Journal article
Nonrestorative Treatments for Caries: Systematic Review and Network Meta-analysis
Journal of dental research, Vol.98(1), pp.14-26
01/01/2019
DOI: 10.1177/0022034518800014
PMCID: PMC6304695
PMID: 30290130
Abstract
The goal of nonrestorative or non- and microinvasive caries treatment (fluoride- and nonfluoride-based interventions) is to manage the caries disease process at a lesion level and minimize the loss of sound tooth structure. The purpose of this systematic review and network meta-analysis was to summarize the available evidence on nonrestorative treatments for the outcomes of 1) arrest or reversal of noncavitated and cavitated carious lesions on primary and permanent teeth and 2) adverse events. We included parallel and split-mouth randomized controlled trials where patients were followed for any length of time. Studies were identified with MEDLINE and Embase via Ovid, Cochrane CENTRAL, and Cochrane Database of Systematic Reviews. Pairs of reviewers independently conducted the selection of studies, data extraction, risk-of-bias assessments, and assessment of the certainty in the evidence with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Data were synthesized with a random effects model and a frequentist approach. Forty-four trials (48 reports) were eligible, which included 7,378 participants and assessed the effect of 22 interventions in arresting or reversing noncavitated or cavitated carious lesions. Four network meta-analyses suggested that sealants + 5% sodium fluoride (NaF) varnish, resin infiltration + 5% NaF varnish, and 5,000-ppm F (1.1% NaF) toothpaste or gel were the most effective for arresting or reversing noncavitated occlusal, approximal, and noncavitated and cavitated root carious lesions on primary and/or permanent teeth, respectively (low- to moderate-certainty evidence). Study-level data indicated that 5% NaF varnish was the most effective for arresting or reversing noncavitated facial/lingual carious lesions (low certainty) and that 38% silver diamine fluoride solution applied biannually was the most effective for arresting advanced cavitated carious lesions on any coronal surface (moderate to high certainty). Preventing the onset of caries is the ultimate goal of a caries management plan. However, if the disease is present, there is a variety of effective interventions to treat carious lesions nonrestoratively.
Details
- Title: Subtitle
- Nonrestorative Treatments for Caries: Systematic Review and Network Meta-analysis
- Creators
- O. Urquhart - American Dental AssociationM. P. Tampi - American Dental AssociationL. Pilcher - American Dental AssociationR. L. Slayton - University of WashingtonM. W. B. Araujo - American Dental AssociationM. Fontana - University of Michigan–Ann ArborS. Guzman-Armstrong - University of IowaM. M. Nascimento - University of FloridaB. B. Novy - 7 DentaQuest Institute and DentaQuest Oral Health Center, Westborough, MA, USA.N. Tinanoff - University of Maryland, College ParkR. J. Weyant - University of PittsburghM. S. Wolff - Univ Penn, Philadelphia, PA 19104 USAD. A. Young - University of the PacificD. T. Zero - University of IndianapolisR. Brignardello-Petersen - McMaster UniversityL. Banfield - McMaster UniversityA. Parikh - Midwestern UniversityG. Joshi - 16 GC America, Alsip, IL, USA.A. Carrasco-Labra - American Dental Association
- Resource Type
- Journal article
- Publication Details
- Journal of dental research, Vol.98(1), pp.14-26
- Publisher
- Sage
- DOI
- 10.1177/0022034518800014
- PMID
- 30290130
- PMCID
- PMC6304695
- ISSN
- 0022-0345
- eISSN
- 1544-0591
- Number of pages
- 13
- Grant note
- GC America Novartis Pharmaceuticals; Novartis National Institute of Dental and Craniofacial Research (NIDCR)-National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Dental & Craniofacial Research (NIDCR) Church Dwight Procter Gamble; Procter & Gamble SDI Oral Biotech Colgate Xlear Health Resources and Services Administration; United States Department of Health & Human Services; United States Health Resources & Service Administration (HRSA) Colgate-Palmolive Elevate Oral Care Shofu Oral BioTech, LLC Johnson Johnson; Johnson & Johnson; Johnson & Johnson USA GlaxoSmithKline Voco NIDCR-NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Dental & Craniofacial Research (NIDCR) Ivoclar
- Language
- English
- Date published
- 01/01/2019
- Academic Unit
- Pediatric Dentistry; Operative Dentistry
- Record Identifier
- 9984367723102771
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