Comparative Evaluation of Giomer-Based and Nanohybrid Restorative Materials in Carious and Non-Carious Cervical Lesion Restorations: A 36-Month Prospective Longitudinal Randomized Controlled Clinical Trail Study Assessing Clinical, Periodontal and Oral Bi

Abstract

Background: Contemporary restorative dentistry increasingly emphasizes materials that combine esthetic and mechanical performance with biological activity. Giomer-based restorative materials incorporate surface pre-reacted glass-ionomer fillers capable of releasing multiple ions, whereas nanohybrid resin composites provide favorable esthetics, polishability, and mechanical properties. Comparative evidence regarding their medium-term performance across carious and non-carious lesions, particularly when periodontal and biological outcomes are considered alongside conventional clinical criteria, remains limited.

Objective: To compare the 36-month esthetic, functional, biological, periodontal, and overall clinical performance of Giomer-based and Nanohybrid restorative materials in carious and non-carious lesions intracoronal restorations.

Methods: This prospective longitudinal randomized controlled clinical trial study was conducted at Tertiary care Hodpital from 01^st October 2023 to 01^st July 2026, primarily included 750 restorations, equally divided between Giomer-based and Nanohybrid restorative material groups (375 each). The intracoronal restorations comprised 403 carious and 347 non-carious lesions. Clinical performance was assessed over 36 months using standardized criteria covering surface luster, staining, marginal staining, color match, anatomical form, retention, fracture, marginal adaptation, postoperative sensitivity, recurrent caries, tooth integrity, gingival inflammation, bleeding on probing, and overall periodontal response. Categorical variables were compared using the chi-square or Fisher's exact test, and Cramer's V was used to quantify effect size where appropriate. A p-value <0.05 was considered statistically significant.

Results: Overall clinical success was significantly higher with Giomer-based restorations as compare to Nanohybrid- restorations (92.3% vs 86.9%; p=0.017, Cramer's V=0.087). Giomer- based restorations demonstrated significantly better marginal staining (90.1% vs 84.8%; p=0.027) and marginal adaptation (90.9% vs 85.3%; p=0.018). Gingival inflammation (15.7% vs 22.4%; p=0.020) and bleeding on probing (13.9% vs 20.8%; p=0.012) were less frequent around Giomer- based restorations. Overall periodontal acceptability was also higher in the Giomer-based restorations group (85.3% vs 78.4%; p=0.014). Recurrent/secondary caries occurred in 4.8% of Giomer-based restorations and 8.3% of Nanohybrid- restorations, although this difference did not reach statistical significance (p=0.055). Other esthetic and biological parameters were generally comparable.

Conclusion: Both Giomer-based and Nanohybrid-restorative materials demonstrated satisfactory 36-month clinical performance in carious and non-carious lesions. Giomer-based restorations showed modest advantages in marginal integrity, periodontal response, and overall clinical success. Longer-term controlled studies are required to determine whether these differences persist and result in meaningful improvements in restoration longevity. When long-term durability, clinical longevity, functional, periodontal and oral biological parameters are a primary consideration, Giomer based restorations have provided; clinically acceptable outcomes and are preferred favorably as compare to Nanohybrid restorative materials in carious and non carious lesion restorations.