International journal of clinical pediatric dentistry · 2025
Comparison of Success of Glass Ionomer Cements with Calcium Hydroxide and Tricalcium Silicate Cements in Indirect Pulp Treatments of Molars in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
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Neelkanthan Shreyas, Jawdekar Ashwin M, Mistry Laresh N
Аннотация
BACKGROUND: Biological materials such as glass ionomer cement (GIC), calcium hydroxide cement (Ca(OH)₂) and tricalcium silicate cement (TCS) have been effective in the indirect pulp treatment (IPT) of advanced carious lesions in molars. GIC has been in use for a long time as a biomimetic material with the added advantage of fluoride release for the treatment of the same.
OBJECTIVES: Our study compared the success of GIC vs Ca(OH)₂ and TCS in IPT of molars in primary and permanent teeth in 4-18-year-old children.
SEARCH: Two researchers, SN and AMJ, independently searched the literature using appropriate keyword combinations, and conflicts were resolved by a third author, LNM. The search was conducted using PubMed and extended to other search engines.
SELECTION CRITERIA: Randomized controlled trials (RCTs) (both split-mouth and parallel-arm), reported in or with full translations available in English, and a follow-up period of at least 6 months were included. Children aged 4-18 years with carious molars (primary and permanent) who had received IPTs with GIC and other cements were included.
DATA COLLECTION AND ANALYSIS: A data extraction sheet was prepared to include all details. The risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. Publication bias was assessed using funnel plot analysis. Meta-analysis were conducted using forest plots. The certainty of evidence was reported using the GRADE method. RevMan 5.4 software was used.
RESULTS: The success of GIC was compared with Ca(OH)₂ and TCS in IPT. Three studies were included in the meta-analysis; the pooled success of GIC vs Ca(OH)₂ [OR (95% CI)] 1.02 (0.29, 3.61) (p < 0.74). Two studies were included in the meta-analysis comparing GIC vs TCS; the pooled success [OR (95% CI)] 0.33 (0.03, 3.29). Results were statistically nonsignificant. Heterogeneity was low (I² = 0%); hence, the fixed-effects model (FEM) was used. The success of GIC IPT (from four studies) was [% (95% CI)] 96.09% (92.88, 98.13).
CONCLUSION: The overall success of GIC IPT was 96%. GIC was comparable to Ca(OH)₂ and TCS. The RoB was moderate, and publication bias was unascertained.
HOW TO CITE THIS ARTICLE: Neelkanthan S, Jawdekar AM, Mistry LN. Comparison of Success of Glass Ionomer Cements with Calcium Hydroxide and Tricalcium Silicate Cements in Indirect Pulp Treatments of Molars in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Int J Clin Pediatr Dent 2025;18(4):473-478.
OBJECTIVES: Our study compared the success of GIC vs Ca(OH)₂ and TCS in IPT of molars in primary and permanent teeth in 4-18-year-old children.
SEARCH: Two researchers, SN and AMJ, independently searched the literature using appropriate keyword combinations, and conflicts were resolved by a third author, LNM. The search was conducted using PubMed and extended to other search engines.
SELECTION CRITERIA: Randomized controlled trials (RCTs) (both split-mouth and parallel-arm), reported in or with full translations available in English, and a follow-up period of at least 6 months were included. Children aged 4-18 years with carious molars (primary and permanent) who had received IPTs with GIC and other cements were included.
DATA COLLECTION AND ANALYSIS: A data extraction sheet was prepared to include all details. The risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. Publication bias was assessed using funnel plot analysis. Meta-analysis were conducted using forest plots. The certainty of evidence was reported using the GRADE method. RevMan 5.4 software was used.
RESULTS: The success of GIC was compared with Ca(OH)₂ and TCS in IPT. Three studies were included in the meta-analysis; the pooled success of GIC vs Ca(OH)₂ [OR (95% CI)] 1.02 (0.29, 3.61) (p < 0.74). Two studies were included in the meta-analysis comparing GIC vs TCS; the pooled success [OR (95% CI)] 0.33 (0.03, 3.29). Results were statistically nonsignificant. Heterogeneity was low (I² = 0%); hence, the fixed-effects model (FEM) was used. The success of GIC IPT (from four studies) was [% (95% CI)] 96.09% (92.88, 98.13).
CONCLUSION: The overall success of GIC IPT was 96%. GIC was comparable to Ca(OH)₂ and TCS. The RoB was moderate, and publication bias was unascertained.
HOW TO CITE THIS ARTICLE: Neelkanthan S, Jawdekar AM, Mistry LN. Comparison of Success of Glass Ionomer Cements with Calcium Hydroxide and Tricalcium Silicate Cements in Indirect Pulp Treatments of Molars in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Int J Clin Pediatr Dent 2025;18(4):473-478.