Background
Encapsulated glass ionomer cement is a promising option for atraumatic restorative treatment due to its potential to minimize the operator factor. This study aimed to compare two encapsulated glass ionomer cements, Equia Forte (GC Corp) and Riva Self Cure (SDI), in terms of their survival rates and costs for restoring occluso-proximal cavities in primary molars. The study was conducted in the city of Tietê, Brazil, and followed up with children over a period of 24 months.
Methods
Children aged 4–8 years with occlusal-proximal dentin carious lesions in primary molars were randomly assigned to receive either Equia Forte (EF) or Riva Self Cure (RSC). The primary outcome was 24-month restoration survival, analyzed using Kaplan-Meier survival analysis, Cox regression, and intention-to-treat (ITT) analysis. Secondary outcomes included a 24-month restoration cost analysis using Monte-Carlo simulation. Treatment was performed by two trained final-year students in a school setting, and one trained and calibrated examiner evaluated the restorations after 2, 6, 12, 18, and 24 months.
Results
A total of 152 children (76 in EF group and 76 in RSC group) were included in the study, and 135 (88.8%) were followed up at 24 months. There was no significant difference in the primary outcome between the two groups, with an overall restoration survival rate of 39% (45% in EF and 32% in RSC). However, there was a significant difference in the estimated incremental cost between the two groups, with RSC being more cost-effective from the Brazilian perspective (EF cost: $25.48, RSC cost: $19.30, incremental cost: US$6.18).
Conclusion
After two years of follow-up, Riva Self Cure showed comparable restoration survival to Equia Forte, while being more cost-effective from the Brazilian perspective. Encapsulated glass ionomer cements are a viable option for atraumatic restorative treatment, and their cost-effectiveness should be considered when selecting a material for such treatments.
Trial Registration
This randomized clinical trial was registered on ClinicalTrials.Gov - NCT02730000 (06/04/2016)