Challenges with studies investigating longevity of dental restorations—a critique of a systematic review

Chadwick, Barbara Lesley; Treasure, Elizabeth; Dummer, P. M. H.; Dunstan, Frank David John; Gilmour, Alan Scott Maxwell; Jones, R.; Phillips, Ceri; Stevens, James D.; Rees, John; Richmond, Stephen

doi:10.1016/s0300-5712(01)00003-3

Cited by 68 publications

(75 citation statements)

References 25 publications

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“…Chadwick et al [107] comprehensively discussed the problems associated with outcome measures of restoration failures. There has been a need for the development of reliable and more objective criteria for clinical performance of restorations based on evidence and minimal intervention policy.…”

Section: Clinical Evaluationmentioning

confidence: 99%

Challenges to the clinical placement and evaluation of adhesively-bonded, cervical composite restorations

Kubo

Yokota

et al. 2013

Dental Materials

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Objectives: The incidence of non-carious cervical lesions (NCCLs) has been increasing.The clinical performance of resin composites in NCCLS was previously unsatisfactory due to their non-retentive forms and margins lying on dentin. In order to address this problem, a lot of effort has been put into developing new dentin adhesives and restorative techniques. This article discusses these challenges and the criteria used for evaluating clinical performance as they relate to clinical studies, especially long-term clinical trials. Polymerization contraction, thermal changes and occlusal forces generate debonding stresses at adhesive interfaces.Methods: In laboratory studies, we have investigated how these stresses can be relieved by various restorative techniques and how bond strength and durability can be enhanced. Lesion forms, restorative techniques, adhesives (adhesive strategies, bond strengths, bond durability, and the relationship between enamel and dentin bond strengths) were found to have a complex relationship with microleakage. With regard to some restorative techniques, only several short-term clinical studies were available.

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Section: Clinical Evaluationmentioning

confidence: 99%

Challenges to the clinical placement and evaluation of adhesively-bonded, cervical composite restorations

Kubo

Yokota

et al. 2013

Dental Materials

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“…The only studies considered acceptable by the systematic review 36 on the longevity of restorations, were controlled or a prospective series of cases where specific criteria were given on why restorations were to be replaced. Chadwick et al (2001) 37 produced a hierarchy of study designs. Their paper concluded that the ideal study design to assess the longevity of restorations would be multicentre, multioperator studies for assessment periods greater than 10 years.…”

Section: Results Of the Clinical Trials Presented In Tablementioning

confidence: 99%

“…36 Those responsible for this work have also reflected on the problems of designing a clinical trial to assess restoration longevity. 37 Much thought was given as to how restoration failure could be determined from the literature. Two approaches were possible: the first was to accept that if a restoration was actually replaced it had failed.…”

Section: What Constitutes Failure? the Choice Of Observersmentioning

confidence: 99%

The tunnel restoration

Ratledge

Treasure

2002

Br Dent J

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“…Reports of the incidence as well as the prevalence of secondary caries have ranged from insignificant to extensive and multiple authors have voiced scepticism with regard to their validity in both directions [1][2][3][147][148][149]. Which estimates of secondary caries should we believe?…”

Section: Secondary Caries Incidence In Controlled Clinical Studies Vementioning

confidence: 99%

“…The list of potential biases that likely influences the estimates is extensive and includes selection bias, performance bias, detection or assessment bias, attrition bias and reporting bias. Respective typical examples are patient recruitment amongst dental students; studies not conducted in general dental practice, lack of operational descriptive criteria or judgement of own clinical work; high number of patient dropouts especially amongst the unhappy ones; and the reporting of surrogate or alternative outcomes rather than patient-relevant ones [147,148].…”

Section: Secondary Caries Incidence In Controlled Clinical Studies Vementioning

confidence: 99%

Secondary caries and microleakage

Jokstad

2016

Dental Materials

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Objectives: To critically appraise experimental ex vivo research that has focussed on secondary caries, and to offer possible explanations for the seemingly poor correlation to clinical observations. Methods: The literature relating to the etiopathogenesis or prevention of secondary caries gained from experimental ex vivo research was reviewed, with particular emphasis on microleakage and artificial caries-like lesions.Results: It is doubtful whether a caries wall lesion can exist independently of an outer enamel caries lesion. Microleakage experiments apparently continue to emerge regardless of multiple reviews questioning the reliability and validity of the method. Several of the approaches used to generate artificial caries-like lesions are very aggressive. Remarkably little discussion has evolved about how these aggressive approaches create microenvironments that do not occur in reality. Corrosion-and biodegradation products may influence the biofilm qualitatively and quantitatively and it is difficult to replicate these variables in any ex vivo environment. Clinical data sampling method, patient demography as well as study methodology influences the incidence and prevalence estimates of secondary caries. Clinical results based on clinical work in settings where cost per unit time is of nominal concern do not provide any indications on how the restorative material will perform when placed by the average dentists in the mouths of their spectrum of patients during a busy workday.Recommendations: The term "wall lesion" including its variants is ill defined, has been, and is still being used indiscriminately. Stakeholders should avoid using this ambiguous label due to its connotation to an entity that does not exist per se.

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Challenges with studies investigating longevity of dental restorations—a critique of a systematic review

Cited by 68 publications

References 25 publications

Challenges to the clinical placement and evaluation of adhesively-bonded, cervical composite restorations

Challenges to the clinical placement and evaluation of adhesively-bonded, cervical composite restorations

The tunnel restoration

Secondary caries and microleakage

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