A critical review on the association of hyposalivation and dental caries in children and adolescents.

OBJECTIVE: The purpose of this critical review is to assess if children and adolescents with hyposalivation are more affected by dental caries than those with normal flow rate. DESIGN: A literature search was performed using keywords and MeSH terms related to hyposalivation and dental caries in the Medline/PubMed, Web of Science, Cochrane Library, Scopus, LILACS/BBO databases and in gray literature without language or date restrictions until March 2022. Observational studies that accessed the presence of dental caries in patients up to 18 years-old with hyposalivation and compared with a control group (normal salivation rate) were considered eligible. The results from search were imported to EndNote Web, where duplicates were removed followed by title/abstract and full text analysis. RESULTS: A total of 12,236 non-duplicated studies were found and 14 fulfilled the criteria and were included in the present review, 9 cross-sectional and 5 cohorts. Stimulated salivary flow rates were assessed in 3644 participants, aged 3-17 years. Three cohort and three cross-sectional studies observed association between low salivary flow rates and the presence of dental caries, while the other 9 included articles did not verify this association. However, the absence of a standard criteria for the hyposalivation classification in young patients was observed and brough light to this important limitation among the studies. CONCLUSION: The salivary flow rate estimation for caries risk assessment must be the target of further studies to make possible and reliable, homogeneous, and unbiasedly assessment of the association between hyposalivation and dental caries in young patients.

Longevity of indirect restorations cemented with self-adhesive resin luting with and without selective enamel etching. A Systematic review and meta-analysis.

OBJECTIVE: To investigate the influence of the selective etching in the survival rates of indirect restorations cemented with self-adhesive resin luting. MATERIALS AND METHODS: The eligibility criteria were formulated based on PICOS strategy. The search without restrictions was performed in PubMed/Medline, the Cochrane Library, Web of Science, Scopus, LILACS databases and gray literature until May 2018. Cochrane Collaboration's tool was performed for assessing the risk of bias. According to the bias risk analysis, the studies were classified as low risk of bias and high quality of evidence. The systematic review was conducted according to PRISMA and registered in PROSPERO (CRD42018091202). The meta-analysis was performed using RevMan 5.3 software (RevMan, Copenhagen, Denmark) and the risk ration and confidence interval was obtained (p < 0.05). RESULTS: After database screening, removal of duplicates and eligibility criteria application, two studies were selected for this systematic review, with 65 participants (34 in one and 31 in the other). The pooled meta-analysis demonstrated no statistically significant difference in clinical longevity for selective etching in indirect restorations (P > .05; I2 = 0%) and risk ratio of 0.46 [0.19-1.09]. CONCLUSIONS: Based on the findings, the results of this systematic review suggest that the selective enamel etching prior to application of self-adhesive luting cements systems for indirect restoration do not influence the clinical longevity of indirect restorations. CLINICAL SIGNIFICANCE: The knowledge of the clinical steps of adhesive procedures is fundamental to the success of adhesive restorations and their longevity. Self-adhesive resin cements simplify the luting procedure of indirect restorations. However, adding a step that could significantly improve long-term survival would be of great value. Thus, the results of this systematic review will provide data so that the decision making regarding materials used for adhesive cementation is conducted based on scientific evidence.