ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Limited evidence to show safety of Resin-Modified Glass Compared to Conventional Glass-Ionomers
Clinical Question In adult patients requiring a restoration, would resin-modified glass-ionomers be as biocompatible as conventional glass-ionomers?
Clinical Bottom Line Resin-modified glass-ionomers are not as biocompatable as conventional glass-ionomers, however there have been no reports of harm to patients and dental personnel.
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) 18539324Nicholson/2008Narrative Review of over 50 published papers
Key resultsWhen light cured, resin-modified glass ionomers release HEMA which has the potential to cause harmful effects to the pulp such as inflammation, sensitization, and allergic reactions. However, there has been no literature published reporting allergies in dental professionals when working specifically with resin-modified glass ionomers.
#2) 11021634Geurtsen/2001Narrative review
Key resultsMicrobial effects have been observed with respect to biocompatibility of the resin components of resin-modified glass-ionomers and various tissues, but there is very little reliable information of biologic and clinical interactions and how they would influence patients and the profession.
Evidence Search ("Glass Ionomer Cements"[Mesh] AND "Methacrylates/toxicity"[Mesh]) AND "Dental Pulp"[Mesh]
Comments on
The Evidence
Nicholson and colleagues reported a review of over 50 papers published on resin-modified glass ionomers and the harmful resin component, 2-hydroxyethyl methacrylate (HEMA). No inclusion parameters were used and the authors did not report assessing the studies for validity. No meta analysis was done. In addition, of all the studies reviewed only one was a clinical study comparing pulp capping using a resin-modified glass ionomer (Vitremer) versus calcium hydroxide. The majority of the studies reviewed looked at the biological effects of HEMA found in resin materials other than resin-modified glass ionomers. The authors used the results of these studies to make conclusions about the biocompatibility of resin-modified glass ionomers. For that reason, the validity of this narrative review is further decreased and it cannot be considered strong evidence. The Guesrtsen study was also a narrative review which cannot be considered strong evidence. Further clinical research is needed.
Applicability There has been recent concern of potential biohazards of the resin component of resin-modified glass ionomers, HEMA (2-hydroxyethyl methacrylate). When placed in the mouth of dental patients, HEMA may be absorbed into the pulp or disseminate systemically, and could potentially lead to adverse effects to the patient. In addition absorption of these substances due to manual contact could cause detrimental effects on dental professionals.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords Resin-modified glass ionomer Dental Pulp Methacrylates Hydroxethyl Methacrylate
ID# 2465
Date of submission: 03/07/2013spacer
E-mail plochc@livemail.uthscsa.edu
Author Caitlyn Ploch
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Rita Renee Parma, DDS
Faculty mentor/Co-author e-mail parma@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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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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