Clinical Evaluation of Glass-Ionomer versus Bulk-Fill Resin-Composite in Children

Objectives: Glass-ionomer based restorative system (GIC) is commonly indicated for posterior restorations due to the increase in demand for filling the cavity in bulk without polymerization devices. Bulk-fill resin composites (BRC) are proposed as alternatives to GIC that do not require incremental filling. This clinical study evaluated the clinical performance of these two types of materials.
Methods: Between May-2014 and April-2015, a total of 35 patients (10-12 years of age), who had matched pair of mandibular carious molars with Class I or Class II cavities were enrolled in the study. Each patient received two restorations randomly either with a GIC (EQUIA, GC) with a self-adhesive nanofilled coating (Equia Coat, GC) or BRC (Tetric EvoCeram, Ivoclar Vivadent) after using a self-etch adhesive (AdheSe OneF, Ivoclar Vivadent). Two independent examiners evaluated the restorations at baseline and at 6, 12 months (modified US Public Health Service criteria).
Results: Mean observation period was 10.4 months. Depth of cavities ranged between 2.5 to 6 mm with a mean of 3.7 mm. While 2 chipppings were observed with GIC, no failures were observed for BRCs. GIC restorations with chippings were repaired. Secondary caries did not occur in any of the teeth. Marginal discoloration criteria were similar in both materials (1 GIC, 1 BRC) but marginal deterioration (4 GIC, 2 BRC), anatomical form change (3 GIC, 0 BRC), and surface porosity (2 GIC, 0 BRC) were more common with the GIC.
Conclusions: Both glass-ionomer cement and bulk-fill resin composite performed similar up to 18 months in permanent molars in Class I and II cavities in terms of retention, providing that two chipping incidences were observed with the GIC with more common surface degradation.