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Adhesively bonded versus non-bonded amalgam restorations for dental cariesFedorowicz Z, Nasser M, Wilson N
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SummaryAdhesively or non-adhesively bonded amalgam restorations for dental cariesTooth decay is a common problem affecting both children and adults. Cavities form in the teeth by the action of acid producing bacteria present in dental plaque. A number of techniques and a variety of materials can be used to restore teeth and one of the most commonly used and comparatively cheap filling material is dental amalgam (a mixture of mercury and metal alloy particles). The review authors sought to evaluate the added benefit of using an adhesive to bond amalgam to tooth structure to see if bonded fillings would last longer.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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October 07. 2009 AbstractBackgroundDental caries (tooth decay) is one of the commonest diseases which afflicts mankind, and has been estimated to affect up to 80% of people in high-income countries. Caries adversely affects and progressively destroys the tissues of the tooth, including the dental pulp (nerve), leaving teeth unsightly, weakened and with impaired function. The treatment of lesions of dental caries, which are progressing through dentine and have caused the formation of a cavity, involves the provision of dental restorations (fillings). ObjectivesTo assess the effects of adhesive bonding on the in-service performance and longevity of restorations of dental amalgam. Search strategyDatabases searched July 2009: the Cochrane Oral Health Group's Trials Register; CENTRAL (The Cochrane Library 2009, Issue 3); MEDLINE (1950 to July 2009); and EMBASE (1980 to July 2009). Selection criteriaRandomised controlled trials comparing adhesively bonded versus traditional non-bonded amalgam restorations in conventional preparations utilising deliberate retention, in adults with permanent molar and premolar teeth suitable for Class I and II amalgam restorations only. Data collection and analysisTwo review authors independently screened papers, extracted trial details and assessed the risk of bias in the included study. Main resultsOne trial with 31 patients who received 113 restorations was included. At 2 years only 3 out of 53 restorations in the non-bonded group were lost, which was attributed to a lack of retention, and 55 of 60 bonded restorations survived with five unaccounted for at follow-up. Post-insertion sensitivity was not significantly different (P > 0.05) at baseline or 2-year follow-up. No fractures of tooth tissue were reported and there was no significant difference between the groups or matched pairs of restorations in their marginal adaptation (P > 0.05). Authors' conclusionsThere is no evidence to either claim or refute a difference in survival between bonded and non-bonded amalgam restorations. This review only found one methodologically sound but somewhat under-reported trial. This trial did not find any significant difference in the in-service performance of moderately sized adhesively bonded amalgam restorations, in terms of their survival rate and marginal integrity, in comparison to non-bonded amalgam restorations over a 2-year period. In view of the lack of evidence on the additional benefit of adhesively bonding amalgam in comparison with non-bonded amalgam, it is important that clinicians are mindful of the additional costs that may be incurred. |