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Survival of high-strength glass ionomer restorations placed in permanent dentition of high caries risk patients using an art modified approach: 10-year results

Grant number: 07/04276-0
Support type:Regular Research Grants
Duration: November 01, 2007 - July 31, 2009
Field of knowledge:Health Sciences - Dentistry - Dental Materials
Principal Investigator:Maria Fidela de Lima Navarro
Grantee:Maria Fidela de Lima Navarro
Home Institution: Faculdade de Odontologia de Bauru (FOB). Universidade de São Paulo (USP). Bauru , SP, Brazil

Abstract

In 1997 one study, employing the modified atraumatic treatment was conducted on low-income pregnant women in the city of Bauru. In the study mentioned above, eighty-one pregnant women, mean age 19.1 (3.7) years, presenting a mean number of 14.0 decayed surfaces were engaged in an oral health promotion program. The patients were randomly divided in two groups. In group 1 (n = 43) all types of cavities (Class I, II, III, IV, and V) were restored with a type II glass-ionomer cement specifically developed for ART (Fuji IX ; GC Dental Co. Japan). In group 2 (n = 38) posterior cavities (Class I, II, and reconstruction) were restored with a reinforced ZOE cement (IRM ; Dentsply). The Class III, IV and anterior and posterior Class V cavities were restored with a universal hybrid composite (Fill Magic ; Vigodent , Brazil). After two years the success rate of glass ionomer cement range from 77.1 to 92.5% depending on size and class of restoration. There were no statistically significant diferences between composite resin and glass ionomer success rate. Access to dentin lesions in the proximal surfaces was performed with a high-speed bur. The entrance of small lesions was also widened using high speed burs. Excavators were used to remove soft carious dentin, preserving the partially demineralised dentin as much as possible (modified ART approach). Clinical investigations conducted in children and adolescents at low risk to caries assure the good clinical performance for a three-year period in permanent teeth, with results similar to those achieved by one-surface amalgam restorations. However, because the technique was developed recently, clinical investigations at long-term are scarce and focused on one-surface cavities. Van Duinen et al demonstrated that glass-ionomer adjacent to tooth structure and in contact with the oral fluids, frequently altered into a material with unexpected cutting resistance and displaying raised Calcium- and Phosphate content. It was remarkable that such an altered layer was only detectable after a couple of years performance, whilst its thickness increased with time. This indicates that, with time, the exchange process continues and consequently the glass-ionomer restoration gains in quality, starting from the outer surface and the junction with tooth structure. As saliva and its minerals play a crucial role in mineralization processes, it can be understood that only under in vivo circumstances the glass-ionomer surface changed into the new structure. In analogy to the (re-) mineralising power on tooth structures, the potential of saliva as a reinforcing agent for restorative materials was suggested. The aim of this study is:1.To evaluate the survival rates of glass ionomer cement restorations after a 10-year period through the clinical and radiographic observations.2.To evaluate the patient satisfaction with the treatment received using a simplified questionnaire.3.To verify the presence of the pseudo-enamel; through scanning electron microscopy (SEM). (AU)

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
ZANATA, REGIA LUZIA; MAGALHAES, ANA CAROLINA; PEREIRA LAURIS, JOSE ROBERTO; ATTA, MARIA TERESA; WANG, LINDA; DE LIMA NAVARRO, MARIA FIDELA. Microhardness and chemical analysis of high-viscous glass-ionomer cement after 10 years of clinical service as ART restorations. Journal of Dentistry, v. 39, n. 12, p. 834-840, DEC 2011. Web of Science Citations: 14.
ZANATA, REGIA LUZIA; FAGUNDES, TICIANE CESTARI; CARVALHO DE ALMENDRA FREITAS, MARIA CRISTINA; PEREIRA LAURIS, JOSE ROBERTO; DE LIMA NAVARRO, MARIA FIDELA. Ten-year survival of ART restorations in permanent posterior teeth. CLINICAL ORAL INVESTIGATIONS, v. 15, n. 2, p. 265-271, APR 2011. Web of Science Citations: 23.

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