A 2‐year clinical study of two glass ionomer cements used in the atraumatic restorative treatment (ART) technique

Abstract

The purpose of the study was to evaluate, in a clinical study over 2 years, the deterioration of two glass ionomer cements used with the atraumatic restorative treatment (ART) technique or approach. Fifty-five Fuji IX and 45 ChemFil Superior restorations were placed randomly in 23 adult patients, mainly in small occlusal preparations in molar teeth. The restorations were placed in a dental hospital by one dentist using the ART technique. Photographs, radiographs and replicas were obtained at baseline and subsequent recalls. Both cements were easy to mix and place, but the radiolucency of ChemFil Superior was a disadvantage. Both cements also showed early high losses of sealant and restorative material. After 2 years, 34.5% of the sealants appeared to be completely lost, with caries recorded in 5.3% of the exposed fissures. In some instances, these small lesions may have been present, but not detected clinically, at the time of sealing. Restoration failures of 7.0% were from wear and fracture of the cements and recurrent caries. Mean cumulative wear was 83.1 microm for Fuji IX and 104.0 microm for ChemFil Superior, which was not statistically significant. The cements became darker after their placement to more closely match the restored teeth, but there were few exact matches. There was no surface staining and only minor marginal discrepancies and staining associated with the restorations. Although the short-term clinical performance of the two glass ionomer cements was reasonable, the materials require further improvements in their mechanical properties, to reduce sealant losses and wear. The cements evaluated appear suitable for restricted use only, in posterior teeth.

Evaluation of glass ionomer sealants placed according to the ART approach in a community with high caries experience: 1-year follow-up

“…In this study, the sealants, regardless of their retention levels, showed to be beneficial. The caries-free teeth after 1 year were 98.5% for both tested groups and it is in accordance with other studies that presented rates of caries-free teeth varying from 96.1% to 100% after one year 3 , 8 – 10 , 13 , 14 , 17 .…”

“…In relation to the retention rates and the caries-incidence, there were no statistically significant differences between the experimental and test groups by gender, type of first molar and jaw at the 1 year recall. This result observed was comparable to those presented in literature 3 , 5 , 13 , 14 , 19 , probably due to standardization of procedures.…”

“…ART studies report an operator effect on the success of treatment 8 – 10 , 13 , 14 . In those studies, the outcomes revealed that less experienced operators obtain worse results compared to experienced ones 8 – 10 , 13 , 14 . In the present study, only one operator previously trained and calibrated assisted by one chair-side assistant placed all sealants.…”

Caries preventive efficacy of silver diammine fluoride (SDF) and ART sealants in a school-based daily fluoride toothbrushing program in the Philippines

“…Other studies have reported retention rates of high viscosity GIC sealants that vary considerably [30-33]. This variance may be explained by the clinical conditions (field setting) under which sealants are placed, the teeth selected for sealing, operator factors and inadequate training.…”

Comparison between visual clinical examination and the replica method for assessments of sealant retention over a 2-year period

“…One way to overcome these shortcomings is to apply the replica method using die stone, which has been used successfully for evaluating restorations, 11,12 detecting developmental enamel defects 13 and measuring the cement thickness of placed crowns. 14 However, this method has rarely been used for assessing dental sealant retention.…”