Teaching of posterior composites for the restoration of permanent teeth in undergraduate dental training programmes: Systematic review and meta-analysis

Philipp Kanzow; Clemens Lechte; Annette Wiegand; Nairn H F Wilson; Christopher D Lynch; Igor R Blum

doi:10.1016/j.jdent.2023.104589

Teaching of posterior composites for the restoration of permanent teeth in undergraduate dental training programmes: Systematic review and meta-analysis

J Dent. 2023 Aug:135:104589. doi: 10.1016/j.jdent.2023.104589. Epub 2023 Jun 17.

Authors

Philipp Kanzow¹, Clemens Lechte², Annette Wiegand², Nairn H F Wilson³, Christopher D Lynch⁴, Igor R Blum⁵

Affiliations

¹ Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany. Electronic address: philipp.kanzow@med.uni-goettingen.de.
² Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany.
³ King's College London, United Kingdom.
⁴ University Dental School & Hospital, University College Cork, Wilton, Cork, Ireland.
⁵ Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, United Kingdom.

PMID: 37336355
DOI: 10.1016/j.jdent.2023.104589

Abstract

Objectives: To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools.

Study selection: Quantitative studies reporting on dental schools' teaching regarding the placement of PCRs in permanent teeth. Random-effects meta-analyses and meta-regressions were performed. Risk of bias was assessed based on the Medical Education Research Study Quality Instrument (MERSQI).

Sources: Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Web of Science, and Scopus) were searched in January 2023.

Data: Forty sources reporting on 34 studies having surveyed 1,286 dental schools were included. Overall, 92.7% (95%-CI: 88.2-95.5) of dental schools reported to teach PCRs. PCRs in three-surface Class II cavities are taught by 82.0% (95%-CI: 70.4-89.7). The mandatory use of liners in deep cavities is taught by 78.3% (95%-CI: 68.9-85.5), and 44.0% (95%-CI: 34.3-54.2) reported to teach bulk-fill composites. While most posterior restorations placed by students were composites (56.1%; 95%-CI: 46.0-65.8), 94.7% (95%-CI: 86.6-98.0) of dental schools (still) teach posterior amalgam restorations. The proportion of dental schools teaching PCRs in three-surface Class II cavities increased and the mean proportion of PCRs among all posterior restorations increased over time (p_adj.≤0.003).

Conclusions: The teaching of PCRs in dental schools around the world reflects the increased use of resin composite in clinical practice, with students in countries where dental amalgam continues to be used, placing more posterior composites than restorations of dental amalgam. The teaching of PCRs, which is anticipated to increase, will continue to be refined with further developments in adhesive materials, devices, instrumentation, and techniques.

Clinical significance: Graduating dentists can be expected to be familiar with the use of resin composites for the restoration of posterior teeth.

Keywords: Education; Minimally invasive dentistry; Operative dentistry; Posterior composites; Systematic review; Teaching.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Composite Resins
Dental Amalgam
Dental Caries* / therapy
Dental Cavity Preparation / methods
Dental Restoration, Permanent* / methods
Humans
Students
Teaching

Substances

Dental Amalgam
Composite Resins