Gingival Reactions Around and Plaque Formation on Resin Composites and Glass-Ionomer Cements

Abstract

This review covers plaque growth on and gingival reactions adjacent to composite resin and glass-ionomer cement restorations. Despite large variations in surface roughness and chemical composition of the restoratives, no clinically measurable differences in the presence or development of plaque and gingivitis were seen. However, more pronounced signs of subclinical gingivitis adjacent to resin composites, compared with non-filled surfaces, were shown by an increase of crevicular fluid levels. This can be explained by the chemical composition of the composites and/or by clinical, not visible, small amounts of dental plaque, which increase the rate of recolonization on these surfaces. The faster recolonization can imply a higher risk for periodontal disease in susceptible patients, especially when resin composites are used more frequently in the more-difficult-to-clean posterior cavities. The effect of fluoride leaching of glass-ionomer cement on the growth of cariogenic micro-organisms is reviewed. Initially, with the still-high fluoride leaching, a lower frequency of mutans streptococci was seen on glass ionomer and glass ionomer cermet cements, compared with amalgam, resin composites, or enamel. After longer periods, this difference disappeared, explained by a too-low level of fluoride leaching from the cement, which had no effect on the micro-organisms. Contrasting results were found for the cermet restorations, where the antibacterial effects of silver ions also can contribute to the inhibition of growth.