Pulp response to resin-modified glass ionomer and calcium hydroxide cements in deep cavities: A quantitative systematic review.
ABSTRACT To quantitatively determine whether the pulp response to resin-modified glass ionomer cements placed in deep cavities differs from that generated by calcium hydroxide cement.
Five databases were searched for articles up to 31 May 2009.
Inclusion criteria: titles/abstracts relevant to topic; published in English; two-arm longitudinal in vivo trial; containing computable dichotomous datasets for test and control group. Exclusion criteria: not all entered subjects accounted for at the end of the trial; subjects of both groups not followed up in the same way; trial on animal tissue.
One randomized and five non-randomized control trials, reporting on 1 and 17 datasets, respectively, were accepted. From non-randomized trials, the Relative Risk with 95% Confidence Interval of 13 datasets showed no statistically significant differences (p>0.05) and 4 showed a statistically significant difference between both materials. Meta-analysis of datasets from these trials found no difference between the inflammatory cell response after 30 days (0.87; 95%CI 0.59-1.26; p=0.46); 38% less inflammatory cell response with calcium hydroxide after 60 days (0.62; 95%CI 0.50-0.76; p<0.00001); higher number of intact odontoblasts beneath restored cavities after 381 days (0.56; 95%CI 0.38-0.82; p=0.0008). The results from the randomized control trial (1.40; 95%CI 0.92-2.14; p=0.11) indicated no difference in clinically identifiable pulp symptoms after two years. All trials showed limited internal validity due to selection bias.
No conclusive statement about the superiority of either type of material can yet be made. Further high-quality randomized control trials are needed.
Article: Synthesis and biocompatibility of an experimental glass ionomer cement prepared by a non-hydrolytic sol-gel method.[show abstract] [hide abstract]
ABSTRACT: The aims of this study were to demonstrate the synthesis of an experimental glass ionomer cement (GIC) by the non-hydrolytic sol-gel method and to evaluate its biocompatibility in comparison to a conventional glass ionomer cement (Vidrion R). Four polyethylene tubes containing the tested cements were implanted in the dorsal region of 15 rats, as follows: GI - experimental GIC and GII - conventional GIC. The external tube walls was considered the control group (CG). The rats were sacrificed 7, 21 and 42 days after implant placement for histopathological analysis. A four-point (I-IV) scoring system was used to graduate the inflammatory reaction. Regarding the experimental GIC sintherization, thermogravimetric and x-ray diffraction analysis demonstrated vitreous material formation at 110oC by the sol-gel method. For biocompatibility test, results showed a moderate chronic inflammatory reaction for GI (III), severe for GII (IV) and mild for CG (II) at 7 days. After 21 days, GI presented a mild reaction (II); GII, moderate (III) and CG, mild (II). At 42 days, GI showed a mild/absent inflammatory reaction (II to I), similar to GII (II to I). CG presented absence of chronic inflammatory reaction (I). It was concluded that the experimental GIC presented mild/absent tissue reaction after 42 days, being biocompatible when tested in the connective tissue of rats.Brazilian dental journal 01/2010; 21(6):499-507.