There was an overall success rate of 93% (for 864
restorations) over a minimum period of 3 years of
restored primary teeth with a modified glassionomer
cement.
ANALYSIS
This article, which is both socially and clinically
relevant, cites the surgeon general’s recent report
on oral health, noting the “tremendous ongoing
need for pediatric dental care.”
The strength of this retrospective study is that the
procedure was performed by a single clinician
using one specific material over a minimum of 3
years in a relatively homogeneous population. In
the past, many studies with glass-ionomer cements
and related materials have been measured in
months. This 3-year period is probably adequate in
the pedodontic population, although it would have
been meaningful to state how many of the restorations
were lost to exfoliation versus secondary
caries/attrition.
Since only those patients who had at least 3 years
of follow-up were selected, the true failure rates are
not known. Possibly those patients in whom the
restorations failed moved to other practices. Ideally,
in studies that evaluate prognosis, a defined representative
sample of patients assembled at the time
the filling was placed should be included in the
study. The post hoc selection of only those patients
remaining in the practice leads to a convenience
sample.
Whether the clinician was aware, before
performing the procedures, that his patients
would be the subject of this retrospective study
was not made clear. If he did know, why did he
change the protocol with regard to the
liquid/powder ratio and the discontinued use of
sealant application—especially if he had been calibrated
(vs Public Health Service Methodology)? If
he did not know, was he calibrated prior to the
retrospective study?
As a last point, it would have been a more useful
study had the use of amalgam, the traditional
benchmark, been used as a control. Nevertheless,
this article does provide meaningful evidence for
the routine use of related materials cements as an
effective restorative material in children.
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