Comparison of smart burs and chemo-mechanical caries removal systems in primary molars – A systematic review and meta-analysis
Background: Smart burs and chemo-mechanical caries removal (CMCR) systems are considered viable alternatives to traditional cavity preparation techniques. Numerous clinical studies have been conducted to assess and compare the impact of these two techniques; nevertheless, these studies have demonstr...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-10-01
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| Series: | Journal of Indian Society of Pedodontics and Preventive Dentistry |
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| Online Access: | https://journals.lww.com/10.4103/jisppd.jisppd_308_24 |
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| author | Deepshikha Mehrotra Sanjana R. Kodical Shilpa Shetty Naik |
| author_facet | Deepshikha Mehrotra Sanjana R. Kodical Shilpa Shetty Naik |
| author_sort | Deepshikha Mehrotra |
| collection | DOAJ |
| description | Background:
Smart burs and chemo-mechanical caries removal (CMCR) systems are considered viable alternatives to traditional cavity preparation techniques. Numerous clinical studies have been conducted to assess and compare the impact of these two techniques; nevertheless, these studies have demonstrated considerable variability in their findings. The objectives of the present systematic review and meta-analysis were to compare the efficacy, efficiency, and patient comfort of CMCR systems and smart burs in primary molars.
Methodology:
The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. Ten electronic databases up to May 30, 2024 were searched for in vivo clinical studies comparing at least one CMCR system with smart burs in terms of clinical and/or microbiological efficacy, efficiency (time taken for complete caries removal), and patient comfort in primary molars. Reviews, abstracts, case series and reports, letters to the editor, animal studies, and unpublished data were excluded. The risk of bias (ROB) assessment was conducted using the ROBINS-I and Cochrane ROB tools for nonrandomized and randomized clinical studies, respectively. The analysis was performed using Review Manager version 5.4.1 provided by the Cochrane Collaboration. The standardized mean difference served as the summary with a random effects model (P < 0.05).
Results:
A total of 154 studies were identified and screened out of which five were included in the qualitative synthesis and four studies were deemed suitable for a meta-analysis. The overall quality assessment revealed a presence of moderate-to-low ROB. The data extracted from the five studies were tabulated. The summary odds ratio for clinical efficacy (0.43 [95% confidence interval (CI) = 0.13–1.49]) showed no statistically significant difference between CMCR systems and Smart burs (Z = 1.33 and P = 0.18). A statistically significant difference ([Z = 5.85 and P < 0.00001] and [Z = 2.84 and P = 0.005]) in terms of microbiological efficacy (446.46 [95% CI = 296.89–596.02]) and efficiency (−0.68 [95% CI = −1.16–−0.21]) was observed between CMCR systems and smart burs. Smart burs performed better in terms of microbiological efficacy and efficiency. Due to variability in the scales used to evaluate patient comfort, meta-analysis was not possible.
Conclusion:
Within the limitations of this study, Smart burs performed better in terms of microbiological efficacy and efficiency and hence can be used as an alternative to CMCR systems in primary molars. |
| format | Article |
| id | doaj-art-c8b28f2df0084abca485c727a13f927f |
| institution | OA Journals |
| issn | 0970-4388 1998-3905 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wolters Kluwer Medknow Publications |
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| series | Journal of Indian Society of Pedodontics and Preventive Dentistry |
| spelling | doaj-art-c8b28f2df0084abca485c727a13f927f2025-08-20T02:13:32ZengWolters Kluwer Medknow PublicationsJournal of Indian Society of Pedodontics and Preventive Dentistry0970-43881998-39052024-10-0142425726610.4103/jisppd.jisppd_308_24Comparison of smart burs and chemo-mechanical caries removal systems in primary molars – A systematic review and meta-analysisDeepshikha MehrotraSanjana R. KodicalShilpa Shetty NaikBackground: Smart burs and chemo-mechanical caries removal (CMCR) systems are considered viable alternatives to traditional cavity preparation techniques. Numerous clinical studies have been conducted to assess and compare the impact of these two techniques; nevertheless, these studies have demonstrated considerable variability in their findings. The objectives of the present systematic review and meta-analysis were to compare the efficacy, efficiency, and patient comfort of CMCR systems and smart burs in primary molars. Methodology: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. Ten electronic databases up to May 30, 2024 were searched for in vivo clinical studies comparing at least one CMCR system with smart burs in terms of clinical and/or microbiological efficacy, efficiency (time taken for complete caries removal), and patient comfort in primary molars. Reviews, abstracts, case series and reports, letters to the editor, animal studies, and unpublished data were excluded. The risk of bias (ROB) assessment was conducted using the ROBINS-I and Cochrane ROB tools for nonrandomized and randomized clinical studies, respectively. The analysis was performed using Review Manager version 5.4.1 provided by the Cochrane Collaboration. The standardized mean difference served as the summary with a random effects model (P < 0.05). Results: A total of 154 studies were identified and screened out of which five were included in the qualitative synthesis and four studies were deemed suitable for a meta-analysis. The overall quality assessment revealed a presence of moderate-to-low ROB. The data extracted from the five studies were tabulated. The summary odds ratio for clinical efficacy (0.43 [95% confidence interval (CI) = 0.13–1.49]) showed no statistically significant difference between CMCR systems and Smart burs (Z = 1.33 and P = 0.18). A statistically significant difference ([Z = 5.85 and P < 0.00001] and [Z = 2.84 and P = 0.005]) in terms of microbiological efficacy (446.46 [95% CI = 296.89–596.02]) and efficiency (−0.68 [95% CI = −1.16–−0.21]) was observed between CMCR systems and smart burs. Smart burs performed better in terms of microbiological efficacy and efficiency. Due to variability in the scales used to evaluate patient comfort, meta-analysis was not possible. Conclusion: Within the limitations of this study, Smart burs performed better in terms of microbiological efficacy and efficiency and hence can be used as an alternative to CMCR systems in primary molars.https://journals.lww.com/10.4103/jisppd.jisppd_308_24chemo-mechanical caries removalminimally invasive dentistrypolymer bursprimary molarssmart burs |
| spellingShingle | Deepshikha Mehrotra Sanjana R. Kodical Shilpa Shetty Naik Comparison of smart burs and chemo-mechanical caries removal systems in primary molars – A systematic review and meta-analysis Journal of Indian Society of Pedodontics and Preventive Dentistry chemo-mechanical caries removal minimally invasive dentistry polymer burs primary molars smart burs |
| title | Comparison of smart burs and chemo-mechanical caries removal systems in primary molars – A systematic review and meta-analysis |
| title_full | Comparison of smart burs and chemo-mechanical caries removal systems in primary molars – A systematic review and meta-analysis |
| title_fullStr | Comparison of smart burs and chemo-mechanical caries removal systems in primary molars – A systematic review and meta-analysis |
| title_full_unstemmed | Comparison of smart burs and chemo-mechanical caries removal systems in primary molars – A systematic review and meta-analysis |
| title_short | Comparison of smart burs and chemo-mechanical caries removal systems in primary molars – A systematic review and meta-analysis |
| title_sort | comparison of smart burs and chemo mechanical caries removal systems in primary molars a systematic review and meta analysis |
| topic | chemo-mechanical caries removal minimally invasive dentistry polymer burs primary molars smart burs |
| url | https://journals.lww.com/10.4103/jisppd.jisppd_308_24 |
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