rates were 78.8% and 76.0% in the restoration group and 59.3% and 47.8% in the sealing group, respectively. Multivariate Cox regression showed that lesions smaller than 2 mm in the mesiodistal extent were less prone to fail after one year (p = 0.03). However, survival curves (log-rank test) were statistically significantly different only after two years (p < 0.001). CONCLUSIONS Sealing ICDAS 5 occlusal lesions of deciduous molars using RMGIC achieved lower survival rates than restorations. Both sealing and restoration effectively arrested caries progression for two years. Clinical relevance Sealing dentine carious lesions can be effective for treating lesions involving the inner and outer half of the dentine. Ultraconservative treatments can arrest carious lesions presenting obvious cavitation in primary molars. TRIAL REGISTRATION ReBEC Register no. RBR-225n35.
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Meta-Analysis of In-Vitro Bonding of Glass-Ionomer Restorative Materials to Primary Teeth. MATERIALS 2021; 14:ma14143915. [PMID: 34300834 PMCID: PMC8304208 DOI: 10.3390/ma14143915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/25/2021] [Accepted: 07/03/2021] [Indexed: 11/17/2022]
Abstract
Restoration of primary teeth is among the main clinical applications of glass-ionomer cements (GIC). The aim of the study was to review and summarize existing evidence of in vitro bond strength of glass-ionomer (GI) restoratives to enamel and dentin of primary teeth. A literature search was performed in PubMed/Medline, Scopus, Web of Science, Cochrane, and Google Scholar databases to identify studies published until April 2021. The search strategy was: (“glass”) and (“ionomer”) and (“primary” or “deciduous”) and (“bond” or “tensile” or “shear”). Two researchers independently retrieved articles that reported on the bond strength of GIC to primary dentin and/or enamel. The meta-analysis was performed to compare the bond strength values of conventional (C) GIC and resin-modified (RM) GIC to different substrates. From 831 potentially eligible articles, 30 were selected for the full-text examination, and 7 were included in the analysis. Studies were rated at high (3), medium (3), and low (1) risk of bias. RM-GIC showed higher bond strength to primary enamel and dentin compared to the C-GIC. Meta-analysis of in vitro studies, evaluating bonding properties of GI restoratives to primary teeth, suggests the superior performance of RM-GIC. However, there is a lack of studies that examine the properties of novel GI formulations.
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Möhn M, Bulski JC, Krämer N, Rahman A, Schulz-Weidner N. Management of Amelogenesis Imperfecta in Childhood: Two Case Reports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137204. [PMID: 34281141 PMCID: PMC8297319 DOI: 10.3390/ijerph18137204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/29/2021] [Accepted: 06/29/2021] [Indexed: 11/16/2022]
Abstract
Amelogenesis imperfecta (AI) is defined as an interruption of enamel formation due to genetic inheritance. To prevent malfunction of the masticatory system and an unaesthetic appearance, various treatment options are described. While restoration with a compomer in the anterior region and stainless steel crowns in the posterior region is recommended for deciduous dentition, the challenges when treating such structural defects in mixed or permanent dentition are changing teeth and growing jaw, allowing only temporary restoration. The purpose of this case report is to demonstrate oral rehabilitation from mixed to permanent dentition. The dentition of a 7-year-old patient with AI type I and a 12-year-old patient with AI type II was restored under general anesthesia to improve their poor aesthetics and increase vertical dimension, which are related to problems with self-confidence and reduced oral health quality of life. These two cases show the complexity of dental care for structural anomalies of genetic origin and the challenges in rehabilitating the different phases of dentition.
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Affiliation(s)
- Mirja Möhn
- Dental Clinic, Department of Pediatric Dentistry, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany; (J.C.B.); (N.K.); (N.S.-W.)
- Correspondence: ; Tel.: +49-641-9946241
| | - Julia Camilla Bulski
- Dental Clinic, Department of Pediatric Dentistry, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany; (J.C.B.); (N.K.); (N.S.-W.)
| | - Norbert Krämer
- Dental Clinic, Department of Pediatric Dentistry, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany; (J.C.B.); (N.K.); (N.S.-W.)
| | - Alexander Rahman
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany;
| | - Nelly Schulz-Weidner
- Dental Clinic, Department of Pediatric Dentistry, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany; (J.C.B.); (N.K.); (N.S.-W.)
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Frankenberger R, Winter J, Schmalz G. [Amalgam and alternatives-discussions on mercury reduction in the environment]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:847-855. [PMID: 34143251 PMCID: PMC8212278 DOI: 10.1007/s00103-021-03355-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/17/2021] [Indexed: 11/06/2022]
Abstract
Dental amalgam has been successfully used for the restoration of carious lesions for more than 180 years. It is clinically characterized by high longevity and low technique sensitivity. For decades, dental amalgam has been discussed in the public, especially due to its roughly 50% mercury content. Since the Minamata Convention was published in 2013 with the primary goal of reducing the anthropogenic mercury release into the environment, the previously muted amalgam discussion has received fresh impetus. Another considerable disadvantage of amalgam is its silver/greyish color, which simply no longer matches patients' esthetic demands.The present paper describes the basic problems with amalgam against the background of multiple biological, clinical, and health policy factors. Possible consequences of the Minamata Convention concerning legal regulations as well as the use of dental biomaterials and therefore also relating to the future national healthcare system are discussed. Finally, possible amalgam alternatives and the urgent need for biomedical research towards restorative dentistry are presented, embedded into the crucial question of whether we are actually conducting the correct debate.
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Affiliation(s)
- Roland Frankenberger
- Abteilung für Zahnerhaltungskunde, Med. Zentrum für Zahn‑, Mund- und Kieferheilkunde, Philipps-Universität Marburg und Universitätsklinikum Gießen und Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Deutschland.
| | - Julia Winter
- Abteilung für Zahnerhaltungskunde, Med. Zentrum für Zahn‑, Mund- und Kieferheilkunde, Philipps-Universität Marburg und Universitätsklinikum Gießen und Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Deutschland
| | - Gottfried Schmalz
- Poliklinik für Zahnerhaltung und Parodontologie, Universitätsklinikum Regensburg, Regensburg, Deutschland
- Klinik für Parodontologie, ZMK-Kliniken, Universität Bern, Bern, Schweiz
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Wilde S, Sarti CS, Toniolo J, Oliveira BP, Gouvea DB, Santos NMD, Borges MLV, Rodrigues JA. Influence of Isolation Technique on the Survival of Resin-Modified Glass-Ionomer Restorations in Primary Molars: A 9-Months Randomized Controlled Trial. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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16
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Kielbassa AM, Oehme EP, Shakavets N, Wolgin M. In vitro wear of (resin-coated) high-viscosity glass ionomer cements and glass hybrid restorative systems. J Dent 2020; 105:103554. [PMID: 33309807 DOI: 10.1016/j.jdent.2020.103554] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/08/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The aim of the present study was to investigate the volumetric abrasive wear of a high-viscosity glass ionomer cement (hvGIC; Equia Fil) and a glass hybrid restorative system (ghRS; Equia Forte), each being recommended as amalgam alternatives. Both materials were applied with or without their respective resinous coating, and were compared with a conventional GIC (Ketac Fil) and a hybrid composite resin (CR; G-ænial Posterior). METHODS 78 standardized occlusal Class I cavities were restored with the various materials (n = 13 per group). Before and after chewing simulation (30,000 cycles at 40 N), each sample underwent optical scanning procedures (Omnicam). A comparison of the total wear using a fluorescence-aided identification technique (OraCheck) followed, and differences (α = 5%) between groups were compared by means of MANOVA. RESULTS Regarding the wear rates of hvGIC and ghRS, no differences could be observed (p > .050), and this was not affected by the resinous coating. All hvGIC and ghRS restorations showed significantly higher abrasive wear than CR (p < .001), while the conventional GIC displayed a significant underperformance compared with any other material (p < .001). CONCLUSIONS Resinous coating of hvGIC or ghRS does not appear to exert an effective long-term protection against advanced abrasive wear. Compared to the conventional GIC showing a considerable substance loss, both hvGIC and ghRS materials revealed an improved abrasion resistance, but clearly failed to meet the excellent values of the CR. CLINICAL SIGNIFICANCE Occlusal loading should be carefully considered when using hvGIC or ghRS as amalgam (or composite resin) alternatives for the restoration of posterior teeth.
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Affiliation(s)
- Andrej M Kielbassa
- Department of Operative Dentistry, Periodontology, and Endodontology, University School of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstraße 124, 3500, Krems, Austria.
| | - Eric Paul Oehme
- Department of Operative Dentistry, Periodontology, and Endodontology, University School of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstraße 124, 3500, Krems, Austria
| | - Natalia Shakavets
- Department of Pediatric Dentistry, Faculty of Dentistry, Belarusian State Medical University (BSMU), Dzerzhinsky Avenue 83, 220116, Minsk, Belarus
| | - Michael Wolgin
- Department of Operative Dentistry, Periodontology, and Endodontology, University School of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstraße 124, 3500, Krems, Austria
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Restorative thresholds for carious lesions in primary molars: French dentist's decisions. Eur Arch Paediatr Dent 2020; 22:441-448. [PMID: 33185858 DOI: 10.1007/s40368-020-00577-z] [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: 06/25/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Questionnaire surveys have been undertaken worldwide to investigate practices and knowledge related to carious lesion management, particularly in adults. The primary objective of this cross-sectional survey was to investigate restorative thresholds (RTs) used for carious lesions in primary molars by dentists practising paediatric dentistry in France. Dentists were surveyed by a specifically developed questionnaire based on clinical and radiographic caries classifications. The secondary objective was to explore restorative management strategies in primary molars. METHODS A structured questionnaire assessing RTs and management strategies for occlusal and approximal carious lesions of primary molars was anonymously and electronically administered via SurveyMonkey® to dentists who were members of the Société Française d'Odontologie Pédiatrique. Descriptive analyses, Chi-square test, McNemar test, and logistic regression analyses considering dependent RT variables for occlusal and approximal carious lesions were performed. RESULTS Among 250 dentists surveyed, 201 responded (response rate 80.4%). Overall, 43% (n = 87) and 75% (n = 151) of respondents would place their RTs in enamel for occlusal and approximal lesions, respectively. Dentists with an exclusive practice of paediatric dentistry more frequently would choose a RT in dentine for approximal lesions than did other dentists (p = 0.010). A preparation technique including sound dental tissues was less frequent for occlusal than approximal lesions (n = 31; 15% vs n = 60; 30%). Overall, 75% (n = 151) of respondents used the same restorative material for occlusal and approximal lesions. CONCLUSION In general, dentists practising paediatric dentistry in France overtreated lesions on primary molars, which contradicts minimal intervention recommendations. RTs are too often indicated for enamel-confined carious lesions.
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Santamaría RM, Abudrya MH, Gül G, Mourad MS, Gomez GF, Zandona AGF. How to Intervene in the Caries Process: Dentin Caries in Primary Teeth. Caries Res 2020; 54:306-323. [PMID: 32854105 DOI: 10.1159/000508899] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 05/03/2020] [Indexed: 11/19/2022] Open
Abstract
For an ORCA/EFCD consensus, this review systematically assessed available evidence regarding interventions performed and materials used to manage dentin carious lesions in primary teeth. A search for systematic reviews (SRs) and randomized clinical trials (RCTs) with a follow-up of at least 12 months after intervention was performed in PubMed, LILACS, BBO, and the Cochrane Library. The risk of bias tool from the Cochrane Collaboration and the PRISMA Statement were used for assessment of the included studies. From 101 screened articles, 2 SRs and 5 RCTs, which assessed the effectiveness of interventions in terms of pulp vitality and success of restoration, and 10 SRs and 1 RCT assessing the success of restorative materials were included. For treatments involving no carious tissue removal, the Hall technique showed lower treatment failure for approximal carious lesions compared to complete caries removal (CCR) and filling. For the treatment of deep carious lesions, techniques involving selective caries removal (SCR) showed a reduction in the incidence of pulp exposure. However, the benefit of SCR over CCR in terms of pulp symptoms or restoration success/failure was not confirmed. Regarding restorative materials, preformed metal crowns (PMCs) used to restore multisurface lesions showed the highest success rates compared to other restorative materials (amalgam, composite resin, glass ionomer cement, and compomer), and in the long term (12-48 months) these were also less likely to fail. There is limited evidence supporting the use of PMCs to restore carious lesions with single cavities. Among nonrestorative options, silver diammine fluoride was significantly more effective in arresting caries than other treatments for treating active carious lesions of different depths. Considerable heterogeneity and bias risk were observed in the included studies. Although heterogeneity observed among the studies was substantial, the trends were similar. In conclusion, less invasive caries approaches involving selective or no caries removal seem advantageous in comparison to CCR for patients presenting with vital, symptomless, carious dentin lesions in primary teeth. There is evidence in favor of PMCs for restoring multisurface carious lesions in primary molars.
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Affiliation(s)
- Ruth M Santamaría
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany,
| | - Mohamed Hassan Abudrya
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Gülsün Gül
- Department of Comprehensive Care, Tufts University, Boston, Massachusetts, USA
| | - Mhd Said Mourad
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Grace Felix Gomez
- Department of Community Dentistry, Case Western Reserve University, Cleveland, Ohio, USA
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Corrêa-Faria P, Viana KA, Raggio DP, Hosey MT, Costa LR. Recommended procedures for the management of early childhood caries lesions - a scoping review by the Children Experiencing Dental Anxiety: Collaboration on Research and Education (CEDACORE). BMC Oral Health 2020; 20:75. [PMID: 32183770 PMCID: PMC7079355 DOI: 10.1186/s12903-020-01067-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/06/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Early childhood caries (ECC) affects millions of children up to 6 years old. Its treatment positively impacts the quality of life of children and their families. However, there is no consensus on how to treat ECC. Thus, we performed a scoping review to identify the recommended procedures for the management of ECC lesions. METHODS A search was performed in PubMed, Scopus, The Cochrane Library, The International Guideline Library and pediatric dentistry associations around the world were contacted by email for unpublished search documents. ECC guidelines/guidance/policies were considered eligible regardless of language and publication date. RESULTS From a total of 828 references, 52 full-text articles were assessed for eligibility and 22 included in the scoping review. We found different procedures recommendations for the management of ECC lesions. For incipient lesions, minimally invasive methods such as professional fluoride and cariostatic (silver diamine) applications, as well as surveillance were recommended. If restoration was required, the recommended materials were glass ionomer cement, composite resin, amalgam and stainless-steel crown. Interim restorations and Atraumatic Restorative Treatment (ART) were also recommended. Extractions have been suggested for teeth with lesions with pulpal involvement, depending on the child's behaviour and other clinical conditions. CONCLUSIONS Non-operative procedures, restorative and extraction were recommended for the management of ECC, depending on the extent of the lesions. There is no difference between different management guidelines/guidance/policies for ECC lesions.
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Affiliation(s)
- Patrícia Corrêa-Faria
- Dentistry Graduate Program, School of Dentistry, Universidade Federal de Goiás, Praça Universitária, Goiânia, Goiás, 74605220, Brazil.
| | - Karolline Alves Viana
- Dentistry Graduate Program, School of Dentistry, Universidade Federal de Goiás, Praça Universitária, Goiânia, Goiás, 74605220, Brazil
| | - Daniela Prócida Raggio
- Graduate Program in Dental Sciences, School of Dentistry, Universidade de São Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Marie Therese Hosey
- Head of Paediatric Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Luciane Rezende Costa
- Dentistry Graduate Program, School of Dentistry, Universidade Federal de Goiás, Praça Universitária, Goiânia, Goiás, 74605220, Brazil
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Maran BM, Ziegelmann PK, Burey A, de Paris Matos T, Loguercio AD, Reis A. Different light-activation systems associated with dental bleaching: a systematic review and a network meta-analysis. Clin Oral Investig 2019; 23:1499-1512. [PMID: 30767069 DOI: 10.1007/s00784-019-02835-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/25/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES A systematic review and a network meta-analysis were performed to answer the following research question: "Is there any light-activation protocol capable of improving color change efficacy when associated with an in-office bleaching gel in adults?" MATERIAL AND METHODS A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE without date and/or language restrictions in April 23, 2017 (updated on March 30, 2018). IADR abstracts (1990-2018), unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials conducted in adults that included at least one group treated with in-office dental bleaching with light activation were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. A random-effects Bayesian-mixed treatment comparison (MTC) model was used to combine light-activated versus light-free in-office bleaching with direct light-free comparison trials. A meta-analysis with independent analysis (high- and low-concentrate hydrogen peroxide [HP]) was conducted for color change (∆E*, ∆SGU). RESULTS After the removal of duplicates, title, and abstract screening, 28 studies remained. Nine were considered to be at a low RoB, five were at a high RoB, and the remaining were at an unclear RoB. The MTC analysis showed no significant difference in color change (ΔE* and ΔSGU) between light-activation protocols and light-free in-office bleaching, regardless of the HP concentration in the efficacy of the bleaching. CONCLUSION No type of light-activated in-office bleaching was superior to light-free in-office bleaching for both high- and low-concentrate in-office bleaching gels (PROSPERO-CRD42017078743). CLINICAL RELEVANCE Although many times dental professionals use "laser whitening" as a form of marketing, this study confirmed that no type of light-activation for in-office bleaching can improve the bleaching efficacy.
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Affiliation(s)
- Bianca Medeiros Maran
- Department of Restorative Dentistry, School of Dentistry, State University of Western Paraná, Rua Engenharia, 464 - Universitário, Cascavel, Paraná, 85819-190, Brazil
| | - Patrícia K Ziegelmann
- Statistics Department and Post-Graduation Program in Epidemiology, Federal University of Rio Grande do Sul, Rua Paulo Gama, 110 - Farroupilha, Porto Alegre, Rio Grande do Sul, 90040-060, Brazil
| | - Adrieli Burey
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, BlocoM, Sala 64-A, Uvaranas, Ponta Grossa, Paraná, 84030-900, Brazil
| | - Thalita de Paris Matos
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, BlocoM, Sala 64-A, Uvaranas, Ponta Grossa, Paraná, 84030-900, Brazil
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M, Sala 64-A, Uvaranas, Ponta Grossa, Paraná, 84030-900, Brazil
| | - Alessandra Reis
- Department of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M, Sala 64-A, Uvaranas, Ponta Grossa, Paraná, 84030-900, Brazil.
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