Challenging the Concept that OptiBond FL and Clearfil SE Bond in NCCLs Are Gold Standard Adhesives: A Systematic Review and Meta-analysis.

PURPOSE: The following PICO (Patient/Population, Intervention, Comparison, and Outcomes) question was proposed: "Are retention rates of composite resin restorations in noncarious cervical lesions (NCCLs) when using adhesives considered "gold standard" (OptiBond FL and Clearfil SE Bond) higher than those obtained with other adhesives brands"? METHODS: A search was performed in February 2019 (updated in November 2019) in the PubMed/MEDLINE, EMBASE, LILACS, BBO, Web of Science, Cochrane Library, Grey Literature, and IADR abstracts (1990-2018); unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials (RCTs) conducted in NCCLs that compared either OptiBond FL or Clearfil SE Bond adhesive with other commercially available adhesives were included. The risk of bias (RoB) was applied by using the Cochrane Collaboration tool. A meta-analysis was performed for retention rates at different follow-up times using a random effects model for both the adhesives. Heterogeneity was assessed with the Cochran Q test and I2 statistics. Grading of Recommendations: Assessment, Development and Evaluation (GRADE) assessed the quality of evidence. RESULTS: After removal of duplicates and noneligible articles, 25 studies remained for qualitative synthesis, as one study was common to the two adhesives, of which 9 studies were used for the OptiBond FL meta-analysis and 14 for the Clearfil SE Bond meta-analysis. No significant differences were observed for retention rates in follow-up periods of 12-24 months (p=0.97), 36-48 months (p=0.72), or 108-156 months (p=0.73) for OptiBond FL; and for 12-24 months (p=0.10) and 36-48 months (p=0.17) for Clearfil SE Bond. A significant difference was only found for OptiBond FL at 60-96 months (p=0.02), but only three studies were included in this meta-analysis. CONCLUSIONS: The evidence from available RCTs conducted in NCCLs that compared OptiBond FL or Clearfil SE Bond does not support the widespread concept that these adhesives are better than any other competitive brands available in the dental market.

Evaluation of Tooth Sensitivity of In-office Bleaching with Different Light Activation Sources: A Systematic Review and a Network Meta-analysis.

OBJECTIVES: A systematic review and network meta-analysis were performed to answer the following research question: Are there differences in the risk and the intensity of tooth sensitivity (TS) among eight light activation systems for in-office bleaching in adults? METHODS: Randomized controlled trials (RCTs) that compared at least two different in-office bleaching light activations were included. The risk of bias (RoB) was evaluated with the RoB tool version 1.0 from the Cochrane Collaboration tool. A random-effects Bayesian mixed treatment comparison (MTC) model was used independently for high- and low-concentration hydrogen peroxide. The certainty of the evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach. A comprehensive search was performed in PubMed, Bridge Base Online (BBO), Latin American and Caribbean Health Sciences Literature database (LILACS), Cochrane Library, Scopus, Web of Science, and grey literature without date and language restrictions on April 23, 2017 (updated on September 26, 2019). Dissertations and theses, unpublished and ongoing trials registries, and IADR (International Association for Dental Research) abstracts (2001-2019) were also searched. RESULTS: After title and abstract screening and the removal of duplicates, 32 studies remained. Six were considered to be at low RoB, three had high RoB, and the remaining had an unclear RoB. The MTC analysis showed no significant differences among the treatments in each network. In general, the certainty of the evidence was graded as low due to unclear RoB and imprecision. CONCLUSION: There is no evidence that the risk and intensity of TS are affected by light activation during in-office bleaching.