Do Bulk-Fill Resin Composites Present More Susceptibility to Marginal Degradation in Different Clinical Scenarios? A Systematic Review and Meta-Analysis

Abstract Objective: To compare the marginal degradation (susceptibility to marginal adaptation and marginal discoloration) of composite restorations placed in class II and V cavities using conventional and bulk-fill resin composites. Material and Methods: This study was approved by PROSPERO database (#42020201596). PubMed, Scopus, Embase, Web of Science, Lilacs, Cochrane, Open Grey, Clinical Trials, and Rebec databases were searched by three independent investigators using MeSH terms, supplementary concepts, synonyms, and free keywords, based on the PICOS strategy (P, population: restoration in permanent teeth; I, intervention: bulk-fill resin composite; C, comparison: conventional resin composite; O, outcome: marginal discoloration and adaptation; and S, study design: randomized and non-randomized clinical trials). The risk of bias was evaluated according to the Cochrane Collaboration's tool, the meta-analyses by RevMan software, the certainty of evidence by the Grading of Recommendations Assessment, Development, and Evaluation, and the leave-one-out sensitivity test. The prevalence of successful events and the total number of restorations were used to calculate the risk difference at a confidence interval of 95%, according to a fixed-effect model. The heterogeneity was evaluated using the I2 index. Results: 16 from 10,780 studies were selected and included for qualitative and quantitative analysis. Two studies were considered as high risk of bias, one showing some concerns, and 13 as low risk of bias. Four meta-analyses evaluated the marginal adaptation and marginal discoloration in class II and V cavities, with a nonsignificant heterogeneity (I2 = 0%, p>0.05). The certainty of evidence was considered high, except for two subgroups of each outcome. Conclusion: There is evidence that composite restorations using conventional and bulk-fill resin composites present similar clinical performance related to marginal degradation (AU).

Análise dos diferentes protocolos e técnicas de clareamento dentário em consultório: uma revisão de literatura / Analysis of different protocols and techniques of dental whitening in the dental office: a literature review

Objetivo: Este trabalho tem o objetivo de revisar na literatura as diferentes técnicas pelas quais é realizado o procedimento de clareamento dentário no consultório, a fim de que seja um meio de contribuição para uma atualização no conhecimento dos profissionais. Materiais e Métodos: Para a composição do trabalho se realizou uma busca bibliográfica de estudos publicados nos últimos anos, tanto nacionais quanto internacionais, através das bases de dados: PubMED, Scielo (Scientific Eletronic Library) e Google Acadêmico. Foram utilizados os seguintes descritores para a pesquisa: Clareamento Dental, Consultório, Métodos, Protocolos. Resultados: Os estudos demonstram que o clareamento dentário no consultório produz resultados eficazes, quando utilizados os géis clareadores peróxido de hidrogênio e peróxido de carbamida em altas concentrações. A aplicação do gel clareador no consultório pode ser realizada com uma aplicação única e ininterrupta, pelo tempo recomendado pelo fabricante, possibilitando ganho de tempo com o clareamento pelo profissional. Além disso, a sensibilidade dentária pós clareamento possui um menor percentual quando realizado no consultório. Ao revisar alguns estudos associando o clareamento dentário com a luz para produzir um melhor resultado de dente branco, obteve-se que a luz apenas contribui para aumentar a velocidade de reação dos agentes clareadores, diminuindo o tempo clínico. Conclusão: O clareamento dental realizado no consultório é uma prática comum para cirurgiões-dentistas. Entretanto, é importante atualizar as técnicas e protocolos utilizados em busca de melhorias no procedimento, dando maior conforto e melhor qualidade na estética dos dentes.

Objective: This work aims to review literature concerning different techniques by which dental whitening procedure is performed in the dental office to contribute to an update in the knowledge of professionals. Materials and Methods: To compose the work, a bibliographic search of both national and international studies published in recent years was carried out based on data published on PubMED, Scielo (Scientific Electronic Library), and Google Scholar. The following descriptors were used: Dental Whitening, Dental Office, Methods, Protocols. Results: Studies show that inoffice tooth whitening produces satisfactory results when bleaching with hydrogen peroxide and carbamide peroxide are used at high temperatures. The application of the gel whitener in the office can be performed with a single, uninterrupted application, for the time recommended by the manufacturer, allowing the professional to save time with the whitening procedure. In addition, a low percentage of tooth sensitivity was noticed after bleaching performed in the office. When reviewing some associated studies of tooth whitening using light to produce a better white tooth result, it was observed that the application of light to increase the reaction speed of the bleaching agents only showed to decrease the clinical time of the procedure. Conclusion: Dental whitening performed in the office is a common practice for dentists. However, it is important to update techniques and protocols used in the search for improvements in the procedure, offering greater comfort and better quality in the aesthetics of the teeth.