Avaliação de resinas compostas bulk-fill: análise do desempenho clínico em odontopediatria

Abstract

This thesis is composed of two scientific articles, whose main theme is restorations in primary teeth with bulk-fill composite resins. Article 1: Clinical behavior of bulk-fill restorations in primary molars: A systematic review and meta-analysis. The aim of this study was to systematically review the literature of clinical trials found in PubMed, Scopus, Web of Science, EMBASE, and Lilacs/BBO databases, up to June 2022, in order to compare the longevity of bulk-fill restorations and others direct restorative materials in primary molars. From 710 identified studies, 10 were selected for full-text reading and 6 were selected for systematic review and meta-analysis. The overall meta-analysis comparison did not show significant effect of material on restorations failure (Z = 1.58; P = 0.11). This study showed that bulk-fill composite resins can be an alternative restorative material for Pediatric Dentistry, since it has similar longevity to other considered control materials and a shorter clinical restorative time. Article 2: Enamel instrumentation negatively impacts on the survival of composite restorations after selective removal of carious tissue in primary molars: up to 24-months randomized clinical trial. This randomized, double-blind clinical trial evaluated the influence of enamel instrumentation on the performance of composite resin restorations in primary molars submitted to selective removal of carious tissue. One hundred and thirty-two cavitated occlusal caries lesions, in deep dentin, in primary teeth, were selected and randomly allocated into two intervention groups, a non-instrumented (NIE) and an instrumented (IE; enamel margins were instrumented with a diamond bur before restoration). Composite restorations were evaluated after 3, 6, 12, 18 and 24 months. Success and survival curves were created and compared using Kaplan-Meier estimation and log-rank. The overall clinical success at 24 months from NIE and IE restorations were 93.2% (55/59) and 80.3% (49/61), respectively. A statistically significant difference was found only between the survival rates (p = 0.036), favoring the NIE group. Thus, he use of diamond burs in cavosurface enamel for selective removal of carious tissue, in primary molars, with active carious lesions, cavities and in deep dentin, compromised the clinical performance of bulk-fill composite resin restorations, requiring a more rigorous clinical follow-up.