Antibacterial agents in composite restorations for the prevention of dental caries

  • Review
  • Intervention

Authors


Abstract

Background

Dental caries is a multifactorial disease in which the fermentation of food sugars by bacteria from the biofilm (dental plaque) leads to localised demineralisation of tooth surfaces, which may ultimately result in cavity formation. Resin composites are widely used in dentistry to restore teeth. These restorations can fail for a number of reasons, such as secondary caries, and restorative material fracture and other minor reasons. From these, secondary caries, which are caries lesions developed adjacent to restorations, is the main cause for restorations replacement. The presence of antibacterials in both the filling material and the bonding systems would theoretically be able to affect the initiation and progression of caries adjacent to restorations. This is an update of the Cochrane review published in 2009.

Objectives

To assess the effects of antibacterial agents incorporated into composite restorations for the prevention of dental caries.

Search methods

We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 23 July 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 6), MEDLINE via OVID (1946 to 23 July 2013) and EMBASE via OVID (1980 to 23 July 2013). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov), the metaRegister of Controlled Trials (www.controlled-trials.com) and the World Health Organization International Clinical Trials Registry platform (www.who.int/trialsearch) for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.

Selection criteria

Randomised controlled trials comparing resin composite restorations containing antibacterial agents with composite restorations not containing antibacterial agents.

Data collection and analysis

Two review authors conducted screening of studies in duplicate and independently, and although no eligible trials were identified, the two authors had planned to extract data independently and assess trial quality using standard Cochrane Collaboration methodologies.

Main results

We retrieved 308 references to studies, none of which matched the inclusion criteria for this review and all of which were excluded.

Authors' conclusions

We were unable to identify any randomised controlled trials on the effects of antibacterial agents incorporated into composite restorations for the prevention of dental caries. The absence of high level evidence for the effectiveness of this intervention emphasises the need for well designed, adequately powered, randomised controlled clinical trials. Thus, conclusions remain the same as the previously published review, with no included clinical trials.

Plain language summary

Use of antibacterial substances in resin-based fillings to prevent further tooth decay (next to the filling) developing after treatment

Review question

The main question addressed by this review is how effective the use of antibacterial agents in composite (resin-based, tooth-coloured) fillings might be in preventing the development of further decay either underneath or next to the filling (secondary caries).

Background

When tooth decay (caries) has caused a cavity in a tooth a range of materials can be used as fillings. These include resin composite, glass ionomer cement, amalgam and compomers. Tooth decay that may develop next to or underneath, a filling at a later stage is a common concern in dental practice and may reduce the life span of these fillings. It is thought that including a substance that kills and prevents the growth of bacterial (also known as an antibacterial agent) in some dental fillings, for example resin composites, could help prevent the development of this secondary caries.

Study characteristics

The Cochrane Oral Health Group carried out this review of existing studies and the evidence is current up to 23 July 2013.

The review authors have not found any trials to support or disprove the effectiveness of antibacterial agents incorporated into fillings to prevent further tooth decay.

Key results

No trials were found that were suitable for inclusion in this review.

Quality of the evidence

Currently there is no evidence to support using antibacterial agents in fillings.

Laički sažetak

Upotreba antibakterijskih sredstava u ispunima na bazi smole da bi se spriječilo daljnje propadanje zuba (pokraj ispuna) koje se razvija nakon provedene terapije.

Istraživačko pitanje

Glavno pitanje ovog pregleda je koliko učinkovito može biti korištenje antibakterijskih sredstava u kompozitnim ispunima (na bazi smole ili u bojama zuba) u sprječavanju daljnjih propadanja zuba ispod ili pokraj ispuna (sekundarni karijes).

Dosadašnje spoznaje

Kada karijes izazove šupljinu u zubu, postoji cijeli spektar materijala koji se mogu rabiti za ispune. To uključuje kompozitne smole, stakleno-ionomerni cement (jedini materijal za ispunu koji prianja za tvrdo zubno tkivo), amalgam (materijal koji je često korišten u stomatologiji za restauraciju zuba) te kompomer (materijal koji se u medicini od 1990-ih koristi kao restorativni materijal). Zubni karijes koji se pojavljuje u kasnoj fazi ispod ili pokraj ispuna čest je problem u stomatološkoj praksi, a može smanjiti životni vijek tih ispuna. Pretpostavlja se da bi stavljanje spojeva koji uništavaju i sprječavaju razvoj bakterija (antibakterijsko sredstvo) u nekim zubnim ispunima, npr. kompozitnoj smoli, moglo spriječiti razvoj sekundarnih karijesa.

Značajke istraživanja

Cochrane urednička skupina za oralno zdravlje (engl. Cochrane Oral Health Group) priredila je ovaj sustavni pregled postojećih istraživanja i dokaza objavljenih do 23.srpnja 2013.

Autori ovog pregleda nisu pronašli nikakve studije koje bi potvrdile ili opovrgnule učinkovitost antibakterijskih sredstava uključenih u sastav zubne ispune da bi se spriječilo daljnje propadanje zuba.

Ključni rezultati

Nisu pronađena odgovarajuća istraživanja koja bi se mogla uključiti u ovaj pregled.

Kvaliteta dokaza

Trenutno nema dokaza koji bi poduprli korištenje antibakterijskih sredstava u zubnim ispunima.

Bilješke prijevoda

Cochrane Hrvatska
Prevela: Natalia Koncul
Ovaj sažetak preveden je u okviru volonterskog projekta prevođenja Cochrane sažetaka. Uključite se u projekt i pomozite nam u prevođenju brojnih preostalih Cochrane sažetaka koji su još uvijek dostupni samo na engleskom jeziku. Kontakt: cochrane_croatia@mefst.hr

Ringkasan bahasa mudah

Penggunaan bahan antibakteria dalam tampalan berasaskan resin untuk mencegah pembentukan kerosakan gigi lanjutan (di sebelah tampalan) selepas rawatan.

Soalan ulasan

Soalan utama yang ingin dijawab dalam ulasan ini adalah berkesankah penggunaan agen antibakteria dalam tampalan komposit (berasaskan resin, sewarna gigi) untuk mencegah kerosakan berterusan sama ada di bawah atau bersebelahan tampalan (karies sekunder)

Latar belakang

Apabila kerosakan gigi (karies) menyebabkan pembentukan kaviti pada gigi, pelbagai bahan boleh digunakan sebagai tampalan. Ini termasuklah resin komposit, simen ionomer kaca, amalgam dan kompomer. Kerosakan gigi yang boleh terbentuk bersebelahan atau di bawah sesuatu tampalan, adalah menjadi perhatian utama dalam amalan pergigian dan ia boleh mengurangkan jangka hayat tampalan-tampalan tersebut. Penambahan bahan yang boleh membunuh atau mencegah pertumbuhan bakteria (juga dipanggil agen antibakteria) ke dalam tampalan pergigian, misalnya resin komposit, mungkin boleh mencegah pembentukan karies sekunder.

Ciri kajian

Kumpulan Kesihatan Oral Cochrane membuat ulasan kajian sedia ada dan bukti adalah terkini sehingga 23 Julai 2013.

Para penulis ulasan tidak menjumpai sebarang kajian untuk menyokong atau menyangkal keberkesanan agen antibakteria yang dimasukkan ke dalam tampalan untuk mencegah kerosakan gigi.

Keputusan utama

Tidak ada kajian yang sesuai untuk dimasukkan ke dalam ulasan ini.

Kualiti bukti.

Pada masa kini tidak terdapat sebarang bukti untuk menyokong penggunaan bahan tampalan yang mengandungi agen antibakteria.

Catatan terjemahan

Diterjemahkan oleh Noorliza Mastura Ismail (Kolej Perubatan Melaka-Manipal). Disunting oleh Tuan Hairulnizam Tuan Kamauzaman (Universiti Sains Malaysia). Untuk sebarang pertanyaan berkaitan terjemahan ini sila hubungi noorliza.mastura@manipal.edu.my