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Do bioactive materials show greater retention rates in restoring permanent teeth than non-bioactive materials? A systematic review and network meta-analysis of randomized controlled trials

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Abstract

Objectives

To answer the following research question: does the clinical evaluation of restorations on permanent teeth with bioactive materials show greater retention rates than those with non-bioactive materials?

Materials and methods

A search strategy was used in the following databases: MEDLINE via PubMed, Scopus, Web of Science, LILACS, BBO, Embase, The Cochrane Library, and OpenGrey. Randomized controlled trials (RCTs), with a minimum of 2-year follow-up and evaluating at least one bioactive material in permanent teeth were included. Risk of bias was detected according to the Cochrane Collaboration tool for assessing the risk of bias (RoB 2.0), and network meta-analysis was performed using a random-effects Bayesian-mixed treatment comparison model.

Results

Twenty-seven studies were included. The success of the restorations was assessed using modified USPHS system in 24 studies and the FDI criteria in 3 studies. Network meta-analysis revealed three networks based on restoration preparations. Resin composites were ranked with higher SUCRA values, indicating a greater likelihood of being the preferred treatment for class I, II, and III restorations. In class V, resin-modified glass ionomer cement was ranked with the highest value.

Conclusion

Bioactive restorative materials showed similar good clinical performance in terms of retention similarly to conventional resin composites.

Clinical significance

The findings must be interpreted with caution because many RCT on restorative materials aim to verify the equivalence of new materials over the gold standard material rather than their superiority. The present systematic review also suggests that new RCT with longer follow-up periods are necessary.

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Funding

This study was funded by São Paulo Research Foundation (FAPESP; grants 2019/14729–9 and 2020/15561–1).

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Authors and Affiliations

  1. Department of Restorative Dentistry, São Paulo State University – UNESP, Avenida Engenheiro Francisco José Longo, 777, São José Dos Campos, Brazil

    Juliana Benace Fernandes, Sheila Mondragón Contreras, Eduardo Bresciani & Taciana Marco Ferraz Caneppele

  2. Braz Cubas University, Avenida Francisco Rodrigues Filho 1233, Mogi das Cruzes, Brazil

    Manuela da Silva Spinola

  3. A.T. Still University, Missouri School of Dentistry, 500 W Jefferson St, Kirksville, Missouri, USA

    Graziela Ribeiro Batista

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  1. Juliana Benace Fernandes
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  2. Sheila Mondragón Contreras
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  3. Manuela da Silva Spinola
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  4. Graziela Ribeiro Batista
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  5. Eduardo Bresciani
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  6. Taciana Marco Ferraz Caneppele
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Contributions

Conceptualization: T.M.F.C. and E.B. Methodology: J.B.F., S.M.C. and T.M.F.C. Statistical analysis: T.M.F.C and E.B. Writing—original draft: J.B.F., S.M.C., M.S.S, G.R.B., E.B. and T.M.F.C. Reviewing the manuscript: T.M.F.C. and M.S.S.

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Fernandes, J.B., Contreras, S.M., da Silva Spinola, M. et al. Do bioactive materials show greater retention rates in restoring permanent teeth than non-bioactive materials? A systematic review and network meta-analysis of randomized controlled trials. Clin Oral Invest 28, 44 (2024). https://doi.org/10.1007/s00784-023-05414-3

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