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Polymeric Materials for Dental Applications II

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A special issue of Polymers (ISSN 2073-4360). This special issue belongs to the section "Biomacromolecules, Biobased and Biodegradable Polymers".

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 41930

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Prof. Dr. Daniel Torres-Lagares

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School of Dentistry, University of Seville, Seville, Spain
Interests: oral surgery; dental materials; oral cancer; implant dentistry
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Dr. María-Angeles Serrera-Figallo

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Independent Research Scholar, Av. Fuerzas Armadas n1, 18014 Granada, Spain
Interests: oral medicine; oral surgery; dental materials; handicapped patients
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Dr. María Rizo-Gorrita

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School of Dentistry, University of Seville, Seville, Spain
Interests: oral surgery; dental materials; implant dentistry
Special Issues, Collections and Topics in MDPI journals

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Dear Colleagues,

The materials used in dentistry, given the especially harsh conditions they must endure, have always needed to be of high quality, both in terms of technology and development. In today’s world, this premise remains valid. New bleaching materials, restorers or regenerators are the topic of important research works and developments that make this area a constantly evolving field. Polymeric materials, given the large number of situations in which they can be used, are one of the groups that have aroused the most interest in this evolution. This volume will be focused on the latest advances in this field.

Dr. Daniel Torres-Lagares
Dr. María-Angeles Serrera-Figallo
Dr. María Rizo-Gorrita
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Polymers is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

dental materials
restorative dentistry
regeneration
whitening materials
scaffolds
dental implants
healing materials
polymers

Related Special Issue

Polymeric Materials for Dental Applications in Polymers (16 articles)

Published Papers (12 papers)

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15 pages, 3750 KiB

Open AccessArticle

Retention Capacity of Original Denture Adhesives and White Brands for Conventional Complete Dentures: An In Vitro Study

by Joana Mendes, José Manuel Mendes, Pedro Barreiros, Carlos Aroso and António Sérgio Silva

Polymers 2022, 14(9), 1749; https://0-doi-org.brum.beds.ac.uk/10.3390/polym14091749 - 26 Apr 2022

Cited by 5 | Viewed by 2147

Abstract

(1) Introduction: Denture adhesives (DAs) promote stability, chewing ability, and quality of life. The objective of this study was to compare the effectiveness of original brand DAs and white brands in their retention of conventional complete dentures. (2) Methods: This study followed the recommendations of the international standard ISO 10873. Three original brands of DA (Corega^® Fixação 3D, GlaxoSmithKline^®, Stafford Miller Ltd., Dungarvan Co. Waterford, Ireland), KuKident^® Pro Procter & Gamble Technical Centres^®, Ltd., Whitehal Lane, Germany and Elgydium^® Fix, Laboratórios URGO^® SL, Florida, Spain) were compared to three white brands (Fixação Extra Forte Pingo Doce^®, Laboratórios Cosmodent^®, Cantabria, Spain), Fixador de Próteses (Continente^®, Propack^®,Gmbh, Ladenburg, Germany) and Creme Fixador de Próteses (Auchan^®, Ellipse^®, Roubaix, France). Their retention capacities were analyzed using a mechanical test device. (3) Results: The mean retentive ability of original brand adhesives (M = 11.16, SD = 5.27) was significantly higher (t(298) = 11.88; p < 0.001) than that of the white brands (M = 5.92, SD = 1.18). When comparing all brands, statistically significant differences were also observed, F(5.294) = 707.68 (p < 0.001). The generic adhesive results were more homogeneous. The generic brands from Continente^® (M = 5.24, SD = 0.94) and Auchan^® (M = 5.80, SD = 0.79) were not significantly different, while the Pingo Doce^® brand obtained significantly higher mean retention results (M = 6.71, SD = 1.28). (4) Conclusions: The original brands of DA have a significantly higher retentive ability than the white brands. Elygidim^® Fix had the worst result of the three original brands, and the product from Pingo Doce^® had the best result among the three white brands. Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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20 pages, 48974 KiB

Open AccessArticle

The Structural Integrity and Fracture Behaviour of Teeth Restored with PEEK and Lithium-Disilicate Glass Ceramic Crowns

by Sami Aldhuwayhi, Muhammad Syafiq Alauddin and Nicolas Martin

Polymers 2022, 14(5), 1001; https://0-doi-org.brum.beds.ac.uk/10.3390/polym14051001 - 01 Mar 2022

Cited by 8 | Viewed by 2919

Abstract

Polyetheretherketone (PEEK) is a unique polymer material which has recently been introduced to dentistry. This study aimed to assess the structural integrity of PEEK as a posterior tooth crown and compared it with ceramic-based material. A total of 31 monolithic CAD-CAM PEEK (Juvora^TM, Strumann, Andover, MA, USA) crowns and 31 lithium disilicate (IPS e.max^®CAD, Voclar Vivadent AG, Liechtenstein) crowns were created and cemented on dentin-like teeth (AlphaDie^®MF, Schütz Dental GmbH, Rosbach, Germany) in a precise procedure mimicking the physical and mechanical properties of natural teeth and periodontal ligaments. A static compressive strength test using a universal testing machine and a dynamic fatigue test using a chewing simulator machine were used until crown failure to assess the fracture behaviour by mode of fracture (fractographic analysis) and 3D digital subtraction analysis. The results showed that PEEK has a greater fracture resistance than IPS e.max^®CAD by 2060 N to 703 N. Additionally, in fatigue limit, IPS e.max^®CAD showed a constant failure under 2.0 Kg (=320 N) before 5000 chewing cycles while PEEK survived at a significantly higher load > 11 Kg (930 N). Furthermore, PEEK showed a continued survival at >1,250,000 cycles while the mean fatigue life of IPS e.max^®CAD was around 133,470 cycles. PEEK illustrated a significantly less catastrophic failure mode with some plastic deformation at the fractographic stereomicroscope and in the 3D digital subtraction analysis. Using PEEK for crowns looks very promising, however, further clinical studies are required to assure this study’s results. Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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15 pages, 474 KiB

Open AccessArticle

Universal Adhesives and Adhesion Modes in Non-Carious Cervical Restorations: 2-Year Randomised Clinical Trial

by Patricia Manarte-Monteiro, Joana Domingues, Liliana Teixeira, Sandra Gavinha and Maria Conceição Manso

Polymers 2022, 14(1), 33; https://0-doi-org.brum.beds.ac.uk/10.3390/polym14010033 - 22 Dec 2021

Cited by 6 | Viewed by 2733

Abstract

This prospective, double-blind, six-arm parallel randomised controlled trial aimed to compare the performance of two universal adhesives (UAs) in non-carious cervical lesions (NCCLs), using the FDI criteria, and analysed if participants/NCCLs’ characteristics influenced the outcome. Thirty-eight 18- to 65-year-old participants were seeking routine dental care at a university clinic. At baseline, 210 NCCLs were randomly allocated to six groups (35 restorations’ each). The UAs tested were FuturabondU (FBU) and AdheseUniversal (ADU) applied in either etch-and-rinse (ER) and self-etch (SE) modes. FuturabondDC (FBDC) in SE and in SE with selective enamel etching (SE-EE) modes were controls. NCCLs were restored with AdmiraFusion. The analysis included nonparametric tests, Kaplan-Meier and log-rank tests (α = 0.05). At 2-years, of 191 restorations, ten were missed due to retention loss (all groups, p > 0.05). FBDC (p = 0.037) and FBU (p = 0.041) performed worse than ADU in SE mode. FBDC and FBU also showed worse functional success rate (p = 0.012, p = 0.007, respectively) and cumulative retention rates (p = 0.022, p = 0.012, respectively) than ADU. Some participants/NCCLs’ characteristics influenced (p < 0.05) the outcomes. FBU did not perform as well as ADU, especially in SE mode and due to functional properties. Participants’ age and NCCLs’ degree of dentin sclerosis and internal shape angle influenced FBU performance. Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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13 pages, 1394 KiB

Open AccessArticle

Effects of Monomer Composition of Urethane Methacrylate Based Resins on the C=C Degree of Conversion, Residual Monomer Content and Mechanical Properties

by Codruta Sarosi, Marioara Moldovan, Andrada Soanca, Alexandra Roman, Timea Gherman, Ancuta Trifoi, Andrea Maria Chisnoiu, Stanca Cuc, Miuta Filip, Georgiana Florentina Gheorghe and Radu Marcel Chisnoiu

Polymers 2021, 13(24), 4415; https://0-doi-org.brum.beds.ac.uk/10.3390/polym13244415 - 16 Dec 2021

Cited by 16 | Viewed by 2771

Abstract

(1) Background: This study investigated the influence of Bis-GMA, TEGDMA, UDMA, and two different polyethylene glycol (PEG)-containing, UDMO-based co-monomers on the Young’s modulus and flexural strength, degree of methacrylate C=C double bond conversion and residual monomer elution of experimental dental resins. (2) Methods: Urethane methacrylate-based monomer was synthesised via a radical chain growth polymerization mechanism using PEG in order to improve the mechanical properties. Dental resins were formulated using Bis-GMA, UDMA, or UDMO as base monomers combined with TEGDMA as a dilution monomer and DMAEM + CQ as the photo-initiator system. Degree of conversion (DC), mechanical properties, and residual monomer content of light-activated methacrylate resin formulations were evaluated and statistically analysed by ANOVA and a Tukey’s test. (3) Results: PEG-containing UDMO resins had lower Young’s modulus and elastic strength than UDMA-derived resin for all irradiation times. The highest DC (67,418%) was observed for the PEG-containing UDMO-based resin formulation when light cured for 40 s. For all samples, DC increased with the photo-polymerization time. The amount of residual monomer decreased after increasing the light-curing period from 20 to 40 s, resin with UDMO content 0.01 mol of PEG having the smallest amount of free eluted monomer. (4) Conclusions: A strong structure–property relationship exists in photo-cured dimethacrylate-based dental resins. The time and quantity of the photochemical initiation system can influence the physical–mechanical properties of the resins but also the monomers in their composition. Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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20 pages, 6109 KiB

Open AccessArticle

Effects of the Washing Time and Washing Solution on the Biocompatibility and Mechanical Properties of 3D Printed Dental Resin Materials

by Na-Kyung Hwangbo, Na-Eun Nam, Jong-Hoon Choi and Jong-Eun Kim

Polymers 2021, 13(24), 4410; https://0-doi-org.brum.beds.ac.uk/10.3390/polym13244410 - 16 Dec 2021

Cited by 30 | Viewed by 4751

Abstract

Three-dimensional (3D) printing technology is highly regarded in the field of dentistry. Three-dimensional printed resin restorations must undergo a washing process to remove residual resin on the surface after they have been manufactured. However, the effect of the use of different washing solutions and washing times on the biocompatibility of the resulting resin restorations is unclear. Therefore, we prepared 3D-printed denture teeth and crown and bridge resin, and then washed them with two washing solutions (isopropyl alcohol and tripropylene glycol monomethyl ether) using different time points (3, 5, 10, 15, 30, 60, and 90 min). After this, the cell viability, cytotoxicity, and status of human gingival fibroblasts were evaluated using confocal laser scanning. We also analyzed the flexural strength, flexural modulus, and surface SEM imaging. Increasing the washing time increased the cell viability and decreased the cytotoxicity (p < 0.001). Confocal laser scanning showed distinct differences in the morphology and number of fibroblasts. Increasing the washing time did not significantly affect the flexural strength and surface, but the flexural modulus of the 90 min washing group was 1.01 ± 0.21 GPa (mean ± standard deviation), which was lower than that of all the other groups and decreased as the washing time increased. This study confirmed that the washing time affected the biocompatibility and mechanical properties of 3D printed dental resins. Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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17 pages, 47156 KiB

Open AccessArticle

Synergies of Human Umbilical Vein Endothelial Cell-Laden Calcium Silicate-Activated Gelatin Methacrylate for Accelerating 3D Human Dental Pulp Stem Cell Differentiation for Endodontic Regeneration

by Wei-Yun Lai, Tzu-Hsin Lee, Jian-Xun Chen, Hooi-Yee Ng, Tsui-Hsien Huang and Ming-You Shie

Polymers 2021, 13(19), 3301; https://0-doi-org.brum.beds.ac.uk/10.3390/polym13193301 - 27 Sep 2021

Cited by 5 | Viewed by 1969

Abstract

According to the Centers for Disease Control and Prevention, tooth caries is a common problem affecting 9 out of every 10 adults worldwide. Dentin regeneration has since become one of the pressing issues in dentistry with tissue engineering emerging as a potential solution for enhancing dentin regeneration. In this study, we fabricated cell blocks with human dental pulp stem cells (hDPSCs)-laden alginate/fish gelatin hydrogels (Alg/FGel) at the center of the cell block and human umbilical vascular endothelial cells (HUVEC)-laden Si ion-infused fish gelatin methacrylate (FGelMa) at the periphery of the cell block. ¹H NMR and FTIR results showed the successful fabrication of Alg/FGel and FGelMa. In addition, Si ions in the FGelMa were noted to be bonded via covalent bonds and the increased number of covalent bonds led to an increase in mechanical properties and improved degradation of FGelMa. The Si-containing FGelMa was able to release Si ions, which subsequently significantly not only enhanced the expressions of angiogenic-related protein, but also secreted some cytokines to regulate odontogenesis. Further immunofluorescence results indicated that the cell blocks allowed interactions between the HUVEC and hDPSCs, and taken together, were able to enhance odontogenic-related markers’ expression, such as alkaline phosphatase (ALP), dentin matrix phosphoprotein-1 (DMP-1), and osteocalcin (OC). Subsequent Alizarin Red S stain confirmed the benefits of our cell block and demonstrated that such a novel combination and modification of biomaterials can serve as a platform for future clinical applications and use in dentin regeneration. Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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16 pages, 5597 KiB

Open AccessArticle

The Development of Light-Curable Calcium-Silicate-Containing Composites Used in Odontogenic Regeneration

by Yi-Ting Lin, Ming-You Shie, Yen-Hong Lin, Chia-Che Ho, Chia-Tze Kao and Tsui-Hsien Huang

Polymers 2021, 13(18), 3107; https://0-doi-org.brum.beds.ac.uk/10.3390/polym13183107 - 15 Sep 2021

Cited by 3 | Viewed by 1917

Abstract

Pulp regeneration is one of the most successful areas in the field of tissue regeneration, despite its current limitations. The biocompatibility of endodontic biomaterials is essential in securing the oral microenvironment and supporting pulp tissue regeneration. Therefore, the objective of this study was to investigate the new light-curable calcium silicate (CS)-containing polyethylene glycol diacrylate (PEGDA) biocomposites’ regulation of human dental pulp stem cells (hDPSCs) in odontogenic-related regeneration. The CS-containing PEGDA (0 to 30 wt%) biocomposites are applied to endodontics materials to promote their mechanical, bioactive, and biological properties. Firstly, X-ray diffraction and Fourier-transform infrared spectroscopy showed that the incorporation of CS increased the number of covalent bonds in the PEGDA. The diameter tension strength of the CS-containing PEGDA composite was significantly higher than that of normal PEGDA, and a different microstructure was detected on the surface. Samples were analyzed for their surface characteristics and Ca/Si ion-release profiles after soaking in simulated body fluid for different periods of time. The CS30 group presented better hDPSC adhesion and proliferation in comparison with CS0. Higher values of odontogenic-related biomarkers were found in hDPSCs on CS30. Altogether, these results prove the potential of light-curable CS-containing PEGDA composites as part of a ‘point-of-care’ strategy for application in odontogenesis-related regeneration. Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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12 pages, 1959 KiB

Open AccessArticle

In Vitro Assessment of the Cell Metabolic Activity, Cytotoxicity, Cell Attachment, and Inflammatory Reaction of Human Oral Fibroblasts on Polyetheretherketone (PEEK) Implant–Abutment

by Tzu-Yu Peng, Yin-Hwa Shih, Shih-Min Hsia, Tong-Hong Wang, Po-Jung Li, Dan-Jae Lin, Kuo-Ting Sun, Kuo-Chou Chiu and Tzong-Ming Shieh

Polymers 2021, 13(17), 2995; https://0-doi-org.brum.beds.ac.uk/10.3390/polym13172995 - 03 Sep 2021

Cited by 20 | Viewed by 3730

Abstract

The purpose of this research is to compare the cytotoxicity of polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) with conventional dental implant–abutment materials, namely titanium alloy (Ti-6Al-4V) and yttria-stabilized tetragonal zirconia polycrystal (Y-TZP), to evaluate the cell metabolic activity, cytotoxicity, and inflammation potential of human oral fibroblasts (HOF) on these materials. Disk-shaped specimens were designed and prepared via a dental computer-aided manufacturing technology system. Surface topography, roughness, and free energy were investigated by atomic force microscope and contact angle analyzer; cell metabolic activity and cytotoxicity by MTT assay; and morphological changes by scanning electron microscopy (SEM). The effect of pro-inflammatory gene expression was evaluated by RT-qPCR. The obtained data were analyzed with one-way analysis of variance and post-hoc Tukey’s honest significant difference tests. PEEK and PEKK exhibited higher submicron surface roughness (0.04 μm) and hydrophobicity (>80°) than the control. Although the cell activity of PEEK was lower than that of Ti-6Al-4V and Y-TZP for the first 24 h (p < 0.05), after 48 h there was no difference (p > 0.05). According to the cell cytotoxicity and the pro-inflammatory cytokine gene expression assays, there was no difference between the materials (p > 0.05). SEM observations indicated that HOF adhered poorly to PEKK but properly to Ti-6Al-4V, Y-TZP, and PEEK. PEEK and PEKK show comparable epithelial biological responses to Ti-6Al-4V and Y-TZP as implant–abutment materials. Between the two polymeric materials, the PEEK surface, where the HOF showed better cell metabolic activity and cytotoxicity, was a more promising implant–abutment material. Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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11 pages, 1288 KiB

Open AccessArticle

Complications of Poly-l-Lactic Acid and Polyglycolic Acid (PLLA/PGA) Osteosynthesis Systems for Maxillofacial Surgery: A Retrospective Clinical Investigation

by Yuhei Matsuda, Masaaki Karino, Tatsuo Okui and Takahiro Kanno

Polymers 2021, 13(6), 889; https://0-doi-org.brum.beds.ac.uk/10.3390/polym13060889 - 14 Mar 2021

Cited by 13 | Viewed by 2904

Abstract

Two second-generation PLLA/PGA bioresorbable osteosynthetic plate systems for oral and maxillofacial surgery are available in Japan. The two systems have different PLLA-PGA component ratios (RapidSorb^®, 85:15; Lactosorb^®, 82:18) and plate and screw shapes. We conducted a retrospective study to compare our clinical evaluation and examine the incidence of postoperative complications between the two plate systems. A retrospective survey was conducted in 148 patients (midfacial fracture/trauma (68.2%) and dentofacial deformity patients (31.8%); males (54.7%); median age, 37.5 years) treated using maxillofacial osteosynthetic plate systems. The complications included plate exposure (7.4%), infection, (2.7%), and plate breakage (0.7%). Multivariate logistic regression analysis showed a significant correlation between sex (female), plate system (Lactosorb^®), number of plates, and pyriform aperture and periorbital sites of plate placement (p < 0.05). Additionally, the propensity score-adjusted model showed a significant correlation between Lactosorb^® and postoperative complications (odds ratio 1.007 (95% confidence interval, 1.001–1.055), p < 0.01). However, the two plate systems showed a low incidence rate of complications, and the plate integration and survivability were similar using 2.0-mm or 1.5-mm resorbable plate regardless of the plate system. Our findings suggest that female sex and a greater number of plates are risk factors for postoperative complications, whereas pyriform aperture and periorbital plate placements reduce the risk. Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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22 pages, 5633 KiB

Open AccessReview

Zn-containing Adhesives Facilitate Collagen Protection and Remineralization at the Resin-Dentin Interface: A Narrative Review

by Manuel Toledano, Manuel Toledano-Osorio, Matthias Hannig, Álvaro Carrasco-Carmona, María T. Osorio, Franklin García-Godoy, Inmaculada Cabello and Raquel Osorio

Polymers 2022, 14(3), 642; https://0-doi-org.brum.beds.ac.uk/10.3390/polym14030642 - 08 Feb 2022

Cited by 4 | Viewed by 2639

Abstract

This is a narrative review of the literature assessing the potential effectiveness of doping dentin polymeric adhesives with zinc compounds in order to improve bonding efficacy, remineralization and protection against degradation. A literature search was conducted using electronic databases, such as PubMed, MEDLINE, DIMDI and Web of Science. Through our search, we found literature demonstrating that Zn-doped dentin adhesives promote protection and remineralization of the resin-dentin interfaces. The increased bioactivity has also facilitated dentinal tubules’ occlusion by crystals’ precipitation contributing to improved sealing efficacy of restorations. Loading dentin adhesives with zinc gives rise to an increase of both crystallinity of mineral and crosslinking of collagen. The main role of zinc, in dentin adhesives, is to inhibit collagen proteolysis. We concluded that zinc exerts a protective effect through binding at the collagen-sensitive cleavage sites of matrix-metalloproteinases (MMPs), contributing to dentin matrix stabilization. Zinc may not only act as a MMPs inhibitor, but also influence signaling pathways and stimulate metabolic effects in dentin mineralization and remineralization processes. Zn-doped adhesives increase the longevity of dentin bonding through MMPs inhibition. Zn poses a remineralization strategy in demineralized dentin. Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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11 pages, 51627 KiB

Open AccessReview

Biomechanical Aspects of Various Attachments for Implant Overdentures: A Review

by Bharat Mirchandani, Ting Zhou, Artak Heboyan, Sirasa Yodmongkol and Borvornwut Buranawat

Polymers 2021, 13(19), 3248; https://0-doi-org.brum.beds.ac.uk/10.3390/polym13193248 - 24 Sep 2021

Cited by 18 | Viewed by 5784

Abstract

There have been considerable recent technological developments for implant overdenture attachments. This study presents an overview of the biomechanical and biomolecular aspects of various attachments for implant overdenture. Available articles on attachments for implant overdenture were reviewed from January 1980 to August 2021 in the ScienceDirect, MEDLINE/PubMed, and Web of Science resources, and relevant studies were included in this study. We focused on the following topics: attachment systems, retention of various attachments, stress distribution with different attachments, the design and fabrication of attachments, digital techniques in overdenture attachments, and the effects of attachments in peri-implant health. We found that plastic resin is commonly used for ball and bar attachments, whereas nylon resin is commonly used in locator attachments. The locator system offers a valuable attachment option for implant-retained overdenture. Attachment retention reduces while lateral force increases with implant inclination in overdenture. The higher the retention of an overdenture attachment, the higher the transferred stresses. Additionally, clip loading produces more stress in implants and precision elements than bar-retained dentures. As such, we conclude that the ball and locator systems the best overdenture systems due to their superior tissue response, survival rate, and patient satisfaction. Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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17 pages, 4487 KiB

Open AccessSystematic Review

Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis

by Manuel Toledano-Osorio, Esther Muñoz-Soto, Manuel Toledano, Marta Vallecillo-Rivas, Cristina Vallecillo, Pablo Ramos-García and Raquel Osorio

Polymers 2022, 14(7), 1453; https://0-doi-org.brum.beds.ac.uk/10.3390/polym14071453 - 02 Apr 2022

Cited by 9 | Viewed by 6326

Abstract

Gingival recessions are a prevalent oral mucosa alteration. To solve this pathology, palatal mucosa or polymeric soft tissue substitutes are used when performing coronal advanced flap (CAF) or tunnel (TUN) surgical techniques. To evaluate which is the most successful approach, a literature review and meta-analysis were conducted. For the electronic search the National Library of Medicine, the Cochrane Oral Health Group Trials Register, EMBASE and WOS were used. Pooled data for the percentage of root coverage was collected and weighted means were calculated. Heterogeneity was determined using the Higgins (I²) statistic and a random-effects model was applied. Thirteen studies were included in the systematic review (12 randomized and 1 controlled clinical trials) in which both techniques (394 patients) were compared with a follow-up of 4 to 12 months. Galbraith and Baujat plots were used to control for the presence of potential outliers. After performing the meta-analysis (11 studies), the mean root coverage was similar when using the TUN or CAF techniques (p = 0.49). The only differences between the two were found for single recessions, where CAF offered a higher percentage of root coverage (mean difference = 4.98%; p = 0.006). There were no differences when applying an autograft or a polymeric substitute with either of the two tested surgical techniques (p = 0.445). Full article

(This article belongs to the Special Issue Polymeric Materials for Dental Applications II)

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