Conventional GIC versus compomer restorations - longevity in primary teeth
Midentistry review group


Abstract
There is no difference between high-viscosity GIC and compomer.

This abstract is prepared and maintained by Midentistry, currently published in The MI Compendium, 3rd edition, Copyright © 2009, 2010  Midentistry. The full data of this review is available in http://www.midentistry.com/secure-folder/content/3/fur0102.asp   (ISBN: 0-620-34080-0)

This record should be cited as:  Midentistry. Conventional GIC versus compomer restorations - longevity in primary teeth. Minim Interv Comp Database Syst Rev 2010;  1: RV001020100405.

This version first published online: May 04, 2010
Last revised: May 04, 2010


Objectives
To assess whether restorations in primary teeth placed with compomers have a higher survival rate than restorations placed with GIC.


Search strategy
The trials were identified from a search of the PubMed database on: January 06, 2010 using the terms: ("(("Compomers"[Mesh] AND "Glass Ionomer Cements"[Mesh]) OR "glass ionomer "[Substance Name]) AND "Tooth, Deciduous"[Mesh]

Inclusion criteria
- relevant (comparing resin-modified GIC versus Compomers in primary teeth)
- 2-arm clinical trial
- published in English

Data collection and analysis
In line with inclusion criteria, the systematic literature search identified 3 trials of which a total of 58 separate datasets (DS) could be extracted.

Main results and Authors' conclusions
Due to high methodological heterogeneity only 2 datasets were pooled for meta-analysis (RR 0.99 - 95%CI 0.96 - 1.03; p = 0.63). The meta-analysis results showed no difference in recurrent caries between high-viscosity GIC and compomer after 12 months. No difference was found between between high-viscosity GIC and compomer in restoration longevity, specifically in bulk fracture, margin integrity, original surface texture, wear and postoperative sensitivity. When the compomer Dyract was compared to the non-high viscosity (older, obsolete type) GIC Chemfil Superior the following observations could be made:
- Dyract had a 71% higher chance to resist wear after 42 months
- Dyract had a 59% higher chance to retain marginal integrity after 42 months
- Dyract had a 94% higher chance to retain a surface texture similar to polished enamel after 36 months
- Dyract had a 99% higher chance to retain its interproximal contact points after 12 months
No difference between Dyract and Chemfil Superior was observed regarding post-operative sensitivity, material discoloration and recurrent caries after 42 months.
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Quality assessment was conducted by 2 different reviewers using a structured. Differences were resolved by discussion and consensus. During the assessment, randomization of the sequence allocation was done in all trials, however, how the random sequence was allocated remained unclear (= A*) in 2 trials. Concealment of allocation was not reported in all trials (= B). There was inadequate assessor assignment (= C) in one trial as the evaluator and operator was the same person. The assessor assignment was unclear (= B) for the other 2 trials. Assessment blinding was not reported (= C) in all trials. The results of the quality assessment suggest that the outcome of all included trials may be limited by selection and detection bias. In addition, further factors may have had a confounding influence on the trial results, such as the lack of information regarding possible exposure to external fluoride sources, lack of differentiation between type of teeth or cavities, as well as unclear baseline caries prevalence among the treated children.

The overall clinical results show no difference between high-viscosity GIC and compomers in primary teeth. It has to be noted that the  available clinical results may be limited by potential selection and detection bias as well as due to further confounder effect, i.e. due to possible access to external fluoride sources. Further high quality randomized control trials are needed.