The preventive effect of glass ionomer cement restorations on secondary caries formation: A systematic review and meta-analysis

Dent Mater. 2023 Dec;39(12):e1-e17. doi: 10.1016/j.dental.2023.10.008. Epub 2023 Oct 12.

Abstract

Objective: The objective is to compare the preventive effect on secondary caries of glass ionomer cement (GIC) restorations with amalgam or resin-composite restorations.

Methods: Two independent researchers conducted a systematic search of English publications in PubMed, Web of Science, Cochrane and Scopus. They selected randomized clinical trials comparing secondary caries incidences around GIC restorations (conventional GIC or resin-modified GIC) with amalgam or resin-composite restorations. Meta-analysis of the secondary-caries incidences with risk ratio (RR) and 95% confidence interval (95% CI) as the effect measure was performed.

Results: This review included 64 studies. These studies included 8310 GIC restorations and 5857 amalgam or resin-composite restorations with a follow-up period from 1 to 10 years. Twenty-one studies with 4807 restorations on primary teeth and thirty-eight studies with 4885 restorations on permanent teeth were eligible for meta-analysis. The GIC restorations had a lower secondary caries incidence compared with amalgam restorations in both primary dentition [RR= 0.55, 95% CI:0.41-0.72] and permanent dentition [RR= 0.20, 95% CI:0.11-0.38]. GIC restorations showed similar secondary caries incidence compared with resin-composite restorations in primary dentition [RR= 0.92, 95% CI:0.77-1.10] and permanent dentition [RR= 0.77, 95% CI:0.39-1.51]. Conventional GIC restorations showed similar secondary caries incidence compared with resin-modified GIC-restored teeth in both primary dentition [RR= 1.12, 95% CI:0.67-1.87] and permanent dentition [RR= 1.63, 95% CI:0.34-7.84].

Conclusions: GIC restorations showed a superior preventive effect against secondary caries compared to amalgam restorations, and a similar preventive effect against secondary caries compared to resin-composite restorations in both primary and permanent teeth. [PROSPERO Registration ID: CRD42022380959].

Keywords: Caries; Glass ionomer cement; Prevention; Restoration; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Composite Resins / therapeutic use
  • Dental Amalgam / therapeutic use
  • Dental Caries Susceptibility
  • Dental Caries* / prevention & control
  • Dental Restoration, Permanent*
  • Glass Ionomer Cements
  • Humans

Substances

  • Glass Ionomer Cements
  • Composite Resins
  • Dental Amalgam