Abstract
Statement of problem
Established restorative protocols for patients after head and neck radiotherapy are
lacking, increasing the failure rates of dental adhesive restorations.
Purpose
The purpose of this systematic review and meta-analysis was to analyze the evidence
regarding the impact of head and neck radiotherapy on the longevity of dental adhesive
restorations.
Material and methods
A search was performed using PubMed, Scopus, and Embase in May 2018 (updated in November
2020). Data extraction was performed regarding the percentage of restoration failure
among dental adhesive materials, including glass ionomer cements, resin-modified glass
ionomer cements, and composite resins. Risk of bias was assessed by the meta-analysis
of statistics assessment and review instrument (MAStARI). Confidence in cumulative
evidence was evaluated by the Grading of Recommendation, Assessment, Development,
and Evaluation (GRADE) protocol.
Results
Four studies met the inclusion criteria. All included studies were classified as having
a moderate risk of bias and reported results regarding class V restorations. Overall,
composite resins presented lower failure rates at 2 years (30%) when compared with
resin-modified glass ionomer (41%) and glass ionomer cements (57%). Meta-analysis
showed that the risk of failure with glass ionomer cements was greater than with resin-modified
glass ionomer cements (RR: 1.71, P<.001). Composite resins presented lower risk of failure when compared with glass
ionomer (RR: 2.29, P<.001) and resin-modified glass ionomer cements (RR: 1.30, P=.03). Three studies reported results regarding fluoride compliance, which had a negative
effect on the survival rates of glass ionomer and resin-modified glass ionomer cements
and a positive effect on composite resin restorations.
Conclusions
The results suggest that composite resin restorations associated with fluoride gel
compliance seems to be the best alternative for restoring class V lesions in patients
after head and neck radiotherapy. However, the results showed moderate certainty of
evidence, which justifies the need for more randomized clinical trials regarding this
subject.
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Article info
Publication history
Published online: March 11, 2021
Identification
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© 2021 by the Editorial Council for the Journal of Prosthetic Dentistry.
