• Ayesha Sabeen Mufti


Background: Dental caries is the most prevalent communicable disease in the world amongst the population of the children. Objective: To compare the outcome of restorations in primary molars using two Glass ionomer cements Ketac-Molar, a Glass ionomer cement (GIC) and Vitremer, a Resin modified glass ionomer cement (RMGIC) in small and medium sized cavities. Methodology: A randomized controlled trial was conducted on 27 children between ages 4–9 years who had bilateral matched pair of carious lesions in primary posterior teeth. A split mouth design was used in which two materials, Ketac Molar and Vitremer, were placed on contralateral sides of the oral cavity in the same patient. The aim was to compare clinical performance of these restorations after 6 months using United States Public Health Service (USPHS) criteria. Data were collected six months after restoration using USPHS criteria. Statistical analysis was conducted using SPSS-16. Categorical variables were described as frequencies, and percentages. Chi-square test was used to compare the frequencies between groups keeping statistical significance at p≤0.05. Results: Based on the USPHS criteria, after six months the results of Ketac Molar and Vitemer were comparable, except for sensitivity where RMGIC performed significantly better (p=0.040). Though not significantly different, GIC performed better in 2/10 variables namely marginal discoloration and surface staining. RMGIC did better in 4/10 variables namely marginal integrity, retention, secondary caries and sensitivity. Both cements performed almost equally well in 4/10 variables, i.e., colour match, anatomic form, surface texture and proximal contact. Conclusion: Overall the clinical performance of Vitremer was better than Ketac molar and is to be considered as a preferable material for restoration of primary molars. More studies are recommended to confirm the results of the present study.Keywords: Dental caries, Restoration, Ketac Molar (Glass Ionomer Cement), Vitremer (Resin Modified Glass Ionomer Cement), USPHS criteria


Maher R. Dental disorders in Pakistan-a national pathfinder study. J Pak Med Assoc 1991;41(10):250–2.

Lo EC, Luo Y, Fan MW, Wei SH. Clinical investigation of two glass-ionomer restoratives used with the atraumatic restorative treatment approach in China: two-years results. Caries Res 2001;35(6):458–63.

Blinkhorn AS, Davies RM. Caries prevention. A continued need worldwide. Int Dent J 1996;46(3):119–25.

Kemoli AM, van Amerongen WE. Influence of the cavity-size on the survival rate of proximal ART restorations in primary molars. Int J Paediatr Dent 2009;19(6):423–30.

Taifour D, Frencken JE, Beiruti N, van 't Hof MA, Truin GJ. Effectiveness of glass-ionomer (ART) and amalgam restorations in the deciduous dentition: results after 3 years. Caries Res 2002;36(6):437–44.

Ali S, Bhatto MUD, Syed A, Arooj HC, Iqbal Z. Prevalence of school caries among poor locality school children of Lahore. Pak Oral Dent J 2012;32(2):279–82.

Kemoli AM, van Amerongen WE, Opinya GN. Short communication: Influence of different isolation methods on the survival of proximal ART restorations in primary molars after two years. Eur Arch Paediatr Dent 2010;11(3):136–9.

Daou MH, Tavernier B, Meyer JM. Clinical evaluation of four different dental restorative materials: one-year results. Schweiz Monatsschr Zahnmed 2008;118(4):290–5.

Ercan E, Dulgergil CT, Soyman M, Dalli M, Yildirim I. A field-trial of two restorative materials used with atraumatic restorative treatment in rural Turkey: 24-month results. J Appl Oral Sci 2009;17(4):307–14.

Anusavice KJ. Does ART have a place in preservative dentistry? Community Dent Oral Epidemiol 1999;27(6):442–8.

Gao W, Peng D, Smales RJ, Yip KH. Comparison of atraumatic restorative treatment and conventional restorative procedures in a hospital clinic: evaluation after 30 months. Quintessence Int 2003;34(1):31–7.

Honkala E, Behbehani J, Ibricevic H, Kerosuo E, Al-Jame G. The atraumatic restorative treatment (ART) approach to restoring primary teeth in a standard dental clinic. Int J Paediatr Dent 2003;13(3):172–9.

Yu C, Gao XJ, Deng DM, Yip HK, Smales RJ. Survival of glass ionomer restorations placed in primary molars using atraumatic restorative treatment (ART) and conventional cavity preparations: 2-year results. Int Dent J 2004;54(1):42–6.

Ismail AI. Reactor paper: minimal intervention techniques for dental caries. J Public Health Dent 1996;56(3 Spec No):155–60.

Hubel S, Mejare I. Conventional versus resin-modified glass-ionomer cement for Class II restorations in primary molars. A 3-year clinical study. Int J Paediatr Dent 2003;13(1):2–8.