Use of glass-ionomer cement as a restorative material : an umbrella review

The aim of this study was to evaluate, through an umbrella review, whether primary and permanent teeth can be definitively restored with glass ionomer cements. A systematic search of the studies available in the literature was conducted in the electronic databases MEDLINE/Pubmed, Scopus and Web of Science. Two independent, calibrated examiners. The eligibility criteria were: (1) to be a systematic review (2) to evaluate the clinical longevity of glass ionomer cements (GICs) in primary and permanent teeth (3) to be clinical trials. The systematic reviews that met these criteria were reviewed in their entirety and those who presented at least one of the following exclusion criteria were then considered ineligible: (1) not being a systematic review of clinical trials; (2) not evaluating the longevity/clinical performance of GICs; (3) studies of dental restorative materials in teeth with enamel alterations. Methodological quality was measured using the AMSTAR-2 tool and the risk of bias of the included systematic reviews by the ROBIS tool. The level of evidence analysis was performed using the GRADE tool. Twenty-four eligible articles were identified, only 13 articles were included. Glass ionomer cements seems to be a viable choice in both dentitions, but primary dentition presents more evidence, especially regarding the ART technique. There is conflicting evidence on which type of glass ionomer is the best and comparisons to other dental materials are lacking. In conclusion, more high-quality studies are needed with longer follow up periods (>6 years), especially in permanent teeth