Is there a best conventional material for restoring posterior primary teeth? A network meta-analysis

Area of Science:

• Dentistry
• Pediatric Dentistry
• Dental Materials Science

Background:

• Assessing the long-term success of dental restorative materials in primary teeth is crucial for pediatric dental care.
• Conventional restorative materials are widely used in primary molars, but their comparative longevity varies.
• Evidence-based guidelines are needed to inform material selection for optimal outcomes in pediatric patients.

Purpose of the Study:

• To systematically review and compare the longevity of various conventional restorative materials used in posterior primary teeth.
• To identify which materials offer superior durability and reduced failure rates in primary molars.
• To provide clinical recommendations for material choice in pediatric restorative dentistry.

Main Methods:

• A systematic review adhering to the PRISMAN statement was conducted, with PROSPERO registration (CRD42016035775).
• A comprehensive electronic search of multiple databases (PubMed/MEDLINE, Cochrane, Scopus, TRIP, Clinical Trials) was performed up to January 2017.
• Seventeen randomized clinical trials comparing the longevity of at least two conventional restorative materials in primary molars were included, with data analyzed using pairwise and network meta-analyses.

Main Results:

• Conventional glass ionomer cement demonstrated a significantly higher risk of failure when used for restoring primary molars compared to compomer, resin-modified glass ionomer cement, amalgam, and composite resin.
• The risk of bias assessment indicated a low risk in most evaluated studies (45.38% of all items across studies).
• Network meta-analysis confirmed the increased failure risk associated with conventional glass ionomer cement in this context.

Conclusions:

• Conventional glass ionomer cement is associated with a greater risk of failure in primary molar restorations.
• Pediatric dentists are advised against using conventional glass ionomer cement for restoring primary molars.
• Alternative materials like compomer, resin-modified glass ionomer cement, amalgam, and composite resin may offer better longevity for primary molar restorations.