Non-Cochrane · intervention · PM41378054
Clinical effectiveness of ion-releasing restorations compared to composite restorations in pediatric dental treatments: a systematic review and meta-analysis.
Arbildo-Vega Heber Isac, Cruzado-Oliva Fredy Hugo, Vásquez-Rodrigo Hernán, et al. · Frontiers in dental medicine · 2025 · PubMed · doi:10.3389/fdmed.2025.1651696
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
14
current version
GRADE rated
12
No studies
0
Included studies
16
linked below
No studies 0 · 0%Ungraded 2 · 14.3%Very low 0 · 0%Low 1 · 7.1%Moderate 3 · 21.4%High 8 · 57.1%
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 | Children who received dental restorations (primary/permanent teeth; Class I, II and V cavities) | Children aged 4-11 years with primary molar restorations (9 RCTs; 26-180 patients and 16-176 teeth per study) |
| Intervention | Ion-releasing restorations (IRR): all GIC derivatives (RMGIC, HV-GIC, conventional GIC, glass hybrid), polyacid-modified composite (compomer), giomer, and any manufacturer-declared ion-releasing material | IRR materials used: compomer/PMRC, RMGIC, HVGIC, GIC, and giomer (n=9) |
| Comparison | Restoration with composite resin (CR) | Composite resin, including one bulk-fill composite (n=9) |
| Outcomes | Retention; marginal adaptation; marginal discoloration; marginal or tooth integrity; secondary caries; color or translucency; surface texture or luster; surface staining; wear; anatomic form; post-operative sensitivity; periodontal tissue; integrity of contact point; occlusion (14 clinical outcomes) | 12 outcomes meta-analyzed and GRADE-rated (secondary caries, marginal discoloration, marginal adaptation, marginal/tooth integrity, color/translucency, surface texture/luster, surface staining, retention, anatomic form, sensibility, periodontal tissue, contact point); wear and occlusion each assessed in 1 study but not pooled |
| Study designs | Randomized clinical trials (RCTs) with follow-up >=1 year, using FDI or USPHS evaluation criteria | 9 RCTs (2 parallel, 7 cross-over) |
| Timing | Follow-up >=1 year | Follow-up 1-2 years |
Search date: Up to January 2024. Databases: PubMed; Cochrane Library; Scopus; Web of Science; Scielo; gray literature: Google Scholar, OpenGrey, ProQuest; plus reference lists of included studies
Questions and results
Ion-releasing restorations (IRR): RMGIC, HVGIC, GIC, compomer/PMRC, giomer vs Composite resin (CR), including bulk-fill composite
Population: Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Integrity of contact point 2 to 5 years No significant difference between IRR and CR in integrity of contact point (high certainty). Source: Table 4 (GRADE evidence profile, final row; outcome label truncated in source table and reconciled to 'integrity of contact point' via the… · same question in other reviews | RR 0.99 [0.91, 1.08] -8 [-74, 65] per 1,000 | 3 studies · 229 participants | High |
Absence of sensibility (post-operative sensitivity) 1 to 2 years No significant difference between IRR and CR in post-operative sensitivity (high certainty). Source: Table 4 (GRADE evidence profile); Results (Synthesis of results; GRADE analysis) · same question in other reviews | RR 1.02 [0.95, 1.11] 19 [-48, 106] per 1,000 | 3 studies · 197 participants | High |
Adequate marginal adaptation 1 to 2 years No significant difference between IRR and CR in marginal adaptation (high certainty). Source: Table 4 (GRADE evidence profile); Results (Synthesis of results; GRADE analysis) · same question in other reviews | RR 1.02 [0.96, 1.08] 18 [-36, 72] per 1,000 | 5 studies · 335 participants | High |
Absence of secondary caries 1 to 2 years Ion-releasing and composite restorations show no significant difference in absence of secondary caries in children (high certainty). Source: Table 4 (GRADE evidence profile); Results (Synthesis of results; GRADE analysis) · same question in other reviews | RR 1.01 [0.99, 1.03] 9 [-9, 27] per 1,000 | 9 studies · 1145 participants | High |
Adequate color or translucency 1 to 2 years No significant difference between IRR and CR in color or translucency (moderate certainty; downgraded for inconsistency). Source: Table 4 (GRADE evidence profile); Results (Synthesis of results; GRADE analysis) · same question in other reviews | RR 1.02 [0.97, 1.07] 19 [-29, 67] per 1,000 | 6 studies · 600 participants | Moderate Downgraded: inconsistency |
Proper anatomic form 1 to 2 years No significant difference between IRR and CR in anatomic form (high certainty). Source: Table 4 (GRADE evidence profile); Results (Synthesis of results; GRADE analysis) · same question in other reviews | RR 1.00 [0.99, 1.01] 0 [-9, 9] per 1,000 | 8 studies · 1044 participants | High |
Absence of wear 2 years Wear was assessed in a single trial and was not pooled or GRADE-rated (ungraded). Source: Results (Characteristics of included studies; Synthesis of results narrative); Table 3 (study 45, Dermata et al.) · same question in other reviews | no estimate extracted | 1 study | Ungraded |
Adequate marginal or tooth integrity 1 to 2 years No significant difference between IRR and CR in marginal or tooth integrity (high certainty). Source: Table 4 (GRADE evidence profile); Results (Synthesis of results; GRADE analysis) · same question in other reviews | RR 1.00 [0.99, 1.01] 0 [-9, 9] per 1,000 | 6 studies · 930 participants | High |
Occlusion 2 years Occlusion was assessed in a single trial and was not pooled or GRADE-rated (ungraded). Source: Results (Characteristics of included studies; Synthesis of results narrative); Table 3 (study 45, Dermata et al.) · same question in other reviews | no estimate extracted | 1 study | Ungraded |
Absence of marginal discoloration 1 to 2 years No significant difference between IRR and CR in marginal discoloration (moderate certainty; downgraded for inconsistency). Source: Table 4 (GRADE evidence profile); Results (Synthesis of results; GRADE analysis) · same question in other reviews | RR 1.00 [0.93, 1.08] 0 [-62, 71] per 1,000 | 6 studies · 872 participants | Moderate Downgraded: inconsistency |
Retention 1 to 2 years No significant difference between IRR and CR in restoration retention (high certainty). Source: Table 4 (GRADE evidence profile); Results (Synthesis of results; GRADE analysis) · same question in other reviews | RR 1.02 [0.98, 1.07] 19 [-19, 66] per 1,000 | 5 studies · 555 participants | High |
Proper surface texture or luster 1.5 to 2 years No significant difference between IRR and CR in surface texture or luster (high certainty). Source: Table 4 (GRADE evidence profile); Results (Synthesis of results; GRADE analysis) · same question in other reviews | RR 1.00 [0.97, 1.02] 0 [-30, 20] per 1,000 | 4 studies · 720 participants | High |
Proper surface staining 1.5 to 2 years No significant difference between IRR and CR in surface staining (moderate certainty; downgraded for inconsistency). Source: Table 4 (GRADE evidence profile); Results (Synthesis of results; GRADE analysis) · same question in other reviews | RR 1.07 [0.87, 1.31] 66 [-122, 292] per 1,000 | 2 studies · 131 participants | Moderate Downgraded: inconsistency |
Adequate periodontal tissue 1.5 to 2 years Uncertain whether IRR and CR differ in periodontal tissue outcomes (low certainty; downgraded for very serious inconsistency). Source: Table 4 (GRADE evidence profile); Results (Synthesis of results; GRADE analysis) · same question in other reviews | RR 1.13 [0.87, 1.47] 112 [-112, 405] per 1,000 | 3 studies · 231 participants | Low Downgraded: inconsistency |
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 | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Partial Yes | no |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Yes | RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | RCT: Partial 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 | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Moderate | Moderate | yes |
Included primary studies 16
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Ersin 2006 A clinical evaluation of resin-based composite and glass ionomer cement restorations placed in primary teeth using the ART approach:… PMID:17082278 | 3 other reviews | not stated | not extracted yet | not extracted yet |
| Ersin, 2006 A clinical evaluation of resin-based composite and glass ionomer cement restorations placed in primary teeth using the ART approach DOI:10.14219/jada.archive.2006.0087 | 2 other reviews | not stated | not extracted yet | not extracted yet |
| Akman 2020 Clinical evaluation of bulk-fill resins and glass ionomer restorative materials: A 1-year follow-up randomized clinical trial in children. PMID:32246655 | 1 other review | not stated | not extracted yet | not extracted yet |
| Akman, 2020 Clinical evaluation of bulk-fill resins and glass ionomer restorative materials: A 1-year follow-up randomized clinical trial in children DOI:10.4103/njcp.njcp_519_19 | 1 other review | not stated | not extracted yet | not extracted yet |
| Andersson-Wenckert, 2006 Flowable resin composite as a class II restorative in primary molars: A two-year clinical evaluation DOI:10.1080/00016350600788245 | 1 other review | not stated | not extracted yet | not extracted yet |
| Dermata, 2018 Comparison of resin modified glass ionomer cement and composite resin in class II primary molar restorations: a 2-year parallel randomised… DOI:10.1007/s40368-018-0371-7 | 1 other review | not stated | not extracted yet | not extracted yet |
| Hse, 1997 CLINICAL EVALUATION OF COMPOMER IN PRIMARY TEETH: 1-YEAR RESULTS DOI:10.14219/jada.archive.1997.0366 | 1 other review | not stated | not extracted yet | not extracted yet |
| Pascon 2006 Clinical evaluation of composite and compomer restorations in primary teeth: 24-month results. PMID:16242232 | 1 other review | not stated | not extracted yet | not extracted yet |
| Sengul 2015 Clinical Evaluation of Restorative Materials in Primary Teeth Class II Lesions. PMID:26161601 | 1 other review | not stated | not extracted yet | not extracted yet |
| Sengul, 2015 Clinical Evaluation of Restorative Materials in Primary Teeth Class II Lesions DOI:10.17796/1053-4628-39.4.315 | 1 other review | not stated | not extracted yet | not extracted yet |
| Andersson-Wenckert 2006 Flowable resin composite as a class II restorative in primary molars: A two-year clinical evaluation. PMID:17123909 | this review only | not stated | not extracted yet | not extracted yet |
| Bektas Donmez 2016 Clinical performance of aesthetic restorative materials in primary teeth according to the FDI criteria. PMID:27759409 | this review only | not stated | not extracted yet | not extracted yet |
| Dermata 2018 Comparison of resin modified glass ionomer cement and composite resin in class II primary molar restorations: a 2-year parallel randomised… PMID:30324561 | this review only | not stated | not extracted yet | not extracted yet |
| Hse 1997 Clinical evaluation of compomer in primary teeth: 1-year results. PMID:9260418 | this review only | not stated | not extracted yet | not extracted yet |
| Oz 2022 DOI:10.22038/jdmt.2022.62404.1500 | this review only | not stated | not extracted yet | not extracted yet |
| Pascon, 2006 Clinical evaluation of composite and compomer restorations in primary teeth: 24-month results DOI:10.1016/j.jdent.2005.08.003 | 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).