Clinical performance of indirect restorations with cervical margin relocation in posterior teeth: A systematic review

With the increasing acceptance of the clinical use of bulk-fill resins, it is necessary to investigate the in vivo performance of these restorative materials. In this perspective, this systematic review to evaluate the clinical performance of Bulk-fill resins in restorations of vital, primary and permanent posterior teeth. PubMed, Cochrane, Scopus, LILACS, BBO and Capes publications search base were searched without restriction regarding the year of publication or language of the article. The inclusion criteria were clinical trials that evaluated the efficacy of resins composed of bulk-fill compared to the incremental technique. For the selection of articles and data extraction, two calibrated evaluators evaluated abstracts and complete articles. A total of 1443 abstracts were identified, of which 14 articles were included in the review. Of these, 01 was classified with a high level of evidence; 08 were moderate and 05 with a low level of evidence. The studies presented an average follow-up of the restorations of 35.1 months. A large part of the studies (75%) demonstrated that the occurrence of postoperative sensitivity. The high failure rate was more prevalent in class II restorations. The marginal adaptation/color change was material dependent and the occurrence of secondary caries in bulk-fill resin restorations was not significant concerning conventional resins in most studies. In the short term, the satisfactory clinical performance of bulk-fill resins used in primary and permanent restorations, with clinical outcomes and results equivalent to conventional composite resins were observed.

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Vital Pulp Therapy in Permanent Mature Posterior Teeth with Symptomatic Irreversible Pulpitis: A Systematic Review of Treatment Outcomes

Medicina ◽

10.3390/medicina57060573 ◽

2021 ◽

Vol 57 (6) ◽

pp. 573

Author(s):

João Miguel Santos ◽

Joana F. Pereira ◽

Andréa Marques ◽

Diana B. Sequeira ◽

Shimon Friedman

Keyword(s):

Systematic Review ◽

Root Canal ◽

Small Sample ◽

Risk Of Bias ◽

Root Canal Treatment ◽

Cochrane Library ◽

Posterior Teeth ◽

Pulp Therapy ◽

Vital Pulp Therapy ◽

Irreversible Pulpitis

Background and Objectives: Symptomatic irreversible pulpitis in permanent mature teeth is a common indication for nonsurgical root canal treatment (NSRCT), but contemporary studies have reported on vital pulp therapy (VPT) applied in such teeth as a less invasive treatment. This systematic review assessed the outcomes of VPT, including partial and full pulpotomy performed with hydraulic calcium silicate cements (HCSCs) in permanent mature posterior teeth diagnosed with symptomatic irreversible pulpitis. Materials and Methods: The PRISMA guidelines were followed. The search strategy included PubMed®, EMBASE, Cochrane library and grey literature electronic databases. The quality assessment of the identified studies followed the Cochrane Collaboration Risk of Bias, ROBINS-I and Newcastle–Ottawa Scale tools. Results: The search of primary databases identified 142 articles, of which 9 randomized controlled trials and 3 prospective cohort studies were selected for review. The risk-of-bias was assessed as ‘high’ or ‘serious’, ‘fair’, and ‘low’ for three, seven and two articles, respectively. One to five years after VPT using HCSCs, the success rates mostly ranged from 78 to 90%. Based on two articles, the outcomes of the VPT and NSRCT were comparable at one and five years. Despite the necessity for the intra-operative pulp assessment in VPT procedures, the majority of the studies did not fully report on this step or on the time needed to achieve hemostasis. Small sample sizes, of under 23 teeth, were reported in three studies. Conclusions: The reviewed 12 articles reported favorable outcomes of the VPT performed with HCSCs in permanent mature posterior teeth with symptomatic irreversible pulpitis, with radiographic success in the range of 81 to 90%. Two articles suggested comparable outcomes of the VPT and root canal treatment. Universal case selection and outcome criteria needs to be established for VPT when considered as an alternative to NSRCT. This evidence supports the need for further research comparing longer-term outcomes of both of the treatment modalities.

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Diagnosis of SARS-Cov-2 Infection by RT-PCR Using Specimens Other Than Naso- and Oropharyngeal Swabs: A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics11020363 ◽

2021 ◽

Vol 11 (2) ◽

pp. 363

Author(s):

Vânia M. Moreira ◽

Paulo Mascarenhas ◽

Vanessa Machado ◽

João Botelho ◽

José João Mendes ◽

...

Keyword(s):

Systematic Review ◽

Clinical Performance ◽

Point Of Care ◽

Meta Analysis ◽

High Sensitivity ◽

Nasopharyngeal Swab ◽

Sample Collection ◽

Rt Pcr ◽

Oropharyngeal Swab ◽

Nucleic Acid Assays

The rapid and accurate testing of SARS-CoV-2 infection is still crucial to mitigate, and eventually halt, the spread of this disease. Currently, nasopharyngeal swab (NPS) and oropharyngeal swab (OPS) are the recommended standard sampling techniques, yet, these have some limitations such as the complexity of collection. Hence, several other types of specimens that are easier to obtain are being tested as alternatives to nasal/throat swabs in nucleic acid assays for SARS-CoV-2 detection. This study aims to critically appraise and compare the clinical performance of RT-PCR tests using oral saliva, deep-throat saliva/posterior oropharyngeal saliva (DTS/POS), sputum, urine, feces, and tears/conjunctival swab (CS) against standard specimens (NPS, OPS, or a combination of both). In this systematic review and meta-analysis, five databases (PubMed, Scopus, Web of Science, ClinicalTrial.gov and NIPH Clinical Trial) were searched up to the 30th of December, 2020. Case-control and cohort studies on the detection of SARS-CoV-2 were included. The methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS 2). We identified 1560 entries, 33 of which (1.1%) met all required criteria and were included for the quantitative data analysis. Saliva presented the higher accuracy, 92.1% (95% CI: 70.0–98.3), with an estimated sensitivity of 83.9% (95% CI: 77.4–88.8) and specificity of 96.4% (95% CI: 89.5–98.8). DTS/POS samples had an overall accuracy of 79.7% (95% CI: 43.3–95.3), with an estimated sensitivity of 90.1% (95% CI: 83.3–96.9) and specificity of 63.1% (95% CI: 36.8–89.3). The remaining index specimens could not be adequately assessed given the lack of studies available. Our meta-analysis shows that saliva samples from the oral region provide a high sensitivity and specificity; therefore, these appear to be the best candidates for alternative specimens to NPS/OPS in SARS-CoV-2 detection, with suitable protocols for swab-free sample collection to be determined and validated in the future. The distinction between oral and extra-oral salivary samples will be crucial, since DTS/POS samples may induce a higher rate of false positives. Urine, feces, tears/CS and sputum seem unreliable for diagnosis. Saliva testing may increase testing capacity, ultimately promoting the implementation of truly deployable COVID-19 tests, which could either work at the point-of-care (e.g. hospitals, clinics) or at outbreak control spots (e.g., schools, airports, and nursing homes).

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Current Trends in Dental Composites

Critical Reviews in Oral Biology & Medicine ◽

10.1177/10454411950060040301 ◽

1995 ◽

Vol 6 (4) ◽

pp. 302-318 ◽

Cited By ~ 249

Author(s):

J.L. Ferracane

Keyword(s):

Wear Resistance ◽

Clinical Performance ◽

Color Stability ◽

Dental Composites ◽

Filler Materials ◽

Posterior Teeth ◽

The Past ◽

Current Trends ◽

Dentin Adhesives ◽

High Concentrations

The clinical performance of dental composites has been significantly improved over the past decade through modifications in formulation that include: using more stable polymerization promoters for greater color stability; incorporating high concentrations of finely ground fillers to produce adequate strength and excellent wear resistance while retaining translucency ; adding radiopacifying agents for improved diagnostics; and utilizing dentin adhesives. However, there are problems which limit the use of composites, especially in posterior teeth. The materials remain very technique-sensitive, due to the extensive contraction which accompanies polymerization and negatively influences marginal sealing. In addition, the materials are generally considered to have inadequate mechanical properties and wear resistance in contact areas to serve as total replacements for amalgams. Current efforts are focusing on several areas, including the development of non- or minimally-shrinking dental composites containing spiro-orthocarbonates as additives to dimethacrylates or epoxy-base resins, and the production of alternative filler materials for ideal wear resistance and esthetics. This paper reviews the composition and characteristics of current dental composites, as well as recent areas of study.

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Endocrown restorations for extensively damaged posterior teeth: clinical performance of three cases

Restorative Dentistry & Endodontics ◽

10.5395/rde.2018.43.e38 ◽

2018 ◽

Vol 43 (4) ◽

Cited By ~ 5

Author(s):

Konstantinos Tzimas ◽

Maria Tsiafitsa ◽

Paris Gerasimou ◽

Effrosyni Tsitrou

Keyword(s):

Clinical Performance ◽

Posterior Teeth

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Supplementary techniques for pain control during root canal treatment of lower posterior teeth with irreversible pulpitis: A systematic review and meta-analysis

Australian Endodontic Journal ◽

10.1111/aej.12212 ◽

2017 ◽

Vol 44 (1) ◽

pp. 14-25 ◽

Cited By ~ 11

Author(s):

Pinpana Tupyota ◽

Pattama Chailertvanitkul ◽

Malinee Laopaiboon ◽

Chetta Ngamjarus ◽

Paul V. Abbott ◽

...

Keyword(s):

Systematic Review ◽

Root Canal ◽

Pain Control ◽

Meta Analysis ◽

Root Canal Treatment ◽

Posterior Teeth ◽

Irreversible Pulpitis

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Long-term Short Implants Performance: Systematic Review and Meta-Analysis of the Essential Assessment Parameters

Brazilian Dental Journal ◽

10.1590/0103-6440201300265 ◽

2015 ◽

Vol 26 (4) ◽

pp. 325-336 ◽

Cited By ~ 12

Author(s):

Thais Marques Simek Vega Gonçalves ◽

Sergio Bortolini ◽

Matteo Martinolli ◽

Bruna Fernandes Moreira Alfenas ◽

Daiane Cristina Peruzzo ◽

...

Keyword(s):

Systematic Review ◽

Survival Rate ◽

Clinical Performance ◽

Meta Analysis ◽

Implant Failure ◽

Cochrane Library ◽

Implant Survival ◽

Implant Survival Rate ◽

Short Implants

<p>Lack of standard criteria in the outcome assessment makes it difficult to draw conclusions on the clinical performance of short implants and, under these circumstances, determine the reasons for implant failure. This study evaluated, through a systematic review of the literature and meta-analysis, the essential parameters required to assess the long-term clinical performance of short and extra-short implants. Electronic databases (Pubmed-MEDLINE, Cochrane Library Database, Embase, and Lilacs) were searched by two independent reviewers, without language limitation, to identify eligible papers. References from the selected articles were also reviewed. The review included clinical trials involving short dental implants placed in humans, published between January 2000 and March 2014, which described the parameters applied for outcome's measurements and provided data on survival rates. Thirteen methodologically acceptable studies were selected and 24 parameters were identified. The most frequent parameters assessed were the marginal bone loss and the cumulative implant survival rate, followed by implant failure rate and biological complications such as bleeding on probing and probing pocket depths. Only cumulative implant survival rate data allows meta-analysis revealing a positive effect size (from 0.052 (fixed) to 0.042 (random)), which means that short implant appears to be a successful treatment option. Mechanical complications and crown-to-implant (C/I) ratio measurement were also commonly described, however, considering the available evidence; no strong conclusions could be drawn since different methods were used to assess each parameter. By means of this literature review, a standard evaluation scheme is proposed, being helpful to regiment further investigations and comparisons on future studies.</p>

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