Clinical Effectiveness of Fiber-reinforced Composite Space Maintainer and Band and Loop Space Maintainer in a Pediatric Patient: A Systematic Review and Meta-analysis

Objectives: This systematic review aimed to evaluate the clinical effectiveness of fiber-reinforced composite space maintainer (FRCSM) and band and loop space maintainer (BLSM) in a pediatric patient.Eligibility criteria: Randomized controlled trials (RCTs) were conducted on 3-12-year-old children who received FRCSM and BLSM. Information sources: Literature search of electronic databases such as PubMed, Cochrane, and Google Scholar for the time period of 2000 to October 2020. Risk of bias: Cochrane collaboration's risk of bias tool was used to assess the risk of bias.Included studies: The search resulted in 147 published studies. After the removal of duplicate studies and full-text analysis, eight studies were selected. Synthesis of results: Fiber-reinforced composite restoration (FRCSM) was judged to be good for short-term space maintenance with good esthetics, less time-consuming, and good patient and parental acceptance. Meta-analysis was done for failure rate at 6 months and 12 months. After 6 months, the FRCSM group showed less failure, with a risk ratio of 0.83 (95% CI = 0.47-1.49; Z value = 0.61). However, after 12 months, the FRCSM group showed more failure, with a risk ratio of 1.30 (95% CI = 0.04-4.23; Z value = 0.44). Description of the effect: FRCSM performed better than BLSM for a short-term, i.e., around 6 months but after 12 months of space maintainer placement BLSM performed better than the FRCSM.Strengths and limitations of evidence: The strength of this systematic review is its complete adherence to the PRISMA statement 2009. This review attempted to evaluate the effectiveness of FRCSM when compared with BLSM which has not been evaluated before. Additionally, only RCTs were included in this review adding to its validity. This review also included a meta-analysis that compared the failure rate at the 6th and 12th month. The main shortcoming of this systematic review is the limited number of databases searched and the limited number of existing studies. Interpretation: Within the limitations of this review, it can be stated that the FRCSM is an effective space maintainer for short-term space maintenance. However, it is necessary to conduct more RCTs with larger sample size, preferably using a split-mouth design to improve the longevity of FRCSM. Additionally, it is also necessary to standardize the technique of fabrication of FRCSM since an existing study showed high heterogeneity in the technique of fabrication.Funding: None. Registration: The protocol of this systematic review was registered on PROSPERO (ID-CRD42020165831).Kamki H, Kalaskar R, Balasubramanian S, et al. Clinical Effectiveness of fiber-reinforced Composite Space Maintainer and Band and Loop Space Maintainer in a Pediatric Patient: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2021;14(S-1):S82-S93.