n Journal of Minimum Intervention in Dentistry - In cavities of comparable size and tooth location, do ART restorations have a better survival rate then amalgam restoration? [2008] : grey literature

Volume 8, Issue 3
  • ISSN : 1998-801X


[This document has been captured as part of the JMID-section for Grey- literature. Grey (or gray) literature refers to informally published written material that may be difficult to trace via conventional databases and/or journals as it is not formally published or is not widely accessible. However, Grey literature may still be an important source of information. Examples of grey literature include e.g.: patents, reports, working documents or unpublished manuscripts]

The systematic literature search identified 16 articles in compliance with the broad inclusion criteria. Of these, 10 articles were rejected due to insufficient internal validity. Six articles were accepted, 1 of which was a systematic review/meta-analysis. Five trials were accepted for data extraction and further meta-analysis. Clinical heterogeneity was observed and articles grouped accordingly. The pooled odds ratios (OR) for the separate groups were 1.84 (CI 95% 1.34 - 2.54); 1.56 (CI 95% 1.06 - 2,28); 1.28 (CI 95% 1.00 - 1.64) and 0.54 (CI 95% 0.02 - 14.35) for Class I/permanent teeth after 3-6 years; Class I/primary teeth after 2-3 years; Class II/primary teeth and Class II/permanent teeth after 2-3 years, respectively. These results indicate that Class I ART restorations have a higher success rate and Class II ART restorations a similar success rate in both dentitions then amalgam restorations of the same size. The odds ratios of 1.84 for Class I/permanent teeth and 1.56 for Class I/primary teeth indicate that the odds for survival of ART restorations is 84% and 56%, respectively, higher than for amalgam restorations. These results differ from the results of the meta-analysis by Frencken et al. (2004) for single-surface ART restorations in the permanent dentition. The later found no difference between ART and amalgam restorations. The reason is that this meta-analysis did not accept 2 trials due to aspects of internal validity and it included 1 trial published after 2004. For these reasons this meta-analysis is more valid and updated. Furthermore, these results are consistent with only 1 rejected trial in the permanent dentition / Class I. The results of all other rejected trials differ. The reason for such difference may be due to the insufficient external validity of the rejected trials, as well as their clinical and methodological heterogeneity: length of trials; type of materials used. There is a need for further high quality randomized control trials in order to confirm these results, particularly for Class II restorations in the permanent dentition. It is recommended that reporting of such studies should follow the CONSORT statement.

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