Published Article

Direct materials for restoring caries lesions: Systematic review and meta-analysis—a report of the American Dental Association Council on Scientific Affairs

Original Publisher or Platform

Journal of the American Dental Association

Original Article Link

https://doi.org/10.1016/j.adaj.2022.09.012

Publication Date

1-2023

Abstract

This search strategy was constructed to support the research for the peer reviewed article listed above. Full article 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 ionomer 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.

PICO(T) or Research Question

  1. In patients with primary teeth, regardless of caries removal technique and without pulp therapy, what is the comparative effect of restorative materials [amalgam, resin composites, compomers (polyacid modified composite resin), resin-modified glass ionomer cements, or conventional glass ionomer cements, preformed metal crowns (conventional or Hall Technique), and preformed aesthetic crowns], in treating moderate and advanced cavitated caries lesions on anterior or posterior teeth?
  2. In patients with permanent teeth, regardless of caries removal technique and without pulp therapy, what is the comparative effect of restorative materials [amalgam, resin composites, compomers (polyacid modified composite resin), resin-modified glass ionomer cements, or conventional glass ionomer cements, preformed metal crowns], in treating moderate and advanced cavitated caries lesions on anterior or posterior teeth?

Search Type

Meta-Analyses, Systematic Review

Databases included

PubMed or PubMed subsidiary, Embase, Cochrane, Other

Acknowledgments

The ADA Council on Scientific Affairs commissioned this work. The full article was authored by:

Lauren Pilcher, MSPH; Sarah Pahlke, MS; Olivia Urquhart, MPH; Kelly K. O’Brien, MLIS; Vineet Dhar, BDS, MDS, PhD; Margherita Fontana, DDS, PhD; Carlos González-Cabezas, DDS, MSD, PhD; Martha Ann Keels, DDS, PhD; Ana Karina Mascarenhas, BDS, MPH, DrPH; Marcelle M. Nascimento, DDS, MS, PhD; Jeffrey A. Platt, DDS, MS; Gregory J. Sabino, DDS, PhD; Rebecca L. Slayton, DDS, PhD; Norman Tinanoff, DDS, MS; Douglas A. Young, DDS, EdD, MBA, MS; Domenick T. Zero, DDS, MS; Malavika P. Tampi, MPH; DeVonna Purnell, DMD; Josefina Salazar, DDS, MSc; Spiro Megremis, PhD, MS; Diane Bienek, PhD, MS; Alonso Carrasco-Labra, DDS, MSc, PhD.

Download
Request Accessible Version

Share

COinS