Cochrane · intervention · CD007517

Adhesively bonded versus non‐bonded amalgam restorations for dental caries

Agnihotry, A, Fedorowicz, Z, Nasser, M · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library

Oral HealthDental caries3 versionsAMSTAR 2: not assessed
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
6
current version
GRADE rated
2
No studies
3
Included studies
1
as reported
No studies 3 · 50%Ungraded 1 · 16.7%Very low 0 · 0%Low 2 · 33.3%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

ElementPlanned (methods)Found (results)
PopulationAdults and adolescents with permanent posterior molar and premolar teeth suitable for Class I and II, but excluding Class V, amalgam restorations31 participants (21 male, 10 female; 35 matched pairs of teeth) with 113 Class II amalgam restorations, followed up for 2 years
InterventionAdhesively bonded amalgam restorations in conventional preparations utilising deliberate retention. All types of bonding agents were consideredAdhesively bonded amalgam restorations (Panavia 21TC with ED primer) (n=60)
ComparisonTraditional non‐bonded amalgam restorationsNon‐bonded amalgam restorations (n=53)
OutcomesPrimary: Survival of the restoration (longevity/survival to defined time points yearly up to a maximum of 10 years). Secondary: Post‐insertion sensitivity or pain assessed by a validated pain scale; Secondary caries, as diagnosed clinically; Marginal deterioration of the restoration and fracture of the remaining tooth tissue; Economic data: direct costs of materials and any reported associated indirect costs; Adverse effects: any specific adverse effects related to any clinically diagnosed reactionsSurvival of restoration (n=113); Post‐insertion sensitivity (USPHS; n=113); Secondary caries (no data); Marginal deterioration / marginal adaptation (USPHS Alpha; n=113); Fracture of remaining tooth tissue (none reported); Economic data (no data); Adverse effects (none reported)
Study designsRandomised controlled trials (RCTs) to include paired tooth and split‐mouth designs, with a minimum length of follow‐up of 2 years; unit of randomisation at the level of the tooth or the individual patient. Only studies assessing in‐service performance and longevity using clearly defined criteria (e.g. USPHS or recognised modifications)1 split‐mouth RCT (Setcos 1999), assessed at unclear risk of bias
TimingMinimum length of follow‐up of 2 years; outcome data categorised at time‐points 1, 2, 5 and 10 years2 years (baseline and 24‐month follow‐up)

Search date: 2016-01. Databases: Cochrane Oral Health Group Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE via Ovid (1946 to 21 January 2016); EMBASE via Ovid (1980 to 21 January 2016); US National Institutes of Health Trials Registry (ClinicalTrials.gov); WHO International Clinical Trials…

Questions and results

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Adhesively bonded amalgam restorations in conventional preparations utilising deliberate retention (all bonding agents) vs Traditional non‐bonded amalgam restorations

Population: Adults and adolescents with permanent posterior molar and premolar teeth suitable for Class I and II, but excluding Class V, amalgam restorations
6 questions
OutcomeEffectEvidenceStatus / GRADE
Survival of the restoration
Mean 24 months
Survival of the restoration - Follow‐up: mean 24 months | Illustrative comparative risks: Assumed risk (Control) See comment; Corresponding risk (Adhesive bonding) See comment | Relative effect (95% CI): Not estimable…1 study · 31 participantsLow
Downgraded: risk of bias, imprecision
Marginal deterioration of the restoration and fracture of the remaining tooth tissue
Mean 24 months
Marginal deterioration of the restoration and fracture of the remaining tooth tissue - Follow‐up: mean 24 months | Study population | Relative effect (95% CI): Not estimable | Number of participants (studies): 31 (1…1 study · 31 participantsLow
Downgraded: risk of bias, imprecision
Economic data: direct costs of materials and any reported associated indirect costs
Economic data: direct costs of materials and any reported associated indirect costs - not measured | See comment | See comment | Not estimable | - | See comment | No study addressed this outcome0 studiesNo studies
Adverse effects
Adverse effects: any event for which the causal relationship between the event and the amalgam restoration is at least a reasonable possibility - not measured | See comment | See comment | Not estimable | - | See…0 studiesNo studies
Secondary caries, as diagnosed clinically
Secondary caries, as diagnosed clinically - not measured | See comment | See comment | Not estimable | - | See comment | No study addressed this outcome0 studiesNo studies
Post‐insertion sensitivity or pain assessed by a validated pain scale
Baseline and 24 months
Post‐insertion sensitivity or pain assessed by a validated pain scale - not measured | See comment | See comment | Not estimable | - | See comment | No study addressed this outcome1 study · 31 participantsUngraded