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Efficacy of different cavity liners compared to no cavity lining in managing deep caries in vital permanent teeth - a
Esra Kosan1, Deniz Kosan2, Richard Sturm3
1Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitaetsmedizin Berlin, Berlin, Germany. zahnaerztinkosan@gmail.com.
Objective:
This review aimed to evaluate whether the use of a certain cavity lining material (I) in patients with deep caries lesions in mature or immature permanent teeth associated with no symptoms or reversible pulpitis (P) is as efficacious as other materials or no cavity lining (C) in terms of patient-reported and clinically-reported outcomes (O), with "failure" identified as the primary critical outcome.
Materials And Methods:
Two independent reviewers selected studies, extracted data, and assessed the risk of bias. The systematic literature search was restricted to English-language publications using Cochrane Review, PubMed (Medline) and Ovid databases. Search strategies included combinations of free keywords, controlled vocabulary terms (Medical Subject Headings-MeSH), Boolean operators, truncations and proximity operators. Eligible studies included randomized controlled trials (RCTs), and comparative clinical trials (CCTs). Due to variability in reported outcomes, a meta-analysis was not conducted. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.
Results:
Analysis of 12 studies showed no significant differences in clinical outcomes between restorations with and without cavity liners. Studies directly comparing restorations with and without liners showed no statistically significant differences in key outcomes such as failure rates, postoperative hypersensitivity or secondary caries. (GRADE: low certainty) and minimizing postoperative hypersensitivity (GRADE: very low certainty). The effect of cavity lining on tooth survival (success rate: 94%-100%) and restoration longevity (failure rate: 0%-6%) was of low certainty.
Conclusion:
Cavity liners, regardless of the material, do not consistently deliver superior clinical outcomes compared to no liners.
Clinical Relevance:
The findings of this systematic review suggest that routine use of cavity liners in deep caries management may not be necessary for achieving successful restorative outcomes.
