Residual caries and marginal integrity in relation to class II glass ionomer restorations in primary molars

Abstract

Aim: To assess the effectiveness of three treatment methods (ART, Carisolv^TM and rotary instruments) in caries removal and sealing capability of hand-mixed glass ionomer in the management of proximal caries in deciduous molars. Methods: In a clinical study 217 dentally naïve children (age 7.5, SD 0.57) were randomly divided in three treatment groups and among 4 operators. Each child received one class II glass ionomer restoration. Immediately after restoration bitewings were made. The dependent variables were: residual caries and marginal adaptation. Independent variables were operator effect, child’s behaviour and time to remove caries. Results: There was no statistical significant difference in residual caries between the three treatment methods (p> 0.05). In 33% of the cases a clear radiolucency underneath the restoration was visible on the bitewings. In 26% doubt existed on the presence of residual caries. A clear cervical gap was seen in 16% of the restorations, while in 18% signs of cervical gaps were less obvious. Between the four operators a significant difference in relation to residual caries (p=0.015) was found as well as a significant difference between the operators for the preparation time in the three treatment methods (p<0.05). The child’s behaviour seems to have no influence on residual caries and marginal gaps. Conclusion: This study indicates that there is no preparation method superior to another, though the treatment methods seem to be sensitive for operator effects. Using hand-mixed glass ionomer cement resulted in considerable number of cervical gaps found.