TY - JOUR
T1 - Impact of head and neck radiotherapy on the longevity of dental adhesive restorations
T2 - A systematic review and meta-analysis
AU - Palmier, Natália Rangel
AU - Madrid Troconis, Cristhian Camilo
AU - Normando, Ana Gabriela Costa
AU - Guerra, Eliete Neves Silva
AU - Araújo, Anna Luíza Damaceno
AU - Arboleda, Lady Paola Aristizábal
AU - Fonsêca, Jéssica Montenegro
AU - de Pauli Paglioni, Mariana
AU - Gomes-Silva, Wagner
AU - Vechiato Filho, Aljomar José
AU - González-Arriagada, Wilfredo Alejandro
AU - Paes Leme, Adriana Franco
AU - Prado-Ribeiro, Ana Carolina
AU - Brandão, Thaís Bianca
AU - de Goes, Mario Fernando
AU - Lopes, Marcio Ajudarte
AU - Santos-Silva, Alan Roger
N1 - Funding Information:
The authors thank S?o Paulo Research Foundation (FAPESP) for financial support (process numbers 2018/04657-8; 2018/02233-6; 2016/22862-2; 2013/18402-8 and 2012/06138-1) and the National Council for Scientific and Technological Development (CNPq), Brazil. The authors also state that this study was financed in part by the Coordination for the Improvement of Higher Education Personnel -Brazil (CAPES)- Finance Code 001.
Publisher Copyright:
© 2021 Editorial Council for the Journal of Prosthetic Dentistry
PY - 2021/11
Y1 - 2021/11
N2 - Statement of problem: Established restorative protocols for patients after head and neck radiotherapy are lacking, increasing the failure rates of dental adhesive restorations. Purpose: The purpose of this systematic review and meta-analysis was to analyze the evidence regarding the impact of head and neck radiotherapy on the longevity of dental adhesive restorations. Material and methods: A search was performed using PubMed, Scopus, and Embase in May 2018 (updated in November 2020). Data extraction was performed regarding the percentage of restoration failure among dental adhesive materials, including glass ionomer cements, resin-modified glass ionomer cements, and composite resins. Risk of bias was assessed by the meta-analysis of statistics assessment and review instrument (MAStARI). Confidence in cumulative evidence was evaluated by the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) protocol. Results: Four studies met the inclusion criteria. All included studies were classified as having a moderate risk of bias and reported results regarding class V restorations. Overall, composite resins presented lower failure rates at 2 years (30%) when compared with resin-modified glass ionomer (41%) and glass ionomer cements (57%). Meta-analysis showed that the risk of failure with glass ionomer cements was greater than with resin-modified glass ionomer cements (RR: 1.71, P<.001). Composite resins presented lower risk of failure when compared with glass ionomer (RR: 2.29, P<.001) and resin-modified glass ionomer cements (RR: 1.30, P=.03). Three studies reported results regarding fluoride compliance, which had a negative effect on the survival rates of glass ionomer and resin-modified glass ionomer cements and a positive effect on composite resin restorations. Conclusions: The results suggest that composite resin restorations associated with fluoride gel compliance seems to be the best alternative for restoring class V lesions in patients after head and neck radiotherapy. However, the results showed moderate certainty of evidence, which justifies the need for more randomized clinical trials regarding this subject.
AB - Statement of problem: Established restorative protocols for patients after head and neck radiotherapy are lacking, increasing the failure rates of dental adhesive restorations. Purpose: The purpose of this systematic review and meta-analysis was to analyze the evidence regarding the impact of head and neck radiotherapy on the longevity of dental adhesive restorations. Material and methods: A search was performed using PubMed, Scopus, and Embase in May 2018 (updated in November 2020). Data extraction was performed regarding the percentage of restoration failure among dental adhesive materials, including glass ionomer cements, resin-modified glass ionomer cements, and composite resins. Risk of bias was assessed by the meta-analysis of statistics assessment and review instrument (MAStARI). Confidence in cumulative evidence was evaluated by the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) protocol. Results: Four studies met the inclusion criteria. All included studies were classified as having a moderate risk of bias and reported results regarding class V restorations. Overall, composite resins presented lower failure rates at 2 years (30%) when compared with resin-modified glass ionomer (41%) and glass ionomer cements (57%). Meta-analysis showed that the risk of failure with glass ionomer cements was greater than with resin-modified glass ionomer cements (RR: 1.71, P<.001). Composite resins presented lower risk of failure when compared with glass ionomer (RR: 2.29, P<.001) and resin-modified glass ionomer cements (RR: 1.30, P=.03). Three studies reported results regarding fluoride compliance, which had a negative effect on the survival rates of glass ionomer and resin-modified glass ionomer cements and a positive effect on composite resin restorations. Conclusions: The results suggest that composite resin restorations associated with fluoride gel compliance seems to be the best alternative for restoring class V lesions in patients after head and neck radiotherapy. However, the results showed moderate certainty of evidence, which justifies the need for more randomized clinical trials regarding this subject.
KW - head and neck
KW - Radiotherapy
KW - dental adhesive
UR - http://www.scopus.com/inward/record.url?scp=85102452154&partnerID=8YFLogxK
U2 - 10.1016/j.prosdent.2021.02.002
DO - 10.1016/j.prosdent.2021.02.002
M3 - Article
C2 - 33715834
SN - 0022-3913
VL - 128
SP - 886
EP - 896
JO - The Journal of Prosthetic Dentistry
JF - The Journal of Prosthetic Dentistry
IS - 5
ER -