Abstract
|Objective: To compare, through a systematic review and a meta-analysis, the clinical effect of the adhesive strategies of universal adhesives (UA) in the treatment of non-carious cervical lesions (NCCLs). Material and Method: A search of the literature was carried out up to January 2018, in the biomedical databases: Pubmed, Embase, Scielo, Science Direct, SIGLE, LILACS, BBO, Google Scholar and the Central Register of Cochrane Clinical Trials. The selection criteria of the studies were as: randomized clinical trials, with a maximum age of 5 years and which report the clinical effects (marginal adaptation, discoloration or marginal staining, presence of secondary caries, postoperative sensitivity, retention and fractures) of the UA in the treatment of NCCLs. The risk of study bias was analyzed through the Cochrane Handbook of systematic reviews of interventions. Results: The search strategy resulted in eight articles that reported no difference in marginal adaptation, discoloration or marginal staining, presence of secondary caries and postoperative sensitivity among the adhesive strategies of the UA; however they reported a difference between the retention and the presence of fractures, with the conventional adhesive strategy resulting in a better clinical effect. Conclusion: The reviewed literature suggests that the conventional adhesive strategy of UAs results in greater retention and absence of fractures in the treatment of NCCLs.
Highlights
Non-carious cervical lesions (NCCLs) are hard tissue defects in the cervical region of the teeth that is not caused by a bacterial agent.[1,2] These lesions appear in various forms and have been found in living individuals as well as in skeletons and fossils at ancient sites.[3]
Selection process and data extraction: We reviewed the titles and abstracts of each of the studies obtained following the inclusion and exclusion criteria described above; the full texts of the studies that met these parameters were obtained in order to determine their risk of bias
Assessment of the studies bias risk For assessing the risk of bias, each study was analyzed according to the Cochrane Handbook of Systematic Reviews of Interventions.[14]
Summary
Non-carious cervical lesions (NCCLs) are hard tissue defects in the cervical region of the teeth that is not caused by a bacterial agent.[1,2] These lesions appear in various forms and have been found in living individuals as well as in skeletons and fossils at ancient sites.[3] It is among the most frequent pathologies that affect dental structures and its severity has been associated with aging. Epidemiological studies on the prevalence of NCCLs are still scarce in the literature, but there are reports that it affects up to 76% of the middle-aged adult population in China.[1,2,4] Several studies have proposed several etiological factors for NCCLs, such as: aging, sex, oral hygiene habits, saliva, consumption of acidic beverages, teeth-brushing intensity, state of the periodontium, number of teeth, occlusion, occlusal contact area, occlusal erosion and attrition.
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