Cochrane · intervention · CD009858

Rubber dam isolation for restorative treatment in dental patients

Miao, C, Yang, X, Wong, MCM, et al. · Cochrane Database of Systematic Reviews · 2021 · 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
15
current version
GRADE rated
8
No studies
6
Included studies
6
as reported
No studies 6 · 40%Ungraded 1 · 6.7%Very low 7 · 46.7%Low 1 · 6.7%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)
PopulationDental patients undergoing direct or indirect restorative treatment (no age or gender restriction)Dental patients, mostly children (n=1342 randomised; 233 lost to follow-up)
InterventionRubber dam isolation and moisture control (alone or with saliva aspiration)Rubber dam (n=6 studies)
ComparisonCotton rolls (with or without saliva aspiration)Cotton rolls (n=5 studies); Isolite system (n=1 study)
OutcomesPrimary: Survival rate of the restorations (0.5/6 months, 1, 2, 5, 10 years); Adverse events. Secondary: Clinical evaluation of restoration's quality (colour match, cavo-surface marginal discolouration, anatomic form, marginal adaptation, caries); Costs (direct cost of treatment; time needed to accomplish treatment); Participant acceptance/satisfactionSurvival rate of restorations (n=4 reported; 6, 12, 18, 24 months); Restoration quality (n=1); Operation/chair time (n=3); Participant acceptance/satisfaction (n=2)
Study designsRCT (incl. split-mouth; min 1 month)RCT incl. split-mouth (n=6)
Timing6 months, 1, 2, 5, 10 years6 months; 12 months; 18 months; 24 months

Search date: 2021-01. Databases: Cochrane Oral Health's Trials Register; CENTRAL; MEDLINE Ovid; Embase Ovid; LILACS BIREME Virtual Health Library; SciELO BIREME Virtual Health Library; Chinese BioMedical Literature Database (CBM); VIP; China National Knowledge Infrastructure (CNKI); ClinicalTrials.gov; WHO International Clinical…

Questions and results

Show all 3 versions

Rubber dam isolation and moisture control (alone or with saliva aspiration) vs Cotton rolls (with or without saliva aspiration)

Population: Dental patients undergoing direct or indirect restorative treatment (no age or gender restriction)
9 questions
OutcomeEffectEvidenceStatus / GRADE
Survival rate of restorations (6 months)
6 months · Non-carious cervical lesions (composite restoration)
OR 2.29 [1.05, 4.99]
811 per 1000 vs 908 per 1000
2 studies · 192 participantsLow
Downgraded: risk of bias, imprecision
Costs: treatment/operation time
NCCL composite (Loguercio); fissure sealing (Ammann, narrative)
MD -0.40 [-2.26, 1.46]1 study · 30 participantsVery low
Downgraded: risk of bias, imprecision
Costs: direct cost of treatment
no estimate extracted0 studiesNo studies
Survival rate of restorations (24 months)
24 months · Primary molars (proximal atraumatic restorative treatment)
HR 0.80 [0.66, 0.97]1 study · 559 participantsVery low
Downgraded: risk of bias, imprecision
Survival rate of restorations (18 months)
18 months · Non-carious cervical lesions (composite restoration)
OR 1.00 [0.45, 2.25]1 study · 30 participantsVery low
Downgraded: risk of bias, imprecision
Adverse events
treatment phase
Adverse events | Outcome not reported0 studiesNo studies
Clinical evaluation of restoration's quality
6, 12, 18 months · Non-carious cervical lesions (composite restoration)
Loguercio 2015: no significant differences (P>0.05) in marginal staining and marginal adaptation of NCCL restorations between rubber dam and cotton rolls/retraction cords at 6, 12 and 18 months.1 study · 30 participantsUngraded
Participant acceptance/satisfaction
Non-carious cervical lesions (composite restoration)
Evidence did not support higher acceptance/preference for rubber dam than cotton rolls (P = 0.85 from binomial test on 28 participants; very low-certainty evidence) (Loguercio 2015).1 study · 28 participantsVery low
Downgraded: risk of bias, imprecision
Survival rate of restorations (12 months)
12 months · Non-carious cervical lesions (composite restoration)
OR 1.38 [0.45, 4.28]1 study · 30 participantsVery low
Downgraded: risk of bias, imprecision

Rubber dam isolation vs Isolite system

Population: Dental patients undergoing restorative treatment (no age or gender restriction)
6 questions
OutcomeEffectEvidenceStatus / GRADE
Costs: operation/chair time
Pit and fissure sealing (permanent molars)
MD 9.36 [8.42, 10.30]1 study · 42 participantsVery low
Downgraded: risk of bias, imprecision
Participant acceptance/satisfaction
Pit and fissure sealing (permanent molars)
Rubber dam may be associated with significantly lower satisfaction than the Isolite system but evidence very uncertain, mainly worse comfort (31%, P=0.02) and less preference (26%, P=0.002) (Alhareky 2014).1 study · 42 participantsVery low
Downgraded: risk of bias, imprecision
Adverse events
treatment phase
no estimate extracted0 studiesNo studies
Clinical evaluation of restoration's quality
no estimate extracted0 studiesNo studies
Costs: direct cost of treatment
no estimate extracted0 studiesNo studies
Survival rate of the restorations
no estimate extracted0 studiesNo studies