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Koç-Vural U, Kerimova-Köse L, Kiremitci A. Long-term clinical comparison of a resin-based composite and resin modified glass ionomer in the treatment of cervical caries lesions. Odontology 2024:10.1007/s10266-024-00958-6. [PMID: 38837034 DOI: 10.1007/s10266-024-00958-6] [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: 12/11/2023] [Accepted: 05/28/2024] [Indexed: 06/06/2024]
Abstract
This 72-month study compared the clinical effectiveness of a resin-based composite (RBC) (Spectrum TPH3, Dentsply Sirona) with a resin-modified glass ionomer cement (RMGIC) (Riva Light Cure, SDI) in restoring cervical caries lesions (CCLs). Thirty-three patients, each with at least two CCLs, were enrolled. After caries removal, the dimensions of the cavities were recorded. In a split-mouth study design, a total of 110 restorations were randomly placed. Fifty-five restorations were placed with RBC using an etch-and-rinse adhesive system (Prime&Bond NT, Dentsply Sirona), while the remaining 55 were restored with RMGIC. The restorations were assessed at baseline, 6, 12, 18, 24, 36, 60, and 72 months according to modified USPHS criteria. Statistical analysis included Pearson Chi-square, Friedman tests, Kaplan Meier, and Logistic Regression analysis (p < 0.05). After 72 months, 47 restorations in 19 patients were evaluated (55% follow-up rate). Seventy-five percent of the RBC (n = 26) and 74% (n = 21) of the RMGIC restorations were fully retained. There were no significant differences between materials regarding retention and marginal adaptation (p > 0.05). Cavity dimensions, caries activity, and retention exhibited no correlation (p > 0.05). The increase in marginal staining in both groups over time was significant (p < 0.001). RMGIC restorations exhibited higher discoloration than RBC restorations (p = 0.014). At 72 months, three secondary caries lesions were detected in both restoration groups: two RMGIC and one RBC. There were no reports of sensitivity. After 72 months, both RBC and RMGIC restorations were clinically successful, with similar retention and marginal adaptation scores. However, it is noteworthy that RMGIC restorations tend to discoloration over time compared to RBC. The trial is registered in the database of "Clinical Trials". The registration number is NCT0372-2758, October 29, 2018.
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Affiliation(s)
- Uzay Koç-Vural
- Department of Restorative Dentistry, School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Leyla Kerimova-Köse
- Department of Restorative Dentistry, School of Dentistry, Baskent University, Ankara, Turkey.
| | - Arlin Kiremitci
- Department of Restorative Dentistry, School of Dentistry, Hacettepe University, Ankara, Turkey
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Arbildo-Vega HI, Cruzado-Oliva FH, Coronel-Zubiate FT, Luján-Valencia SA, Meza-Málaga JM, Aguirre-Ipenza R, Echevarria-Goche A, Luján-Urviola E, Castillo-Cornock TB, Serquen-Olano K, Farje-Gallardo CA. Clinical Effectiveness of Ion-Releasing Restorations versus Composite Restorations in Dental Restorations: Systematic Review and Meta-Analysis. Dent J (Basel) 2024; 12:158. [PMID: 38920859 PMCID: PMC11203382 DOI: 10.3390/dj12060158] [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: 04/16/2024] [Revised: 05/19/2024] [Accepted: 05/21/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND To compare the clinical effectiveness of ion-releasing restorations (IRR) vs. composite resin (CR) in dental restorations. METHODS A systematic search was carried out from articles published until January 2024, in the biomedical databases: PubMed, Cochrane Library, Scielo, Scopus, Web of Science and Google Scholar. Randomized clinical trials were included, with a follow-up time greater than or equal to 1 year, without time and language limits and which reported the clinical effect of IRR compared to CR in dental restorations. The RoB 2.0 tool was used to assess the risk of bias of the included studies and the GRADEPro GDT tool was used to assess the quality of evidence and the strength of recommendation of the results. RESULTS The search yielded a total of 1109 articles. After excluding those that did not meet the selection criteria, 29 articles remained for the quantitative synthesis. The analysis found no statistically significant difference when comparing the dental restorations with IRRs or CRs. CONCLUSION The literature reviewed suggests that there are no differences between the IRRs and CRs in dental restorations.
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Affiliation(s)
- Heber Isac Arbildo-Vega
- Faculty of Dentistry, Dentistry School, Universidad San Martín de Porres, Chiclayo 14012, Peru; (H.I.A.-V.); (T.B.C.-C.); (K.S.-O.)
- Faculty of Human Medicine, Human Medicine School, Universidad San Martín de Porres, Chiclayo 14012, Peru
| | - Fredy Hugo Cruzado-Oliva
- Faculty of Stomatology, Stomatology School, Universidad Nacional de Trujillo, Trujillo 13001, Peru;
| | - Franz Tito Coronel-Zubiate
- Faculty of Health Sciences, Stomatology School, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas, Chachapoyas 01001, Peru;
| | - Sara Antonieta Luján-Valencia
- Postgraduate School, Universidad Católica de Santa María, Arequipa 04013, Peru;
- Faculty of Dentistry, Dentistry School, Universidad Católica de Santa María, Arequipa 04013, Peru;
| | - Joan Manuel Meza-Málaga
- Faculty of Dentistry, Dentistry School, Universidad Católica de Santa María, Arequipa 04013, Peru;
- Faculty of Medicine, Medicine School, Universidad Católica de Santa María, Arequipa 04013, Peru
| | | | | | - Eduardo Luján-Urviola
- Faculty of Dentistry, Universidad Andina Néstor Cáceres Velásquez, Juliaca 21104, Peru;
| | - Tania Belú Castillo-Cornock
- Faculty of Dentistry, Dentistry School, Universidad San Martín de Porres, Chiclayo 14012, Peru; (H.I.A.-V.); (T.B.C.-C.); (K.S.-O.)
- Faculty of Health Sciences, Stomatology School, Universida Señor de Sipán, Chiclayo 14000, Peru
| | - Katherine Serquen-Olano
- Faculty of Dentistry, Dentistry School, Universidad San Martín de Porres, Chiclayo 14012, Peru; (H.I.A.-V.); (T.B.C.-C.); (K.S.-O.)
- Faculty of Health Sciences, Stomatology School, Universida Señor de Sipán, Chiclayo 14000, Peru
| | - Carlos Alberto Farje-Gallardo
- Faculty of Health Sciences, Stomatology School, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas, Chachapoyas 01001, Peru;
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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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Ge KX, Quock R, Chu CH, Yu OY. The preventive effect of glass ionomer cement restorations on secondary caries formation: A systematic review and meta-analysis. Dent Mater 2023; 39:e1-e17. [PMID: 37838608 DOI: 10.1016/j.dental.2023.10.008] [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: 04/27/2023] [Revised: 09/19/2023] [Accepted: 10/05/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE The objective is to compare the preventive effect on secondary caries of glass ionomer cement (GIC) restorations with amalgam or resin-composite restorations. METHODS Two independent researchers conducted a systematic search of English publications in PubMed, Web of Science, Cochrane and Scopus. They selected randomized clinical trials comparing secondary caries incidences around GIC restorations (conventional GIC or resin-modified GIC) with amalgam or resin-composite restorations. Meta-analysis of the secondary-caries incidences with risk ratio (RR) and 95% confidence interval (95% CI) as the effect measure was performed. RESULTS This review included 64 studies. These studies included 8310 GIC restorations and 5857 amalgam or resin-composite restorations with a follow-up period from 1 to 10 years. Twenty-one studies with 4807 restorations on primary teeth and thirty-eight studies with 4885 restorations on permanent teeth were eligible for meta-analysis. The GIC restorations had a lower secondary caries incidence compared with amalgam restorations in both primary dentition [RR= 0.55, 95% CI:0.41-0.72] and permanent dentition [RR= 0.20, 95% CI:0.11-0.38]. GIC restorations showed similar secondary caries incidence compared with resin-composite restorations in primary dentition [RR= 0.92, 95% CI:0.77-1.10] and permanent dentition [RR= 0.77, 95% CI:0.39-1.51]. Conventional GIC restorations showed similar secondary caries incidence compared with resin-modified GIC-restored teeth in both primary dentition [RR= 1.12, 95% CI:0.67-1.87] and permanent dentition [RR= 1.63, 95% CI:0.34-7.84]. CONCLUSIONS GIC restorations showed a superior preventive effect against secondary caries compared to amalgam restorations, and a similar preventive effect against secondary caries compared to resin-composite restorations in both primary and permanent teeth. [PROSPERO Registration ID: CRD42022380959].
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Affiliation(s)
| | - Ryan Quock
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China; Department of Restorative Dentistry and Prosthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, TX, USA
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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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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Goodacre CJ, Eugene Roberts W, Munoz CA. Noncarious cervical lesions: Morphology and progression, prevalence, etiology, pathophysiology, and clinical guidelines for restoration. J Prosthodont 2023; 32:e1-e18. [PMID: 35920595 DOI: 10.1111/jopr.13585] [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: 05/22/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To synthesize the literature regarding noncarious cervical lesions (NCCLs) and propose clinical guidelines when lesion restoration is indicated. MATERIAL AND METHODS A PubMed search was performed related to NCCL morphology, progression, prevalence, etiology, pathophysiology, and restoration. RESULTS NCCLs form as either rounded (saucerlike) depressions with smooth, featureless surfaces that progress mainly in height or as V-shaped indentations that increase in both height and depth. Prevalence ranges from less than 10% to over 90% and increases with age. Common locations are the facial surfaces of maxillary premolars. They have a multifactorial etiology due to personal habits such as excessive horizontal toothbrushing and consumption of acidic foods and drinks. Occlusal factors have been identified as contributing to the prevalence of NCCLs in some studies, whereas other studies indicate there is no relationship. The concept of abfraction has been proposed whereby mechanical stress from occlusal loading plays a role in the development and progression of NCCLs with publications supporting the concept and others indicating it lacks the required clinical documentation. Regardless of the development mechanism, demineralization occurs and they are one of the most common demineralization diseases in the body. Treatment should be managed conservatively through preventive intervention with restorative treatment delayed until it becomes necessary due to factors such as lesion progression, impact on patient's quality of life, sensitivity, poor esthetics, and food collection may necessitate restoration. Composite resins are commonly used to restore NCCLs although other materials such as glass ionomer and resin-modified glass ionomer are also used. Sclerotic dentin does not etch like normal dentin and therefore it has been recommended to texture the dentin surface with a fine rotary diamond instrument to improve restoration retention. Some clinicians use mechanical retention to increase retention. Beveling of enamel is used to increase the bonding area and retention as well as enhance the esthetic result by gradually creating a color change between the restoration and tooth. Both multistep and single-step adhesives have been used. Dentin etching should be increased to 30 seconds due to the sclerotic dentin with the adhesive agent applied using a light scrubbing motion for 20 seconds but without excessive force that induces substantial bending of a disposable applicator. Both flowable and sculptable composite resins have been successfully used with some clinicians applying and polymerizing a layer of flowable composite resin and then adding an external layer of sculptable composite resin to provide enhanced resistance to wear. When caries is present, silver diamine fluoride has been used to arrest the caries rather than restore the lesion. CONCLUSIONS Noncarious cervical lesions (NCCLs) form as smooth saucerlike depressions or as V-shaped notches. Prevalence values as high as 90% and as low as 10% have been reported due to habits such as excessive toothbrushing and an acidic diet. Occlusal factors have been proposed as contributing to their presence but it remains controversial. Publications have both supported and challenged the concept of abfraction. They are one of the most common demineralization diseases in the body. Conservative treatment through prevention is recommended with restorative treatment delayed as long as possible. When treatment is needed, composite resins are commonly used with proposed restorative guidelines including texturing the sclerotic dentin, beveling the enamel, potential use of mechanical retention, 30 seconds of acid etching, and use of either multistep or single-step adhesives in conjunction with a light scrubbing motion for 20 seconds without excessive force placed on disposable applicators.
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Affiliation(s)
- Charles J Goodacre
- Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, California
| | - W Eugene Roberts
- Adjunct Professor Mechanical Engineering, Indiana University & Purdue University, Indianapolis, Indiana
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Evaluation of the Mechanical Properties of Three Resin-Modified Glass-Ionomer Materials. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4690656. [PMID: 35958806 PMCID: PMC9363206 DOI: 10.1155/2022/4690656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/15/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022]
Abstract
This study is aimed at evaluating the flexural strength (FS), fracture toughness (FT), and diametral tensile strength (DTS) of three resin-modified glass-ionomer cements (RMGICs): Ketac Nano, Riva Light Cure, and Fuji II LC. One hundred twenty specimens were prepared from the RMGIC materials (
). The cements were mixed and inserted into different mould sizes according to the test performed: FS: rectangular Teflon mould (
); FT: notchless triangular prism (NTP) Teflon mould (
); and DTS: ring road stainless steel mould (
). Specimens were light cured for 20 seconds on each surface and stored in distilled water at
for seven days prior to tests. To evaluate the influence of storage in the mechanical properties of the RMGIs, specimens tested for DTS were stored in distilled water at
for 32 days prior to test. Data were analyzed by ANOVA and Tukey’s test (
). Fuji II LC presented significantly higher values for all tests employed when compared to Ketac Nano and Riva LC RMGIs. There was no significant difference on DTS before and after the 32-day storage for each material. Fuji II LC presented superior mechanical properties when compared to Ketac Nano, and Riva LC storage showed no influence on the mechanical properties of the RMGI materials tested.
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Jain A, Schollmeyer A, Peter T, Xie XJ, Anamali S. Survival analysis of crown margin repair: A retrospective study in a dental school setting. J Am Dent Assoc 2021; 153:414-420. [PMID: 34973706 DOI: 10.1016/j.adaj.2021.08.012] [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: 01/25/2021] [Revised: 08/02/2021] [Accepted: 08/27/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Repairing crowns with defective margins is minimally invasive and cost-effective compared with replacement. The authors' objectives were to examine the survival trajectory of crown margin repairs and to determine the factors associated with survival. METHODS Records of adult patients from January 2008 through August 2019 were reviewed for crown margin repairs completed at University of Iowa College of Dentistry. A total of 1,002 crown margin repairs were found. Each repair was followed through the end of study in 2019 or until an event (for example, additional repair, endodontic treatment, crown replacement, or extraction). A Cox proportional hazards model was used to study the relationship between selected covariates and time to event. RESULTS During the follow-up period, 32.8% of the repairs needed reintervention. In the final model, repair material was the only significant covariate. No difference was found between the survival of repairs done with resin-modified glass ionomer and amalgam. However, the repairs done with resin-based composite and conventional glass ionomer were more likely (1.5 times: 95% CI, 1.02 to 2.10 times; and 2 times: 95% CI, 1.40 to 2.73 times, respectively) to need reintervention than were those done with amalgam. CONCLUSIONS Median survival time of crown margin repairs was 5.1 years (95% CI, 4.48 to 5.72 years). Median survival times for amalgam, resin-modified glass ionomer, resin-based composite, and glass ionomer repair materials were 5.7 years (95% CI, 4.80 to 6.25 years), 5.3 years (95% CI, 4.73 to 6.34 years), 3.2 years (95% CI, 2.51 to 6.19 years), and 3.0 years (95% CI, 2.53 to 3.62 years), respectively. PRACTICAL IMPLICATIONS When considering crown margin repairs, resin-modified glass ionomer or amalgam is preferable to resin-based composite or glass ionomer.
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Battancs E, Fráter M, Sáry T, Gál E, Braunitzer G, Szabó P. B, Garoushi S. Fracture Behavior and Integrity of Different Direct Restorative Materials to Restore Noncarious Cervical Lesions. Polymers (Basel) 2021; 13:polym13234170. [PMID: 34883673 PMCID: PMC8659675 DOI: 10.3390/polym13234170] [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: 11/13/2021] [Revised: 11/25/2021] [Accepted: 11/28/2021] [Indexed: 01/09/2023] Open
Abstract
The purpose of this study was to analyze the fracture resistance and marginal leakage of noncarious cervical lesion (NCCL) restorations made of different restorative materials. Eighty upper premolars were randomly divided into four groups (n = 20/group). Standardized NCCL cavity preparations were performed on the buccal surface of the teeth and then restored with four different materials. Group 1: Packable resin composite (PC); Group 2: Highly flowable resin composite (HF); Group 3: Low flowable resin composite (LF); Group 4: Resin modified glass ionomer cement (RMGIC). After restorations were completed, cyclic and static fracture behavior was evaluated using a loading testing machine. Extra restored teeth were sectioned and then stained (n = 5/group). The specimens were viewed under a stereo microscope and the percentage of microgaps at the tooth–restoration interface was calculated. All restored teeth survived after fatigue loading. There was no statistically significant (p > 0.05) difference between the tested restorations after the static loading test. NCCLs restored with highly filled flowable composite showed the least microleakage among the tested groups (p < 0.05). The investigated restorative materials are acceptable for NCCL restorations in terms of fracture resistance and microleakage.
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Affiliation(s)
- Emese Battancs
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (E.B.); (T.S.); (E.G.)
| | - Márk Fráter
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (E.B.); (T.S.); (E.G.)
- Correspondence:
| | - Tekla Sáry
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (E.B.); (T.S.); (E.G.)
| | - Emese Gál
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (E.B.); (T.S.); (E.G.)
| | | | - Balázs Szabó P.
- Department of Food Engineering, Faculty of Engineering, University of Szeged, H-6725 Szeged, Hungary;
| | - Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterials Center—TCBC, Institute of Dentistry, University of Turku, FI-20520 Turku, Finland;
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Joe Asir JJ, Sherwood IA, Amaechi BT, Vaanjay M, Swathipriyadarshini S, Prince PE. Influence of desensitizing agents in management of noncarious cervical lesion and bonded restorations: A preliminary 12-week report. J Conserv Dent 2020; 23:341-347. [PMID: 33623233 PMCID: PMC7883786 DOI: 10.4103/jcd.jcd_389_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 08/28/2020] [Accepted: 09/21/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The primary objective of this study was to investigate the effectiveness in reducing dentin hypersensitivity in noncarious cervical lesions (NCCLs) by home-based desensitizing toothpaste (TP), in-office Gluma desensitizer application, and resin-modified glass-ionomer cement (RMGIC) restoration. The secondary objective was to evaluate the long-term outcome of the glass-ionomer cement restoration following the application of bioactive glass-containing desensitizer TP. MATERIALS AND METHODS A total of 73 patients or 151 teeth were included in the study and randomly allotted to one of the four different treatment groups. Pre- and postoperative symptom and air-blast/tactile sensitivity scores were recorded for statistical analysis. Postoperative sensitivity was analyzed at 1, 4, and 12 weeks after treatment. Nonparametric statistical tests were employed. RESULTS Kruskal-Wallis test noted a significant reduction in postoperative sensitivity at all time periods with the RMGIC group compared to other treatment options. Significantly higher patient dropout was observed in desensitizing TP regimen. CONCLUSIONS This interim 12-week report on dentin hypersensitivity management of NCCLs concludes that resin-modified glass-ionomer restoration was able to achieve a significant instant reduction in sensitivity and patient satisfaction compared to other noninvasive at-home and in-office procedures. CLINICAL RELEVANCE This interim 12-week report on dentin hypersensitivity management of noncarious cervical lesions concludes that resin-modified glass-ionomer restoration was able to achieve a significant reduction in sensitivity, and patient satisfaction was higher compared to other noninvasive at-home and in-office procedures.
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Affiliation(s)
- J. Joyson Joe Asir
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India
| | - I. Anand Sherwood
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, University of Texas Health, San Antonio, USA
| | - M. Vaanjay
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India
| | - S. Swathipriyadarshini
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India
| | - P. Ernest Prince
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India
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Correia AMO, Andrade MR, Tribst JPM, Borges ALS, Caneppele TMF. Influence of Bulk-fill Restoration on Polymerization Shrinkage Stress and Marginal Gap Formation in Class V Restorations. Oper Dent 2020; 45:E207-E216. [DOI: 10.2341/19-062-l] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2019] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
Restoring Class V cavities with a regular bulk-fill composite presents a more favorable biomechanical behavior than restoring with a regular nano-filled composite.
SUMMARY
Purpose:
This study evaluated the influence of Class V cavity extension and restorative material on the marginal gap formation, before and after aging, and the theoretical polymerization shrinkage stress distribution in a tooth restoration.
Methods and Materials:
Class V cavities with the depth of 2 mm, cervical/incisal distance of 4 mm, and margins located in the enamel 1 mm above the cementoenamel junction were prepared in 60 bovine incisors in two mesiodistal dimensions (n=30): 2.9-mm large extension cavities (LE) or 1.4-mm small extension cavities (SE). The cavities' depths were validated using a periodontal probe, while the mesiodistal and cervical/incisal distances were measured using a stereomicroscope. After adhesive application (Clearfil SE Bond), each group was randomly divided into two groups (n=15) according to the restorative material: Filtek Z350 XT (N) or Filtek Bulk Fill Posterior (BF). The marginal gap formation between the tooth structure and the restorative material was evaluated using a stereomicroscope before and after thermocycling for 15,000 cycles (5°C and 55°C). Data were analyzed using repeated-measures analysis of variance (ANOVA) and Tukey test for multiple comparisons (α=0.05). A three-dimensional geometric model with the same dimensions as the experimental test was created for each cavity, and the restorations were modeled for each restorative material. In the analysis software, the finite element mesh was created with tetrahedral quadratic elements, and the polymerization shrinkage was simulated by thermal analogy. The maximum principal stress was used to express the tensile stress in the adhesive interface through colorimetric graphs.
Results:
For the marginal gap, the repeated-measures ANOVA revealed a significant effect only for the factors composite resin (df=1, F=4.09, p=0.04) and thermal aging (df=1, F=44.35, p<0.001). For all numerical simulations, higher stress concentration occurred at the enamel margin, and the stress peak decreased in the following sequence: LE-N (17.0 MPa) > SE-N (15.0 MPa) > LE-BF (9.1 MPa) > SE-BF (8.2 MPa).
Conclusion:
Marginal gaps in the specimens fell between approximately 12 and 17 μm; however, the regular bulk-fill composite showed less gap formation and better stress distribution around the cavity margin than the regular nano-filled composite, regardless of the cavity extension.
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Correia A, Bresciani E, Borges AB, Pereira DM, Maia LC, Caneppele T. Do Tooth- and Cavity-related Aspects of Noncarious Cervical Lesions Affect the Retention of Resin Composite Restorations in Adults? A Systematic Review and Meta-analysis. Oper Dent 2020; 45:E124-E140. [PMID: 32053461 DOI: 10.2341/19-091-l] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE The purpose was to perform a systematic review and meta-analysis based on the following research question: do tooth- and cavity-related aspects of noncarious cervical lesions (NCCLs) affect the retention of composite restorations? METHODS Randomized clinical trials (RCTs) that evaluated the retention rate of resin restorations in NCCLs were included for the identification and comparison of their characteristics. The search was conducted in PubMed and adapted for Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), Cochrane Library, and System for Information on Grey Literature in Europe (SIGLE) without restrictions until July 2018. Unpublished and ongoing trial registries were also searched. The Cochrane Collaboration tool was used for assessing risk of bias. The quality of the evidence was graded using the Grading of Recommendations: Assessment, Development and Evaluation. Using the random effects model, a meta-analysis was conducted for each aspect (arch distribution, tooth location, wear facets, dentin sclerosis, shape, size, depth, occluso-gingival distance, and margin location). RESULTS We retrieved 6738 articles. After removal of duplicates and nonrelevant articles, 24 RCTs remained. The anterior tooth location favored the retention rates of restoration of NCCLs (relative risk [RR], 1.08; 95% confidence interval [CI], 1.00-1.16). The presence of wear facets is a risk factor for the retention of restorations (RR, 0.91; 95% CI, 0.83-0.99). The evidence was moderate for arch distribution and low or very low for all other factors because of heterogeneity, imprecision, and inconsistency. CONCLUSION The tooth location and the presence of wear facets can affect the retention of composite resins in NCCLs.
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Correia A, Jurema A, Andrade MR, Borges A, Bresciani E, Caneppele T. Clinical Evaluation of Noncarious Cervical Lesions of Different Extensions Restored With Bulk-fill or Conventional Resin Composite: Preliminary Results of a Randomized Clinical Trial. Oper Dent 2019; 45:E11-E20. [PMID: 31794342 DOI: 10.2341/18-256-c] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE This randomized clinical trial evaluated the influence of the occlusogingival distance (OGD) of noncarious cervical lesions (NCCLs) on the clinical performance of a regular bulk-fill resin composite and a regular nanofilled resin composite. METHODS AND MATERIALS A total of 140 restorations were randomly placed in 77 participants by one operator. NCCLs were divided into four groups (n=35) according to OGD (1.5 mm±10% or 3 mm±10%) and resin composites (Filtek Bulk Fill Posterior [B] or Filtek Z350 XT [C]) used: 1.5 mm-B, 1.5 mm-C, 3 mm-B, and 3 mm-C. A two-step self-etch adhesive (Clearfil SE Bond) was applied following manufacturer instructions in all restorative procedures. Restorations were polished 1 week after placement. Clinical evaluation was performed at baseline (7 days), 6 months, and 1 year by two calibrated examiners, according to the modified US Public Health Service criteria evaluating fractures/retention, marginal staining, marginal adaptation, recurrence of caries, anatomic form, postoperative sensitivity, and surface texture. The Kruskal-Wallis test was used for intergroup comparison in each follow-up; the Friedman analysis of variance, followed by the least significant difference test (multiple comparisons) was used for intragroup comparison between baseline and follow-up times (α=0.05). RESULTS Two restorations were lost at 12 months (1 for 1.5 mm-B and 1 for 3 mm-B). The retention rates at 12 months were 100% for 1.5 mm-C, 97% for 1.5 mm-B, 100% for 3 mm-C; and 97% for 3 mm-B, with no statistical difference among the groups (p=0.570). At 12 months, a statistically significant difference was found among the follow-up times for the same group (1.5 mm-B, 1.5 mm-C, and 3 mm-B) regarding the marginal staining criterion; moreover, the 3 mm-C group showed a significant difference from 6 months. No significant difference was found for the other parameters. CONCLUSION Both resin composites showed acceptable clinical performance, and the OGD of NCCLs did not influence the clinical performance of resin composite restorations after 12 months.
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Caneppele TMF, Meirelles LCF, Rocha RS, Gonçalves LL, Ávila DMS, Gonçalves SEDP, Bresciani E. A 2-year clinical evaluation of direct and semi-direct resin composite restorations in non-carious cervical lesions: a randomized clinical study. Clin Oral Investig 2019; 24:1321-1331. [PMID: 31297659 DOI: 10.1007/s00784-019-03011-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 07/03/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the 2-year success of resin composite restorations in non-carious cervical lesions (NCCLs) using the direct or semi-direct techniques. MATERIALS AND METHODS Thirty volunteers presenting with at least two NCCLs were included. Each participant received one restoration using the direct technique and the other using the semi-direct technique, totaling 60 restorations. Time for completing the treatment was computed. Assessments at baseline, 7 days, and 6, 12, and 24 months were performed using the modified United States Public Health Service criteria. Descriptive analysis was reported as a percentage of successful treatments. For inferential analysis, the Student t test was used to evaluate the differences between extension, depth, and time. The chi-square/Fisher tests were used to compare treatment success after each period (α = 0.05). The results were evaluated by using the Kaplan-Meier survival analysis. RESULTS Differences were detected regarding mean ± standard deviation time, in which direct and semi-direct procedures were accomplished in 21.8 (± 14.5) and 35.3 (± 19.9) min, respectively. Of the 60 restorations placed, 7 failed in the direct group while 8 failed in the semi-direct group up to 2 years. No differences were detected between restorative protocols. The cumulative survival was 88.5% and 88.4% for the direct technique and semi-direct techniques after 24 months, respectively. CONCLUSION The tested restorative protocols present similar results for NCCLs within the studied periods. CLINICAL RELEVANCE The semi-direct technique exhibited clinical performance similar to direct technique for NCCL, demonstrating an alternative for restorations of these lesions.
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Affiliation(s)
- Taciana Marco Ferraz Caneppele
- GAPEC - Academic Group of Clinical Research, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), Av. Eng. Francisco José Longo, no. 777, São José dos Campos, São Paulo, 12245-000, Brazil.
| | - Laura Célia Fernandes Meirelles
- GAPEC - Academic Group of Clinical Research, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), Av. Eng. Francisco José Longo, no. 777, São José dos Campos, São Paulo, 12245-000, Brazil
| | - Rafael Santos Rocha
- GAPEC - Academic Group of Clinical Research, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), Av. Eng. Francisco José Longo, no. 777, São José dos Campos, São Paulo, 12245-000, Brazil
| | - Lucélia Lemes Gonçalves
- GAPEC - Academic Group of Clinical Research, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), Av. Eng. Francisco José Longo, no. 777, São José dos Campos, São Paulo, 12245-000, Brazil
| | - Daniele Mara Silva Ávila
- GAPEC - Academic Group of Clinical Research, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), Av. Eng. Francisco José Longo, no. 777, São José dos Campos, São Paulo, 12245-000, Brazil
| | - Sérgio Eduardo de Paiva Gonçalves
- GAPEC - Academic Group of Clinical Research, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), Av. Eng. Francisco José Longo, no. 777, São José dos Campos, São Paulo, 12245-000, Brazil
| | - Eduardo Bresciani
- GAPEC - Academic Group of Clinical Research, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), Av. Eng. Francisco José Longo, no. 777, São José dos Campos, São Paulo, 12245-000, Brazil
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Koc Vural U, Gokalp S, Kiremitci A. Effect of cavity lining on the restoration of root surface carious lesions: a split-mouth, 5-year randomized controlled clinical trial. Clin Oral Investig 2019; 24:979-989. [DOI: 10.1007/s00784-019-03001-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 06/28/2019] [Indexed: 10/26/2022]
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Correia AMDO, Tribst JPM, Matos FDS, Platt JA, Caneppele TMF, Borges ALS. Polymerization shrinkage stresses in different restorative techniques for non-carious cervical lesions. J Dent 2018; 76:68-74. [DOI: 10.1016/j.jdent.2018.06.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 06/14/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022] Open
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Physical property investigation of contemporary glass ionomer and resin-modified glass ionomer restorative materials. Clin Oral Investig 2018; 23:1295-1308. [PMID: 29998443 DOI: 10.1007/s00784-018-2554-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The objective of this study was to investigate selected physical properties of nine contemporary and recently marketed glass ionomer cement (GIC) and four resin-modified glass ionomer cement (RMGI) dental restorative materials. MATERIALS AND METHODS Specimens (n = 12) were fabricated for fracture toughness and flexure strength using standardized, stainless steel molds. Testing was completed on a universal testing machine until failure. Knoop hardness was obtained using failed fracture toughness specimens on a microhardness tester, while both flexural modulus and flexural toughness was obtained by analysis of the flexure strength results data. Testing was completed at 1 h, 24 h, 1 week, and then at 1, 3, 6, and 12 months. Mean data was analyzed with Kruskal-Wallis and Mann-Whitney (p = 0.05). RESULTS Physical properties results were material dependent. Physical properties of the GIC and RMGI products were inferior at 1 h compared to that at 24 h. Some improvement in selected physical properties were noted over time, but development processes were basically concluded by 24 h. A few materials demonstrated improved physical properties over the course of the evaluation. CONCLUSIONS Under the conditions of this study: 1. GIC and RMGI physical property performance over time was material dependent; 2. Polyalkenoate maturation processes are essentially complete by 24 h; 3. Although differences in GIC physical properties were noted, the small magnitude of the divergences may render such to be unlikely of clinical significance; 4. Modest increases in some GIC physical properties were noted especially flexural modulus and hardness, which lends support to reports of a maturing hydrogel matrix; 5. Overall, GIC product physical properties were more stable than RMGI; 6. A similar modulus reduction at 6 months for both RMGI and GIC produced may suggest a polyalkenoate matrix change; and 7. Globally, RMGI products demonstrated higher values of flexure strength, flexural toughness, and fracture toughness than GIC materials. CLINICAL RELEVANCE As compared to RMGI materials, conventional glass ionomer restorative materials demonstrate more stability in physical properties.
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Pinto-Sinai G, Brewster J, Roberts H. Linear Coefficient of Thermal Expansion Evaluation of Glass Ionomer and Resin-Modified Glass Ionomer Restorative Materials. Oper Dent 2018; 43:E266-E272. [PMID: 29953342 DOI: 10.2341/17-381-l] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this evaluation was to evaluate the linear coefficient of thermal expansion (LCTE) of 12 conventional glass ionomer (GIC) and four resin-modified glass ionomer (RMGI) restorative materials. METHODS GIC and RMGI specimens (2 mm × 5 mm × 5 mm) were fabricated (n=12) following manufacturer instructions and were placed in 0.2M phosphate-buffered saline and stored at 37°C and 98% humidity for one week. Specimens had LCTE determined with a thermomechanical analysis (TMA) unit using a 15°C-50°C heating cycle as well as a 50°C-15°C cooling cycle at a 5°C/min rate, using a 3-mm ball-point probe under 0.02 N probe pressure with all specimens kept saturated with PBS using a specially designed quartz container. Each specimen was tested three times, with the mean representing the specimen LCTE. Mean results between specimen heating and cooling were compared with paired Wilcoxon sign rank test, while results between materials were compared with Kruskal-Wallis/Dunn's ( α=0.05). RESULTS GIC LCTE ranged from approximately 5°C to 20°C ppm °K-1, while the RMGI LCTE ranged from approximately 25°C to 47°C ppm °K-1. With some exception, the LCTE during cooling displayed a greater trend. SIGNIFICANCE Under moisture conditions similar to the oral cavity, GIC materials overall had LCTE values closer to that reported for tooth structure. RMGI materials displayed higher values, which was thought to be related to the amount of resin in the matrix. A generally greater LCTE trend with cooling for all materials was noted, but the small magnitude of the difference is presently thought to be of minor clinical significance.
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Reis A, de Geus JL, Wambier L, Schroeder M, Loguercio AD. Compliance of Randomized Clinical Trials in Noncarious Cervical Lesions With the CONSORT Statement: A Systematic Review of Methodology. Oper Dent 2018; 43:E129-E151. [DOI: 10.2341/17-060-l] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
The literature was reviewed to evaluate the compliance of randomized clinical trials (RCTs) with the CONsolidated Standards of Reporting Trials (CONSORT ) and the risk of bias of these studies through the Cochrane Collaboration risk of bias tool (CCRT). RCTs were searched at Cochrane Library, PubMed, and other electronic databases to find studies about adhesive systems for cervical lesions. The compliance of the articles with CONSORT was evaluated using the following scale: 0 = no description, 1 = poor description, and 2 = adequate description. Descriptive analyses about the number of studies by journal, follow-up period, country, and quality assessments were performed with CCRT for assessing risk of bias in RCTs. One hundred thirty-eight RCTs were left for assessment. More than 30% of the studies received scores of 0 or 1. Flow chart, effect size, allocation concealment, and sample size were more critical items, with 80% receiving a score of 0. The overall CONSORT score for the included studies was 15.0 ± 4.8 points, which represents 46.9% of the maximum CONSORT score. A significant difference among countries was observed (p<0.001), as well as range of year (p<0.001). Only 4.3% of the studies were judged as at low risk; 36.2% were classified as having unclear risk and 59.4% as having high risk of bias. The adherence of RCTs evaluating adhesive systems to the CONSORT is low with unclear/high risk of bias.
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Affiliation(s)
- A Reis
- Alessandra Reis, DDS, PhD, professor, Restorative Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - JL de Geus
- Juliana L de Geus, MS, PhD, professor, School of Dentistry, School Paulo Picanço, Fortaleza, Ceará, Brazil and Department of Restorative Dentistry, Guairacá Faculty, Guarapuava, Paraná, Brazil
| | - L Wambier
- Leticia Wambier, Restorative Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil and professor, Graduate Program in Clinical Dentistry, University of Positivo, Curitiba, Paraná, Brazil
| | - M Schroeder
- Marcos Schroeder, DDS, PhD, professor, Prosthodontics and Dental Materials, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - AD Loguercio
- Alessandro D. Loguercio, DDS, MS, PhD, professor, Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil
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Clinical performance of a glass ionomer restorative system: a 6-year evaluation. Clin Oral Investig 2016; 21:2335-2343. [DOI: 10.1007/s00784-016-2028-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 12/06/2016] [Indexed: 11/26/2022]
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