Clinical effectiveness of restorative materials for the restoration of carious primary teeth without pulp therapy: a systematic review

Prefabricated Zirconia Crowns and Preformed Metal Crowns in the Treatment of Severely Childhood Caries and Anterior Crossbite in a Child with Autistic Spectrum Disorder

Crowns have been recommended to treat decayed teeth and rebuild teeth function. The dental management of children with autism is a tremendous challenge for pediatric dentists due to the impaired behaviors and communication disorders. In this context, a 5-year-old boy with autism was treated to solve carious lesions under the assistance of general anesthesia. The posterior occlusal function was restored, and the crossbite existing in the primary anterior teeth was approached merely by NuSmile® zirconia crowns (ZCs) rather than orthodontic intervention. We conducted an 18-month period. Throughout the long-term follow-up, the boy's masticatory efficiency was remarkably improved and the anterior teeth had transferred into the correct position with adequate overbite to maintain the new relationship, thus ameliorating the appearance of tissue on the labial surface and enhancing his quality of life and oral health.

Evaluation of the shear bond strength of a tricalcium silicate-based material to four self-adhering glass ionomer materials: an in vitro study

Background

This study aimed to evaluate and compare the shear bond strength (SBS) of EQUIA Forte HT with that of other restorative materials, including EQUIA Forte, glass ionomer cement (GIC), and resin-modified glass ionomer cement (RMGIC) when bonded to NeoMTA 2.

Materials and methods

A total of 120 holes were created in Teflon molds and filled with NeoMTA 2. The restorative materials were immediately applied using customized silicone molds. The samples were randomly divided into two main groups: one to measure the immediate SBS and the other to measure the delayed SBS. These two main groups were further divided into four subgroups based on the restorative material used: EQUIA Forte HT, EQUIA Forte, GIC, and RMGIC.

Results

The study groups showed statistically significant differences in the mean SBS (p < 0.0001). The immediate SBS of the RMGIC group (mean ± SD: 5.43 ± 1.22) was significantly higher than those of the GIC and EQUIA Forte groups, with no significant difference found compared to the SBS of EQUIA Forte HT. In the delayed SBS, both the RMGIC and EQUIA Forte HT groups (4.98 ± 0.67 and 4.93 ± 0.60, respectively) demonstrated significantly higher bond strengths than the GIC and EQUIA Forte groups (3.81 ± 0.57 and 4.2 ± 0.63, respectively). However, there were no statistically significant differences between the RMGIC and EQUIA Forte HT groups or between the GIC and EQUIA Forte groups.

Conclusion

Based on our findings, EQUIA Forte HT has shown promising outcomes when used as a restorative material following pulpotomies, with results comparable to those of RMGIC.

Silver diamine fluoride modified atraumatic restorative treatment compared to conventional restorative technique on carious primary molars-A randomized controlled trial

OBJECTIVE

To compare the success of silver diamine fluoride-modified atraumatic restorative technique (SMART) with that of the conventional drill and fill method in restoring carious lesions in primary molars.

METHOD

Children (4-8years old) reporting to a tertiary care hospital setting with asymptomatic cavitated dentinal carious lesions in primary molars were randomly allocated to two groups; SMART and Conventional; and subsequently restored with Glass Ionomer Cement (GIC). Follow-up evaluations were carried out by blinded independent evaluator at 6-months intervals to assess the status of restorations. Primary outcome was the success of restorations at 24 months and the secondary outcome was the child's behaviour and acceptance of the treatment at the time of interventions. Two sample Z-test of proportion, logistic regression analysis and Chi-square test were used to compare the outcomes in two groups.

RESULTS

A total of 226 children (SMART group, 112 and conventional, 114) were included with 280 and 282 GIC restorations placed by the SMART and the conventional method respectively. At 24-months, 459 (81.6 %) primary molars were available for evaluation. Success rates of restorations was 38.4 % and 45.8 % % in SMART and conventional groups respectively (p = 0.105). The rate of acceptability of treatment in the SMART and conventional group was 79 % and 56 % (p<0.001) respectively.

CONCLUSION

There was no significant difference in the success rates of GIC restorations by SMART and conventional technique in carious primary molars at 24 months. SMART was better accepted by children as compared to the conventional restorative technique.

CLINICAL SIGNIFICANCE

SMART can be an alternative option to treat the asymptomatic carious lesions in primary molars and is well accepted by children than the conventional drill and fill technique thus implying that it has a useful role in un-cooperative children.

Compomers for the restorative treatment of dental caries in primary teeth: An umbrella review

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.

Clinical effectiveness of restorative materials for the restoration of carious lesions in pulp treated primary teeth: a systematic review

Purpose

To systematically review the clinical performance of restorative materials after pulp therapy of carious primary teeth. It is part 2 of a systematic review on the clinical effectiveness of restorative materials for the management of carious primary teeth supporting the European Academy of Paediatric Dentistry (EAPD) guideline development.

Methods

Four electronic databases were systematically searched up to December 28th, 2020. Randomised controlled clinical trials (RCTs) on restorative materials for the restoration of carious primary teeth after pulp therapy were included. Failure rate, annual failure rate (AFR) and reasons for failure were recorded. Studies were sorted by restorative materials. The Cochrane Risk of bias tool for randomised trials (RoB 2.0) was used for quality assessment.

Results

After identification of 1685 articles and screening of 41 papers from EAPD review group 1, 5 RCTs were included. Restored primary molars with pulpotomy presented the following AFRs: composite resin (CR) 0%, preformed metal crowns (PMCs) 2.4–2.5%, resin-modified glass-ionomer cement combined with CR 3.8%, compomer 8.9%, and amalgam 14.3%. Maxillary primary incisors receiving pulpectomy exhibited AFRs of 0–2.3% for composite strip crowns (CSCs) depending on the post chosen. Reasons for failure were secondary caries, poor marginal adaptation, loss of retention and fracture of restoration. All studies were classified as high risk of bias. Meta-analyses were not feasible given the clinical/methodological heterogeneity amongst studies.

Conclusion

Considering any limitations of this review, CR and PMCs can be recommended for primary molars after pulpotomy, and CSCs for primary incisors receiving pulpectomy. However, a need for further well-designed RCTs was observed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40368-022-00744-4.