Tiwari Rahul V C, Managutti Anil, Lakshmi D Prasanna, Mohindru Kunal, Damarasingu Rajesh, Dubey Alok
Department of OMFS, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India.
Periodontics, Andhra Dental Implant and Laser Care, Vijayawada, Andhra Pradesh, India.
J Pharm Bioallied Sci. 2023 Jul;15(Suppl 1):S79-S85. doi: 10.4103/jpbs.jpbs_518_22. Epub 2023 Jul 5.
The success of restoration processes depends on the efficient control of moisture and microorganisms. Dental restorative procedures frequently use rubber dams as an isolation technique. There is still room for evidence-based discussion over how rubber dam use affects the durability and caliber of dental restorations. In this review, the effects of rubber dam isolation vs alternative isolation techniques for dental restorative procedures are compared.
An extensive online search in the various databanks of the EMBASE, Medline, Pubmed, and Scopus was conducted. The keywords searched were "isolation, oral surgery, dental surgery, retractors, rubber dam, and methods of isolation." The studies selected were longitudinal research design and randomized trials. To ascertain the risk of bias, meta-analysis was carried out. The outcome was measured as the successful restoration at the end of follow-up period representing the thorough isolation.
A total of 1342 people were involved in six studies from across the world that were carried out between 2010 and 2015. High bias risk existed in all the studies. Five investigations compared the rubber dam vs cotton rolls. Due to discrepancies in the data supplied, one study was omitted from the analysis. Three of the four trials that were still running showed restored survival rates with all having a follow-up of at least six months. The survival of the restored composite teeth for six months in rubber dam isolation with odds ratio of 2.29, 1.38, and 1.00 at the end of six months, one year and one and half year respectively. However, the evidence was very low and speculative. The isolation was seen effective in the primary teeth specifically for the proximal lesions. None of the included studies discussed side effects or provided information on the treatment's upfront costs.
The application of rubber dams in dental techniques may result in successful outcome compared to cotton rolls, according to some low-certainty evidence revealed in this research. Other times, the evidence is really ambiguous. It is necessary to conduct additional, high-quality studies investigating how rubber dam use affects various restorative procedures.
修复过程的成功取决于对湿度和微生物的有效控制。牙科修复程序经常使用橡皮障作为一种隔离技术。关于使用橡皮障如何影响牙科修复体的耐久性和质量，仍有基于证据进行讨论的空间。在本综述中，比较了橡皮障隔离与牙科修复程序中其他隔离技术的效果。
在EMBASE、Medline、Pubmed和Scopus的各种数据库中进行了广泛的在线搜索。搜索的关键词是“隔离、口腔外科、牙科手术、牵开器、橡皮障和隔离方法”。所选研究为纵向研究设计和随机试验。为确定偏倚风险，进行了荟萃分析。结果衡量指标为随访期结束时代表完全隔离的成功修复情况。
2010年至2015年间在全球进行的六项研究共涉及1342人。所有研究均存在高偏倚风险。五项研究比较了橡皮障与棉卷。由于所提供数据存在差异，一项研究被排除在分析之外。仍在进行的四项试验中有三项显示了修复后的生存率，所有试验的随访期均至少为六个月。橡皮障隔离下复合牙修复体在六个月、一年和一年半时的六个月生存率分别为优势比2.29、1.38和1.00。然而，证据非常少且具有推测性。隔离在乳牙中对邻面病变特别有效。纳入的研究均未讨论副作用或提供治疗前期成本的信息。
根据本研究揭示的一些低确定性证据，与棉卷相比，在牙科技术中应用橡皮障可能会取得成功结果。其他时候，证据确实不明确。有必要进行更多高质量研究，以调查使用橡皮障如何影响各种修复程序。
