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Title Restoration Materials In Dry Mouth Patients
Clinical Question For a patient with dry mouth, which restorative material, amalgam or resin composite, has the lowest incidence of recurrent caries?
Clinical Bottom Line Glass ionomer has the lowest incidence of recurrent caries when compared to amalgam. (See Comments on the CAT below)
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) 12636121Haveman/2003111 restorations in 9 xerostomic patientsRandomized Controlled Split Mouth Study
Key resultscaries did not develop at the cavosurface margin of 85% of Ketac-Fil restorations, 88% percent of Vitremer restorations, and 56% of tytin amalgam restorations with fluoride use. Restorations with caries at the cavosurface margin developed in non-fluoride users: 36% of Ketac-Fil restorations, 27% of Vitremer restorations, and 68% of tytin restorations. Patients with the glass inonomer restorations had lower rate of caries at the cavosurface margin than did patients with amalgam restorations (P <0.05).
Evidence Search Search caries Search recurrence, Search composite resinSearch dental amalgam, Search xerostomia
Comments on
The Evidence
Haveman (2003), a randomized controlled split mouth study, had similar groups at start, all exhibiting xerostomia. There was greater than 80% completion rate. Follow up was adequate (2 years). Compliance was adequate. Recall bias unlikely, and no competing interests were evident. Groups were not treated the same in that restorations were placed by three practitioners, and not all restorations were evaluated by the same clinician. This study had a very small number of subjects (n=9).
Applicability The subject of the presented article is representative of the patient population of interest, in which the success of resin restorations are compared to amalgam restorations in xerostomic patients. No potential harm to the patient. Patient benefit is the placement of the most successful restorative material.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords Dry mouth, xerostomia, amalgam, resin composite, caries
ID# 789
Date of submission: 04/14/2011spacer
E-mail garciam30@livemail.uthscsa.edu
Author Meagan D. Garcia
Co-author(s) e-mail
Faculty mentor/Co-author Vidya Sankar, DMD, MHS
Faculty mentor/Co-author e-mail SankarV@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 Petrina Gerogianni, Rebeka Andrade (San Antonio, TX) on 10/03/2014
A PubMed and Trip Database search conducted on September 2014 confirmed the aforementioned statement. One more recent publications was found; DeMoor RJ, 2009, PMID: 19997859 (2 year prospective Clinical Trial). The study showed that in xerostomic, head-neck irradiated cancer patients, glass-ionomer (especially the conventionally setting formulation) provided higher clinical caries inhibition.

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