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ORIGINAL ARTICLE
Year : 2019  |  Volume : 12  |  Issue : 3  |  Page : 233-236

Comparative evaluation of retention and antibacterial efficacy of Compomer and Glass Hybrid Bulk Fill restorative material as a conservative adhesive restoration in children with mixed dentition: An in vivo study


1 KLE Academy of Higher Education and Research (KAHER), KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
2 Department of Pedodontics and Preventive Dentistry, KLE VK Institute of Dental Sciences, KAHER, Belagavi, Karnataka, India
3 Department of Oral Pathology and Microbiology, KLE VK Institute of Dental Sciences, KAHER, Belagavi, Karnataka, India

Date of Web Publication15-Oct-2019

Correspondence Address:
Dr. Shivayogi M Hugar
Department of Pedodontics and Preventive Dentistry, K.L.E.S Academy of Higher Education and Research (KAHER)'s KLE VK Institute of Dental Sciences, Nehru Nagar, Belagavi - 590 010, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kleuhsj.kleuhsj_244_18

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  Abstract 


AIM: The aim of the study is to compare and evaluate the retention and antibacterial efficacy of Compomer and Glass Hybrid Bulk Fill restorative material as a conservative adhesive restoration in children with mixed dentition.
MATERIALS AND METHODS: Sixty children of age 6–12 years with mixed dentition were selected and divided into Group I – Compomer and Group II – Glass Hybrid Bulk Fill. After thorough oral prophylaxis and baseline collection of saliva, restorative treatment was carried out using the two materials. Retention of the material and salivary Streptococcus mutans count (CFU/ml of saliva) was estimated at 1 month and 3 months after restorative procedure.
RESULTS: The retention rate with Glass Hybrid Bulk Fill group and Compomer group was 100%. Statistical significant reduction in salivary S. mutans colony count was seen with both the groups at both different time intervals. Maximum reduction was noted in Glass Hybrid Bulk Fill group at 3-month intervals, and gradual reduction was seen with Compomer group.
CONCLUSION: Both the materials, Glass Hybrid Bulk Fill restorative material and Compomer, showed good retention. Moreover, both the materials have shown good antimicrobial activity after 3-month follow-up.

Keywords: Children, retention, saliva, Streptococcus mutans


How to cite this article:
Mundada MV, Hugar SM, Hallikerimath S, Badkar CM, Davalbhakta R, Soneta SP. Comparative evaluation of retention and antibacterial efficacy of Compomer and Glass Hybrid Bulk Fill restorative material as a conservative adhesive restoration in children with mixed dentition: An in vivo study. Indian J Health Sci Biomed Res 2019;12:233-6

How to cite this URL:
Mundada MV, Hugar SM, Hallikerimath S, Badkar CM, Davalbhakta R, Soneta SP. Comparative evaluation of retention and antibacterial efficacy of Compomer and Glass Hybrid Bulk Fill restorative material as a conservative adhesive restoration in children with mixed dentition: An in vivo study. Indian J Health Sci Biomed Res [serial online] 2019 [cited 2019 Nov 19];12:233-6. Available from: http://www.ijournalhs.org/text.asp?2019/12/3/233/269200




  Introduction Top


The practice of dentistry for children is an integral component of children's health care.[1] Various biomimetic materials are being used these days. Recently, a Glass Hybrid Bulk Fill restorative material (a modification of GIC restorative material) has been introduced. EQUIA ® Forte Fil is a fast-setting, esthetic restorative material with an increase in physical properties, achieved through the introduction of novel glass hybrid technology.[2]

Studies have shown a correlation between salivary levels of mutans streptococci and restoration longevity.[3] As there are no studies carried out in children in Indian scenario to evaluate and compare clinical properties of Compomer and Glass Hybrid Bulk Fill restorative material for its use as conservative adhesive restoration, and also, its correlation with Streptococcus mutans, an attempt was made to evaluate the retention and antibacterial efficacy of Compomer and Glass Hybrid Bulk Fill restorative material.


  Materials and Methods Top


The study was conducted in the Department of Pedodontics and Preventive Dentistry with the assistance from the Department of Oral Pathology and Microbiology, KLE Academy of Higher Education and Research, KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India. Ethical clearance for the study was obtained from the Institutional Review Board of the KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India.

Based on the previous study where the confidence level is 85%, the probability is 0.05.[4] Thus, the sample size derived was 26 in each group. Considering the 15% dropout, the sample size chosen was 30 in each group.

Hence, a total of 60 sample size was selected and divided into two study groups of 30 each.

Participants for the study were selected according to the following inclusion criteria, i.e., children with mixed dentition, maxillary, or mandibular first permanent molars with occlusal caries (Class I) involving enamel or dentin (Type 1 or Type 2 conservative adhesive restoration) and children having 2–3 decayed teeth. The exclusion criteria were any proximal carious lesion, special child, and if patient was on any medication.

All the 60 samples of the study group were equally divided into two equal groups.

  • GROUP I (Compomer group): (Twinky Star ®, VOCO GmbH, Germany)
  • GROUP II (Glass Hybrid Bulk Fill group): (EQUIA ® Forte GC, Europe).


A case history was recorded in a special format prepared for this study.[5] The findings were recorded, and preoperative intraoral photographs and intraoral periapical radiographs were taken. Oral prophylaxis was done, and saliva sample was collected to assess the baseline S. mutans count and necessary treatment was given. All the procedures of patient selection, saliva collection, restoration, and postoperative assessment were carried out by a single investigator to avoid any bias.

The saliva was collected between 9 and 11 am.[6] Collection of the sample was carried out by suction method using sterile disposable syringes.[7] Saliva was collected for microbiological assessment of S. mutans count on four occasions: baseline, 1 month and 3 months.

The teeth selected for the study were isolated using rubber dam, and fluoride-free pumice prophylaxis was carried out on the concerned tooth. The tooth preparation for Class I cavity was carried out to receive the restorations using high-speed round diamond points according to minimally invasive dentistry principles.

The immediate postoperative evaluation of all the restorations was done and recorded in a master chart. Patients were given postoperative instructions of not to drink or take water for 30 min and soft diet for the next 24 h. Patients were asked to come for follow-up at 1 and 3 months. Restorations were evaluated for checking retention of the restoration as per the United States Public Health Service (USPHS) Ryge criteria.[8]

Statistical analysis

The results were tabulated and entered on the excel sheet. Then, the results were subjected to the following statistical tests using IBM SPSS software (version 20.0 Chicago IL, USA).

  • Descriptive analysis was carried out to evaluate retention of restorative material in both the groups at 1-month and 3-month intervals, respectively
  • Chi-square test was used for comparison of qualitative data between two groups
  • Independent t-test for intergroup comparison of S. mutans colony count at baseline, 1 month and 3 months
  • Dependent t-test for comparison of time points in two groups with respect to mean S. mutans colony count at baseline, 1 month, and 3 months.



  Results Top


A total of 60 restorations were evaluated at 3 months recall. The difference between the percentages of retention of restorative material in both the groups was not statistically significant [Table 1].
Table 1: The comparison of retention of the restorative material in Compomer group (Group I) and Glass Hybrid Bulk Fill restorative material (Group II)

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In accordance with the antibacterial property in Compomer group [Group I], gradual reduction occurred in mean S. mutans CFU/ml of saliva from 1298.67 × 105 CFU/ml of saliva to 810.00 × 105 CFU/ml of saliva at 1 month and 655.00 × 105 CFU/ml of saliva at 3 months [Table 2].
Table 2: The difference between the mean Streptococcus mutans colony forming units/ml of saliva (×105 colony forming units/ml) in two groups, namely Compomer group (Group I) and Glass Hybrid Bulk Fill group (Group II) at baseline, 1 month and 3-month time points using independent t-test

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Glass hybrid group showed drastic reduction in mean S. mutans CFU/ml of saliva from 1401.67 (±213.14) at baseline to 644.17 (±230.60) at 1 month and 190.00 (±84.60) at 3 months.


  Discussion Top


Dr. G. V. Black, the father of modern dentistry, invented the rules for dentistry in the late 1800s. The foremost of his rules was the concept of “Extension for Prevention,” i.e., remove the possibility of further decay on the surface of the tooth already afflicted with caries. Hence, this involved removal of a substantial amount of tooth structure, more than the actual decay. Hence, a lot of healthy tooth was destroyed in the process.[9]

Prevention of dental caries and minimal intervention dentistry plays a vital role in pediatric dental practice.[10] Hence, with the approach of minimally invasive dentistry, dental caries is treated as an infectious condition rather than an end product of it and therefore now, no longer radical “Extension for Prevention” is practiced but has changed to “Constriction with Conviction.”[9]

The present study compared the retention and antibacterial efficacy of Compomer and Glass Hybrid Bulk Fill restorative material for retention and its antibacterial property using microbiological method under randomized clinical trial setting. Children with mixed dentition were included in the study with a mean age of 10.82 ± 1.05 years because at this age, they are highly susceptible to dental caries and are undergoing multiple permanent tooth eruption.

Various researchers have found that the most frequent variable in caries risk assessment models is one that describes past caries experience. Thus, in this trial, deft/DMFT 2–3 was considered as one of the inclusion criteria, indicating child at moderate-to-high caries risk.

Saliva and plaque can be used for the estimation of S. mutans count. Due to the ease of sampling and processing, saliva was used in the study. Unstimulated saliva was used as it has lower concentration of bicarbonate ions, thus reducing the bias due to the buffering action of saliva. In our study, suction method was used for collection of saliva from the floor of mouth using sterile disposable syringe to avoid any contamination and its ease of use.[6] Salivary flow rate shows a circadian rhythm, so for standardization salivary samples were taken between 9 am and 11 am to minimize the effect of circadian rhythm on the samples.[7]

In the present study first permanent teeth were used because it being the first permanent tooth to erupt in the oral cavity, it is the one which is most commonly affected with dental caries.[11] The present study used the USPHS criteria for clinical evaluation of the restorations.

The use of attractive and glittering colors attracts the attention of children and results in their collaboration during dental treatment. Furthermore, the choice of different colors by children has a good effect on their fear and impatience, and they would willingly maintain oral hygiene. In our study, very good results have been found with the use of colored compomer material with respect to retention.[12]

Recent advances in resin-based restorative materials resulted in the development of bulk fill composite to overcome the need for incremental layering. It speeds up the restoration process by complete restoration of the cavity in a single step. The impressive esthetics widen the posterior restorative options to fulfill patients' expectations. Based on the EQUIA system, clinically proven over several years, Glass Hybrid Bulk Fill offers a great alternative for routine use. This was in accordance with a study done by Grossi et al. in which Glass Hybrid Bulk Fill showed promising results.[13]

When intergroup comparison was done between the two groups, it was observed that in glass hybrid, there was reduction of S. mutans level at 1 and 3 months and maximum at 3 months and the reduction in Compomer group was gradual, and hence, the antimicrobial property was maintained at 3 months. This shows that both the materials have antibacterial effectiveness, and this was highly significant in Glass Hybrid Bulk Fill group at 3-month interval compared to Compomer group having maintained antibacterial effectiveness. Glass Hybrid Bulk Fill group and Compomer group have shown better retention at 3-month interval, with complete retention of 100% indicating good retention property.

From the result mentioned above, it can be seen that in the intragroup analysis, there was marked reduction in S. mutans colony count at 3-month interval compared to baseline. This shows that the antimicrobial property of this material showed greatest effect at 3 months.

Even though our study showed that Glass Hybrid Bulk Fill restoration was better than compomer restoration at 1 and 3 months, there are some of the limitations of our study, which include smaller sample size and short follow-up period, and to justify its use a larger sample size and long follow-up should be carried out.

In future, it will be interesting to obtain corresponding data with the relationship between mutans streptococci and the success of different minimal intervention techniques in larger population.

In our country, majority of people reside in the rural part of India. Since the advent of caries starts from early age, the school children need to be targeted.


  Conclusion Top


Both the materials, Glass Hybrid Bulk Fill restorative material and Compomer, showed good retention, and it was not statistically significant. Moreover, both the materials have shown good antimicrobial activity after 3-month follow-up.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mohan Das U, Viswanath D, Azher U. Clinical evaluation of resin composite and resin modified glass ionomer in class III restorations of primary maxillary incisors: A comparative in vivo study. Int J Clin Pediatr Dent 2009;2:13-9.  Back to cited text no. 1
    
2.
GC Europe. Introducing the Restorative Innovation of Glass Hybrid Technology: A Comprehensive Guide to Technology (manual). GC Europe; 2011.  Back to cited text no. 2
    
3.
Bentley CD, Broderius CA, Drake CW, Crawford JJ. Relationship between salivary levels of mutans streptococci and restoration longevity. Caries Res 1990;24:298-300.  Back to cited text no. 3
    
4.
Viechtbauer W, Smits L, Kotz D, Budé L, Spigt M, Serroyen J, et al. A simple formula for the calculation of sample size in pilot studies. J Clin Epidemiol 2015;68:1375-9.  Back to cited text no. 4
    
5.
World Health Organization. Oral Health Surveys: Basic Methods. 4th ed. Geneva: World Health organization; 1997.  Back to cited text no. 5
    
6.
Navazesh M. Methods for collecting saliva. Ann N Y Acad Sci 1993;694:72-7.  Back to cited text no. 6
    
7.
Dawes C. Circadian rhythms in human salivary flow rate and composition. J Physiol 1972;220:529-45.  Back to cited text no. 7
    
8.
Bayne SC, Schmalz G. Reprinting the classic article on USPHS evaluation methods for measuring the clinical research performance of restorative materials. Clin Oral Investig 2005;9:209-14.  Back to cited text no. 8
    
9.
Jingarwar MM, Bajwa NK, Pathak A. Minimal intervention dentistry – A new frontier in clinical dentistry. J Clin Diagn Res 2014;8:ZE04-8.  Back to cited text no. 9
    
10.
Gujjar KR, Sumra N. Minimally invasive dentistry – A review. Int J Clin Prev Dent 2013;9:109-20.  Back to cited text no. 10
    
11.
Ebrahimi M, Ajami BA, Sarraf Shirazi AR, Afzal Aghaee M, Rashidi S. Dental treatment needs of permanent first molars in Mashhad schoolchildren. J Dent Res Dent Clin Dent Prospects 2010;4:52-5.  Back to cited text no. 11
    
12.
Khodadadi E, Khafri S, Aziznezhad M. Comparison of surface hardness of various shades of twinky star colored compomer light-cured with QTH and LED units. Electron Physician 2016;8:2355-60.  Back to cited text no. 12
    
13.
Grossi JA, Cabral RN, Ribeiro AP, Leal SC. Glass hybrid restorations as an alternative for restoring hypomineralized molars in the ART model. BMC Oral Health 2018;18:65.  Back to cited text no. 13
    



 
 
    Tables

  [Table 1], [Table 2]



 

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