Abstract
ObjectiveThis prospective, randomized, split-mouth clinical trial evaluated the clinical performance of conventional glass ionomer cement (GIC; Riva Self-Cure, SDI), supplied in capsules or in powder/liquid kits and placed in Class I cavities in permanent molars by the Atraumatic Restorative Treatment (ART) approach.Material and MethodsA total of 80 restorations were randomly placed in 40 patients aged 11-15 years. Each patient received one restoration with each type of GIC. The restorations were evaluated after periods of 15 days (baseline), 6 months, and 1 year, according to ART criteria. Wilcoxon matched pairs, multivariate logistic regression, and Gehan-Wilcoxon tests were used for statistical analysis.ResultsPatients were evaluated after 15 days (n=40), 6 months (n=34), and 1 year (n=29). Encapsulated GICs showed significantly superior clinical performance compared with hand-mixed GICs at baseline (p=0.017), 6 months (p=0.001), and 1 year (p=0.026). For hand-mixed GIC, a statistically significant difference was only observed over the period of baseline to 1 year (p=0.001). Encapsulated GIC presented statistically significant differences for the following periods: 6 months to 1 year (p=0.028) and baseline to 1 year (p=0.002). Encapsulated GIC presented superior cumulative survival rate than hand-mixed GIC over one year. Importantly, both GICs exhibited decreased survival over time.ConclusionsEncapsulated GIC promoted better ART performance, with an annual failure rate of 24%; in contrast, hand-mixed GIC demonstrated a failure rate of 42%.
Highlights
The Atraumatic Restorative Treatment (ART) approach is based on the removal of infected tooth tissues with hand instruments, followed by restoration of the cavity and sealing of adjacent pits and fissures2
Hand mixing of glass ionomer cement (GIC) might allow for an increased incidence of operator errors during material preparation, as the ratio of powder to liquid may vary according to manufacturer’s recommendations4
The socio-economic status assessment indicated that 77.5% of the participants were classified as class C; 20% as class D; and 2.5% as class E
Summary
The Atraumatic Restorative Treatment (ART) approach is based on the removal of infected tooth tissues with hand instruments, followed by restoration of the cavity and sealing of adjacent pits and fissures. The Atraumatic Restorative Treatment (ART) approach is based on the removal of infected tooth tissues with hand instruments, followed by restoration of the cavity and sealing of adjacent pits and fissures2 This approach, which is an economical and effective method to prevent and control carious lesion development, causes less discomfort and dental anxiety to patients than the conventional rotatory instruments. With the purpose of decreasing these variables, encapsulated dental cements have been introduced in the market21 These premade mixtures utilize mechanical mixing methods and allow standardization of the powder/liquid ratio in a sealed capsule, which is expected to reduce variation in clinical outcomes
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