Clinical Effectiveness of Restorative Materials for the Restoration of Carious Primary Teeth: An Umbrella Review

Abstract

Since untreated dental caries remain a worldwide burden, this umbrella review aimed to assess the quality of evidence on the clinical effectiveness of different restorative materials for the treatment of carious primary teeth. A literature search in electronic bibliographic databases was performed to find systematic reviews with at least two-arm comparisons between restorative materials and a follow-up period ≥12 months. Reviews retrieved were screened; those eligible were selected, and the degree of overlap was calculated using the 'corrected covered area' (CCA). Data were extracted and the risk of bias was assessed using the ROBIS tool. Fourteen systematic reviews with a moderate overlap (6% CCA) were included. All materials studied performed similarly and were equally efficient for the restoration of carious primary teeth. Amalgam and resin composite had the lowest mean failure rate at 24 months while high-viscosity and metal-reinforced glass ionomer cements had the highest. At 36 months, high-viscosity glass ionomer cements showed the highest failure rate with compomer showing the lowest. Most reviews had an unclear risk of bias. Within the limitations of the review, all materials have acceptable mean failure rates and could be recommended for the restoration of carious primary teeth.

Keywords: biomaterials; dental caries; primary teeth; restorative materials; umbrella review.

Figure 1

PRISMA flow diagram.

Figure 2

The failure rate of restorative materials at 24 months. Abbreviations: A: amalgam; CO: compomer; GIC: glass-ionomer cement; HVGIC: high-viscosity glass-ionomer cement; MRGIC: metal-reinforced glass-ionomer cement; RC: resin composite; RMGIC: resin-modified glass-ionomer cement; SSC: stainless steel crown; n: represents the number of reviews in which the efficacy of the specific material was assessed; Min: minimum value for failure rate; Max: maximum value for failure rate.

Figure 3

The failure rate of restorative materials at 36 months. Abbreviations: A: amalgam; CO: compomer; GIC: glass-ionomer cement; HVGIC: high-viscosity glass-ionomer cement; MRGIC: metal-reinforced glass-ionomer cement; RC: resin composite; RMGIC: resin-modified glass-ionomer cement; SSC: stainless steel crown; n: represents the number of reviews in which the efficacy of the specific material was assessed; Min: minimum value for failure rate; Max: maximum value for failure rate.