Scoping review of trials evaluating adhesive strategies in pediatric dentistry: where do simplified strategies lie?

Abstract

Background Adhesive restorations allow a conservative approach to caries management and are increasingly used as a restorative option in pediatric dentistry. Placement can be difficult in children because of the cooperation required for multiple bonding steps. Due to this, it is vital to assess if novel, simpler strategies have been featured in clinical trials and if clinical trials are researching the different existing adhesive strategies. Methods This review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis adapted for Scoping Reviews (PRISMA-ScR) guidelines. PubMed/Medline, Cochrane Central, Scopus and EMBASE were used for systematic search, using free keywords and controlled search terms. Clinical trials of children requiring a restorative intervention which featured adhesive strategies were included. Only peer-reviewed trials of primary teeth restored with resin composites, published in the last 10-year period were eligible. Data charting was accomplished independently by two reviewers, and studies were summarized according to their date, type, intervention, sample size, observation period, outcomes and conclusions. Quality assessment was performed using Cochrane’s Risk of Bias 2.0 tool. Results 700 potentially relevant references were found, which after a rigorous inclusion scheme, resulted in a total of 8 eligible clinical trials. Out of these, 7 were randomized clinical trials. Most trials featured a split-mouth design and the observation period ranged from 12 to 36 months. The trials evaluated interventions of two self-adhesive composites, two bulk-fill composites, two novel composites, one compomer and eight adhesives from different strategies. Most studies (4/8) included were judged to raise some concerns regarding risk of bias, while two were classified as high risk and two as low. Conclusion Few studies comparing adhesive strategies were found, especially adhesives in sound substrates. The existing studies do not reflect all current approaches that could be used in pediatric dentistry. Further studies addressing bioactive composites and contemporary adhesives are necessary.

Clinical Effectiveness of Restorative Materials for the Restoration of Carious Primary Teeth: An Umbrella Review

“…Literature searches in most reviews were performed within MEDLINE, Science–Direct, Web of Science, Google Scholar, Cochrane, and Embase databases, with two reviews [ 20 , 26 ] restricted to MEDLINE and EMBASE and another two [ 27 , 28 ] solely to MEDLINE. Two reviews also explored grey literature and dissertations [ 29 , 30 ] and four checked the National Institutes of Health and the World Health Organization International Clinical Trials Registry for ongoing trials [ 29 , 30 , 31 , 32 ]. A timeframe was defined from 1966 to 2021, with one review narrowing it between 1996 and 2017 [ 8 ], one between 2012 and 2016 [ 20 ], and one reporting a 10-year time frame [ 32 ].…”

“…Two reviews also explored grey literature and dissertations [ 29 , 30 ] and four checked the National Institutes of Health and the World Health Organization International Clinical Trials Registry for ongoing trials [ 29 , 30 , 31 , 32 ]. A timeframe was defined from 1966 to 2021, with one review narrowing it between 1996 and 2017 [ 8 ], one between 2012 and 2016 [ 20 ], and one reporting a 10-year time frame [ 32 ]. Most studies placed no language restrictions, apart from three reviews [ 28 , 32 , 33 ] that included studies only published in English.…”

“…A timeframe was defined from 1966 to 2021, with one review narrowing it between 1996 and 2017 [ 8 ], one between 2012 and 2016 [ 20 ], and one reporting a 10-year time frame [ 32 ]. Most studies placed no language restrictions, apart from three reviews [ 28 , 32 , 33 ] that included studies only published in English.…”

“…Nine reviews included only randomized control trials (RCTs), three included both RCTs and non-RCTs [ 8 , 27 , 32 ], one included both RCTs and an observational study [ 34 ] and one included nine RCTs, one longitudinal study and one study with no information regarding its design [ 28 ] ( Table 1 ). From the available data, 80 primary studies were of split-mouth design, and 70 of parallel-arm design.…”

Determination of Dental Adhesive Composition throughout Solvent Drying and Polymerization Using ATR–FTIR Spectroscopy

“…Clinicians often opt for simplified single-component adhesives. These require fewer time-consuming clinical steps and reduce the possibility of errors [3,29]. Whilst OS is used following tooth etch and rinse, OU can be applied with or without tooth etching and GB is self-etching.…”