Made available in DSpace on 2017-07-24T19:22:05Z (GMT). No. of bitstreams: 1 THAYNARA BOING.pdf: 2103458 bytes, checksum: e706074b69bce3f72ba788d2a4560bc1 (MD5) Previous issue date: 2017-04-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The aim of this systematic review was to compare the clinical effectiveness of non-carious cervical restorations with glass ionomer cement /resin-modified glass ionomer cement (GIC/RMGIC) or composite resin (CR). The following factors were analyzed: retention rates, color, surface texture, marginal adaptation, marginal discoloration and secondary caries. Methods:According to the PRISMA guidelines, systematic review was undertaken using a selection process in two phases, different references were identified and articles were included for qualitative analysis and were included in a meta-analysis. The authors searched the following electronic database: Cochrane, Lilacs, BBO, Pubmed, Scopus and Web Of Science. Additional search of grey literature was performed. Were also searched the abstracts from the IADR (1990-2015), ongoing trials in trials registries, the CAPES database for theses and the ProQuest database for theses and dissertations. We included only randomized clinical trials. Quality of the evidence for each outcome was assessed using the GRADE tool. Results: A total of 1530 articles were identified, but only 19 articles from 15 studies remained for analysis, which were all judged at “unclear” risk of bias. Ten of the 15 studies evaluated resin-modifed glass ionomer cements, (GIC/RMGIC) that showed higher retention rates in all follow-ups (1 to 3 years; p < 0.0001 and at 5 years; p< 0.00001). No difference was observed for marginal discoloration, marginal adaptation and secondary caries in all followups (p > 0.05). CR showed better color match than GIC/RMGIC only at 2 years (p = 0.03). Higher surface texture was observed in GIC/RMGIC in all follow-ups (at 1 year p= 0.0003; at 3 years p = 0.0004). Quality of evidence was graded as moderate or low due to the unclear risk of bias and imprecision in some outcomes. Conclusions: The retention rates of GIC/RMGIC were superior to composite resins in all study follow-ups, but a higher surface texture was observed in the GIC/RMGIC compared to CR. / Comparar a efetividade clínica de restaurações cervicais não cariosas com cimento de ionômero de vidro / cimento de ionômero de vidro modificado por resina (CIV/CIVMR) ou à base de resina composta (RC). Por meio de revisão sistemática da literatura, os seguintes fatores foram analisados: taxas de retenção, cor, textura de superfície, adaptação marginal, descoloração marginal e cárie secundária. Métodos: De acordo com a orientação do PRISMA, a revisão sistemática foi realizada utilizando um processo de seleção em duas fases, identificaram-se diferentes referências e os artigos foram incluídos para uma análise qualitativa e posteriormente meta– análises. Os autores pesquisaram nas seguintes bases de dados: Cochrane, Lilacs e BBO, Pubmed, Scopus e Web Of Science. Uma pesquisa adicional na literatura cinzenta foi realizada. Foram pesquisados também os resumos do IADR (1990-2015), os ensaios em andamento nos registros de ensaios clínicos, as bases de dados CAPES e ProQuest para teses e dissertações. Foram incluídos apenas ensaios clínicos randomizados. A qualidade da evidência para cada resultado foi avaliada usando a ferramenta GRADE. Resultados: Foram identificados 1530 artigos, mas apenas 19 artigos de 15 estudos (4 de acompanhamento de estudos anteriores) permaneceram para análise, os quais foram todos julgados com risco de viés "moderado". Dez dos 15 estudos avaliaram CIVMR. Os CIV/CIVMR apresentaram maiores taxas de retenção em todos os seguimentos (1 a 3 anos, p <0,0001 e 5 anos, p <0,00001). Não houve diferença para descoloração marginal, adaptação marginal e cárie secundária em todos os seguimentos (p> 0,05). A RC mostrou melhor estabilidade de cor do que CIV/CIVMR apenas aos 2 anos (p = 0,03). Observou-se maior rugosidade no CIV/CIVMR em todos os acompanhamentos (1 ano p = 0,0003, aos 3 anos p = 0,0004). A qualidade da evidência foi classificada como moderada ou baixa, devido ao risco indefinido de viés e imprecisão em alguns resultados. Conclusões: As taxas de retenção de CIV/CIVMR foram superiores às resinas compostas em todos os acompanhamentos do estudo, mas observou-se maior textura superficial nesses CIV/CIVMR em relação às RCs.

In individuals claiming compensation for occupational noise induced hearing loss, a population with a high incidence of nonorganic hearing loss, a reliable and valid behavioural pure tone (PT) threshold is not always achievable. Recent studies have compared the accuracy of behavioural PT threshold estimation using the slow cortical auditory evoked potentials (SCAEP) and auditory steady-state responses (ASSR) but there is no consensus regarding recommended technique. A review of the literature indicated that no comparison has been completed on the use of SCAEP and a single frequency ASSR technique. A research project was therefore initiated with the aim of comparing the clinical effectiveness (accuracy) and clinical efficiency (time required) of SCAEP and ASSR for behavioural PT threshold estimation in adults exposed to occupational noise. Adult participants were divided into a group with normal hearing (behavioural PT thresholds < 20 dBHL; n = 15) and a group of participants with hearing loss (n = 16 adults), the latter of which were recruited from individuals referred for audiometric screening, as part of hearing conservation programs, and who were, therefore, exposed to occupational noise. The GSI Audera electrophysiological system was used for both SCAEP and ASSR threshold measurement at 0.5, 1, 2 and 4 kHz. Use was made of tone burst stimuli for the SCAEP (rise and fall of 10 ms with 80 ms plateau), while amplitude and frequency modulated (AM/FM) stimuli was used during ASSR testing. The system’s 40 Hz protocol was chosen for use during ASSR recording while participants slept because this led to lparticipants. ASSR thresholds could not be measured in two of the three sleeping participants in the preliminary study using an 80 Hz modulation rate due to excessive noise. The mean SCAEP difference scores (SCAEP threshold minus behavioural PT threshold) for both participant groups were -0.2+10.2, 2.8+10.1,5.8+9.7, 0.5+10.4 at 0.5, 1, 2, and 4 kHz respectively, while ASSR difference scores were 25.3+12.8, 21.7+11.3,32.3+12.2, 27.1+13.8. The SCAEP correlations with behavioural PT thresholds across frequencies (r = 0.85) were also stronger than ASSR correlations (r = 0.75). Therefore, with regard to proximity of auditory evoked potentials (AEP) to behavioural PT thresholds and consistency of this relationship, the SCAEP, rather than ASSR, is the AEP of choice. However, the SCAEP took on average 10.1 minutes longer to complete than the ASSR. Clinical effectiveness was given comparably more weight than the clinical efficiency of the AEP technique to estimate behavioural PT thresholds due to the impact on overcompensation for occupational noise induced hearing loss. As such, the study acknowledged the SCAEP as the AEP of choice for the purpose of behavioural PT thresholds in adults exposed to occupational noise. It is important to note that the conclusion reached in the current study arose from the comparison of the SCAEP with a specific ASSR technique. Accuracy of ASSR estimation of behavioural PT thresholds is strongly influenced by stimulus and recording parameters of the system used, and by the participant variables. Copyright / Dissertation (MCommunication Pathology)--University of Pretoria, 2010. / Speech-Language Pathology and Audiology / Unrestricted