Dear All,

let’s synthesise together the results of this paper, even if some of these results might first appear to contradict each other. Even if the results of the study are seen as valid, there might be a discussion of how useful the results are and if these results might lead to new research or to new applications.

This will be an education strategy that will make All of Us become more familiar with the advanced literature in their new field of study. Moreover we will test our ability to act as scientific reviwers

In addition, this journal club will help improve our skills of understanding and debating current topics of active interest in their field.

9 thoughts on “Giomer

  1. I found this article very interesting in that it compared two versions of Giomer currently available. Apparently the higher filler composite (Beautifil II) did not do as well as the Flow Plus material. I found it interesting that they attribute this to flowability and better “wetting” along the cavity walls. They also discuss the low elastic modulus that “was reported to relieve the stresses at the adhesive interfaces generated by the occlusal forces.” allowing the composite to “flex” with the tooth. This “elastic buffer” is mentioned to have “sufficient flexibility to resist polymerization shrinkage stress and favorably dissipate stresses…”. I wrote about this behavior in Inside Dentistry; Jul/Aug 2011
    Volume 7, Issue 7, A “Resin Cone Technique” Using Giomer Products
    – See more at:

  2. I know this may not be quite the scientific paper as some may have created, but remember, this is coming from a mere general practitioner of dentistry doing my best to search the literature to find answers to the questions I had at that time.

  3. Beautiful Flow Plus F00 restorative material achieved clinically better acceptable results than Beautiful II after three years of service in conservative class I cavities. This great material has the self-leveling ability thus reducing the instrumentation required. Most clinicians prefer it as an easy to use material. And yes I agree with John here, the article has posted some great results

  4. Sometime, but not always, before reading an article, and before consider this article as guidance for our clinical procedures, or for any other tasks (e.g. research, academic, teaching…..), it is important to consider the reputation and the quartile of the journal where the paper has been published in.
    This is the first potential issue of this paper. Tanta Dental Journal is not a high impact journal, unfortunately.

    • Number of patients included in the study: not really significant (a pre-statistical analysis for patient inclusion should have been performed)

    • Lack of standardization in the cavity preparation procedures. It seems that the authors worked in different dentine substrates and sometime they applied CaOH. This may influence the results and cause a lack of standardization.

    • In all cases they have applied FL-Bond II adhesive……………and adhesive with 40% fluoride releasing and recharging S-PRG filler. In few words, they have mainly tested the effect of this adhesive and not as they said: “The research null hypothesis was that there is no difference in the clinical performance of Beautifil II and Beautiful Flow Plus F00 in conservative class I cavities.

    • Moreover there is no control (Negative vs Positive) group; so what are they actually evaluating????

    • The criteria of assessment was based on “Cvar JF, Ryge G. Criteria for the clinical evaluation of dental restorative materials. US Public health service Publication 1971, No 790-244 San Francisco Government Printing Office”. However, the authors should have used or at least also considered the following revised version, “Wilson MA, Cowan AJ, Randall RC, Crisp RJ, Wilson NH. A practice-based, randomized, controlled clinical trial of a new resin composite restorative: one-year results. Oper Dent. 2002;27:423–429.”

    • Nevertheless, the authors observed some differences between the two composites, although the use of a fluoride-release adhesive. Indeed, Beautifil flow plus F00 has significantly better mar gingival adaptation (P<0.01), marginal discoloration (P< 0.01), surface roughness (P <0.01) and surface morphology (P<0.01) versus Beautifil II. • At this point, the only conclusion the authors can report is that Beautiful flow plus F00 works better that Beautifil II. At these points the authors should discuss the reasons (composition, improvements and so on….) why one material is better than the other • Since materials with ability to recharge with fluoride have been studied, the author should have also considered the hygiene compliance and the diet of the patients; as these variables may also influence the results • The authors state “favorable adaptation, effortless delivery and void free restoration of the flowable giomer products as claimed by the manufacturer might be the reason for this result especially in class I conservative restorations”………….so at this point the question is: is this a scientific publication or an advertising publication? • The funny thing is that a flowable composite is performing better than a “convional” one containing more than 83wt% filler content; well, this latter should have been a real disaster of materials. This is the authors should have included different control groups. • I agree with John about the nice discussion on “low elastic modulus that “was reported to relieve the stresses at the adhesive interfaces generated by the occlusal forces.” allowing the composite to “flex” with the tooth. This “elastic buffer” is mentioned to have “sufficient flexibility to resist polymerization shrinkage stress and favourably dissipate stresses…” However, all these observations are clinically important for “short-term” results (especially when referred to polymerisation shrinkage) and should not have any effect on long-term results as those observed in this study. • In conclusion: I would have rejected this paper as reviewer of a good IF journal

  5. You will eventually make me a critical review scientist Tore! Your observations are fabulous. I am learning from the best in the world!

    • So John, next time you receive a paper for review from a journal, you know now how to kill it or accept it 🙂 ………….thanks a lot for your nice words that I do not deserve at all 😉

  6. Gentlemen,

    very well done.
    Should serve as a learning experience.

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