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The effect of bioceramic materials on dentin formation and their use to protect the dentin-pulp complex-a systematic
Ana Lívia Cuel de Moraes1, Lívia Maiumi Uehara1, João Marcos Carvalho-Silva1
1Department of Dental Materials and Prosthesis, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, SP, 14040-904, Brazil.
Abstract:
This systematic review aims to promote a systematic search of the literature to provide relevant information for the clinical choice of bioceramic material for the protection of the dentin-pulp complex, as well as to stimulate new projects and research aimed at expanding knowledge about its characteristics and benefits. The objective was to answer the following question: "Do bioceramic materials act on dentin formation and can they be used to protect the dentin-pulp complex?". This systematic review followed the PRISMA guidelines and was registered in PROSPERO. A customized search strategy was applied in five databases and in the gray literature. The selection of articles was performed independently by two reviewers in two stages, based on eligibility criteria. Inclusion: Randomized or non-randomized clinical studies that used bioceramics for pulp protection and evaluated dentin tissue formation. Exclusion: Literature reviews, book chapters, in vivo/in vitro studies, theses and articles that did not evaluate dentin formation by bioceramics. Risk of bias was assessed using ROBINS-I (for non-randomized studies) and ROB 2 (for randomized trials). The meta-analysis was performed using Review Manager Web, and GRADE was used to assess the certainty of the evidence. A total of 147 potential studies were found, 117 were evaluated based on their titles and abstracts, and 7 were selected for full-text review. Of these, 5 were included in this systematic review. The five articles included presented a low overall risk of bias. Qualitative and quantitative analyses suggested that bioceramic material, when compared to control groups, presented greater thickness and quality of the dentin bridge, greater inflammation, but lower values of pulp necrosis, as confirmed by meta-analysis. Thus, the question posed by this systematic review was answered, since the bioceramic materials evaluated act on dentin formation and can be used to protect the dentin-pulp complex.
