scholarly journals Microleakage of Direct Restorations. Comparisonbetween Bulk-Fill and Traditional Composite Resins:Systematic Review and Meta-Analysis

Author(s):  
Francesca Zotti ◽  
Edoardo Falavigna ◽  
Giorgia Capocasale ◽  
Daniele De Santis ◽  
Massimo Albanese

AbstractSince the bulk-fill composites were produced, there was a progressive diffusion of their use for direct conservative treatment in posterior teeth. Their chemical structure increases the depth of cure and decreases the polymerization contraction; in this manner, bulk-fill composites can be placed in 4 mm single layers and the treatment times are considerably reduced. However, aesthetic and mechanical properties and impact on microleakage of bulk-fill resins are still unclear.This systematic review and meta-analysis aimed to assess the risk of microleakage of direct posterior restorations made of bulk-fill versus conventional composite resins.Researches were performed on PubMed and Scopus databases. Eligible in vivo studies, published since 2006, were reviewed. Outcomes of marginal discoloration, marginal adaptation, and recurrent caries were considered to conduct the systematic review and meta-analysis. Secondary data were examined to implement additional analysis and assess the risk of bias.Eight randomized clinical trials were analyzed, involving 778 direct restorations. The summary of RCTs led to significant but inconsistent results; the marginal discoloration and recurrent caries were found to be improved respectively by 5.1 and 1.4%, whereas the marginal adaptation was reduced of 6.5%. Secondary analyses revealed that follow-up periods, the adhesive system used and the class of carious lesions evaluated are confounding factors, and they result in a risk of bias across studies.Bulk-fill composites are innovative materials for conservative dentistry and they can be used to reduce treatment steps and duration of operative times. There are insufficient data to explore the relationship between bulk-fill composites and microleakage and further investigations are needed.

2021 ◽  
Vol 10 (10) ◽  
pp. e552101018981
Author(s):  
Ana Carolina Soares Diniz ◽  
Vinicius Souza Correa ◽  
Meire Coelho Ferreira ◽  
Leily Macedo Firoozmand

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.


2021 ◽  
Vol 67 (1) ◽  
pp. 27-34
Author(s):  
Fernanda Cardoso ◽  
Jéssica Breder ◽  
Priscila Apolinário ◽  
Henrique Oliveia ◽  
Maria Saidel ◽  
...  

BACKGROUND: Plantago major is a medicinal plant that has been used for centuries to treat various health conditions including wounds. PURPOSE: To investigate the effectiveness of the topical use of P major in healing skin wounds in animal models. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was conducted. Seven (7) electronic databases (Virtual Health Library, Public/Publisher MEDLINE, Scopus, Web of Science, Embase, Cumulative Index of Nursing and Allied Health Literature, and CAB Direct) were searched for controlled studies published in English from January 2006 to March 2020. The Collaborative Approach to Meta Analysis and Review of Animal Data from Experimental Studies tools guided the evaluation of the studies and determined their quality. The Systematic Review Center for Laboratory Animal Experimentation was used to assess the risk of bias. RESULTS: Of the 176 publications identified, 4 met the inclusion criteria. Studies included 20 to 100 animals and varying concentrations of P major. There were no reports of losses during research. Wound healing was assessed between 17 and 21 days following wounding. The best response in terms of wound contraction rate occurred with 10%, 20%, and 50% concentrations when compared with control groups. One (1) study did not have an animal ethics committee review. All studies had a high risk of bias and a lack of methodological rigor. CONCLUSION: The results of this review did not find evidence about the in vivo effectiveness of P major for wound healing. More rigorous preclinical studies with adequate sample sizes are required to identify the best concentrations and formulations as well as increase understanding about the mechanisms of action of P major in wound healing.


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Steven Kwasi Korang ◽  
Sophie Juul ◽  
Emil Eik Nielsen ◽  
Joshua Feinberg ◽  
Faiza Siddiqui ◽  
...  

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) which has rapidly spread worldwide. Several human randomized clinical trials assessing potential vaccines are currently underway. There is an urgent need for a living systematic review that continuously assesses the beneficial and harmful effects of all available vaccines for COVID-19. Methods/design We will conduct a living systematic review based on searches of major medical databases (e.g., MEDLINE, EMBASE, CENTRAL) and clinical trial registries from their inception onwards to identify relevant randomized clinical trials. We will update the literature search once a week to continuously assess if new evidence is available. Two review authors will independently extract data and conduct risk of bias assessments. We will include randomized clinical trials comparing any vaccine aiming to prevent COVID-19 (including but not limited to messenger RNA; DNA; non-replicating viral vector; replicating viral vector; inactivated virus; protein subunit; dendritic cell; other vaccines) with any comparator (placebo; “active placebo;” no intervention; standard care; an “active” intervention; another vaccine for COVID-19) for participants in all age groups. Primary outcomes will be all-cause mortality; a diagnosis of COVID-19; and serious adverse events. Secondary outcomes will be quality of life and non-serious adverse events. The living systematic review will include aggregate data meta-analyses, trial sequential analyses, network meta-analyses, and individual patient data meta-analyses. Within-study bias will be assessed using Cochrane risk of bias tool. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) and Confidence in Network Meta-Analysis (CINeMA) approaches will be used to assess certainty of evidence. Observational studies describing harms identified during the search for trials will also be included and described and analyzed separately. Discussion COVID-19 has become a pandemic with substantial mortality. A living systematic review assessing the beneficial and harmful effects of different vaccines is urgently needed. This living systematic review will regularly inform best practice in vaccine prevention and clinical research of this highly prevalent disease. Systematic review registration PROSPERO CRD42020196492


2020 ◽  
Vol 45 (3) ◽  
pp. E124-E140
Author(s):  
AMO Correia ◽  
E Bresciani ◽  
AB Borges ◽  
DM Pereira ◽  
LC Maia ◽  
...  

SUMMARY 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.


2020 ◽  
Vol 75 ◽  
pp. 104226
Author(s):  
Juliana Simeão Borges ◽  
Luiz Renato Paranhos ◽  
Gabriela Leite de Souza ◽  
Felipe de Souza Matos ◽  
Ítalo de Macedo Bernardino ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ana Carolina de Figueiredo Costa ◽  
Thays Allane Cordeiro Maia ◽  
Paulo Goberlânio de Barros Silva ◽  
Lucas Guimarães Abreu ◽  
Delane Viana Gondim ◽  
...  

Abstract Objectives The aim of this systematic review and meta-analysis was to assess the effects of low-level laser therapy (LLLT) on the orthodontic mini-implants (OMI) stability. Materials and methods An unrestricted electronic database search in PubMed, Science Direct, Embase, Scopus, Web of Science, Cochrane Library, LILACS, Google Scholar, and ClinicalTrials.gov and a hand search were performed up to December 2020. Randomized clinical trials (RCTs) or non-randomized clinical trials (Non-RCTs) that assessed the effects of LLLT on the OMI stability were included. Data regarding the general information, LLLT characteristics, and outcomes were extracted. The authors performed risk of bias assessment with Cochrane Collaboration’s or ROBINS-I tool. Meta-analysis was also conducted. Results Five RCTs and one Non-RCT were included and 108 patients were evaluated. The LLLT characteristics presented different wavelength, power, energy density, irradiation time, and protocol duration. Five RCTs had a low risk of selection bias. Two RCTs had a low risk of performance and detection bias. All RCTs had a low risk of attrition bias, reporting bias and other bias. The Non-RCT presented a low risk of bias for all criteria, except for the bias in selection of participants. The meta-analysis revealed that LLLT significantly increased the OMI stability (p < 0.001, Cohen’s d = 0.67) and the highest clinical benefit was showed after 1 (p < 0.001, Cohen’s d = 0.75), 2 (p < 0.001, Cohen’s d = 1.21), and 3 (p < 0.001, Cohen’s d = 1.51) months of OMI placement. Conclusions LLLT shows positive effects on the OMI stability.


2017 ◽  
Vol 51 (5) ◽  
pp. 527-541 ◽  
Author(s):  
Ana Cláudia Chibinski ◽  
Letícia Maíra Wambier ◽  
Juliana Feltrin ◽  
Alessandro Dourado Loguercio ◽  
Denise Stadler Wambier ◽  
...  

A systematic review was performed to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in children when compared with active treatments or placebos. A search for randomized clinical trials that evaluate the effectiveness of SDF for caries control in children compared to active treatments or placebos with follow-ups longer than 6 months was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and grey literature. The risk of bias tool from the Cochrane Collaboration was used for quality assessment of the studies. The quality of the evidence was evaluated using the GRADE approach. Meta-analysis was performed on studies considered at low risk of bias. A total of 5,980 articles were identified. Eleven remained in the qualitative synthesis. Five studies were at “low,” 2 at “unclear,” and 4 studies at “high” risk of bias in the key domains. The studies from which the information could be extracted were included for meta-analysis. The arrestment of caries at 12 months promoted by SDF was 66% higher (95% CI 41-91%; p < 0.00001) than by other active material, but it was 154% higher (95% CI 67-85%; p < 0.00001) than by placebos. Overall, the caries arrestment was 89% higher (95% CI 49-138%; p < 0.00001) than using active materials/placebo. No heterogeneity was detected. The evidence was graded as high quality. The use of SDF is 89% more effective in controlling/arresting caries than other treatments or placebos. The quality of the evidence was graded as high.


2016 ◽  
Vol 16 (2) ◽  
pp. 135-146 ◽  
Author(s):  
Tae-Young Choi ◽  
Jong In Kim ◽  
Hyun-Ja Lim ◽  
Myeong Soo Lee

Background. Insomnia is a prominent complaint of cancer patients that can significantly affect their quality of life and symptoms related to sleep quality. Conventional drug approaches have a low rate of success in alleviating those suffering insomnia. The aim of this systematic review was to assess the efficacy of acupuncture in the management of cancer-related insomnia. Methods. A total of 12 databases were searched from their inception through January 2016 without language restriction. Randomized controlled trials (RCTs) and quasi-RCTs were included if acupuncture was used as the sole intervention or as an adjunct to another standard treatment for any cancer-related insomnia. The data extraction and the risk of bias assessments were performed by 2 independent reviewers. Results. Of the 90 studies screened, 6 RCTs were included. The risk of bias was generally unclear or low. Three RCTs showed equivalent effects on the Pittsburgh Sleep Quality Index and 2 RCTs showed the similar effects on response rate to those of conventional drugs at the end of treatment. The other RCT showed acupuncture was better than hormone therapy in the numbers of hours slept each night and number of times woken up each night. The 3 weeks of follow-up in 2 RCTs showed superior effects of acupuncture compared with conventional drugs, and a meta-analysis showed significant effects of acupuncture. Two RCTs tested the effects of acupuncture on cancer-related insomnia compared with sham acupuncture. One RCT showed favourable effects, while the other trial failed to do so. Conclusion. There is a low level of evidence that acupuncture may be superior to sham acupuncture, drugs or hormones therapy. However, the number of studies and effect size are small for clinical significance. Further clinical trials are warranted.


2021 ◽  
Author(s):  
Fernando Tortosa ◽  
Gabriela Carrasco ◽  
Martin Ragusa ◽  
Pedro Haluska ◽  
Ariel Izcovich

AbstractObjetivesTo assess the effects of convalescent plasma treatment in patients with coronavirus disease (COVID-19).Study designSystematic review and Meta-analysisData sourcesA systematic search was carried out on the L · OVE (Living OVerview of Evidence) platform for COVID-19 until October 31, 2020Study selectionRandomized clinical trials in which people with probable or confirmed COVID-19 were randomized to drug treatment, standard care, or placebo. Pairs of reviewers independently screened potentially eligible articles.MethodsThe PRISMA guidelines were followed for conducting a systematic review and meta-analysis. The risk of bias of the included studies was assessed using the Cochrane risk of bias tool 2.0, and the certainty of the evidence using the recommendation assessment, development and evaluation (GRADE) approach. For each outcome, the interventions were classified into groups, from most to least beneficial or harmful.ResultsWe identified 10 RCTs (randomized controlled trials) involving 11854 patients in which convalescent plasma was compared with standard of care or other treatments. The results of five RCTs that evaluated the use of convalescent plasma in patients with COVID-19 did not show significant differences in the effect on mortality and the need for invasive mechanical ventilation.ConclusionsCurrent evidence is insufficient to recommend the use of convalescent plasma in the treatment of moderate or severe COVID-19.Contribution of the authors


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