Use of glass ionomer cement containing antibiotics to seal off infected dentin: a randomized clinical trial

Abstract

Dental materials with antibacterial properties can prevent the harmful effects caused by oral cariogenic bacteria. This double-blind controlled clinical trial evaluated the performance of a glass ionomer cement (GIC) added with antibiotics for sealing infected dentin in atraumatic restorations of primary molars. The study enrolled 45 children (45 teeth) between 5 and 8 years of age, of both genders, divided into two groups: GC (n=22), where cavities were lined with a conventional GIC (Vidrion F) and GA (n=23), with cavities lined with Vidrion F added with 1% each of metronidazole, ciprofloxacin and cefaclor antibiotic. Both groups were restored with Ketac Molar Easymix. Molars with carious lesions on the inner half of dentin without clinical or radiographic pulp damage were selected. Patients were evaluated clinically (pain, fistulas or mobility) and radiographically (area of caries, periapical region and furcation) after 1, 3, 6 and 12 months. For statistical analysis, chi-squared or Fisher's exact tests were used with a 5% significance level. GA (82.6-95.7%) had better results than GC (12.5-36.4%) in all evaluations (p<0.05) and the difference in the success rate was 46.2-72.5% higher for GA. The use of the antibiotic-containing GIC liner on infected dentin proved satisfactory when applied in deciduous teeth.

Antimicrobial properties of conventional restorative filling materials and advances in antimicrobial properties of composite resins and glass ionomer cements—A literature review

“…Antibiotics have been added directly to restorative materials [27,28,[139][140][141][142]. Mixtures of ciprofloxacin, minocycline, cefaclor and metronidazole, have been added to GIC powder [27,139].…”

“…GICs with mixtures of ciprofloxacin and metrodnidazole have been claimed to enhance fluoride release [141]. GICs with added antibiotics have also shown increased success rates in clinical trials [142]. The use of such materials was suggested especially for atraumatic restorative treatment (ART) [28,142].…”

“…GICs with added antibiotics have also shown increased success rates in clinical trials [142]. The use of such materials was suggested especially for atraumatic restorative treatment (ART) [28,142]. Since the ART approach using GIC is mostly indicated for use in posterior teeth it is necessary that the material shows strong enough physical properties against the occlusal load in posterior region [28].…”

Selamento de lesões de cárie oclusais em molares decíduos: relato de dois casos clínicos

“…Ferreira et al 21 (2013) realizaram um estudo em que foram selecionados molares decíduos de crianças entre 5 e 8 anos de idade com lesões de cá-rie em metade interna de dentina, sem presença de danos pulpares clínicos ou radiográficos, e optaram pelo selamento com cimento de ionômero de vidro, sem remoção prévia de tecido cariado. Os pacientes foram avaliados, clinica e radiograficamente, após um, três, seis e 12 meses e apresentaram bons resultados, justificando, assim, a conduta clínica adotada no caso, em que a lesão de cárie encontrava--se com progressão no início da metade interna de dentina.…”

Clinical aspects of Atraumatic Restorative Treatment

“…De meest eff ectieve toevoeging bleek 1% chloorhexidinediacetaat te zijn (Imazato, 2009). Maar ook een combinatie van 1% metronidazol, ciprofl oxacine en cefaclor in een onderlaag van glasionomeercement bleek in staat microorganismen in gedemineraliseerd dentine te doden (Ferreira et al, 2013). Voorts hebben glasionomeercementen de potentie ionen als calcium, fosfor en fl uor vrij te geven aan glazuur en dentine en om cariëslaesies in glazuur in grootte en diepte te verminderen (Donly et al, 1999;Ngo et al, 2006;Trairatvorakul et al, 2011;Bezerra et al, 2012).…”