48-month comperative evaluation of a novel glass ionomer cement and a resin composite in restoring non-carious cervical lesions of patients with systemic diseases: A randomized clinical trial

Objective: This randomized clinical trial evaluated the 48-month clinical performance of a glass ionomer cement (GIC) and a resin composite (RC) in restoring non-carious cervical lesions (NCCLs) in patients with systemic diseases. Methods: A single clinician placed 134 restorations in 30 patients with systemic diseases. The NCCLs were divided into two groups based on the restorative system used: a conventional restorative GIC, Fuji Bulk (GC, Tokyo Japan) [FB] and a posterior RC, G-ænial Posterior (GC, Tokyo Japan) [GP] along with a universal adhesive in etch & rinse mode. All procedures followed the manufacturer's guidelines. The restorations were evaluated for retention, marginal discoloration, marginal adaptation, secondary caries, surface texture and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria at baseline (1 week) and at 6, 12, 36 and 48 months. Chi-square and Dunn's tests were used for statistical analysis (p < 0.05). Results: At the 48-month mark, recall rate was 60 %. Seven FB (18.4 %) and 4 GP (13.3 %) restorations lost retention (p = 0.57). There was no significant difference between the survival rates of FB (82.1 %) and GP (89.3 %) (log rank= 0.305). When compared to baseline, significant changes were observed in marginal adaptation, marginal discoloration and surface texture after 48 months both for FB and GP (p < 0.05), without any significant difference between the groups at any evaluation periods (p > 0.05). Conclusion: After 48 months, both the restorative GIC and the RC demonstrated acceptable clinical performance in treating NCCLs of patients with systemic diseases. Clinical Significance: This study shows that a GIC demonstrated no significant differences in medium-term clinical performance compared to RC for restoring non-carious cervical lesions (NCCLs) in patients with systemic diseases. The results suggest that GIC may be a more cost-effective and less technique-sensitive alternative, offering potential benefits for patients with complex medical conditions or limited oral hygiene, where a simpler and more efficient restorative approach could enhance treatment outcomes.