Review on fluoride-releasing restorative materials--fluoride release and uptake characteristics, antibacterial activity and influence on caries formation

Biocompatibility, mechanical, and bonding properties of a dental adhesive modified with antibacterial monomer and cross-linker

OBJECTIVES

This study investigated the antibacterial, cytotoxicity, and mechanical properties of a dental adhesive modified with quaternary ammonium monomer ((2-acryloyloxyethyl)dimethyldodecylammonium bromide) and cross-linker (bis(2-acryloyloxyethyl)methyldodecylammonium bromide).

MATERIALS AND METHODS

Monomer (M), cross-linker (C), or a combination of these (M + C) were incorporated into adhesive Adper Single Bond Plus (SB) in 5, 10, or 25% (as wt%). A colony-forming unit and MTT assays were used to evaluate antibacterial properties against Streptococcus mutans and cell viability. Resin-dentin beams (0.9 ± 0.1 mm²) were evaluated for micro-tensile bond strength (μTBS) after 24 h, 6 months, and 3 years. Hourglass specimens were evaluated for ultimate tensile strength (UTS) after 24 h, 1 week, and 6 months. Micro-hardness measurements after softening in ethanol were taken as an indirect assessment of the polymer cross-linking density. Kruskal-Wallis, one-way ANOVA, two-way ANOVA, and Student's t test were used for analysis of the antibacterial, cytotoxicity, μTBS, UTS, and hardness data, all with a significance level of p < 0.05.

RESULTS

10%M and 25%M demonstrated a significant reduction in S. mutans relative to SB (p < 0.001). No differences in cytotoxicity were detected for any of the groups. After 6 months, no changes in μTBS were shown for any of the groups. After 3 years, all groups evidenced a significant decrease in μTBS (p < 0.05) except 5%M, 5%C, and 5%M + 5%C. All groups demonstrated either stable or significantly increased UTS after 6 months. Except for the cross-linker groups, a significant decrease in micro-hardness was shown for all groups after softening in ethanol (p < 0.05).

CONCLUSIONS

A 5-10% of monomer may render the resin antibacterial without a compromise to its mechanical and bonding properties.

CLINICAL RELEVANCE

Biomodification of a resin adhesive with an antibacterial monomer and cross-linker may help improve the life span of adhesive restorations.

Effect of water aging on the anti-biofilm properties of glass ionomer cement containing fluoro-zinc-silicate fillers

A previous study has reported that a novel fluoro-zinc-silicate glass ionomer cement (Caredyne Restore) showed superior anti-biofilm effects by interfering with bacterial adhesion. However, the active ions may degrade with time. This study aimed to assess the valid anti-biofilm effects of Caredyne Restore after being aged by water immersion for 3 weeks. Streptococcus mutans biofilm was allowed to grow on the surface before and after water aging for 24 h using a modified Robbins device flow-cell system. The results showed water aging promoted biofilm formation. Insufficient amount of fluoride and zinc ions were released from Caredyne Restore after water aging under neutral pH condition. An acidic pH is needed to exert effective anti-biofilm properties. As the release of active ions from Caredyne Restore will gradually decrease after the restoration,  the restoration may not prevent biofilm formation after 3 weeks while neutral pH is maintained by the buffering capacity of saliva.

Effects of a surface prereacted glass-ionomer filler coating material on biofilm formation and inhibition of dentin demineralization

OBJECTIVES

This study investigated the ability of a surface prereacted glass-ionomer (S-PRG) coating material to inhibit the biofilm formation and demineralization of dentin.

METHODS AND MATERIALS

Dentin specimens were randomly divided into three groups: (1) no coating (control), (2) S-PRG filler-containing coat, and (3) a nonS-PRG filler-containing coat. Streptococcus mutans biofilms were grown on the dentin surfaces in a microcosm for 20 h. Then, the quantity of bacteria and water-insoluble glucan in the retained biofilm on the dentin surface were measured. Regarding demineralization inhibition test, specimens were demineralized for 5 days then sectioned into halves and observed under confocal laser scanning microscope (CLSM). One-way ANOVA and Tukey's HSD were used for statistical analysis.

RESULTS

The estimated mean surface roughness for specimens in the S-PRG group was statistically significantly higher than the estimates for both the nonS-PRG and the control group specimens. The quantity of bacteria and water-insoluble glucan/mm² revealed that the S-PRG group prevented biofilm formation and bacterial adhesion to the dentin surface compared with the control and nonS-PRG groups. The S-PRG group recorded the highest acid-resistance ability with no surface loss.

CONCLUSION

Application of S-PRG barrier coat on dentin surfaces can inhibit biofilm formation as well as protecting the dentin surface against demineralization.

CLINICAL SIGNIFICANCE

Coating material containing S-PRG fillers might be used for caries prevention, through inhibiting biofilm formation, enhancing mineralization, and reducing acidic attack by cariogenic bacteria.

Evaluation of F, Ca, and P release and microhardness of eleven ion-leaching restorative materials and the recharge efficacy using a new Ca/P containing fluoride varnish

OBJECTIVES

The objectives of this study were to evaluate fluoride (F), calcium (Ca), and phosphate (P) release of ion-leaching restorative materials (ILMs), their recharge efficacy with a Ca/P-containing F varnish, and relative microhardness.

METHODS

Thirteen groups of materials were investigated. Cylindrical-shaped specimens were fabricated. Deionised water or lactic-acid solution were used as the storage media. Solutions were changed after 1d, 4d, 7d, and 14d of ion release and at the same periods after recharge with MI Varnish (7 -h storage). F, Ca, and P measurements were accomplished using a fluoride-ion selective electrode, atomic absorption spectrometry, and colourimetric method by spectrophotometer, respectively. Relative Vickers hardness was proceeded with similar specimens used in the F assay (4 periods). SEM/EDS was additionally performed. Statistical analyses were calculated in each parameter (p < 0.05).

RESULT

Hardness of several ILMs immediately increased after recharge. After 28d, Ketac Universal [a high-viscosity glass-ionomer cement (HVGIC)] showed the highest hardness similar to the resin composite control. Although 2 HVGICs (Zirconomer and Equia Forte Fil) ranked as first and second for F release/re-release, some HVGICs had inferior or comparable F capacity to RMGICs (Fuji VIII and Fuji II LC) and a resin-based (RB) ILM (Cention N). Cention N, Activa-Restorative (RB-ILM), and Zirconomer were the top-3 ranking for Ca release/re-release. Activa-Restorative showed the highest P release, whereas Cention N displayed the greatest recharge ability for P.

CONCLUSIONS

Zirconomer showed a versatile performance for ion-release/re-release, especially for F. Cention N had excellent capacity in relation to Ca release and recharge ability of Ca/P.

CLINICAL SIGNIFICANCE

With the F varnish recharge protocol, Zirconomer, Equia Forte, and Fuji VIII seems to have an ability to inhibit initial caries initiation. Cention N is a promising resin-based material that could be an alternative for high caries risk patients due to the high Ca release/recharge with acceptable F release.

Effects of short-time exposure of surface pre-reacted glass-ionomer eluate on dental microcosm biofilm

This study evaluated the antibacterial effects of short-time exposure of surface pre-reacted glass-ionomer (S-PRG) eluate on oral microcosm biofilm. Biofilms were treated with an S-PRG eluate at different concentrations (25%, 50%, and 100%), distilled water (DW), and 0.1% chlorhexidine (CHX) twice a day for 5 min repeatedly. After 7 days, the total and aciduric bacterial counts and biofilm dry weights were measured. An image analysis program calculated the red/green (R/G) ratios in the biofilm autofluorescence images. Microscopic analyses quantified the biofilm thickness and live/dead cell ratio and determined morphological changes in the biofilm. Bacterial counts and dry weights were not significantly different in the DW group for all S-PRG eluate concentrations. An increasing trend in the R/G ratio for 7 days biofilm treatment was observed for the S-PRG eluate and the DW groups. Furthermore, the live/dead cell ratios in the biofilm and the biofilm thickness of the S-PRG eluate groups were similar to those of the DW group. The bacteria morphology inside the biofilm changed only in the CHX group. Short-time S-PRG eluate treatment showed no significant antibacterial and antibiofilm effects. These results indicated that limited biofilm formation inhibition can be obtained by using only the S-PRG eluate.

An antibacterial dental light-cured glass-ionomer cement with improved hardness

An antibacterial dental light-cured glass-ionomer cement has been developed and evaluated. An antibacterial furanone derivative was synthesized and covalently attached onto the surface of alumina filler particles. The formed antibacterial fillers were then mixed into a light-curable glass-ionomer cement formulation. Surface hardness and bacterial viability were used to evaluate the modified cements. Effects of coated furanone moiety content on the modified fillers, modified alumina filler particle size and loading, and total glass filler content were investigated. Results showed that increasing antibacterial furanone content, modified particle size and loading, and total glass filler content generally increased surface hardness. Increasing furanone moiety, filler loading and total filler content increased antibacterial activity. On the other hand, increasing particle size decreased antibacterial activity. The leaching tests indicate that the modified experimental cement showed no leachable antibacterial component to bacteria and cells.

Antimicrobial properties, compressive strength and fluoride release capacity of essential oil-modified glass ionomer cements-an in vitro study

OBJECTIVES

This study was designed to investigate the antimicrobial properties, compressive strength and fluoride release capacities of high-viscous glass ionomer cements (GICs) after incorporation of cinnamon and thyme essential oils.

MATERIALS AND METHODS

Experimental-modified GICs were prepared by incorporation of thyme and cinnamon essential oils into the liquid phase of the cement at 5 and 10% v/v. Antimicrobial activity against selected microorganisms (Streptococcus mutans and Candida albicans) was done using direct contact test. Compressive strength of the four new formulations and control group was tested using a universal testing machine while fluoride ion release was measured by ion-selective electrode at 1, 7, 14 and 28 days. Data analysis and comparisons between groups were performed using factorial and one-way ANOVA and Tukey's tests.

RESULTS

All newly formulated GICs exhibited significantly higher inhibitory effects against both Streptococcus mutans and Candida albicans growth when compared to conventional GIC (p < 0.05). Compressive strength of 5% cinnamon-modified GIC (MPa = 160.32 ± 6.66) showed no significant difference when compared with conventional GIC (MPa = 165.7 ± 5.769) (p value > 0.05). Cumulative fluoride-releasing pattern at days 7, 14, and 28 were 10% cinnamon-GIC > 5% thyme-GIC > 5% cinnamon-GIC > 10% thyme GIC > conventional GIC.

CONCLUSIONS

Incorporation of 5% cinnamon oil into glass ionomer resulted in better antimicrobial effects against S. mutans and C. albicans and increased fluoride-release capacity without jeopardizing its compressive strength.

CLINICAL RELEVANCE

The 5% cinnamon-modified GIC appears to be a promising alternative restorative material in ART technique.

Novel CaF2 Nanocomposites with Antibacterial Function and Fluoride and Calcium Ion Release to Inhibit Oral Biofilm and Protect Teeth

(1) Background: The objective of this study was to develop a novel dental nanocomposite containing dimethylaminohexadecyl methacrylate (DMAHDM), 2-methacryloyloxyethyl phosphorylcholine (MPC), and nanoparticles of calcium fluoride (nCaF₂) for preventing recurrent caries via antibacterial, protein repellent and fluoride releasing capabilities. (2) Methods: Composites were made by adding 3% MPC, 3% DMAHDM and 15% nCaF₂ into bisphenol A glycidyl dimethacrylate (Bis-GMA) and triethylene glycol dimethacrylate (TEGDMA) (denoted BT). Calcium and fluoride ion releases were evaluated. Biofilms of human saliva were assessed. (3) Results: nCaF₂+DMAHDM+MPC composite had the lowest biofilm colony forming units (CFU) and the greatest ion release; however, its mechanical properties were lower than commercial control composite (p < 0.05). nCaF₂+DMAHDM composite had similarly potent biofilm reduction, with mechanical properties matching commercial control composite (p > 0.05). Fluoride and calcium ion releases from nCaF₂+DMAHDM were much more than commercial composite. Biofilm CFU on composite was reduced by 4 logs (n = 9, p < 0.05). Biofilm metabolic activity and lactic acid were also substantially reduced by nCaF₂+DMAHDM, compared to commercial control composite (p < 0.05). (4) Conclusions: The novel nanocomposite nCaF₂+DMAHDM achieved strong antibacterial and ion release capabilities, without compromising the mechanical properties. This bioactive nanocomposite is promising to reduce biofilm acid production, inhibit recurrent caries, and increase restoration longevity.

Evaluation of Caries-Free Restorations Bonded with Various Adhesive Systems: In Vitro Study

Purpose. Secondary caries originate from a leakage pathway where oral acids can penetrate faster and demineralize the tooth substrate deeper which can be visualized by dye penetration. The ability to prevent secondary caries by contemporary adhesive systems was evaluated in this study. Dye penetration distance through leakage and into the tooth substrate adjacent to Class V restorations after artificial caries exposure was compared. Materials and Methods. Previously frozen extracted human molars were used to prepare the Class V cavities at the CEJ on axial surfaces. All cavities were restored with either the resin-composite or amalgam with or without resin adhesives: dry bonding: Super-Bond D-Liner II Plus; moist bonding: All-Bond 2; and self-etch bonding: AQ Bond and Clearfil Protect Bond. Two subgroups of Super-Bond D-Liner II Plus were immersed for 14 days at 37°C either in artificial saliva (negative control) or the artificial caries solution. The other groups were soaked in the artificial caries solution. The distance of dye penetration into the adjacent enamel, cementum/dentin, and tooth-resin interfaces was measured after immersion in 0.5% basic fuchsin dye for 24 h. The tooth-resin interfacial layer was investigated using SEM. Results. No dye penetration into the tooth-resin interface was found in Super-Bond D-Liner II Plus and AQ Bond groups which demonstrated a constant hybrid layer after a chemical challenge. The leakage distance at the cementum/dentin-resin interface of All-Bond 2, Clearfil Protect Bond, and non-adhesive amalgam (positive control) groups was significantly higher than the distance of dye penetration into the adjacent demineralized root surface (p<0.05). Conclusion. Caries associated with either amalgam or resin-composite restorations can be prevented using resin adhesives which can penetrate into the intact tooth substrate to form a stable hybrid layer. With caries-free restorations, tooth vitality may be conserved lifelong.

Biomimetic Aspects of Restorative Dentistry Biomaterials

Biomimetic has emerged as a multi-disciplinary science in several biomedical subjects in recent decades, including biomaterials and dentistry. In restorative dentistry, biomimetic approaches have been applied for a range of applications, such as restoring tooth defects using bioinspired peptides to achieve remineralization, bioactive and biomimetic biomaterials, and tissue engineering for regeneration. Advancements in the modern adhesive restorative materials, understanding of biomaterial-tissue interaction at the nano and microscale further enhanced the restorative materials' properties (such as color, morphology, and strength) to mimic natural teeth. In addition, the tissue-engineering approaches resulted in regeneration of lost or damaged dental tissues mimicking their natural counterpart. The aim of the present article is to review various biomimetic approaches used to replace lost or damaged dental tissues using restorative biomaterials and tissue-engineering techniques. In addition, tooth structure, and various biomimetic properties of dental restorative materials and tissue-engineering scaffold materials, are discussed.

Nano metal fluorides: small particles with great properties

The recently developed fluorolytic sol–gel route to metal fluorides opens a very broad range of both scientific and technical applications of the accessible high surface area metal fluorides, many of which have already been applied or tested. Specific chemical properties such as high Lewis acidity and physical properties such as high surface area, mesoporosity and nanosize as well as the possibility to apply metal fluorides on surfaces via a non-aqueous sol make the fluorolytic synthesis route a very versatile one. The scope of its scientific and technical use and the state of the art are presented.

Zinc-Calcium-Fluoride Bioglass-Based Innovative Multifunctional Dental Adhesive with Thick Adhesive Resin Film Thickness

Apart from producing high bond strength to tooth enamel and dentin, a dental adhesive with biotherapeutic potential is clinically desirable, aiming to further improve tooth restoration longevity. In this laboratory study, an experimental two-step universal adhesive, referred to as Exp_2UA, applicable in both the etch-and-rinse (E&R) and self-etch (SE) modes and combining a primer, containing 10-methacryloyloxydecyldihydrogen phosphate as a functional monomer with chemical binding potential to hydroxyapatite, with a bioglass-containing hydrophobic adhesive resin, was multifactorially investigated. In addition to primary property assessment, including measurement of bond strength, water sorption, solubility, and polymerization efficiency, the resultant adhesive-dentin interface was characterized by transmission electron microscopy (TEM), the filler composition was analyzed by energy-dispersive X-ray spectroscopy, and the bioactive potential of the adhesive was estimated by measuring the long-term ion release and assessing its antienzymatic and antibacterial potential. Four representative commercial adhesives were used as reference/controls. Application in both the E&R and SE modes resulted in a durable bonding performance to dentin, as evidenced by favorable 1 year aged bond strength data and a tight interfacial ultrastructure that, as examined by TEM, remained ultramorphologically unaltered upon 1 year of water storage aging. TEM revealed a 20 μm thick hydrophobic adhesive layer with a homogeneous bioglass filler distribution. Adequate polymerization conversion resulted in extremely low water sorption and solubility. In situ zymography revealed reduced endogenous proteolytic activity, while Streptococcus mutans biofilm formation was inhibited. In conclusion, the three-/two-step E&R/SE Exp_2UA combines the high bonding potential and bond degradation resistance with long-term ion release, rendering the adhesive antienzymatic and antibacterial potential.

Comparative evaluation of fluoride release and re-release and recharge potential of Zirconomer Improved and Cention

BACKGROUND

The cariostatic action associated with fluoride-releasing restorative materials is mainly attributed to a sustained release of fluoride. This research aims on comparing Cention N and Zirconomer Improved in vitro fluoride release and re-release.

METHODS

Test materials were grouped into two categories containing 15 samples each. The cumulative fluoride release and re-release measurements was made during 1st, 7th and 15th day. The independent sample t-test and paired t-test was used to check mean differences. The level of significance was kept at p<0.05.

RESULTS

At day 1, 7 and 15 the initial fluoride release of zirconomer group was significantly higher (p<0.05) than the cention group. It was found that from day 1 to day 7 the mean initial fluoride release has significantly reduced (p<0.05) for both the groups. Similar results were also seen when comparisons were done between day 7 to day 15 (p<0.05) and day 1 to day 15 (p<0.05) for both the groups.

CONCLUSION

Zirconomer was more efficient in initial and fluoride re-release than the Cention N restorative material. Further in vivo studies with more parameters are recommended to evaluate fluoride release and cariostatic performance of Cention N and Zirconomer in real environmental circumstances.

Current aspects and prospects of glass ionomer cements for clinical dentistry

Glass ionomer cement (GIC) is a tailor-made material that is used as a filling material in dentistry. GIC is cured by an acid-base reaction consisting of a glass filler and ionic polymers. When the glass filler and ionic polymers are mixed, ionic bonds of the material itself are formed. In addition, the extra polymer anion reacts with calcium in enamel or dentin to increase adhesion to the tooth tissue. GICs are widely used as adhesives for artificial crowns or orthodontic brackets, and are also used as tooth repair material, cavity liner, and filling materials. In this review, the current status of GIC research and development and its prospects for the future have been discussed in detail.

Antibacterial and mechanical properties of arginine-containing glass ionomer cements

OBJECTIVE

The study investigated the effect of incorporating l-arginine (Arg) in a glass ionomer cement (GIC) on its mechanical properties and antibacterial potential.

METHODS

Pre-determined proportions (1%, 2%, and 4% by wt.) of Arg were incorporated in GIC powder; while GIC without Arg served as control. The flexural strength, nanohardness, surface roughness, elemental analysis using SEM-EDX (n = 6) and F/Arg/Ca/Al/Si release in deionized water for 21 days were assessed. The antibacterial potential was evaluated in a multi-species biofilm model with Streptococcus mutans, Streptococcus sanguinis, Streptococcus gordonii, and Lactobacillus acidophilus for 72 h. Real-time qPCR was used to analyse biofilm bacterial concentrations. Propidium monoazide modification of real-time qPCR was performed to quantify viable/dead bacteria. The pH, lactic acid, ADS activity, and H₂O₂ metabolism were measured. Confocal microscopy was used to investigate the biofilm bacterial live/dead cells, density, and thickness.

RESULTS

There was no difference in flexural strength among the different groups (p > 0.05). No significant difference in nanohardness and surface roughness was observed between 4% Arg + GIC and control (p > 0.05). The 4% Arg + GIC showed significantly higher F/Arg/Al/Si release than the other groups (p < 0.05), reduced total bacterial concentration and growth inhibition of viable S. mutans and S. sanguinis (p < 0.05). Lactic acid formation for 4% Arg + GIC was significantly higher than 1% Arg + GIC (p < 0.05). The spent media pH of 4% Arg + GIC was higher than the other groups (p < 0.05), with proportionately lower ammonia and higher H₂O₂ released (p < 0.05).

SIGNIFICANCE

Addition of 4% l-arginine in GIC enhanced its antibacterial activity via a biofilm modulatory effect for microbial homeostasis, with no detrimental effect on its mechanical properties.

Novel pit and fissure sealant containing nano-CaF2 and dimethylaminohexadecyl methacrylate with double benefits of fluoride release and antibacterial function

OBJECTIVE

Pit and fissure sealants with antibacterial and remineralization properties have broad application prospects in caries prevention. The objectives of this study were to: (1) develop a novel pit and fissure sealant containing CaF₂ nanoparticles (nCaF₂) and dimethylaminohexadecyl methacrylate (DMAHDM); and (2) investigate the effects of nCaF₂ and DMAHDM on biofilm response and fluoride (F) ion release for the first time.

METHODS

Helioseal F was used as a control. Bioactive sealants were formulated with DMAHDM and nCaF₂. Flow properties, enamel shear bond strength, hardness and F ion releases were measured. Streptococcus mutans (S. mutans) biofilms were grown on sealants. Biofilm metabolic activity, lactic acid production, colony-forming units (CFU), and pH of biofilm culture medium were measured.

RESULTS

Adding 5% DMAHDM and 20% nCaF₂ did not reduce the paste flow and enamel bond strength, compared to control (p < 0.05). Hardness of sealants with 20% nCaF₂ and DMAHDM was higher than control (p < 0.05). The F ion release from 20% nCaF₂ was much higher than that of commercial control (p < 0.05). The sealant with DMAHDM reduced the S. mutans biofilm CFU by 4 logs. The pH in biofilm medium of the new bioactive sealant was much higher (pH 6.8) than that of commercial sealant (pH 4.66) (p < 0.05).

SIGNIFICANCE

The new bioactive pit and fissure sealant with nCaF₂ and DMAHDM achieved high fluoride release and strong antibacterial performance. This novel fluoride-releasing and antibacterial sealant is promising to inhibit caries and promote the remineralizaton of enamel and dentin.

Novel fluoride rechargeable dental composites containing MgAl and CaAl layered double hydroxide (LDH)

OBJECTIVE

This study aims to incorporate 2:1 MgAl and 2:1 CaAl layered double hydroxides (LDHs) in experimental dental-composites to render them fluoride rechargeable. The effect of LDH on fluoride absorption and release, and their physico-mechanical properties are investigated.

METHODS

2:1 CaAl and 2:1 MgAl LDH-composite discs prepared with 0, 10 and 30wt% LDH were charged with fluoride (48h) and transferred to deionized water (DW)/artificial saliva (AS). Fluoride release/re-release was measured every 24h (ion-selective electrodes) with DW/AS replaced daily, and samples re-charged (5min) with fluoride every 2 days. Five absorption-release cycles were conducted over 10 days. CaAl and MgAl LDH rod-shaped specimens (dry and hydrated; 0, 10 and 30wt%) were studied for flexural strength and modulus. CaAl and MgAl LDH-composite discs (0, 10, 30 and 45wt% LDH) were prepared to study water uptake (over 7 weeks), water desorption (3 weeks), diffusion coefficients, solubility and cation release (ICP-OES).

RESULTS

CaAl LDH and MgAl LDH-composites significantly increased the amount of fluoride released in both media (P<0.05). In AS, the mean release after every recharge was greater for MgAl LDH-composites compared to CaAl LDH-composites (P<0.05). After every recharge, the fluoride release was greater than the previous release cycle (P<0.05) for all LDH-composites. Physico-mechanical properties of the LDH-composites demonstrated similar values to those reported in literature. The solubility and cation release showed a linear increase with LDH loading.

SIGNIFICANCE

LDH-composites repeatedly absorbed/released fluoride and maintained desired physico-mechanical properties. A sustained low-level fluoride release with LDH-composites could lead to a potential breakthrough in preventing early stage carious-lesions.

Enhancing the Mechanical Properties of Glass-Ionomer Dental Cements: A Review

This paper reviews the strategies that have been reported in the literature to attempt to reinforce glass-ionomer dental cements, both conventional and resin-modified. These cements are widely used in current clinical practice, but their use is limited to regions where loading is not high. Reinforcement might extend these applications, particularly to the posterior dentition. A variety of strategies have been identified, including the use of fibres, nanoparticles, and larger particle additives. One problem revealed by the literature survey is the limited extent to which researchers have used International Standard test methods. This makes comparison of results very difficult. However, it does seem possible to draw conclusions from this substantial body of work and these are (1) that powders with conventional particle sizes do not reinforce glass-ionomer cements, (2) certain fibres and certain nanoparticles give distinct improvements in strength, and (3) in the case of the nanoparticles these improvements are associated with differences in the morphology of the cement matrix, in particular, a reduction in the porosity. Despite these improvements, none of the developments has yet been translated into clinical use.

Comparison of antibacterial effects of orthodontic composites containing different nanoparticles on Streptococcus mutans at different times

Introduction:

Plaque accumulation can cause white spot lesions. Adding nanoparticles to composites can be effective in reducing the number and function of microorganisms.

Objective:

The aim of this study was to evaluate the antibacterial effects of orthodontic composites containing different nanoparticles on Streptococcus mutans at different times.

Methods:

Hydroxyapatite, titanium oxides, zinc oxide, copper oxide and silver oxide nanoparticles were prepared at 0.5% and 1% weight concentrations. Accordingly, ten study groups and one control group were obtained. Then, 26 composite discs were prepared from each group. Strain of Streptococcus mutans was cultured, and colonies of Streptococcus mutans were counted. Further bacterial culture was swapped onto enriched Mueller-Hinton agar. The composites were placed on the culture medium, and after incubation the diameter of growth inhibition was measured. To investigate the long-term effect of nanoparticles, the colonies were counted at days 3, 15 and 30.

Results:

The results showed that 1% copper oxide and 1% silver oxide significantly reduced the number of bacteria (p< 0.05), but there was no significant difference between the other groups and control group (p> 0.05). At day three, there was a significant difference between control group and 0.5% silver oxide, 1% silver oxide and 1% copper oxide groups (p< 0.05). However, colonies had grown in all groups at day 30 but showed no significant difference with control group (p> 0.05).

Conclusion:

Addition of 1% copper oxide and 1% silver oxide has short-term antibacterial effects, so the clinical use of these nanoparticles cannot be justified.

Commercially Available Fluoride-Releasing Restorative Materials: A Review and a Proposal for Classification

Resin composite and glass ionomer cement (GIC) are the most commonly used dental materials to perform direct restorations. Both have specific characteristics that explain their popularity and their limits. More than 20 years ago, the first attempt (followed by others) to combine the advantages of these two families was performed with compomers, but it was not very successful. Recently, new formulations (also called 'smart materials') with claimed ion release properties have been proposed under different family names, but there are few studies on them and explanations of their chemistries. This comprehensive review aims to gather the compositions; the setting reactions; the mechanical, self-adhesive, and potential bulk-fill properties; and the ion release abilities of the large existing families of fluoride-releasing restorative materials and the new restorative materials to precisely describe their characteristics, their eventual bioactivities, and classify them for an improved understanding of these materials. Based on this work, the whole GIC family, including resin-modified and highly viscous formulations, was found to be bioactive. Cention N (Ivoclar Vivadent, AG, Schaan, Lietschentein) is the first commercially available bioactive resin composite.

An In-Vitro Comparative Evaluation of Pre-treatment With Nano-Silver Fluoride on Inhibiting Secondary Caries at Tooth Restoration Interface

Introduction and aim

Dental caries is the global burden worldwide and has a negative effect on the quality of life. Restorative materials in pediatric dentistry have shown satisfactory properties; however, the highest failures are still reported due to the occurrence of secondary caries. The article aims to assess the effectiveness of pre-treatment with nano-silver fluoride (NSF) in inhibiting secondary caries at the tooth restoration interface.

Materials and methods

Forty tooth specimens were prepared from 20 newly extracted human premolar teeth by sectioning the tooth mesiodistally. Class V cavities were prepared on each specimen at enamel dentin junction. Specimens were randomly distributed into four groups (n=10): 1) glass ionomer cement (GIC) restoration, 2) composite restoration 3) NSF pre-treatment + GIC restoration, 4) NSF pre-treatment + composite restoration. After sterilization, specimens were subjected to artificial caries formation by pH cycling method for 14 days. Specimens were sectioned and mounted to evaluate the demineralization by using the Vickers microhardness test. Outer lesion depth was measured at the tooth restoration interface on digital radiographs. Data was analyzed using Student unpaired t-test, one-way ANOVA, and Tukey honestly significant difference (HSD) post hoc test.

Results

The mean microhardness value of pre-treated GIC and composite group with NSF was more than the non-treated NSF group, with a significant difference at the enamel, indicating lesser demineralization. Outer lesion depth was lesser in the pre-treated group showing better tooth restoration integrity with a statistically significant difference between the groups.

Conclusion

Pre-treatment with NSF is beneficial in increasing the resistance of GIC and composite resin restoration to secondary caries formation.

Effects of surface coating on the flexural strength of fluoridereleasing restorative materials after water aging for one year

Purpose:

To evaluate the effects of surface coating and one-year water storage on the flexural strength of fluoride-releasing restorative materials.

Materials and methods:

Forty specimens were prepared from each material; GCP Glass Fill (GCP), Amalgomer CR (AHL), Zirconomer (Shofu), Fuji IX GP Capsule (GC), Beautifil II (Shofu), Estelite Σ Quick (Tokuyama) and reliaFIL LC (AHL). The specimens were randomly divided into two groups; surface coated with G-Coat Plus (GC) and uncoated. Each group was subdivided into two groups stored in distilled water at 37◦C for 24 h and 1 year before testing (n=10). The flexural strength was evaluated using three-point bending test according to the ISO 4049:2009 standard using a universal testing machine. After flexural strength test, a cross-section of the coated specimens was evaluated with scanning electron microscopy (SEM).

Results:

A significant increase was observed on the flexural strength of Amalgomer CR, Zirconomer and Fuji IX GP after 24 h when G-Coat Plus was applied (p<0.05). This significant increase was observed on the flexural strength of only Amalgomer CR and Zirconomer after 1 year (p<0.05). The highest flexural strength was obtained with Beautifil II, Estelite Σ Quick and reliaFIL LC after 24 h and 1 year (p<0.05). After 1 year, there was decrease on the flexural strength of the other materials except Beautifil II, Estelite Σ Quick and reliaFIL LC.

Conclusion:

The resin coating improved the flexural strength of some glass ionomer-based materials but the water aging decreased the same physical properties.

Synergistic effect of zeolite/chitosan in the removal of fluoride from aqueous solution

Today, fluoride represents one of the most often found, and resilient, pollutants threatening the health of millions of people around the globe. The use of biosorbents is an interesting alternative technique for the removal of fluorine-ions. Chitosan is a natural biopolymer with surface groups capable of removing fluorine; however, their lack of mechanical stability restricts its application. In the present work, we proposed that such limitations can be overcame by forming a composite with zeolite (ZCC). A proper zeolite-to-chitosan ration must be kept to prevent a collapse of the material's capacity. Two ZCCs at ratios of 1:1 and 1:3 were formed and tested for the removal of fluoride from aqueous solution. The composites were characterized by Electron Microscopy, FT-IR, N₂ physisorption, and potentiometric titration techniques. During fluoride adsorption studies, the effects of pH and temperature were analysed and thermodynamic parameters for adsorption were calculated. The results demonstrated that there is a chemical interaction between the zeolite and chitosan components leading to a superior adsorption performance than if there was a simple physical mixture of the precursors. Maximum adsorption capacities were reached using the composite material with the lowest chitosan content due to reduced constriction of the zeolite pores and a better dispersion of overall the adsorption sites. Both pH and temperature had a significant, and negative, impact on the adsorption; these effects were discussed. The present work represents an advance in the development of functional biocomposites for the removal of pollutants from aqueous solutions.

Effect of smear layer deproteinization with HOCl solution on the dentin bonding of conventional and resin-modified glass-ionomer cements

The effect of smear layer-deproteinizing pretreatment using hypochlorous acid (HOCl) on the micro-shear bond strengths (μSBS) of conventional and resin-modified glass-ionomer cements (GIC) to dentin was investigated and compared with demineralizing pretreatment with polyacrylic acid (PAA). Three GICs: Fuji IX GP Extra (restorative conventional GIC), GC Fuji II LC EM (restorative resin-modified GIC), and GC Fuji Luting EX (luting resin-modified GIC), were used. One hundred fifty human molars were divided into groups (n = 10) according to the cements and dentin pretreatments; no pretreatment (control), 10 s PAA pretreatment, and HOCl pretreatment for 5, 15, or 30 s. After 24 h, μSBS was tested and the data were statistically analyzed using a two-way ANOVA, followed by Tukey's post-hoc test. HOCl pretreatment significantly increased μSBS of conventional GIC compared to the control group. For resin-modified restorative GIC, 5 s HOCl deproteinization significantly increased μSBS, while longer application times did not. There was no significant difference between HOCl-pretreated and control groups of resin-modified luting GIC. PAA pretreatment increased the μSBS of all cements significantly. In conclusion, smear layer deproteinization with HOCl can enhance the dentin bonding of conventional GIC. However, the residual radicals may adversely affect the polymerization of resin-modified GICs.

Synthesis of poly(acrylic-co-itaconic acid) through precipitation photopolymerization for glass-ionomer cements: Characterization and properties of the cements

OBJECTIVE

The aim of this study was to synthesize poly(acrylic acid-co-itaconic acid) (PAA-co-PIA) ionomer through a novel precipitation photopolymerization technique. The ionomer was characterized and the effect of its structural parameters, such as molecular weight and copolymer composition were investigated on the mechanical properties of glass-ionomer prepared using the ionomer.

METHODS

Design of experiment (DOE) was used to examine the effect of monomer ratio and the amount of chain transfer agent on the molecular weight and final conversion of the ionomers synthesized through the precipitation photopolymerization. The copolymer compositions were identified using FTIR and ¹H-NMR spectroscopy. The molecular weights of the copolymers were evaluated by GPC. A series of PAA-co-PIA copolymers were then synthesized via the photopolymerization technique in three monomer ratios and two molecular weight ranges (high and low) to study the properties of the glass ionomers thereof. Experimental dental glass-ionomer cements were prepared by mixing the synthesized polymers with glass powder and their compressive properties were determined according to ISO 9917-1:2007 after storing for 0, 1, 7 and 28 days in distilled water. The scanning electron microscopy (SEM) was used to study the fracture surface morphology of the cements.

RESULTS

The PAA-co-PIA polymers were synthesized by the photopolymerization method in a short time and high purity. The DOE showed that by decreasing the acrylic acid/itaconic acid ratio and increasing the amount of transfer agent, the molecular weight and final conversion decreased significantly. By increasing the itaconic acid content in the copolymer composition and increasing the molecular weight in a constant copolymer composition, the compressive strength and modulus were increased. Microstructures revealed that cements made of the higher molecular weight poly acids showed lower cracks and voids.

SIGNIFICANCE

The precipitation photopolymerization technique provides a promising and facile method in the synthesis of ionomers which are used in dental cements and other application.

Resistance to demineralisation of adjacent enamel and dentine, fluoride release and dentine bond strength of fluoride-containing self-etch adhesive systems

BACKGROUND

The current study aimed to assess the amount of fluoride released from fluoride-containing dental adhesives and its effect on micro-tensile bond strength (µTBS) and on resistance to demineralisation of dentine and enamel.

MATERIAL AND METHODS

Two fluoride-containing dental adhesives, and a fluoride-free adhesive were used as experimental adhesives. After thermal cycling the µ-TBS of adhesives to dentine and the failure mode were assessed. The fluoride release and cross-sectional microhardness (CSMH) of specimens were measured before and after one day, 7 and 28 days of pH-cycling. The data were analysed using one-way ANOVA, Weibull statistics and repeated measures ANOVA.

RESULTS

The results indicated a significant difference between the group of FL and both the SE and LBF groups (p≤0.001). The CSMH values of both the dentine and enamel underneath the adhesives was reduced at 28 th day of the pH-cycling compared to the baseline (p≤0.001). From day 1 to day 28, the released fluoride declined in both the fluoride containing dental adhesives (p≤0.001).

CONCLUSIONS

Based on the results, the released fluoride from dental adhesives may adversely influence the bond strength and durability of the resin/dentine interface. Moreover, the released fluoride didn't improve the resistance to demineralisation of adjacent enamel and dentine to bond interface. Key words:Fluoride release, micro-tensile bond strength, microhardness, fluoride-containing adhesives.

Dental Caries Preventive Considerations: Awareness of Undergraduate Dental Students

The aim of this study was to assess awareness and knowledge of undergraduate dental students of common caries-related preventive considerations and to highlight these factors in a concise manner to act as a guide for dental practitioners. A sample of 118 undergraduate students at a local government dental school was included. An interactive survey that contains questions related to common preventive strategies against dental caries was presented to the students. The survey contained 22 questions concerning dietary and therapeutic strategies. Students casted their votes using their mobile cellphones. The correct answer for each question was shown to the students, and further discussion was held. Data was collected, and the statistical analysis was conducted using one-sample z- and chi-squared tests at 0.05 significance level. The students answered the questions related to oral hygiene practices, xylitol, and the common knowledge regarding fluoride. The questions related to the use of chlorhexidine, dietary factors, and fluoride formulations were answered mostly incorrectly. The students seemed to grasp details of important concepts of flossing, brushing, reducing frequency of sugar exposure, and the use of fluoride products. Still, more emphasis should be given to increase students’ awareness of dietary guidelines for caries prevention, since adequate knowledge of these modalities is paramount for graduating dentists.

Antibacterial efficacy and remineralization capacity of glycyrrhizic acid added casein phosphopeptide-amorphous calcium phosphate

The aim was to evaluate remineralization capacity and antibacterial efficiency of Tooth Mousse and various amounts of glycyrrhizic acid added Tooth Mousse on primary tooth enamel. Three groups were formed; Group 1 (CPP-ACP), Group 2 (CPP-ACP + 5% glycyrrhizic acid), and Group 3 (CPP-ACP + 10% glycyrrhizic acid) in order to evaluate remineralization capacity. Enamel samples were immersed in demineralization solution and then remineralization agents were applied. Surface microhardness and SEM analyses were performed at the beginning, after demineralization and remineralization. For antibacterial tests, four groups were formed; Group 1, Group 2 and Group 3 and Group 4 (control). Biofilms were then exposed to 10% sucrose eight times per day for 7 days. After biofilm growth period, samples were treated with materials to evaluate antibacterial efficiency except control group. After application of materials, samples were incubated 2 more days at 37°C and at the end of this period, absorbance values of biofilms were determined and data were analyzed. An increase in microhardness values was Group 2 > Group 3 > Group 1, respectively, but there were no significant differences. After remineralization, microhardness values showed significant increases when compared to demineralized groups, but there was no significant difference. All groups showed decreased absorbance value of biofilm when compared with control group but they were insignificant. It was observed that both in Group 2 and Group 3, glycyrrhizic acid did not have a negative effect on remineralization and although they have an increase, it was insignificant. Although glycyrrhizic acid added CPP-ACP groups showed increased antibacterial activity, they were not statistically significant.

Acidity-induced release of zinc ion from BioUnionTM filler and its inhibitory effects against Streptococcus mutans

BioUnion filler incorporated into restorative/coating materials is a new bio-functional glass powder. The most unique function of BioUnion filler is its ability to release Zn²⁺ in acidic environments. In this study, the ion release profile of BioUnion filler under acidic conditions and its antibacterial effects against Streptococcus mutans were evaluated. The concentrations of Zn²⁺ released from BioUnion fillers into acetic acids were greater than those released into water. S. mutans inhibition by BioUnion fillers was greater with sucrose than without sucrose, reflecting a decrease in suspension pH in response to the addition of sucrose. Exposure to acids increased Zn²⁺ release from BioUnion fillers, and the fillers after repeated exposure to acids demonstrated inhibitory effects against S. mutans. These findings suggest that BioUnion filler accelerated the release of Zn²⁺ under acidic conditions, which induced bactericidal/inhibitory effects against S. mutans.

Antimicrobial Efficacy of Triphala and Propolis-modified Glass Ionomer Cement: An In Vitro Study

Background

The antimicrobial activity of restorative materials has a major role in preventing recurrent caries.

Aim

To assess the antimicrobial activity of triphala and propolis-modified glass ionomer cement (GIC) against Streptococcus mutans and Lactobacillus.

Materials and methods

The samples were prepared using cylindrical molds (6 mm in diameter and 2 mm in thickness). A total of 30 samples were prepared containing 10 samples in each group. Group I, 10 samples of glass ionomer with aqueous extract of triphala were prepared; group II, 10 samples of glass ionomer with 50% of ethanolic extract of propolis (EEP); and group III as control consisting of 10 samples of glass ionomer. The samples were placed in to agar plates containing inoculum of S. mutans and Lactobacillus and incubated at 37°C for 48 hours and using a digital caliper, zones of inhibition formed around specimens were measured.

Results

Data obtained were analyzed using nonparametric Kruskal-Wallis test followed by pairwise comparison was done using Dunn-Bonferroni test. Group I and group II showed highest antimicrobial efficacy against S. mutans and Lactobacillus with no statistical significant difference, i.e., (p value > 0.05) but in both groups I and II, there was a statistical significant difference when comparing with group III i.e., (p < 0.05).

Conclusion

Thus, triphala and propolis-modified GIC provided higher antibacterial effect with increased level of inhibition against the S. mutans and Lactobacillus; hence, it can be used as a choice of restorative material to treat dental caries. Further studies are required to determine the physical and mechanical characteristics of the material.

How to cite this article

Paulraj J, Nagar P. Antimicrobial Efficacy of Triphala and Propolis-modified Glass Ionomer Cement: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(5):457-462.

Antibiofilm activities of fluoride releasing restorative materials

Backround/Aim: The purpose of this in vitro study is to evaluate the antibiofilm and antimicrobial activities of 5 different restorative materials that release fluoride. Material and Methods: Five different fluoride releasing restorative materials [Riva Self Cure (SDI, Australia), Riva Light Cure (SDI, Australia), Riva Silver (SDI, Australia), Dyract® XP (DENTSPLY, Germany) and Beautifil II (SHOFU, Japan)] and one composite resin material (Grandio, VOCO, Germany) were selected for this study. A total of 48 specimens (8 of each) were prepared using Teflon molds (4.0 mm-diameter and 2.0 mm-thickness). The antibacterial and antibiofilm activities of the mentioned restorative materials on Streptococcus mutans were evaluated. The data obtained were evaluated by One-Way analysis and Tukey's Test (p<0.05). Results: As a result, no correlation was found in terms of antibacterial and antibiofilm activities of the restorative materials evaluated in the study. While the dental plaque (matrix) accumulation was detected at least on the Grandio resin, the materials with the least cell adhesion were Light Cure and Riva Self Cure since it showed antiadhesive properties for S. mutans. Conclusions: Although the highest antibacterial activity against S. mutans was detected in resin-modified glass ionomers, biofilm matrix (dental plaque) accumulation was mostly detected on these material surface in our study.

Fluoride Release of Fresh and Aged Glass Ionomer Cements after Recharging with High-Fluoride Dentifrice

Objective

This study aimed to evaluate F release from GICs before and after recharging with F-dentifrices and after aging process.

Methods

Fifteen specimens of GICs (conventional, resin modified, and high viscosity) and composite resin were stored individually in a polystyrene tube containing 2 ml of deionized water (DW), with water replacement every 24 hours. After 15 days, the specimens were treated with a dentifrice suspension (1 : 3 by volume) containing 0 μg F/g (n = 5), 1,100 μg F/g (n = 5), or 5,000 μg F/g (n = 5). After 3 min, the specimens were rinsed and replaced in new tubes with 2 ml of DW. This procedure was performed 2x/day for 2 days. The readings were taken on days 1, 5, 10, and 15 before and after the treatments. A second experiment was performed, using the same specimens of the previous study that were submitted to an aging process (specimens were kept in 2 ml of DW, remaining at 37°C for 36 weeks). Readings using specific electrode for F detection were taken on days 1, 5, 10, and 15 after treatment of the samples as described above. Data were analyzed by ANOVA and Tukey's test with α fixed at 5%.

Results

It was observed that the highest release of F for all the GICs occurred on the first day after the treatments, especially when using a high-fluoride dentifrice, with decreasing release over time. Also, although aged GICs still recharge with F treatments, the amount of F released was lower than fresh materials.

Conclusion

GICs present a high F recharge and release capacity, especially in the first 24 hours and after the treatment with a high-fluoride dentifrice, even after material aging.

Physicochemical, Mechanical, and Antimicrobial Properties of Novel Dental Polymers Containing Quaternary Ammonium and Trimethoxysilyl Functionalities

The aims of this study were to evaluate the physicochemical and mechanical properties, antimicrobial (AM) functionality, and cytotoxic potential of novel dental polymers containing quaternary ammonium and trimethoxysilyl functionalities (e.g., N-(2-(methacryloyloxy)ethyl)-N,N-dimethyl-3-(trimethoxysilyl)propan-1-aminium iodide (AMsil1) and N-(2-(methacryloyloxy)ethyl)-N,N-dimethyl-11-(trimethoxysilyl)undecan-1-aminium bromide (AMsil2)). AMsil1 or AMsil2 were incorporated into light-cured (camphorquinone + ethyl-4-N,N-dimethylamino benzoate) urethane dimethacrylate (UDMA)/polyethylene glycol-extended UDMA/ethyl 2-(hydroxymethyl)acrylate (EHMA) resins (hereafter, UPE resin) at 10 or 20 mass %. Cytotoxic potential was assessed by measuring viability and metabolic activity of immortalized mouse connective tissue and human gingival fibroblasts in direct contact with monomers. AMsil-UPE resins were evaluated for wettability by contact angle measurements and degree of vinyl conversion (DVC) by near infra-red spectroscopy analyses. Mechanical property evaluations entailed flexural strength (FS) and elastic modulus (E) testing of copolymer specimens. The AM properties were assessed using Streptococcus mutans (planktonic and biofilm forms) and Porphyromonas gingivalis biofilm. Neither AMsil exhibited significant toxicity in direct contact with cells at biologically relevant concentrations. Addition of AMsils made the UPE resin more hydrophilic. DVC values for the AMsil-UPE copolymers were 2%-31% lower than that attained in the UPE resin control. The mechanical properties (FS and E) of AMsil-UPE specimens were reduced (11%-57%) compared to the control. Compared to UPE resin, AMsil1-UPE and AMsil2-UPE (10% mass) copolymers reduced S. mutans biofilm 4.7- and 1.7-fold, respectively (p ≤ 0.005). Although not statistically different, P. gingivalis biofilm biomass on AMsil1-UPE and AM AMsil2-UPE copolymer disks were lower (71% and 85%, respectively) than that observed with a commercial AM dental material. In conclusion, the AM function of new monomers is not inundated by their toxicity towards cells. Despite the reduction in mechanical properties of the AMsil-UPE copolymers, AMsil2 is a good candidate for incorporation into multifunctional composites due to the favorable overall hydrophilicity of the resins and the satisfactory DVC values attained upon light polymerization of AMsil-containing UDMA/PEG-U/EHMA copolymers.

The effect of the addition of propolis to resin-modified glass ionomer cement bracket adhesive materials on the growth inhibition zone of Streptococcus mutans

Background: Orthodontic treatments progress alongside the development of adhesive materials. The present study aimed to determine the antibacterial properties of propolis, a natural product, in a mixture of resin-modified glass ionomer cement by observing the growth inhibition zone of  Streptococcus mutans.Methods: This was an in vitro study conducted on 45 samples of adhesive material, which were divided into control group (resin-modified glass ionomer cement bracket adhesive material), two groups of propolis concentrations (15%, and 25%) and duration (0, 15, and 30 days). The antibacterial effect of each sample was evaluated against S. mutans using an agar plate diffusion test. Measurement of the diameter of the growth inhibition zone of S. mutans was carried out. The data obtained were analyzed statisticallyThe significance value of the Kruskal Wallis and Mann-Whitney test was set at p <0.05, while the significance value of the normality and homogeneity test was set at p> 0.05). Datas in this study that were not normally distributed (p = 0.012) but homogeneous (p = 0.110) were analyzed by the Kruskal-Wallis test (p = 0.003) and then the Mann-Whitney test was performed to determine differences in significance between groups. Results: There was a relationship between concentration and duration of propolis to the growth inhibition zone of S. mutans (p=0.003). The addition of 25% propolis concentration inhibited the growth of S. mutans more than the addition of 15% and without propolis (control group). The addition of propolis to resin-modified glass ionomer cement for 15 days was more effective in inhibiting the growth of S. mutans.Conclusion: The addition of propolis to adhesive materials provides an inhibitory effect on the growth of S. mutans, which may be effective in the world of preventive dentistry.

The effect of the addition of propolis to resin modified glass ionomer cement bracket adhesive materials on the growth inhibition zone of Streptococcus mutans

Background: Orthodontic treatments progress alongside the development of adhesive materials. The aim of the present study was to determine the antibacterial properties of propolis, a natural product, in a mixture of resin modified glass ionomer cement by observing the growth inhibition zone of Streptococcus mutans. Methods: This was an in vitro study conducted on 45 samples of adhesive material, which were divided into three groups of propolis concentrations (0%, 15%, and 25%) and duration (0, 15, and 30 days). The antibacterial effect of each sample was evaluated against S. mutans using an agar plate diffusion test. Measurement of the diameter of the growth inhibition zone of S. mutans were carried out. The data obtained were analyzed statistically by Kruskal Wallis test. Results: There was a relationship between concentration and duration of propolis to the growth inhibition zone of S. mutans (p<0.05). The addition of 25% propolis concentration inhibited the growth of S. mutans more than the addition of 15% and 0% propolis concentration. The addition of 0%, 15%, and 25% propolis concentration to resin modified glass ionomer cement for 15 days was more effective in inhibiting the growth of S. mutans.Conclusion: The addition of propolis to adhesive materials provides an inhibitory effect on the growth of S. mutans, which may be effective in the world of preventive dentistry.

Microhardness of glass carbomer and high-viscous glass Ionomer cement in different thickness and thermo-light curing durations after thermocycling aging

Background

The objective of our study was to compare the upper and lower surface microhardness and surface changes of Glass Carbomer Cement (GCP) and EQUIA Forte (EF) in different thickness after thermo-light curing durations and aging.

Methods

A total of 504 samples (5 mm-diameter) were prepared by using GCP-252 (GCP Dental, and Vianen, Netherlands) and EF-252 (EQUIA Forte, GC, Tokyo, Japan). Three different thickness samples (2, 4, and 6 mm) were prepared with 84 samples in each subgroup. The samples were prepared by three curing procedures (Non-exposed, 60s, 90s). Their varnishes were applied to the upper surfaces of half of each subgroup (n = 7). The upper microhardness measurements were evaluated before and after aging. To compare the effect of different thicknesses, the bottom surfaces of the samples were evaluated before aging in terms of microhardness measurements. Also, the upper surfaces were analyzed in the SEM before and after aging.

Results

The upper surface values of all the samples were higher than the bottom values (p < 0.05). There were no significant differences between the varnished and non-varnished samples in both materials (p > 0.05). Although this increase was not significant in some groups, temperature variations increased the surface microhardness values of both materials except for the non-exposed-varnished EF samples. The highest microhardnesses values were recorded in the non-exposed-varnished EF (125.6 ± 6.79) and unvarnished GCP (88.1 ± 7.59) samples which were thermo-light cured for 90 s before aging. The bottom hardness values were affected by thickness variations in both GCP and EF materials (p < 0.05). The sample deformations and microcracks after aging were greater than before in all the materials. Thermo-light curing in 90 s to the samples reduced the cracks in both the materials before and after aging.

Conclusions

Thermal aging adversely affected the microhardness of the materials, which is important for clinical success. The thermo-light curing process improved the microhardness of the GCP group without varnish application. Varnish application increased the microhardness of the EF group without applying thermo-light curing. The microhardness of the bottom surfaces decreased with increasing thickness. The thermo-light curing did not increase the bottom surface microhardness of all the samples.

New Pre-reacted Glass Containing Dental Composites (giomers) with Improved Fluoride Release and Biocompatibility

The aim of the present work was to prepare a series of novel restorative giomers and investigate the morphology, the physico-chemical properties (residual monomer, fluoride release), and the cytotoxicity of the new materials. The experimental giomers were prepared as light-cured pastes by blending different resin matrices comprising aromatic/aliphatic/urethane (di) methacrylates, with hybrid fillers containing pre-reacted glasses (PRGs), a radiopaque glass, and nano fluorhydroxyapatite. Polyalkenoic acids based on acrylic acid/itaconic acid/N-acryloyl -L-leucine modified or not with methacrylic groups, together with a superficially active glass, were used to prepare the PRGs. The fluoride ion release of the experimental giomers was investigated within a period of 60 days of storage in bidistilled water while using a fluoride ion selective electrode. Beautifil II commercial product was used as a reference. Cell cytotoxicity tests were done in vitro, in accordance with ISO 10993-122012 proceedings. Human dermal fibroblasts and umbilical endothelial vein cultures were used. The values that were obtained for cumulative fluoride release for all experimental giomers were higher than for the Beautifil II product, being more than twice the ones that were obtained for the commercial product after 60 days of storage in bidistilled water. The experimental biomaterials showed similar and/or better results when compared to the commercial one; this effect was maintained in all tested conditions.

Fluoride Release from Two High-Viscosity Glass Ionomers after Exposure to Fluoride Slurry and Varnish

The effect of brushing with different fluoride slurries on the fluoride release (FR) of different high-viscosity glass ionomer cements (GICs) was investigated. Fifty-eight discs were fabricated from two high-viscosity GICs (GC Fuji IX (F9) and 3M ESPE Ketac-fil (KF)). Five specimens from each brand were used to measure Vickers microhardness and the remaining were randomly assigned to one of four groups (n = 6) based on two-factor combinations: (1) fluoride concentration in the abrasive slurry (275 or 1250 ppm fluoride as NaF) and (2) immersion in a 22,500 ppm fluoride-containing solution. Specimens were brushed for a total of 20,000 strokes over 4 days with daily FR measurement. Data were analyzed using analysis of variance and Bonferroni tests (α = 0.05). Baseline FR and microhardness values were different between the two tested material brands. Exposure to a 22,500 ppm solution was associated with higher FR but not the exposure to 1250 ppm slurries. Brushing and immersion of glass ionomer cements in a 22,500 ppm F solution led to higher FR that was more sustained for KF. Type of the glass ionomer, progressive brushing, and fluoride varnish affected FR but not the fluoride content in the abrasive slurry.

The Influence of Mixing Methods on the Compressive Strength and Fluoride Release of Conventional and Resin-Modified Glass Ionomer Cements

Objective

To evaluate the compressive strength and fluoride ion release of conventional and resin-modified glass ionomer cement mixing methods (hand mix and mechanical mix) compared to ready-to-use ones.

Materials and Methods

Two conventional glass ionomer cements (GICs) (Fuji II and Fuji II Caps), two resin-modified GICs (Fuji II LC and Fuji II L Caps), and one ready-to-use GIC (Ionoseal, Voco) were used. For the compressive strength test, cylindrical specimens (6 mm × 4 mm) of each group were prepared. The test was performed in a universal testing machine (EMIC DL2000). For the fluoride release test, specimens were prepared in the form of discs and placed in deionized/distilled water, which were replaced daily for 15 days. The fluoride ion release readings were performed on an electrode (Orion 96-09) connected to a digital ion analyzer (Quimis 0400ISE). The compressive strength data were analyzed with one-way ANOVA, and the ion release data were submitted to repeated measures ANOVA (material vs. time) and Holm-Sidak post test (α = 5%).

Results

The one-way ANOVA showed statistical difference between the tested materials (p < 0.001). Ionoseal showed the highest values of compressive strength (p < 0.001). Mechanical manipulation increased the compressive strength only for conventional GIC, and resin-modified GIC did not present any statistical difference. Conventional GIC (mechanical mix) showed higher fluoride release on first day than the other groups tested.

Conclusion

There was influence of the mixing methods of the materials on the compressive strength and fluoride release pattern of the glass ionomer cements.

Antibacterial, physical and mechanical properties of bonding agent containing synthesized Zinc Dimethacrylate

Background

The aim of this study includes synthesis of zinc dimethacrylate ionomer (ZDMA) by a new method, incorporate it into resin bonding and evaluate its antibacterial, physical and mechanical properties.

Material and Methods

Resin adhesives containing 0 to 5% wt of ZDMA was produced and the following tests were accomplished: A: Antibacterial test: 1.Direct contact test. 2.Material aging; in both of them the bacterial colony counting were performed. B: Physical test: 1.Degree of conversion (D.C). 2.Evaluating the amount of released Zinc ion release in aqueous medium. C: Mechanical test: 1.Compressive strength test. 2.Shear bond test (enamel and dentine separately). The obtained results were statistically analyzed using One Way ANOVA and LSD post hoc test (α=0.05).

Results

The anti-bacterial test revealed that all the ZDMA containing groups significantly reduced the amount of Streptococcus Mutans bacteria. Moreover, the D.C in all ZDMA groups was enhanced. Furthermore, ion release analysis revealed noticeable stability of Zn2+ in samples, as in the 5wt.% group it was even after nine cycle of 24h wash. On the other hand, the compressive strength was significantly reduced just in the 5% ZDMA group while the other groups were superior comparing to the control. In addition, there was no significant difference among the enamel shear bond strength of the groups. However, about the dentine shear bond strength, only the 5% ZDMA group was significantly higher than the control.

Conclusions

Low percentages of ZDMA in adhesive could impart anti-bacterial efficacy without challenging its mechanical and physical properties.

Key words:Dental Resin Bonding, Zinc, Streptococcus mutans, Degree of conversion, Compressive strength.