A prospective and randomized clinical trial evaluating the effectiveness of ART restorations with high-viscosity glass-ionomer cement versus conventional restorations with resin composite in Class II cavities of permanent teeth: two-year follow-up

MENEZES-SILVA, Rafael; VELASCO, Sofia R Maito; BRESCIANi, Eduardo; BASTOS, Roosevelt da Silva; NAVARRO, Maria Fidela de Lima

doi:10.1590/1678-7757-2020-0609

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Journal of Applied Oral Science

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Original Article • J. Appl. Oral Sci. 29 • 2021 • https://doi.org/10.1590/1678-7757-2020-0609 copy

A prospective and randomized clinical trial evaluating the effectiveness of ART restorations with high-viscosity glass-ionomer cement versus conventional restorations with resin composite in Class II cavities of permanent teeth: two-year follow-up

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To compare the effectiveness of ART restorations using High Viscosity Glass-ionomer cement (HVGIC) with conventional restorations using resin composite in Class II cavities of permanent teeth, in a 2-year follow-up.

Methodology

Seventy-seven restorations were made with each restorative material, Equia Fil-GC Corporation (ART restorations) and Z350-3M (conventional restoration), in 54 participants in this parallel and randomized clinical trial. Restorations were evaluated at 6 months, 1 and 2 years using the ART and the modified United States Public Health Service (USPHS) criteria. Chi-square test and Survival Analysis (p<0.05) were used for statistical analysis.

Results

The success rates for ART restorations were 98.7% (6 months) and 95.8% (1 year) for both criteria. At 2 years, success rate was 92% and 90.3% when scored by the modified USPHS and ART criteria (p=0.466), respectively. The success rates for conventional restorations were 100% (6 months), 98.7% (1 year) and 91.5% (2 years) for both assessment criteria. ART restorations presented a lower survival rate by the criterion of ART (83.7%) when compared to the modified USPHS criterion of (87.8%), after 2 years (p=0.051). The survival of conventional restorations was 90.7% for both evaluation criteria.

Conclusion

At the 2-years follow-up evaluation, no statistically significant difference was observed between the success rate of ART restorations with HVGIC compared to conventional restorations with resin composite in Class II cavities of permanent teeth.

Permanent dentition; Atraumatic restorative treatment; Glass-ionomer cement; Resin composite; Clinical trial

Scores*	6 months			1 year			2 years
	ART restorations n(%)	Conventional restorations n (%)	p**	ART restorations n(%)	Conventional restorations n (%)	p**	ART restorations n(%)	Conventional restorations n (%)	p**
(1) Restoration present and correct	65 (84.4)	74 (96.1)	0.033	56 (78.9)	73 (97.4)	0.003	43 (67.2)	59 (84.3)	0.064
(2) Small marginal defect and/or wear with less than 0.5 mm; without need of repair	11 (14.3)	3 (3.9)		12 (16.9)	1 (1.3)		13 (20.3)	5 (7.2)

(3) Marginal Defect exceeding 0.5 mm. Need of repair	-	-		1 (1.4)	0 (0.0)		-	-
(4) Wear exceeding 0.5 mm. Need of repair	-	-		1 (1.4)	0 (0.0)		-	-
(6) Restore and/or fracture tooth. Need of repair	1 (1.3)	0 (0.0)		1 (1.4)	1 (1.3)		2 (3.1)	4 (5.7)
(7) Restoration has completely disappeared. Treatment is needed	-	-		-	-		1 (1.6)	1 (1.4)
(9) Tooth has been extracted	-	-		-	-		2 (3.1)	0 (0.0)
(10) Sensitivity or pulpal involvement	-	-		-	-		3 (4.7)	1 (1.4)

Clinical parameters	Rating	6 months			1 year			2 years
		ART restorations n(%)	Conventional restorations n (%)	p	ART restorations n(%)	Conventional restorations n (%)	p	ART restorations n(%)	Conventional restorations n (%)	p
Color	Alpha	33 (43.4)	55 (71.4)	< 0.001	32 (45.0)	38 (51.4)	0.609	31 (50.0)	35 (53.0)	0.368
	Bravo	43 (56.6)	22 (28.6)		39 (55.0)	36 (48.6)		31 (50.0)	31 (47.0)
Marginal discoloration	Alpha	75 (98.7)	74 (96.1)	0.315	65 (91.5)	70 (94.6)	0.785	56 (90.3)	62 (94.0)	0.294
	Bravo	1 (1.3)	3 (3.9)		6 (8.5)	4 (5.4)		6 (9.7)	4 (6.0)
Relapse of caries	Alpha	76 (100.0)	77 (100.0)	-	69 (97.2)	74 (100.0)	0.235	59 (95.2)	64 (97.0)	0.221
	Charlie	0 (0.0)	0 (0.0)		2 (2.8)	0 (0.0)		3 (4.8)	2 (3.0)
Anatomical shape	Alpha	43 (56.6)	70 (90.9)	<0.001*	45 (63.4)	66 (89.2)	< 0.001 *	32 (51.6)	54 (81.8)	0.001*
	Bravo	33 (43.4)	7 (9.1)		23 (32.4)	8 (10.8)		29 (46,.8)	10 (15.2)
	Charlie	0 (0.0)	0 (0.0)		3 (4.2)	0 (0.0)		1 (1.6)	2 (3.0)
Marginal integrity	Alpha	70 (90.9)	72 (93.5)	0.471*	56 (78.9)	69 (92.0)	0.072 *	50 (80.6)	56 (80.0)	0.361*
	Bravo	6 (7.8)	5 (6.5)		12 (16.9)	5 (6.7)		10 (16.1)	8 (11.4)
	Charlie	0 (0.0)	0 (0.0)		2 (2.8)	0 (0.0)		0 (0.0)	2 (2.9)
	Delta	1 (1.3)	0 (0.0)		1 (1.4)	1 (1.3)		2 (3.3)	4 (5.7)
Surface texture	Alpha	42 (55.3)	63 (81.8)	<0.001	32 (45.1)	56 (75.7)	< 0.001	32 (51.6)	48 (72.7)	0.022
	Bravo	34 (44.7)	14 (18.2)		39 (54.9)	18 (24.3)		30 (48.4)	18 (27.3)
Restoration quality**	Ideal	25 (32.5)	47 (61.0)	0.001*	27 (38.0)	36 (48.0)	0.310*	21 (33.9)	27 (38.6)	0.830*
	Satisfactory	51 (66.2)	30 (39.0)		41 (57.8)	38 (50.7)		36 (58.1)	37 (52.9)
	Unsatisfactory	1 (1.3)	0 (0.0)		3 (4.2)	1 (1.3)		5 (8.0)	6 (8.5)

Faculdade De Odontologia De Bauru - USP Serviço de Biblioteca e Documentação FOB-USP, Al. Dr. Octávio Pinheiro Brisolla 9-75, 17012-901 Bauru SP Brasil, Tel.: +55 14 32358373 - Bauru - SP - Brazil
E-mail: jaos@usp.br

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[1] Corresponding address: Rafael Menezes Silva Alameda Dr. Otávio Pinheiro Brisola, 9-75 - Vila Nova - Cidade Universitária - Bauru - SP - 17012-901 - Brasil. Phone: +55 14 998146904 e-mail: rafa18ms@hotmail.com