Restorative treatments for caries lesions – ADA guideline

Photograph of carious teeth

In this blog we take a look at the latest clinical practice guideline from the American Dental Association on restorative treatments for primary and permanent teeth with moderate and advanced caries.

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Direct restorative materials for treating cavitated carious lesions

Dental_Restoration

This review of different direct restorative materials for treating cavitated caries lesions on anterior and posterior primary and permanent teeth included 38 RCTs. None of the included studies was at low risk of bias and the findings suggest that the effectiveness of each included direct restorative material varied across outcomes. There was also limited evidence to support clinically important differences between the direct restorative materials assessed.

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Class II restorations in primary molars

shutterstock_72680830 - erupting incisors & caries

This review comparing compare the success rate of five tooth-coloured materials for class II restorations in primary molars included 10 RCTs. No differences in failure rates were seen for composite resin,resin-modified glass ionomer cement or compomers although all included studies were at high risk of bias.

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Primary teeth: which restorative material last longer?

PMC 2

This review of the longevity of posterior restoration in primary teeth included 31 studies. composite resin had the lowest annual failure rate while stainless steel crowns had the highest success rate. The studies all have a high risk of bias so the findings should be interpreted cautiously.

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Crowns more effective than fillings for decay in primary molar teeth

PMC 2

Five RCTs were included in this Cochrane review comparing crowns with fillings for the management of caries in primary molars. Moderate evidence found crowns reduced the risk of major failure or pain in the long term compared to fillings

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Direct anterior restorations have good survival rates

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This review of direct anterior restorative materials included 21 studies and covered a wide range of materials and adhesive systems. Overall the failure rates were low for both class III and class IV restorations.

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Review finds glass ionomer had lowest annual failure rate in non-carious cervical lesions

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Non-carious cervical lesions (NCCLs) are saucer or wedge-shaped defects that appear along the cementum-enamel junction as a result of gradual loss of dental tissues in the absence of caries. Their aetiology has not been fully clarified. NCCLs are restored using adhesive materials glass-ionomers and their resin-modified version, poly-acid modified composites (known as ‘compomers’), composite and [read the full story…]

Which type of fissure sealant lasts longest?

iStock_000001604217XSmall dental laser

Fissure sealants are a recommended procedure for the prevention of occlusal caries in permanent molars. The aim of this review was to assess the clinical retention of pit and fissure sealants in relation to observation time and material type. The authors searched the Embase, Medline and CENTRAL (Cochrane Central Register of Controlled Trials)  databases for [read the full story…]