Two-year clinical performance of glass ionomer and resin composite restorations in xerostomic head- and neck-irradiated cancer patients

Abstract

The aim of this study was to evaluate the clinical performance of adhesive filling materials in class V cavities in xerostomic head- and neck-irradiated cancer patients, in terms of marginal adaptation, anatomical form and recurrent caries. We selected 35 high-caries-risk, post-radiation, xerostomic adults with ≥3 cervical carious lesions in the same arch. Every patient received a KetacFil (KF), PhotacFil (PF) and Herculite XRV (HX) restoration. Patients were instructed to use a neutral 1% sodium fluoride gel in custom trays, on a daily basis. After 6, 12, 18 and 24 months, the restorations were examined for material loss, marginal integrity and recurrent caries. Fluoride compliance was determined at each recall appointment and recorded as the percentage of recommended use during that interval [compliance of ≤50% = NFUs, >50% = FUs]. Only 30 patients were available for recall at 6 months, with 28 patients at 12 and 18 months, and 27 patients at 24 months. In the NFU group, differences in recurrent caries were found between KF and HX at all observation times (p < 0.05). Differences (p < 0.05) in adaptation and/or anatomical form were found between KF and PF in NFUs after 18 and 24 months. In FUs, significant differences were observed between KF and PF, and KF and HX after 6 and 12 months, between KF and HX, PF and HX after 18 and 24 months. In summary, glass ionomers (especially the conventionally setting formulation) provide clinical caries inhibition but erode easily, while composite resin provides greater structural integrity.

Elemental analysis of caries-affected root dentin and artificially demineralized dentin

“…Conventional GIC or RMGI is useful in caries management because it exhibits chemical adherence and fluoride release 2. RMGI is the material of choice in root surface restoration because light-cured resin polymerization can be used, which allows for immediate setting, improved strength, and esthetic enhancement 1314. RMGI has bonding capacity that enhances its ionic bonding to hydroxyapatite and it exhibits micromechanical interlocking similar to that of conventional GIC 15.…”

Precáncer y cáncer bucal

“…En ese trabajo se comenta el escaso conocimiento de la clínica de las lesiones precancerosas que tienen los estudiantes de Odontología de la clínica de la Facultad de Medicina de la Universidad de Lagos, Nigeria. Destacaríamos, igualmente, un trabajo sobre quimioterapia 18 , otro sobre radioterapia de intensidad modulada 19 , otro sobre crioterapia 20 y un ú ltimo sobre té cnicas de restauració n dental 21 .…”

Pre-radiotherapy dental extractions and osteoradionecrosis: a retrospective analysis and cross-sectional study on quality of life

“…De Moor et al [48] demonstrated significantly less recurrent caries around Class V GICs compared to resin composites in irradiated patients. This difference was particularly marked when fluoride use was low.…”

“…p16 negative cases had poorer quality of life, as did current and ex-smokers, with current smokers faring worse. 48 Pre-RT dental extractions by number revealed that >8 were associated with a significantly worse quality of life than those who had no extractions. While 1-7 pre-RT extractions and post-RT extractions were associated with a reduced quality of life, this was not found to be significant at levels applied.…”

“…Free radicals can interfere with polymerization of resins while irradiation also activates enzymes including matrix metalloproteinases (MMPs) within dentine, which have been shown to hydrolyse dentine bonding agents [47]. Consequently, loss of retention or development of recurrent caries around composite restorations is often observed [48].…”