Lack of high level evidence on the effects of antibacterials in resin-based fillings

Composite_resin_fillng_2

Should we be using resins containing antibacterial agents to fill these cavities?

When tooth decay or caries has caused a cavity to form in a tooth a range of materials can be used to fill it. These include resin composites, glass ionomer cement, amalgam and compomers. Tooth decay that may develop next to or underneath a filling at a later stage is a common concern in dental practice and may reduce the life span of these fillings. It is thought that the inclusion of a substance that kills and preventions the growth of bacteria in some dental fillings could help prevent the development of secondary caries.

What was the research?

A systematic review of the evidence to find out how effective the use of antibacterial agents in composite fillings might be in preventing the development of further decay, either underneath or next to the filling.

Who conducted the research?

The research was conducted by a team led by Tatiana Pereira-Cenci from the Federal University of Pelotas, Brazil, on behalf of the Cochrane Oral Health Group. Maximiliano S Cenci, Zbys Fedorowicz and Marina Azevedo were also on the team.

What evidence was included in the review?

The team searched for randomised controlled trials on the topic, but could not find any which met the inclusion criteria of the review. There are no trials to support or disprove the effectiveness of antibacterial agents incorporated into fillings to prevent further tooth decay.

What are the implications for dentists and the general public?

Considering that new materials containing antibacterial agents are expected to have additional costs in comparison to other filling materials, their use in clinical practice cannot be justified or recommended until reliable evidence is available.

What should researchers look at in the future?

Well-designed clinical trials of antibacterial containing resin composites should be undertaken and reported. These should address outcomes that are important to dentists and to patients.

Link

Pereira-Cenci T, Cenci MS, Fedorowicz Z, Azevedo M. Antibacterial agents in composite restorations for the prevention of dental caries. Cochrane Database of Systematic Reviews 2013, Issue 12. Art. No.: CD007819. DOI: 10.1002/14651858.CD007819.pub3.