The influence of montmorillonite clay reinforcement on the performance of a glass ionomer restorative

The Antibacterial Properties of a Reinforced Zinc Oxide Eugenol Combined with Cloisite 5A Nanoclay: An In-Vitro Study

Pulpotomies and pulpectomies are the most common clinical approach for dental caries in the primary dentition. Reinforced zinc oxide eugenol (ZOE) is an ideal material for filling in the pulp chamber after pulp therapies. The aim of this study was to assess the addition of Cloisite 5A nanoclay material to ZOE and evaluate its antibacterial properties. In this case-control study, the nanoclay nanoparticles were dissolved using a solvent (Eugenol) in different concentrations and their antibacterial properties were assessed using the agar diffusion test and biofilm analysis of Streptococcus mutans (S. mutans), Enterococcus faecalis (E. faecalis), and Escherichia coli (E. coli) in in vitro conditions using the AATCC 100 standards. The diameter of the inhibition zone was measured and assessed statistically using the SPSS software (Version 28, IBM, Chicago, IL, USA) with a significance level of 0.05. The antibacterial properties of the ZOE with nanoclay particles were significantly greater in comparison to the plain ZOE against E. faecalis, S. mutans, and E. coli. The inhibition zone against E. coli under the effect of the ZOE and nanoclay particles combined was significantly higher than that against E. faecalis and S. mutans. The current study showed that the addition of Cloisite 5A nanoclay particles can improve the antibacterial properties of ZOE significantly at certain concentrations.

Assessing the Influence of Thermocycling on Compressive Strength, Flexural Strength, and Microhardness in Green-Mediated Nanocomposite-Enhanced Glass Ionomer Cement Compared to Traditional Glass Ionomer Cement

Background and objective Glass ionomer cement (GIC), also known as polyalkenoate cement, has been extensively used in dentistry for both luting and restorative purposes. Despite being the first choice for aesthetic restorations due to their chemical bonding ability to teeth, GICs have faced challenges such as low mechanical properties, abrasion resistance, and sensitivity to moisture, leading to the search for improved materials.  This study aims to assess the effects of thermocycling on the compressive, flexural strength, and microhardness of green-mediated nanocomposite-modified GIC in comparison to traditional GIC. Methodology Green-mediated nanoparticles, consisting of chitosan, titanium, zirconia, and hydroxyapatite (Ch-Ti-Zr-HA), were synthesized using a one-pot synthesis technique to form nanocomposites. These nanocomposites were then incorporated into GIC specimens in varying concentrations (3%, 5%, and 10%), denoted as Group I, Group II, and Group III, respectively. Group IV served as the control, consisting of conventional GIC. To assess the performance of the novel restorative materials over an extended period, compressive strength, flexural strength, and microhardness were measured before and after thermocycling using a universal material testing machine. Furthermore, scanning electron microscopy (SEM) analysis was carried out following the thermocycling process. The collected data were subjected to statistical analysis through one-way analysis of variance (ANOVA) and paired t-tests. Results  The findings demonstrated that, in comparison to the control group, both the mean compressive strength and flexural strength, as well as hardness, were notably higher for the 10% and 5% nanocomposite-modified GIC specimens before and after thermocycling (P < 0.05). Notably, there was no notable difference observed between the 5% and 10% concentrations (P > 0.05). These results suggest that incorporating green-mediated nanocomposites (Ch-Ti-Zr-HA) modified GIC at either 5% or 10% concentration levels leads to improved mechanical properties, indicating their potential as promising alternatives in dental restorative materials. Conclusions Based on our findings, it can be inferred that the 10% and 5% concentrations of green-mediated (Ch-Ti-Zr-HA) modified GIC exhibit superior compressive and flexural strength compared to conventional GIC. Additionally, analysis of the scanning electron microscope (SEM) morphology revealed that green-mediated GIC displays smoother surface characteristics in contrast to conventional GIC. These results underscore the potential advantages of utilizing green-mediated nanocomposite-modified GIC in dental applications, suggesting enhanced mechanical properties and surface quality over conventional.

Mechanical Properties and Ion Release from Fibre-Reinforced Glass Ionomer Cement

The aim of this study was to compare the mechanical properties and ion release from a commercially available resin-modified glass ionomer cement to a formulation reinforced by the addition of short glass fibres at various percentages. Methods: Three experimental groups were prepared by adding a mass ratio of 10%, 15% and 20% of short glass fibres to the powder portion of the cement from a capsule (GC Fuji II LC), while the control group contained no fibres. Microhardness (n = 12), fracture toughness, and flexural, compressive and diametral tensile strength (n = 8) were evaluated. To study ion release, readings were obtained utilising fluoro-selective and calcium-selective electrodes after 24 h, 7 days and 30 days (n = 12). The spatial distribution of fibres within the material was evaluated through scanning electron microscopy. The data were analysed using one-way ANOVA with a Bonferroni adjustment. Results: The findings suggest that elevating fibre weight ratios to 20 wt% results in improved mechanical properties (p < 0.05) in microhardness, flexural strength, diametral tensile strength and fracture toughness. In terms of ion release, a statistically significant difference (p < 0.001) was observed between the groups at the conclusion of 24 h and 7 days, when the fluoride release was much higher in the control group. However, after 30 days, no significant distinction among the groups was identified (p > 0.05). Regarding calcium release, no statistically significant differences were observed among the groups at any of the evaluated time points (p > 0.05). SEM showed the fibres were homogeneously incorporated into the cement in all experimental groups. Conclusions: Resin-modified glass ionomer enhanced with short glass fibres at a weight loading of 20% showcased the most favourable mechanical properties while concurrently maintaining the ability to release fluoride and calcium after a 30-day period.

Evaluating Glass Ionomer Cement Longevity in the Primary and Permanent Teeth-An Umbrella Review

The aim of this umbrella review was to evaluate the longevity of glass ionomer cement (GIC) as a restorative material for primary and permanent teeth. Research in the literature was conducted in three databases (MedLine/PubMed, Web of Science, and Scopus). The inclusion criteria were: (1) to be a systematic review of clinical trials that (2) evaluated the clinical longevity of GICs as a restorative material in primary and/or permanent teeth; the exclusion criteria were: (1) not being a systematic review of clinical trials; (2) not evaluating longevity/clinical performance of GICs as a restorative material; and (3) studies of dental restorative materials in teeth with enamel alterations, root caries, and non-carious cervical lesions. Twenty-four eligible articles were identified, and 13 were included. The follow-up periods ranged from 6 months to 6 years. Different types of GICs were evaluated in the included studies: resin-modified glass ionomer cement (RMGIC), compomers, and low- and high-viscosity glass ionomer cement. Some studies compared amalgam and composite resins to GICs regarding longevity/clinical performance. Analyzing the AMSTAR-2 results, none of the articles had positive criteria in all the evaluated requisites, and none of the articles had an a priori design. The criteria considered for the analysis of the risk of bias of the included studies were evaluated through the ROBIS tool, and the results of this analysis showed that seven studies had a low risk of bias; three studies had positive results in all criteria except for one criterion of unclear risk; and two studies showed a high risk of bias. GRADE tool was used to determine the quality of evidence; for the degree of recommendations, all studies were classified as Class II, meaning there was still conflicting evidence on the clinical performance/longevity of GICs and their recommendations compared to other materials. The level of evidence was classified as Level B, meaning that the data were obtained from less robust meta-analyses and single randomized clinical trials. To the best of our knowledge, this is the first umbrella review approaching GIC in permanent teeth. GICs are a good choice in both dentitions, but primary dentition presents more evidence, especially regarding the atraumatic restorative treatment (ART) technique. Within the limitation of this study, it is still questionable if GIC is a good restorative material in the medium/long term for permanent and primary dentition. Many of the included studies presented a high risk of bias and low quality. The techniques, type of GIC, type of cavity, and operator experience highly influence clinical performance. Thus, clinical decision-making should be based on the dental practitioner's ability, each case analysis, and the patient's wishes. More evidence is needed to determine which is the best material for definitive restorations in permanent and primary dentition.

An Evaluation of Experimental Calcium Ion-Leachable Nanocomposite Glass Ionomer Cements

Glass ionomer cements (GICs) are among the main restorative dental materials used broadly in daily clinical practice. The incorporation of clay nanoparticles as reinforcing agents is one potential approach to improving GIC properties. This study aims to investigate whether the incorporation of calcium-modified clay (Ca-clay) nanoparticles in conventional GICs alters their structural characteristics, along with their physicochemical and mechanical properties. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) analyses were performed to assess the surface characterization of GIC nanocomposites, whereas a setting reaction was carried out via an attenuated total reflection Fourier transform infrared spectrometer (ATR-FTIR). A universal testing machine was used for compression tests, while calcium ion release was quantified using inductively coupled plasma optical emission spectrometry (ICP-OES). GIC composite groups reinforced with Ca-clay were found to release a fine amount of calcium ions (5.06-9.91 ppm), with the setting reaction being unaffected for low Ca-clay loadings. The median compressive strength of 3 wt% in the Ca-clay group (68.97 MPa) was nearly doubled compared to that of the control group (33.65 MPa). The incorporation of Ca-clay nanoparticles in GICs offers a promising alternative among dental restorative materials regarding their chemical and mechanical properties.

Effect of aging on mechanical and antibacterial properties of fluorinated graphene reinforced glass ionomer: In vitro study

OBJECTIVES

This study: 1) aims to test the mechanical and antibacterial properties of fluorinated graphene strengthened glass ionomer materials (FG/GICs); 2) aims to investigate the effects of thermo-cycling on (FG/GICs).

MATERIALS AND METHODS

Fluorinated graphene (FG) with bright white color was prepared from fluorinated graphite (SIGMA Aldrich), using modified Hummer's method, to be added to conventional glass ionomer cements (GICs). In addition to a control group (group 1), experimentally modified GICs were prepared by adding FG to the conventional glass ionomer powder with three different weight ratios; (group 2, 1 wt %; group 3, 2.5 wt %; and group 4, 5 wt %) using mechanical blending method. Experimental groups of the specimens (n = 240) were divided, for each concentration (n = 120) half of the specimens were subjected to thermo-cycling. Hardness, compressive strength, and antibacterial activity of (FG/GICs) were measured with and without thermo-cycling. Compressive strength was measured by a universal testing machine, hardness was measured using a Vickers micro-hardness tester, and antibacterial effects against staphylococcus aureus and streptococcus mutans were tested by the pellicle sticking method. For statistical analysis, numerical data were explored for normality and variance homogeneity using Shapiro-Wilk and Leven's tests respectively.

RESULTS

The prepared (FG/GICs) showed an increase in hardness in group 4 (p < 0.001). Groups 3 and 4 gave the highest compressive strength values with no significant difference between them (p < 0.001). Groups 2, 3, and 4 showed improved antibacterial activity with no statistical difference between them (p > 0.001). Results after thermo-cycling showed significantly decreased hardness, and compressive strength values (p < 0.001), however, the results of antibacterial activity against streptococcus mutans showed no statistical difference after thermo-cycling (group 2, p = 0.05; group 3, p = 0.18; group 4, p = 0.26). The same results were observed for antibacterial activity against staphylococcus aureus (p = 0.92, p = 0.14, and p = 0.48 respectively).

CONCLUSION

FG can be considered a promising additive to GICs to promote its anti-cariogenic effects, however, these antibacterial effects are only useful in the short term, as aging adversely affected their mechanical properties. The 2.5 wt % FG/GICs is suggested to be the most encouraging, as after aging, it represented the highest compressive strength among all groups, while its hardness values were at least comparable to that of conventional glass ionomer.

CLINICAL SIGNIFICANCE

FG/GICs can be considered an anti-cariogenic restoration in temporary restorative interventions, as in certain cases in deciduous teeth where considerable esthetics may be required, especially those with difficult moisture control, where neither resin composite restorations nor amalgam restorations will be indicated. It can also be used for patients with high caries index or in atraumatic restorative treatment (ART) in low-income countries.

Effect of Nanostructures on the Properties of Glass Ionomer Dental Restoratives/Cements: A Comprehensive Narrative Review

Overall perspective of nanotechnology and reinforcement of dental biomaterials by nanoparticles has been reported in the literature. However, the literature regarding the reinforcement of dental biomaterials after incorporating various nanostructures is sparse. The present review addresses current developments of glass ionomer cements (GICs) after incorporating various metallic, polymeric, inorganic and carbon-based nanostructures. In addition, types, applications, and implications of various nanostructures incorporated in GICs are discussed. Most of the attempts by researchers are based on the laboratory-based studies; hence, it warrants long-term clinical trials to aid the development of suitable materials for the load bearing posterior dentition. Nevertheless, a few meaningful conclusions are drawn from this substantial piece of work; they are as follows: (1) most of the nanostructures are likely to enhance the mechanical strength of GICs; (2) certain nanostructures improve the antibacterial activity of GICs against the cariogenic bacteria; (3) clinical translation of these promising outcomes are completely missing, and (4) the nanostructured modified GICs could perform better than their conventional counterparts in the load bearing posterior dentition.

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.

Modifications of Glass Ionomer Cement Powder by Addition of Recently Fabricated Nano-Fillers and Their Effect on the Properties: A Review

The aim of this article is to provide a brief insight regarding the recent studies and their recommendations related to the modifications to glass ionomer cement (GIC) powder in order to improve their properties. An electronic search of publications was made from the year 2000 to 2018. The databases included in the current study were EBSCOhost, PubMed, and ScienceDirect. The inclusion criteria for the current study include publication with abstract or full-text articles, original research, reviews or systematic reviews, in vitro, and in vivo studies that were written in English language. Among these only articles published in peer-reviewed journals were included. Articles published in other languages, with no available abstract and related to other nondentistry fields, were excluded. A detailed review of the recent materials used as a filler phase in GIC powder has revealed that not all modifications produce beneficial results. Recent work has demonstrated that modification of GIC powder with nano-particles has many beneficial effects on the properties of the material. This is due to the increase in surface area and surface energy, along with better particle distribution of the nano-particle. Therefore, more focus should be given on nano-particle having greater chemical affinity for GIC matrix as well as the tooth structure that will enhance the physicochemical properties of GIC.

Mechanical properties and water sorption of two experimental glass ionomer cements with hydroxyapatite or calcium fluorapatite formulation

In this study the mechanical behavior and water sorption (Ws) of experimental glass-ionomer-cements (GICs) with hydroxyapatite (HA) or calcium fluorapatite (CFA) prototype formulations were examined. Specimens from two experimental and one commercially available GIC were prepared in three protocols; (1) according to the manufacturer's instructions, (2) with coating and (3) with heat application. The specimens were stored in distilled water or artificial saliva at 37°C for 7- and 30-days. Flexural strength (FS), Vickers hardness (VHN) and Ws of GICs were evaluated. Experimental GICs showed higher FS values than commercial GIC (p<0.001). Higher FS and VHN values were observed when GICs were prepared according to manufacturer's recommendation. FS was affected only by GIC-type (η²=0.027), whereas VHN was affected by GIC-type (η²=0.331), treatment-protocols (η²=0.067), storage-medium (η²=0.100) and increased storage-duration (η²=0.317). The tested parameters did not significantly influence the Ws of all tested GICs (p>0.05). The GICs with HA or CFA formulations might represent a promising approach due to their FS, VHN and Ws characteristics.

Effect of discontinuous glass fibers on mechanical properties of glass ionomer cement

Aim: This study investigated the reinforcing effect of discontinuous glass microfibers with various loading fractions on selected mechanical properties of self-cure glass ionomer cement (GIC).

Method: Experimental fiber reinforced GIC (Exp-GIC) was prepared by adding discontinuous glass microfiber (silane/non-silane treated) of 200–300 µm in length to the powder of self-cure GIC (GC Fuji IX) with various mass ratios (15, 20, 25, 35, and 45 mass%) using a high speed mixing device. Flexural strength, flexural modulus, work of fracture, compressive strength and diametral tensile strength were determined for each experimental and control materials. The specimens (n = 8) were wet stored (37 °C for one day) before testing. Scanning electron microscopy equipped with energy dispersive spectrometer was used to analysis the surface of silanized or non-silanized fibers after treated with cement liquid. The results were analyzed with using multivariate analysis of variance MANOVA.

Results: Fiber-reinforced GIC (25 mass%) had significantly higher mechanical performance of flexural modulus (3.8 GPa), flexural strength (48 MPa), and diametral tensile strength (18 MPa) (p < .05) compared to unreinforced material (0.9 GPa, 26 MPa and 8 MPa). No statistical significant difference in tested mechanical properties was recorded between silanized and non-silanized Exp-GIC groups. Compressive strength did not show any significant differences (p > .05) between the fiber-reinforced and unreinforced GIC.

Conclusion: The use of discontinuous glass microfibers with self-cure GIC matrix considerably increased the all of the studied properties except compressive strength.

Nanoclay-Reinforced Glass-Ionomer Cements: In Vitro Wear Evaluation and Comparison by Two Wear-Test Methods

Glass ionomer cement (GIC) represents a major transformation in restorative dentistry. Wear of dental restoratives is a common phenomenon and the determination of the wear resistance of direct-restorative materials is a challenging task. The aim of this paper was to evaluate the wear resistance of novel glass ionomer cement by two wear-test methods and to compare the two wear methods.The wear resistance of a conventional glass ionomer cement (HiFi Advanced Health Care Kent, UK) and cements modified by including various percentages of nanoclays (1, 2 and 4 wt %) was measured by a reciprocating wear test (ball-on-flat) and Oregon Health and Sciences University's (OHSU) wear simulator. The OHSU wear simulation subjected the cement specimens to three wear mechanisms, namely abrasion, three-body abrasion and attrition using a steatite antagonist. The abrasion wear resulted in material loss from GIC specimen as the steatite antagonist forced through the exposed glass particles when it travelled along the sliding path.The hardness of specimens was measured by the Vickers hardness test. The results of reciprocation wear test showed that HiFi-1 resulted in the lowest wear volume 4.90 (0.60) mm³ (p < 0.05), but there was no significant difference (p > 0.05) in the wear volume in comparison to HiFi, HiFi-2 and HiFi-4. Similarly, the results of OHSU wear simulator showed that the total wear volume of HiFi-4 1.49 (0.24) was higher than HiFi-1 and HiFi-2. However, no significant difference (p > 0.05) was found in the OHSU total wear volume in GICs after nanoclay incorporation. The Vickers hardness (HV) of the nanoclay-reinforced cements was measured between 62 and 89 HV. Nanoclay addition at a higher concentration (4%) resulted in higher wear volume and wear depth. The total wear volumes were less dependent upon abrasion volume and attrition volume. The total wear depths were strongly influenced by attrition depth and to some extent by abrasion depth. The addition of nanoclay in higher wt % to HiFi did not result in significant improvement in wear resistance and hardness. Nonetheless, wear is a very complex phenomenon because it is sensitive to a wide number of factors that do not necessarily act in the same way when compared using different parameters.

Novel Nanotechnology of TiO2 Improves Physical-Chemical and Biological Properties of Glass Ionomer Cement

The aim of this study was to assess the performance of glass ionomer cement (GIC) added with TiO₂ nanotubes. TiO₂ nanotubes [3%, 5%, and 7% (w/w)] were incorporated into GIC's (Ketac Molar EasyMix™) powder component, whereas unblended powder was used as control. Physical-chemical-biological analysis included energy dispersive spectroscopy (EDS), surface roughness (SR), Knoop hardness (SH), fluoride-releasing analysis, cytotoxicity, cell morphology, and extracellular matrix (ECM) composition. Parametric or nonparametric ANOVA were used for statistical comparisons (α ≤ 0.05). Data analysis revealed that EDS only detected Ti at the 5% and 7% groups and that GIC's physical-chemical properties were significantly improved by the addition of 5% TiO₂ as compared to 3% and GIC alone. Furthermore, regardless of TiO₂ concentration, no significant effect was found on SR, whereas GIC-containing 7% TiO₂ presented decreased SH values. Fluoride release lasted longer for the 5% and 7% TiO₂ groups, and cell morphology/spreading and ECM composition were found to be positively affected by TiO₂ at 5%. In conclusion, in the current study, nanotechnology incorporated in GIC affected ECM composition and was important for the superior microhardness and fluoride release, suggesting its potential for higher stress-bearing site restorations.

Hollow glass fibers in reinforcing glass ionomer cements

OBJECTIVE

This study investigated the reinforcing effect of hollow and solid discontinuous glass fiber fillers with two different loading fractions on select mechanical properties of conventional and resin modified glass ionomer cements (GICs).

METHODS

Experimental fiber reinforced GIC was prepared by adding discontinuous glass fiber (hollow/solid) of 0.5mm in length to the powder of commercial GICs (GC Fuji IX and II LC) with two different weight ratios (5 and 10wt%) using a high speed mixing machine. Fracture toughness, work of fracture, flexural strength, flexural modulus, compressive strength and diametral tensile strength were determined for each experimental and control material. The specimens (n=7) were wet stored (37°C for one day) before testing. Scanning electron microscopy was used to evaluate the microstructure of the experimental fiber reinforced GICs. Fiber length analysis was carried out to investigate the fiber length distribution of experimental GICs. The results were analyzed statistically using ANOVA followed by Tukey's post hoc test. Level of significance was set at 0.05.

RESULTS

An increase in fracture toughness (280 and 200%) and flexural strength (170 and 140%) of hollow discontinuous glass fiber reinforced (10wt%) conventional and resin modified GICs respectively, were achieved compared to unreinforced materials (p<0.05). Compressive strength did not show any significant differences (p>0.05) between the fiber reinforced and unreinforced GICs.

SIGNIFICANCE

The use of hollow discontinuous glass fiber fillers with conventional and resin modified GIC matrix is a novel reinforcement. It yielded superior toughening and flexural performance compared to the particulate GICs used.

Modification of pristine nanoclay and its application in wood-plastic composite

The modification of pristine nanoclay and its application in wood plastic composite (WPC) have been investigated in this paper. Pristine nanoclay was modified using transition metal ion (TMI) which was copper (II) chloride to achieve good dispersion and to improve properties of WPC. The morphology, composition, structure, and thermal stability of TMI-modified nanoclay were studied by field emission scanning electron microscopy (FESEM), energy dispersive X-ray analysis (EDX), X-ray diffraction (XRD) and thermogravimetric analysis (TGA) analysis. The pristine (WPC/MMT) and TMI-modified (WPC/MMT Cu) nanoclay based WPC were made from polypropylene (PP), wood flour (WF), and maleic anhydride grafted polypropylene (MAPP) coupling agent. Pristine and modified nanoclay with different concentration (1 wt%, 2.5 wt%, 4 wt% and 5 wt%) were used as a reinforcing filler for WPC. Mechanical, physical, morphological, and thermal properties of the prepared composites were evaluated. Result exhibit that at 1 wt% nanoclay content, the tensile, flexural, and impact strength of WPC/MMT improved by approximately 6%, 4%, and 8%, respectively, compared to WPC without nanoclay. For the WPC/MMT Cu, the improvements in these properties were about 2.6, 2.1 and 3 times higher than the WPC/MMT. The physical and thermal properties also improved by incorporating modified nanoclay in WPC.

Conventional glass-ionomer materials: A review of the developments in glass powder, polyacid liquid and the strategies of reinforcement

OBJECTIVES

The development of glass-ionomers (GIs) from the earliest experimental GI formulations to the modern day commercially available GIs was reviewed. The aim of the review was to identify the developments in the glass powder and polyacid liquid constituents of GIs since their inception in the late 1960s.

DATA

The glass powder has undergone major changes from the earliest GI powder formulation (G200) in an effort to enhance the reactivity with the polyacid liquid. The GI liquids have also been optimised by the manufacturers in terms of polyacid composition, molecular weight and concentration to improve the handling characteristics. Despite these developments in the glass powder and polyacid liquid constituents, GIs cannot 'truly' be advocated for the restoration of posterior dentition due to the poor mechanical properties when compared with dental amalgam and resin-based composites (RBCs).

SOURCES

Various attempts to improve the mechanical properties of GIs through substitution of reinforcing fillers to the GI powder or modification of the GI liquid were identified in the dental literature. Despite the claimed improvements in mechanical properties of the modified GIs, a wide variation in mixing and testing conditions was identified which prevented a valid assessment of the reported reinforcement strategies. When investigating a GI reinforcement strategy it is crucial that the mixing and testing conditions are standardised to allow a valid comparison between studies.

STUDY SELECTION

The dental literature reporting the earliest experimental GIs to modern day commercially available GIs (1969-2015) was reviewed. In addition, full-text publications and abstracts published in English reporting various GI reinforcement strategies were included.

CONCLUSION

Nevertheless, major improvements in GI formulations through a reinforcement strategy have yet to be made to enable clinical usage of GIs for the restoration of posterior dentition.

CLINICAL SIGNIFICANCE

GIs chemically are inherently weak but bond to sound tooth structure without the need for preconditioning or removal of sound tooth structure such that improvements in the mechanical properties of GIs would be desirable. Although advances have been made through different GI glass powder and polyacid liquid formulations over the past 40 years, further improvements in the mechanical properties of the current GIs are required to be indicated for the restoration of posterior dentition. The literature is replete with reports on GI reinforcement, however, improved reporting and control of mixing and testing conditions are required for a valid assessment of the reinforcement strategies.

Nanoclay addition to a conventional glass ionomer cements: Influence on physical properties

OBJECTIVE

The objective of the present study is to investigate the reinforcement effect of polymer-grade montmorillonite (PGN nanoclay) on physical properties of glass ionomer cement (GIC).

MATERIALS AND METHODS

The PGN nanoclay was dispersed in the liquid portion of GIC (HiFi, Advanced Healthcare, Kent, UK) at 1%, 2% and 4% (w/w). Fourier-transform infrared (FTIR) spectroscopy was used to quantify the polymer liquid of GICs after dispersion of nanoclay. The molecular weight (Mw) of HiFi liquid was determined by gel permeation chromatography. The compressive strength (CS), diametral-tensile strength, flexural strength (FS) and flexural modulus (Ef) of cements (n = 20) were measured after storage for 1 day, 1 week and 1 month. Fractured surface was analyzed by scanning electron microscopy. The working and setting time (WT and ST) of cements was measured by a modified Wilson's rheometer.

RESULTS

The FTIR results showed a new peak at 1041 cm(-1) which increased in intensity with an increase in the nanoclay content and was related to the Si-O stretching mode in PGN nanoclay. The Mw of poly (acrylic acid) used to form cement was in the range of 53,000 g/mol. The nanoclay reinforced GICs containing <2% nanoclays exhibited higher CS and FS. The Ef cement with 1% nanoclays was significantly higher. The WT and ST of 1% nanoclay reinforced cement were similar to the control cement but were reduced with 2% and 4% nanoclay addition.

CONCLUSION

The dispersion of nanoclays in GICs was achieved, and GIC containing 2 wt% nanoclay is a promising restorative materials with improved physical properties.

Advances in dental materials

The dental market is replete with new resorative materials marketed on the basis of novel technological advances in materials chemistry, bonding capability or reduced operator time and/or technique sensitivity. This paper aims to consider advances in current materials, with an emphasis on their role in supporting contemporary clinical practice.

Effect of nanoclay dispersion on the properties of a commercial glass ionomer cement

Objective. The reinforcement effect of polymer-grade montmorillonite (PGV and PGN nanoclay) on Fuji-IX glass ionomer cement was investigated. Materials and Method. PGV and PGV nanoclays (2.0 wt%) were dispersed in the liquid portion of Fuji-IX. Fourier-transform infrared (FTIR) spectroscopy and gel permeation chromatography (GPC) were used to quantify acid-base reaction and the liquid portion of GIC. The mechanical properties (CS, DTS, FS, and E f ) of cements (n = 20) were measured at 1 hour, 1 day, and 1 month. The microstructure was examined by cryo-SEM and TEM. Results. FTIR shows that the setting reaction involves the neutralisation of PAA by the glass powder which was linked with the formation of calcium and aluminium salt-complexes. The experimental GICs (C-V and C-N) exhibited mechanical properties in compliance to ISO standard requirement have higher values than Fuji-IX cement. There was no significant correlation of mechanical properties was found between C-V and C-N. The average Mw of Fuji-IX was 15,700 and the refractive index chromatogram peak area was 33,800. TEM observation confirmed that nanoclays were mostly exfoliated and dispersed in the matrix of GIC. Conclusion. The reinforcement of nanoclays in GICs may potentially produce cements with better mechanical properties without compromising the nature of polyacid neutralisation.

Nanoclays reinforced glass ionomer cements: dispersion and interaction of polymer grade (PG) montmorillonite with poly(acrylic acid)

Montmorillonite nanoclays (PGV and PGN) were dispersed in poly(acrylic acid) (PAA) for utilization as reinforcing filler in glass ionomer cements (GICs). Chemical and physical interaction of PAA and nanoclay (PGV and PGN) was studied. PAA–PGV and PAA–PGN solutions were prepared in different weight percent loadings of PGV and PGN nanoclay (0.5-8.0 wt%) via exfoliation-adsorption method. Characterization was carried out by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and fourier transform infrared (FTIR) spectroscopy. XRD results of PAA–PGN demonstrated that the interlayer space expanded from 12.83 to 16.03 Å indicating intercalation whereas the absence of the peak at d(001) in PAA–PGV indicated exfoliation. XPS scans of PGV and PGN nanoclays depicted the main peak of O 1s photoelectron due to Si–O–M (M = Mg, Al, Fe) whereas, Si–O–Al linkages were identified by Si 2p or Si 2s and Al 2p or Al 2s peaks. The disappearance of the Na peak confirmed that PAA molecules exchanged sodium ions present on surface of silicate layers and significantly reduced the electrostatic van-der-Waals forces between silicate plates resulting in intercalation or exfoliation. FTIR spectra of PAA–nanoclay suspensions demonstrated the presence of a new peak at 1,019 cm(-1) associated with Si–O– stretching vibrations which increased with increasing nanoclays concentration. Information concerning the dispersion of nanoclay in PAA aqueous solutions, chemical reaction and increase interlayer space in montmorillonite nanoclay is particularly useful regarding dispersion and reinforcement of nanoclay in PAA.

To compare the microleakage among experimental adhesives containing nanoclay fillers after the storages of 24 hours and 6 months

Objectives:

To compare the microleakage among experimental adhesives containing nanoclay fillers after the storages of 24 hours and 6 months.

Materials and Methods:

Class V cavities were prepared on extracted human molars with the occlusal margins located in enamel and the cervical margins in cementum. Phosphoric acid was applied to the enamel and dentin margins.Subsequently, the cavities were treated using four groups of experimental adhesive systems and restored with a resin composite. Adper Single Bond® was used as control group. After 24- hour and 6- month storages, the samples were subjected to thermocycling shocks and then immersed in silver nitrate as well as developer solution and finally evaluated for leakage. The data were analyzed using SPSS software.

Results:

Based on Kruskal –Wallis test, significant differences were found between groups regarding microleakage. The Mann- Whitney test showed that Leakage was significantly lower in Adper Single Bond® compared to the other groups in dentinal margins after 24 hours and 6 months and in enamel margins after 6 months. The Wilcoxon Signed Ranks test showed that the enamel leakage in experimental adhesives was significantly lower than dentinal leakage after 24 hours as well as enamel leakage in Adper Single Bond and adhesive with 0.5% PMAA-g-nanoclay was significantly lower than dentinal margins after storage period of 6 months.

Conclusion:

All the experimental adhesives were effective in reducing enamel leakage after 24 hours, but were not effective in reducing dentinal leakage after 24 hours as well as in enamel and dentinal leakage after a 6-month storage. No improvement was observed in the microleakage in dentin in both short (24 hrs) and long times (6 months).

The high microleakage in the adhesives is probably attributed to the high concentration of HEMA in the recipe of the bonding agent.

Setting time and expansion in different soaking media of experimental accelerated calcium-silicate cements and ProRoot MTA

OBJECTIVES

The setting time and the expansion in deionized water, phosphate-buffered saline (PBS), 20% fetal bovine serum (FBS)/80% PBS or hexadecane oil of experimental accelerated calcium-silicate cements and ProRoot MTA were evaluated.

STUDY DESIGN

Different compounds such as sodium fluoride, strontium chloride, hydroxyapatite, and tricalcium phosphate were separately added to a basic experimental calcium-silicate cement to test their effect on setting and expansion. The initial and final setting times were determined using appropriate Gilmore needles. A linear variable differential transformer (LVDT) device was used to test the restricted hygroscopic linear expansion over 180 minutes of cements immersed in different solutions. Results were statistically compared using a 2-way ANOVA test (cement type versus solution type).

RESULTS

All experimental cements showed initial setting times between 28 and 45 minutes and final setting times between 52 and 80 minutes. MTA showed a final setting time of 170 minutes. Final setting time of all experimental cements was faster than MTA. All cements showed slight (0.04%-0.77%) expansion in water, PBS, or FBS/PBS. Only fluoride-containing cement showed a significant expansion in water (6.68%) and in PBS (6.72%). The PBS/FBS contamination significantly reduced the expansion of fluoride-containing cement (2.98%) and MTA (0.07%). In contrast, cements showed a slight shrinkage when immersed in hexadecane, especially fluoride-containing cement.

CONCLUSIONS

The study demonstrated that: (1) the setting time of calcium-silicate cements may be effectively reduced; (2) the expansion is a water dependent mechanism owing to water uptake, because no expansion occurred in cements immersed in oil; (3) a correlation between setting time and expansion in water and PBS exists; (4) fluorine-containing cement showed a significant expansion in water and in PBS; (5) the immersion in FBS/PBS strongly reduced the expansion of MTA and fluoride-doped cement suggesting that fluid contamination (ie, blood) during surgical procedures may greatly affect the expansion of some calcium-silicate cements.

Is encapsulation of posterior glass-ionomer restoratives the solution to clinically induced variability introduced on mixing?

OBJECTIVES

Three GI restorative systems were evaluated to determine if encapsulated GI restoratives performed more favorably than the hand-mixed equivalents prepared with powder contents progressively decreased from that recommended by manufacturers in 10% increments for a constant weight of liquid which are routinely employed in clinical practice.

METHODS

Mean compressive fracture strengths, associated Weibull moduli and mean elastic moduli were determined for series of 30 nominally identical cylindrical specimens for three hand-mixed GI restoratives prepared with 100-50% of the recommended powder content for a constant weight of liquid and the equivalent encapsulated GI restoratives mechanically mixed in the Capmix or Rotomix machines.

RESULTS

Decreasing the powder content of the three hand-mixed GI restoratives for a constant weight of liquid from that recommended by the manufacturers resulted in a progressive deterioration of the mean compressive fracture strengths and the mean elastic modulus. The elastic modulus was more sensitive than the compressive fracture strength to highlighting the impact of mixing ratio variations in the GI restoratives. There were no significant differences between mean compressive fracture strengths of mechanically mixed encapsulated GI restoratives, however, variations in mean elastic modulus were dependent upon the mixing time employed.

CONCLUSIONS

The employment of an intrinsic material property was more sensitive than a non-intrinsic material property to highlight the impact of mixing ratio variations in hand-mixed restoratives and the effect that the method of mechanical mixing has on encapsulated GI restoratives. Encapsulated GI restoratives are a potential solution to the operator induced variability associated with hand-mixed GI restoratives.

The impact of montmorillonite clay addition on the in vitro wear resistance of a glass-ionomer restorative

OBJECTIVES

The in vitro wear resistance of a glass-ionomer (GI) restorative ChemFil Superior (Dentsply DeTrey, Kanstanz, Germany) reinforced with either a pristine calcium montmorillonite (Ca-MMT) or an organically modified 12-amino-dodecanoicacid treated montmorillonite (ADA-MMT) clay was evaluated to investigate the potential of MMT reinforced GI restoratives as posterior filling materials.

METHODS

The wear resistance of a GI restorative reinforced with 0.5-2.5 wt.% Ca-MMT and ADA-MMT was assessed for groups of four disc-shaped specimens using the OHSU oral wear simulator operating at 20 N abrasion and 90 N attrition forces for 50,000 cycles at a frequency of 1 Hz in the presence of a poppy seed and PMMA micro-sphere slurry. The wear facet of each specimen was quantified by measuring the mean wear depth and mean volumetric wear in the abrasion (40-60% of wear facet) and attrition (80-90%) regions in conjunction with the mean total wear depth and mean total volumetric wear.

RESULTS

The addition of Ca-MMT clay resulted in a significant increase in the mean total volumetric wear and mean total wear depth of the GI restorative as the concentration of clay was increased utilising the one-way ANOVA and Tukey's test comparisons at a 95% significance level. When ADA-MMT clay was added to the GI no significant differences in mean total volumetric wear and mean total wear depth were evident (P<0.05).

CONCLUSIONS

The addition of Ca-MMT clay to the GI restorative resulted in a significant decrease in the in vitro wear resistance. ADA-MMT clay additions to the powder element of the GI restorative did not significantly enhance the in vitro wear resistance.