COMPARISON OF CLINICAL SUCCESS RATE BETWEEN GIOMER RESIN COMPOSITE AND RESIN-MODIFIED GLASS IONOMER CEMENT RESTORATIONS IN PRIMARY MOLARS: A RANDOMIZED CLINICAL TRIAL

[Audio] Good afternoon everyone. My name is Valeria. Today I going to present my doctoral project entitled: COMPARISON OF CLINICAL SUCCESS RATE BETWEEN GIOMER RESIN COMPOSITE AND RESIN-MODIFIED GLASS IONOMER CEMENT RESTORATIONS IN PRIMARY MOLARS: A RANDOMIZED CLINICAL TRIAL.

[Audio] It seems complicated...but don't worry.We will explain!.

[Audio] When there is a cavity caused by decay in the baby tooth or primary tooth, it needs to be restored..

[Audio] In other words, a material must be placed on the cavity so the tooth can recover his function..

[Audio] Restorations in primary teeth are very common procedures in pediatric practice, there are different types of direct restorative materials recommended for these teeth such as glass ionomer cement, resin composite , amalgam and stainless steel crown ( CORRÊA-FARIA et al., 2020). Despite this variety, the failure rate of restorations in primary teeth is high and regardless of the type of material..

[Audio] A high failure rate is associated to restorations that span multiple tooth surfaces at the same time. And the presence of secondary caries is the main reason for the failure of restorations in primary teeth..

[Audio] Therefore, the ideal restorative material should: adhere well to the tooth and prevent secondary caries.

[Audio] With that in mind, Giomer composite resin was developed. It is a restorative material made with a new bioactive technology..

[Audio] This filler has an anti-plaque action, is able to release and recharge fluorine and 5 other important ions, but his functional aesthetic properties remain preserved..

[Audio] This technology called Giomer, are microparticles of glass inside a permeable resin matrix and a pre-activated layer of ions that can be released to the tooth surface and also incorporated into the particle in mouth environment ( KOOI et al., 2012)..

[Audio] In addition to the fluoride that contributes to remineralization, the structure has other 5 ions, such as aluminum is capable of controlling sensitivity, boron which prevents bacterial adhesion and silicate which also helps in tooth remineralization..

[Audio] Since the registration of its patent in 2003, there have been many laboratory studies on giomer resin composite, but only two studies have evaluated the clinical performance of Giomer restorations in primary teeth. The two studies compared Giomer with other materials, such as composite resin and glass ionomer cement. The first one found no significant difference after 24 months of follow-up. And the second verified superiority of Giomer after 12 months of follow-up..

[Audio] The Giomer composite unites properties of glass ionomer cement and composite resin, making it an interesting material for use in pediatric dentistry. It is expected that the chances of restoration failure due to material characteristics or secondary caries lesions will decrease with the use of Giomer. Despite the importance of previously published studies, they have limitations related to the description of the randomization process and control of confounding factors. So, more clinicalstudies with strong desings are needed..

[Audio] Thus, the general objective of this study will be to evaluate the clinical success rates of restorations made with Giomer and compare them with glass ionomer cement restorations in occlusal-proximal cavities of primary molars multifaced cavities..

[Audio] This study will be conducted at the Pediatric Dentistry clinic at UFMG This is a split-mouth randomized clinical trial, single blind, which will be conducted according to Consort guidelines, the registration of this study will be done in clinicaltrials..

[Audio] Children from 4 to 8 years of age, with at least two primary molars affected by multifaceted cavities and without toothache will be included in the study..

[Audio] The sample size calculation shows that 131 teeth in each group must be included. Since each child must have two teeth eligible for the procedures, the minimum number of children must be 131. These number was Increased of 20% of the sample to minimize the occurrence of losses, so a total of 160 teeth per group will be needed..

[Audio] The scientific team will consist of 3 members ( examiner, assistant and operator).The examiner will be responsible for the oral examination for the detection of caries in all patients and will carry out the initial clinical evaluation of the mouth and restorations in the follow-up periods. The assistant will shedule patients, record all the data. A trained operator will perform restorations for all teeth..

[Audio] Initially, children will be instructed to perform oral hygiene with a toothbrush, toothpaste and dental floss. Then, patients will be evaluated lying on the dental chair, following all current national biosafety standards and recommendations. An air jet will be used to dry the dental surfaces for the diagnosis of caries. The visual evaluation will be carried out under artificial illumination of the reflector. In addition,a radiographic exame will be performed to assess the depth of the caries lesion..

[Audio] After the oral examination, the children included will receive treatment on selected teeth. In all groups, local anesthesia with 2% lidocaine will be performed. After checking the effect of anesthesia, the tooth will be isolated with a rubber dam. Afterwards, the selective removal of decayed tissue will be performed..

[Audio] Subsequently, the tooth randomly selected to group 1 will be restored with giomer resin composite from shofu, following all the manufacturer's instructions..

[Audio] And the tooth ramdomly selected to group 2 will be restored with glass ionomer cement Vitremer from 3M, also following the manufacturer's instructions..

[Audio] In follow-ups children and their restorations will be reassessed in six, twelve, eightteen and twanty four months after the first assessment, Reminders will be carried out by the research team by phone calls, text messages or email. During the appointments all the steps of clinical evaluation will be repeated, to evaluate the restoration status..

Results. The clinical part of the study will be conducted during 2022 and 2023. The final results will be presented in the first semester of 2024..

[Audio] Thank you very much for your attention!We are available to answer possible questions..