Non-Cochrane · intervention · PM36357453
Secondary caries and marginal adaptation of ion-releasing versus resin composite restorations: a systematic review and meta-analysis of randomized clinical trials.
Albelasy Eman H, Hamama Hamdi H, Chew Hooi Pin, et al. · Scientific reports · 2022 · PubMed · doi:10.1038/s41598-022-19622-6
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
13
current version
GRADE rated
10
No studies
0
Included studies
37
linked below
No studies 0 · 0%Ungraded 3 · 23.1%Very low 0 · 0%Low 10 · 76.9%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with permanent dentition in need of restorations | Patients with permanent dentition (Class I, II, V and NCCL); 22 RCTs (15 split-mouth, 7 parallel); mainly university settings across Turkey, Brazil, Sweden, India, Vietnam, Belgium, Germany and others; ages ~8-88 years |
| Intervention | Ion-releasing restorations (all GIC derivatives - RMGIC, HV-GIC, conventional GIC, glass hybrid; polyacid-modified composite/compomer; giomer; any manufacturer-stated ion-releasing material) | Ion-releasing materials: HV-GIC (5 studies), glass hybrid (2), RMGIC (9), conventional GIC (2), compomer/polyacid-modified composite (7) |
| Comparison | Resin composite restoration applied with any adhesive system | Resin composite (nano-hybrid, micro-hybrid, bulk-fill, nanofilled, microfilled) |
| Outcomes | Caries around restorations (secondary caries) and marginal adaptation | Secondary caries (dichotomous; very low event rates - GIC 15/1448 [0.8%], composite 16/1637 [0.9%]) and marginal adaptation (ordinal USPHS/FDI dichotomized to acceptable/unacceptable) |
| Study designs | Randomized clinical trials (parallel or split-mouth); permanent dentition; Black's Class I, II, V and NCCL; FDI and/or USPHS evaluation; commercially available materials (discontinued products excluded) | 22 RCTs included; abstract states 10 studies meta-analyzed (forest plots Figs. 3-5 display up to ~14 study-arms across outcomes/follow-ups) |
| Timing | Minimum follow-up 1 year | Follow-up 1-10 years (most 2-3 years; two long-term studies at 7 and 10 years; one terminated at 1 year) |
Search date: 21 May 2021 (databases searched until 21 May 2021; no date or language restriction). Databases: MEDLINE (via PubMed); Scopus; OpenGrey (grey literature); ClinicalTrials.gov (ongoing trials)
Questions and results
Ion-releasing glass ionomer cement (GIC) restorations vs Resin composite restorations
Population: Patients with permanent dentition in need of restorations
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Unacceptable marginal adaptation 1 year, 18 months to 2 years, and 3 years · All types of cavities Across follow-up periods, there was no statistically significant difference in unacceptable marginal adaptation between GIC and resin composite restorations. Source: Figure 5 · same question in other reviews | RD 0.01 [-0.01, 0.03] | 9 studies · 2725 participants | Ungraded |
Secondary caries (caries around restorations), all cavity types 3 years Population: Patients with permanent dentition in need of restorations (all cavity types: Black's Class I, II, V, and non-carious cervical lesions) At 3 years there were no secondary caries events and no difference between ion-releasing (GIC) and resin composite restorations (RD 0.00, 95% CI -0.02 to 0.02; low certainty). Source: Table 2 (SoF; Secondary caries-Three-year follow-up); Figure 3 (forest plot subtotal 1.1.3); Results 'Secondary caries' · same question in other reviews | RD 0.00 [-0.02, 0.02] | 3 studies · 321 participants | Low Downgraded: risk of bias, imprecision |
Unacceptable marginal adaptation 1 year · All types of cavities Ion-releasing GIC restorations may have little or no difference in unacceptable marginal adaptation at 1 year (low certainty). Source: Figure 5; Table 2 · same question in other reviews | RD 0.01 [-0.02, 0.03] -10 [-30, 20] per 1000 | 9 studies · 1386 participants | Low Downgraded: risk of bias, imprecision |
Marginal adaptation (unacceptable marginal adaptation) 3 years Population: Patients with permanent dentition in need of restorations (all cavity types: Black's Class I, II, V, and non-carious cervical lesions) At 3 years there were no marginal adaptation failures and no difference between ion-releasing (GIC) and resin composite restorations (RD 0.00, 95% CI -0.02 to 0.02; low certainty). Source: Table 2 (SoF; Marginal adaptation-Three-year follow-up); Figure 5 (forest plot subtotal 1.2.3); Results 'Marginal adaptation' · same question in other reviews | RD 0.00 [-0.02, 0.02] | 3 studies · 321 participants | Low Downgraded: risk of bias, imprecision |
Secondary caries (caries around restorations), all cavity types 18 months-2 years Population: Patients with permanent dentition in need of restorations (all cavity types: Black's Class I, II, V, and non-carious cervical lesions) At 18 months to 2 years, no significant difference in secondary caries between ion-releasing (GIC) and resin composite restorations (RD -0.00, 95% CI -0.01 to 0.01; low certainty). Source: Table 2 (SoF; Secondary caries-18 months to 2 years follow-up); Figure 3 (forest plot subtotal 1.1.2); Results 'Secondary caries' · same question in other reviews | RD -0.00 [-0.01, 0.01] | 8 studies · 1087 participants | Low Downgraded: risk of bias, imprecision |
Secondary caries (caries around restorations), all cavity types Overall (1 year, 18 months-2 years, and 3 years pooled) Population: Patients with permanent dentition in need of restorations (all cavity types: Black's Class I, II, V, and non-carious cervical lesions) Pooled across follow-up periods, ion-releasing (GIC) and resin composite restorations show no significant difference in secondary caries (RD -0.00, 95% CI -0.01 to 0.00; not separately GRADE-rated). Source: Figure 3 (forest plot overall total); Results 'Secondary caries'; Abstract · same question in other reviews | RD -0.00 [-0.01, 0.00] | 12 studies · 3085 participants | Ungraded |
Unacceptable marginal adaptation 3 years · All types of cavities No unacceptable-marginal-adaptation events occurred in either group at 3 years (low certainty). Source: Figure 5; Table 2 · same question in other reviews | RD 0.00 [-0.02, 0.02] 0 [-20, 20] per 1000 | 3 studies · 321 participants | Low Downgraded: risk of bias, imprecision |
Secondary caries 1 year · All types of cavities Ion-releasing GIC restorations may have little or no difference in secondary caries at 1 year (low certainty). Source: Figure 3; Table 2 · same question in other reviews | RD -0.00 [-0.01, 0.01] -0 [-10, 10] per 1000 | 12 studies · 1677 participants | Low Downgraded: risk of bias, imprecision |
Marginal adaptation (unacceptable marginal adaptation) 18 months-2 years Population: Patients with permanent dentition in need of restorations (all cavity types: Black's Class I, II, V, and non-carious cervical lesions) At 18 months to 2 years, no significant difference in marginal adaptation between ion-releasing (GIC) and resin composite restorations (RD 0.03, 95% CI -0.02 to 0.08; I2=94%; low certainty). Source: Table 2 (SoF; Marginal adaptation-18 months to 2 years follow-up); Figure 5 (forest plot subtotal 1.2.2); Results 'Marginal adaptation' · same question in other reviews | RD 0.03 [-0.02, 0.08] | 7 studies · 1018 participants | Low Downgraded: risk of bias, imprecision |
Marginal adaptation (unacceptable marginal adaptation) 1 year Population: Patients with permanent dentition in need of restorations (all cavity types: Black's Class I, II, V, and non-carious cervical lesions) At 1 year, no significant difference in unacceptable marginal adaptation between ion-releasing (GIC) and resin composite restorations, though heterogeneity was high (RD 0.01, 95% CI -0.02 to 0.03; I2=79%; low certainty). Source: Table 2 (SoF; Marginal adaptation-One-Year follow-up); Figure 5 (forest plot subtotal 1.2.1); Results 'Marginal adaptation' · same question in other reviews | RD 0.01 [-0.02, 0.03] | 9 studies · 1386 participants | Low Downgraded: risk of bias, imprecision |
Secondary caries (caries around restorations), all cavity types 1 year Population: Patients with permanent dentition in need of restorations (all cavity types: Black's Class I, II, V, and non-carious cervical lesions) At 1 year, ion-releasing (GIC) and resin composite restorations show no significant difference in secondary caries (RD -0.00, 95% CI -0.01 to 0.01; low certainty). Source: Table 2 (SoF; Secondary caries-1-year follow-up); Figure 3 (forest plot subtotal 1.1.1); Results 'Secondary caries' · same question in other reviews | RD -0.00 [-0.01, 0.01] | 12 studies · 1677 participants | Low Downgraded: risk of bias, imprecision |
Secondary caries 18 months to 2 years · All types of cavities Ion-releasing GIC restorations may have little or no difference in secondary caries at 18 months to 2 years (low certainty). Source: Figure 3; Table 2 · same question in other reviews | RD -0.00 [-0.01, 0.01] -0 [-10, 10] per 1000 | 8 studies · 1087 participants | Low Downgraded: risk of bias, imprecision |
Ion-releasing restoration (glass ionomer-based and compomer/polyacid-modified composite) vs Resin composite restoration
Population: Patients with permanent dentition in need of restorations in load-bearing cavities (Class I/II posterior)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Secondary caries (caries around restorations), load-bearing cavities Last reported follow-up (2-3 years) In load-bearing cavities, ion-releasing (GIC and compomer) and resin composite restorations show no significant difference in secondary caries (RD -0.00, 95% CI -0.01 to 0.01; not GRADE-rated). Source: Figure 4 (forest plot overall total); Results 'Secondary caries' and 'Descriptive analysis' · same question in other reviews | RD -0.00 [-0.01, 0.01] | 6 studies · 883 participants | Ungraded |
AMSTAR 2 appraisal
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | Yes | no |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | Yes · N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | Yes · N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | No | no |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | No | no |
| Overall | Critically Low | Critically Low | yes |
Included primary studies 37
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Balkaya et al. 2020 A Two-year Clinical Comparison of Three Different Restorative Materials in Class II Cavities. PMID:31738696 | 1 other review | not stated | not extracted yet | not extracted yet |
| De Moor et al. 2011 Two-year clinical performance of glass ionomer and resin composite restorations in xerostomic head- and neck-irradiated cancer patients. PMID:19997859 | 1 other review | not stated | not extracted yet | not extracted yet |
| Gallo et al. 2005 Three-year clinical evaluation of a compomer and a resin composite as Class V filling materials. PMID:15986945 | 1 other review | not stated | not extracted yet | not extracted yet |
| Gurgan et al. 2020 A randomized controlled 10 years follow up of a glass ionomer restorative material in class I and class II cavities. PMID:31351909 | 1 other review | not stated | not extracted yet | not extracted yet |
| Jassal et al. 2018 Clinical Effectiveness of a Resin-modified Glass Ionomer Cement and a Mild One-step Self-etch Adhesive Applied Actively and Passively in… PMID:29782222 | 1 other review | not stated | not extracted yet | not extracted yet |
| Koc Vural et al. 2020a Clinical comparison of a micro-hybride resin-based composite and resin modified glass ionomer in the treatment of cervical caries lesions:… PMID:32902766 | 1 other review | not stated | not extracted yet | not extracted yet |
| Menezes-Silva et al. 2019 Randomized clinical trial of class II restoration in permanent teeth comparing ART with composite resin after 12 months. PMID:30612246 | 1 other review | not stated | not extracted yet | not extracted yet |
| Miletic et al. 2020 Clinical Performance of a Glass-Hybrid System Compared with a Resin Composite in the Posterior Region: Results of a 2-year Multicenter… PMID:32435764 | 1 other review | not stated | not extracted yet | not extracted yet |
| Oz et al. 2020 One-year evaluation of a new restorative glass ionomer cement for the restoration of non-carious cervical lesions in patients with… PMID:33111883 | 1 other review | not stated | not extracted yet | not extracted yet |
| Pollington et al. 2008 A clinical evaluation of a resin composite and a compomer in non-carious Class V lesions. A 3-year follow-up. PMID:18435377 | 1 other review | not stated | not extracted yet | not extracted yet |
| Santiago et al. 2010 Two-year clinical evaluation of resinous restorative systems in non-carious cervical lesions. PMID:21203706 | 1 other review | not stated | not extracted yet | not extracted yet |
| Van Dijken et al. 2019 A randomized controlled evaluation of posterior resin restorations of an altered resin modified glass-ionomer cement with claimed… PMID:30527586 | 1 other review | not stated | not extracted yet | not extracted yet |
| Balkaya et al. 2020 A Two-year Clinical Comparison of Three Different Restorative Materials in Class II Cavities DOI:10.2341/19-078-c | this review only | not stated | not extracted yet | not extracted yet |
| Brackett et al. 2003 Two-year clinical performance of Class V resin-modified glass-lonomer and resin composite restorations. PMID:14531590 | this review only | not stated | not extracted yet | not extracted yet |
| Celik et al. 2019 Three-year clinical evaluation of high-viscosity glass ionomer restorations in non-carious cervical lesions: a randomised controlled… DOI:10.1007/s00784-018-2575-y | this review only | not stated | not extracted yet | not extracted yet |
| Celik et al. 2019 Three-year clinical evaluation of high-viscosity glass ionomer restorations in non-carious cervical lesions: a randomised controlled… PMID:30120605 | this review only | not stated | not extracted yet | not extracted yet |
| De Moor et al. 2011 Two-year clinical performance of glass ionomer and resin composite restorations in xerostomic head- and neck-irradiated cancer patients DOI:10.1007/s00784-009-0355-4 | this review only | not stated | not extracted yet | not extracted yet |
| Diem et al. 2014 The effect of a nano-filled resin coating on the 3-year clinical performance of a conventional high-viscosity glass-ionomer cement DOI:10.1007/s00784-013-1026-z | this review only | not stated | not extracted yet | not extracted yet |
| Diem et al. 2014 The effect of a nano-filled resin coating on the 3-year clinical performance of a conventional high-viscosity glass-ionomer cement. PMID:23832616 | this review only | not stated | not extracted yet | not extracted yet |
| Folwaczny et al. 2000 Tooth-colored filling materials for the restoration of cervical lesions: a 24-month follow-up study. PMID:11203827 | this review only | not stated | not extracted yet | not extracted yet |
| Gurgan et al. 2020 A randomized controlled 10 years follow up of a glass ionomer restorative material in class I and class II cavities DOI:10.1016/j.jdent.2019.07.013 | this review only | not stated | not extracted yet | not extracted yet |
| Jassal et al. 2018 Clinical Effectiveness of a Resin-modified Glass Ionomer Cement and a Mild One-step Self-etch Adhesive Applied Actively and Passively in… DOI:10.2341/17-147-c | this review only | not stated | not extracted yet | not extracted yet |
| Koc Vural et al. 2020 Twenty-four-month clinical performance of a glass hybrid restorative in non-carious cervical lesions of patients with bruxism: a… DOI:10.1007/s00784-019-02986-x | this review only | not stated | not extracted yet | not extracted yet |
| Koc Vural et al. 2020 Clinical comparison of a micro-hybride resin-based composite and resin modified glass ionomer in the treatment of cervical caries lesions:… DOI:10.1007/s10266-020-00550-8 | this review only | not stated | not extracted yet | not extracted yet |
| Koc Vural et al. 2020b Twenty-four-month clinical performance of a glass hybrid restorative in non-carious cervical lesions of patients with bruxism: a… PMID:31297658 | this review only | not stated | not extracted yet | not extracted yet |
| Menezes-Silva et al. 2019 Randomized clinical trial of class II restoration in permanent teeth comparing ART with composite resin after 12 months DOI:10.1007/s00784-018-2787-1 | this review only | not stated | not extracted yet | not extracted yet |
| Miletić et al. 2020 DOI:10.3290/j.jad.a44547 | this review only | not stated | not extracted yet | not extracted yet |
| Onal et al. 2005 The two-year clinical performance of esthetic restorative materials in noncarious cervical lesions DOI:10.14219/jada.archive.2005.0085 | this review only | not stated | not extracted yet | not extracted yet |
| Onal et al. 2005 The two-year clinical performance of esthetic restorative materials in noncarious cervical lesions. PMID:16329418 | this review only | not stated | not extracted yet | not extracted yet |
| Perdigao et al. 2012 Randomized clinical trial of two resin-modified glass ionomer materials: 1-year results. PMID:22770485 | this review only | not stated | not extracted yet | not extracted yet |
| Perdigão et al. 2012 Randomized Clinical Trial of Two Resin-Modified Glass Ionomer Materials: 1-year Results DOI:10.2341/11-415-c | this review only | not stated | not extracted yet | not extracted yet |
| Santiago et al. 2010 Two-year clinical evaluation of resinous restorative systems in non-carious cervical lesions DOI:10.1590/s0103-64402010000300010 | this review only | not stated | not extracted yet | not extracted yet |
| Turkun et al. 2008 Noncarious class V lesions restored with a polyacid modified resin composite and a nanocomposite: a two-year clinical trial. PMID:19058687 | this review only | not stated | not extracted yet | not extracted yet |
| Van Dijken et al. 2012 A 7-year randomized prospective study of a one-step self-etching adhesive in non-carious cervical lesions. The effect of curing modes and… DOI:10.1016/j.jdent.2012.08.017 | this review only | not stated | not extracted yet | not extracted yet |
| Van Dijken et al. 2012 A 7-year randomized prospective study of a one-step self-etching adhesive in non-carious cervical lesions. The effect of curing modes and… PMID:22955004 | this review only | not stated | not extracted yet | not extracted yet |
| Van Dijken et al. 2019 A randomized controlled evaluation of posterior resin restorations of an altered resin modified glass-ionomer cement with claimed… DOI:10.1016/j.dental.2018.11.027 | this review only | not stated | not extracted yet | not extracted yet |
| Wucher et al. 2002 A 3-year clinical evaluation of a compomer, a composite and a compomer/composite (sandwich) in class II restorations. PMID:12572648 | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Clinical efficacy of bioactive restorative materials in controlling secondary caries: a systematic review and network meta-analysis. (2023) | 12 | 0.14 |