Absence of carious lesions at margins of glass-ionomer cement and amalgam restorations: An update of systematic review evidence

Abstract

BackgroundThis article aims to update the existing systematic review evidence elicited by Mickenautsch et al. up to 18 January 2008 (published in the European Journal of Paediatric Dentistry in 2009) and addressing the review question of whether, in the same dentition and same cavity class, glass-ionomer cement (GIC) restored cavities show less recurrent carious lesions on cavity margins than cavities restored with amalgam.MethodsThe systematic literature search was extended beyond the original search date and a further hand-search and reference check was done. The quality of accepted trials was assessed, using updated quality criteria, and the risk of bias was investigated in more depth than previously reported. In addition, the focus of quantitative synthesis was shifted to single datasets extracted from the accepted trials.ResultsThe database search (up to 10 August 2010) identified 1 new trial, in addition to the 9 included in the original systematic review, and 11 further trials were included after a hand-search and reference check. Of these 21 trials, 11 were excluded and 10 were accepted for data extraction and quality assessment. Thirteen dichotomous datasets of primary outcomes and 4 datasets with secondary outcomes were extracted. Meta-analysis and cumulative meta-analysis were used in combining clinically homogenous datasets. The overall results of the computed datasets suggest that GIC has a higher caries-preventive effect than amalgam for restorations in permanent teeth. No difference was found for restorations in the primary dentition.ConclusionThis outcome is in agreement with the conclusions of the original systematic review. Although the findings of the trials identified in this update may be considered to be less affected by attrition- and publication bias, their risk of selection- and detection/performance bias is high. Thus, verification of the currently available results requires further high-quality randomised control trials.

Therapeutic effect of glass‐ionomers: an overview of evidence

“…23 This trend was confirmed when the three-year results were combined with data from an eight-year study 24 using meta-analysis (OR = 2.35; 95% CI 1.18-4.71; p = 0.02). 23 …”

“…23 The difference between both materials regarding the numbers of carious lesions of multiple-surface GIC restorations in primary teeth after three years was not statistically significant (OR 2.00; 95% CI 0.06-5.06; p = 0.10) but tended to favour GIC. 23 This trend was confirmed when the three-year results were combined with data from an eight-year study 24 using meta-analysis (OR = 2.35; 95% CI 1.18-4.71; p = 0.02). 23 …”

Caries lesion prevention and arrestment in approximal surfaces in contact with glass ionomer cement restorations – A systematic review and meta‐analysis

“…The fluoride release of the Glass Ionomer Cements (GIC) has also shown promising results in this subject 4,5 . Significant decrease in new caries lesion in the margins of restorations made with GIC has been confirmed by systematic reviews when compared to restorations made with resin composite 6 and with amalgam 7 .…”

Efeito de materiais restauradores em contato proximal com lesões de cárie em dentes decíduos

“…Embora anteriormente tenha sido demonstrado que não há evidências conclusivas sobre o efeito preventivo dos cimentos de ionômero de vidro sobre a formação de lesões de cárie secundárias (Randall;Wilson, 1999), atualmente este potencial anticariogênico é aceito e comprovado (Mickenautsch et al, 2009). Entretanto, dúvidas permanecem com relação ao efeito anticariogênico de outros materiais que liberam flúor, uma vez que revisões sistemáticas já demonstraram similar desempenho entre cimentos de ionômero puros e modificados por resina ) e entre cimentos de ionômero modificado por resina e resinas que contenham flúor , porém superior desempenho para os modificados por resina quando comparados à resina convencional Mickenautsch, 2011).…”

“…O efeito carioestático de materiais restauradores que liberam flúor sobre lesões de cárie secundárias adjacentes à restauração já encontra-se bem sedimentado na literatura (Van Dijken, 1996;Tantbirojn et al, 1997;Yaman, et al, 2004;Mickenautsch et al, 2009). …”