ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Glass Ionomer Restorations May Be More Effective Than Resin Composites at Preventing Recurrent Caries in Class V Lesions Over a 5-Year Period
Clinical Question In adults with carious Class 5 lesions, are glass ionomers more effective than traditional resin composites at preventing recurrent caries over a 5-year period?
Clinical Bottom Line Although there is no statistical difference between glass ionomer and resin composite in preventing recurrent caries in most patients, there may be some added benefit with the fluoride-releasing effect of glass ionomer in more compromised patients, such as the xerostomatic patient with poor oral hygiene.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 12216559McComb/200245 high risk caries patients post head & neck radiotherapy Clinical Trial
Key resultsIn fluoride gel-noncompliant patients, the glass ionomers were statistically significantly more effective at preventing recurrent caries compared to the composite resin over 2 years (p=0.05).
#2) 16924979Franco/200630 healthy adultsRandomized Controlled Trial
Key resultsThe results showed that secondary caries prevention between the two materials was not statistically significant over a 5-year period (p=0.144).
#3) 21299939Yengopal/20076 Clinical TrialsSystematic review of randomized trials
Key results17 sets of data used from the included trials indicated that there was no statistical significance in caries prevention (P >0.05) for 25 months, while 7 sets of data indicated there was a statistical significance (P<0.05) over 2 years.
Evidence Search "Composite Resins"[Mesh] AND "Glass Ionomer Cements"[Mesh]) AND "Dental Caries"[Mesh]
Comments on
The Evidence
The sample sizes were rather small for the two clinical trials; however, their long follow-up periods add to their validity. The McComb trial was funded by 3M, and all three restorative materials used in the study were 3M products, so there may have been competing interests. The systematic review showed varying results, indicating a possibility of bias. This could be attributed to the selection process, wherein only two reviewers chose articles deemed worthy based on a set of parameters. The parameters used to choose the articles, the reviewers' ability to find articles that met that criteria, and their opinions on deeming an article worthy or rejecting it are all potential areas of bias.
Applicability Patients with Class V lesions who have bad oral habits, are xerostomatic, lack access to fluoride or do not use it, or have highly cariogenic oral flora would benefit from using glass ionomer to restore their lesions, due to its fluoride-releasing effect. Patients not falling into one or more of these categories can be restored with either material with similar efficacy.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords Class V lesions, Cervical Lesions, Secondary Caries, Resin Composite, Glass Ionomer
ID# 2889
Date of submission: 04/10/2015spacer
E-mail Balderasjo@livemail.uthscsa.edu
Author Juan Balderas
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author James B. Summitt, DDS, MS
Faculty mentor/Co-author e-mail SUMMITT@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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