Influence of Isolation Technique on the Survival of Resin-Modified Glass-Ionomer Restorations in Primary Molars: A 9-Months Randomized Controlled Trial

Sabrina Wilde,Maria Luiza Vieira Borges,Daiana Back Gouvea,Nicole Marchioro Dos Santos,Caroline Simão Sarti,Bethania Paludo Oliveira,Julia Toniolo,Jonas Almeida Rodrigues

doi:10.1590/pboci.2021.061

Sabrina Wilde, Maria Luiza Vieira Borges + Show 6 more

Open Access

https://doi.org/10.1590/pboci.2021.061

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Abstract

Objective: T o compare the survival of occlusal and occlusal-proximal restorations performed with resin-modified glass-ionomer cement (RMGIC) in deciduous molars using rubber dam and cotton rolls isolation . Material and Methods: Ninety-two patients were included and 200 deciduous molars with cavitated occlusal or occlusoproximal dentin caries lesions were randomized into two groups: cotton rolls (n = 100) and rubber dam (n = 100) and RMGIC restorations were placed. At baseline and in the follow-up visit, presence, severity and activity of caries lesions were registered. Two independent, blinded examiners evaluated the treated teeth clinically using the USPHS criteria and radiographically after 9 months. Descriptive analysis, survival curve (log-rank test) and Cox regression were performed to assess risk factors related to failure. Results: Out of the 179 teeth (92 cotton rolls group and 87 rubber dam group) evaluated at 9-month follow-up period. No lesion progression was observed radiographically. The overall treatment success rate was 85.47% (83.47% for cotton rolls and 87.35 rubber dam group). No significant difference between isolation methods was observed in the log-rank test (p = 0.16). Cox regression showed no risk factors related to failure . Conclusion: No difference was found in the survival of occlusal and occlusal-proximal restorations performed with RMGIC in deciduous molars using a rubber dam and cotton rolls isolation after a 9-month follow-up period.

Highlights

Restorative treatments are performed to aid biofilm control, protect the pulp-dentin complex, and restore the integrity of the dental structure, thereby recovering functional and esthetic needs and causing no unnecessary damage
No difference was found in the survival of occlusal and occlusalproximal restorations performed with resinmodified glass-ionomer cement (RMGIC) in deciduous molars using a rubber dam and cotton rolls isolation after a 9-month follow-up period
Complete carious tissue removal of deep carious lesions has been proven to increase the occurrence of pulpal exposure and postoperative pulpal symptoms compared with selective carious tissue removal [2,3]

Summary

Introduction

Restorative treatments are performed to aid biofilm control, protect the pulp-dentin complex, and restore the integrity of the dental structure, thereby recovering functional and esthetic needs and causing no unnecessary damage. Carious tissue removal ensures the conditions for a long-lasting restoration, preserves remineralizable tissue, maintains pulp vitality, and achieves an adequate seal [1]. Complete carious tissue removal of deep carious lesions has been proven to increase the occurrence of pulpal exposure and postoperative pulpal symptoms compared with selective carious tissue removal [2,3]. Selective caries removal (SCR) is a contemporary approach for the restorative treatment of deep caries lesions in dentin, showing good results along time [1,4]. SCR of soft dentin has been recommended to avoid pulp exposure and allow the placement of a durable restoration [1]. Despite the benefits of SCR, evidence regarding survival of restoration in deciduous teeth is limited [2]

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