Evidence-based assessment of tooth-colored restorations in proximal lesions of primary molars.

UNLABELLED The purpose of this study was, using evidence-based dentistry, to compare the successes of glass ionomer cement (GIC), resin-modified GIC (RmGIC), composite resin (CR), and polyacid-modified composite resin (PAMCR) in primary molar proximal lesions. METHODS The PICOT question was: P: in primary molar proximal lesions; I: does the use of 1 material (GIC, RmGIC, CR, or PAMCR); C: compared with the remaining materials; O (Outcome): result in higher success rates; T: when followed for at least 1 year? Relevant articles (256) were identified from databases then sieved by titles, abstracts, and full texts. Following exclusions, 36 dinical trials-including 25 randomized clinical trials (RCTs)-remained. Extracted data were meta-analyzed. RESULTS GIC restorations had a significantly (P<.05) lower likelihood of success than RmGIC and CR restorations. Overall success rates were: (1) GIC (691 restorations)=75%; (2) RmGIC (276)=89%; (3) CR (620)=83%; (4) PAMCR (596)=87%. Mean success rates did not differ significantly (P>.05): (1) GIC (6 studies)=65+/-34%; (2) RmGIC (3 studies)=93+/-7%; (3) CR (7 studies)=85+/-12%; and (4) PAMCR (8 studies)=90+/-10%. CONCLUSIONS Few articles were available to determine the best material. Recognizing material improvements since 1990, earlier data may be noncomparable. RmGIC had the highest success rates, but fewest studies and fewest restorations; only one product was assessable. Prospective RCTs should be of at least 5 years' duration to determine correctly the success rate of Class II restorations in primary molars.