Impact of head and neck radiotherapy on the longevity of dental adhesive restorations: A systematic review and meta-analysis

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Palmier, Natalia Rangel ; Madrid Troconis, Cristhian Camilo ; Costa Normando, Ana Gabriela ; Silva Guerra, Eliete Neves ; Damaceno Araujo, Anna Luiza ; Aristizabal Arboleda, Lady Paola ; Fonseca, Jessica Montenegro ; Paglioni, Mariana de Pauli ; Gomes-Silva, Wagner ; Vechiato Filho, Aljomar Jose ; Gonzalez-Arriagada, Wilfredo Alejandro ; Paes Leme, Adriana Franco ; Prado-Ribeiro, Ana Carolina ; Brandao, Thais Bianca ; de Goes, Mario Fernando ; Lopes, Marcio Ajudarte ; Santos-Silva, Alan Roger

• Document type: Journal article
• Source: JOURNAL OF PROSTHETIC DENTISTRY; v. 128, n. 5, p. 11-pg., 2022-11-30.

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. (J Prosthet Dent 2022;128:886-96) (AU)

• FAPESP's process: 12/06138-1 - A prospective study of radiation-induced trismus in patients with oral squamous cell carcinoma
• Grantee: Ana Carolina Prado Ribeiro e Silva
• Support Opportunities: Regular Research Grants
• FAPESP's process: 18/02233-6 - Oncological safety of the use of intraoral and extraoral photobiomodulation in patients with oral cavity and oropharyngeal squamous cell carcinoma
• Grantee: Alan Roger dos Santos Silva
• Support Opportunities: Regular Research Grants
• FAPESP's process: 16/22862-2 - Impact of age in radiation-induced oral toxicities of young patients with oral cancer
• Grantee: Jaqueline de Lima Correia
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 18/04657-8 - Salivary protein markers of radiation-related oral toxicites
• Grantee: Natália Rangel Palmier
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 13/18402-8 - Evaluation of the direct effects of radiation on the enamel, dentin and dental pulp of head and neck cancer patients
• Grantee: Alan Roger dos Santos Silva
• Support Opportunities: Regular Research Grants