UTCAT847, Found CAT view, CRITICALLY APPRAISED TOPICs

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Title

Xerostomia And Its Effects On Dental Restorative Materials

Clinical Question

In a patient with xerostomia which dental restoration amalgam, resin composite, or glass ionomer best combats the occurrence of secondary caries throughout the lifetime of the restoration?

Clinical Bottom Line

Glass Ionomer best combats secondary caries due to the fact that it releases fluoride throughout the lifetime of the restoration. Fluoride treatment is essential in a patient with xerostomia. (See Comments on the CAT below)

Best Evidence

(you may view more info by clicking on the PubMed ID link)

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
#1) 12636121	Haveman/2003	Group of 9 xerostomic patients and placed 111 restorations in these patients	Randomized Split Mouth Design
Key results	The glass ionomer preformed better at resisting secondary caries in these patients that didn’t use any fluoride gel. Materials that release fluoride and patients who take a fluoride have a much better chance resisting secondary caries then do the materials and patients who don’t use fluoride regimens. However, there was no difference in marginal integrity between the three materials.
#2) 12216559	McComb/2002	45 patients who had all undergone radiation for head and neck cancer and were all xerostomic	Case Series
Key results	In patients who were very compliant with fluoride treatment (used more than 50% of the time) all three dental restorations (glass ionomer, resin modified glass ionomer, and resin composite) all held up nicely and none had secondary caries. In the patients who were not compliant with the fluoride regimen the glass ionomer and resin modified glass ionomer restorations showed to be 80% more resistant than resin composite restoration without fluoride.

Evidence Search

Search ("Xerostomia"[Mesh]) AND "Dental Amalgam"[Mesh]Search ("Xerostomia"[Mesh]) AND "Composite Resins"[Mesh

Comments on
The Evidence

In both articles the patient base started with the same problem and were treated the same way besides the restorations that were placed in each patient. There was adequate completion rate in each article and the compliance was good for each. Each set of patients received adequate follow up. In the Havemen article patients were recalled at 2 years and in the McComb article patient recalls were made at 6,12,18, and 24 months.

Applicability

The evidence in these articles shows that fluoride treatment either from glass ionomer or any fluoride regimen is highly recommended for the xerostomic patient in order to prevent the possibility of recurrent caries.

Specialty/Discipline

(General Dentistry) (Restorative Dentistry) (Dental Hygiene)

Keywords

Xerostomia, dental amalgam, composite resin, glass ionomer, recurrent caries

ID#

847

Date of submission:

04/01/2011

E-mail

wieck@livemail.uthscsa.edu

Author

Blaine Wieck

Co-author(s)

Co-author(s) e-mail

Faculty mentor/Co-author

Joseph Connor, DDS

Faculty mentor/Co-author e-mail

connorj@uthscsa.edu

Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)	post a rationale
None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

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