Ricerc@Sapienza

BACKGROUND: Glass ionomers are materials formed by a
polymer matrix cross-linked with ionic bonds to which glass
reinforcing particles are incorporated. Currently they are
widely used in dentistry, available with different consistencies
and viscosities that differ depending on the use, ranging
from conservative, prosthetic and orthodontics. They have
good adhesion to dental structures and a compression resistance
very similar to dentin. They constitute a layer of elastic
material able to dissipate the mechanical and thermal stresses
to which they are subjected. The aim of the present study was
to evaluate the operational possibilities of these materials and
specifically the importance that these materials play in the
treatment of caries pathology in patients with autism spectrum
disorder syndrome
METHODS: The methods used for this work were a search
for articles in English and Italian, published on PubMed from
1990 to 2016, using the following keywords: “Glass Ionomer
Cements”, “Dental Restoration Repair”, “Dental Restoration
Failure”, “Dental Restoration, Temporary”, “Dental
Restoration, Permanent”. In addition to literature we also
relied on the clinic, evaluating qualitatively and quantitatively
restorations of carious cavities with glass ionomer material
carried out in the La Sapienza dental clinic in Rome. In 2013,
a pilot study was developed at the Unit Operative Complex
(UOC) of Pedodontics of the Policlinico Umberto I of Rome
with the aim of creating an innovative model of approach to
improve the oral conditions of patients Special needs. For the
study, 151 subjects with special needs between the ages of 4
and 40 were enrolled. The subjects examined already had at
the age of 2/3 years “serious” cognitive-behavioral deficits,
with problematic relational modalities and verbal difficulties
Of the 151 patients included in the study, 31% needed conservative
treatments, for a total of 141 restorative dentistry
services, performed in the lateral sectors and therefore divided
mainly into first and second class reconstructions, according
to the principles of Minimal invasion. 20% of the sample was
instead subjected to groove sealing, for a total of 120 seals.
The success criteria adopted for the evaluation of the study
were: a success code (1) when the restoration is entirely present
in the prepared cavity and three failure codes: (2) when
the reconstruction is partially present, (3) when the reconstruction
is absent and (4) when the reconstruction is absent and a
carious lesion has developed again in the bottom of the cavity
that we had previously cleaned and prepared.
RESULT S: Of the 141 restorations and 120 sealings performed,
after a follow-up at 6, 12 and 24 months the results
obtained were different. With regard to the 141 first and
second class restorations, these have provided the following
results: 88% Code 1 (125), 9% Code 2 (13), 1.3% Code 3
(2), 0.7% Code 4 (1). Of the 120 sealings performed were:
72.5% Code 1 (87), 19% Code 2 (23), 8.5% Code 3 (10), 0%
Code 4 (0).CONCLUSION S: The conclusions drawn from this work lead
us to consider glass ionomers as materials of choice in the
treatment and prevention of caries in subjects with special and
non-collaborative needs, in which the use of composite resins
is hindered by the impossibility of isolating the field operation
with the rubber dam for obvious compliance problems, a factor
that limits the use of the composite and does not guarantee
optimal adhesion to dental tissues, favoring detachment and
possible recurrence of caries.