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The Clinical Evidence-Base Of Oral Health Care Products And The
Current “Rinshotrial” App As Possible Dissemination Tool (Preprint)
S Mickenautsch
Author affiliations:
Review Center For Health Science Research (RCHSR), 84 Concorde Road East, Bedfordview/Johannesburg, 2008, South Africa, ORCID
Number: 0000-0002-4994-2328.
Department of Community Dentistry, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York
Rd., Parktown/Johannesburg 2193, South Africa.
Correspondence:
Steffen Mickenautsch, BDS, PhD
Review Center For Health Science Research (RCHSR), 84 Concorde Road East, Bedfordview/Johannesburg, 2008,
South Africa, Email: neem@global.co.za
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ABSTRACT
Introduction
Prospective, controlled clinical trials avoid the pitfalls of uncontrolled and/or retrospective studies.
Aims and objectives
To conduct systematic literature searches for prospective, controlled clinical trials concerning oral
health care products on the market and dissemination of the results through a smart phone app.
Methods
Database search and reference lists check. Trial selection criteria: prospective, controlled clinical
trial design; report published 1990 or later; product names reported in trial. From the accepted trials
data points are extracted per product and include: full publication reference, city of first author’s
affiliation. Data is made accessible as app for Android 5.0 and iOS smart phones.
Results
Until 2019, a total of 1685 data points for 446 products were found for caries preventive /
remineralization products, dental filling materials and fissure sealant materials, combined. The
results were presented through the RinshoTrial app, available on Google’s Play Store and Apple’s
App Store.
Discussion
The RinshoTrial app may assist in the dissemination of commercial product-specific prospective,
controlled clinical trial references. It generates easy usable reference lists of conducted trials per
product, as well as maps concerning the location of the trial research centers, worldwide. Reference
list and maps can be emailed and shared on social media from the app, directly. However, the
RinshoTrial app gives no indication for trial quality and can only be a supportive, preliminary tool
for trial appraisal.
Keywords:
Prospective, controlled clinical trials, oral health care products, RinshoTrial.
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INTRODUCTION
Belief about the effectiveness of oral health care products may be supported by many sources: research trials
of any type or design, expert opinion or own anecdotal experiences. Whether such belief reflects reality is a
matter of whether such sources are valid. The validity of (and thus the ability to generalise from) expert
opinion or own anecdotal experiences has been questioned 1,2 and the validity of laboratory-based studies has
been shown not to reflect clinical reality.3 Hence, the need for clinical trials as evidence-base for therapeutic
oral health care products has been emphasized.4
However, the validity of clinical trials depends largely on the characteristics of their applied study
method, such as whether trials include a comparison against a control intervention and whether they measure
therapeutic effects in time (prospectively) or in the past (retrospectively). Retrospective, controlled clinical
trials may provide valuable estimates about rare risk factors where prospective trials are not feasible5 but
unlike prospective, controlled clinical trials they can only be observational and thus carry a high risk of
systematic error (bias).6 Uncontrolled clinical trials, even when prospective, simply lack a benchmark or
standard against which test-treatment results can be compared. For that reason, the causal relationship between
the characteristics and outcome of the test-treatment is uncertain.7 Therefore, any judgement based on
uncontrolled trials about treatment effectiveness is arbitrary, since it is not clear whether any other
intervention, may it be a placebo or a gold standard treatment, would have yielded the same result in the
selected patient cohort. Against such background, it is concluded that any belief about the effectiveness of
commercial oral health care products should at minimum be based on results from prospective, controlled
clinical trials. Of course, results of such trials may still be misleading for many other reasons that are subject
to trial appraisal in systematic reviews, such as effectiveness of randomisation; statistical power, due to
sample size, etc.8
Nonetheless, prospective, controlled clinical trials do at least avoid the pitfalls of laboratory and
clinical non-controlled or retrospective studies. Hence, the identification of such trials provides an important
first step when questioning the evidence-base of an oral health care product. Dissemination of such
information to dental academia with e.g. interest in potential therapeutic gold-standards for future clinical
trials, or to oral health care providers with interest in questioning current products on the market, may be
assisted through simple online tools such as smart phone apps. One of such app is “RinshoTrial” (Figure 1),
available on Google’s Play Store and Apple’s App Store (Figure 2).
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MATERIALS AND METHODS
The RinshoTrial app was conceptionalized in 2019. The app has a free 3-day try-out period and is available
thereafter on a 12-month subscription basis for a low annual fee. The app is not sponsored or supported by any
product manufacturer or related interest group and, in order to retain its editorial independence, is financed
solely through its subscription-user base.
App functions
The app provides a search function for oral health care products. Products can be searched by name and yield
per product a map of geographical locations where prospective, controlled clinical trials were conducted in the
world, as well as a full reference list of the published trials reports (Figure 1). In addition, the app allows
email forwarding and social media sharing of both maps and lists. The app also provides a function for users
to request further information about any product’s evidence-base. The app data for oral health care products is
regularly updated (at least once per year) and can be extended. Data updates can be followed by use of a
dedicated online blog.9
Systematic literature search
Systematic literature searches are conducted in PubMed, DOAJ, LILACS, IndMed, CNKI and GoogleScholar
for published clinical trials and systematic review reports that are relevant to selected product categories,
without limitations regarding the publication language. Publications in non-English language are translated
preliminary with the GoogleTranslate online tool10 and further in depth with the help of translators. The
identified systematic review reports are traced in full copy and from these references of included/excluded
trials extracted. The cut-off dates, trial selection criteria, searched databases and strings of search terms per
systematic review report are recorded in MS Excel. The reference lists of all identified trials are further
checked for possible relevant studies.
Trial selection criteria are prospective, controlled clinical trial design; trial report published 1990 or
later; product names reported in study. From the accepted trial reports data points are extracted, per product
name and product category. Each data point comprises of author names, report title, journal name, publication
year, journal volume, first page number; city of first author’s academic affiliation. All data points are entered
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in Unicode Text-format into the app’s backend portal and made accessible through the app on Android 5.0 or
iOS based smart phones.
RESULTS
By 2019, the systematic literature search identified a total of 1685 data points for 446 products in the product
categories: Caries preventive products/ remineralization products; Dental filling materials and Fissure sealant
materials (Table 1).
Caries preventive and tooth remineralization products
PubMed was searched on the 10 November 2018 using the string of search terms: (remineralization OR
remineralization) OR "Tooth Remineralization"[Mesh] AND ("Dental Enamel"[Mesh] OR enamel) and the
following set search limits: Article types: Clinical study, clinical trial, pragmatic clinical trial, randomised
controlled trial, systematic reviews, meta-analysis. In total, 218 trial reports and 35 systematic reviews (Table
2) of clinical trials were found. Of the identified systematic reviews, 20 were further updated in 2019. From
the original database search, reference checks of the systematic review reports and their updates, a total of 425
trial reports could be included for review. Of these, 182 trial reports were found in line with the selection
criteria and accepted for data extraction (Figure 3). A total of 225 data points, were extracted from the
accepted trial reports concerning 67 caries preventive and tooth remineralizing products.
Fissure sealant materials
PubMed was searched on the 26 July 2019 for systematic review reports using the search term: ‘fissure
sealant’. A total of 58 citations were found. Of these, 15 systematic reviews of clinical trials were included
(Table 3). Two of the systematic reviews were further updated in 2019. From the reference check of the
systematic reviews a total of 205 trial reports were included for review. Of these, 143 trial reports were found
in line with the selection criteria and accepted for data extraction (Figure 3). A total of 267 data points were
extracted from the accepted trial reports concerning 77 fissure sealant materials.
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Dental filling materials
The databases PubMed, DOAJ, LILACS, IndMed, GoogleScholar were searched up to 26 April 2018 using
several strings of search terms (Table 4). In addition, journal hand search was conducted. CNKI database was
searched up to 25 July 2018. These two searches were updated on the 27 June 2019 and 14 July 2019,
respectively. A total of 739 trial reports were found in line with the selection criteria and accepted for data
extraction (Figure 3). A total of 1193 data points were extracted from the accepted trial reports concerning 302
dental filling materials.
DISCUSSION
Limitations of the applied systematic search strategy
The aim of the applied systematic literature search is to identify as many prospective, clinical controlled trials
for caries preventive products/ remineralization products, dental filling materials and fissure sealant materials,
as possible. The most important limitations of the search results, so far, were the inability to trace 124 trial
reports in full copy to date with potential relevance for caries preventive products/ remineralization products
and the fact that, so far, 20 out of 35 and 2 out of 15 systematic reviews were updated, only, for caries
preventive products/ remineralization products and fissure sealant materials, respectively. However, the
RhinshoTrial app, like any systematic review of clinical trials, relies on consistent, regular updating, in order
to remain relevant. Hence, continued updates are ongoing, including the tracing of remaining trial reports,
which will be added in time to the app’s database. App users can inform themselves about these updates via
the app’s online blog.9
App strengths
While many systematic reviews provide their information per product types (Table 2 and 3), such as ‘fluoride
varnishes’ or ‘fissure sealants’, the RinshoTrial app provides a unique reference source directly related to
specific commercial dental products, based on systematic literature searches exclusively concerning
prospective, controlled clinical trials. Reason for the commercial product focus was the considerations that in
the ‘real world’ oral health care providers apply specific products during patient treatment and trialists include
specific products into their clinical trials and not random samples of a particular product type. This is
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important, since many products of the same product type may differ substantially from each other in their
(often undisclosed by manufactures) chemical composition and clinical merits.
The RinshoTrial app generates easy usable, product specific, reference lists that can be directly
emailed from the app to e.g. a collaborating librarian for article tracing. It also provides a geographic overview
in form of maps, concerning the location of research centers in the world that included any particular products
in their clinical trials (Figure 1). In addition, both reference lists and maps can be easily shared from the app
on social media for peer-to-peer or group discussions about a specific product’s clinical evidence-base.
The app provides further opportunities for dental academics, interested in conducting a systematic
review to a particular product or product range, in form of a first bibliographic basis as evidence overview.
Oral health care provider, who are interested in existing products on the market, have the opportunity to easily
access reference lists of clinical trial reports, relevant for reading up on clinical product efficacy. Furthermore,
the app provides interested users the opportunity to compare the volume of current clinical evidence between
different, perhaps even competing, products.
App limitations
Besides its strengths, RinshoTrial’s most important limitation is its lack of trial quality measure, i.e. the lack
of indication regarding trial validity and precision. In this context, app users need to be aware that a large
volume of listed trials for a particular product may lead to the false impression that such product has a strong
evidence-base or perhaps at least stronger than a product with fewer listed trials. It is important to note that
prospective, controlled clinical trials, albeit being of higher quality than retrospective, uncontrolled or
laboratory studies, may still suffer from severe shortcomings, such as a too low sample size or lack of
effective randomisation. Therefore, further appraisal of trial quality remains warranted before any quality
judgment about the evidence-base of a specific product can be made. In addition, the app does not provide any
information about actual trial results. Instead, the app provides a function to request further information per
product.
Another important limitation of the RinshoTrial app is the ambiguity of non-included products, since
such products may either not been included, due to lack of prospective, controlled clinical trials for them or
due to any existing trials not been captured into the app’s database, yet. Hence, the app gives no indication for
the evidence-base of not included products.
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A further limitation is that the app includes only a few dental product categories, so far. However, the utility
of the app will increase with its extension to further relevant clinical topics, such as implantology, endodontics
or orthodontics. App users are able to receive notification about the inclusion of further added product
categories, via the app’s dedicated online notifier.9
SUMMARY
Prospective, controlled clinical trials avoid the pitfalls of uncontrolled and/or retrospective clinical study
designs. Hence, the identification of such trials provides an important first step when questioning the
evidence-base of any dental product. Dissemination of such information to dental academia or oral health care
providers with interest in questioning current products on the market, may be assisted through the RinshoTrial
app. The app generates easy usable, product specific, reference lists that can be directly emailed from the app
and geographic overviews in form of maps, concerning the location of research centers in the world that
included any particular product in their clinical trials. In addition, the reference list and maps can be easily
shared from the app on social media for peer-to-peer or group discussions. The app’s main limitation is that it
gives no indication for the quality or the results of the included trials and thus can only be a supportive tool
prior actual trial appraisal.
9
References
1. Sackett DL, Rosenberg WM. The need for evidence-based medicine. J R Soc Med 1995; 88: 620-4.
2. Irwig L, Irwig J, Trevena L, Sweet M. Smart health choices: Making sense of health advice. London:
Hammersmith Press; 2008: 103 –111. Chapter 8, The weakness of one.
3. Mickenautsch S, Yengopal V. Do laboratory results concerning high-viscosity glass-ionomers versus
amalgam for tooth restorations indicate similar effect direction and magnitude than that of controlled
clinical trials? - A Meta-Epidemiological Study. PLoS One 2015; 10: e0132246.
4. Hill AB. The clinical trial. N Engl J Med 1952; 247: 113-9.
5. Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease.
J Natl Cancer Inst 1959; 22: 719-48.
6. Sutherland SE. Evidence-based dentistry: Part IV. Research design and levels of evidence. J Can Dent
Assoc 2001; 67: 375-8.
7. Mickenautsch S, Yengopal V. Reports of uncontrolled clinical trials for directly placed restorations in
vital teeth. Braz Oral Res 2017; 31: e48.
8. Berger VW. Selection bias and covariate imbalances in randomized clinical trials. New York: John
Wiley & Sons; 2005: 1-84. Part I, Is there a problem with reliability in medical studies?
9. RinshoTrial Update Notifier. Website: https://rinshotrial.blogspot.com (Accessed: October 21,2019).
10. Google Translate. Website: https://translate.google.com (Accessed: October 21,2019).
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Table 1. Identified data points per products and oral health care topics
Product categories Caries preventive & tooth remineralization products Fissure sealant materials Dental filling materials
Number of products 67 77 302
Data points 225 267 1193
Table 2. Caries preventive and tooth remineralization products: Included published systematic reviews
Systematic review reports Date of most
recent update
1 Marinho VC, Higgins JP, Logan S, Sheiham A. Topical fluoride (toothpastes, mouthrinses, gels or varnishes) for preventing
dental caries in children and adolescents. Cochrane Database Syst Rev. 2003;(4):CD002782. 16.06.2019
2 Tubert-Jeannin S, Auclair C, Amsallem E, Tramini P, Gerbaud L, Ruffieux C, Schulte AG, Koch MJ, Rège-Walther M,
Ismail A. Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children. Cochrane
Database Syst Rev. 2011 Dec 7;(12):CD007592.
12.10.2011*
3 Marinho VC, Worthington HV, Walsh T, Clarkson JE. Fluoride varnishes for preventing dental caries in children and
adolescents. Cochrane Database Syst Rev. 2013 Jul 11;(7):CD002279. 13.05.2013*
4 Benson PE, Parkin N, Dyer F, Millett DT, Furness S, Germain P. Fluorides for the prevention of early tooth decay
(demineralised white lesions) during fixed brace treatment. Cochrane Database Syst Rev. 2013 Dec 12;(12):CD003809. 31.01.2013*
5 Marinho VC, Worthington HV, Walsh T, Chong LY. Fluoride gels for preventing dental caries in children and adolescents.
Cochrane Database Syst Rev. 2015 Jun 15;(6):CD002280. 22.04.2016*
6 Walsh T, Oliveira-Neto JM, Moore D. Chlorhexidine treatment for the prevention of dental caries in children and
adolescents. Cochrane Database Syst Rev. 2015 Apr 13;(4):CD008457. 25.02.2015*
7 Riley P, Moore D, Ahmed F, Sharif MO, Worthington HV. Xylitol-containing products for preventing dental caries in
children and adults. Cochrane Database Syst Rev. 2015 Mar 26;(3):CD010743. 14.08.2014*
8 Ahovuo-Saloranta A, Forss H, Hiiri A, Nordblad A, Mäkelä M. Pit and fissure sealants versus fluoride varnishes for
preventing dental decay in the permanent teeth of children and adolescents. Cochrane Database Syst Rev. 2016 Jan
18;(1):CD003067.
18.12.2015*
9 Takahashi R, Ota E, Hoshi K, Naito T, Toyoshima Y, Yuasa H, Mori R, Nango E. Fluoride supplementation (with tablets,
drops, lozenges or chewing gum) in pregnant women for preventing dental caries in the primary teeth of their children.
Cochrane Database Syst Rev. 2017 Oct 23;10:CD011850.
25.01.2017*
10 Duangthip D, Jiang M, Chu CH, Lo EC. Non-surgical treatment of dentin caries in preschool children--systematic review.
BMC Oral Health. 2015 Apr 3;15:44. 09.07.2019
11 Okada EM, Ribeiro LN, Stuani MB, Borsatto MC, Fidalgo TK, Paula-Silva FW, Küchler EC. Effects of chlorhexidine
varnish on caries during orthodontic treatment: a systematic review and meta-analysis. Braz Oral Res. 2016 Nov
28;30(1):e115.
11.07.2019
12 Derks A, Katsaros C, Frencken JE, van't Hof MA, Kuijpers-Jagtman AM. Caries-inhibiting effect of preventive measures
during orthodontic treatment with fixed appliances. A systematic review. Caries Res. 2004 Sep-Oct;38(5):413-20. 19.06.2019
13 James P, Parnell C, Whelton H. The caries-preventive effect of chlorhexidine varnish in children and adolescents: a
systematic review. Caries Res. 2010;44(4):333-40. 24.06.2019
14 Slot DE, Vaandrager NC, Van Loveren C, Van Palenstein Helderman WH, Van der Weijden GA. The effect of chlorhexidine
varnish on root caries: a systematic review. Caries Res. 2011;45(2):162-73. 24.06.2019
15 Zhang Q, van Palenstein Helderman WH, van't Hof MA, Truin GJ. Chlorhexidine varnish for preventing dental caries in
children, adolescents and young adults: a systematic review. Eur J Oral Sci. 2006 Dec;114(6):449-55. 20.06.2019
16 Mickenautsch S, Yengopal V. Anticariogenic effect of xylitol versus fluoride -a quantitative systematic review of clinical
trials. Int Dent J. 2012 Feb;62(1):6-20. 03.07.2019
17 Mickenautsch S, Yengopal V. Effect of xylitol versus sorbitol: a quantitative systematic review of clinical trials. Int Dent J.
2012 Aug;62(4):175-88. 05.07.2019
18 Tang X, Sensat ML, Stoltenberg JL. The antimicrobial effect of chlorhexidine varnish on mutans streptococci in patients with
fixed orthodontic appliances: a systematic review of clinical efficacy. Int J Dent Hyg. 2016 Feb;14(1):53-61. 10.07.2019
19 Wierichs RJ, Meyer-Lueckel H. Systematic review on noninvasive treatment of root caries lesions. J Dent Res. 2015
Feb;94(2):261-71. 01.05.2014*
20 Janakiram C, Deepan Kumar CV, Joseph J. Xylitol in preventing dental caries: A systematic review and meta-analyses. J Nat
Sci Biol Med. 2017 Jan-Jun;8(1):16-21. 10.07.2019
21 Freires IA, Denny C, Benso B, de Alencar SM, Rosalen PL. Antibacterial Activity of Essential Oils and Their Isolated
Constituents against Cariogenic Bacteria: A Systematic Review. Molecules. 2015 Apr 22;20(4):7329-58. 10.07.2019
22 Abdullah Z, John J. Minimally Invasive Treatment of White Spot Lesions—A Systematic Review. Oral Health Prev Dent.
2016;14(3):197-205. 01.06.2014*
23 Azarpazhooh A, Main PA. Fluoride varnish in the prevention of dental caries in children and adolescents: a systematic
review. J Can Dent Assoc. 2008 Feb;74(1):73-9. 01.01.2007*
24 Indrapriyadharshini K, Madan Kumar PD, Sharma K, Iyer K. Remineralizing potential of CPP-ACP in white spot lesions - A
systematic review. Indian J Dent Res. 2018 Jul-Aug;29(4):487-496. 11.07.2019
25 Xiaotong W, Nanquan R, Jing X, Yuming Z, Lihong G. [Remineralization effect of casein phosphopeptide-amorphous
calcium phosphate for enamel demineralization: a system review]. Hua Xi Kou Qiang Yi Xue Za Zhi. 2017 Dec 1;35(6):629-
635.
12.07.2019
26 Höchli D, Hersberger-Zurfluh M, Papageorgiou SN, Eliades T. Interventions for orthodontically induced white spot lesions: a
systematic review and meta-analysis. Eur J Orthod. 2017 Apr 1;39(2):122-133. 11.07.2019
27 Elhennawy K, Schwendicke F. Managing molar-incisor hypomineralization: A systematic review. J Dent. 2016 Dec;55:16-
24. 11.07.2019
28 Gao SS, Zhang S, Mei ML, Lo EC, Chu CH. Caries remineralisation and arresting effect in children by professionally applied
fluoride treatment - a systematic review. BMC Oral Health. 2016 Feb 1;16:12. 08.07.2019
29 Lenzi TL, Montagner AF, Soares FZ, de Oliveira Rocha R. Are topical fluorides effective for treating incipient carious
lesions?: A systematic review and meta-analysis. J Am Dent Assoc. 2016 Feb;147(2):84-91. 11.07.2019
11
30 Urquhart O, Tampi MP, Pilcher L, Slayton RL, Araujo MWB, Fontana M, Guzmán-Armstrong S, Nascimento MM, Nový
BB, Tinanoff N, Weyant RJ, Wolff MS, Young DA, Zero DT, Brignardello-Petersen R, Banfield L, Parikh A, Joshi G,
Carrasco-Labra A. Nonrestorative Treatments for Caries: Systematic Review and Network Meta-analysis. J Dent Res. 2019
Jan;98(1):14-26.
01.06.2017*
31 Yengopal V, Mickenautsch S. Caries preventive effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP):
a meta-analysis. Acta Odontol Scand. 2009;67(6):321-32. 23.06.2019
32 Chen H, Liu X, Dai J, Jiang Z, Guo T, Ding Y. Effect of remineralizing agents on white spot lesions after orthodontic
treatment: a systematic review. Am J Orthod Dentofacial Orthop. 2013 Mar;143(3):376-382. 04.11.2011*
33 Lopatiene K, Borisovaite M, Lapenaite E. Prevention and Treatment of White Spot Lesions During and After Treatment with
Fixed Orthodontic Appliances: a Systematic Literature Review. J Oral Maxillofac Res. 2016 Jun 30;7(2):e1. 11.07.2019
34 Wang Y, Li J, Sun W, Li H, Cannon RD, Mei L. Effect of non-fluoride agents on the prevention of dental caries in primary
dentition: A systematic review. PloS One. 2017 Aug 7;12(8):e0182221. 16.12.2016*
35 Tao S, Zhu Y, Yuan H, Tao S, Cheng Y, Li J, He L. Efficacy of fluorides and CPP-ACP vs fluorides monotherapy on early
caries lesions: A systematic review and meta-analysis. PLoS One. 2018 Apr 30;13(4):e0196660. 01.08.2017*
* Systematic review not updated to date.
Table 3. Fissure sealant materials: Included published systematic reviews
Systematic review reports Date of most
recent update
1 Alirezaei M, Bagherian A, Sarraf Shirazi A. Glass ionomer cements as fissure sealing materials: yes or no?: A systematic
review and meta-analysis. J Am Dent Assoc. 2018 Jul;149(7):640-649.e9. 20.09.2017*
2 Papageorgiou SN, Dimitraki D, Kotsanos N, Bekes K, van Waes H. Performance of pit and fissure sealants according to
tooth characteristics: A systematic review and meta-analysis. J Dent. 2017 Nov;66:8-17. 23.02.2017*
3 Ahovuo-Saloranta A, Forss H, Walsh T, Nordblad A, Mäkelä M, Worthington HV. Pit and fissure sealants for preventing
dental decay in permanent teeth. Cochrane Database Syst Rev. 2017 Jul 31;7:CD001830. 03.08.2016*
4 Wright JT, Tampi MP, Graham L, Estrich C, Crall JJ, Fontana M, Gillette EJ, Nový BB, Dhar V, Donly K, Hewlett ER,
Quinonez RB, Chaffin J, Crespin M, Iafolla T, Siegal MD, Carrasco-Labra A. Sealants for preventing and arresting pit-and-
fissure occlusal caries in primary and permanent molars: A systematic review of randomized controlled trials-a report of the
American Dental Association and the American Academy of Pediatric Dentistry. J Am Dent Assoc. 2016 Aug;147(8):631-
645.e18.
01.05.2013*
5 Mickenautsch S, Yengopal V. Caries-Preventive Effect of High-Viscosity Glass Ionomer and Resin-Based Fissure Sealants
on Permanent Teeth: A Systematic Review of Clinical Trials. PLoS One. 2016 Jan 22;11(1):e0146512. 16.01.2015*
6 Hiiri A, Ahovuo-Saloranta A, Nordblad A, Mäkelä M. Pit and fissure sealants versus fluoride varnishes for preventing dental
decay in children and adolescents. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD003067. 01.11.2009*
7 Mickenautsch S, Yengopal V. Validity of sealant retention as surrogate for caries prevention--a systematic review. PLoS
One. 2013 Oct 23;8(10):e77103. 21.10.2012*
8 Mickenautsch S, Yengopal V. The modified Ottawa method to establish the update need of a systematic review: glass-
ionomer versus resin sealants for caries prevention. J Appl Oral Sci. 2013 Sep-Oct;21(5):482-9. 01.05.2012*
9 Kühnisch J, Mansmann U, Heinrich-Weltzien R, Hickel R. Longevity of materials for pit and fissure sealing--results from a
meta-analysis. Dent Mater. 2012 Mar;28(3):298-303. 30.09.2011*
10 Yengopal V, Mickenautsch S. Resin-modified glass-ionomer cements versus resin-based materials as fissure sealants: a
meta-analysis of clinical trials. Eur Arch Paediatr Dent. 2010 Feb;11(1):18-25. 15.04.2009*
11 Yengopal V, Mickenautsch S, Bezerra AC, Leal SC. Caries-preventive effect of glass ionomer and resin-based fissure
sealants on permanent teeth: a meta analysis. J Oral Sci. 2009 Sep;51(3):373-82. 15.01.2008*
12 Azarpazhooh A, Main PA. Pit and fissure sealants in the prevention of dental caries in children and adolescents: a systematic
review. J Can Dent Assoc. 2008 Mar;74(2):171-7. 01.01.2007*
13 16: Beiruti N, Frencken JE, van 't Hof MA, van Palenstein Helderman WH. Caries-preventive effect of resin-based and glass
ionomer sealants over time: a systematic review. Community Dent Oral Epidemiol. 2006 Dec;34(6):403-9. 01.12.2004*
14 18: Muller-Bolla M, Lupi-Pégurier L, Tardieu C, Velly AM, Antomarchi C. Retention of resin-based pit and fissure sealants:
A systematic review. Community Dent Oral Epidemiol. 2006 Oct;34(5):321-36. 09.09.2019
15 20: Mejàre I, Lingström P, Petersson LG, Holm AK, Twetman S, Källestål C, Nordenram G, Lagerlöf F, Söder B, Norlund
A, Axelsson S, Dahlgren H. Caries-preventive effect of fissure sealants: a systematic review. Acta Odontol Scand. 2003
Dec;61(6):321-30.
19.08.2019
* Systematic review not updated to date.
Table 4. Dental filling materials: Strings of search terms
Database searched: PubMed / Online: http://www.ncbi.nlm.nih.gov/pubmed
Search terms:
[1] (((tooth restoration) OR tooth filling) OR dental filling) OR "Dental Restoration, Permanent"[Mesh] Sort by: PublicationDate Filters: Clinical
Trial; Abstract; Humans
[2] (amalgam OR composite OR glass-ionomer OR compomer) AND restoration Sort by: PublicationDate Filters: Clinical Trial; Abstract; Humans
[3] atraumatic restorative treatment (no filters)
[4] composite restorations (Filters activated: Clinical Trial, Abstract.)
[5] compomer restoration (Filters activated: Clinical Trial, Abstract.)
[6] amalgam restoration (Filters activated: Clinical Trial, Abstract.)
[7] glass ionomer restoration (Filters activated: Clinical Trial, Abstract.)
Database searched: DOAJ / Online: http://www.doaj.org
12
[1] Dental Restoration
[2] composite restoration
[3] compomer restoration
[4] amalgam restoration
[5] glass ionomer restoration
[6] atraumatic restorative treatment
Database searched: LILACS / Online: http://pesquisa.bvsalud.org/portal/
[1] Dental Restoration
[2] composite restoration
[3] compomer restoration
[4] amalgam restoration
[5] glass ionomer restoration
[6] atraumatic restorative treatment
Database searched: IndMed / Online: http://indmed.nic.in/indmed.html
Limit: Controlled Clinical Trial
[1] Dental AND Restoration
[2] composite AND restoration
[3] compomer AND restoration
[4] amalgam AND restoration
[5] glass ionomer AND restoration
[6] atraumatic AND restorative AND treatment
Database searched: GoogleScholar/ Online: http://indmed.nic.in/indmed.html
[1] "tooth Restoration"+"clinical trial"
[2] "composite restoration"+"clinical trial"
[3] "compomer restoration"+"clinical trial"
[4] "atraumatic restorative treatment"+"clinical trial"
[5] "glass ionomer restoration"+"clinical trial"
[6] "amalgam restoration"+"clinical trial"
Database searched CNKI / Online: http://cnki.net
Limit: Clinical study
[1] tooth Restoration
[2] composite restoration
[3] compomer restoration
[4] atraumatic restorative treatment
[5] glass ionomer restoration
[6] amalgam restoration
[7] 玻璃离子水门汀
[8] 光固化复合树脂 AND 修复牙
[9] 银汞合金 AND 修复牙
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Figure 1. Screenshots of RinshoTrial’s main functions
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Figure 2. QR (Quick response) – codes for RinshoTrial app access
To scan a QR – code use smart phone with a camera and QR-scanner function enabled.
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Figure 3. Flow diagram of trial selection
