Beyond Amalgam: Evaluating the Clinical Efficacy of Two Glass Ionomer Cements in Managing Dental Caries

Alternatives to Amalgam: Glass Ionomer Cements

Abstract

Background: Concerns about dental amalgam safety led to interest in alternatives like glass ionomer cements (GICs).

Objective: This study evaluated and compared the clinical performance of two different GIC compositions, Type II and Type IX, in managing dental caries.

Methods: This randomized clinical trial compared the performance of two distinct glass ionomer cement (GIC) formulations in managing dental caries. The study involved 16 patients with 48 affected teeth, which were randomly assigned to receive either Type II or Type IX GIC restorations using a split-mouth design. Two independent, blinded examiners evaluated the restorations at baseline, 1 month, and 3 months using a modified version of the USPHS criteria. Inter-examiner reliability was assessed using kappa statistics. Statistical analysis was performed using IBM SPSS 26.0 software, employing Fisher's exact test, Pearson's chi-square test, descriptive statistics, and McNemar's test to analyze the data

Results: The study participants consisted of 16 individuals with 48 teeth. All 24 matched tooth pairs were correctly identified in terms of the side of the mouth. The arch was also correctly identified in 95.8% of cases, with only one incorrect match. Five clinical criteria: retention, marginal integrity, anatomic form, sensitivity, and surface texture recorded changes across both GICs, while marginal discolouration and secondary caries demonstrated stable and favourable outcomes throughout the evaluation period. Overall, the results indicate that Type IX consistently showed a higher proportion of acceptable outcomes across most criteria, outperforming Type II over time, however, this was not statistically significant.

Conclusion: Both Type IX and Type II Glass Ionomer Cements (GICs) have demonstrated exceptional clinical efficacy and longevity in dental restorations. A comparative analysis revealed no statistically significant differences in performance between these two GIC formulations.