Features and benefits of glass ionomer materials in restorative dentistry: operational possibilities in patients with autism spectrum disorder

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.