Effect of topical applications containing surface pre-reacted glass-ionomer filler on dental hard tissues-A systematic review

Objectives The objective of this systematic review was to assess the efficacy of topical applications containing surface pre-reacted glass-ionomer filler on dental hard tissues. Data sources A comprehensive literature search was conducted in PubMed, MEDLINE, Embase, Scopus, ClinicalTrials.gov, Lilacs and Cochrane Central Register of Controlled Trials (until 15.08.2022). Google and Open Grey were used to search for grey literature and handsearching was conducted. Study selection Clinical and in vitro studies conducted on human adult teeth were considered eligible without date and language restrictions. The electronic database generated 2,488 results. In total, 227 studies were found to be relevant from which 71 duplicates were removed. Title and abstract screening were then conducted, and a total of 33 studies met the inclusion criteria were assessed for full text screening. Two authors concluded that 11 studies satisfied the eligibility criteria. In vitro studies were evaluated using an accepted quality assessment tool for dental studies. Cochrane risk of bias tool was used for quality assessment of clinical randomised studies, whilst ROBINS-I tool was used for non-randomised studies. Results Nine in vitro and only two non-randomised clinical trials were reported to meet the eligibility criteria. Results were grouped and analysed separately according to the study design. Different modes of surface pre-reacted glass-ionomer filler delivery were reported in the included studies. Three studies tested the effect of surface pre-reacted glass-ionomer filler containing toothpastes, whilst three studies investigated the effect of polishing pastes with surface pre-reacted glass-ionomer filler, three studies used eluates as surface pre-reacted glass-ionomer filler delivery method and two studies reported the effect of the coatings. The effect of those vehicles was tested on enamel, dentine or oral biofilm. Each study was analysed individually, and heterogeneity was detected among in vitro and clinical studies. Half of the in vitro studies were medium risk, whilst three were low and two studies presented with high risk. In clinical trials, outcome, confounding, selection biases were reported. Meta-analysis was therefore unable to be carried out. Conclusion Regardless of the mode of delivery and type of studies, all included studies demonstrated the efficacy of surface pre-reacted glass-ionomer filler containing topical applications to inhibit demineralisation of dental hard tissues at a dose dependant manner. Antimicrobial properties towards cariogenic species were also reported. Clinical significance Surface pre-reacted glass-ionomer filler containing topical applications may serve as potential caries preventive and cariostatic tools. The systematic review registered in PROSPERO, International prospective register of systematic reviews, No. CRD42022347130.