EFFECTIVENESS OF RESIN INFILTRATION IN CARIES INHIBITION AND AESTHETIC APPEARANCE IMPROVEMENT OF WHITE-SPOT LESIONS: AN UMBRELLA REVIEW.

OBJECTIVES: Resin infiltration technique is a minimal interventive approach to manage white-spot lesions. The present umbrella review aimed to comprehensively appraise the previously published systematic reviews on the effectiveness of resin infiltration in arresting caries progression and improving the aesthetic appearance of white-spot lesions. MATERIAL AND METHODS: Ten electronic databases were searched between January 1960 and May 2021. Only systematic reviews published in English on the use of resin infiltration in primary or permanent teeth were included. The degree of overlap across each review was calculated using the Corrected Covered Areas method and their evidence quality were assessed using A MeaSurement Tool to Assess systematic Reviews 2 assessment tool. Umbrella meta-analysis was carried out using a random-effects model. RESULTS: Thirteen systematic reviews were chosen, but only eight were eligible for an umbrella meta-analysis. The overall Corrected Covered Areas value was very high (19.8%), whereas only three studies were classified as 'High Quality'. Qualitative synthesis suggested that resin infiltration demonstrated acceptable aesthetic results, whereas quantitative analysis showed favourable outcomes in minimizing the risk of caries progression (RR: 0.32; 95% CI: 0.29-0.36). White-spot lesions treated with resin infiltrant in permanent teeth demonstrated a lower risk of caries progression (P < .001) than primary teeth. Overall, low data heterogeneity was observed (I2: 0%-20%). However, quantitative umbrella analysis on the aesthetic outcome was unable to perform due to limited data. CONCLUSION: Resin infiltration can be regarded as an effective treatment modality in minimizing the risk of caries progression and improving the aesthetic appearance of white-spot lesions. Future well-designed high-quality systematic reviews with long-term follow-up and more control of confounding variables are warranted.

Is pulpotomy a promising modality in treating permanent teeth? An umbrella review.

Emerging evidence suggests the use of less invasive therapy such as pulpotomy in treating permanent teeth with pulp exposure and signs of pulpitis. Hence, this umbrella review aims to evaluate the available systematic reviews on pulpotomy treated permanent teeth. Articles published between January 1970 and May 2021 were searched in ten electronic databases and five textbooks. Only systematic reviews published in English that examined the use of pulpotomy on either carious or traumatic pulpal exposed in mature or immature permanent teeth with signs of pulpitis were selected. The Corrected Covered Areas (CCAs) were calculated to identify the overlap in primary studies, whereas the AMSTAR 2 assessment tool was used to analyze the risk of bias in each included review. Nine systematic reviews were chosen of which two systematic reviews focused solely on coronal pulpotomy, one on partial pulpotomy, and the remaining focused on both coronal and partial pulpotomies. Overall, only two reviews were rated as 'High Quality'. Umbrella analyses showed that both coronal and partial pulpotomies revealed overall high success rates ranging from 88.5% to 90.6%. However, the currently available evidence on the effects of different pulpal medicaments and restorative materials on the success rate of pulpotomy were still inconclusive. Pulpotomy can be regarded as a promising modality in treating mature and immature permanent teeth with carious pulpal exposure or signs of pulpitis. Nonetheless, further high-quality clinical trials with long-term follow-up and better control of confounding factors are warranted in the future.