Antibacterialagentsin composite restorationsfor the prevention of dentalcaries

Abstract

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, excessive wear, marginal degradation, tooth sensitivity, pulpal death, and restorative material fracture. Caries adjacent to restorations is one of the main causes for restoration 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. Objectives To assess the effects of antibacterial agents incorporated into composite restorations for the prevention of dental caries. Search methods We searched the following databases in February 2009: theCochraneOralHealthGroup’sTrialsRegister;theCochraneCentralRegister ofControlledTrials(CENTRAL)(TheCochraneLibrary2009,Issue1);MEDLINEviaOVID(1950toFebruary2009)withoutfilter; and EMBASE via OVID (1980 to February 2009) without filter. Selection criteria Randomised controlled clinical trials(RCTs) comparing resin composite restorations containing antibacterial agentswithnon-antibacterial containing composite restorations. 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 toextract data independently and assess trial quality using standard Cochrane Collaboration methodologies. Main results We retrieved 128 references to studies, none of which matched the inclusion criteria for this review and all of which were excluded. Authors’conclusions We were unableto identify any randomised controlled trials on the effects ofantibacterial agents incorporated into compositer estorations for the prevention of dental caries. The absence of high level evidence for the effectiveness of this intervention emphasises the need for welldesigned, adequately powered, randomised controlled clinical trials.