The presence of residues within the root canal after post-space preparation can influence the bond strength between resin cement and root dentin when using fiberglass posts (FGPs). Currently, there is no consensus in the literature regarding what is the best solution for the removal of debris after post-space preparation. This systematic review involved "in vitro" studies to investigate if cleaning methods of the root canal after post-space preparation can increase the retention of FGPs evaluated by the push-out test. Searches were carried out in PubMed (MEDLINE) and Scopus databases up to July2017. English language studies published from 2007 to July 2017 were selected. 475 studies were found, and 9 were included in this review. Information from the 9 studies were collected regarding the number of samples, storage method after extraction, root canal preparation, method of post-space preparation, endodontic sealer, resin cement, cleaning methods after post-space and presence of irrigant activation. Five studies presented the best results for the association of sodium hypochlorite (NaOCl) and ethylenediamine tetra-acetic acid (EDTA), while in the other 4 studies, the solutions that showed improved retention of FGPs were photoninduced photoacoustic streaming (PIPS), Qmix, Sikko and EDTA. The results showed heterogeneity in all comparisons due to a high variety of information about cleaning methods, different concentrations, application time, type of adhesive system and resin cements used. In conclusion, this review suggests that the use of NaOCl/EDTA results in the retention of FGPs and may thus be recommended as a post-space cleaning method influencing the luting procedure.
This study aimed to assess the survival of glass ionomer cement (GIC) restorations performed using the atraumatic restorative treatment (ART) in elderly patients. The systematic review protocol was registered in the PROSPERO database. The records were searched until August 2020 in eight electronic bibliographic databases, and included randomized and non-randomized clinical trials and observational studies, with no restrictions on the language or year of publication. Study selection and data extraction were performed independently by two reviewers. Data were extracted, summarized, collected for qualitative analysis, and evaluated for individual risk of bias using the Joanna Briggs Institute's Critical Appraisal Tool. The literature search retrieved 5,186 records; however, only seven studies fulfilled the eligibility criteria and were included. The studies were published between 2002 and 2019. A total of 1,239 restorations were investigated at intervals of 6, 12, 24, and 60 months of follow-up. Some studies had a low risk of bias, while others had moderate and high risk of bias. In general, GIC restorations placed using ART were considered satisfactory. The 6-month, 12-month, and 24-month survival rates ranged from 81.3% to 97.2%, 72.2% to 94%, and 63% to 87%, respectively; additionally, the survival rate for the longest follow-up period (60 months) was 85%. Given the best evidence-based information regarding caries removal, we highlight the need to provide a conservative and effective technique for use in elderly patients. ART is a promising and viable alternative that guarantees the survival of restorations in elderly patients.
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