Restorative approaches to treat dentin caries in preschool children: systematic review

Authors:

ABSTRACT

Aim

Dental restorations have long been used for the management of early childhood caries, but there is a need to have an
evidence based approach when selecting the most appropriate restorative intervention to treat dentin caries in preschool children. This
systematic review aimed to assess the effectiveness of restorative treatments of dentin caries in primary teeth in preschool children.

Methods

Design: A systematic search of the main electronic databases (Pubmed, Cochrane Collaboration,
EMBASE) was conducted to identify peer reviewed papers published in English in the years 1947-2014. Search keywords and MeSH
headings were "dental caries", "primary dentition" and "dental restoration". The inclusion criteria were clinical studies conducted in
children under 6 years old, and reported findings on the longevity or failure of restorations in primary teeth. Retrieved papers were read
by two reviewers independently to assess suitability for inclusion, and the final decision was made by consensus. The quality of the
included studies was assessed and data were extracted for analysis.

Results

The search identified 348 papers for screening.
Among these, 218 papers did not satisfy the study inclusion criteria. Consequently, 130 full papers were retrieved and reviewed. Finally,
9 papers were included. Most of the trials were assessed as having high risk of bias. Five included studies that compared the success
rates of restorations with different filling materials and liner materials. Two studies showed clinical advantages of using minimally
invasive approaches in caries removal and cavity preparation. The other two trials showed low success rates of interim GI restorations
done in a field setting, compared to the high caries arrest rates of silver diammine fluoride application.

Conclusion

Within the
limitation of this systematic review, there is insufficient evidence to make recommendations regarding which material and technique is
the most appropriate for restorative treatment in young children. Minimally invasive approaches are advantageous in operative caries
management in primary teeth in preschool children. More well-designed randomised controlled trials are required to confirm these
findings.

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