Secondary caries and marginal adaptation of ion-releasing versus resin composite restorations: a systematic review and meta-analysis of randomized clinical trials

Abstract

This systematic review was aimed to evaluate occurrence of secondary caries and marginal adaptation in ion-releasing materials versus resin composite. Electronic search of PubMed, Scopus, and Open Grey databases with no date or language restrictions until May 21st, 2021, was conducted. Randomized clinical trials that compared ion-releasing restorations versus resin composite were included. For quantitative analysis, a random-effects meta-analysis with risk difference as an effect measure and a 95% confidence interval was used. Quality of evidence was assessed using The Grading of Recommendations, Assessment, Development, and Evaluation criteria. The risk of bias was evaluated using the Cochran Collaboration Risk of Bias tool. The inclusion criteria were met by 22 studies, and 10 studies were included in the meta-analysis. Three follow-up periods (1 year, 18 months–2 years, and 3 years) were evaluated. The overall quality of evidence for secondary caries and marginal adaptation outcomes was low. The results of the meta-analysis showed no significant difference (p > 0.05) in both outcomes between ion-releasing materials and resin composite. The occurrence of secondary caries was not dependent on the nature of the restorative material. It is more likely a complex process that involves the same risk factors as primary carious lesions.

Clinical performance of two ion‐releasing bulk‐fill composites in class I and class II restorations: A two‐year evaluation

“…This demographic could potentially benefit from the use of ion‐releasing restorations. A recent systematic review 44 has pointed out that in clinical trials where no significant difference was observed between ion‐releasing restorations and traditional composites, a reduction in secondary caries was evident only 45 when the patient population indicated a higher‐risk. A longer follow‐up will be conducted to identify the impact on the occurrence of secondary caries.…”

Intramedullary bone tissue reaction of ion-releasing resin-modified glass-ionomer restoration versus two calcium silicate-based cements: an animal study

“…The ingredients of the new ion-releasing resin composite restorative material contain glass particles and a hydrophilic ionic resin matrix that facilitates the diffusion of fluoride, phosphate and calcium ions into the surrounding environment 3 , 22 , 25 . It was reported that complete healing occurred following retrograde resin placement with 97% success rate 26 .…”

“…Therefore, using animal models, like rodents and rabbits are suitable choice for testing biological, regenerative and mineralizing characteristics of new materials in less invasive and non-critical sized surgical procedures 24 . The ingredients of the new ion-releasing resin composite restorative material contain glass particles and a hydrophilic ionic resin matrix that facilitates the diffusion of fluoride, phosphate and calcium ions into the surrounding environment 3,22,25 . It was reported that complete healing occurred following retrograde resin placement with 97% success rate 26 .…”

“…In the context, it has been reported that hydroxy apatite particles formed on the surface of ACTIVA after 30 days of immersion in phosphate buffered saline after utilization of SEM, PulseTor SDD (Silicon Drift Detector) and Energy-dispersive X-ray spectroscopy (EDS) analysis 42 . It has been also shown that ACTIVA has the ability to form dentinal tubules integrated resin tags with 2.0-2.5 Ca/P ratio across the hybrid layer 3,42 .…”

“…A recently introduced category of an altered ion-releasing RMGI restorative materials has shown a promising results in the field of restorative dentistry 3 , 4 . Mineral Trioxide Aggregate is one of a calcium silicate-based biomaterial which was introduced in 1993 and since then it has been widely used by endodontists for the treatment of roots’ perforation, apexification as a root-end filling material 5 .…”