Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;23(5):727-759.
doi: 10.1007/s40368-022-00725-7. Epub 2022 Jul 12.

Clinical effectiveness of restorative materials for the restoration of carious primary teeth without pulp therapy: a systematic review

S Amend  1 , C Boutsiouki  2 , K Bekes  3 , D Kloukos  4 , N N Lygidakis  5 , R Frankenberger  6 , N Krämer  2
Affiliations

Clinical effectiveness of restorative materials for the restoration of carious primary teeth without pulp therapy: a systematic review

S Amend et al. Eur Arch Paediatr Dent. 2022 Oct.

Abstract

Purpose: To systematically search the available evidence and evaluate the clinical effectiveness of restorative materials for restoration of carious primary teeth. The findings aimed to support the European Academy of Paediatric Dentistry (EAPD) guidelines development.

Methods: Literature search was performed by searching 4 electronic databases for eligible randomised controlled clinical trials (RCTs) comparing restorative materials for the restoration of carious primary teeth up to December 28th, 2020. Quality assessment was performed with the revised Cochrane risk-of-bias tool for randomized trials (RoB 2).

Results: Of 1685 identified articles 29 RCTs were finally deemed as eligible for inclusion. Annual failure rates were: Amalgam 1-28%; atraumatic restorative treatment 1.2-37.1%; glass-ionomer cement (GIC) 7.6-16.6%, metal-reinforced GIC 29.9%, resin-modified GIC 1.9-16.9%, high-viscosity GIC 2.9-25.6%; glass carbomer ≤ 46.2%; compomer 0-14.7%; composite resin (CR) 0-19.5%, bulk-fill CR 0-16.9%; zirconia crowns 3.3%, composite strip crowns 15%, and preformed metal crowns (Hall-Technique) 3.1%. Secondary caries, poor marginal adaptation, loss of retention, and fracture of restoration were reported as reasons for failure. Four studies were evaluated at unclear and 25 at high risk of bias. Clinical and methodological heterogeneity, and the diversity of tested materials across included studies did not allow for meta-analyses.

Conclusions: Within the limitations of this systematic review, namely, the heterogeneity and the overall high risk of bias among included studies, clear recommendations based on solid evidence for the best restorative approach in primary teeth cannot be drawn. There is a need for future thoroughly implemented RCTs evaluating restorations in primary teeth to close this knowledge gap.

Keywords: Caries; Clinical effectiveness; Dentine; Primary teeth; Restorative materials; Systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests to declare that are relevant to the content of this systematic review.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram presenting the study selection process, the numbers of studies identified, eligible, and included in the systematic review. PFS pit and fissure sealing, RCT randomised clinial trial
Fig. 2
Fig. 2
Quality assessment for the potential risk of bias
See this image and copyright information in PMC

References

    1. Adamczyk E, Spiechowicz E. Plaque accumulation on crowns made of various materials. Int J Prosthodont. 1990;3(3):285–291. - PubMed
    1. Akman H, Tosun G. Clinical evaluation of bulk-fill resins and glass ionomer restorative materials: A 1-year follow-up randomized clinical trial in children. Niger J Clin Pract. 2020;23(4):489–497. doi: 10.4103/njcp.njcp_519_19. - DOI - PubMed
    1. Alaki SM, Abdulhadi BS, Abd El Baki MA, Alamoudi NM. Comparing zirconia to anterior strip crowns in primary anterior teeth in children: a randomized clinical trial. BMC Oral Health. 2020; 20(1): 313. 10.1186/s12903-020-01305-1 - PMC - PubMed
    1. Alrashdi M, Ardoin J, Liu JA. Zirconia crowns for children: a systematic review. Int J Paediatr Dent. 2021 doi: 10.1111/ipd.12793. - DOI - PubMed
    1. Alves dos Santos MP, Luiz RR, Maia LC. Randomised trial of resin-based restorations in Class I and Class II beveled preparations in primary molars: 48-month results. J Dent. 2010; 38(6): 451–459. 10.1016/j.jdent.2010.02.004 - PubMed

Publication types

MeSH terms