Maturation affects fluoride uptake by glass-ionomer dental cements

Fluoride exchange by glass-ionomer dental cements and its clinical effects: a review

The topic of fluoride release and uptake by glass-ionomer (glass polyalkenoate) dental cements is reviewed. The study was based on a literature search carried out using PubMed. The main key words used were glass-ionomer and fluoride, and further refinements were made by adding the keywords anti-microbial, anti-caries and remineralization. Papers were selected from the initial search, which concentrated on fundamental aspects of fluoride release, including kinetics and the influence of the cement composition, and resulting clinical performance against caries. Other relevant papers were cited where they added useful and relevant data. From these published papers, it was possible to explain the detailed mechanism of fluoride release by glass-ionomer cements and also its uptake. Fluoride release has been shown to be a two-step process. In neutral solutions, the steps can be divided into early wash-out and long-term diffusion. In acid conditions, the early wash-out remains, though with greater amounts of fluoride released, and the long-term release becomes one of slow dissolution. The effect of fluoride on the viability of oral micro-organisms has been described, and glass-ionomers have been shown to release sufficient fluoride to reduce the size and viability of adjacent populations of oral bacteria. The effect of low levels of fluoride on the remineralization of tooth tissue has been considered. Levels needed to increase remineralization are much lower than those needed to adversely affect oral bacteria, from which we conclude that glass-ionomers release sufficient fluoride to promote remineralization. Despite this, there remains uncertainty about their overall contribution to sound oral health, given the widespread use of other sources of fluoride, such as toothpastes.

The Fluoride Ion Release from Ion-Releasing Dental Materials after Surface Loading by Topical Treatment with Sodium Fluoride Gel

The study aimed to investigate the rechargeability of ion-releasing dental material specimens immersed in distilled water for 25 months, which depleted their ion-releasing ability. Four restorative dental materials (alkasite composite, giomer, glass-ionomer, and composite material) presented with 24 specimens were studied after topical treatment with a concentrated fluoride gel. The effect of resin coating on the ion uptake and release was investigated on additional 42 specimens of restorative dental materials with coatings. The composite materials were coated with two adhesive systems, whereas the glass-ionomer was coated with the special coating resin. After topical fluoride exposure, ion release and specimen mass were measured at 1, 2, 3, 4, 5, 6, 7, and 14-day intervals using an ion-selective electrode and an analytical balance, respectively. The cumulative fluoride levels for the uncoated specimens of alkasite composite were significantly higher than those of giomer and glass-ionomer cement, with no statistically significant difference between the latter two materials. The conventional composite had the lowest cumulative concentration of fluoride ions (p < 0.05). The adhesive systems affected the fluoride recharge and reduced the ion concentrations absorbed by the specimens. Specimens coated with universal adhesive showed significantly higher ion release compared to universal fluoride-releasing adhesive or special coating resin for glass-ionomers (p < 0.05). No statistically significant change in specimen mass was observed during the 14-day period. Surface coating with adhesive systems as well as special coating resin for glass-ionomers affects the fluoride recharge process.

Effect of the Addition of Varying Concentrations of Silver Nanoparticles on the Fluoride Uptake and Recharge of Glass Ionomer Cement

This study aimed to compare the amount of fluoride uptake and the recharge and release characteristics of conventional glass ionomer cement (GIC) without any additives in comparison to conventional glass ionomer cement supplemented with silver nanoparticles (AgNPs) at two concentrations: 0.1% and 0.2% (w/w). A total of 60 specimens were used in this in vitro study. The sample was divided into six groups—including three groups without fluoride charge: Group 1 (conventional GIC), Group 2 (GIC with 0.1% silver nanoparticles), and Group 3 (GIC with 0.2% silver nanoparticles; and three groups with fluoride charge: Group 4 (conventional GIC with fluoride); Group 5 (GIC with 0.1% silver nanoparticles with fluoride); Group 6 (GIC with 0.2% silver nanoparticles with fluoride), where Group 1 is considered the control group and the other five groups are used as the test groups. The amount of fluoride released was measured on days 1, 2, 7, 15, and 30. The comparisons were made between the groups with and without fluoride and among all the groups. A significant difference in the amount of fluoride released was observed between the groups, with the highest amount occurring in Group 1, followed by Group 2; the lowest amount of fluoride released was observed in Group 3 (p < 0.05). The groups with fluoride recharge (Groups 4, 5, and 6) exhibited a higher amount of fluoride release than the groups with no recharge (Groups 1, 2, and 3); however, Group 1 has more fluoride release compared to all other groups on days 1, 2, 7, 15, and 30 (p < 0.05). The amount of released fluoride decreased from day 1 to day 30 in all of the groups in the study. Despite the antimicrobial and anticariogenic benefits of adding silver nanoparticles to GIC, it seems that fluoride release characteristics are significantly affected by the addition of this material. This may force the clinician to a compromise between the antimicrobial benefit of silver nanoparticles and the remineralizing advantage of fluoride.

Determination of chemical species of fluoride during uptake mechanism of glass-ionomer cements with NMR spectroscopy

OBJECTIVE

The aim of the present study was to determine the chemical species formed inside glass-ionomer cements after fluoride uptake and to investigate the depth of penetration of fluoride ions within the cement matrix.

METHODS

An experimental fluoride-free glass with composition 2SiO₂-AlO₃-CaO was produced. The glass powder was mixed with aqueous poly(acrylic acid) (PAA), and allowed to set. The resulting specimens were stored in 20ml KF solution with 1000ppm fluorine for 24h and then placed into the same amount of water as for 24h. A fluoride selective electrode was used to give the F concentration of the respective solutions. ¹⁹F MAS-NMR spectra were recorded on powdered cement specimens using a Bruker AVANCE-NEO 600 spectrometer. In addition, SEM observation and EDX chemical analysis were conducted on the cross-section of a carefully fractured specimen.

RESULTS

Fluoride was shown to be mainly present in the surface layers of the specimen after placement in the KF solution, and only a small fraction was re-released into water. ¹⁹F NMR spectroscopy showed that AlF complexes were formed within the cement.

SIGNIFICANCE

The fluoride taken up by a free-fluoride glass ionomer cement mostly occupies surface layers and is retained because it bonds to aluminum within the matrix. This finding explains why the majority of fluoride taken up by conventional glass ionomer cements is retained.

The effect of temperature and ionic solutes on the fluoride release and recharge of glass-ionomer cements

OBJECTIVE

To determine the effect of storage temperature and the presence of sodium chloride in solution on the fluoride uptake and release of glass-ionomer cements.

METHODS

Several commercial brands were used, and stored at either room temperature (21-23°C) or 37°C, in KF solution at a concentration of 1000ppm F^- with and without 0.9% NaCl present. Fluoride levels in the storage solutions after 24h were measured using a fluoride-ion selective electrode. Specimens were then stored in water, and fluoride release after 24h was determined. Studies were also carried out to determine chloride levels when specimens were stored in 0.9% NaCl, with or without 1000 ppm fluoride, again using an ion selective electrode.

RESULTS

All glass-ionomer specimens took up fluoride, and most of the fluoride was retained over the next 24 h when the specimens were stored in water. There was a slight variation in the amount of fluoride taken up with storage temperature and with the presence of sodium chloride. All specimens also took up chloride, with greater uptake at higher temperatures, but little or no effect when KF was also present in solution.

SIGNIFICANCE

The substantial retention of fluoride after 24h in deionised water confirms previous findings and suggests that an insoluble species, possibly SrF₂, forms in situ. Chloride uptake has not been reported previously, and its significance requires further investigation. Fluoride and chloride uptake were apparently independent of each other, which suggests that the ions are taken up at different sites in the cement. This may relate to differences in the respective sizes and hydration states of F^- and Cl^- ions.

Fluoride release and uptake in enhanced bioactivity glass ionomer cement ("glass carbomer™") compared with conventional and resin-modified glass ionomer cements

Objectives

To study the fluoride uptake and release properties of glass carbomer dental cements and compare them with those of conventional and resin-modified glass ionomers.

Materials and Methods

Three materials were used, as follows: glass carbomer (Glass Fill), conventional glass ionomer (Chemfil Rock) and resin-modified glass ionomer (Fuji II LC). For all materials, specimens (sets of six) were matured at room temperature for time intervals of 10 minutes, 1 hour and 6 weeks, then exposed to either deionized water or sodium fluoride solution (1000 ppm in fluoride) for 24 hours. Following this, all specimens were placed in deionized water for additional 24 hours and fluoride release was measured.

Results

Storage in water led to increase in mass in all cases due to water uptake, with uptake varying with maturing time and material type. Storage in aqueous NaF led to variable results. Glass carbomer showed mass losses at all maturing times, whereas the conventional glass ionomer gained mass for some maturing times, and the resin-modified glass ionomer gained mass for all maturing times. All materials released fluoride into deionized water, with glass carbomer showing the highest release. For both types of glass ionomer, uptake of fluoride led to enhanced fluoride release into deionized water. In contrast, uptake by glass carbomer did not lead to increased fluoride release, although it was substantially higher than the uptake by both types of glass ionomer.

Conclusions

Glass carbomer resembles glass ionomer cements in its fluoride uptake behavior but differs when considering that its fluoride uptake does not lead to increased fluoride release.

Glass ionomer cements with milled, dry chlorhexidine hexametaphosphate filler particles to provide long-term antimicrobial properties with recharge capacity

OBJECTIVE

Glass ionomer cements (GICs) are a versatile material, offering the opportunity for ion exchange with the oral environment. The aim of this study was to develop a GIC that delivers a controlled, rechargeable dose of chlorhexidine (CHX) over an extended period without compromising mechanical properties.

METHODS

GICs were supplemented with finely milled particles of chlorhexidine hexametaphosphate (CHX-HMP). CHX release into artificial saliva was measured over 660 days, and recharge with CHX and CHX-HMP was investigated. Mechanical properties were investigated, and an agar diffusion test was carried out to assess antimicrobial properties using Streptococcus mutans and Scardovia wiggsiae.

RESULTS

Dose-dependent CHX release was observed, and this was ongoing at 660 days. Compared with related studies of GICs containing CHX-HMP, the fine, dry particles resulted in fewer adverse effects on mechanical properties, including tensile, compressive and biaxial flexural strength, with 1% CHX-HMP GICs indistinguishable from control specimens. The GICs could be recharged with CHX using both a conventional CHX digluconate solution comparable to commercial mouthrinses, and a suspension of CHX-HMP of equivalent concentration. Recharging with CHX digluconate increased subsequent CHX release by 50% compared with no recharge, and recharging with CHX-HMP increased subsequent CHX release by 100% compared with no recharge. The GICs inhibited growth of St. mutans and Sc. wiggsiae in a simple agar diffusion model.

SIGNIFICANCE

These materials, which provide sustained CHX release over clinically relevant timescales, may find application as a restorative material intended to inhibit secondary caries as well as in temporary restorations and fissure sealants.

Comparison of resin-based and glass ionomer sealants with regard to fluoride-release and anti-demineralization efficacy on adjacent unsealed enamel

This study compared resin-based and glass ionomer sealants with regard to their fluoride-release behavior and anti-demineralization potential on adjacent unsealed enamel surfaces. Sealant cavities prepared on bovine enamel blocks were filled with fluoride-containing resin sealants [TeethmateF-1 (TF), Clinpro^TM (CP)], and glass ionomer sealant [Fuji VII (FVII)]. Specimens were then incubated in artificial saliva for 14 days to measure fluoride. Thereafter, demineralization was performed for 10 days, and the anti-demineralization efficacy was assessed by Swept Source Optical Coherence Tomography (SS-OCT), and cross-sectional nanohardness. All data were statistically analyzed by using ANOVA. FVII exhibited the highest fluoride release. SS-OCT and nanohardness findings indicated that anti-demineralization efficacy of TF was the greatest, whereas FVII was not significantly different from that of CP. Resin sealants released a lower amount of fluoride but exhibited anti-demineralization effects on the adjacent unsealed enamel surfaces that were comparable to that of a glass ionomer sealant.

A Review of Glass-Ionomer Cements for Clinical Dentistry

This article is an updated review of the published literature on glass-ionomer cements and covers their structure, properties and clinical uses within dentistry, with an emphasis on findings from the last five years or so. Glass-ionomers are shown to set by an acid-base reaction within 2–3 min and to form hard, reasonably strong materials with acceptable appearance. They release fluoride and are bioactive, so that they gradually develop a strong, durable interfacial ion-exchange layer at the interface with the tooth, which is responsible for their adhesion. Modified forms of glass-ionomers, namely resin-modified glass-ionomers and glass carbomer, are also described and their properties and applications covered. Physical properties of the resin-modified glass-ionomers are shown to be good, and comparable with those of conventional glass-ionomers, but biocompatibility is somewhat compromised by the presence of the resin component, 2 hydroxyethyl methacrylate. Properties of glass carbomer appear to be slightly inferior to those of the best modern conventional glass-ionomers, and there is not yet sufficient information to determine how their bioactivity compares, although they have been formulated to enhance this particular feature.

Clinical study of the caries-preventive effect of resin-modified glass ionomer restorations: aging versus the influence of fluoride dentifrice

AIM

The use of fluoride-releasing materials could be compromised due to aging and might also be influenced by other ordinary sources of fluoride. The aim of the present study was to investigate the aging effect on caries development around resin-modified glass ionomer cement (RMGIC) restorations and the influence of fluoride dentifrice use in this process under the oral environment.

METHODS

A clinical study was performed in two phases of 14 days each. A total of 16 volunteers wore palatal devices containing dental slabs restored with either a composite resin or RMGIC, either aged or unaged by thermocycling. To simulate a clinical situation of high caries risk, the slabs were exposed to a 20% sucrose solution 10 times per day via the in situ model, where non-fluoride or a fluoride dentifrice was used. Integrated demineralization was determined by cross-sectional microhardness at both margins of the restoration: enamel and dentin.

RESULTS

For enamel, higher demineralization around the composite restorations was observed, regardless of dentifrice or aging. For dentin, higher demineralization was observed around the aged composite restorations regardless of the dentifrice type used.

CONCLUSIONS

The RMGIC restorations provided more enhanced protection against secondary caries for dentin under aging, and the fluoride dentifrice used in this condition had either no clinically relevance or only a minimal effect.