Carine Tais Welter Meereis1, Eliseu Aldrighi Münchow2, Wellington Luiz de Oliveira da Rosa1, Adriana Fernandes da Silva1, Evandro Piva3. 1. Department of Restorative Dentistry and Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil. 2. Department of Dentistry, Health Science Institute, Federal University of Juiz de Fora, Governador Valadares, Brazil. 3. Department of Restorative Dentistry and Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil. Electronic address: evpiva@pq.cnpq.br.
Abstract
PURPOSE: A systematic review was conducted to determine whether there were composition strategies available to reduce and control polymerization shrinkage stress development in resin-based restorative dental materials. DATA SOURCES: This report was reported in accordance with the PRISMA Statement. Two reviewers performed a literature search up to December 2016, without restriction of the year of publication, in seven databases: PubMed, Web of Science, Scopus, SciELO, LILACS, IBECS, and BBO. STUDY SELECTION: Only laboratory studies that evaluated polymerization shrinkage stress by direct testing were included. Pilot studies, reviews and in vitro studies that evaluated polymerization shrinkage stress by indirect methods (e.g., microleakage or cuspal deflection measurements), finite elemental analysis, or theoretical and mathematical models were excluded. Of the 6113 eligible articles, 62 studies were included in the qualitative analysis, and the meta-analysis was performed with 58 studies. The composition strategy was subdivided according to the modified part of the material: filler phase, coupling agent, or resin matrix. A global comparison was performed with random-effects models (α = 0.05). The only subgroup that did not show a statistical difference between the alternative strategy and the control was 'the use of alternative photo-initiators' (p = 0.29). CONCLUSION: Modification of the resin matrix made the largest contribution to minimizing stress development. The technology used for decreasing stress in the formulation of low-shrinkage and bulk-fill materials was shown to be a promising application for reducing and controlling stress development.
PURPOSE: A systematic review was conducted to determine whether there were composition strategies available to reduce and control polymerization shrinkage stress development in resin-based restorative dental materials. DATA SOURCES: This report was reported in accordance with the PRISMA Statement. Two reviewers performed a literature search up to December 2016, without restriction of the year of publication, in seven databases: PubMed, Web of Science, Scopus, SciELO, LILACS, IBECS, and BBO. STUDY SELECTION: Only laboratory studies that evaluated polymerization shrinkage stress by direct testing were included. Pilot studies, reviews and in vitro studies that evaluated polymerization shrinkage stress by indirect methods (e.g., microleakage or cuspal deflection measurements), finite elemental analysis, or theoretical and mathematical models were excluded. Of the 6113 eligible articles, 62 studies were included in the qualitative analysis, and the meta-analysis was performed with 58 studies. The composition strategy was subdivided according to the modified part of the material: filler phase, coupling agent, or resin matrix. A global comparison was performed with random-effects models (α = 0.05). The only subgroup that did not show a statistical difference between the alternative strategy and the control was 'the use of alternative photo-initiators' (p = 0.29). CONCLUSION: Modification of the resin matrix made the largest contribution to minimizing stress development. The technology used for decreasing stress in the formulation of low-shrinkage and bulk-fill materials was shown to be a promising application for reducing and controlling stress development.
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