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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) 12216559 | McComb/2002 | 45 high risk caries patients post head & neck radiotherapy | Clinical Trial | Key results | In 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) 16924979 | Franco/2006 | 30 healthy adults | Randomized Controlled Trial | Key results | The results showed that secondary caries prevention between the two materials was not statistically significant over a 5-year period (p=0.144). | #3) 21299939 | Yengopal/2007 | 6 Clinical Trials | Systematic review of randomized trials | Key results | 17 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: |
04/10/2015 |
E-mail |
Balderasjo@livemail.uthscsa.edu |
Author |
Juan Balderas |
Co-author(s) |
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Co-author(s) e-mail |
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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?) |
post a rationale |
None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
None available | |
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