Poor evidence regarding whether to use resin-modified glass ionomer or calcium hydroxide cements in deep cavities

anatomy of teeth

This new critical summary from the ADA-Center for Evidence Based Dentistry looks at a 2010 review from Mickenautsch et al. The aim of that review was to compare the pulpal responses to resin-modified glass ionomer cement (RM-GIC) and calcium hydroxide when placed in deep cavities.

The review only included six trials (one randomized and five non-randomized) evaluating 923 permanent and 27 primary teeth. The appraiser noted that randomized and non-randomized trials, primary and permanent teeth, and carious and non-carious teeth were combined into a meta-analysis.

Overall then, the original review was only able to find a small number of low quality studies addressing the question. This means that until more definitive evidence is available clinicians may consider both materials when restoring deep lesions.


ADA- EBD Summary Resin modified glass ionomer cement may promote a similar pulp response to calcium hydroxide under deep cavities

Mickenautsch S, Yengopal V, Banerjee A. Pulp response to resin-modified glass ionomer and calcium hydroxide cements in deep cavities: A quantitative systematic review. Dent Mater. 2010 Aug; 26(8): 761-70. Epub 2010 May 7. Review. PubMed PMID:  20452013.





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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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