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Title For Preventing caries Around Restorations in High caries Risk Patients, Resin Modified Glass Ionomers may be the choice
Clinical Question In caries-active patients, do resin modified glass ionomer (RMGI) restorations prevent caries around restorations more effectively than non-fluoride releasing restorations over 5 years?
Clinical Bottom Line (RMGI) restorations protected adjacent tooth surfaces from caries more than non-fluoride releasing restorations over five years.
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) 20684440Qvist/20101,341 tooth surfaces from 945 childrenRCT
Key resultsAfter 5 years of restoration, 52%, 40%, 54% and 55% of healthy tooth surfaces around RMGI, amalgam, GI and compomer restorations, respectively, were protected from caries development. The rate of progression of existing carious lesions on proximal surfaces was significantly less with RMGI compared with amalgam restorations.
#2) 15471520Kotsanos/200482 tooth surfaces from 36 childrenSplit Mouth RCT
Key resultsThe two years protection rates of adjacent healthy tooth surfaces against caries were 49% and 59% for Resin modified glass ionomer and Amalgam restorations, respectively, though the difference was not statistically significant. RMGI placed for a class II restoration did not affect the radiographic progression of caries at adjacent tooth surfaces when compared with non-fluoride releasing amalgam or composite restoration after 2 years (p ≤ .813).
Evidence Search "Dental Caries"[Mesh] AND "Fluorides"[Mesh] AND "Dental Restoration, Permanent"[Mesh] AND resin modified glass ionomer
Comments on
The Evidence
Qvist 2010 was a clinical study with the results based on clinical and radiographic assessment. RMGI and GI, both of which are flouride-releasing, demonstrated protective effects on adjacent tooth structure, with GI being more protective than RMGI. GI lacks the compressive strength of RMGI leading to early failure. Although the Kotsanos (2004) article was a clinical one, it had relatively fewer subjects, was a radiographic study only, was not double blind and was conducted over a shorter time period compared with the Qvist article.
Applicability RMGI might be particularly useful for patients at high caries risk due to protective flouride-releasing effect and high compressive strength.
Specialty/Discipline (General Dentistry) (Pediatric Dentistry) (Restorative Dentistry)
Keywords Resin modified glass ionomer, Fluoride releasing, caries, Restorative materials
ID# 2172
Date of submission: 02/24/2012spacer
E-mail glick@uthscsa.edu
Author Aaron Glick
Co-author(s) e-mail
Faculty mentor/Co-author Bennett T. Amaechi, BDS, MSc, PhD
Faculty mentor/Co-author e-mail amaechi@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?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Matthew Alonzo and Gurbani Makkar (San Antonio) on 11/28/2017
A PubMed database search was conducted on November 28, 2017 using the same search criteria from this CAT. More recent but lower level evidence was found in a narrative review by Cury et al. 2016 (PMID 26777115). The new evidence concludes there was no clinical significance that fluoride releasing materials protects adjacent tooth surfaces from caries over non- fluoride releasing restorations.

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