Influence of Pre-Heated High-Viscosity Glass Ionomer Cement on Marginal Adaptation and Post-Operative Sensitivity in Pediatric Restorations: A Split-Mouth Randomized Clinical Trial

Introduction: High-viscosity glass ionomer cements (HVGICs) are favored in pediatric dentistry for their fluoride release and chemical adhesion; however, their clinical handling and marginal adaptation remain challenging. This study evaluates whether pre-heating HVGIC improves marginal integrity and reduces post-operative sensitivity in primary molars.

Methods: Sixty primary molars requiring Class I or II restorations in 30 pediatric patients were included in a split-mouth, randomized controlled clinical trial. Each patient received one restoration using conventional HVGIC (control) and one using HVGIC pre-heated to 54°C (experimental) using a standardized thermocompression device. Marginal adaptation was assessed at baseline and 6 months using the modified USPHS criteria. Post-operative sensitivity was evaluated via the Wong-Baker FACES Pain Rating Scale at 24 hours and 7 days.

Results: The pre-heated HVGIC group demonstrated significantly higher scores for marginal adaptation compared to the control group (p < 0.05). At the 6-month recall, 92% of the pre-heated group showed "Alpha" (ideal) marginal integrity, compared to 78% in the control group. Furthermore, reported sensitivity scores were significantly lower in the pre-heated cohort, particularly during the first 24 hours post-procedure.

Conclusion: Pre-heating HVGIC significantly enhances its flow characteristics, leading to superior marginal adaptation and improved patient comfort. This simple, chairside technique optimizes the clinical performance of GICs in pediatric restorative dentistry, providing a more reliable, minimally invasive solution for high-caries-risk patients.