Dental glass ionomer cement reinforced by cellulose microfibers and cellulose nanocrystals

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.

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.

Improvement of the setting properties of mineral trioxide aggregate cements using cellulose nanofibrils

Cellulose nanofibrils (CNFs) exhibit excellent mechanical properties and are used to reinforce various composites. The effects of incorporating CNFs into commercial mineral trioxide aggregate (MTA) cements (NEX MTA (NEX) and ProRoot® MTA (PR)) on the underwater setting properties, compressive strength, and flowability were estimated in this study. NEX mixed without CNFs disintegrated after water immersion. NEX mixed with CNF-suspended solutions showed good setting properties under water immersion and a similar compressive strength, which was kept in air (100% relative humidity). PR did not degrade after water immersion, regardless of the presence of CNFs, and no significant difference in the compressive strength caused by CNFs incorporation was detected. The relative flowability of the NEX mixture decreased with increasing CNFs content up to 1.0 w/v%. The application of CNF-incorporated MTA in various dental cases is promising because CNFs prevent the water-immersion-dependent collapse of some MTA cements immediately after mixing.

Nanocellulose-based porous materials: Regulation and pathway to commercialization in regenerative medicine

We review the recent progress that have led to the development of porous materials based on cellulose nanostructures found in plants and other resources. In light of the properties that emerge from the chemistry, shape and structural control, we discuss some of the most promising uses of a plant-based material, nanocellulose, in regenerative medicine. Following a brief discussion about the fundamental aspects of self-assembly of nanocellulose precursors, we review the key strategies needed for material synthesis and to adjust the architecture of the materials (using three-dimensional printing, freeze-casted porous materials, and electrospinning) according to their uses in tissue engineering, artificial organs, controlled drug delivery and wound healing systems, among others. For this purpose, we map the structure-property-function relationships of nanocellulose-based porous materials and examine the course of actions that are required to translate innovation from the laboratory to industry. Such efforts require attention to regulatory aspects and market pull. Finally, the key challenges and opportunities in this nascent field are critically reviewed.

Mechanical and antibacterial properties of conventional pit and fissure sealants with addition of miswak fibers

The occlusal surface of a tooth is affected by the development of biofilm in pits and fissures as bacteria and food particles accumulate in its complex structure. In this study, miswak fibers containing cellulose and antimicrobial extract were incorporated in commercial pit and fissure sealants. The miswak powder was characterized by different analytical techniques. The powder was mixed in different ratios (0-5%) into a pit and fissure sealant to result in five sealants (Groups 0-5), and their mechanical properties i.e. flexural strength, compressive strength, and Vickers hardness were evaluated. The sealants were also evaluated against streptococcus mutans oral pathogenic bacteria. SEM analysis confirmed irregular shape and micron-size particles of miswak powder. The infrared spectral analysis and X-ray differential peaks showed characteristic peaks related to miswak fibers. The particle appearance increased in prepared pits and fissure sealants with higher loading of miswak powder in SEM analysis. The flexural strength, compressive strength, and Vickers hardness values were obtained in the range of 148-221 (±16.6: p-value < 0.001) MPa, 43.1-50.3 MPa (±1.7: p-value <0.001), and 15.2-21.26 VHN (±0.56: p-value <0.001) for control and prepared sealant specimens respectively. In the antibacterial study, the zone of inhibitions increased with increased content of miswak from 15.6 ± 0.45 mm (Group 1) to 20.3 ± 0.32 mm (Group 5). The MIC was calculated to be 0.039%. The prepared experimental sealant had acceptable mechanical and good antibacterial properties therefore it could be recommended as an efficient pit and fissure sealant.

Current advances of nanocellulose application in biomedical field

Nanocellulose (NC) is a natural fiber that can be extracted in fibrils or crystals form from different natural sources, including plants, bacteria, and algae. In recent years, nanocellulose has emerged as a sustainable biomaterial for various medicinal applications including drug delivery systems, wound healing, tissue engineering, and antimicrobial treatment due to its biocompatibility, low cytotoxicity, and exceptional water holding capacity for cell immobilization. Many antimicrobial products can be produced due to the chemical functionality of nanocellulose, such disposable antibacterial smart masks for healthcare use. This article discusses comprehensively three types of nanocellulose: cellulose nanocrystals (CNC), cellulose nanofibrils (CNF), and bacterial nanocellulose (BNC) in view of their structural and functional properties, extraction methods, and the distinctive biomedical applications based on the recently published work. On top of that, the biosafety profile and the future perspectives of nanocellulose-based biomaterials have been further discussed in this review.

Nanotechnology for Dentistry: Prospects and Applications

In the XXI century, application of nanostructures in oral medicine has become common. In oral medicine, using nanostructures for the treatment of dental caries constitutes a great challenge. There are extensive studies on the implementation of nanomaterials to dental composites in order to improve their properties, e.g., their adhesive strength. Moreover, nanostructures are helpful in dental implant applications as well as in maxillofacial surgery for accelerated healing, promoting osseointegration, and others. Dental personal care products are an important part of oral medicine where nanomaterials are increasingly used, e.g., toothpaste for hypersensitivity. Nowadays, nanoparticles such as macrocycles are used in different formulations for early cancer diagnosis in the oral area. Cancer of the oral cavity-human squamous carcinoma-is the sixth leading cause of death. Detection in the early stage offers the best chance at total cure. Along with diagnosis, macrocycles are used for photodynamic mechanism-based treatments, which possess many advantages, such as protecting healthy tissues and producing good cosmetic results. Application of nanostructures in medicine carries potential risks, like long-term influence of toxicity on body, which need to be studied further. The introduction and development of nanotechnologies and nanomaterials are no longer part of a hypothetical future, but an increasingly important element of today's medicine.

Nano-cellulose Reinforced Glass Ionomer Restorations: An In Vitro study

OBJECTIVE

Various modifications in formulation of glass ionomer cements (GICs) have been made in order to improve the clinical performance of these restorations. The aim of this work was to evaluate the microleakage and microshear bond strength (μSBS) of bacterial cellulose nanocrystal (BCNC)-modified glass ionomer cement (GIC) restorations in primary dentition.

METHODS

A total number of 60 freshly extracted primary molar teeth were selected. Half of the samples were used for μSBS testing (in 2 groups, n = 15). In group 1, conventional GIC (CGIC) of Fuji IX (GC) was placed in cylindrical molds on dentinal surfaces. In group 2, CGIC of Fuji IX containing 1% wt of BCNCs was used. μSBS was evaluated using a universal testing machine. In another part of the study, microleakage of class V restorations was assessed according to the mentioned groups (n = 15). The sectioned samples were observed under stereomicroscope, and microleakage scores were recorded. SPSS version 16.0 (SPSS), independent samples t test, and Mann-Whitney U test were used for statistical analysis at a significance level of P < .05.

RESULTS

Results showed statistically significant differences between the μSBS of CGIC and modified GIC groups (P < .0001). The BCNC-modified GIC group recorded significantly higher bond strength values (3.51 ± 0.033 vs 1.38 ± 0.034 MPa). Also, microleakage scores of CGIC and BCNC-modified GIC restorations were not significantly different (P = .57).

CONCLUSIONS

Based on our findings, it was concluded that incorporating BCNCs (1% wt) into the CGIC of Fuji IX significantly increased the μSBS to the dentin structure of the primary teeth.

Effects of Fiber Loading on Mechanical Properties of Kenaf Nanocellulose Reinforced Nanohybrid Dental Composite Made of Rice Husk Silica

The innovation of nanocellulose as reinforcement filler in composites has been a topic of interest in the development of new biomaterials. The objective of this study was to investigate the mechanical properties of a nanohybrid dental composite made of rice husk silica and loaded with different percentages of kenaf nanocellulose. Kenaf cellulose nanocrystals (CNC) were isolated and characterized using a transmission electron microscope (TEM) (Libra 120, Carl Zeiss, Germany). The experimental composite was fabricated with fiber loadings of 1 wt%, 2 wt%, 3 wt%, 4 wt%, and 6 wt% silane-treated kenaf CNC, and subjected to a flexural and compressive strength test (n = 7) using an Instron Universal Testing Machine (Shimadzu, Kyoto, Japan), followed by a scanning electron microscopic assessment of the flexural specimen’s fracture surface using a scanning electron microscope (SEM) (FEI Quanta FEG 450, Hillsborough, OR, USA). Commercial composites Filtek Z350XT (3M ESPE, St. Paul, MN, USA), Neofil (Kerr Corporation, Orange, CA, USA) and Ever-X Posterior (GC Corporation, Tokyo, Japan) were used as a comparison. The average diameter of kenaf CNC under TEM was 6 nm. For flexural and compressive strength tests, one-way ANOVA showed a statistically significant difference (p < 0.05) between all groups. Compared to the control group (0 wt%), the incorporation of kenaf CNC (1 wt%) into rice husk silica nanohybrid dental composite showed a slight improvement in mechanical properties and modes of reinforcement, which was reflected in SEM images of the fracture surface. The optimum dental composite reinforcement made of rice husk was 1 wt% kenaf CNC. Excessive fiber loading results in a decline in mechanical properties. CNC derived from natural sources may be a viable alternative as a reinforcement co-filler at low concentrations.

Biocompatible carboxymethyl chitosan-modified glass ionomer cement with enhanced mechanical and anti-bacterial properties

Due to the potential adverse effects of conventional dental cements, the demand for biocompatible cements have grown tremendously in the field of dentistry. In this respect, Glass ionomer cements (GICs) are being developed by different researchers. However, low mechanical strength of GIC make them unsuitable for application in high-stress areas. Thus, numerous initiatives to improve mechanical performance have been attempted till date including incorporation of reinforcing fillers. Novelty of the study lies in using carboxymethyl chitosan (CMC) to develop a biocompatible dental cement (DC/CMC-m-GP), which would have enhanced mechanical strength due to greater interaction of CMC with the particles of GIC and better cyto-compatibility due to its cell-proliferation activity. The mechanical strength, acid erosion and fluoride release of DC/CMC-m-GP were studied and compared with control dental cement (DC/Control). DC/CMC-m-GP shows compressive strength of 157.45 M Pa and flexural strength of 18.76 M Pa which was higher as compared to DC/Control. The morphology of the GICs were studied through FESEM. Anti-microbial activity of DC/CMC-m-GP was studied by Agar disc-diffusion method and biofilm assay against S. mutans, which shows that DC/CMC-m-GP inhibits bacterial adhesion on its surface. MTT assay infers that DC/CMC-m-GP was non-cytotoxic and did not affect the cell viability significantly.

Toxicological Assessment of Cellulose Nanomaterials: Oral Exposure

Cellulose nanomaterials (CNMs) have emerged recently as an important group of sustainable bio-based nanomaterials (NMs) with potential applications in multiple sectors, including the food, food packaging, and biomedical fields. The widening of these applications leads to increased human oral exposure to these NMs and, potentially, to adverse health outcomes. Presently, the potential hazards regarding oral exposure to CNMs are insufficiently characterised. There is a need to understand and manage the potential adverse effects that might result from the ingestion of CNMs before products using CNMs reach commercialisation. This work reviews the potential applications of CNMs in the food and biomedical sectors along with the existing toxicological in vitro and in vivo studies, while also identifying current knowledge gaps. Relevant considerations when performing toxicological studies following oral exposure to CNMs are highlighted. An increasing number of studies have been published in the last years, overall showing that ingested CNMs are not toxic to the gastrointestinal tract (GIT), suggestive of the biocompatibility of the majority of the tested CNMs. However, in vitro and in vivo genotoxicity studies, as well as long-term carcinogenic or reproductive toxicity studies, are not yet available. These studies are needed to support a wider use of CNMs in applications that can lead to human oral ingestion, thereby promoting a safe and sustainable-by-design approach.

Long-Term Effect of Modified Glass Ionomer Cement with Mimicked Biological Property of Recombinant Translationally Controlled Protein

This study modified glass ionomer cement (GIC) by adding mimicked biological molecules to reduce cell death. GIC was modified to BIOGIC by adding chitosan and bovine serum albumin for enhancing protein release. The BIOGIC was supplemented with tricalcium phosphate (TCP) and recombinant translationally controlled tumor protein (TCTP) to improve its biological properties. Four groups of materials, GIC, BIOGIC, BIOGIC+TCP, and BIOGIC + TCP + TCTP, were examined by XRD and SEM-EDX. TCTP released from the specimens was determined by an ELISA method. Human dental pulp stem cells (hDPSCs) were harvested and analyzed by MTT assay, apoptosis, gene expression, and cell differentiation. All groups had the same crystallization characteristic peaks of La2O3. The elemental compositions composed of La, Si, and Al are the main inorganic components. The results show that BIOGIC + TCP + TCTP presented significantly higher percentages of cell viability than other groups on day 1 to day 23 (p < 0.05), but were not different after day 24 to day 41 and had reduced cell apoptosis including BAX, TPT1, BCL-2, and Caspase-3. The BIOGIC + TCP + TCTP demonstrated higher odontoblast mineralization and differentiation markers including ALP activity, DSPP, DMP-1, ALP, BMP-2, and OPN. It enhanced cell proliferation and differentiation as well as mineralization with down-regulation of genes related to apoptosis compared with other groups.

TiO2 nanotube-containing glass ionomer cements display reduced aluminum release rates

Titanium dioxide nanotubes (TiO2-nts) were incorporated into a glass ionomer cement (GIC) with improved mechanical properties and antibacterial activity. The aims of the present in vitro study were to define the elemental characterization, aluminum (Al) release rate, and initial working time for GIC reinforced with TiO2-nts, in an experimental caries model. TiO2-nts were incorporated into GIC powder components at 5% by weight, and compared with unblended GIC. Experimental approaches used energy-dispersive spectrometry (EDS), atomic absorption spectrophotometry (AAS), and brightness loss to define surface element properties, Al release rates, and initial working time, respectively. Statistical analysis was performed by 2-way ANOVA, Tukey's test, generalized linear models, and Student's t test (a = 0.05). EDS data analysis revealed that TiO2-nts incorporated into GIC had no significant impact on the typical elemental composition of GICs in an in vitro caries model. Regarding the demineralizing solution, GIC with TiO2-nt significantly decreased the Al release rate, compared with the control group (p < 0.0001). Moreover, TiO2-nt incorporated into GIC did not alter the initial working time of the material (p > 0.05). These findings add information to our scientific body of knowledge concerning the potential impact of TiO2-nt on the performance of conventional GICs.

Enhancing glass ionomer cement features by using the calcium phosphate nanocomposite

This study showed the synthesis of Glass ionomer cements (GIC) modified with calcium phosphate nanoparticles (nCaP). The nCaP/GIC were submitted to mechanical compression and diametral tensile tests. The biocomposite were characterized by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD) and Fourier-transform infrared spectroscopy (FTIR). Cytotoxicity and cell viability tests were performed on the human bone marrow mesenchymal stem cells using a 3-(4,5-dimethylthiazol-2yl)2,5-diphenyl- tetrazolium-bromide assay and LIVE/DEAD assays. Statistically significant differences were observed for mechanical properties (Kruskal-Wallis, p<0.001), nCaP/GIC showed higher resistance to compression and diametral traction. The SEM analyses revealed a uniform distribution nCaP in the ionomer matrix. The EDX and XRD results indicated that hydroxyapatite and calcium β-triphosphate phases. The FTIR spectra revealed the asymmetric band of ν3PO43- between 1100-1030cm-1 and the vibration band associated with ν1PO43- in 963cm-1 associated with nCaP. The nCaP/GIC presented response to adequate cell viability and non-cytotoxic behavior. Therefore, the new nCaP/GIC composite showed great mechanical properties, non-cytotoxic behavior, and adequate response to cell viability with promising dental applications.

Evaluation of the Surface Hardness and Roughness of a Resin-Modified Glass Ionomer Cement Containing Bacterial Cellulose Nanocrystals

The purpose of this study was to evaluate the performance of a resin-modified glass ionomer cement (RMGIC) to which bacterial cellulose nanocrystals (BCNs) were added. BCNs were incorporated into the RMGIC powder in ratios of 0.3%, 0.5%, and 1% (w/w). One control and three experimental groups were enrolled in the study: unmodified RMGIC (control), 0.3% (w/w) BCN-modified RMGIC, 0.5% (w/w) BCN-modified RMGIC, and 1% (w/w) BCN-modified RMGIC. The surface hardness and surface roughness were the parameters assessed. The materials were characterized by scanning electron microscopy (SEM). The data were analyzed using the one-way ANOVA and Kruskal–Wallis tests for surface hardness and roughness, respectively. The addition of BCN resulted in the improvement of surface roughness in all the specimens compared with the control material. The RMGIC modified by 1% (w/w) BCN showed the lowest surface roughness (decreased by 52%) among all tested groups. However, BCN had a negative effect on the surface hardness of RMGIC. The group with 0.3% (w/w) BCN had the least decrease in microhardness (13%). According to the results, the RMGIC group modified by 1% (w/w) BCN had a smoother surface than the other groups. The surface microhardness of the RMGIC decreased after BCNs were added to it.

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.

The effect of bacterial cellulose nanocrystals on the shear bond strength of resin modified glass ionomer cement to dentin

Background

The present study aimed to investigate the effect of bacterial cellulose nanocrystals (BCNC) on the shear bond strength (SBS) of resin modified glass ionomer cement (RMGIC) to dentin.

Material and Methods

A total of 48 freshly extracted intact third molars were randomly divided into four main groups with three different concentrations (0.3%, 0.5% and 1% wt) of BCNC with RMGIC and control group without BCNC. These specimens were kept in distilled water at 37° C for 24h. Shear bond strength was examined, using the universal testing machine. Kruskal-Wallis test and Dunn`s post-hoc test were applied for analysis of data. P<0.05 was considered as the level of significance.

Results

The addition of a 1%wt of BCNC to the RMGIC led to a significant increase in the shear bond strength (7.17 ± 2.14) compared to the control group (2.09 ± 1.80) (P=0.007). The shear bond strength was improved up to 343%.

Conclusions

It was found that the incorporation of 1% wt BCNC to the RMGICs enhanced the SBS properties of the RMGIC significantly. Modifying RMGIC with BCNC might be advantageous in terms of improving the restorative material. Key words:Bacterial cellulose nanocrystals, RMGIC, Shear bond strength.

Effects of Bacterial Cellulose Nanocrystals on the Mechanical Properties of Resin-Modified Glass Ionomer Cements

OBJECTIVES

 The purpose of this study was to evaluate the effect of bacterial cellulose nanocrystals (BCNCs) on the mechanical properties of resin-modified glass ionomer cements (RMGICs) including compressive strength (CS), diametral tensile strength (DTS), and modulus of elasticity (E).

MATERIALS AND METHODS

 BCNCs were incorporated into RMGIC at various concentrations (0.3, 0.5, and 1 wt%). Unmodified RMGIC was used as the control group. The specimens were stored in distilled water at 37°C for 24 hours. CS and DTS, as well as modulus of elasticity, were evaluated using a universal testing machine. The nanostructure of BCNCs was observed via field emission scanning electron microscopy.

STATISTICAL ANALYSIS

 One-way analysis of variance and post-hoc Tukey tests were used for data analysis. Level of significance was at p < 0.05.

RESULTS

 The addition of BCNCs to RMGIC led to an increase in all of the tested mechanical properties compared with the control group, with a significant increase observed for 1 wt% BCNC. CS and DTS improved up to 23%, and modulus of elasticity increased by 44%.

CONCLUSIONS

 The addition of BCNCs to the RMGIC improved the mechanical properties, including CS, elastic modulus, and DTS. Thus, the newly developed RMGICs with BCNCs might represent an ideal and promising novel dental material in restorative dentistry.

Sesame Oil (Sesamum Indicum L.) as a New Challenge for Reinforcement of Conventional Glass Ionomer Cement, Could It Be?

Purpose

Despite the advantages of glass ionomer cement (GIC) including chemical bonding to the tooth structure and fluoride release, its low-grade mechanical properties make it a topic for research. Accordingly, this study was conducted to assess the ability of sesame oil as a natural bioactive additive to reinforce conventional glass ionomer cement.

Materials and Methods

Sesame oil was blended into the liquid component of the cement in ratios of 3 and 5 (v/v%). One control and two experimental groups were enrolled in the study; I: unmodified GIC (control), II: 3 (v/v%) sesame oil-modified GICs, and III: 5(v/v%) sesame oil-modified GICs. Compressive strength, shear bond strength, diametral tensile strength, surface microhardness, surface roughness, and color stability were the parameters assessed. A representative specimen of each group was analyzed for its chemical structure by Fourier transformation infrared spectroscopy. One-way ANOVA followed by Tukey test was used to analyze the collected data of all evaluated parameters except the color stability results, which were analyzed by Student t-test at p < 0.05.

Results

Three and 5 (v/v%) sesame oil-modified GICs exhibited significant increase in their compressive strength, shear bond strength, diametral strength, and surface microhardness. Concurrently, there was a significant decrease in surface roughness (p < 0.05) in both formulations of the modified cement. Both 3 and 5 (v/v%) sesame oil-modified GICs showed a clinically acceptable color change.

Conclusions

Sesame oil seems to be a promising natural bioactive product for reinforcement of conventional GIC with a clinically agreeable esthetic.

Cellulose Modification for Improved Compatibility with the Polymer Matrix: Mechanical Characterization of the Composite Material

The following article is the presentation attempt of cellulose hybrid chemical modification approach as a useful tool in improving the mechanical properties of plant fiber-filled polymer materials. The treatment process is a prolonged method of the cellulose maleinization and consists of two steps: 1. solvent exchange (altering fiber structure); 2. maleic anhydride (MA) chemical grafting (surface modification). Thanks to the incorporated treatment method, the created ethylene-norbornene copolymer composite specimen exhibited an improved performance, tensile strength at the level of (38.8 ± 0.8) MPa and (510 ± 20)% elongation at break, which is higher than for neat polymer matrix and could not be achieved in the case of regular MA treatment. Moreover, both the Payne effect and filler efficiency factor indicate a possibility of the fiber reinforcing nature that is not a common result. Additionally, the polymer matrix employed in this research is widely known for its excellent resistance to aqueous and polar organic media, good biocompatibility, and the ability to reproduce fine structures which makes it an interesting material regarding healthcare applications. Therefore, plant fiber-based polymer materials described in this research might be potentially applied in this area, e.g., medical devices, drug delivery, wearables, pharmaceutical blisters, and trays.

Antimicrobial activity and toxicity of glass ionomer cement containing an essential oil

The aim of this study was to evaluate the antimicrobial activity and toxicity of glass ionomer cement (GIC) modified with 5-methyl-2-(1-methylethyl)phenol (thymol) against Streptococcus mutans in silico and in vitro. The antimicrobial activity of thymol on GIC modified with concentrations of 2% (GIC-2) and 4% (GIC-4) was evaluated in a model of planktonic cell biofilm using agar diffusion test, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), dynamic biofilm (continuous flow cell parallel), and bacterial kinetics. Conventional GIC (GIC-0) was used as a control. Thymol toxicity was evaluated in Artemia salina and in silico using Osiris^® software. Differences between groups were estimated by analysis of variance, followed by Tukey post hoc test, with a 5% significance level. The results of the agar diffusion test between groups were not significantly different (P≥0.05). Thymol had potential bacteriostatic and bactericidal activity against Streptococcus mutans with respect to planktonic growth, with MIC of 100 µg/mL and MBC of 400 µg/mL. The groups GIC-0, GIC-2, and GIC-4 reduced the biofilm by approximately 10, 85, and 95%, respectively. Bacterial kinetics showed efficiency of the modified GICs for up to 96 h. GIC with thymol was effective against S. mutans, with significant inhibition of the biofilms. Analyses in silico and using Artemia salina resulted in no relevant toxicity, suggesting potential for use in humans. GIC-2 was effective against S. mutans biofilm, with decreased cell viability.

Evaluation of Polypropylene Fiber Reinforced Glass Ionomer Cement: A Comparative In-Vitro Study

Aim:

To compare the surface roughness, microtensile bond strength (µTBS), and flexural strength of polypropylene (PP) fibers reinforced glass ionomer cements (GICs).

Materials and Methods:

A comparative in vitro study was designed to test the PP fiber reinforced GIC, which was formed when 0.5–1 mm length PP fibers were added into the powder of conventional GIC. Four groups were prepared (Group 1: control, Group 2: 1 wt% PP fiber, Group 3: 3 wt% PP fiber, and Group 4: 5 wt% PP fiber) to evaluate flexural strength, surface roughness values, and µTBS. A total of 10 samples with 25 × 2.5 × 5 mm dimensions were prepared for each group to test flexural strength. Disk-shaped specimens ( n = 10) of 2 mm thickness and 10 mm diameter were used to test surface roughness. A total of 24 human primary molar teeth were used to evaluate µTBS, and 12 sticks were obtained for each group. The fractured surface analyses of samples from µTBS was performed using scanning electron microscope. The data obtained from the experiments were recorded and analyzed with one-way analyses of variance technique, and the normality was tested using the Shapiro–Wilk technique. A significance level of .05 was used.

Results:

In flexural strength tests, Group 3 (3 wt% PP fiber) showed significantly increased values ( p < .05) when compared with other groups. Group 4 (5 wt% PP) showed significantly highest values in surface roughness tests ( p < .05). No significant differences were seen between the groups ( p > .05) according to µTBS results. More PP fibers were seen in fractured surfaces, when PP ratio increases.

Conclusion:

It was observed that increased PP fiber percentage showed increased surface roughness, and 3 wt% PP fiber gave optimal values for fracture toughness. Incorporation of PP fiber to GIC does not affect the bonding to primary tooth dentine.

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.

Effects of Powdery Cellulose Nanofiber Addition on the Properties of Glass Ionomer Cement

In this study, we aimed to evaluate the effect of the addition of powdery cellulose nanofibers (CNFs) on the mechanical properties of glass ionomer cement (GIC) without negatively affecting its chemical properties. Commercial GIC was reinforced with powdery CNFs (2–8 wt.%) and characterized in terms of flexural strength, compressive strength, diametral tensile strength, and fluoride-ion release properties. Powdery CNFs and samples subjected to flexural strength testing were observed via scanning electron microscopy. CNF incorporation was found to significantly improve the flexural, compressive, and diametral tensile strengths of GIC, and the corresponding composite was shown to contain fibrillar aggregates of nanofibers interspersed in the GIC matrix. No significant differences in fluoride-ion release properties were observed between the control GIC and the CNF-GIC composite. Thus, powdery CNFs were concluded to be a promising GIC reinforcement agent.

Cell physiological effects of glass ionomer cements on fibroblast cells

The cytotoxicity of glass ionomer cements (GICs) was investigated using a novel, cost-effective, easy-to-perform and standardized test. GIC rings were made using in-house designed, custom-made moulds under sterile conditions; 10 with Fuji Equia and 10 with Fuji Triage capsules, placed in direct contact with primary human gingival fibroblasts (HGF) and immortalized human fibroblasts (HFF1). On day 1, 4, 14 and 21, an AlamarBlue® (resazurin) assay was completed towards determining the effects of the GICs on metabolic activities of the cells, whilst cell morphology was examined by light microscopy. The influence of the compounds released from the GIC rings on cell physiological effects (viability, proliferation and adhesion) during 24 h incubation was further investigated by impedimetry. Result trends obtained from this battery of techniques were complementary. At 100 v/v% concentration, the released compounds from Equia were strongly cytotoxic, while at lower concentration (0, 4, 20 v/v%) they were not cytotoxic. In contrast, Triage elicited only slightly transient cytotoxicity. The method proposed has been proved as being efficient, reliable and reproducible and may be useful in quick testing of the cytotoxicity of similar biomaterials by using an immortalized cell line.

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 and optical properties of conventional restorative glass-ionomer cements - a systematic review

Objectives

To perform a systematic review of test methodologies on conventional restorative glass-ionomer cement (GIC) materials for mechanical and optical properties to compare the results between different GICs.

Material and Methods

Screening of titles and abstracts, data extraction, and quality assessments of full-texts were conducted in search for in vitro studies on conventional GICs that follow the relevant specifications of ISO standards regarding the following mechanical and optical properties: compressive strength, flexural strength, color, opacity and radiopacity.

Sources

The Latin American and Caribbean Health Sciences (LILACS), Brazilian Bibliography of Dentistry (BBO) databases from Latin-American and Caribbean System on Health Sciences Information (BIREME) and PubMed/Medline (US National Library of Medicine - National Institutes of Health) databases were searched regardless of language. Altogether, 1146 in vitro studies were selected. Two reviewers independently selected and assessed the articles according to pre-established inclusion/exclusion criteria. Among all the properties investigated, only one study was classified as being of fair quality that tested compressive strength and was included. It was observed that many authors had not strictly followed ISO recommendations and that, for some properties (diametral tensile strength and microhardness), there are no guidelines provided.

Conclusions

It was not possible to compare the results for the mechanical and optical properties of conventional restorative GICs due to the lack of standardization of studies.

Effects of the reinforced cellulose nanocrystals on glass-ionomer cements

OBJECTIVE

Glass-ionomer cements (GICs) modified with cellulose nanocrystals (CNs) were characterized and evaluated for compressive strength (CS), diametral tensile strength (DTS) and fluoride release (F^-).

METHODS

Commercially available GICs (Maxxion, Vidrion R, Vitro Molar, Ketac Molar Easy Mix and Fuji Gold Label 9) were reinforced with CNs (0.2% by weight). The microstructure of CNs and of CN-modified GICs were evaluated by transmission electron microscopy (TEM) and by scanning electron microscopy (SEM) while chemical characterization was by Fourier transform infrared spectroscopy (FTIR). Ten specimens each of the unmodified (control) and CN-modified materials (test materials) were prepared for CS and DTS testing. For the fluoride release evaluation, separate specimens (n=10) of each test and control material were made. The results obtained were submitted to the t-test (p<0.05).

RESULTS

The CN reinforcement significantly improved the mechanical properties and significantly increased the F^- release of all GICs (p<0.05). The GICs with CNs showed a fibrillar aggregate of nanoparticles interspersed in the matrix. The compounds with CNs showed a higher amount of C compared to the controls due to the organic nature of the CNs. It was not possible to identify by FTIR any chemical bond difference in the compounds formed when nanofibers were inserted in the GICs.

SIGNIFICANCE

Modification of GICs with CNs appears to produce promising restorative materials.

Modification of glass ionomer cements on their physical-mechanical and antimicrobial properties

OBJECTIVE

The aim of this review was to provide an insight about the factors affecting the properties of glass ionomer cements and provides a review regarding studies that are related to modification of glass ionomer cements to improve their properties, particularly on physical-mechanical and antimicrobial activity.

METHODS

PubMed and Science Direct were searched for papers published between the years 1974 and 2018. The search was restricted to articles written in English related to modification of glass ionomer cements. Only articles published in peer-reviewed journals were included. The search included literature reviews, in vitro, and in vivo studies. Articles written in other languages, without available abstracts and those related to other field were excluded. About 198 peer-review articles in the English language were reviewed.

CONCLUSION

Based on the finding, most of the modification has improved physical-mechanical properties of glass ionomer cements. Recently, researchers have attempted to improve their antimicrobial properties. However, the attempts were reported to compromise the physical-mechanical properties of modified glass ionomer cements.

CLINICAL SIGNIFICANCE

As the modification of glass ionomer cement with different material improved the physical-mechanical and antimicrobial properties, it could be used as restorative material for wider application in dentistry.

Cellulose Nanomaterials-Binding Properties and Applications: A Review

Cellulose nanomaterials (CNs) are of increasing interest due to their appealing inherent properties such as bio-degradability, high surface area, light weight, chirality and the ability to form effective hydrogen bonds across the cellulose chains or within other polymeric matrices. Extending CN self-assembly into multiphase polymer structures has led to useful end-results in a wide spectrum of products and countless innovative applications, for example, as reinforcing agent, emulsion stabilizer, barrier membrane and binder. In the current contribution, after a brief description of salient nanocellulose chemical structure features, its types and production methods, we move to recent advances in CN utilization as an ecofriendly binder in several disparate areas, namely formaldehyde-free hybrid composites and wood-based panels, papermaking/coating processes, and energy storage devices, as well as their potential applications in biomedical fields as a cost-effective and tissue-friendly binder for cartilage regeneration, wound healing and dental repair. The prospects of a wide range of hybrid materials that may be produced via nanocellulose is introduced in light of the unique behavior of cellulose once in nano dimensions. Furthermore, we implement some principles of colloidal and interfacial science to discuss the critical role of cellulose binding in the aforesaid fields. Even though the CN facets covered in this study by no means encompass the great amount of literature available, they may be regarded as the basis for future developments in the binder applications of these highly desirable materials.

Biocompatibility of a New Dental Glass Ionomer Cement with Cellulose Microfibers and Cellulose Nanocrystals

Developing new restorative materials should avoid damage to tissue structures. This study evaluated the biocompatibility of a commercial dental glass ionomer cement (GIC) mechanically reinforced with cellulose microfibers (GIC+CM) or cellulose nanocrystals (GIC+CN) by implantation of three test specimens in subcutaneous tissue in the dorsal region of 15 Rattus norvegicus albinus rats. Each rat received one specimen of each cement, resulting in the following groups (n=15): Group GIC (Control), Group GIC+CM and Group GIC+NC. After time intervals of 7, 30 and 60 days, the animals were sacrificed and the following aspects were histologically evaluated: type of inflammatory cells, fibroblasts, blood vessels, macrophages, giant cells, type of inflammatory reaction and capsule thickness (µm). These events were scored as (-) absent, (+) light, (++) moderate and (+++) intense. The results were statistically analyzed by Kruskal-Wallis test and Mann-Whitney post test. At 7 days, Group GIC+NC showed more favorable tissue repair because quantitatively there were more fibroblasts (p=0.022), fewer macrophages (p=0.008) and mononuclear cells (p=0.033). Polymorphonuclear neutrophils and giant cells were absent in all experimental periods. At 60 days, test specimens in Group GIC+NC were surrounded by a fibrous tissue capsule with reduced thickness (26.72±2.87 µm) in comparison with Group GIC+CM (41.21±3.98 µm) (p=0.025). In general, all biomaterials showed satisfactory biocompatibility, but glass ionomer cement modified with cellulose nanocrystals showed a more advanced tissue repair.

Potential Applications of Nanocellulose-Containing Materials in the Biomedical Field

Because of its high biocompatibility, bio-degradability, low-cost and easy availability, cellulose finds application in disparate areas of research. Here we focus our attention on the most recent and attractive potential applications of cellulose in the biomedical field. We first describe the chemical/structural composition of cellulose fibers, the cellulose sources/features and cellulose chemical modifications employed to improve its properties. We then move to the description of cellulose potential applications in biomedicine. In this field, cellulose is most considered in recent research in the form of nano-sized particle, i.e., nanofiber cellulose (NFC) or cellulose nanocrystal (CNC). NFC is obtained from cellulose via chemical and mechanical methods. CNC can be obtained from macroscopic or microscopic forms of cellulose following strong acid hydrolysis. NFC and CNC are used for several reasons including the mechanical properties, the extended surface area and the low toxicity. Here we present some potential applications of nano-sized cellulose in the fields of wound healing, bone-cartilage regeneration, dental application and different human diseases including cancer. To witness the close proximity of nano-sized cellulose to the practical biomedical use, examples of recent clinical trials are also reported. Altogether, the described examples strongly support the enormous application potential of nano-sized cellulose in the biomedical field.

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.

Incorporation of PLLA micro-fillers for mechanical reinforcement of calcium-phosphate cement

Calcium phosphate cements (CPCs) are biocompatible, resorbable, injectable and osteoconductive. Those properties render such materials suitable for applications where bone repair and regeneration is required However, their brittle nature limits their application only to non-load-bearing applications. The incorporation of long polymeric fibers can improve the mechanical properties of CPCs, but aggregation is a major problem. Instead, short polymeric fillers can be easily dispersed in the cement matrix, but their reinforcing effect has not been studied yet. In this study, continuous poly-_L-lactic acid fibers (PLLA) with a smooth or porous surface morphology were prepared by electrospinning. PLLA micro-fillers were developed, by means of an aminolysis process, and added to α-TCP or α-TCP/PLGA-based cements. Micro-filler distribution as well as the morphology, cohesiveness, setting times and mechanical properties were evaluated. PLLA micro-fillers were homogeneously dispersed throughout the cement while the handling properties were not significantly affected. A decrease in the initial setting times was observed when PLLA was added, while the mechanical properties were comparable to those of the α-TPC or α-TCP/PLGA compositions.