20 February 2019

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Glass ionomer cements VS resin-based composite for restorations in cervical lesions: Which of these have a long lasting?

Simona Chirico

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Non-carious cervical lesions often fail after restoration with resin composites (RC) due to: lack of cavity preparation, use of simplified adhesives (two-step etch-and-rinse and one- step self-etch) that do not have the chemical potential to bond hypermineralized sclerotic dentin, an additional bacterial layer, and intratubular mineral casts that are comparatively more acid resistant. On the other hand, the highly mineralized nature of sclerotic dentin makes it very suitable for bonding with glass-ionomer cements (GIC) or resin-modified glass-ionomers (RMGIC).

Therefore, do glass ionomer cements have a better performance than resin composites? 

A review published in the Journal of Adhesive Dentistry in 2018, tried to answer this question by comparing the two materials and evaluating: the loss of retention, color match surface texture, marginal adaptation, marginal discoloration, and secondary caries. 

MATERIALS AND METHODS
The literature research was performed using PubMed, Scopus, Web of Science, LILACS, BBO, and Cochrane. A total of 1530 articles were identified, but only 19 reports were chosen for analysis. 

RESULTS
The results obtained by comparing these two materials were evaluated with a follow-up of 1, 2 and 3 years.
GIC showed higher retention rates in all follow-ups (1 to 3 years, p < 0.0001; at 5 years, p < 0.00001).
No difference was observed for marginal discoloration, marginal adaptation and secondary caries in all follow-ups (p > 0.05).
RC showed better color match than GIC only at 2 years (p = 0.03).
Higher roughness was observed in GIC in all follow-ups (at 1 year p = 0.0003; at 3 years p = 0.0004).

CONCLUSIONS
The loss of retention of RMGIC/GIC was inferior to that of RC, but a higher roughness was observed in the RMGIC/GIC when compared to RC in all follow-ups of the clinical studies evaluated. In addition, the color match was better with RC only in the 2-year follow-up when compared to GIC. However, the authors said this should be interpreted with caution, because the articles included are at “unclear” risk of bias and they were judged as moderate to low in these outcomes. Well-designed RCTs with a large sample size should be conducted to confirm the findings of this review and meta-analysis. 

For additional informations:
Are Glass-Ionomer Cement Restorations in Cervical Lesions More Long-Lasting than Resin-based Composite Resins? A Systematic Review and Meta-Analysis