A Retrospective Study of the 3-Year Survival Rate of Resin-Modified Glass-Ionomer Cement Class II Restorations in Primary Molars

the aim was to determine the survival of tooth-coloured restorative materials in proximal restorations of primary teeth at 24 months of follow-up and the influence of the following variables: use of coating, use of cavity conditioner, use of rubber dam isolation, the cavity form, the dentist's experience and the methodological characteristics of the studies. We conducted a search until May 2019, obtaining 16 articles from which 30 independent studies were extracted, which were considered as units of analysis. Four outcome measures were extracted from each study: retention, marginal integrity, anatomic form, and absence of recurrent caries. Separate meta-analyses were carried for each outcome and multiple meta-regression model was applied. The outcomes with the highest mean success rates were absence of recurrent caries and anatomic form. The type of material significantly influenced success rates. The best materials were resin-based material plus total-etching adhesion and resin-modified glass ionomer cement (RMGIC), and the worst high viscosity glass ionomer cement (HVGIC). Atraumatic restorative treatment (ARt) had a lower success rate than the conventional cavity form. RMGic had the best clinical performance and HVGIC the worst. The form of the cavity, blinding and the experience of the operator were the variables that influenced success rates. Proximal primary molar restorations should be performed with RMGIC as it combines good mechanical performance of the resins together with the prevention of secondary caries of glass ionomers. The Global Burden of Disease 2015 study 1 concluded that oral health has not improved in the last 25 years: the age-standardized prevalence rate of untreated caries in primary teeth was 7.8% (573 million children) and 126 million children worldwide had incident cases of caries in primary teeth in 2015. Dental caries, according to the WHO, remains the most frequent chronic disease in early childhood in most communities around the world, having a negative impact on the quality of life of both the child and their family, and is considered a public health problem 2,3. The toxic effects on the patient, health professionals and the environment, the increasing prevalence of minimal intervention restorative approaches and the increased demand for aesthetics, have reduced the use of amalgam as the material of choice for the restoration of primary teeth 4,5. Currently, restorative treatments for primary teeth include a wide variety of tooth-coloured materials such as glass ionomer cements (GIC), resin-modified glass ionomer cement (RMGIC), high viscosity glass ionomer cement (HVGIC), compomers and composite resins (CR). In general, composites are recommended in children with a low risk of caries, compomers in children with a moderate risk and glass ionomers in children with a high risk 6. GICs are good materials for the primary dentition 7 due to their ability to adhere to the dental structure, low polymerization contraction, lack of postoperative sensitivity, biological compatibility and th...

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“…• Insufficient information on evaluation of material performance: 14 10,19,[52][53][54][55][56][57][58][59][60][61][62][63] .…”

Section: Resultsmentioning

confidence: 99%

Success rate of proximal tooth-coloured direct restorations in primary teeth at 24 months: a meta-analysis

Ruiz¹,

Pérez-Guzmán²,

Rubio‐Aparicio³

et al. 2020

Sci Rep

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Section: Discussionmentioning

confidence: 99%

“…Biocem (BC) is a dual-cured RMGI cement which contains bioactive components including phosphate- and calcium-rich soluble glass particles[30]. There have been reports suggesting that BC regenerates tooth structure which may largely relate to the ability of RMGI cements to precipitate apatite mineral at the cement-tooth interface due to fluoride release [30]. The ability to release calcium, phosphate and fluoride ions may be very beneficial for remineralization of enamel and to also aid in establishing a strong interfacial bond between enamel and the cement, but previous studies have shown that for the remineralization of dentin a process-directing agent is critical in order to reinforce the organic matrix [8, 9, 23, 31].…”

Section: Discussionmentioning

confidence: 99%

Integrating the PILP-mineralization process into a restorative dental treatment

et al. 2019

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The addition of charged polymers, like poly-aspartic acid (pAsp), to mineralizing solutions allows for transport of calcium and phosphate ions into the lumen of collagen fibrils and subsequent crystallization of oriented apatite crystals by the so-called Polymer-Induced Liquid Precursor (PILP) mineralization process, leading to the functional recovery of artificial dentin lesions by intrafibrillar mineralization of collagen. Objective: To evaluate the feasibility of applying the PILP method as part of a restorative treatment and test for effectiveness to functionally remineralize artificial lesions in dentin. Materials and Methods: Two methods of providing pAsp to standardized artificial lesions during a restorative procedure were applied: A) pAsp was mixed into commercial RMGI (resin modified glass ionomer) cement formulations and B) pAsp was added at high concentration (25mg/ml) in solution to rehydrate lesions before restoring with a RMGI cement). All specimens were immersed in simulated body fluid for two weeks to allow for remineralization and then analyzed for dehydration shrinkage, integrity of cement-dentin interface, degree of mineralization, and changes in the nanomechanical profile (E-modulus) across the lesion. Results: After the remineralization treatment, lesion shrinkage was significantly reduced for all treatment groups compared to demineralized samples. Pores developed in RMGI when pAsp was added. A thin layer at the dentin-cement interface, rich in polymer formed possibly from a reaction between pAsp and the RMGI. When analyzed by SEM under vacuum, most lesions delaminated from the cement interface. EDS-analysis showed some but not full recovery of calcium and phosphorous levels for treatment groups that involved pAsp. Nanoindentations placed across the interface indicated improvement for RMGI containing 40% pAsp, and were significantly elevated when lesions were rehydrated with pAsp before being restored with RMGI. In particular the most demineralized outer zone recovered substantially in the elastic modulus, suggesting that functional remineralization has been initiated by pAsp delivery upon rehydration of air-dried demineralized dentin. In contrast, the effectiveness of the RMGI on functional remineralization of dentin was minimal when pAsp was absent. Conclusions: Incorporation of pAsp into restorative treatments using RMGIs promises to be a feasible way to induce the PILP-mineralization process in a clinical setting and to repair the structure and properties of dentin damaged by the caries process.

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“…Due to the young age of paediatric patients associated with difficulties with behaviour management and/or limited operators’ technical abilities, it is sometimes impossible to properly isolate teeth to perform composite restorations. Additionally, a previous retrospective study showed that the most common site of restoration failure was the mandibular first primary molar because of unique anatomy of this tooth, presenting a narrow buccolingual width and relatively large pulp chamber. It has been evidenced that resin‐modified glass ionomer cements and compomer presented good clinical performance, with a success rate higher than 90%.…”

Section: Discussionmentioning

confidence: 99%

Performance of resin composite restorations in the primary dentition: a retrospective university‐based study

Ribeiro

Forgerini

Pedrotti

et al. 2018

Int J Paed Dentistry

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A Retrospective Study of the 3-Year Survival Rate of Resin-Modified Glass-Ionomer Cement Class II Restorations in Primary Molars

Abstract: A novel approach comparing materials showed that in this study Vitremer compared very favorably to previously published success rates of other standard restorative materials (amalgam, composite, stainless steel crown, compomer) and other RMGIC studies.

Cited by 16 publications

References 8 publications

Success rate of proximal tooth-coloured direct restorations in primary teeth at 24 months: a meta-analysis

Success rate of proximal tooth-coloured direct restorations in primary teeth at 24 months: a meta-analysis

Integrating the PILP-mineralization process into a restorative dental treatment

Performance of resin composite restorations in the primary dentition: a retrospective university‐based study

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