Treatment of dentin with polyacrylic acid--a retrospective observational study of the effect upon the durability of glass ionomer restorations

This paper reports on the results of a material specific, retrospective observational study. It sought to determine the consequence of pretreatment of cavity margins with the conventional glass polyalkenoate Chemfil II prior to restoration with Tooth Cleanser on restoration durability. All restorations were placed and varnished by senior dental students under the supervision of a staff member. Manufacturer recommendations were followed. Data on each restoration was collected and entered into a relational computer database. Data included details of cavity morphology and the use or non-use of Tooth Cleanser. Six years following the study start a manual search of all records was carried out to determine, for those patients continuing to attend the Dental Hospital, the number of failed and surviving restorations. This yielded a dataset of 149 restorations, of which 41 had been placed with the aid of Tooth Cleanser and 108 without. The number of failed restorations was 20 and 62, respectively. Survival analysis by the Kaplan-Meier method revealed median survival times of 2,094 days, when Tooth Cleanser was used and 1,748 days when not. Although 80% survival times of 1111.0 (SE = 6.3) (With Tooth Cleanser) and 285.0 (SE = 3.8) (Without Tooth Cleanser) days were observed, together with a Hazard Ratio of 1.49 (95% Confidence Intervals 0.92 & 2.31), a Logrank test revealed no statistically significant difference between the survival curves (p = 0.12). It was concluded that although there was a trend for the application of Tooth Cleanser to improve the chances of obtaining a dependable restoration, this effect was not statistically significant.