February - 2011

Glass ionomer cement may be used for clinical management of incipient inter-proximal caries lesions

• Split-mouth study of 41 pairs of permanent posterior teeth in 26 children, 7 to 19 years of age, and residing in an area with less than 0.3 ppm fluoride in drinking water.  Inter-proximal lesions were in the outer-half or inner-half of the enamel at enrollment.  Experimental teeth received elastic separator for two days to allow access to lesion.  Carious surface was cleaned with dental floss and rinsed with water prior to application.  Dentin conditioner was applied to caries lesion for 20 seconds and then rinsed and dried.  Glass ionomer cement was mixed (one drop of liquid for one spoon of powder) and placed on a metal matrix which was then slid through the inter-proximal area and then light-cured for 40 seconds.  A small sponge was then used for application of varnish to the GIC after it set. 
• All participants received 1.23% acidulated phosphate fluoride gel application at baseline and at six-month recall and also twice-daily fluoride dentifrice treatment.  Standardized bitewing radiographs were taken at baseline, 6 months, and 12 months.  Radiographs were digitized for analysis of proximal caries lesions by a blinded investigator.  It was noted that “due to its thinness, the GIC layer was not observable radiographically.” 
• The authors reported that “the depths and severity of lesions in the test and control groups were evenly matched at baseline.”  There were significant differences in mean lesion depth between the control and experimental groups at the 6 and 12 month follow-up.  Percent reduction in lesion depth was 14% for the experimental group and 2% for the control group with lesions treated with GIC “more likely to remain in or regress to the outer half of enamel.”  The authors concluded that “GIC provides an effective approach to the clinical management of incipient proximal caries.” 

        (J Dent Res 2011; 90:99-103)