What are the emerging trends in dental composite materials in permanent teeth with occlusal cavities: self-adhesive vs traditional?

• Published in: Evidence-based dentistry Vol. 25; no. 1; pp. 17 - 18
• Main Authors: Mourão, Carlos Fernando, Lowenstein, Adam
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.03.2024; Nature Publishing Group
• Subjects: 692/700/3032; 692/700/3032/3065/3069; Adaptation; Adhesives; Clinical trials; Comment; Composite materials; Composite Resins - therapeutic use; Dental caries; Dental Caries - therapy; Dental Cements; Dental enamel; Dental Restoration, Permanent - methods; Dental restorative materials; Dentistry; Dentition, Permanent; Etching; Humans; Medicine; Meta-analysis; Resin Cements; Resins; Resins, Plant; Statistical analysis; Teeth
• ISSN: 1462-0049; 1476-5446; 1476-5446
• DOI: 10.1038/s41432-023-00959-4

Design The research is a systematic review and meta-analysis of randomized controlled trials (RCTs). Aim The study aimed to compare the clinical outcomes of self-adhesive flowable composite resins (SAFCs) versus conventional flowable composite resins (FCs) used in occlusal cavity restorations in permanent teeth. Methods This research included a search for RCTs. Multiple databases were systematically searched for RCTs with a minimum 1-year follow-up comparing SAFCs to FCs. Outcomes evaluated were retention, secondary caries, marginal adaptation, marginal discoloration, and postoperative sensitivity based on modified USPHS criteria. Risk of bias was assessed using Cochrane RoB 2 tool. Random effects meta-analyses were conducted where applicable. Certainty of evidence was rated using GRADE approach. Results Five RCTs (four parallel and one split mouth) comprising 138 patients were included. During 1- and 2-year recalls, there were generally no significant differences in clinical performance between SAFCs and FCs. However, FCs applied using the etch-and-rinse technique demonstrated statistically better marginal adaptation at 2 years (3 studies, RR 3.21, 95% CI 1.50–6.83) and marginal discoloration (4 studies, RR 3.40, 95% CI 1.10–10.48). The overall quality of evidence ranged from low to moderate. Conclusions SAFCs showed comparable short-term outcomes to FCs in treating occlusal cavities. Further high-quality RCTs with longer follow-up are warranted to confirm long-term performance of SAFCs. Use of separate enamel etching may improve marginal adaptation and discoloration with FCs.