25 July 2023

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Selective procedures in restorative dentistry

By Lorenzo Breschi and Diego D’Urso

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Introduction 

To follow the doctrine of minimal intervention, selective procedures are becoming increasingly popular in restorative dentistry. Despite the promising opportunities provided by these approaches, not all clinical procedures in restorative dentistry are supported by good research that follows the guidelines of evidence-based dentistry (EBD). 

EBD aims to create a dialogue between dental practitioners and dental research, to drive new research and promote the use of the best available evidence to inform clinical decision-making. Hence, Nagarkar et al. aimed to reduce this knowledge gap by critically inspecting current clinical methods for selected restorative procedures. 

Materials and methods

MEDLINE (National Library of Medicine) via the Ovid interface was used for all literature searches, published in English only. Medical subject headings were used and advanced limits were selected in the Clinical Queries section. Only randomized controlled clinical trials (RCTs), non-randomized controlled clinical trials (NRCTs), systematic reviews (SRs) of RCTs/NRCTs, and evidence-based practice guidelines were included. Furthermore, cost-effectiveness analyses were included due to their practical relevance to the decision-making process. Lastly, to provide comparative or background information, other study designs (in vitro, narrative reviews, case series, cohort studies, etc.) were mostly utilized.

Results

Mixed results were identified regarding the included interventions. Some procedures had adequate evidence supporting them, while others were mostly based on beliefs. The findings reported in this paper are important because what emerged is that there are some gaps in current literature regarding selected restorative procedures. 

Conclusions

Some common restorative procedures lack adequate evidence-based support from high-quality research evidence. 

Nagarkar S, Loguercio AD, Perdigão J. "Evidence-based fact checking for selective procedures in restorative dentistry." Clin Oral Investig. 2023 Feb;27(2):475-488. doi: 10.1007/s00784-022-04832-z. Epub 2023 Jan 6. PMID: 36607490.