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How well are gic product labels related to current systematic review evidence?

From Volume 38, Issue 9, November 2011 | Pages 634-644

Authors

Steffen Mickenautsch

BDS, PhD

Division of Public Oral Health, Faculty of Health Science, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa

Articles by Steffen Mickenautsch

Abstract

Systematic reviews have been recommended as providing the best source of evidence to guide clinical decisions in dentistry. They appraise evidence from trials focused on investigating clinical effects of dental material categories, such as conventional glass-ionomer cements (GIC) or resin-modified GIC. In contrast, the general dental practitioner is introduced to these categories of materials in the form of branded or private product labels that are marketed during dental conventions or through advertisements. Difficulties may arise in recognizing material categories that have been subjected to systematic reviews, because of the multitude of product labels on the current market. Thus, the value and relevance of published systematic review evidence concerning the material categories represented by these labels may remain obscure. Based on a systematic literature search, this article identifies glass-ionomer cement product labels used during clinical trials which, in turn, were subsequently reviewed in systematic review articles (published between 15 April 2009 and 14 April 2011). This article further clarifies how these product labels relate to the systematic review conclusions. The results show that the conventional and resin-modified glass-ionomer cements that were used in most trials were marketed by GC and 3M ESPE, respectively. The conventional GICs used in most of the reviewed trials were Fuji III and Fuji IX, while Vitremer was the most commonly used resin-modified GIC. Evidence from the reviewed trials suggests that GIC provides beneficial effects for preventive and restorative dentistry. However, more trials of higher internal validity are needed in order to confirm (or disprove) these findings. Only GIC products of branded labels and none of private labels were identified, suggesting that private label GIC products have little or no research back-up.

Clinical Relevance: Dental products, such as glass-ionomers cements (GIC), can only be judged as effective when they are based on sufficient research back-up. Systematic reviews of clinical trials provide such back-up at the highest level. Thus clinicians must be able to identify GIC products for which reliable evidence from systematic reviews of clinical studies is available and know about what such evidence contains.

Article

Systematic reviews are described as providing objective overviews of all the evidence currently available on a particular topic of interest.1 Such overviews cover clinical trials in order to establish where effects of healthcare are consistent and where they may vary, through the use of explicit, systematic methods aimed at limiting systematic error (bias) and reducing the chance of effect.2 These types of reviews have been recommended as providing the best source of evidence to guide clinical decisions3,4 and healthcare policy,5 and they receive twice as many citations as non-systematic reviews in peer-reviewed journals.5–7

Systematic reviews are defined as scientific literature reviews aimed at answering clearly formulated questions through the use of systematic and explicit methods for identifying, selecting, and critically appraising relevant research, and for collecting and analysing data from the literature.8 In order to fulfil this function, a systematic review:

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