Evaluating Glass Ionomer Cement Longevity in the Primary and Permanent Teeth—An Umbrella Review

Abstract

The aim of this umbrella review was to evaluate the longevity of glass ionomer cement (GIC) as a restorative material for primary and permanent teeth. Research in the literature was conducted in three databases (MedLine/PubMed, Web of Science, and Scopus). The inclusion criteria were: (1) to be a systematic review of clinical trials that (2) evaluated the clinical longevity of GICs as a restorative material in primary and/or permanent teeth; the exclusion criteria were: (1) not being a systematic review of clinical trials; (2) not evaluating longevity/clinical performance of GICs as a restorative material; and (3) studies of dental restorative materials in teeth with enamel alterations, root caries, and non-carious cervical lesions. Twenty-four eligible articles were identified, and 13 were included. The follow-up periods ranged from 6 months to 6 years. Different types of GICs were evaluated in the included studies: resin-modified glass ionomer cement (RMGIC), compomers, and low- and high-viscosity glass ionomer cement. Some studies compared amalgam and composite resins to GICs regarding longevity/clinical performance. Analyzing the AMSTAR-2 results, none of the articles had positive criteria in all the evaluated requisites, and none of the articles had an a priori design. The criteria considered for the analysis of the risk of bias of the included studies were evaluated through the ROBIS tool, and the results of this analysis showed that seven studies had a low risk of bias; three studies had positive results in all criteria except for one criterion of unclear risk; and two studies showed a high risk of bias. GRADE tool was used to determine the quality of evidence; for the degree of recommendations, all studies were classified as Class II, meaning there was still conflicting evidence on the clinical performance/longevity of GICs and their recommendations compared to other materials. The level of evidence was classified as Level B, meaning that the data were obtained from less robust meta-analyses and single randomized clinical trials. To the best of our knowledge, this is the first umbrella review approaching GIC in permanent teeth. GICs are a good choice in both dentitions, but primary dentition presents more evidence, especially regarding the atraumatic restorative treatment (ART) technique. Within the limitation of this study, it is still questionable if GIC is a good restorative material in the medium/long term for permanent and primary dentition. Many of the included studies presented a high risk of bias and low quality. The techniques, type of GIC, type of cavity, and operator experience highly influence clinical performance. Thus, clinical decision-making should be based on the dental practitioner’s ability, each case analysis, and the patient’s wishes. More evidence is needed to determine which is the best material for definitive restorations in permanent and primary dentition.

Evaluation of setting kinetics, mechanical strength, ion release, and cytotoxicity of high-strength glass ionomer cement contained elastomeric micelles

“…The Minamata Convention advocates for the phasing down of dental amalgam to mitigate the environmental risk of releasing mercury waste into the environment [ 70 ]. The available alternative direct restorative materials, such as GICs, have improved over time but still exhibit limited strength and questionable long-term performance [ 71 ]. The current study demonstrated that GIC added with elastomeric micelles exhibited satisfactory mechanical properties and ion-releasing actions, suggesting its potential as an alternative GIC material.…”

Effect of the Different Dietary Supplements on the Average Surface Roughness and Color Stability of Direct Restorative Materials Used in Pediatric Dentistry

“…GICs are often improved to address their drawbacks by adding some reinforcing particles into the material, such as silver alloy particles, resin monomers, glass fillers, and zirconia ceramics [ 6 ]. Resin-modified GICs (RMGICs) are restorative materials with resin components and were developed to overcome the problems of conventional glass ionomers, such as moisture sensitivity and low initial mechanical strength [ 7 ]. Zirconia-added GICs are known as Zirconomer (white amalgam) [ 4 ], in which the glass component undergoes precise micronization to achieve ideal particle size and properties, and the uniform incorporation of zirconia fillers enhances the mechanical properties [ 8 , 9 , 10 ].…”

Green Synthesis and Investigation of Antimicrobial Activity and Compressive Resilience of Glass Ionomer Cement Modified With Zirconia Nanoparticles: An In Vitro Study

“…Glass ionomer cement (GIC) serves as a dental restorative material in dentistry, utilized for filling and luting purposes. It comprises silicate glass powder and polyacrylic acid, forming an ionomer [ 1 ]. Its primary function is to prevent dental caries, owing to its strong adhesive bond properties with tooth structure, facilitating a tight seal between the tooth's internal structures and its surroundings.…”