Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: An update of systematic review evidence.

Division of Public Oral Health, Faculty of Health Sciences, University of the Witwatersrand - 7 York Rd,, Parktown/Johannesburg 2193, South Africa. .
BMC Research Notes 01/2011; 4:22. DOI: 10.1186/1756-0500-4-22
Source: PubMed

ABSTRACT This article constitutes a partial update of the original systematic review evidence by Yengopal et al. from 15 January 2008 (published in the Journal of Oral Science in 2009) with primary focus on research quality in regard to bias risk in trials. Its aim is to update the existing systematic review evidence from the English literature as to whether caries occurrence on pits and fissures of teeth sealed with either GIC or resin is the same.
In addition to the 12 trials included during the original systematic review, 5 new trials were identified during the database search (up to 26 August 2010) and 2 further trials were included from a hand search and reference check. Of these, 3 trials were excluded and 16 were accepted for data extraction and quality assessment. The quality of accepted trials was assessed, using updated quality criteria, and the risk of bias was investigated in more depth than previously reported. In addition, the focus of quantitative synthesis was shifted to single datasets that were extracted from the accepted trials.
Twenty-six dichotomous and 4 continuous datasets were extracted. Meta-analysis and cumulative meta-analysis were used in combining clinically homogenous datasets. The overall outcome of the computed datasets suggest no difference between the caries-preventive effects of GIC- and resin-based fissure sealants.
This overall outcome is in agreement with the conclusions of the original systematic review. Although the findings of the trials identified in this update may be considered to be less affected by attrition- and publication bias, their risk of selection- and detection-/performance bias is high. Thus, verification of the currently available results requires further high quality randomised control trials.

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    ABSTRACT: Minimal intervention dentistry (MID) is a philosophy of care that aims to conserve tooth tissues throughout a persons' life. This paper aims to review the literature on topics that are related to MID approaches for the management of dental caries and that can be applicable to the paediatric patient. Tools for caries diagnosis and early lesion detection are presented and discussed. More conservative and less invasive techniques for managing enamel and dentine carious lesions in primary and permanent teeth are compared to the traditional treatments. The traditional treatments are centred on the disease and on restoring its sequels, and have been shown to be insufficiently effective in controlling caries disease over time. In contrast, the MID philosophy has created potentially very suitable options for treating children that are considered more child-friendly, less anxiety provoking, preserve more tooth tissues and are equally good as the traditional treatments.
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    ABSTRACT: Minimal Intervention Dentistry (MID) is a modern approach to the management of caries, which emphasizes prevention and early interception of disease, underpinned by an understanding of the role of the dental plaque biofilm in disease initiation and progression, and how this is affected by lifestyle and behavioral factors. The MID approach should be the standard of care in modern restorative dentistry, as it avoids over-zealous restorative interventions as well as supervised neglect. Incorporating the principles of MID into general dental practice for the management of dental caries involves using Caries Risk Assessment (CRA), as well as a minimally invasive restorative approach utilizing conservative caries removal methods, minimal cavity designs and the use of adhesive restorative materials. A range of methods now exist for measuring the contribution of risk factors to dental caries risk, allowing the clinician to target their interventions at the factors operating in the individual patient, by applying the concepts of ecological change to modify the biofilm, and motivational interviewing to alter patient lifestyle and dietary behaviour. This review discusses how the principles of MID are used for individual patient care, and suggests methods for implementation of MID into general dental practice.
    Oral health and dental management. 06/2014; 13(2):285-94.

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