Clinical performance of a glass ionomer restorative system: a 6-year evaluation

Clin Oral Investig. 2017 Sep;21(7):2335-2343. doi: 10.1007/s00784-016-2028-4. Epub 2016 Dec 20.


Objectives: The aim of this study is to evaluate the long-term clinical performance of a glass ionomer (GI) restorative system in the restoration of posterior teeth compared with a micro-filled hybrid posterior composite.

Materials and methods: A total of 140 (80 Cl1 and 60 Cl2) lesions in 59 patients were restored with a GI system (Equia) or a micro hybrid composite (Gradia Direct). Restorations were evaluated at baseline and yearly during 6 years according to the modified-USPHS criteria. Negative replicas at each recall were observed under SEM to evaluate surface characteristics. Data were analyzed with Cohcran's Q and McNemar's tests (p < 0.05).

Results: One hundred fifteen (70 Cl1 and 45 Cl2) restorations were evaluated in 47 patients with a recall rate of 79.6% at 6 years. Significant differences were found in marginal adaptation and marginal discoloration for both restorative materials for Cl1 and Cl2 restorations (p < 0.05). However, none of the materials were superior to the other (p > 0.05). A significant decrease in color match was observed in Equia restorations (p < 0.05). Only one Cl2 Equia restoration was missing at 3 years and another one at 4 years. No failures were observed at 5 and 6 years. Both materials exhibited clinically successful performance after 6 years. SEM evaluations were in accordance with the clinical findings.

Conclusions: Both materials showed a good clinical performance for the restoration of posterior teeth during the 6-year evaluation.

Clinical relevance: The clinical effectiveness of Equia and Gradia Direct Posterior was acceptable in Cl1 and Cl2 cavities subsequent to 6-year evaluation.

Keywords: Clinical performance; Composite resin; Glass ionomer cement; Posterior teeth.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Color
  • Composite Resins / therapeutic use*
  • Dental Caries / therapy*
  • Dental Marginal Adaptation
  • Dental Materials / therapeutic use*
  • Dental Restoration Failure
  • Dental Restoration, Permanent / methods*
  • Female
  • Glass Ionomer Cements / therapeutic use*
  • Humans
  • Male
  • Microscopy, Electron, Scanning
  • Surface Properties


  • Composite Resins
  • Dental Materials
  • Glass Ionomer Cements
  • Gradia