Does isolating the site of a dental restoration during treatment improve the performance of the restoration?

dentist at work with patient, installation of rubber dam or kofferdam

Restorative dental treatments are used to repair damage to teeth caused by tooth decay or accidents. Creating a physical barrier around a treatment site to reduce contamination of the site with saliva is a common practice. Reducing the amount of saliva in the area may enable the materials used for repair to bond together more effectively, improving the performance and reliability of the restoration. It may also reduce exposure to bacteria in the mouth.

Two methods of creating a barrier are commonly used; either a rubber dam around the tooth or cotton rolls together with suction to remove excess saliva. The rubber dam method involves using a sheet of latex in a frame. A small hole is made in the sheet and it is placed over the tooth to be treated creating a barrier around it. Using a rubber dam can isolate the tooth from the rest of the person’s mouth, which allows the tooth to be repaired dry and with relatively less exposure to bacteria in the mouth. A common alternative method of isolation of the tooth is the use of cotton rolls combined with the removal of excess saliva by suction. The evidence on the effects of rubber dam usage versus cotton roll usage is conflicting. Continue reading

New titles registered at the Cochrane Oral Health Group

The Cochrane Oral Health Group Editorial Team met on Monday afternoon and agreed to register two new titles:

Orthodontic treatment for bimaxillary proclination

This topic has been registered by a team based in London, Greece and at the Bahrain Branch of the UK Cochrane Centre. It will compare headgear, transpalatal arches and temporary anchorage devices and look at the evidence of the effectiveness of each.

Assisted design / Computer assisted manufacture (CAD/CAM) in anterior and posterior teeth

This clinically important topic has been registered by a team based at the College of Dentistry, New York University. It will consider whether restorations manufactured using computer-assisted images are more successful than those made conventionally.

The Oral Health Group looks forward to publishing both protocols and working with these teams.

New Cochrane Oral Health Group Reviews and Protocols for May 2012

Issue 5, 2012 of the Cochrane Library has just been published! The Cochrane Oral Health Group has published 2 new reviews and 2 new protocols:

New review: Single crowns versus conventional fillings for the restoration of root filled teeth
Zbys Fedorowicz, Ben Carter, Raphael Freitas de Souza, Carolina de Andrade Lima Chaves, Mona Nasser, Patrick Sequeira-Byron

This new review features one trial with 117 participants, and concludes that there is currently insufficient reliable evidence on the effectiveness of these two treatments.

ImageNew review: Treatments for adults with prominent lower front teeth
Hideko Minami-Sugaya, Débora A Lentini-Oliveira, Fernando R Carvalho, Marco Antonio C Machado, Clóvis Marzola, Humberto Saconato, Gilmar F Prado

Several treatments have been proposed for this condition, including orthopedics, functional appliances, interceptive and corrective orthodontics and surgery. However, only two small trials matched the inclusion criteria for this review, and more evidence is needed to judge effectiveness.


ImageNew protocol: Interdental brushing for the management of periodontal diseases and dental caries in adults
Tina Poklepovic, Dario Sambunjak, Trevor M Johnson, Pauline Imai, Peter Tugwell, Jason W Nickerson, Jan E Clarkson, Helen V Worthington

This is a protocol for a new systematic review, which will consider the effectiveness of interdental brushing to prevent dental caries and periodontal disease, when compared to regular brushing alone.

New protocol: Rubber dam isolation for restorative treatment in dental patients
Yan Wang, Chunjie Li, He Yuan, May CM Wong, Zongdao Shi, Xuedong Zhou

This new review wil consider the effectiveness of rubber dams in isolating the dental treatment area and controlling moisture. It will compare rubber dams with other methods of isolation (for example, cotton rolls).

Other highlights of the Cochrane Library, Issue 5, 2012 include: