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

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF PROSTHETIC DENTISTRY; v. 128, n. 5, p. 11-pg., 2022-11-30.

Resumo

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)

• Processo FAPESP: 12/06138-1 - Estudo prospectivo da incidência de trismo induzido por radioterapia em pacientes com carcinoma espinocelular de boca
• Beneficiário: Ana Carolina Prado Ribeiro e Silva
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 18/02233-6 - Segurança oncológica no uso da fotobiomodulação intraoral e extraoral em pacientes com carcinoma espinocelular de cavidade oral e orofaringe
• Beneficiário: Alan Roger dos Santos Silva
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 16/22862-2 - Impacto da idade sobre as toxicidades bucais induzidas pela radioterapia em pacientes jovens com câncer de boca
• Beneficiário: Jaqueline de Lima Correia
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica
• Processo FAPESP: 18/04657-8 - Proteínas salivares candidatas a marcadores de toxicidade bucal associada à radioterapia
• Beneficiário: Natália Rangel Palmier
• Modalidade de apoio: Bolsas no Brasil - Doutorado
• Processo FAPESP: 13/18402-8 - Avaliação dos efeitos diretos da radiação sobre o esmalte, a dentina e a polpa dental de pacientes com câncer de cabeça e pescoço
• Beneficiário: Alan Roger dos Santos Silva
• Modalidade de apoio: Auxílio à Pesquisa - Regular