Comparative Evaluation of the Mechanical Properties and Fluoride Release of Conventional Glass Ionomer Cement and Bulk-Fill Resin Composites in Permanent Posterior Restorations in a Pakistani Population.
Keywords:
Bulk-fill composite, glass ionomer cement, fluoride release, dental restorations, USPHS criteria, survival analysisAbstract
Background: Dental caries is still a significant oral health issue that requires long-lasting restorative materials with good clinical outcomes and preventive advantages. For posterior restorations, bulk-fill resin composites and glass ionomer cement (GIC) are frequently utilized, each with unique benefits.
Objective: Over the course of a 24-month follow-up period, assess the clinical performance, fluoride release characteristics, and survival outcomes of GIC and bulk-fill composite restorations in posterior teeth.
Materials and Methods: A comparative clinical trial was conducted in two groups (n=66) on 66 posterior restorations that were allocated equally to the GIC and bulk-fill composite group (n=33 each). Restorations were also evaluated in terms of marginal integrity, surface wear, fracture resistance and secondary caries at baseline, 6, 12, 18 and 24 months using modified USPHS criteria. The fluoride release at different intervals was dialogued with the help of an ion-selective electrode. In order to determine group differences, Kaplan-Meier survival analysis and appropriate statistical tests were used.
Results: Bulk-fill restorations were better than GIC in the area of marginal integrity, surface wear, color stability and survival rates (p < 0.05) at 24 months. However, the release and recharge capacity of fluoride was significantly greater at GIC during the trial period (p < 0.001). There was no significant difference in secondary caries and postoperative sensitivity between the groups.
Conclusion: GIC demonstrated higher fluoride-mediated preventative effects, while bulk-fill composites offered better clinical durability. Caries-preventive potential and mechanical performance should be taken into account while choosing a material..
Downloads
References
Akram MA, Dar S, Zehra H, Oad S, Foad H. Prevalence of Dental Caries and its Association with Dietary Habits in Young Adults. Innovative Research Journal of Dentistry. 2024 Dec 31;2(2). https://irjpl.org/irjd/article/view/105
2. Akbar P, Salahuddin N, Ahmad Z, Shah SZ, Shah F, Maknoon D. Role of Actinomyces species in oral Biofilm Formation and Dental Plaque-Related Diseases. Innovative Research in Applied, Biological and Chemical Sciences. 2024 Jun 30;2(1):120-5. DOI: https://doi.org/10.62497/IRABCS.2024.50
3. Uzel İ, Aykut-Yetkiner A, Ersin N, Ertuğrul F, Atila E, Özcan M. Evaluation of Glass-Ionomer versus Bulk-Fill Resin Composite: A Two-Year Randomized Clinical Study. Materials (Basel). 2022 Oct 18;15(20):7271. doi: 10.3390/ma15207271.
4. Sikka N, Brizuela M. Glass Ionomer Cement. [Updated 2024 Mar 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK582145/
5. Zehra B, Shakoor MU, Akbar P, Sattar S, Imtiaz K. Comparative Analysis of Composite Resin and Glass Ionomer Cement in Pediatric Restorative Dentistry. Innovative Research Journal of Dentistry. 2025 Jun 30;3(1):9-16. https://irjpl.org/irjd/article/view/151
6. Durrant L, Mutahar M, Daghrery AA, Albar NH, Alwadai GS, Alqahtani SA, Al Dehailan LA, Abogazalah NN, Alamoudi NA, Al Moaleem MM. Clinical Performance of Glass Ionomer Cement in Load-Bearing Restorations: A Systematic Review. Med Sci Monit. 2024 Feb 14;30:e943489. doi: 10.12659/MSM.943489.
7. Ge KX, Yu-Hang Lam W, Chu CH, Yu OY. Updates on the clinical application of glass ionomer cement in restorative and preventive dentistry. J Dent Sci. 2024 Dec;19(Suppl 1):S1-S9. doi: 10.1016/j.jds.2024.07.021.
8. Almulhim KS, Alghamdi SM, Alqahtani RS, Alsahiem JK, Al-Zain AO, Gad MM, Balhaddad AA. Comparative Evaluation of Commercial Bulk-Fill Resin-Based Composites: Flexural Properties, Roughness, Water Sorption and Solubility, and Color Stability. Dent J (Basel). 2026 Feb 14;14(2):117. doi: 10.3390/dj14020117.
9. Bakitian F. A Narrative Review of the Material Properties, Clinical Efficacy, and Developmental Prospects of Bulk-Fill Resin-Based Composites. Clinical, Cosmetic and Investigational Dentistry. 2026 Dec 31;18(0):12475763. https://www.tandfonline.com/doi/full/10.2147/CCIDE.S583379
10. Zailai A, Alharbi ZA, Dowairi F, Halawi O, Ghulaysan SA, Safhi RE, Mubarki OA, Bashaen RF, Jafari SA, Ghazwani WY, Muslihi AA, Hablool MO, Ageeli AA, Almabdi RH, Jafari RH. Clinical Performance and Survival of Bulk-Fill Resin Composites Compared to Conventional Resin Composites in Posterior Permanent Teeth: A Systematic Review and Meta-analysis. Cureus. 2025 Dec 21;17(12):e99792. doi: 10.7759/cureus.99792.
11. Miranda SB, Lins RBE, Queiroz MF, Leal CFC, Mendonça GL, Dias TA, Montes MAJR. Clinical Performance and Survival of Bulk-Fill Resin Composite Posterior Restorations in Primary Teeth: A Systematic Review and Meta-Analysis. J Clin Med. 2026 Jan 6;15(2):415. doi: 10.3390/jcm15020415.
12. Durão MA, Andrade AKM, Santos MDCMDS, Montes MAJR, Monteiro GQM. Clinical Performance of Bulk-Fill Resin Composite Restorations Using the United States Public Health Service and Federation Dentaire Internationale Criteria: A 12-Month Randomized Clinical Trial. Eur J Dent. 2021 May;15(2):179-192. doi: 10.1055/s-0040-1718639. Epub 2020 Nov 26. PMID: 33242913; PMCID: PMC8184274.
13. Raghip AG, Comisi JC, Hamama HH, Mahmoud SH. Two-year randomized clinical trial to evaluate the performance of posterior bulk-fill resin composite with ionic releasing restorative material. Journal of Dentistry. 2025 Sep 1;160:105912. https://www.sciencedirect.com/science/article/pii/S0300571225003562
14. Bayazıt EÖ, Başeren M, Meral E. Clinical comparison of different glass ionomer-based restoratives and a bulk-fill resin composite in Class I cavities: A 48-month randomized split-mouth controlled trial. J Dent. 2023 Apr;131:104473. doi: 10.1016/j.jdent.2023.104473. Epub 2023 Mar 1. PMID: 36863696.
15. Arbildo-Vega HI, Lapinska B, Panda S, Lamas-Lara C, Khan AS, Lukomska-Szymanska M. Clinical Effectiveness of Bulk-Fill and Conventional Resin Composite Restorations: Systematic Review and Meta-Analysis. Polymers (Basel). 2020 Aug 10;12(8):1786. doi: 10.3390/polym12081786. PMID: 32785019; PMCID: PMC7464794.
16. Saghir A, Rehman T, Irum B, Afreen Z; Ammarah; Nawaz FN. 12 Month's Assessment Of Clinical Efficacy Of Resin Modified Glass Ionomer Cement And Flowable Composites In Restoration Of Non-Carious Cervical Lesions, A Randomized Clinical Trial. J Ayub Med Coll Abbottabad. 2023 Feb-Mar;35(1):7-10. doi: 10.55519/JAMC-01-10780. PMID: 36849368.
17. Dcruz MM, Tapashetti S, Naik B, Shah MA, Mogi P, Horatti P. Comparative evaluation of fluoride release profiles in new glass ionomer cements and conventional type II GIC: Implications for cariostatic efficacy. Bioinformation. 2024 Dec 31;20(12):2009-2014. doi: 10.6026/9732063002002009. PMID: 40230897; PMCID: PMC11993395
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
