Sobrevida de restaurações de resina com tecnologia Giomer e de cimento ionômero de vidro modificado por resina em cavidades oclusoproximais em molares decíduos: ensaio clínico randomizado

Abstract

Background: Occlusoproximal restorations in primary molars present a high number of failures. Such failures occur mainly due to the presence of secondary caries lesions, highlighting the need for materials that, in addition to fulfilling the restorative function, also help in the prevention and control of new lesions. Aim: To evaluate and compare whether the survival rates of resin restorations with Giomer technology (GRC) are inferior to those of resin-modified glass ionomer restorations (RMGIC) in occlusoproximal cavities of primary molars. Materials and Methods: This is a randomized, parallel, single-blind clinical trial carried out at the Postgraduate Clinic of the School of Dentistry of the Federal University of Minas Gerais (FAO UFMG), in Belo Horizonte-MG. Seventy children aged 4 to 8 years with at least one primary molar affected by occlusoproximal caries lesion were included. The initial clinical evaluation and post-treatment assessments were performed by an independent examiner trained and calibrated to assess the clinical aspect of the restorations using the World Dental Federation (FDI) criteria. Socioeconomic factors, factors related to oral health, factors related to the impacted tooth, presence of visible plaque and presence of other caries lesions were also evaluated. The randomization of the type of restoration occurred with the aid of sealed opaque envelopes that were opened immediately before the restorations were placed. The children and their guardians were followed up for twelve months with returns every six months for new evaluations. Descriptive analyses, chisquare test, Kaplan-Meier survival analysis and univariate and multivariate Cox regression were performed. Results: The survival of the restorations at 12 months of follow-up was 82.9% for GRC and 80.0% for RMGIC. To date, the type of restorative material did not impact the longevity of the restorations (p=0.836). The presence of dental plaque was the main factor associated with reduced longevity of restorations (p<0.001). The most frequent failures for GRC restorations were in the fracture/retention criterion, and, in the RMGIC group, in the fracture/retention and marginal adaptation criteria. Conclusion: GRC was not inferior to RMGIC in occlusoproximal restorations in primary molars in one-year follow-up. The presence of dental plaque in the follow-up periods was the main risk factor for restoration failure.