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
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
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Dental patients undergoing direct or indirect restorative treatment (no age or gender restriction) | Dental patients, mostly children (n=1342 randomised; 233 lost to follow-up) |
| Intervention | Rubber dam isolation and moisture control (alone or with saliva aspiration) | Rubber dam (n=6 studies) |
| Comparison | Cotton rolls (with or without saliva aspiration) | Cotton rolls (n=5 studies); Isolite system (n=1 study) |
| Outcomes | Primary: 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/satisfaction | Survival 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 designs | RCT (incl. split-mouth; min 1 month) | RCT incl. split-mouth (n=6) |
| Timing | 6 months, 1, 2, 5, 10 years | 6 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
Current version onlyRubber 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)
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Very low Downgraded: risk of bias, imprecision |
Costs: direct cost of treatment | no estimate extracted | 0 studies | No 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 participants | Very 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 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events treatment phase | Adverse events | Outcome not reported | 0 studies | No 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 participants | Ungraded |
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 participants | Very 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 participants | Very low Downgraded: risk of bias, imprecision |
Rubber dam isolation vs Isolite system
Population: Dental patients undergoing restorative treatment (no age or gender restriction)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Costs: operation/chair time Pit and fissure sealing (permanent molars) | MD 9.36 [8.42, 10.30] | 1 study · 42 participants | Very 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 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events treatment phase | no estimate extracted | 0 studies | No studies |
Clinical evaluation of restoration's quality | no estimate extracted | 0 studies | No studies |
Costs: direct cost of treatment | no estimate extracted | 0 studies | No studies |
Survival rate of the restorations | no estimate extracted | 0 studies | No studies |
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)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Survival rate of restorations (6 months) 6 months · Non-carious cervical lesions (composite restoration) | RR 1.19 [1.04, 1.37] 765 per 1000 vs 910 per 1000 | 1 study · 162 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Costs: direct cost of treatment | no estimate extracted | 0 studies | No studies |
Adverse events treatment phase | no estimate extracted | 0 studies | No studies |
Costs: treatment/operation time Fissure sealing (permanent premolars/molars) | One study (72 children) reported 12.4% less time (108 seconds) to accomplish fissure sealing with rubber dam vs cotton rolls (Ammann 2013); narrative, not pooled. | 1 study · 72 participants | Ungraded |
Clinical evaluation of restoration's quality | no estimate extracted | 0 studies | No studies |
Participant acceptance/satisfaction | no estimate extracted | 0 studies | No 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 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Rubber dam isolation and moisture control (alone or with saliva aspiration) vs Alternative isolation/moisture control, e.g. cotton rolls (with or without same active treatment)
Population: Dental patients undergoing direct or indirect restorative treatment (no age or gender restriction)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse events treatment phase | no estimate extracted | NR | No studies |
Clinical evaluation of restoration's quality baseline, 0.5, 1, 2, 5, 10 years | no estimate extracted | NR | No studies |
Costs: time needed to accomplish treatment | no estimate extracted | NR | No studies |
Costs: direct cost of treatment | no estimate extracted | NR | No studies |
Survival rate of the restorations 0.5, 1, 2, 5, 10 years | no estimate extracted | NR | No studies |