دورية أكاديمية
Diagnostic Strategies for Restorations Management: A 70-Month RCT.
| العنوان: | Diagnostic Strategies for Restorations Management: A 70-Month RCT. |
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| المؤلفون: | Digmayer Romero VH; Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil.; Department of Dentistry, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands., Signori C; Department of Restorative Dentistry, School of Dentistry, Uniavan University Center, Balneário Camboriú, Pelotas, Brazil., Uehara JLS; Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil., Montagner AF; Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil., van de Sande FH; Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil., Maydana GS; Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil., Chaves ET; Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil.; Department of Dentistry, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands., Schwendicke F; Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin, Berlin, Berlin, Germany., Braga MM; Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil., Huysmans MC; Department of Dentistry, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands., Mendes FM; Department of Dentistry, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.; Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil., Cenci MS; Department of Dentistry, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands. |
| مؤلفون مشاركون: | CaCIA Collaborative Group |
| المصدر: | Journal of dental research [J Dent Res] 2024 Jul; Vol. 103 (7), pp. 697-704. Date of Electronic Publication: 2024 May 16. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Country of Publication: United States NLM ID: 0354343 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1544-0591 (Electronic) Linking ISSN: 00220345 NLM ISO Abbreviation: J Dent Res Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Thousand Oaks, CA : Sage Original Publication: Chicago, American Dental Assn. [etc.] |
| مواضيع طبية MeSH: | Dental Restoration, Permanent*/methods , Dental Caries*/therapy , Dental Caries*/diagnosis , Dental Restoration Failure*, Humans ; Female ; Male ; Adult ; Middle Aged ; Dental Marginal Adaptation |
| مستخلص: | We aimed to evaluate the impact of 2 visual diagnostic strategies for assessing secondary caries and managing permanent posterior restorations on long-term survival. We conducted a diagnostic cluster-randomized clinical trial with 2 parallel groups using different diagnostic strategies: (C+AS) based on caries assessment, marginal adaptation, and marginal staining aspects of the FDI (World Dental Federation) criteria and (C) based on caries assessment using the Caries Associated with Restorations or Sealants (CARS) criteria described by the International Caries Detection and Assessment System (ICDAS). The treatment for the restoration was conducted based on the decision made following the allocated diagnostic strategy. The restorations were then clinically reevaluated for up to 71 mo. The primary outcome was restoration failure (including tooth-level failure: pain, endodontic treatment, and extraction). Cox regression analyses with shared frailty were conducted in the intention-to-treat population, and hazard ratios (HRs) and 95% confidence intervals (95% CIs) were derived. We included 727 restorations from 185 participants and reassessed 502 (69.1%) restorations during follow-up. The evaluations occurred between 6 and 71 mo. At baseline, C led to almost 4 times fewer interventions compared with the C+AS strategy. A total of 371 restorations were assessed in the C group, from which 31 (8.4%) were repaired or replaced. In contrast, the C+AS group had 356 restorations assessed, from which 113 (31.7%) were repaired or replaced. During follow-up, 34 (9.2%) failures were detected in the restorations allocated to the C group and 30 (8.4%) allocated to the C+AS group in the intention-to-treat population, with no significant difference between the groups (HR = 0.83; 95% CI = 0.51 to 1.38; P = 0.435, C+AS as reference). In conclusion, a diagnostic strategy focusing on marginal defects results in more initial interventions but does not improve longevity over the caries-focused strategy, suggesting the need for more conservative approaches. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| فهرسة مساهمة: | Keywords: caries; caries detection/diagnosis/prevention; decision making; restorative dentistry; secondary caries |
| تواريخ الأحداث: | Date Created: 20240516 Date Completed: 20240620 Latest Revision: 20240620 |
| رمز التحديث: | 20240620 |
| DOI: | 10.1177/00220345241247773 |
| PMID: | 38752325 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1544-0591 |
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| DOI: | 10.1177/00220345241247773 |