Glass ionomers and caries preventive effect
Mickenautsch S*, Yengopal* V, Bonecker M***, Leal SC**, Bezerra AC**, Oliveira LB****
*Division of Public Oral Health, University of the Witwatersrand, Johannesburg, South Africa
**School of Dentistry, University of Brasilia, Brasilia DF, Brazil
***Department of Orthodontics and Paediatric Dentistry, University of São Paulo, Brazil
****São Leopoldo Mandic Research Center, Campinas, São Paulo, Brazil
Abstract
The combined results of all identified trials indicate that GIC has a caries preventive (anticariogenic / cariostatic) effect.
This abstract is prepared and maintained by Midentistry, currently published in The MI Compendium, 3rd edition, Copyright © 2008 Midentistry. The full data of this review is available in http://www.midentistry.com/secure-folder/content/3/mic11B3.asp (ISBN: 0-620-34080-0)
This record should be cited as: Mickenautsch S, Yengopal V, Bonecker M, Leal SC, Bezerra AC, Oliveira LB. Glass ionomers and caries preventive effect. Minim Interv Comp Database Syst Rev 2008; 1: RV00120080822.
This version first published online: March 03, 2008
Last revised: October 15, 2008
Objectives
To assess whether glass ionomers have any caries preventive/cariostatic effect.
Search strategy
The trials were identified from a search of PubMed and LILACS databases on March 03, 2008 using the terms: ("Cariostatic Agents"[Mesh] OR "Dental Caries"[Mesh] OR "Cariostatic Agents "[Pharmacological Action]) AND ("Glass Ionomer Cements"[Mesh] OR "Cermet Cements"[Mesh]);(GIC sealant* OR Glass ionomer cement sealant) AND (caries OR tooth decay); ("Dental Caries"[Mesh] OR "Dental Caries Susceptibility"[Mesh] OR "Root Caries"[Mesh] OR "Tooth Demineralization"[Mesh]) AND ("Glass Ionomer Cements"[Mesh] OR "Cermet Cements"[Mesh]) AND "Pit and Fissure Sealants"[Mesh] AND Resin modified glass ionomer cement; ("Dental Caries"[Mesh] OR "Dental Caries Susceptibility"[Mesh] OR "Root Caries"[Mesh] OR "Tooth Demineralization"[Mesh]) AND ("Glass Ionomer Cements"[Mesh] OR "Cermet Cements"[Mesh]) AND ("Cariostatic Agents"[Mesh] OR "Dental Caries"[Mesh] OR "Cariostatic Agents "[Pharmacological Action]) AND ("Dental Amalgam"[Mesh] OR "silver mercury amalgam "[Substance Name]); ("Cariostatic Agents"[Mesh] OR "Dental Caries"[Mesh] OR "Cariostatic Agents "[Pharmacological Action]) AND ("Glass Ionomer Cements"[Mesh] OR "Cermet Cements"[Mesh]) AND ("Composite Resins"[Mesh]); cariostáticos and cimentos and de and ionômeros and de and vidro and is updated regularly.
Inclusion criteria
Reviews and in vivo randomized, quasi-randomized trials published in English, Portuguese and Spanish.
Exclusion criteria for reviews
Lack of clear search strategy, key words and databases used, no clear inclusion and exclusion criteria for reviewed publications and includes no study-by-study critique table or discussion of study qualities
Exclusion criteria for trials
Insufficient description of randomization process; insufficient accounting for included subjects at the end of the study; high loss-to-follow up < 33%
Data collection and analysis
63 articles were identified and reviewed. Of these, 28 articles were rejected; 35 articles were accepted, 6 of which were systematic reviews and 29 were clinical trials.
Main results
29 trials were accepted for data extraction and further meta-analysis. Dichotomous data of the accepted trials were pooled, indicating a pooled odds ratio (OR = Global results) of 1.32 (CI 95% 1.10 - 1.58). This means that GIC appears to increase the odds of absence of caries by 32%. The observation that GIC has an anticariogenic effect, as compared to other materials, is supported by available continuous data for restorations and orthodontic cementation. The available continuous data for fissure sealants confirms the observation that low viscosity GIC and resin-based fissure sealants do not differ in their caries preventive effect. These finding are also in line with the results of most rejected trials but not with the conclusions of most of the accepted systematic reviews by other authors. Clinical heterogeneity between trials was identified.
Authors' conclusions
The results suggest that glass ionomers have a (anticariogenic/cariostatic) effect. However, due to the observed clinical heterogeneity between trials, these results need to be regarded with caution and sub-group analysis is recommended in order to confirm these findings.
