The great dental amalgam debate

Sanderson, Susie

doi:10.1038/s41415-022-5217-3

Cited by 6 publications

(3 citation statements)

References 2 publications

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“…The longevity of a restoration is multifactorial, as it depends on the handling, the operator, the adhesion capacity of the material, the way it is applied, in addition to factors related to the patient [47]. Although amalgam remains a restorative material of choice in different countries, given the current evidence and evolution of restorative materials, it is necessary to implement preventive procedures, as well as select and develop materials with less invasive approaches [89,90]. Thus, although the amalgam with uoride is ranked as one of the best materials for the control of SC in permanent teeth, at a follow-up of 2 years or more, this material was discontinued in the dental trade and is not currently available for clinical use.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of bioactive restorative materials in controlling secondary caries: a systematic review and network meta-analysis

Pinto

Jorge

Vasconcelos

et al. 2023

Preprint

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Background: This systematic review and network meta-analysis aimed to compare the clinical efficacy of bioactive and conventional restorative materials in controlling secondary caries (SC) and to provide a classification of these materials according to their effectiveness. Methods: A search was performed in Pubmed, Web of Science, Embase, BBO, Lilacs, Cochrane Library, Scopus, IBECS and gray literature. Clinical trials were included, with no language or publication date limitations. Paired and network meta-analyses were performed with random-effects models, comparing treatments of interest and classifying them according to effectiveness in the permanent and deciduous dentition and at 1-year or 2/more years of follow-up. The risk of bias was evaluated based on the Cochrane guidelines. Results: Sixty-two studies were included in the qualitative syntheses and 39 in the quantitative ones. In permanent teeth, resin composite (RC) (RR=2.00; 95%CI = 1.10, 3.64) and amalgam (AAG) (RR=1.79; 95%CI = 1.04, 3.09) showed a higher risk of SC than Glass Ionomer Cement (GIC). In the deciduous teeth, however, a higher risk of SC was observed with RC than with AAG (RR=2.46; 95%CI = 1.42, 4.27) and in GIC when compared to Resin-Modified Glass Ionomer Cement (RMGIC=1.79; 95%CI = 1.04, 3.09). Most articles showed low or moderate risk of bias. Conclusion: There is a difference between bioactive restorative materials for SC control, with GIC being more effective in the permanent teeth and the RMGIC in the deciduous teeth. Bioactive restorative materials can be adjuvants in the control of SC in patients at high risk for caries.

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy of bioactive restorative materials in controlling secondary caries: a systematic review and network meta-analysis

Pinto

Jorge

Vasconcelos

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The longevity of a restoration is multifactorial, as it depends on the handling, the operator, the adhesion capacity of the material, the way it is applied, in addition to factors related to the patient [ 49 ]. Although amalgam remains a restorative material of choice in different countries, given the current evidence and evolution of restorative materials, it is necessary to implement preventive procedures, as well as select and develop materials with less invasive approaches [ 90 , 91 ]. Thus, although the amalgam with fluoride is ranked as one of the best materials for the control of SC in permanent teeth, at a follow-up of 2 years or more, this material was discontinued in the dental trade and is not currently available for clinical use.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of bioactive restorative materials in controlling secondary caries: a systematic review and network meta-analysis

et al. 2023

View full text Add to dashboard Cite

Background This systematic review and network meta-analysis aimed to compare the clinical efficacy of bioactive and conventional restorative materials in controlling secondary caries (SC) and to provide a classification of these materials according to their effectiveness. Methods A search was performed in Pubmed, Web of Science, Embase, BBO, Lilacs, Cochrane Library, Scopus, IBECS and gray literature. Clinical trials were included, with no language or publication date limitations. Paired and network meta-analyses were performed with random-effects models, comparing treatments of interest and classifying them according to effectiveness in the permanent and deciduous dentition and at 1-year or 2/more years of follow-up. The risk of bias and certainty of evidence were evaluated. Results Sixty-two studies were included in the qualitative syntheses and 39 in the quantitative ones. In permanent teeth, resin composite (RC) (RR = 2.00; 95%CI = 1.10, 3.64) and amalgam (AAG) (RR = 1.79; 95%CI = 1.04, 3.09) showed a higher risk of SC than Glass Ionomer Cement (GIC). In the deciduous teeth, however, a higher risk of SC was observed with RC than with AAG (RR = 2.46; 95%CI = 1.42, 4.27) and in GIC when compared to Resin-Modified Glass Ionomer Cement (RMGIC = 1.79; 95%CI = 1.04, 3.09). Most randomized clinical trials studies showed low or moderate risk of bias. Conclusion There is a difference between bioactive restorative materials for SC control, with GIC being more effective in the permanent teeth and the RMGIC in the deciduous teeth. Bioactive restorative materials can be adjuvants in the control of SC in patients at high risk for caries.

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“…With the phase-out of amalgam fillings, the dental composite is the major alternative. The composite, however, is more expensive and time-consuming to place in addition to having higher failure rates [2]. The most common cause of dental composites' failure is recurrent caries [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Effects of Novel Dental Composites on Streptococcus mutans Biofilms

Yaghmoor,

Abdel-Hadi,

Petridis

et al. 2023

JFB

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With the phase-out of amalgam and the increase in minimally invasive dentistry, there is a growing need for high-strength composite materials that can kill residual bacteria and promote tooth remineralization. This study quantifies how antibacterial polylysine (PLS) and re-mineralizing monocalcium phosphate monohydrate (MCPM) affect Streptococcus mutans biofilms and the strength of dental composites. For antibacterial studies, the MCPM-PLS filler percentages were 0-0, 8-4, 12-6, and 16-8 wt% of the composite filler phase. Composite discs were immersed in 0.1% sucrose-supplemented broth containing Streptococcus mutans (UA159) and incubated in an anaerobic chamber for 48 h. Surface biomass was determined by crystal violet (CV) staining. Growth medium pH was measured at 24 and 48 h. Biofilm bacterial viability (CFU), exo-polysaccharide (water-soluble glucan (WSG) and water-insoluble glucan (WIG)), and extracellular DNA (eDNA) were quantified. This was by serial dilution plate counting, phenol-sulfuric acid microassay, and fluorometry, respectively. The biaxial flexural strengths were determined after water immersion for 1 week, 1 month, and 1 year. The MCPM-PLS wt% were 8-4, 8-8, 16-4 and 16-8. The normalized biomass, WSG, and WIG showed a linear decline of 66%, 64%, and 55%, respectively, as the PLS level increased up to 8%. The surrounding media pH (4.6) was all similar. A decrease in bacterial numbers with the 12-6 formula and a significant reduction with 16-8 compared to the 0-0 formulation was observed. The eDNA concentrations in biofilms formed on 12-6 and 16-8 formulations were significantly less than the 0-0 control and 8-4 formulations. Doubling MCPM and PLS caused a 14 and 19% reduction in strength in 1 week, respectively. Average results were lower at 1 month and 1 year but affected less upon doubling MCPM and PLS levels. Moreover, a 4% PLS may help to reduce total biomass and glucan levels in biofilms on the above composites. Higher levels are required to reduce eDNA and provide bactericidal action, but these can decrease early strength.

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The great dental amalgam debate

Cited by 6 publications

References 2 publications

Clinical efficacy of bioactive restorative materials in controlling secondary caries: a systematic review and network meta-analysis

Clinical efficacy of bioactive restorative materials in controlling secondary caries: a systematic review and network meta-analysis

Clinical efficacy of bioactive restorative materials in controlling secondary caries: a systematic review and network meta-analysis

Effects of Novel Dental Composites on Streptococcus mutans Biofilms

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