Success and Longevity of Restorations in Primary Molars: Glass Ionomer Cement Compared to Composite

Background: In pediatric dentistry, durable restorations are essential, especially in primary molars for effective function and development. Glass Ionomer Cement (GIC) and composite resins are popular choices, each with unique properties and benefits. Aim: To compare the success and longevity of GIC and composite restorations in primary molars. Materials and Methods: This in vivo study, conducted at Saveetha Dental College, involved 144 children aged 4-8 years with Class I carious lesions. Participants received either GIC or composite restorations, evaluated at baseline, 6, and 12 months, using USPHS criteria for retention, marginal adaptation, surface integrity, wear, and secondary caries. Results: The results showed that GIC significantly outperformed composite in reducing marginal discoloration, improving marginal integrity, smoothing surface texture, minimizing wear, lowering sensitivity, and preventing recurrent caries (p < 0.001). Kaplan-Meier survival analysis indicated a 67.1% overall survival rate, with composites proving more durable in older children. Cox regression analysis revealed that composite restorations had higher survival rates, with 76.5% at age 6 and 77.8% at age 7, compared to GIC's 47.6% and 69.2% at these ages. This highlights composite's durability advantage in older children, while GIC’s fluoride release remains beneficial for caries prevention in younger patients. Conclusion: While GIC's fluoride release and simplicity make it advantageous for young children, composite restorations, despite being more technique-sensitive, offer greater longevity in older children. Tailoring restorative choices based on age and clinical needs may optimize outcomes.