DENTAL-2572; No. of Pages 16

ARTICLE IN PRESS d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

Available online at www.sciencedirect.com

ScienceDirect journal homepage: www.intl.elsevierhealth.com/journals/dema

Review

Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations? A systematic review and meta-analysis Alessandra Reis a,∗ , Alessandro Dourado Loguercio a , Marcos Schroeder b , Issis Luque-Martinez a , Danielle Masterson c , Lucianne Cople Maia d a

Department of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748–Uvaranas, Ponta Grossa, PR, CEP 84030-900, Brazil b Department of Dental Materials, Federal University of Rio de Janeiro, School of Dentistry, Cidade Universitária, RJ, CEP 21941-971, Brazil c Federal Universityof Rio de Janeiro. Library. Cidade Universitária, RJ, CEP 21941-971, Brazil d Department of Orthodontic and Pediatric Dentistry, Federal University of Rio de Janeiro, Departament of Pediatric Dentistry, 68066–Cidade Universitária, RJ, CEP 21941-971, Brazil

a r t i c l e

i n f o

a b s t r a c t

Article history:

Objectives. A systematic review and meta-analysis were performed on the risk and intensity

Received 24 September 2014

of postoperative sensitivity (POS) in posterior resin composite restorations bonded with

Received in revised form

self-etch (SE) and etch-and-rinse (ER) adhesives.

7 January 2015

Source. A comprehensive search was performed in the MEDLINE via PubMeb, Scopus, Web of

Accepted 1 June 2015

Science, LILACS, BBO and Cochrane Library and SIGLE without restrictions. The abstracts of

Available online xxx

the annual conference of the IADR (1990–2014), unpublished and ongoing trials registry were also searched. Dissertations and theses were searched using the ProQuest Dissertations and

Keywords:

Periodicos Capes Theses databases.

Adhesive system

Study selection. We included randomized clinical trials that compared the clinical effective-

Posterior restoration

ness of SE and ER used for direct resin composite restorations in permanent dentition of

Randomized clinical trials

adult patients. The risk/intensity of POS was the primary outcome. The risk of bias tool

Systematic review

of the Cochrane Collaboration was used. The meta-analysis was performed on the studies

Postoperative sensitivity

considered ‘low’ risk of bias. Data. After duplicates removal, 2600 articles were identified but only 29 remained in the qualitative synthesis. Five were considered to be ‘high’ risk of bias and eleven were considered to be ‘unclear’ in the key domains, yielding 13 studies for meta-analysis. The overall relative risk of the spontaneous POS was 0.63 (95% CI 0.35 to 1.15), while the stimuli-induced

∗ Corresponding author at: Universidade Estadual de Ponta Grossa–Mestrado em Odontologia, Rua Carlos Cavalcanti, 4748, Bloco M, Sala 64A–Uvaranas, Ponta Grossa, Paraná, 84030-900, Brazil. E-mail addresses: reis [email protected], [email protected] (A. Reis).

http://dx.doi.org/10.1016/j.dental.2015.06.001 0109-5641/© 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

DENTAL-2572; No. of Pages 16

2

ARTICLE IN PRESS d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

POS was 0.99 (95% CI 0.63 to 1.56). The overall standardized mean difference was 0.08 (95%CI −0.19 to 0.35). No overall effect was revealed in the meta-analyses, meaning that no influence of the ER or SE strategy on POS. Significance. The type of adhesive strategy (ER or SE) for posterior resin composite restorations does not influence the risk and intensity of POS. CRD42014006617. © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Contents 1. 2.

3.

4.

1.

Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .00 Materials and methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 2.1. Protocol and registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 2.2. Information sources and search strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 2.3. Eligibility criteria. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .00 2.4. Study selection and data collection process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 2.5. Risk of bias in individual studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 2.6. Summary measures and synthesis of the results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 3.1. Characteristics of included articles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 3.2. Assessment of the risk of bias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 3.3. Meta-analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00

Introduction

The demand for esthetic restorations, the increased fear of amalgam toxicity [1,2] and the environmental problems [3,4] associated with mercury have increasingly led universities to teach resin composite for restorations of posterior cavities in many countries [5–8]. Despite the current good performance of resin composite in posterior teeth [9,10], postoperative sensitivity (POS) [11–13] was already mentioned to be a problem with resin composite restorations. Early clinical studies have also indicated that up to 30% of the study populations have reported POS following placement of a posterior resin composite restoration [14–18], which were mostly attributed to the use of total-etch adhesives (nowadays named etch-and-rinse systems). Etch-and-rinse systems employ a phosphoric acid to etch enamel and dentin prior to the application of the bonding solution. As a consequence, the smear layer is removed and the dentin tubules are opened, increasing the dentin permeability and hydraulic conductance of dentin [19]. During etching, an excessive demineralization may occur reducing the chances for a complete monomer impregnation into the demineralized dentin [20]. An incomplete monomer penetration due to over-etching or inadequate adhesive application may leave voids in the hybridized area as well as denuded collagen fibrils allowing dentin fluid movement [21], under occlusal stress, extreme temperatures and sweet stimuli. This, in turn, sensitizes the nerve endings in the dentin tubules and causes POS. This fact has led to a widespread belief that self-etch systems lowers the risk of POS [22] as they do not remove, but

incorporate the smear layer in the hybridized complex with the advantage of being less technique-sensitive [23]. Although there is a biological plausibility behind this belief with some clinical studies reaching this conclusion [24,25], the perception that self-etch adhesives cause less POS than etch-and-rinse systems seems to be more anecdotal than an evidence-based finding [26], as other clinical trials do not support this trend [27–31]. Recently a meta-analysis has pointed out that POS is a very infrequent finding, not affected by the type of adhesive strategy (ER or SE) employed [32]. This study [32] has some limitations. Firstly, the authors have not applied a broad and sensitive search strategy and only one database was used. Secondly, the authors have not searched the grey literature, which is important to minimize publication bias. Lastly, the risk of bias of the included studies was not evaluated, possibly leading to a biased conclusion. Therefore, we aimed to conduct a systematic review to identify the following focused question: Does the use of a self-etch adhesive compared with an etch-and-rinse system influence the risk and intensity of POS in adult patients with posterior restorations?

2.

Materials and methods

2.1.

Protocol and registration

We registered this study protocol at the PROSPERO database under the registration number CRD42014006617, and we followed the recommendations of the PRISMA statement for the report of this systematic review [33].

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

DENTAL-2572; No. of Pages 16

ARTICLE IN PRESS d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

2.2.

Information sources and search strategy

The controlled vocabulary (mesh terms) and free keyword in the search strategy were defined based on the PICOS question: 1. Population (P): adult patients with the need of posterior restorations. 2. Intervention (I): placement of resin composite restorations with self-etch adhesives. 3. Comparison (C): the intervention should be compared with a resin composite restorations placed with an etch-andrinse adhesive. 4. The outcome (O) risk of postoperative sensitivity was not used in the search strategy to maximize the sensitivity over the specificity of the search strategy. 5. Study design (S): randomized clinical trials.

in the POS up to 1 month after restoration placement. The risk/intensity of POS was the primary outcome of the study. Non-controlled clinical trials, editorial letters, pilot studies, historical reviews, in vitro studies, cohort, observational and descriptive studies, such as case reports and case series were excluded. Additionally, RCT studies were excluded if (1) other types of cavity were treated other than class I and class II; (2) bases or liners were always used before adhesive application; (3) silorane-based adhesives were employed; (4) chemicallycured adhesives were used; (5) the restorations were placed in primary teeth; (6) resin cements were involved in the bonding protocol such as for indirect restorations; (7) polyacid modified resin composites instead of resin composites were employed as restorative materials.

2.4. To identify trials to be included for this review, we searched on the electronic databases MEDLINE via PubMeb, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO) and Cochrane Library (Table 1). An expert librarian (D.M.) guided the whole search strategy. We hand-searched the reference lists of all primary studies for additional relevant publications and the related articles link of each primary study in the PubMed database. No restrictions were placed on the publication date or languages. Other sources were also used. The abstracts of the annual conference of the International Association for Dental Research (IADR) and their regional divisions (1990–2014) were also searched and authors of relevant abstracts were contacted for further information. The grey literature (produced on all levels of government, academics, business and industry in print and electronic formats, but which is not controlled by commercial publishers) was explored using the database System for Information on Grey literature in Europe (SIGLE). Dissertations and theses were searched using the ProQuest Dissertations and Theses Fulltext database as well as the Periódicos Capes Theses database. To locate unpublished and ongoing trials, the following trials registry were also searched: Current Controlled Trials (www.controlled-trials.com), International Clinical trials registry plataform (http://apps.who.int/trialsearch/), the ClinicalTrials.gov (www.clinicaltrials.gov), Rebec (www.rebec. gov.br) and EU Clinical Trials Register (https://www. clinicaltrialsregister.eu). The search strategy along with the date of search for all databases was included in Table 1. This search strategy was appropriately modified for each database. Full text versions of the papers that meet the inclusion criteria were retrieved for further assessment and data extraction.

2.3.

Eligibility criteria

We included parallel or split-mouth randomized clinical trials (RCTs) that compared self-etch and etch-and-rinse adhesives for direct resin composite restorations in permanent dentition of adult patients of any age group. No minimum follow-up period was established since we were interested

3

Study selection and data collection process

Initially, the articles were selected by title and abstracts. Articles appearing in more than one database were considered only once. Full reports were obtained when there was insufficient information in the title and abstract to make a clear decision. Subsequently, full-text articles were acquired and two reviewers (A.R. and A.D.L.) classified those who met the inclusion criteria. Each study received an ID, combining first author and year of publication. The following details were extracted using customized extraction forms: • Details of the study including year of publication and author(s). • Details of study methods including study design and setting. • Details of participants including age and gender. • Details of the adhesives and resin composites used, including restorative protocol (methods of isolation, technique used for resin composite placement and number of operators). • Details of the outcomes including number of restorations with immediate POS and the number of dropouts. When there were multiple reports of the same study (i.e. reports with different follow-ups), data from all reports were extracted directly into a single data collection form to avoid overlapping data. The collection form was pilot tested using a sample of study reports to ensure that the criteria were consistent to the research question. When the POS was reported in different time periods, we collected the data from the shortest period.

2.5.

Risk of bias in individual studies

Two independent reviewers (A.R. and A.D.L.) performed quality assessment of the trials using the Cochrane Collaboration’s tool for assessing risk of bias in RCTs [34]. The assessment criteria contained six items: sequence generation, allocation concealment, blinding of the outcome assessors, incomplete outcome data, selective outcome reporting, and other possible sources of bias. In case of disagreements between the

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

DENTAL-2572; No. of Pages 16

4

ARTICLE IN PRESS d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

Table 1 – Electronic database and search strategy (20/06/2014).

reviewers were resolved through discussion, and if needed, by consulting a third reviewer (L.C.M). The judgment for each entry involved recording ‘yes’ indicating low risk of bias, ‘no’ indicating high risk of bias, and ‘unclear’ indicating either lack of information or uncertainty over the potential for bias, as described in the Cochrane Handbook for Systematic reviews of Interventions 5.1.0 (http://handbook.cochrane.org). Only two out of the six domains in the Cochrane risk of bias tool were considered the key domains for the assessment of the risk of bias. Studies were considered to be at ‘low’ risk of bias if there was adequate sequence generation and allocation concealment (key domains). If one or the two criteria were not met, a study would be considered at high risk of bias. When the study was judged as ‘unclear’ in their key domains, we tried to contact authors to obtain more information and allow a definitive judgment of ‘yes’ or ‘no’.

2.6.

Summary measures and synthesis of the results

The extracted data were analyzed using Revman 5 (Review Manager ver. 5, The Cochrane Collaboration, Copenhagen, Denmark). Data from eligible studies were either dichotomous (risk of POS) or continuous (POS intensity). The data on the risk of POS was grouped according to the type of POS measurement used in each clinical trial into spontaneous and stimuli-induced POS. To summarize the POS for each study, we calculated the standardized mean difference for the intensity of POS and relative risk for the risk of POS. When more than one adhesive of each type was included in the study, their values were combined to make a single entry. When the data from the original study groups were merged in the study report, authors were contacted to provide original values.

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

DENTAL-2572; No. of Pages 16

ARTICLE IN PRESS d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

5

Fig. 1 – Flow diagram of study identification.

The random-effects models were employed for the dichotomous and continuous data. Heterogeneity was assessed using the Cochran Q test and I2 statistics. All analyses were conducted using RevMan (Review Manager, version 5.3 software, Cochrane Collaboration, Copenhagen, The Netherlands).

3.

Results

3.1.

Characteristics of included articles

After the database screening and removal of duplicates, 2600 studies were identified (Fig. 1). After title screening, 190 studies remained and this number was reduced to 51 after careful examination of the abstracts. The full texts of these 51 studies were assessed to check if they were eligible. Among them, 22 were excluded due to the following reasons: (1) lack of one the studied adhesive strategies (ER or SE) [35–41],

(2) non-phosphoric acid ER adhesive [42], (3) employed glass ionomer base in all cavities [43–45], (4) retrospective study [46], (5) not conducted in posterior cavities [47,48] and (6) overlapping data [25,49–55]. The characteristics of the 29 selected studies are listed in Table 2. Few details were available in the IADR abstracts [56–60] in spite of all efforts made to contact authors for further information. Only one study [56] from these six abstracts responded the request email for further information, but it did not have access to the necessary information. The paired tooth design was very common; parallel designs were not accomplished in none of the included studies. However, there were very often multiple restorations placed per patient, with the restoration being the experimental unit. The number of operators who placed the restorations ranged from 1 to 6. Although not all studies reported the setting where the study was conducted [27,57–63], the great majority of them were performed in the university, except three. One study [64]

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

DENTAL-2572; No. of Pages 16

6

ARTICLE IN PRESS d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

was community-based; the second was conducted solely in private clinics [56] and the third one in both the university and private clinics [65] (Table 2). The number of patients included in these studies ranged from 15 to 151 participants. There was a great variability in the range of age of the participants included in the clinical trials. The great majority of the studies used the incremental filling, except one that compared incremental vs. bulk filling [12] and six studies where the filling method was not described. Rubber dam was used in most of the clinical studies. The method of assessment of POS was very variable. Most of the studies used a stimulus (cold, air, loading, etc.) to assess POS (Table 2), except seven studies where no stimulus was employed [29–31,62,63,66,67]. The measured outcome was also variable, with most studies providing the risk of POS with or without stimulus [12,27–29,31,57,59,61–63,65–75]. Other outcomes such as time to response [68,76,77] and intensity of pain after stimulation [30,64,71,73,76–78] were also observed.

Fig. 2 – Summary of the risk of bias assessment according to the he Cochrane Collaboration tool. Underlined authors provided extra information by e-mail to allow assessment of the risk of bias.

3.2.

Assessment of the risk of bias

The assessment of the risk of bias of the selected studies is presented in Fig. 2. Few full-text studies reported the method of randomization employed and how the allocation concealment was performed. As these two items were the key domains of the current systematic review, authors were contacted for further information. Eleven full texts and five abstracts [12,30,56–61,65,67–69,72–75] were considered to be of unclear or ‘high’ or ‘unclear’ risk of bias in these two items. In relation to blinding of participants and evaluators, this domain was judged ‘unclear’ or ‘high’ risk of bias in seven full text articles [28,30,31,61,67,70,74] and five abstracts [56–60]. In the domain incomplete outcome data assessment, just one study [70] was considered ‘high’ risk of bias due a high number of drop-outs, which was not balanced among groups. Other six full texts [30,71,73,74,77,78] and five IADR abstracts [56–60] were judged as ‘unclear’ as they did not report if there was missing data. Regarding selective reporting, all studies were Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

DENTAL-2572; No. of Pages 16

ARTICLE IN PRESS d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

7

Fig. 3 – Forest plot of the risk of spontaneous POS in posterior resin composite restorations performed with self-etch vs. etch-and-rinse adhesives. * Three studies [28,62,63] did not report any event in both study arms and therefore they were not included in this forest plot meta-analysis.

Fig. 4 – Forest plot of the risk of stimuli-induced POS in posterior resin composite restorations performed with self-etch vs. etch-and-rinse adhesives.

considered ‘low’ risk of bias (Fig. 2), except for the five abstracts [56–60], judged as ‘unclear’. In summary, from the 29 studies, six full-text [30,67,69,72–74] were considered to be ‘high’ risk of bias and ten [12,42,56–61,65,75] were considered to be ‘unclear’ in the key domains of the Cochrane risk of bias tool, yielding 13 studies [27–29,31,62–64,66,70,71,76–78] which met the best requirement features (randomization and allocation concealment) for quantitative analysis.

3.3.

Meta-analysis

For the meta-analysis, studies were grouped according to the kind of outcome used to report POS. This resulted in a total of nine studies [27–29,31,49,62,63,66,71], which reported the risk of POS as a dichotomous measure (Figs. 3 and 4) and five studies [53,64,71,76–78], which reported the intensity of POS in a continuous measure (Fig. 5). One study [71] reported both the risk and intensity of POS and were included in both meta-analysis. Among the nine studies, three [28,62,63] did not report any event in both study arms and therefore they were not included in the meta-analysis as they did not provide any indication of either the direction or magnitude of the relative treatment effect.

For all meta-analyses, we included data for only those participants whose results were known (available case analysis). The impact of this decision was evaluated in a sensitivity analysis where an intention-to-treat protocol was applied. No change in the overall significance was shown (data not shown). In one study with continuous data [64], the standard deviation was not reported and we imputed an arbitrary value of twice the mean. Through a sensitivity analysis, we observed that imputations of half, the same, or twice the mean did not produce significant changes in the model (data not shown). The heterogeneity of the studies included in the analysis of the risk of spontaneous POS (Fig. 3) and the risk of stimuliinduced POS (Fig. 4) was not significant (Chi2 test; p = 0.59 and p = 0.51, respectively) and the variability of the studies is probably attributed to chance alone (I2 = 0% in both analyses) than to heterogeneity. For POS intensity (Fig. 5), heterogeneity was not significant (Chi2 p = 0.06), but approximately half of variability was attributed to heterogeneity (I2 = 57%). The overall relative risk of the spontaneous POS (Fig. 3) was 0.63 (95% CI 0.35–1.15), while the stimuli-induced POS was 0.99 (95% CI 0.63–1.56). The overall standardized mean difference (Fig. 5) was 0.08 (95%CI −0.19 to 0.35). All meta-analyses on the risk of POS (p = 0.13 [Fig. 3] and p = 0.96 [Fig. 4]) and the intensity of POS (p = 0.55 [Fig. 5]) revealed no overall effect, meaning

Fig. 5 – Forest plot of the intensity of POS in posterior restorations performed with self-etch vs. etch-and-rinse adhesives. Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

DENTAL-2572; No. of Pages 16

8

ARTICLE IN PRESS d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

that the type of bonding strategy (ER or SE) employed does not influence the risk and intensity of POS in posterior resin composite restorations.

4.

Discussion

Meta-analysis takes the advantage of aggregating information with a higher statistical power for any measure of interest, as opposed to a less precise measure derived from a single study. However, this method presents some weaknesses. Meta-analysis cannot control for sources of bias of individual studies: a good meta-analysis of badly designed studies will still result in bad statistics. This means that only methodologically sound studies should be included in a meta-analysis in a practice called ‘best evidence synthesis’. This is the reason of why we have only included in the quantitative synthesis, studies classified as ‘low’ risk of bias in regard to randomization and allocation concealment, opposed to an earlier study [32]. A correct randomization guarantee that the chance of being allocated in either test or control group is the same for all patients. The most important advantage of proper randomization is that it balances both known and unknown prognostic factors in the assignment of treatments. Besides randomization, allocation concealment is equally important as it protects the randomization process, so that the treatment to be allocated is not known before the patient is enrolled into the study. The adequate management of these two domains minimizes selection bias during care of individual patients as clinical investigators in RCTs often find it difficult to maintain impartiality, which may produce non-comparable groups in baseline features. Unfortunately, the judgment of the risk of bias of these two domains was not straightforward in the 29 studies included in the qualitative synthesis (Table 2), requiring contact with authors. Many studies reported they randomized patients to groups but did not mention how this was done. In regard to allocation concealment, this information was rarely found in the articles. Future studies on posterior resin composites should detail the process of randomization and the allocation concealment to allow readers to assess the risk of bias of the studies without the need to contact the study authors. Another relevant aspect in quality assessment is blinding. Preferably, participants and personnel should be blind in relation to the treatment in order to avoid performance bias. In regard to POS, blinding of participants is even more important as the outcome is not usually measured by researchers, but reported by the participants. However, in this systematic review we did not consider blinding as a key domain. Even if the participant knew the type of adhesive being placed, this would probably not influence their response, as it would require deep understanding and knowledge on the bonding mechanism behind each adhesive type. The parallel design was not accomplished in the RCTs included. Instead, the split-mouth design was used. This design is very popular in oral health research and ideally, the two treatments should be randomly assigned to either the right or left halves of the dentition, so that each patient may experience one outcome for each treatment. The

attractiveness of the design is that it removes a lot of interindividual variability from the estimates of the treatment effect, although this is rarely taken into consideration in the statistical analysis [79]. A disadvantage of this approach is that it may cause selection bias, since it only includes participants with the need of treatment in both sides of the arcades, limiting the external validity of the study [79]. Although this does not seem to be the case in restorative procedures, split-mouth design may lead to biased treatment efficacy estimates due to carryacross effects, which should be excluded based on biological arguments. Researchers usually place many restorations per patient and consider the restoration as the experimental unit and not the patient. This should be re-evaluated in future RCTs; if multiple restorations are required per patient, perhaps the use of any summary measure per treatment would allow a better estimate of the treatment effect having the patient as the experimental unit. There is a great variation among the way researchers assess the POS (Table 2). In a rough manner, four different methods were used by authors in their reports: (1) absolute risk of POS without any stimulation (spontaneous POS); (2) absolute risk of POS after stimulation by different methods (stimuli-induced POS); (3) POS intensity after application of one or different stimulus and (4) time to response after stimulation. In the great majority of the studies, POS was not the primary study outcome. In these studies researchers assessed the POS by asking patients whether or not they experienced spontaneous POS in a specific timeframe. This measure (absolute risk of POS) has normally been based on the participant’s day-to-day experiences to various stimuli rather than a standardized, controlled stimulus. Approximately 50% of the studies [12,29,31,62,63,66–68,71–74] in Table 2 used this approach. The main criticisms to this approach [64] are that it gives equal weight to the people who have experienced different levels of tooth sensitivity, does not account for adaptive and/or protective measures the participant takes in order to minimize discomfort and may be underreported when patient outcomes are not solicited anonymously [80]. Although the use of a stimulus to assess the POS risk and intensity as well as the time to response after stimulation apparently minimizes the aforementioned shortcomings, these approaches are especially important to evaluate pulp vitality rather than POS. These methods are usually based in the assumption that POS to cold or other stimulus commonly decreases over time, while the response time usually increases. However, to produce accurate responses, the use of these approaches should be distinguished from the preoperative sensitivity, which was rarely assessed in the clinical trials [64]. Baseline tooth sensitivity may remain the same, increase/reduce or be completely eliminated by the restorative procedure. A recent study [80] from a practice-based research network reported that approximately 16% of patients without any baseline sensitivity developed it in function of the restorative treatment, while 49% of patients with baseline sensitivity reported no sensitivity after the end of restorative procedure. The aforementioned discussion explains why the studies included in the meta-analysis of the risk of POS was

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

DENTAL-2572; No. of Pages 16

Study ID

Study design/ Setting

Subjects’ age mean ± SD [range] (yrs)

# of subjects [Male %]

Placement technique [# operators]

Rubber dam

Postoperative evaluation (POS)

Stimulus

Type

Outcome evaluated

Paired/ university

36.4 ± n.r. [23–50]

28 [n.r.]

Oblique incremental [2]

Yes

Yes/No

Cold (ice stick)

Paired/ university

29.8 ± n.r. [18–60]

25 [n.r.]

Incremental [1]

When necessary

Yes

Stream of air

Risk without stimulation and time to response after stimulation (s) Risk after stimulation

Boeckler et al. [53,75]*

Paired/ university

57.0 ± n.r. [21–85]

50 [42%]

Incremental [1]

Yes

Yes

Cold (cool spray)

Risk after stimulation

Bottenberg et al. [49,70]*

Tooth as experimental unit/ university

n.r. ± n.r. [19–56]

32 [44%]

Incremental [3]

n.r.

Yes

Stream of air

Risk after stimulation

Browning et al. [64]

Paired/ community-

41 ± n.r. [38–42]

66 [32%]

Incremental [4]

n.r.

Yes/No

Cold (water at 8 ◦ C)

22.8 ± 3.8 [18–37]

72 [25%]

Incremental [1]

When necessary

Yes/No

Cold (ice stick)

Tooth sensitivity before intervention and POS intensity after stimulation (VAS 0–100) Risk without and after stimulation and POS intensity after stimulation (VAS 0–10)

based

Burrow et al. [71]

Tooth as experimental unit/ university

# Restorations [drop-outs] per group

ER–One Step Plusa + Prodigyb SE–Clearfil SE Bondc + Prodigy

28 [0] 28 [0]

ER–Scotchbond 1 XTd + Filtek Z250d SE–Adper Scotchbond SEd + Filtek Z250 ER–Excitee + Tetric Ceram HBe SE–AdheSEe + Tetric Ceram HB ER–Admira Bondf + Admiraf SE1–Etch & Prime 3.0g + Definiteg SE2–Syntac Sprinte + Tetric Cerame ER–Single Bondd + Filtek Z250d SE–Adper Prompt L-Popd + Filtek Z250

25 [0] 25 [0]

ER–Single Bond 2d –no lining + Filtek Supremed SE–Clearfil SE Bondc –no lining + Filtek Supreme (other groups of this study were not described as they did not satisfy the eligibility criteria)

50 [0] 50 [0]

101 [n.r.] 108 [n.r.]

101 [n.r.] 108 [n.r.]

d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

Akpata and Behbehani [68] Baraco et al. [52,69]*

Type of adhesive–Adhesive brand + composite resin brand

26 [n.r.] 26 [n.r.]

ARTICLE IN PRESS

9

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

Table 2 – Summary of the studies included in this systematic review.

Study ID

Study design/ Setting

Subjects’ age mean ± SD [range] (yrs)

# of subjects [Male %]

Placement technique [# operators]

Rubber dam

Postoperative evaluation (POS)

Stimulus

Type

Outcome evaluated

52 [n.r.]

Oblique incremental [1]

Yes

Yes

Cold (without details)

Risk after stimulation

Tooth as experimental unit/ university

n.r. ± n.r. [n.r.]

n.r. [n.r.]

Oblique incremental [n.r.]

n.r.

Yes/No

Risk without stimulation and after stimulation

Delbonset al. [56]

Paired/ private practice

32.6 ± n.r. [n.r.]

50 [n.r.]

n.r. [n.r.]

Yes

n.r.

Cold (cool spray); bite pressure with silicone n.r.

Denehy et al. [57]

Paired/n.r.

n.r. ± n.r. [n.r.]

36 [n.r.]

Incremental [n.r.]

Yes

n.r.

n.r.

Ermis et al. [28]

Paired/ university

33.1 ± n.r. [20–54]

33 [48%]

Incremental [1]

Yes

Yes

Gao et al. [58]

n.r./n.r.

n.r. ± n.r. [n.r.]

n.r. [n.r.]

n.r. [n.r.]

n.r.

n.r.

Stream of compressed air n.r.

Hu and Ling [59]

n.r./n.r.

n.r ± n.r. [n.r.]

72 [n.r.]

n.r. [n.r.]

n.r.

n.r.

n.r.

Kaurari and Bhagwat [61]

n.r./n.r.

n.r. ± n.r. [18–36]

38 [n.r.]

Incremental [n.r.]

Yes

Yes

Water at = / temperatures (25, 20, 15, 10, 5 ◦ C)

n.r.

Risk (unclear whether with or without stimulation) Risk after stimulation

n.r.

Risk (unclear whether with or without stimulation) Risk after stimulation

ER–Adper Single Bondd + Filtek Z250d SE–Clearfil SE Bondc + Filtek Z250 ER1–Adper Scotchbond Multi-Purpose d + Filtek Supreme d ER2–Gluma Comfort One Bond h + Filtek Supreme SE–iBond h + Filtek Supreme ER1–Optibond FLb + Filtek Z350d ER2–Optibond Solo Plusb + Filtek Z350 SE1–Optibond XTRb + Filtek Z350 SE2–Optibond All in Oneb + Filtek Z350 ER–Prime & Bond NTi + TPHi SE–Adper Prompt L-Popb + TPH

52 [n.r.] 52 [n.r.]

ER–Adper Single Bondd + Filtek Z250d SE–Clearfil SE Bondc + Filtek Z250 ER 1–n.r.–n.r. ER2–n.r.–n.r. SE–Clearfil SE Bondc + Clearfil APXc ER–n.r. SE–n.r.

ER–Prime & Bond NTi + Dyract Flowi + Surefili SE–Prompt L-Popd + Surefili (other groups of this study were not described as they did not satisfy the eligibility criteria)

7 [0] 7 [0] 7 [0]

n.r. [n.r.] n.r. [n.r.] n.r. [n.r.] n.r. [n.r.]

n.r. [n.r.] n.r. [n.r.]

44 [0] 43 [0]

n.r. [n.r.] n.r. [n.r.] n.r. [n.r.] n.r. n.r.

20 [0] 20 [0]

d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

n.r. ± n.r. [18–30]

# Restorations [drop-outs] per group

ARTICLE IN PRESS

Paired/n.r.

Casselli and Martins [27] Chermont et al. [72]

Type of adhesive–Adhesive brand + composite resin brand

DENTAL-2572; No. of Pages 16

10

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

Table 2 (Continued )

DENTAL-2572; No. of Pages 16

Study ID

Study design/ Setting

Subjects’ age mean ± SD [range] (yrs)

# of subjects [Male %]

Placement technique [# operators]

Rubber dam

Postoperative evaluation (POS)

Stimulus

Type

Outcome evaluated

Tooth as experimental unit/ university

n.r. ± n.r. [18–50]

n.r. [n.r.]

Oblique Incremental [1]

Yes

Yes/No

Cold (without details)

Risk without stimulation and POS intensity (VAS 0–10) after stimulation

Lopes et al. [54,62]*

Paired/n.r.

n.r. ± n.r. [20–40]

36 [50%]

Oblique incremental [1]

Yes

No



Risk without stimulation

Manchorova et al. [60]

Paired/n.r.

n.r. ± n.r. [n.r.]

89 [n.r.]

n.r. [n.r.]

n.r.

Yes

n.r.

Manhart et al. [50,63]*

Tooth as experimental unit/n.r. Paired/ university and private clinics Tooth as experimental unit/ university

44.3 ± n.r. [19–67]

43 [n.r.]

Incremental [3]

When necessary

No

Cold (without details) and masticatory forces –

n.r ± n.r. [16–49]

52 [52%]

Incremental [5]

When necessary

n.r.



Risk (unclear whether with or without stimulation)

44.3 ± n.r. [11–14]

25 [60%]

Bulk and incremental [2]

No

Yes/No

Occlusal pressure with a PFI 49 instrument

Risk without stimulation and risk after loading

Oberlander et al. [65]

Opdam et al. [12,25]**

Risk without stimulation

# Restorations [drop-outs] per group

ER–Scotchbond Multi-Purpose Plusd + Filtek Z350d SE1–Adper Scotchbond SEd + Filtek Z350 SE2–All Bond SEa + Filtek Z350 ER–Optibond Solob + Prodigy condensableb SE–Etch & Prime 3.0g + Definiteg ER–n.r. + Filtek Supremed SE–n.r. + Filtek Supreme

20 [n.r.] 20 [n.r.] 20 [n.r.]

ER–Syntac Classice + Tetric Cerame SE–Xeno IIIi + Quixfili ER–Solid Bondh + Solitaireh SE–Etch & Prime 3.0g + Definiteg

50 [0] 46 [0]

ER1–Scotchbond MultiPurposed + P50d (incremental) ER2–Scotchbond Multi-Purpose + P50 (bulk) SE–Clearfil Liner Bond 2c + Clearfil Ray Posteriorc (bulk)

16 [0] 16 [0] 16 [0]

40 [n.r.] 38 [n.r.]

n.r. [n.r.] n.r. [n.r.]

d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

Lobato et al. [73]

Type of adhesive–Adhesive brand + composite resin brand

52 [0] 52 [0]

ARTICLE IN PRESS

11

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

Table 2 (Continued )

Study ID

Study design/ Setting

Subjects’ age mean ± SD [range] (yrs)

# of subjects [Male %]

Placement technique [# operators]

Rubber dam

Postoperative evaluation (POS)

Type of adhesive–Adhesive brand + composite resin brand

# Restorations [drop-outs] per group

Outcome evaluated POS intensity after stimulation (VAS 0–10) and time until response (s)

ER–Prime & Bond NTi + Surefili SE–Clearfil SE Bondc + Surefil

n.r. [n.r.] n.r. [n.r.]

POS intensity after stimulation (VAS 0–10) and time until response (s)

ER–Prime & Bond NTi + Esthet-X Micro Matrixi SE–Clearfil SE Bondc + Clearfil AP-Xc

36 [n.r.] 30 [n.r.]

Risk without stimulation

ER–One Step Plusa + Filtek Supremed SE1–Adper Prompt L-Popd + Filtek Supreme SE2–Clearfil S3 Bondc + Filtek Supreme SE3–iBondh + Filtek Supreme ER1–Prime & Bond NTi + Venush ER2–Single Bondd + Venus SE1–iBondh + Venus SE2–Optibond Solo Plus Self-Etchb + Venus ER–Optibond FLb + Herculite XRVb SE1–Clearfil Protect Bondc + Clearfil AP-Xc SE2–iBondh + Charismah

31 [0] 31 [0] 29 [0] 30 [0]

Perdigão et al. [76]

Tooth as experimental unit/ university

n.r ± n.r. [20–54]

44 [n.r.]

Incremental [5]

Yes

Yes/No

Perdigão et al. [77]

Tooth as experimental unit/ university

n.r ± n.r. [21–54]

25 [28%]

Incremental [2]

Yes

Yes/No

Perdigão et al. [29,51]***

Paired/ university

30.7 ± n.r. [18–56]

38 [n.r.]

Incremental [5]

Yes

No

Cold (ice stick); Stream of air; under masticatory forces Cold (ice stick); Stream of air; under masticatory forces –

Perry [30]

Paired/ university

n.r ± n.r. [n.r.]

36 [n.r.]

n.r. [1]

n.r.

No



POS intensity in a ordinal scale (1–5)

Sancakli et al. [78]

Tooth as experimental unit/ university

n.r ± n.r. [18–30]

39 [n.r.]

Incremental [2]

No

Yes

Cold (ice stick) and stream of air

POS intensity after stimulation

12 [n.r.] 12 [n.r.] 36 [n.r.] 12 [n.r]

63 [n.r.] 63 [n.r.] 62 [n.r.]

d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

Type

ARTICLE IN PRESS

Stimulus

DENTAL-2572; No. of Pages 16

12

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

Table 2 (Continued )

DENTAL-2572; No. of Pages 16

Study ID

Sundfeld et al. [66]

Swift et al. [31]

Van Dijken and Pallesen [67]

Subjects’ age mean ± SD [range] (yrs)

# of subjects [Male %]

Placement technique [# operators]

Rubber dam

Postoperative evaluation (POS)

Stimulus

Type

Outcome evaluated

Type of adhesive–Adhesive brand + composite resin brand

# Restorations [drop-outs] per group

Tooth as experimental unit/ university Paired/ university

n.r ± n.r. [13–21]

15 [33%]

Oblique incremental [2]

Yes

No



Risk without stimulation

ER–Adper Single Bond Plusd + Filtek Supreme Plusd SE–Adper Scotchbond SE Plusd + Filtek Supreme Plus

48 [0] 49 [0]

n.r ± n.r. [19–51]

21 [n.r.]

Incremental [6]

When necessary

No#



Risk without stimulation

30 [0] 30 [0]

Tooth as experimental unit/ university

n.r ± n.r. [18–83]

151 [59%]

n.r. [n.r.]

n.r.

Yes/No

Thermal sensitivity (without details) and POS to percurssion

Risk with and without stimulation

Tooth as experimental unit/ university

52.7 ± n.r. [28–86]



Risk without stimulation

ER–Optibond Solo Plusb + Point 4b SE–Xeno IVi + Esthet-Xi ER–Bond Well LCj SE1–Clearfil Liner Bond IIc SE2–FluoroBondk SE3–Mac Bond IIl (other groups of this study were not described as they did not satisfy the eligibility criteria) ER–Excitee + Ceram Xi SE–Xeno IIIi + Ceram Xi

78 [44%]

Oblique incremental [4]

No

No

45 [n.r.] SE1 + SE2 + SE3 = 197 [n.r.] (authors did not specify per group

72 [1] 93 [2]

13

ID–identification; SD–standard deviation; yrs–years; #–number; ER–etch-and-rinse adhesive; SE–self-etch adhesive; n.r.–not reported in the study; POS–postoperative sensitivity; VAS–visual analogue scale. * Two reports of the same study at different follow-ups; both reports were used for extraction of data from the methodology but the outcomes were extracted from the most recent study. ** Two reports with the same data reported under different objectives–both were used for extraction of data from the methodology but the outcomes were extracted from the paper [12] with reduced number of groups. *** Two reports of the same study at different follow-ups; both reports were used for data extraction from the methodology but the outcomes were extracted from the paper with higher sample size [29]. # The authors did not use any stimulus for the immediate POS evaluation, but the 6-month evaluation. a Bisco Inc. Schaumburg, IL, USA. b Kerr, Orange, CA, USA. c Kuraray, Tokyo, Japan. d 3 M ESPE, St. Paul, MN, USA. e Ivoclar Vivadent; Schaan, Liechtenstein. f Voco, Cuxhaven, Germany. g Heraeus Kulzer,Wehrheim, Germany. h Degussa, Hanau, Germany. i Dentsply DeTrey, Konstanz, Germany. j GC Corporation, Tokyo, Japan. k Shofu, Kyoto, Japan. l Tokuyama Dental, Tokyo, Japan.

d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

Unemori et al. [74]

Study design/ Setting

ARTICLE IN PRESS

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

Table 2 (Continued )

DENTAL-2572; No. of Pages 16

14

ARTICLE IN PRESS d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

grouped based on the type of POS measurement into spontaneous POS and stimuli-induced POS. Irrespective of the method employed, the pooled data of the ratio risks from all RCTs included in the meta-analysis revealed that the type of adhesive strategy (ER or SE) used did not affect the risk of POS in posterior resin composite restorations. Similar conclusion was observed for the POS intensity, although with a higher, but non-significant heterogeneity. The extrapolation of these conclusions to the overall practice should be done with caution. A meta-analysis provides at the best of the cases, a good estimate of the pooled data of the individual RCTs. Therefore; the results of this study can only be generalized to the similar conditions to which the individual RCTs were performed. The university setting is more appropriate for determining a material’s optimal performance, while a practice-based setting investigates a material’s typical performance. The great majority of the studies included in the meta-analysis were conducted in a university setting, in which restorations were placed under ideal conditions to produce restorations as near perfect as possible. Calibrated and experienced operators with deep knowledge about the techniques and materials usually place restorations without time constraints. This may explain the difference of the pooled data of the RCTs herein collected with the results of a practice-based study [46], in which selfetch systems favored the reduction in the greatest sensitivity (post-treatment score minus the value at baseline after several stimuli) [46]. Additionally, the individual RCT studies included Class I and Class II cavities without any restriction. This means that the results of the individual studies were a pooled effect of posterior restorations irrespective of the size, depth and complexity of the posterior cavities. Previous studies [81,82] reported that the risk of POS is correlated with the complexity of the restoration. A higher risk of POS was associated with Class II MOD restorations, followed by Class II MO/DO and Class I restorations [81]. The other study [82] reported that clinical cavity depth was the only factor with significant influence on the appearance of POS. Whether or not the use of different adhesive strategies into more complex situations would yield similar risk of POS is yet to be addressed and could be focus of future RCTs. In summary, one may conclude that the type of adhesive strategy (ER or SE) for posterior resin composite restoration does not seem to influence the risk and intensity of POS. However further studies should be conducted to evaluate if this is still applied for large and deep posterior resin composite restorations.

Acknowledgments This study was conducted during the post-doctoral stage of Alessandra Reis under the supervision of the Prof. Lucianne Copple-Maia. The authors of this study would like to thank the following authors who kindly provided information not available in their full texts: Denise Maia, Edward Swift, Hande Sar Sanckali, Jan Van Dijken, Jorge Perdigão, Lawrence Lopes, Marcelo Lobato, Maristela Dutra Correa, Schmalz Gottfried, Renato Sundfeld and Willian David Browning. This study

was partially supported by National Council for Scientific and Technological Development under grants 301937/2009-5, 301891/2010-9, and 301291/2010-1.

references

[1] Rathore M, Singh A, Pant VA. The dental amalgam toxicity fear: a myth or actuality. Toxicol Int 2012;19:81–8. [2] Roberts HW, Charlton DG. The release of mercury from amalgam restorations and its health effects: a review. Oper Dent 2009;34:605–14. [3] al-Shraideh M, al-Wahadni A, Khasawneh S, al-Shraideh MJ. The mercury burden in waste water released from dental clinics. SADJ 2002;57:213–5. [4] Arenholt-Bindslev D. Dental amalgam–environmental aspects. Adv Dent Res 1992;6:125–30. [5] Motisuki C, Lima LM, dos Santos-Pinto L, Guelmann M. Restorative treatment on Class I and II restorations in primary molars: a survey of Brazilian dental schools. J Clin Pediatr Dent 2005;30:175–8. [6] Lynch CD, McConnell RJ, Wilson NH. Teaching of posterior composite resin restorations in undergraduate dental schools in Ireland and the United Kingdom. Eur J Dent Educ 2006;10:38–43. [7] Liew Z, Nguyen E, Stella R, Thong I, Yip N, Zhang F, Burrow MF, Tyas MJ. Survey on the teaching and use in dental schools of resin-based materials for restoring posterior teeth. Int Dent J 2011;61:12–8. [8] Ben-Gal G, Weiss EI. Trends in material choice for posterior restorations in an Israeli dental school: composite resin versus amalgam. J Dent Educ 2011;75:1590–5. [9] Pallesen U, van Dijken JW, Halken J, Hallonsten AL, Hoigaard R. A prospective 8-year follow-up of posterior resin composite restorations in permanent teeth of children and adolescents in Public Dental Health Service: reasons for replacement. Clin Oral Investig 2014;18(3):819–27. [10] Opdam NJ, Bronkhorst EM, Loomans BA, Huysmans MC. 12-year survival of composite vs. amalgam restorations. J Dent Res 2010;89:1063–7. [11] Eick JD, Welch FH. Polymerization shrinkage of posterior composite resins and its possible influence on postoperative sensitivity. Quintessence Int 1986;17:103–11. [12] Opdam NJ, Feilzer AJ, Roeters JJ, Smale I. Class I occlusal composite resin restorations: in vivo post-operative sensitivity, wall adaptation, and microleakage. Am J Dent 1998;11:229–34. [13] Lacy AM. A critical look at posterior composite restorations. J Am Dent Assoc 1987;114:357–62. [14] Brunson WD, Bayne SC, Shurdevant JR, Roberson TM, Wilder AD, Taylor DF. Three-year clinical evaluation of a self-cured posterior composite resin. Dent Mater 1989;5:127–32. [15] Letzel H. Survival rates and reasons for failure of posterior composite restorations in multicentre clinical trial. J Dent 1989;17. Suppl 1:S10-7; discussion S26-8. [16] Stangel I, Barolet RY. Clinical evaluation of two posterior composite resins: two-year results. J Oral Rehabil 1990;17:257–68. [17] Wendt Jr SL, Leinfelder KF. Clinical evaluation of Clearfil photoposterior: 3-year results. Am J Dent 1992;5: 121–5. [18] Wilson NH, Wilson MA, Offtell DG, Smith GA. Performance of occlusin in butt-joint and bevel-edged preparations: five-year results. Dent Mater 1991;7:92–8. [19] Pashley EL, Tao L, Derkson G, Pashley DH. Dentin permeability and bond strengths after various surface treatments. Dent Mater 1989;5:375–8.

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

DENTAL-2572; No. of Pages 16

ARTICLE IN PRESS d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

[20] Wang Y, Spencer P. Effect of acid etching time and technique on interfacial characteristics of the adhesive-dentin bond using differential staining. Eur J Oral Sci 2004;112: 293–9. [21] Brännström M, Aström A. The hydrodynamics of the dentine; its possible relationship to dentinal pain. Int Dent J 1972;22:219–27. [22] Gordan VV, Mjör IA. Short- and long-term clinical evaluation of post-operative sensitivity of a new resin-based restorative material and self-etching primer. Oper Dent 2002;27: 543–8. [23] Frankenberger R, Krämer N, Petschelt A. Technique sensitivity of dentin bonding: effect of application mistakes on bond strength and marginal adaptation. Oper Dent 2000;25:324–30. [24] Unemori M, Matsuya Y, Akashi A, Goto Y, Akamine A. Self-etching adhesives and postoperative sensitivity. Am J Dent 2004;17:191–5. [25] Opdam NJ, Roeters FJ, Feilzer AJ, Verdonschot EH. Marginal integrity and postoperative sensitivity in Class 2 resin composite restorations in vivo. J Dent 1998;26:555–62. [26] Perdigão J, Swift Jr EJ. Critical appraisal: post-op sensitivity with direct composite restorations. J Esthet Restor Dent 2013;25:284–8. [27] Casselli DS, Martins LR. Postoperative sensitivity in Class I composite resin restorations in vivo. J Adhes Dent 2006;8:53–8. [28] Ermis RB, Kam O, Celik EU, Temel UB. Clinical evaluation of a two-step etch&rinse and a two-step self-etch adhesive system in Class II restorations: two-year results. Oper Dent 2009;34:656–63. [29] Perdigão J, Dutra-Correa M, Anauate-Netto C, Castilhos N, Carmo AR, Lewgoy HR, Amore R, Cordeiro HJ. Two-year clinical evaluation of self-etching adhesives in posterior restorations. J Adhes Dent 2009;11:149–59. [30] Perry RD. Clinical evaluation of total-etch and self-etch bonding systems for preventing sensitivity in Class 1 and Class 2 restorations. Compend Contin Educ Dent 2007;28:12–4. [31] Swift Jr EJ, Ritter AV, Heymann HO, Sturdevant JR, Wilder Jr AD. 36-month clinical evaluation of two adhesives and microhybrid resin composites in Class I restorations. Am J Dent 2008;21:148–52. [32] Heintze SD, Rousson V. Clinical effectiveness of direct class II restorations—a meta-analysis. J Adhes Dent 2012;14:407–31. [33] Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097. [34] Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, Cochrane Bias Methods G., Cochrane Statistical Methods G. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928. [35] Andrade AK, Duarte RM, Silva FD, Batista AU, Lima KC, Pontual ML, Montes MA. Clinical evaluation of nanofill and nanohybrid composite in Class I restorations: a 12-month randomized trial. Gen Dent 2012;60:e255–62. [36] Burke FJ, Crisp RJ, Bell TJ, McDermott K, Lamb JJ, Siddons C, Weller B, Balkenhol M. Clinical evaluation of Solitaire-2 restorations placed in United Kingdom general dental practices: 1-year report. Quintessence Int 2003;34:594–9. [37] Carneiro KKL, Lobato MF, Alves ACBA, Silva e Souza Jr MH. Sensibilidade pós-operatória em restaurac¸ões diretas extensas utilizando sistemas adesivos convencionais atuais. Rev Dental Press Estét 2010;7:97–107. [38] de Andrade AK, Duarte RM, Medeiros e Silva FD, Batista AU, Lima KC, Pontual ML, Montes MA. 30-Month randomised clinical trial to evaluate the clinical performance of a nanofill and a nanohybrid composite. J Dent 2011;39:8–15.

15

[39] Krämer N, Garcia-Godoy F, Frankenberger R. Evaluation of resin composite materials. Part II: in vivo investigations. Am J Dent 2005;18:75–81. [40] Shi L, Wang X, Zhao Q, Zhang Y, Zhang L, Ren Y, Chen Z. Evaluation of packable and conventional hybrid resin composites in Class I restorations: three-year results of a randomized, double-blind and controlled clinical trial. Oper Dent 2010;35:11–9. [41] van Dijken JW. A 6-year prospective evaluation of a one-step HEMA-free self-etching adhesive in Class II restorations. Dent Mater 2013;29:1116–22. [42] Abdalla AI, Alhadainy HA. 2-year clinical evaluation of Class I posterior composites. Am J Dent 1996;9:150–2. [43] Borgmeijer PJ, Kreulen CM, van Amerongen WE, Akerboom HB, Gruythuysen RJ. The prevalence of postoperative sensitivity in teeth restored with Class II composite resin restorations. ASDC J Dent Child 1991;58:378–83. [44] Kreulen CM, van Amerongen WE, Akerboom HB, Borgmeijer PJ, Gruythuysen RJ. Radiographic assessments of Class II resin composite restorations in a clinical study: baseline results. ASDC J Dent Child 1992;59:97–107. [45] Kreulen CM, van Amerongen WE, Akerboom HB, Borgmeijer PJ, Kemp-Scholte CM. A clinical study on direct and indirect Class II posterior composite resin restorations: design of the investigation. ASDC J Dent Child 1991;58:281–8. [46] Blanchard P, Wong Y, Matthews AG, Vena D, Craig RG, Curro FA, Thompson VP. Restoration variables and postoperative hypersensitivity in Class I restorations: PEARL Network findings. Part 2. Compend Contin Educ Dent 2013;34: e62–8. [47] Braem M, Lambrechts P, Vanherle G. Clinical evaluation of dental adhesive systems. Part II: A scanning electron microscopy study. J Prosthet Dent 1986;55:551–60. [48] Hafer M, Schneider H, Rupf S, Busch I, Fuchss A, Merte I, Jentsch H, Haak R, Merte K. Experimental and clinical evaluation of a self-etching and an etch-and-rinse adhesive system. J Adhes Dent 2013;15:275–86. [49] Bottenberg P, Jacquet W, Alaerts M, Keulemans F. A prospective randomized clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities: Five-year results. J Dent 2009;37: 198–203. [50] Manhart J, Chen HY, Neuerer P, Thiele L, Jaensch B, Hickel R. Clinical performance of the posterior composite QuiXfil after 3, 6, and 18 months in Class 1 and 2 cavities. Quintessence Int 2008;39:757–65. [51] Perdigão J, Dutra-Correa M, Castilhos N, Carmo AR, Anauate-Netto C, Cordeiro HJ, Amore R, Lewgoy HR. One-year clinical performance of self-etch adhesives in posterior restorations. Am J Dent 2007;20:125–33. [52] Baracco B, Perdigao J, Cabrera E, Giraldez I, Ceballos L. Clinical evaluation of a low-shrinkage composite in posterior restorations: one-year results. Oper Dent 2012;37:117–29. [53] Bekes K, Boeckler L, Gernhardt CR, Schaller HG. Clinical performance of a self-etching and a total-etch adhesive system - 2-year results. J Oral Rehabil 2007;34:855–61. [54] Lopes LG, Cefaly DF, Franco EB, Mondelli RF, Lauris JR, Navarro MF. Clinical evaluation of two packable posterior composite resins. Clin Oral Investig 2002;6:79–83. [55] Denehy GE, Cobb DS, Bouschlicher MR, Vargas MA. Clinical evaluation of a self-etching primer/adhesive in posterior composites. J Dent Res 2000;79A:340. [56] Delbons FB, Cardoso J, Lima RB, Pagani M, Almeida AG, Borges GA, et al. 18-month clinical behavior of 4 adhesion strategies in posterior restorations. J Dent Res 2014; 93A:1144. [57] Denehy GC, Bouschlicher M, Vargas M. Two-year clinical evaluation of a self-etching primer/adheisve in posterior composites. J Dent Res 2002;81A:434.

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

DENTAL-2572; No. of Pages 16

16

ARTICLE IN PRESS d e n t a l m a t e r i a l s x x x ( 2 0 1 5 ) xxx–xxx

[58] Gao X, Wang X, Ji A. Evaluation of SE-Bond on posterior direct composite restorations. J Dent Res 2004;83A:1753. [59] Hu X, Ling J. Postoperative sensitivity of teeth treated with self-etching adhesives. J Dent Res 2005;84B. [60] Manchorova-Veleva NA, Vladimirov S, Keskinova D. The effect of adhesives on post-operative sensitivity and marginal integrity. J Dent Res 2011;90B:239. [61] Kaurani M, Bhagwat SV. Clinical evaluation of postoperative sensitivity in composite resin restorations using various liners. N Y State Dent J 2007;73:23–9. [62] Lopes LG, Cefaly DF, Franco EB, Mondelli RF, Lauris JR, Navarro MF. Clinical evaluation of two packable posterior composite resins: two-year results. Clin Oral Investig 2003;7:123–8. [63] Manhart J, Chen HY, Hickel R. Clinical evaluation of the posterior composite Quixfil in class I and II cavities: 4-year follow-up of a randomized controlled trial. J Adhes Dent 2010;12:237–43. [64] Browning WD, Blalock JS, Callan RS, Brackett WW, Schull GF, Davenport MB, Brackett MG. Postoperative sensitivity: a comparison of two bonding agents. Oper Dent 2007;32: 112–7. [65] Oberländer H, Hiller KA, Thonemann B, Schmalz G. Clinical evaluation of packable composite resins in Class-II restorations. Clin Oral Investig 2001;5:102–7. [66] Sundfeld RH, Scatolin RS, Oliveira FG, Machado LS, Alexandre RS, Sundfeld ML. One-year clinical evaluation of composite restorations in posterior teeth: effect of adhesive systems. Oper Dent 2012;37:E1–8. [67] van Dijken JW, Pallesen U. Four-year clinical evaluation of Class II nano-hybrid resin composite restorations bonded with a one-step self-etch and a two-step etch-and-rinse adhesive. J Dent 2011;39:16–25. [68] Akpata ES, Behbehani J. Effect of bonding systems on post-operative sensitivity from posterior composites. Am J Dent 2006;19:151–4. [69] Baracco B, Perdigao J, Cabrera E, Ceballos L. Two-year clinical performance of a low-shrinkage composite in posterior restorations. Oper Dent 2013;38:591–600. [70] Bottenberg P, Alaerts M, Keulemans F. A prospective randomised clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities: three-year results. J Dent 2007;35:163–71. [71] Burrow MF, Banomyong D, Harnirattisai C, Messer HH. Effect of glass-ionomer cement lining on postoperative sensitivity

[72]

[73]

[74]

[75]

[76]

[77]

[78]

[79]

[80]

[81]

[82]

in occlusal cavities restored with resin composite—a randomized clinical trial. Oper Dent 2009;34:648–55. Chermont AB, Carneiro KK, Lobato MF, Machado SM, Silva e Souza Jr MH. Clinical evaluation of postoperative sensitivity using self-etching adhesives containing glutaraldehyde. Braz Oral Res 2010;24:349–54. Lobato MF, Khayat AIF, Carneiro KK, Silva e Souza Jr MH. valiac¸ão da sensibilidade pós operatória em restaurac¸ões diretas profundas utilizando sistemas adesivos autocondicionantes. Rev Dental Press Estét 2010;7:82–100. Unemori M, Matsuya Y, Akashi A, Goto Y, Akamine A. Composite resin restoration and postoperative sensitivity: clinical follow-up in an undergraduate program. J Dent 2001;29:7–13. Boeckler A, Boeckler L, Eppendorf K, Schaller HG, Gernhardt CR. A prospective, randomized clinical trial of a two-step self-etching vs two-step etch-and-rinse adhesive and SEM margin analysis: four-year results. J Adhes Dent 2012;14:585–92. Perdigão J, Anauate-Netto C, Carmo AR, Hodges JS, Cordeiro HJ, Lewgoy HR, Dutra-Correa M, Castilhos N, Amore R. The effect of adhesive and flowable composite on postoperative sensitivity: 2-week results. Quintessence Int 2004;35:777–84. Perdigão J, Geraldeli S, Hodges JS. Total-etch versus self-etch adhesive: effect on postoperative sensitivity. J Am Dent Assoc 2003;134:1621–9. Sancakli HS, Yildiz E, Bayrak I, Ozel S. Effect of different adhesive strategies on the post-operative sensitivity of class I composite restorations. Eur J Dent 2014;8:15–22. Lesaffre E, Philstrom B, Needleman I, Worthington H. The design and analysis of split-mouth studies: what statisticians and clinicians should know. Stat Med 2009;28:3470–82. Berkowitz GS, Horowitz AJ, Curro FA, Craig RG, Ship JA, Vena D, Thompson VP. Postoperative hypersensitivity in class I resin-based composite restorations in general practice: interim results. Compend Contin Educ Dent 2009;30:356–8, 60, 62-3. Briso AL, Mestrener SR, Delicio G, Sundfeld RH, Bedran-Russo AK, de Alexandre RS, Ambrosano GM. Clinical assessment of postoperative sensitivity in posterior composite restorations. Oper Dent 2007;32:421–6. Auschill TM, Koch CA, Wolkewitz M, Hellwig E, Arweiler NB. Occurrence and causing stimuli of postoperative sensitivity in composite restorations. Oper Dent 2009;34:3–10.

Please cite this article in press as: Reis A, et al. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?. A systematic review and meta-analysis. Dent Mater (2015), http://dx.doi.org/10.1016/j.dental.2015.06.001

Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?: A systematic review and meta-analysis.

A systematic review and meta-analysis were performed on the risk and intensity of postoperative sensitivity (POS) in posterior resin composite restora...
3MB Sizes 0 Downloads 8 Views