Failure rates of class V restorations in the management of root caries in adults – a systematic review

Hayes, Martina; Brady, Paul; Burke, Francis; Allen, Patrick

doi:10.1111/ger.12167

Cited by 34 publications

(17 citation statements)

References 16 publications

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“…Crowns were assumed to require renewal every 12 y (Lucarotti and Burke 2009). For root surface restorations, a replacement every 4 y was assumed (Hayes et al 2016). 2) Prosthetic services: MT were assumed to require a prosthetic tooth replacement therapy, with MT ≤ 4 requiring a fixed dental prosthesis, and MT > 4 a removable dental prosthesis according to the regulations of the statutory health insurance in Germany (KZBV 2018).…”

Section: Methodsmentioning

confidence: 99%

Can We Predict Usage of Dental Services? An Analysis from Germany 2000 to 2015

Schwendicke

Krois

Jordan³

2020

JDR Clinical & Translational Research

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Objectives: We aimed to predict the usage of dental services in Germany from 2000 to 2015 based on epidemiologic and demographic data, and to compare these predictions against claims within the statutory health insurance. Methods: Indicators for operative (number of coronally decayed or filled teeth, root surface caries lesions, and fillings), prosthetic (number of missing teeth), and periodontal treatment needs (number of teeth with probing pocket depths (PPDs) ≥ 4 mm) from nationally representative German Oral Health Studies (1997, 2005, 2014) were cross-sectionally interpolated across age and time, and combined with year- and age-specific population estimates. These, as well as the number of children eligible for individual preventive services (aged 6 to 17 y), were adjusted for age- and time-specific insurance status and services’ utilization to yield predicted usage of operative, prosthetic, periodontal, and preventive services. Cumulative annual usage in these 4 services groups were compared against aggregations of a total of 24 claims positions from the statutory German health insurance. Results: Morbidity, utilization, and demography were highly dynamic across age groups and over time. Despite improvements of individual oral health, predicted usage of dental services did not decrease over time, but increased mainly due to usage shifts from younger (shrinking) to older (growing) age groups. Predicted usage of operative services increased between 2000 and 2015 (from 52 million to 56 million, +7.8%); predictions largely agreed with claimed services (root mean square error [RMSE] 1.9 million services, error range −4.6/+3.8%). Prosthetic services increased (from 2.4 million to 2.6 million, +11.9%), with near perfect agreement to claimed data [RMSE 0.1 million services, error range −8.3/+3.9%]). Periodontal services also increased (from 21 million to 27 million, +25.9%; RMSE 5.2 million services, error range +21.9/+36.5%), as did preventive services (from 22 million to 27 million, +20.4%; RMSE 3 million, error range −13.7/−4.7%). Conclusion: Predicting dental services seems viable when accounting for the joint dynamics of morbidity, utilization, and demographics. Knowledge Transfer Statement: Based on epidemiologic and demographic data, predicting usage of certain dental services is viable when accounting for the dynamics of morbidity, utilization, and demographics.

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Section: Methodsmentioning

confidence: 99%

Can We Predict Usage of Dental Services? An Analysis from Germany 2000 to 2015

Schwendicke

Krois

Jordan³

2020

JDR Clinical & Translational Research

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“…Further trials should account for the expectedly high attrition rates in the target population in their power calculation. Third, the failure rates of both ART and CT restorations were high, which illustrates the challenges of restoring root caries lesions in institutionalised older patients and calls into question if restorative approaches in these situations are generally an appropriate therapy. Alternative non‐invasive treatment options (eg application of silver diamine fluoride (SDF)) may be effective for managing root caries lesions without restoring them .…”

Section: Discussionmentioning

confidence: 99%

“…Third, the failure rates of both ART and CT restorations were high, which illustrates the challenges of restoring root caries lesions in institutionalised older patients 32 and calls into question if restorative approaches in these situations are generally an appropriate therapy.…”

Section: Due To Its Reduced Instrumental and Technical Requirementsmentioning

confidence: 99%

Atraumatic vs conventional restorative treatment for root caries lesions in older patients: Meta‐ and trial sequential analysis

et al. 2019

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Objectives We aimed to appraise the comparative clinical efficacy of atraumatic restorative treatment (ART) versus conventional restorative treatment (CT) using a meta‐analysis, and assessed the robustness of evidence by trial sequential analysis (TSA). Background Due to its simplified clinical approach, ART may be advantageous over CT for restoration of root caries lesions in institutionalised older patients. Methods Three electronic databases (PubMed, Embase and Cochrane CENTRAL) were screened, and hand searches and cross‐referencing performed to identify randomised controlled trials reporting on survival of ART vs CT for restoration of root caries in older patients. Trial selection, data extraction and risk of bias assessment were performed by two independent reviewers. ART and CT were compared using fixed‐ or random‐effects pairwise meta‐analysis for per‐protocol (PP), intention‐to‐treat (ITT) and best‐case scenarios. TSA was used to control for risk of random errors. Results A total of 235 studies were identified, and three trials involving 130 patients (463 restorations) were included. Risk of bias was high or moderate in all but one trial. ART was associated with a significantly increased risk of failure (OR [95% CI] 2.06 [1.06/4.00]) in PP‐ but not in ITT analysis (1.36 [0.92/2.02]). Analyses for best‐case scenarios found great uncertainty introduced by attrition. No firm evidence was reached according to TSA. Conclusions For restoration of root caries, there is insufficient data to clearly rule out whether differences between ART and CT exist. Limited available data indicate there might be an increased risk of failure for ART.

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“…However, previous studies indicated that a commercial resin-modified glass ionomer was not potent enough to inhibit bacterial growth and biofilm formation [22]. In addition, glass ionomer cement was relatively less esthetic for anterior teeth and cervical lesions [50]. Therefore, the present study focused on developing an antibacterial and remineralizing composite for Class V restorations, because it is highly desirable to develop a novel multifunctional composite for Class V restoration to achieve remineralization to strengthen and protect the root structures, while being able to inhibit cariogenic and periodontitis-related pathogens.…”

Section: Discussionmentioning

confidence: 99%

Combining Bioactive Multifunctional Dental Composite with PAMAM for Root Dentin Remineralization

et al. 2017

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Objectives. The objectives of this study were to: (1) develop a bioactive multifunctional composite (BMC) via nanoparticles of amorphous calcium phosphate (NACP), 2-methacryloyloxyethyl phosphorylcholine (MPC), dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of silver (NAg); and (2) investigate the effects of combined BMC + poly (amido amine) (PAMAM) on remineralization of demineralized root dentin in a cyclic artificial saliva/lactic acid environment for the first time. Methods. Root dentin specimens were prepared and demineralized with 37% phosphoric acid for 15 s. Four groups were prepared: (1) root dentin control; (2) root dentin with BMC; (3) root dentin with PAMAM; (4) root dentin with BMC + PAMAM. Specimens were treated with a cyclic artificial saliva/lactic acid regimen for 21 days. Calcium (Ca) and phosphate (P) ion concentrations and acid neutralization were determined. The remineralized root dentin specimens were examined via hardness testing and scanning electron microscopy (SEM). Results. Mechanical properties of BMC were similar to commercial control composites (p = 0.913). BMC had excellent Ca and P ion release and acid-neutralization capability. BMC or PAMAM alone each achieved slight mineral regeneration in demineralized root dentin. The combined BMC + PAMAM induced the greatest root dentin remineralization, and increased the hardness of pre-demineralized root dentin to match that of healthy root dentin (p = 0.521). Significance. The excellent root dentin remineralization effects of BMC + PAMAM were demonstrated for the first time. BMC + PAMAM induced effective and complete root dentin remineralization in an acid challenge environment. The novel BMC + PAMAM method is promising for Class V and other restorations to remineralize and protect tooth structures.

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Failure rates of class V restorations in the management of root caries in adults – a systematic review

Cited by 34 publications

References 16 publications

Can We Predict Usage of Dental Services? An Analysis from Germany 2000 to 2015

Can We Predict Usage of Dental Services? An Analysis from Germany 2000 to 2015

Atraumatic vs conventional restorative treatment for root caries lesions in older patients: Meta‐ and trial sequential analysis

Combining Bioactive Multifunctional Dental Composite with PAMAM for Root Dentin Remineralization

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