Fluoride release from dental cements and composites: A mechanistic study

Adhesive Ability of Different Oral Pathogens to Various Dental Materials: An In Vitro Study

Introduction

In dental treatments, the reason for secondary caries and the failure of root canal treatment is the microbial infection, which concerns most dentists. The challenge of how to reduce the number of bacteria at the filling materials and the number of residual bacteria in the root canal has become a research hotspot. In this study, the bacterial adhesion properties of several common dental materials were compared to provide a theoretical basis for the selection of antibacterial properties of dental materials. Methodology. Three commonly used dental restorative materials and five sealers in root canal treatment were selected. Each material block was immersed in the corresponding supragingival (Streptococcus mutans and Actinomyces viscosus) or subgingival (Porphyromonas gingivalis and Enterococcus faecalis) bacterial solution and cultured under anaerobic conditions at 37°C for 2, 4, 6, 8, 12, 16, 20, and 24 h. The adhesion of bacteria was observed, and the number of different bacteria adhering to various material model disks was calculated at different time intervals under a scanning electron microscope. The adherent CFU load of the materials was determined by colony counting.

Results

Streptococcus mutans and Actinomyces viscosus exhibited the strongest adhesion ability to the resin material blocks. Porphyromonas gingivalis and Enterococcus faecalis exhibited the highest adhesion ability to the AH-Plus sealer block.

Conclusions

In dental treatments, dental materials should be selected based on the chemical, physical, and biological properties of materials. In addition, it is necessary to develop new antibacterial dental materials.

Fluoride release from two types of fluoride-containing orthodontic adhesives: Conventional versus resin-modified glass ionomer cements-An in vitro study

INTRODUCTION

Development of white spot lesions (WSLs) during orthodontic treatment is a common risk factor. Fixation of the orthodontic appliances with glass ionomer cements could reduce the prevalence of WSL's due to their fluoride release capacities. The purpose of this study was to evaluate differences of fluoride release properties from resin-modified and conventional glass ionomer cements (GICs).

METHODS

The resin-modified GICs Fuji ORTHO LC (GC Orthodontics), Meron Plus QM (VOCO), as well as the conventional GICs Fuji ORTHO (GC Orthodontics), Meron (VOCO) and Ketac Cem Easymix (3M ESPE) were tested in this study. The different types of GICs were applied to hydroxyapatite discs according to the manufacturer's instructions and stored in a solution of TISAB III (Total Ionic Strength Adjustment Buffer III) and fluoride-free water at 37°C. Fluoride measurements were made after 5 minutes, 2 hours, 24 hours, 14 days, 28 days, 2 months, 3 months and 6 months. One factor analysis of variance (ANOVA) was used for the overall comparison of the cumulative fluoride release (from measurement times of 5 minutes to 6 months) between the different materials with the overall level of significance set to 0.05. Tukey's post hoc test was used for post hoc pairwise comparisons in the cumulative fluoride release between the different materials.

RESULTS

The cumulative fluoride release (mean ± sd) in descending order was: Fuji ORTHO LC (221.7 ± 10.29 ppm), Fuji ORTHO (191.5 ± 15.03 ppm), Meron Plus QM (173.0 ± 5.89 ppm), Meron (161.3 ± 7.84 ppm) and Ketac Cem Easymix (154.6 ± 6.09 ppm) within 6 months. Analysis of variance detected a significant difference in the cumulative fluoride release between at least two of the materials (rounded p-value < 0.001). Pairwise analysis with Tukey's post hoc test showed a significant difference in the cumulative fluoride release for all the comparisons except M and MPQM (p = 0.061) and KCE and M (p = 0.517).

CONCLUSION

Fluoride ions were released cumulatively over the entire test period for all products. When comparing the two products from the same company (Fuji ORTHO LC vs. Fuji ORTHO from GC Orthodontics Europe GmbH and Meron Plus QM vs. Meron from VOCO GmbH, Mannheim, Germany), it can be said that the resin-modified GICs have a higher release than conventional GICs. The highest individual fluoride release of all GICs was at 24 hours. A general statement, whether resin-modified or conventional GICs have a higher release of fluoride cannot be made.

Fluoride Ion Release Characteristics of Fluoride-Containing Varnishes—An In Vitro Study

Despite the latest advances in orthodontic treatment, white spot lesions remain a common side effect of fixed appliance therapy. An effective treatment for the prevention of white spot lesions is the use of fluoride-containing products. The aim of the present in vitro study was to check the durability of the tested products for their fluoride release into the surrounding solution. Three varnishes (Protecto CaF2 Nano one-step seal, Bifluorid 12 single dose, and Fluor Protector S) were applied to hydroxyapatite discs and kept in diluted Total Ionic Strength Adjustment Buffer III (TISAB III) solution for fluoride ion release measurement. A group of clear hydroxyapatite discs served as the control group. The carrier discs (N = 40) underwent three thermal cycling runs for 20 days. Before the first run and after each run, the fluoride ion concentration in the solution was measured at appointed times (T) T0, T1, T2, and T3. Fluoride ion release was highest at T1 for all products (median values for Protecto CaF2 Nano one-step seal: 0.09 ppm, Bifluorid 12 single dose: 37.67 ppm, and Fluor Protector S: 3.36 ppm) except for the control group, showing its peak at T0 (0.04 ppm). There was a significant difference between the tested fluoride varnishes at all measurement times. Bifluorid 12 achieved significantly higher fluoride release values than the other products (p < 0.05 at all measurement times). A solitary product application of only once or twice per year, as stated by the manufacturers, cannot be supported.

The synergistic effects of SrF2 nanoparticles, YSZ nanoparticles, and poly-ε-l-lysin on physicomechanical, ion release, and antibacterial-cellular behavior of the flowable dental composites

Resin-based pit-and-fissure sealants (flowable resin composites) were formulated using bisphenol-A-glycerolatedimethacrylate (Bis-GMA)-triethylene glycol dimethacrylate-(TEGDMA)-diurethanedimethacrylate (UDMA) mixed monomers and multiple fillers, including synthetic strontium fluoride (SrF₂) nanoparticles as a fluoride-releasing and antibacterial agent, yttria-stabilized zirconia (YSZ) nanoparticles as an auxiliary filler, and poly-ε-l-lysin (ε-PL) as an auxiliary antibacterial agent. Based on the physical, mechanical and initial antibacterial properties, the formulated nano-sealant containing 5 wt% SrF₂, 5 wt% YSZ and 0.5 wt% ε-PL was selected as the optimal specimen and examined for ion release and cytotoxicity. The results showed an average release rate of 0.87 μg·cm^-2·day^-1 in the aqueous medium (pH 6.9) and 1.58 μg·cm^-2·day^-1 in acidic medium (pH 4.0). The maximum cytotoxicity of 20% toward human bone marrow mesenchymal stem cells (hMSCs) was observed according to the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) cytotoxicity assay and acridine orange staining test. A synergy between SrF₂ nanoparticles and ε-PL exhibited a better antibacterial activity in terms of colony reduction compared to the other samples. However, the inclusion of SrF₂ and ε-PL caused mechanically weakening of the sealants that was partly compensated by incorporation of YSZ nanoparticles (up to 10 wt%).

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.

Validation of a Real-Time ISE Methodology to Quantify the Influence of Inhibitors of Demineralization Kinetics in vitro Using a Hydroxyapatite Model System

The aim was to validate a novel protocol to measure the cariostatic efficacies of demineralization inhibitors by repeating previous SMR (scanning microradiography) studies investigating the dose response of Zn2+ and F- on demineralization kinetics in vitro using real-time Ca2+ ion selective electrodes (ISEs). In this study, Ca2+ release was used as a proxy for the extent of demineralization. Forty-eight hydroxyapatite (HAP) discs were allocated into 16 groups (n = 3) and adding either increasing [Zn2+], or [F-], similar to those used in the previous SMR studies. Each HAP disc was immersed in 50 mL, pH 4.0, buffered acetic acid for 1 h, and real-time ISE methodology was used to monitor the rate of increase in [Ca2+] in the demineralization solution. Next, either zinc acetate or sodium fluoride was added into each demineralization solution accordingly. Then after each [Zn2+] or [F-] addition, the HAP disc was further demineralized for 1 h, and ISE measurements were continued. The percentage reduction in the rate of calcium loss from hydroxyapatite (PRCLHAP) at each [Zn2+] or [F-] was calculated from the decrease in Ca2+ release rate, similar to that used in the previous SMR studies. A log-linear relationship between mean PRCLHAP and inhibitor concentration was found for both Zn2+ and F-, similar to that reported for each ion in the previous SMR studies. In conclusion, real-time Ca2+ ISE systems can be used to measure the cariostatic efficacies of demineralization inhibitors.

The Feasibility and Functional Performance of Ternary Borate-Filled Hydrophilic Bone Cements: Targeting Therapeutic Release Thresholds for Strontium

We examine the feasibility and functionality of hydrophilic modifications to a borate glass reinforced resin composite; with the objective of meeting and maintaining therapeutic thresholds for Sr release over time, as a potential method of incorporating antiosteoporotic therapy into a vertebroplasty material. Fifteen composites were formulated with the hydrophilic agent hydroxyl ethyl methacrylate (HEMA, 15, 22.5, 30, 37.5 or 45 wt% of resin phase) and filled with a borate glass (55, 60 or 65 wt% of total cement) with known Sr release characteristics. Cements were examined with respect to degree of cure, water sorption, Sr release, and biaxial flexural strength over 60 days of incubation in phosphate buffered saline. While water sorption and glass degradation increased with increasing HEMA content, Sr release peaked with the 30% HEMA compositions, scanning electron microscope (SEM) imaging confirmed the surface precipitation of a Sr phosphate compound. Biaxial flexural strengths ranged between 16 and 44 MPa, decreasing with increased HEMA content. Degree of cure increased with HEMA content (42 to 81%), while no significant effect was seen on setting times (209 to 263 s). High HEMA content may provide a method of increasing monomer conversion without effect on setting reaction, providing sustained mechanical strength over 60 days.

Influence of Porous Spherical-Shaped Hydroxyapatite on Mechanical Strength and Bioactive Function of Conventional Glass Ionomer Cement

Glass-ionomer-cement (GIC) is helpful in Minimal Intervention Dentistry because it releases fluoride ions and is highly biocompatible. The aim of this study is to investigate the mechanisms by which hydroxyapatite (HAp) improves the mechanical strength and bioactive functioning of GIC when these materials are combined to make apatite ionomer cement (AIC). A conventional GIC powder was mixed with porous, spherical-HAp particles (HApS), crystalline HAp (HAp200) or one of two types of cellulose. The micro-compressive strengths of the additive particles were measured, and various specimens were evaluated with regard to their compressive strengths (CS), fluoride release concentrations (fluoride electrode) and multi-element release concentrations. The AIC was found to release higher concentrations of fluoride (1.2 times) and strontium ions (1.5 times) compared to the control GIC. It was detected the more release of calcium originated from HApS than HAp200 in AIC. The CS of the AIC incorporating an optimum level of HAp was also significantly higher than that of the GIC. These results suggest that adding HAp can increase the release concentration of ions required for remineralization while maintaining the CS of the GIC. This effect does not result from a physical phenomenon, but rather from chemical reactions between the HAp and polyacrylic acid of GIC.

Release of fluoride from orthodontic adhesives and penetration into enamel

OBJECTIVE

The purpose of this work was to compare fluoride release from three orthodontic adhesives and fluoride penetration into the enamel surface.

MATERIALS AND METHODS

A total of 156 extracted human premolar teeth were randomly assigned to three experimental groups and one control group (without bonding) with 39 teeth per group. Brackets were bonded to teeth using Fuji Ortho LC^®, Illuminate^®, or Light Bond^®. The amount of fluoride released (ppm) into artificial saliva was measured by a fluoride ion-selective electrode connected to an ion analyzer on days 1, 3, 7, and 30. Fluoride penetration was investigated after 1, 2, and 3 months; 13 teeth of each group were randomly selected at every period of study and sectioned across the center of the bracket. The surface of the cross-section was studied under the scanning electron microscope, and the fluoride concentration (weight%) at 1, 2, and 3 µm below the outer enamel surface was determined by energy-dispersive X-ray microanalysis.

RESULTS

On days 1, 3, 7, and 30, the mean cumulative fluoride release from the three orthodontic adhesives were significantly different (p < 0.05). Illuminate^® released the greatest fluoride, followed by Fuji Ortho LC^® and Light Bond^®. After 1, 2, and 3 months, fluoride penetration into enamel was only found from Fuji Ortho LC^®. The fluoride concentration decreased with depth but there were no significant differences (p > 0.05) over time at all depths.

CONCLUSIONS

The in vitro study indicated that fluoride release is a common property of the three fluoride-releasing orthodontic adhesives: Illuminate^®, Fuji Ortho LC^®, and Light Bond^®. However, detectable fluoride penetration is a specific property of Fuji Ortho LC^®. Further clinical studies should be undertaken to investigate the benefit of the two adhesives Illuminate^® and Fuji Ortho LC^® on protection of enamel demineralization.

pH-responsive release of chlorhexidine from modified nanoporous silica nanoparticles for dental applications

A pH-sensitive stimulus-response system for controlled drug release was prepared by modifying nanoporous silica nanoparticles (NPSNPs) with poly(4-vinylpyridine) using a bismaleimide as linker. At physiological pH values, the polymer serves as gate keeper blocking the pore openings to prevent the release of cargo molecules. At acidic pH values as they can occur during a bacterial infection, the polymer strains become protonated and straighten up due to electrostatic repulsion. The pores are opened and the cargo is released. The drug chlorhexidine was loaded into the pores because of its excellent antibacterial properties and low tendency to form resistances. The release was performed in PBS and diluted hydrochloric acid, respectively. The results showed a considerably higher release in acidic media compared to neutral solvents. Reversibility of this pH-dependent release was established. In vitro tests proved good cytocompatibility of the prepared nanoparticles. Antibacterial activity tests with

Effect of brushing with two different abrasives on fluoride release by high-viscosity glass ionomer cement

The effect of brushing with two abrasive levels on the fluoride release of high-viscosity glass ionomers (GIs) was investigated. Forty-eight GI discs were fabricated and randomly assigned to one of the four groups. Treatments, performed for 30 days, included exposure to a carboxymethylcellulose (CMC) solution without fluoride (CMC-F), CMC with 275 ppm fluoride (CMC+F), CMC with fluoride plus brushing with a low abrasive slurry (relative enamel abrasivity = 4; L-ab), and CMC with fluoride plus brushing with a high abrasive slurry (relative enamel abrasivity = 7; H-ab). Fluoride release was measured after 1, 2, 3, 4, 5, 10, 15, 20, 25, and 30 days. Surface analysis was performed using optical profilometry in addition to scanning electron microscopy. Data were compared using one-way analysis of variance (α = 0.05). Fluoride release was significantly different among groups, with group H-ab showing the highest rates. Cumulative fluoride release was 10% and 30% greater in groups L-ab and H-ab than in group CMC+F. High surface roughness values were associated with H-ab as well as greater exposure of silica fillers, as observed by scanning electron microscopy. Fluoride release from conventional GIs is enhanced by brushing with high abrasive slurries.

Do conventional glass ionomer cements release more fluoride than resin-modified glass ionomer cements?

OBJECTIVES

The aim of this study was to evaluate the fluoride release of conventional glass ionomer cements (GICs) and resin-modified GICs.

MATERIALS AND METHODS

The cements were grouped as follows: G1 (Vidrion R, SS White), G2 (Vitro Fil, DFL), G3 (Vitro Molar, DFL), G4 (Bioglass R, Biodinâmica), and G5 (Ketac Fil, 3M ESPE), as conventional GICs, and G6 (Vitremer, 3M ESPE), G7 (Vitro Fil LC, DFL), and G8 (Resiglass, Biodinâmica) as resin-modified GICs. Six specimens (8.60 mm in diameter; 1.65 mm in thickness) of each material were prepared using a stainless steel mold. The specimens were immersed in a demineralizing solution (pH 4.3) for 6 hr and a remineralizing solution (pH 7.0) for 18 hr a day. The fluoride ions were measured for 15 days. Analysis of variance (ANOVA) and Tukey's test with 5% significance were applied.

RESULTS

The highest amounts of fluoride release were found during the first 24 hr for all cements, decreasing abruptly on day 2, and reaching gradually decreasing levels on day 7. Based on these results, the decreasing scale of fluoride release was as follows: G2 > G3 > G8 = G4 = G7 > G6 = G1 > G5 (p < 0.05).

CONCLUSIONS

There were wide variations among the materials in terms of the cumulative amount of fluoride ion released, and the amount of fluoride release could not be attributed to the category of cement, that is, conventional GICs or resin-modified GICs.

Effects of porous-hydroxyapatite incorporated into glass-ionomer sealants

The purpose of the present study was to evaluate the mechanical and chemical properties of a novel glass ionomer cement for use as a pit and fissure sealant containing a porous hydroxyapatite, namely, apatite ionomer cement (AIC). Control sealant samples were used Fuji III (GIC-S). The experiment sealant samples (AIC-S) consisted of porous spherical hydroxyapatite (HApS) particles added at 28 wt% to GIC-S powder. The GIC-S and AIC-S samples were evaluated through mechanical strength measurements, scanning electron microscopy observations, energy dispersive X-ray spectroscopy analysis, fluoride ion release tests, and antibacterial tests. The flexural strength of the AIC-S was significantly higher than that of GIC-S for each period, 1 h, 24 h and 1 year. The fluoride release dose for AIC-S was consistently higher than that for GIC-S. In addition, the antibacterial properties of AIC-S were superior to those of GIC-S. The novel AIC-S may be a more suitable sealant material for pits and fissures with intact and/or infected enamel.

Ion release from, and fluoride recharge of a composite with a fluoride-containing bioactive glass

OBJECTIVES

Materials that are capable of releasing ions such as calcium and fluoride, that are necessary for remineralization of dentin and enamel, have been the topic of intensive research for many years. The source of calcium has most often been some form of calcium phosphate, and that for fluoride has been one of several metal fluoride or hexafluorophosphate salts. Fluoride-containing bioactive glass (BAG) prepared by the sol-gel method acts as a single source of both calcium and fluoride ions in aqueous solutions. The objective of this investigation was to determine if BAG, when added to a composite formulation, can be used as a single source for calcium and fluoride ion release over an extended time period, and to determine if the BAG-containing composite can be recharged upon exposure to a solution of 5000ppm fluoride.

METHODS

BAG 61 (61% Si; 31% Ca; 4% P; 3% F; 1% B) and BAG 81 (81% Si; 11% Ca; 4% P; 3% F; 1% B) were synthesized by the sol-gel method. The composite used was composed of 50/50 Bis-GMA/TEGDMA, 0.8% EDMAB, 0.4% CQ, and 0.05% BHT, combined with a mixture of BAG (15%) and strontium glass (85%) to a total filler load of 72% by weight. Disks were prepared, allowed to age for 24h, abraded, then placed into DI water. Calcium and fluoride release was measured by atomic absorption spectroscopy and fluoride ion selective electrode methods, respectively, after 2, 22, and 222h. The composite samples were then soaked for 5min in an aqueous 5000ppm fluoride solution, after which calcium and fluoride release was again measured at 2, 22, and 222h time points.

RESULTS

Prior to fluoride recharge, release of fluoride ions was similar for the BAG 61 and BAG 81 composites after 2h, and also similar after 22h. At the four subsequent time points, one prior to, and three following fluoride recharge, the BAG 81 composite released significantly more fluoride ions (p<0.05). Both composites were recharged by exposure to 5000ppm fluoride, although the BAG 81 composite was recharged more than the BAG 61 composite. The BAG 61 composite released substantially more calcium ions prior to fluoride recharge during each of the 2 and 22h time periods. Thereafter, the release of calcium at the four subsequent time points was not significantly different (p>0.05) for the two composites.

SIGNIFICANCE

These results show that, when added to a composite formulation, fluoride-containing bioactive glass made by the sol-gel route can function as a single source for both calcium and fluoride ions, and that the composite can be readily recharged with fluoride.

NaF-loaded core-shell PAN-PMMA nanofibers as reinforcements for Bis-GMA/TEGDMA restorative resins

A kind of core-shell nanofibers containing sodium fluoride (NaF) was produced and used as reinforcing materials for dimethacrylate-based dental restorative resins in this study. The core-shell nanofibers were prepared by coaxial-electrospinning with polyacrylonitrile (PAN) and poly(methyl methacrylate) (PMMA) solutions as core and shell fluids, respectively. The produced PAN-PMMA nanofibers varied in fiber diameter and the thickness of PMMA shell depending on electrospinning parameters. NaF-loaded nanofibers were obtained by incorporating NaF nanocrystals into the core fluid at two loadings (0.8 or 1.0wt.%). Embedment of NaF nanocrystals into the PAN core did not damage the core-shell structure. The addition of PAN-PMMA nanofibers into Bis-GMA/TEGDMA clearly showed the reinforcement due to the good interfacial adhesion between fibers and resin. The flexural strength (Fs) and flexural modulus (Ey) of the composites decreased slightly as the thickness of PMMA shell increasing. Sustained fluoride releases with minor initial burst release were achieved from NaF-loaded core-shell nanofibers and the corresponding composites, which was quite different from the case of embedding NaF nanocrystals into the dental resin directly. The study demonstrated that NaF-loaded PAN-PMMA core-shell nanofibers were not only able to improve the mechanical properties of restorative resin, but also able to provide sustained fluoride release to help in preventing secondary caries.

Fluoride Concentration from Dental Sealants

A randomized clinical trial was performed in schoolchildren (6-7 yrs) to evaluate fluoride concentration in interproximal fluid after the placement of 3 different sealants. The sample consisted of 2,776 children randomly divided: 926 in the high-viscosity Glass-ionomer Cement group (GIC group), 923 in the fluoride Resin-based group (fluoride-RB group), and 927 in the no-fluoride Resin-based group (RB group). In total, 2,640 children completed the trial. Sealants were applied following manufacturer’s instructions. Interproximal fluid samples were collected at baseline and 2, 7, and 21 days after application of sealants, by insertion of a standardized paperpoint into the interproximal mesial space of the sealed tooth for 15 seconds. Fluoride concentration was evaluated by means of a fluoride ion-selective electrode. At 2 days after sealant application, fluoride concentration was significantly higher in GIC and fluoride-RB groups compared with that in the RB group ( p < .01). Mean fluoride concentrations after 7 days were 2.54 (SE 0.68) ppm, 0.85 (SE 0.26) ppm, and 0.53 (SE 0.11) ppm for the three groups, respectively. After 21 days, fluoride concentration in the GIC group remained higher than that in the other two groups. High-viscosity GIC sealants increased the fluoride concentrations in interproximal fluid more than did a Resin-based sealant containing fluoride (ClinicalTrials.gov NCT01588210).

Fluoride release of glass ionomer restorations after bleaching with two different bleaching materials

Objective:

This study was designed to evaluate the effect of two bleaching agents on the fluoride release of three types of glass ionomer materials.

Materials and Methods:

A total of 90 specimens of the tested materials (Ketac Fil, Photac Fil and F2000) were prepared by a split Teflon ring with an internal diameter of 5 mm and thickness of 2 mm. The tested materials were applied and bleached according to manufacturer instructions. Fluoride release measurements were made by using specific ion electrode.

Results:

Results revealed that bleaching with opalescence Xtra caused little increase in fluoride release from Ketac Fil and Photac Fil but has no effect on F2000. However, Opalescence Quick had no significant effect on the three tested materials.

Conclusions:

Bleaching effect on fluoride release is material dependent and time has a significant role on fluoride release.

In vitro marginal fit of three all-ceramic crown systems before and after cementation

STATEMENT OF THE PROBLEM

Full-coverage all-ceramic restorations are widely used. The impact of various classifications of luting agent on marginal discrepancies is not well understood.

PURPOSE

The purpose of this study was to evaluate the cervical fit of all ceramic crowns (IPS e.maxPress, Cergogold, and In Ceram) on bovine teeth with two luting agents before and after cementation.

MATERIALS AND METHODS

Ninety bovine incisors were embedded in resin. The coronal portions of the teeth were prepared to receive full-coverage crowns. Thirty crowns of 7.0 ± 0.5 mm height, 8.0 mm cervical diameter, and 4.2 mm incisal diameter were fabricated for each ceramic system. The crowns were seated on the teeth, and the marginal discrepancy was measured using a measuring microscope. Then, 15 crowns of each ceramic system were luted on the teeth with resin cement (Variolink II) or resin-modified glass ionomer cement (Rely X luting), and the marginal discrepancy was measured. The results were submitted to analysis of variance, t test and Tukey's test (p<0.05).

RESULTS

The three ceramic systems showed cervical fits after cementation statistically inferior to cervical fits before cementation for the two cements. The IPS e.maxPress showed values for cervical fit statistically superior to Cergogold before cementation. No statistically significant difference was found between IPS e.maxPress and In Ceram and In Ceram and Cergogold. After cementation, no statistically significant difference was found for the three ceramics systems when luted with resin or resin-modified glass ionomer luting agents.

CONCLUSIONS

Within the limitations of this study, it can be concluded that both cements studied increase the marginal discrepancy between the crown and the preparation for the three ceramic systems evaluated.

Caries-preventive Activity of Fluoride-containing Resin-based Desensitizers

Objective

The purpose of this study was to evaluate the effects of different desensitizing agents on the prevention of root caries when applied to root surfaces.

Materials and Methods

Thirty human roots were sectioned into quarters with a 3 × 4 mm window. A desensitizer (VX, Clinpro™ XT Varnish; SP, Seal & Protect®; or PB, Clearfil™ Protect Bond) was applied to three of the quarters in each window. Teeth were stored separately in water for one day, 30 days, or 60 days. The remaining quarter, without the application of desensitizer, served as a control. After storage in water, all specimens were subjected to pH cycling. Scanning electron microscopy was used to observe the demineralization bands created on the subsurface layer. The weight percentages of fluorine (F), silica, and calcium (Ca) were determined using electron probe microanalysis to quantify the elemental distributions in the root dentin. The concentrations of F released during a pH cycling were measured.

Results

For the control group, the average lesion depth was 18.92 ± 5.42 μm, and the average Ca loss was 15.66% ± 6.80% in the superficial layer and 30.44% ± 9.61% in the subsurface layer. No Ca loss occurred in the desensitizer-treated groups. All desensitizing agents remained intact for at least 60 days. F levels were increased in the hybrid layer but not in the subhybrid area. Outward release of F diminished with time.

Conclusion

The F-containing resin-based desensitizers protected exposed root surfaces from demineralization. F liberated from the desensitizers was detected only at minimal levels.

Fluoride release from restorative materials

The aim of this study was to evaluate in vitro fluoride (F) release from 4 restorative materials (3M ESPE): Ketak Molar Easymix [KME - conventional glass ionomer cement (GIC)]; Rely-X luting 2 [RL2 - resin-modified GIC (RMGIC)]; Vitremer (VIT- RMGIC); and Filtek Z250 [Z250 - negative control]. Disc-shaped specimens were fabricated according to the manufacturer's instructions and placed into 10 mL of reverse osmosis water at 37°C until the analyses were done using a liquid membrane for selective F ion electrode (Orion 710). F release was evaluated every 6 h in the first day and thereafter daily during 28 days (d). The results were analyzed statistically by two-way ANOVA and Tukey's test (α=0.05). Mean F release and standard deviation values (in ppm) were: KME: 6 h- 0.34 ± 0.04; 24 h- 1.22 ± 0.30; 7 d- 0.29 ± 0.09; 14 d- 0.20 ± 0.04; 28 d- 0.16 ± 0.01; RL2: 6 h- 2.46 ± 0.48; 24 h-12.33 ± 2.93; 7 d- 1.37 ± 0.38; 14 d- 0.80 ± 0.13; 28 d- 0.80 ± 0.21; VIT: 6 h- 0.98 ± 0.35; 24 h- 4.35 ± 1.22; 7 d- 0.66 ± 0.23; 14 d- 0.40 ± 0.07; 28 d- 0.39 ± 0.08; Z250: 6 h- 0.029 ± 0.001; 24 h- 0.024 ± 0.009; 7 d- 0.023 ± 0.004; 14 d- 0.025 ± 0.001; 28 d- 0.028 ± 0.001. RL2 RMGIC released more F than the other materials in all periods. The greatest release of F occurred in the first 24 h.

Glass-ionomer cement restorative materials: a sticky subject?

Glass-ionomer cement (GIC) materials have been in clinical use since their inception 40 years ago. They have undergone several permutations to yield different categories of these materials. Although all GICs share the same generic properties, subtle differences between commercial products may occur. They have a wide range of uses such as lining, bonding, sealing, luting or restoring a tooth. In general, GICs are useful for reasons of adhesion to tooth structure, fluoride release and being tooth-coloured although their sensitivity to moisture, inherent opacity, long-term wear and strength are not as adequate as desired. They are useful in situations where they are not disadvantaged by their comparatively lower physical properties, such as where there is adequate remaining tooth structure to support the material and where they are not subject to heavy occlusal loading. The last decade has seen the use of these materials being extended. However, they are likely to retain their specific niches of clinical application.

Cariostatic effect of fluoride-containing restorative materials associated with fluoride gels on root dentin

Secondary caries is still the main cause of restoration replacement, especially on the root surface

Neutralizing effect by resin-based materials containing silane-coated glass fillers

The aim of this study was to evaluate the fluoride release, neutralizing ability and inhibitory effect on secondary caries of resin-based materials containing a silane-coated glass filler. Resin-based materials containing fluoro-boro-alumino-silicate glass coated by 3-methacryloxypropyltrimethoxysilane or 3-aminopropyltrimethoxysilane were used and resin material containing glass filler without coating was used as a control. The fluoride release and pH value after immersion were measured for 10 weeks. The inhibitory effect was also evaluated. During the initial period, the material with 3-aminopropyltrimethoxysilane gave the greater amount of fluoride release and produced a higher pH value compared with the other materials. However, the neutralizing ability of the material with 3-aminopropyltrimethoxysilane filler became weaker with ageing of the specimens. The mean depth of outer lesions was similar among the three materials. Within the limitations of this study, secondary caries around restorations could not be inhibited even for products showing high fluoride releasing and neutralizing ability.

Biofilm Formation on Dental Restorative and Implant Materials

Biomaterials for the restoration of oral function are prone to biofilm formation, affecting oral health. Oral bacteria adhere to hydrophobic and hydrophilic surfaces, but due to fluctuating shear, little biofilm accumulates on hydrophobic surfaces in vivo. More biofilm accumulates on rough than on smooth surfaces. Oral biofilms mostly consist of multiple bacterial strains, but Candida species are found on acrylic dentures. Biofilms on gold and amalgam in vivo are thick and fully covering, but barely viable. Biofilms on ceramics are thin and highly viable. Biofilms on composites and glass-ionomer cements cause surface deterioration, which enhances biofilm formation again. Residual monomer release from composites influences biofilm growth in vitro, but effects in vivo are less pronounced, probably due to the large volume of saliva into which compounds are released and its continuous refreshment. Similarly, conflicting results have been reported on effects of fluoride release from glass-ionomer cements. Finally, biomaterial-associated infection of implants and devices elsewhere in the body is compared with oral biofilm formation. Biomaterial modifications to discourage biofilm formation on implants and devices are critically discussed for possible applications in dentistry. It is concluded that, for dental applications, antimicrobial coatings killing bacteria upon contact are more promising than antimicrobial-releasing coatings.

Fluoride release and cariostatic potential of orthodontic adhesives with and without daily fluoride rinsing

INTRODUCTION

In this study, we aimed to evaluate the fluoride-release profiles and caries lesion development in an enamel model with brackets cemented with 4 orthodontic adhesives with and without daily fluoride exposure.

METHODS

Four orthodontic adhesives (Ketac Cem mu, 3M ESPE, Seefeld, Germany; Fuji Ortho LC, GC Corporation, Tokyo, Japan; Light-Bond, Reliance Orthodontic Products, Itasca, Ill; and Transbond XT, 3M Unitek, Monrovia, Calif) were used. Brackets were bonded on bovine enamel with each adhesive (n = 10) and subjected to alternate cycles of demineralizing (pH 4.55) and remineralizing (pH 6.8) solutions. Unbracketed enamel samples served as a reference. Five samples from each group were immersed in a fluoride mouth rinse (250 ppm fluoride) for 1 minute each day (test groups). Fluoride release was measured at regular intervals over 28 days. The mineral distribution of peribracket enamel after 28 days was quantified by transversal microradiographs.

RESULTS

Fluoride-release profiles of Ketac Cem mu, Fuji Ortho LC, and Light-Bond were high for the first 24 hours and reached a constant level after 2 weeks. Fuji Ortho LC released significantly more fluoride than did the other adhesives in both the control and test groups (P <0.01, repeated measures ANOVA and Bonferroni test). Enamel bonded with Fuji Ortho LC had significantly shallower lesions and less mineral loss (P <0.01, 2-way ANOVA, and Tukey HSD).

CONCLUSIONS

Bonding of orthodontic brackets with Fuji Ortho LC resulted in less peribracket enamel demineralization with and without daily fluoride rinsing, mainly due to its better fluoride-release profile. In contrast, Transbond XT and Light-Bond offered few cariostatic effects to the enamel.

Shear bond strength of orthodontic brackets bonded with different self-etching adhesives

INTRODUCTION

The purpose of this study was to compare the shear bond strength (SBS) of orthodontic brackets bonded with 4 self-etching adhesives.

METHODS

A total of 175 extracted premolars were randomly divided into 5 groups (n = 35). Group I was the control, in which the enamel was etched with 37% phosphoric acid, and stainless steel brackets were bonded with Transbond XT (3M Unitek, Monrovia, Calif). In the remaining 4 groups, the enamel was conditioned with the following self-etching primers and adhesives: group II, Transbond Plus and Transbond XT (3M Unitek); group III, Clearfil Mega Bond FA and Kurasper F (Kuraray Medical, Tokyo, Japan); group IV, Primers A and B, and BeautyOrtho Bond (Shofu, Kyoto, Japan); and group V, AdheSE and Heliosit Orthodontic (Ivoclar Vivadent AG, Liechtenstein). The teeth were stored in distilled water at 37 degrees C for 24 hours and debonded with a universal testing machine. The adhesive remnant index (ARI) including enamel fracture score was also evaluated. Additionally, the conditioned enamel surfaces were observed under a scanning electron microscope.

RESULTS

The SBS values of groups I (19.0 +/- 6.7 MPa) and II (16.6 +/- 7.3 MPa) were significantly higher than those of groups III (11.0 +/- 3.9 MPa), IV (10.1 +/- 3.7 MPa), and V (11.8 +/- 3.5 MPa). Fluoride-releasing adhesives (Kurasper F and BeautyOrtho Bond) showed clinically acceptable SBS values. Significant differences were found in the ARI and enamel fracture scores between groups I and II.

CONCLUSIONS

The 4 self-etching adhesives yielded SBS values higher than the bond strength (5.9 to 7.8 MPa) suggested for routine clinical treatment, indicating that orthodontic brackets can be successfully bonded with any of these self-etching adhesives.

Examination of composite resins with electron microscopy, microhardness tester and energy dispersive X-ray microanalyzer

This study was conducted to examine the ultrastructures of eight recently improved light-cure restorative composite resins with scanning and transmission electron microscopes (SEM and TEM). Additionally, Vickers hardness, volume/weight fraction of filler, and chemical composition were analyzed. Composite resins selected for evaluation were Beautifil II, Clearfil AP-X, Clearfil Majesty, Estelite sigma, Filtek Supreme, Filtek Z250, Solare, and Synergy. SEM and TEM images revealed a great diversity in ultrastructure, and Vickers hardness test showed significant differences amongst all the composite resins (except between Clearfil Majesty and Estelite sigma, and between Filtek Supreme and Filtek Z250). By means of EDX, similar elements such as C, O, and Si were detected, but the concentration was different in every composite resin. Results obtained in this study served to validate that the methods employed in this study SEM and TEM at high magnification--were useful in examining the ultrastructures of composite resins. It was also found that the ultrastructure, size of filler particles, volume/weight fraction of filler, and chemical composition of the composite resins had an effect on Vickers hardness. Given the great diversity of ultrastructures amongst the composite resins, which stemmed from the different revolutionary technologies used to manufacture them, further studies are warranted in the search of clinical applications that optimally match the differing properties of these materials.

Microhardness and fluoride release of restorative materials in different storage media

This study evaluated the surface microhardness and fluoride release of 5 restorative materials - Ketac-Fil Plus, Vitremer, Fuji II LC, Freedom and Fluorofil - in two storage media: distilled/deionized water and a pH-cycling (pH 4.6). Twelve specimens of each material, were fabricated and the initial surface microhardness (ISM) was determined in a Shimadzu HMV-2000 microhardness tester (static load Knoop). The specimens were submitted to 6- or 18-h cycles in the tested media. The solutions were refreshed at the end of each cycle. All solutions were stored for further analysis. After 15-day storage, the final surface microhardness (FSM) and fluoride release were measured. Fluoride dose was measured with a fluoride-specific electrode (Orion 9609-BN) and digital ion analyzer (Orion 720 A). The variables ISM, FSM and fluoride release were analyzed statistically by analysis of variance and Tukey's test (p<0.05). There was significant difference in FSM between the storage media for Vitremer (pH 4.6 = 40.2 +/- 1.5; water = 42.6 +/- 1.4), Ketac-Fil Plus (pH 4.6 = 73.4 +/- 2.7; water = 58.2 +/- 1.3) and Fluorofil (pH 4.6 = 44.3 +/- 1.8; water = 38.4 +/- 1.0). Ketac-Fil Plus (9.9 +/- 18.0) and Fluorofil (4.4 +/- 1.3) presented higher fluoride release in water, whereas Vitremer (7.4 +/- 7.1), Fuji II LC (5.7 +/- 4.7) and Freedom (2.1 +/- 1.7) had higher fluoride release at pH 4.6. Microhardness and fluoride release of the tested restorative materials varied according to the storage medium.

Examination of six orthodontic adhesives with electron microscopy, hardness tester and energy dispersive X-ray microanalyzer

OBJECTIVE

To examine the ultrastructure of six light-cure orthodontic adhesives with scanning electron microscope (SEM) and transmission electron microscope (TEM), microhardness tester, and energy dispersive X-ray microanalyzer (EDX).

MATERIALS AND METHODS

The orthodontic adhesives evaluated were Transbond XT, Light Bond, BeautyOrtho Bond, Kurasper F, Heliosit Orthodontic, and Salivatect. Specimens of each adhesive were carefully prepared for observation under SEM and TEM. Furthermore, the Vickers hardness was tested, and the adhesives were evaluated with EDX.

RESULTS

SEM and TEM images illustrated great diversity of the adhesives ultrastructure. The Vickers hardness test showed significant differences among all the adhesives (except Transbond XT and Salivatect). Although some similar elements were detected with EDX, the concentration was different in each adhesive.

CONCLUSION

Orthodontic brackets can be bonded to the enamel surface with the adhesives available on the market. However, orthodontists might achieve better results identifying their properties and compositions.

Aluminium and fluoride release into artificial saliva from dental restoratives placed in teeth

This study examined the release of aluminium and fluoride from restorative materials placed in either deciduous or young permanent immature teeth stored in artificial saliva for 1 month. Cavities were prepared in extracted teeth, then filled with a fluoride releasing restorative (glass-ionomer, compomer or composite resin), with and without conditioning as appropriate. The teeth were then stored in artificial saliva for 1 month, after which the amount of aluminium and fluoride released was determined spectrophotometrically. With all materials tested, both aluminium and fluoride were released in all cases. Young immature teeth were associated with lower level of ion release which was attributed to the absorption of ions by the enamel. However, unconditioned samples were usually associated with similar ion release to conditioned ones, suggesting that the loss of mineral phase on conditioning has only a marginal effect on the capacity for ion uptake. The ratio of aluminium to fluoride released varied with the type of tooth, deciduous conditioned teeth generally absorbing proportionately less aluminium than young immature teeth. The overall conclusion is that interaction with ions released by restorative materials is influenced by type of tooth.