European Archives of Paediatric Dentistry

, Volume 12, Issue 1, pp 5–14 | Cite as

Caries-preventive effect of resin-modified glass-ionomer cement (Rm-GIC) versus composite resin: a quantitative systematic review

  • V. Yengopal
  • S. MickenautschEmail author


AIM: To determine whether resin-modified glass-ionomer cement (RM-GIC), when compared with composite resins (CR), offers a significant caries-preventive effect. STUDY DESIGN: Quantitative systematic review. METHODS: Five databases were searched until 29 July 2010. Inclusion criteria were: relevant to review question related to orthodontic or restorative treatment; published in English; prospective clinical 2-arm study. Exclusion criteria were: no computable data reported; study groups not followed up in the same way. References of included articles were checked. The outcome measure was absence of carious lesions. Dichotomous datasets for both groups were extracted from accepted trials. Trials were assessed for selection-, detection/performance, attrition and publication bias. RESULTS: Of the 11 trials included, 6 were accepted and 24 datasets extracted; 17 datasets showed no difference after 4 weeks to >25 months. There were 7 datasets that favoured (p < 0.05) RM-GIC after 12 — 24 months. The results are limited by risk of selection-, detection-/performance bias and attrition bias. Risk of publication bias was identified. CONCLUSIONS: The overall results showed either no difference between the materials, or indicated that RM-GIC has a superior caries-preventive effect. The clinical meaning of this result remains uncertain due to risk of bias. High-quality randomised control trials are needed in order to answer the review question conclusively.

Key words

resin-modified glass ionomers composite resin caries systematic review 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Andersson-Wenckert I, Sunnegårdh-Grönberg K. Flowable resin composite as a class II restorative in primary molars: A two-year clinical evaluation. Acta Odontol Scand 2006; 64:334–340.PubMedCrossRefGoogle Scholar
  2. Bax L, Yu LM, Ikeda N, Tsuruta H, Moons KGM. Development and validation of MIX: comprehensive free software for meta-analysis of causal research data. BMC Med Res Methodol 2006; 6: 50.PubMedCrossRefGoogle Scholar
  3. Berger VW. Selection bias and covariate imbalances in randomised clinical trials. Chichester: John Wiley & Sons, Ltd., 2005.CrossRefGoogle Scholar
  4. Berger VW, Alperson SY. A general framework for the evaluation of clinical trial quality. Rev Recent Clin Trials 2009; 4: 79–88.PubMedCrossRefGoogle Scholar
  5. Burgess JO, Gallo JR, Ripps AH, Walker RS, Ireland EJ. Clinical evaluation of four Class 5 restorative materials: 3-year recall. Am J Dent 2004; 17: 147–150.PubMedGoogle Scholar
  6. Chalmers TC, Matta RJ, Smith H Jr, Kunzler AM. Evidence favoring the use of anticoagulants in the hospital phase of acute myocardial infarction. N Engl J Med 1977; 297:1091–1096.PubMedCrossRefGoogle Scholar
  7. Chung CK, Millett DT, Creanor SL, Gilmour WH, Foye RH. Fluoride release and cariostatic ability of a compomer and a resin-modified glass ionomer cement used for orthodontic bonding. J Dent 1998; 26:533–538.PubMedCrossRefGoogle Scholar
  8. Donly KJ, Segura A, Wefel JS, Hogan MM. Evaluating the effects of fluoride-releasing dental materials on adjacent interproximal caries. J Am Dent Assoc 1999; 130:817–825.PubMedGoogle Scholar
  9. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629–634.PubMedCrossRefGoogle Scholar
  10. Egger M, Jüni P, Bartlett C, Holenstein F, Sterne J. How important are comprehensive literature searches and the assessment of trial quality in systematic reviews? Empirical study. Health Technol Assess 2003; 7:1–76.PubMedGoogle Scholar
  11. Ewoldsen N, Herwig L. Decay-inhibiting restorative materials: past and present. Compend Contin Educ Dent 1998; 19: 981–986.PubMedGoogle Scholar
  12. Fuks AB, Araujo FB, Osorio LB, Hadani PE, Pinto AS. Clinical and radiographic assessment of Class II esthetic restorations in primary molars. Pediatr Dent 2000; 22: 479–485.PubMedGoogle Scholar
  13. Gaworski M, Weinstein M, Borislow AJ, Braitman LE. Decalcification and bond failure: A comparison of a glass ionomer and a composite resin bonding system in vivo. Am J Orthod Dentofacial Orthop 1999; 116:518–521.PubMedCrossRefGoogle Scholar
  14. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions 4.2.6. In: The Cochrane Library, Issue 4. Chichester: John Wiley & Sons, Ltd.; 2006:82:113–114.Google Scholar
  15. Jang KT, Garcia-Godoy F, Donly KJ, Segura A. Remineralizing effects of glass ionomer restorations on adjacent interproximal caries. ASDC J Dent Child 2001; 68:125–128.PubMedGoogle Scholar
  16. Kilpatrick NM, Murray JJ, McCabe JF. A clinical comparison of a light cured glass ionomer sealant restoration with a composite sealant restoration. J Dent 1996; 24: 399–405.PubMedCrossRefGoogle Scholar
  17. Kjaergard LL, Villumsen J, Gluud C. Reported Methodological quality and discrepancies between large and small randomised trials in meta-Analyses. Ann Intern Med 2001; 135: 982–989.PubMedGoogle Scholar
  18. Kotsanos N, Dionysopoulos P. Lack of effect of fluoride releasing resin modified glass ionomer restorations on the contacting surface of adjacent primary molars. a clinical prospective study. Eur J Paediatr Dent 2004; 5:136–142.PubMedGoogle Scholar
  19. Lesaffre E, Garcia Zattera MJ, Redmond C, Huber H, Needleman I. Reported methodological quality of split-mouth studies. J Clin Periodontol 2007; 34: 756–61.PubMedCrossRefGoogle Scholar
  20. McComb D, Erickson RL, Maxymiw WG, Wood RE. A clinical comparison of glass ionomer, resin-modified glass ionomer and resin composite restorations in the treatment of cervical caries in xerostomic head and neck radiation patients. Oper Dent 2002; 27:430–437.PubMedGoogle Scholar
  21. McDonagh MS, Whiting PF, Wilson PM, et al. Systematic review of water fluoridation. BMJ 2000; 321:855–859.PubMedCrossRefGoogle Scholar
  22. Mejáre I, Lingström P, Petersson LG, et al. Caries-preventive effect of fissure sealants: a systematic review. Acta Odontol Scand 2003; 61:321–330.PubMedCrossRefGoogle Scholar
  23. Mickenautsch S. Systematic reviews, systematic error and the acquisition of clinical knowledge. BMC Med Res Methodol 2010; 10:53.PubMedCrossRefGoogle Scholar
  24. Mickenautsch S, Yengopal V, Leal SC, Oliveira LB, Bezerra AC, Bönecker M. Absence of carious lesions at margins of glass-ionomer and amalgam restorations: a meta-analysis. Eur Archs Paediatr Dent 2009; 10:41–46.Google Scholar
  25. Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel — group randomised trials. Lancet 2001; 357:1191–1194.PubMedCrossRefGoogle Scholar
  26. Mjör IA, Toffenetti F. Secondary caries: A literature review with case reports. Quintessence Int 2000; 31:165–179.PubMedGoogle Scholar
  27. Nagamine M, Itota T, Torii Y, Irie M, Staninec M, Inoue K. Effect of resinmodified glass ionomer cements on secondary caries. Am J Dent 1997; 10:173–178.PubMedGoogle Scholar
  28. Okida RC, Mandarino F, Sundfeld RH, de Alexandre RS, Sundefeld ML. In vitro-evaluation of secondary caries formation around restoration. Bull Tokyo Dent Coll 2008; 49:121–128.PubMedCrossRefGoogle Scholar
  29. Paradella TC, Koga-Ito CY, Jorge AO. Ability of different restorative materials to prevent in situ secondary caries: analysis by polarized light-microscopy and energy-dispersive X-ray. Eur J Oral Sci 2008; 116:375–380.PubMedCrossRefGoogle Scholar
  30. Park SH, Kim KY. The anticariogenic effect of fluoride in primer, bonding agent, and composite resin in the cavosurface enamel area. Oper Dent 1997; 22:115–120.PubMedGoogle Scholar
  31. Rothstein HR, Sutton AJ, Borenstein M. Publication bias in meta-analysis. In: Publication bias in meta-analysis — prevention, assessment and adjustment. Chichester: John Wiley & Sons, Ltd.; 2005a: 1–7.CrossRefGoogle Scholar
  32. Rothstein HR, Sutton AJ, Borenstein M. Software for publication bias. In: Publication bias in meta-analysis — prevention, assessment and adjustment. Chichester: John Wiley & Sons, Ltd.; 2005b: 193–220.CrossRefGoogle Scholar
  33. Takeuti ML, Marquezan M, Rodrigues CR, Rodrigues Filho LE, Rocha Rde O. Inhibition of demineralisation adjacent to tooth-colored restorations in primary teeth after 2 in vitro challenges. J Dent Child (Chic) 2007; 74: 209–214.Google Scholar
  34. Tantbirojin D, Douglas WH, Verslius A. Inhibitive effect of a resin modified glass ionomer cement on remote artificial caries. Caries Res 1997; 31:275–280.CrossRefGoogle Scholar
  35. Torii Y, Itota T, Okamoto M, Nakabo S, Nagamine M, Inoue K. Inhibition of artificial secondary caries in root by fluoride-releasing restorative materials. Oper Dent 2001; 26: 36–43.PubMedGoogle Scholar
  36. Twetman S, Axelsson S, Dahlgren H, et al. Caries-preventive effect of fluoride toothpaste: a systematic review. Acta Odontol Scand 2003; 61:347–355.PubMedCrossRefGoogle Scholar
  37. van Dijken JW. Durability of new restorative materials in Class III cavities. J Adhes Dent 2001; 3: 65–70.PubMedGoogle Scholar
  38. Wiegand A, Buchalla W, Attin T. Review on fluoride-releasing restorative materials-fluoride release and uptake characteristics, antibacterial activity and influence on caries formation. Dent Mater 2007; 23:343–362.PubMedCrossRefGoogle Scholar
  39. Wilson RM, Donly KJ. Demineralisation around orthodontic brackets bonded with resin-modified glass ionomer cement and fluoride-releasing resin composite. Pediatr Dent 2001; 23:255–259.PubMedGoogle Scholar
  40. Yengopal V, Mickenautsch S. Resin-modified glass-ionomer cements versus resin-based materials as fissure sealants: a meta-analysis of clinical trials. Eur Arch Paediatr Dent 2010; 11:18–25.PubMedGoogle Scholar

Copyright information

© European Archives of Paediatric Dentistry 2011

Authors and Affiliations

  1. 1.Division of Public Oral Health, Faculty of Health SciencesUniversity of the WitwatersrandParktown, JohannesburgSouth Africa

Personalised recommendations