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Fernandes JB, Contreras SM, da Silva Spinola M, Batista GR, Bresciani E, Caneppele TMF. Do bioactive materials show greater retention rates in restoring permanent teeth than non-bioactive materials? A systematic review and network meta-analysis of randomized controlled trials. Clin Oral Investig 2023; 28:44. [PMID: 38153565 DOI: 10.1007/s00784-023-05414-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES To answer the following research question: does the clinical evaluation of restorations on permanent teeth with bioactive materials show greater retention rates than those with non-bioactive materials? MATERIALS AND METHODS A search strategy was used in the following databases: MEDLINE via PubMed, Scopus, Web of Science, LILACS, BBO, Embase, The Cochrane Library, and OpenGrey. Randomized controlled trials (RCTs), with a minimum of 2-year follow-up and evaluating at least one bioactive material in permanent teeth were included. Risk of bias was detected according to the Cochrane Collaboration tool for assessing the risk of bias (RoB 2.0), and network meta-analysis was performed using a random-effects Bayesian-mixed treatment comparison model. RESULTS Twenty-seven studies were included. The success of the restorations was assessed using modified USPHS system in 24 studies and the FDI criteria in 3 studies. Network meta-analysis revealed three networks based on restoration preparations. Resin composites were ranked with higher SUCRA values, indicating a greater likelihood of being the preferred treatment for class I, II, and III restorations. In class V, resin-modified glass ionomer cement was ranked with the highest value. CONCLUSION Bioactive restorative materials showed similar good clinical performance in terms of retention similarly to conventional resin composites. CLINICAL SIGNIFICANCE The findings must be interpreted with caution because many RCT on restorative materials aim to verify the equivalence of new materials over the gold standard material rather than their superiority. The present systematic review also suggests that new RCT with longer follow-up periods are necessary.
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Affiliation(s)
- Juliana Benace Fernandes
- Department of Restorative Dentistry, São Paulo State University - UNESP, Avenida Engenheiro Francisco José Longo, 777, São José Dos Campos, Brazil
| | - Sheila Mondragón Contreras
- Department of Restorative Dentistry, São Paulo State University - UNESP, Avenida Engenheiro Francisco José Longo, 777, São José Dos Campos, Brazil
| | | | - Graziela Ribeiro Batista
- A.T. Still University, Missouri School of Dentistry, 500 W Jefferson St, Kirksville, Missouri, USA
| | - Eduardo Bresciani
- Department of Restorative Dentistry, São Paulo State University - UNESP, Avenida Engenheiro Francisco José Longo, 777, São José Dos Campos, Brazil
| | - Taciana Marco Ferraz Caneppele
- Department of Restorative Dentistry, São Paulo State University - UNESP, Avenida Engenheiro Francisco José Longo, 777, São José Dos Campos, Brazil.
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Pinto NS, Jorge GR, Vasconcelos J, Probst LF, De-Carli AD, Freire A. Clinical efficacy of bioactive restorative materials in controlling secondary caries: a systematic review and network meta-analysis. BMC Oral Health 2023; 23:394. [PMID: 37322456 PMCID: PMC10268411 DOI: 10.1186/s12903-023-03110-y] [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: 03/23/2023] [Accepted: 06/06/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND This systematic review and network meta-analysis aimed to compare the clinical efficacy of bioactive and conventional restorative materials in controlling secondary caries (SC) and to provide a classification of these materials according to their effectiveness. METHODS A search was performed in Pubmed, Web of Science, Embase, BBO, Lilacs, Cochrane Library, Scopus, IBECS and gray literature. Clinical trials were included, with no language or publication date limitations. Paired and network meta-analyses were performed with random-effects models, comparing treatments of interest and classifying them according to effectiveness in the permanent and deciduous dentition and at 1-year or 2/more years of follow-up. The risk of bias and certainty of evidence were evaluated. RESULTS Sixty-two studies were included in the qualitative syntheses and 39 in the quantitative ones. In permanent teeth, resin composite (RC) (RR = 2.00; 95%CI = 1.10, 3.64) and amalgam (AAG) (RR = 1.79; 95%CI = 1.04, 3.09) showed a higher risk of SC than Glass Ionomer Cement (GIC). In the deciduous teeth, however, a higher risk of SC was observed with RC than with AAG (RR = 2.46; 95%CI = 1.42, 4.27) and in GIC when compared to Resin-Modified Glass Ionomer Cement (RMGIC = 1.79; 95%CI = 1.04, 3.09). Most randomized clinical trials studies showed low or moderate risk of bias. CONCLUSION There is a difference between bioactive restorative materials for SC control, with GIC being more effective in the permanent teeth and the RMGIC in the deciduous teeth. Bioactive restorative materials can be adjuvants in the control of SC in patients at high risk for caries.
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Affiliation(s)
- Noeleni Souza Pinto
- School of Dentistry, Universidade Federal de Mato Grosso Do Sul, Av. Costa E Silva, S/N, Universitário, Campo Grande, MS 79070-900 Brazil
| | - Gabriela Rebouças Jorge
- School of Dentistry, Universidade Federal de Mato Grosso Do Sul, Av. Costa E Silva, S/N, Universitário, Campo Grande, MS 79070-900 Brazil
| | | | - Livia Fernandes Probst
- Unidade de Avaliação de Tecnologias Em Saúde, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Alessandro Diogo De-Carli
- School of Dentistry, Universidade Federal de Mato Grosso Do Sul, Av. Costa E Silva, S/N, Universitário, Campo Grande, MS 79070-900 Brazil
| | - Andrea Freire
- School of Dentistry, Universidade Federal de Mato Grosso Do Sul, Av. Costa E Silva, S/N, Universitário, Campo Grande, MS 79070-900 Brazil
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Pimentel ES, França FMG, Turssi CP, Basting RT, Vieira-Junior WF. Effects of in vitro erosion on surface texture, microhardness, and color stability of resin composite with S-PRG fillers. Clin Oral Investig 2023:10.1007/s00784-023-04968-6. [PMID: 36995429 DOI: 10.1007/s00784-023-04968-6] [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: 11/24/2022] [Accepted: 03/19/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES To evaluate the effect of acid erosion on different physical properties of resin composite with S-PRG (surface pre-reacted glass) fillers, by conducting simulations of intrinsic and extrinsic sources. MATERIALS AND METHODS Cylindrical samples (Ø6 vs. 2 mm) of a conventional nanohybrid resin composite (Forma, Ultradent) and of a nanohybrid resin composite with S-PRG filler (Beautifil II, Shofu) were exposed to erosive cycling (5 days), based on (n=12) remineralizing solution (control); 0.3% citric acid (pH=2.6); or 0.01 M hydrochloric acid (pH=2). Roughness (Ra), microhardness (KHN), and color (CIEL*a*b*, CIEDE2000, and Vita scale (SGU)) factors were analyzed at the initial and final time points, and the general color changes (ΔEab, ΔE00, ΔSGU) were calculated. Final images were obtained using scanning electron microscopy (SEM). The data were evaluated by generalized models, Mann-Whitney, Wilcoxon, Kruskal-Wallis, and Dunn tests (α=0.05). RESULTS Regarding KHN, there was no difference between the groups or the time periods (p = 0.74). As for Ra, there was a significant increase in the Ra of both composites after cycling with hydrochloric acid, but only the resin composite with S-PRG filler showed a change in Ra after cycling with citric acid (p = 0.003). After cycling with citric and hydrochloric acid, the highest Ra values were found for the resin composite with S-PRG filler (p < 0.0001), corroborating the result of images (SEM) indicating loss of filler and porosities in this material. The resin composite with S-PRG filler showed higher ΔEab and ΔE00, in addition to more negative ΔSGU values and lower L* values after exposure to both acids, compared to the control (p < 0.05). CONCLUSION The acidic conditions altered the roughness and color stability of the materials tested, pointing out that the resin composite containing S-PRG filler showed greater degradation of its physical properties than the conventional resin composite. CLINICAL RELEVANCE Bioactive materials are relevant, considering that their properties interact with dental hard tissues; however, the S-PRG-based resin composite showed greater degradation under acidic conditions than the conventional resin composite.
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Affiliation(s)
- Eliene Soares Pimentel
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira, 13, Campinas, SP, CEP, 13045-755, Brazil
| | - Fabiana Mantovani Gomes França
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira, 13, Campinas, SP, CEP, 13045-755, Brazil
| | - Cecilia Pedroso Turssi
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira, 13, Campinas, SP, CEP, 13045-755, Brazil
| | - Roberta Tarkany Basting
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira, 13, Campinas, SP, CEP, 13045-755, Brazil
| | - Waldemir Francisco Vieira-Junior
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira, 13, Campinas, SP, CEP, 13045-755, Brazil.
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de Souza Penha KJ, de Oliveira Roma FR, Aroucha Coelho LM, Maia-Filho EM, Firoozmand LM. One-year follow-up of microscopical and clinical behavior of bioactive self-etching resin sealant. J Conserv Dent 2023; 26:188-193. [PMID: 37205883 PMCID: PMC10190092 DOI: 10.4103/jcd.jcd_582_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/04/2023] [Accepted: 02/01/2023] [Indexed: 05/21/2023] Open
Abstract
Background The development of early carious lesions can be prevented with the use of sealants. This study aimed to evaluate the retention and sealant quality of conventional and bioactive self-etching sealants by direct (clinical) and indirect (microscopical) assessment. Materials and Methods Sixty newly erupted mandibular second molars (International Caries Detection and Assessment System ≤2) from adolescents were selected for the split-mouth trial study. The tooth was randomized and treated with conventional Fluoroshield (FS) and BeautiSealant (BS) bioactive self-etching sealants. Molds were taken and cast with epoxy resin after treatment. Indirect and direct assessments of retention degree and sealant remnant quality were performed after baseline, 1 month, and 1 year. The Chi-square test, ordinal regression, reasons of chance, and Fleiss' kappa statistical test were employed. Results After 1 month, greater total retention was observed for FS, but 1-year follow-up demonstrated no retention difference for FS and BS. The odds ratios showed an 86% greater chance of FS showing better marginal adaptation, after 1 month. At 1 year, the clinical assessment showed better anatomical shape and marginal adaptation scores for FS, but no microscopical difference was observed. A pour agreement between clinical and microscopical data was observed. Conclusions The 1-year follow-up showed no significant difference in the degree of retention, and in the microscopic evaluation of the conventional sealant (FS) and the bioactive self-etching sealant (BS), but in the clinical evaluation, better marginal and anatomical adaptation scores for FS were observed.
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Affiliation(s)
| | | | | | | | - Leily Macedo Firoozmand
- Departments of Dental Post-Graduation Program, Federal University of Maranhão, São Luis, MA, Brazil
- Department of Dentistry I, Federal University of Maranhão, São Luis, MA, Brazil
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Ng TCH, Chu CH, Yu OY. A concise review of dental sealants in caries management. FRONTIERS IN ORAL HEALTH 2023; 4:1180405. [PMID: 37138858 PMCID: PMC10149715 DOI: 10.3389/froh.2023.1180405] [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: 03/06/2023] [Accepted: 03/29/2023] [Indexed: 05/05/2023] Open
Abstract
This concise review provides an update of the use of dental sealants. Dental sealants protect a tooth from caries development by providing a physical barrier to microorganism colonisation and creating a favorable environment for patients to clean. Some sealants release fluoride ions to promote remineralization. Dental sealants can be applied on pits and fissures of primary and permanent teeth to prevent and arrest early enamel caries. They are effective in caries prevention. The preventive fraction of resin sealant is up to 61% after 5 years. Dental sealants can be classified as resin, glass ionomer and hybrid (compomer or giomer) according to the material. Recent studies from 2012 to 2022 showed resin sealant has a high retention rate of up to 80% after 2 years, whereas glass ionomer sealants is 44%. Chemical etching with 37% phosphoric acid is the standard of care, whereas laser or air-abrasion cannot does not increase the sealant retention rate. Moist control is critical and studies found the use of rubber dam and cotton rolls had similar success for sealant retention. The longevity of dental sealant is also associated with clinical operative factors, including approaches of moisture control, enamel pretreatment, selection of dental adhesive, and time of acid etching.
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Abdelwahed AG, Essam S, Abdelaziz MM. Marginal Adaptation and Depth of Cure of Flowable versus Packable Bulk-fill Restorative Materials: An In Vitro StudyMarginal Adaptation and Depth of Cure of Flowable versus Packable Bulk-fill Restorative Materials: An In Vitro Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: To investigate the marginal adaptation and depth of cure of a flowable bulk-fill giomer (BEAUTIFIL Flow Plus X [BFP]), a flowable bulk-fill resin composite (PALFIQUE BULK FLOW [PBF]) bulk-fill resin composite, a packable bulk-fill giomer (BEAUTIFL-Bulk Restorative [BBR]), and two packable bulk-fill resin composites (X-tra fil [XF]) and (Filtek™ One Bulk Fill Restorative [FOB]).
Materials and Methods: Twenty-five standardized class II cavities were prepared in the occlusomesial surfaces of maxillary premolars. A self-etching dental adhesive was used. All restorative materials were applied, and light cured according to their manufacturer's instructions. The teeth were subjected to 2500 thermal cycles between 5° C and 55° C. Epoxy resin replicas were obtained to examine the marginal by calculating the percentage of the continuous margin over the total margin length. using SEM at 200× magnification. For assessing the depth of cure, fifty specimens with 4 mm height were prepared. Vickers microhardness testing was used to assess the depth of cure was calculating the bottom-to-top ratio of each specimen. If this ratio reaches 0.80 or more, an adequate depth of cure is achieved.
Results: Regarding marginal adaptation, there was no significant difference between different groups before (p=0.398) and after (p=0.644) thermocycling. Within all groups, there was a significant decrease in marginal adaptation after thermocycling (p<0.001). Regarding the depth of cure, all restorative materials achieved the required 0.8 bottom-to-top ratio. There was a significant difference between different groups (p<0.001). The highest value was found in BFP group (0.97±0.02), while the lowest value was found in BBR group (0.81±0.11).
Conclusions: The marginal adaptation and depth of cure of bulk-fill giomer restorative materials are acceptable. Therefore, their use in restoration of 4-mm deep class II cavities is appealing.
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Water Sorption and Solubility of Flowable Giomers. MATERIALS 2021; 14:ma14092399. [PMID: 34063032 PMCID: PMC8124910 DOI: 10.3390/ma14092399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/30/2021] [Accepted: 05/01/2021] [Indexed: 11/17/2022]
Abstract
The objective of this study is the characterization of a novel experimental flowable giomer (G) regarding water sorption, water solubility, and the microstructural characteristics, in comparison to three commercial giomers: Beautifil flow Plus X F00 (B-F00), Beautifil flow F02 (B-F02) and Beautifil flow Plus X F03 (B-F03), Shofu, Kyoto, Japan. Methods: Water sorption/solubility was performed by weighing the specimens before and after water immersion for 1, 2, 3, 14, 21 and 30 days. Data analysis was carried out with the software Origin2019b Graphing & Analysis using the ANOVA test and the Tukey test for post hoc comparison of the groups of materials. The microstructural analyses were done with a scanning electron microscope (SEM) and an atomic force microscope (AFM). The results showed significant differences between the tested materials (p < 0.05). For sorption, the Tukey test indicated differences between all four sample groups, except between B-F02 and B-F03, which exhibited no differences in any of the investigation days. The Tukey test also showed significant differences regarding solubility between all sample groups in the 30-day interval. SEM images and roughness showed that after 30 days of immersion in water, the experimental giomer G had the roughest surface.
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Kelić K, Par M, Peroš K, Šutej I, Tarle Z. Fluoride-Releasing Restorative Materials: The Effect of a Resinous Coat on Ion Release. Acta Stomatol Croat 2021; 54:371-381. [PMID: 33642601 PMCID: PMC7871432 DOI: 10.15644/asc54/4/4] [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] [Indexed: 01/19/2023] Open
Abstract
Objective To determine the effect of two adhesive systems and a glass ionomer coating resin on fluoride release and concurrent pH changes over a period of 168 days. Material and methods Four restorative materials were investigated: a giomer Beautiful II, an “alkasite” material Cention, a conventional composite Filtek Z250, and a glass ionomer cement Fuji IX Extra. Light-cured composite specimens were coated using G-aenial Bond and Clearfil Universal Bond Quick. Glass ionomer specimens were coated using GC Fuji Coat LC. Uncoated specimens were used as references. Quantitative fluoride release and pH changes were measured after1 h, 24 h, 2 days, 7 days, 28 days, 84 days, and 168 days. Results The cumulative fluoride release after 168 days increased for uncoated specimens in the following order: Filtek Z250 < Beautifil II < Cention < Fuji IX Extra. A comparatively lower fluoride release was measured for the composites coated with Clearfil Universal Bond Quick, with cumulative values after 168 days increasing in the following order: Filtek Z250 < Beautifil II < Cention. The composites coated with G-aenial Bond showed lower fluoride release compared to the uncoated specimens, with cumulative values increasing in the following order: Filtek Z250 < Beautifil II < Cention. The composites coated with G-aenial Bond showed pH values in the acidic range (4.4-5.7) after 1 h and 24 h. Conclusion Fluoride release varied among the investigated restorative materials and depended on the use of dental adhesives and coatings. The pH of all materials, coating types and time points varied.
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Affiliation(s)
- Katarina Kelić
- Stomatološka poliklinika Zagreb, Perkovčeva ulica 3, Zagreb, Croatia
| | - Matej Par
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Kristina Peroš
- Department of Pharmacology, School of Dental Medicine, University of Zagreb, Šalata 11, Zagreb, Croatia
| | - Ivana Šutej
- Department of Pharmacology, School of Dental Medicine, University of Zagreb, Šalata 11, Zagreb, Croatia
| | - Zrinka Tarle
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
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Rusnac ME, Gasparik C, Delean AG, Aghiorghiesei AI, Dudea D. Optical properties and masking capacity of flowable giomers. Med Pharm Rep 2021; 94:99-105. [PMID: 33629056 PMCID: PMC7880075 DOI: 10.15386/mpr-1924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/24/2020] [Accepted: 11/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background and aims To assess the color, translucency and masking properties of novel flowable giomers. Methods Three flowable giomers were used for the fabrication of 1-mm thick samples (n=126) in three different consistencies (Beautifil flow Plus X F00; Beautifil flow F02; Beautifil flow Plus X F03, Shofu Dental Corporation, Japan) and two shades (VITA Classical shade A2 and A3). The relative spectral reflectance was recorded over white, black, C3 (VITA Classical shade C3 simulating a severe tooth discoloration), and a tested-sample colored background. Lightness (L*), and color coordinates a* and b*, Relative Translucency parameter (RTP00) and masking capacity of C3 background were calculated; differences in color and translucency were compared with thresholds for perceptibility and acceptability (PT and AT). Statistical analyses used significance tests for paired samples. Results All tested materials displayed increased values of L*: for A2 F00=86.16(±0.86), F02=86.39(±0.63), F03=86.40(±0.63); for A3: F00=84.24(±0.58), F02=83.34(±0.3), F03=84.19(±0.4), as well as of RTP: for A2 F00=30.34(±0.88), F02=31.37(±0.94), F03=31.11(±1.15), for A3 F00=29.64(±1.64), F02=30.79(±1.02), F03=30.1(±1.26). For A2 samples, the masking capacity was significantly different for all materials, whilst for A3 there were differences only between F00-F03 and F02-F03. Conclusions The tested flowable giomers proved high values of lightness and translucency. The color differences between the materials with the same designation and different consistencies were below the perceptibility threshold in most cases. In addition, the differences in relative translucency parameter ranged between the perceptibility and acceptability thresholds. However, all tested flowable giomers had an unacceptable masking capacity for a dyschromic background.
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Affiliation(s)
- Mara Elena Rusnac
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristina Gasparik
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ada Gabriela Delean
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandra Iulia Aghiorghiesei
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Dudea
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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