OBJECTIVE:

To quantitatively determine whether the pulp response to resin-modified glass ionomer cements placed in deep cavities differs from that generated by calcium hydroxide cement.

SOURCES:

Five databases were searched for articles up to 31 May 2009.

STUDY SELECTION:

Inclusion criteria: titles/abstracts relevant to topic; published in English; two-arm longitudinal in vivo trial; containing computable dichotomous datasets for test and control group. Exclusion criteria: not all entered subjects accounted for at the end of the trial; subjects of both groups not followed up in the same way; trial on animal tissue.

DATA:

One randomized and five non-randomized control trials, reporting on 1 and 17 datasets, respectively, were accepted. From non-randomized trials, the Relative Risk with 95% Confidence Interval of 13 datasets showed no statistically significant differences (p>0.05) and 4 showed a statistically significant difference between both materials. Meta-analysis of datasets from these trials found no difference between the inflammatory cell response after 30 days (0.87; 95%CI 0.59-1.26; p=0.46); 38% less inflammatory cell response with calcium hydroxide after 60 days (0.62; 95%CI 0.50-0.76; p<0.00001); higher number of intact odontoblasts beneath restored cavities after 381 days (0.56; 95%CI 0.38-0.82; p=0.0008). The results from the randomized control trial (1.40; 95%CI 0.92-2.14; p=0.11) indicated no difference in clinically identifiable pulp symptoms after two years. All trials showed limited internal validity due to selection bias.

CONCLUSION:

No conclusive statement about the superiority of either type of material can yet be made. Further high-quality randomized control trials are needed.

Copyright 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.