Elsevier

Dental Abstracts

Volume 61, Issue 3, May–June 2016, Page 154
Dental Abstracts

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Antibacterial role of cavity liners

https://doi.org/10.1016/j.denabs.2016.02.038Get rights and content

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Background

Cavity liners are a common part of the treatment for dentin in the pulp area and are placed after removing deep caries lesions. They are believed to protect the pulp and may foster the development of reactionary dentin, reduce pulpal inflammation, or isolate the pulp from chemical irritants. A key cited purpose for their use is to reduce the number of bacteria in the site. However, few trials support these uses with clear evidence of the effectiveness of cavity liners. Studies that compared the

Methods

Fourteen studies covering 500 treated sites were reviewed. Most of the patients were children or adolescents, but the age of the group ranged from 4 to 67 years. The primary analysis focused on the number of cavities remaining infected after sealing or the number that became less infected or cleared of infection after sealing. The specific treatments evaluated were no liner or a placebo liner; calcium hydroxide; mineral trioxide aggregate (MTA); antibiotic or disinfectant; calcium phosphates;

Results

Pairwise comparisons revealed no significant differences between any of the groups that achieved sterile cavity floors. Cavities with no liners had odds of being infected 1.5 times higher than cavities lined with calcium hydroxide. The findings of comparisons of calcium phosphates and antibiotics/disinfectants, of antibiotics and no active liner, and of ZOE and calcium hydroxide were similar. Network analysis indicated that the odds of having no positive bacterial samples were greatest for the

Discussion

None of the liners clearly proved itself better than the other options. Some liners are more likely to achieve sterile cavities; others are more likely to reduce bacterial numbers in cavities.

Clinical Significance

The current evidence doesn’t support any specific cavity treatment with respect to maintaining a sterile cavity or reducing bacterial presence. It is likely that the excavation of the carious dentin and the quality of the restoration placed may be more important determinants of sterile

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Schwendicke F, Tu Y-K, Hsu L-Y, et al: Antibacterial effects of cavity lining: A systematic review and network meta-analysis. J Dent 43:1298-1307. 2015

Reprints available from F Schwendicke, Charité Ctr for Dental Medicine, Dept for Operative and Preventive Dentistry, Aßmannshauser Str 4-6, 14197 Berlin, Germany; fax: +49 30 450 7562 556; e-mail: [email protected]

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