Toughness, bonding and fluoride-release properties of hydroxyapatite-added glass ionomer cement

Deep margin elevation in class II cavities: A comparative evaluation of microleakage and interface integrity using confocal laser microscopy and scanning electron microscopy

Aim

This study aims to evaluate the microleakage between the gingival seat and base material and to assess the interface integrity between the base material and overlying composite in class II cavities restored using deep margin elevation.

Materials and Methods

Thirty maxillary molars (n = 30) were taken, and class II cavities were prepared with a gingival seat extending below the cementoenamel junction. These teeth were divided into three groups for subgingival margin elevation using different materials: Group A (n = 10) - flowable composite, Group B (n = 10) - glass ionomer cement (GIC), and Group C (n = 10) - GIC with nanohydroxyapatite (GIC n-HAp). The remaining cavities were restored with bulk-fill composite. After undergoing 1000 thermocycling cycles, half of the samples were examined for microleakage using confocal laser microscopy, and the other half were assessed for interface integrity using scanning electron microscopy. Microleakage was statistically analyzed by one-way ANOVA, and interface integrity was analyzed by Kruskal-Wallis tests.

Results

The study found that GIC n-HAp exhibited significantly lower microleakage between the base material and gingival seat than flowable composite and GIC. However, regarding interface integrity between the base material and bulk-fill composite, flowable composite, and GIC outperformed GIC n-HAp.

Conclusions

Incorporating n-HAp into GIC effectively reduced microleakage at the dentin-base material interface. However, the interface integrity between GIC n-HAp and the composite poses a challenge.

Glass ionomer cement with calcium-releasing particles: Effect on dentin mineral content and mechanical properties

OBJECTIVE

to evaluate the effect a glass ionomer cement (GIC) containing hydroxyapatite (HAp) or calcium silicate (CaSi) particles on mineral content and mechanical properties of demineralized dentin. Ion release and compressive strength (CS) of the cements were also evaluated.

METHODS

GIC (Fuji 9 Gold Label, GC), GIC+ 5%HAp and GIC+ 5%CaSi (by mass) were evaluated. Ion release was determined by induced coupled plasma optical emission spectroscopy (Ca2+/Sr2+) or ion-specific electrode (F-) (n = 3). A composite (Filtek Z250, 3 M ESPE) was used as control in remineralization tests. Demineralized dentin discs were kept in contact with materials in simulated body fluid (SBF) at 37 °C for eight weeks. Mineral:matrix ratio (MMR) was determined by ATR-FTIR spectroscopy (n = 5). Dentin hardness (H) and elastic modulus (E) were determined by nanoindentation (n = 10). CS was tested after 24 h and 7d in deionized water (n = 12). Data were analyzed by ANOVA/Tukey test (α = 0.05).

RESULTS

Ca2+ and Sr2+ release was higher for the modified materials (p < 0.05). Only GIC+ 5%HAp showed higher F- release than the control (p < 0.05). All groups showed statistically significant increases in MMR, with no differences among them after 8 weeks (p > 0.05). No differences in dentin H or E were observed among groups (p > 0.05). HAp-modified GIC showed increased initial CS, while adding CaSi had the opposite effect (p < 0.05). After 7 days, GIC+ 5%CaSi presented lower CS in relation to control and GIC+ 5%HAp (p < 0.05).

SIGNIFICANCE

GIC modification with HAp or CaSi affected CS and increased ion release; however, none of the groups showed evidence of dentin remineralization in comparison to the negative control.

Effect of a calcium silicate cement and experimental glass ionomer cements containing calcium orthophosphate particles on demineralized dentin

OBJECTIVE

The study aims to evaluate the effect of a glass ionomer cement (GIC; Fuji 9 Gold Label, GC) with added calcium orthophosphate particles and a calcium silicate cement (CSC; Biodentine, Septodont) regarding ion release, degradation in water, mineral content, and mechanical properties of demineralized dentin samples.

METHODS

GIC, GIC + 5% DCPD (dicalcium phosphate dihydrate), GIC + 15% DCPD, GIC + 5% β-TCP (tricalcium phosphate), GIC + 15% β-TCP (by mass), and CSC were evaluated for Ca2+/Sr2+/F- release in water for 56 days. Cement mass loss was evaluated after 7-day immersion in water. Partially demineralized dentin disks were kept in contact with materials while immersed in simulated body fluid (SBF) at 37 °C for 56 days. The "mineral-to-matrix ratio" (MMR) was determined by ATR-FTIR spectroscopy. Dentin hardness and elastic modulus were obtained by nanoindentation. Samples were observed under scanning and transmission electron microscopy. Data were analyzed by ANOVA/Tukey test (α = 0.05).

RESULTS

Ca2+ release from CSC and GIC (μg/cm2) were 4737.0 ± 735.9 and 13.6 ± 1.6, respectively. In relation to the unmodified GIC, the addition of DCPD or β-TCP increased ion release (p < 0.001). Only the dentin disks in contact with CSC presented higher MMR (p < 0.05) and mechanical properties than those restored with a resin composite used as control (p < 0.05). Mass loss was similar for GIC and CSC; however, the addition of DCPD or β-TCP increased GIC degradation (p < 0.05).

CONCLUSION

Despite the increase in ion release, the additional Ca2+ sources did not impart remineralizing capability to GIC. Both unmodified GIC and CSC showed similar degradation in water.

CLINICAL RELEVANCE

CSC was able to promote dentin remineralization.

Herbalism and glass-based materials in dentistry: review of the current state of the art

Half a million different plant species are occurring worldwide, of which only 1% has been phytochemically considered. Thus, there is great potential for discovering novel bioactive compounds. In dentistry, herbal extracts have been used as antimicrobial agents, analgesics, and intracanal medicaments. Glass-ionomer cement (GIC) and bioactive glass (BAG) are attractive materials in dentistry due to their bioactivity, adhesion, and remineralisation capabilities. Thus, this review summarizes the evidence around the use of phytotherapeutics in dental glass-based materials. This review article covers the structure, properties, and clinical uses of GIC and BAG materials within dentistry, with an emphasis on all the attempts that have been made in the last 20 years to enhance their properties naturally using the wisdom of traditional medicines. An extensive electronic search was performed across four databases to include published articles in the last 20 years and the search was concerned only with the English language publications. Publications that involved the use of plant extracts, and their active compounds for the green synthesis of nanoparticles and the modification of GIC and BAG were included up to May 2023. Plant extracts are a potential and effective candidate for modification of different properties of GIC and BAG, particularly their antimicrobial activities. Moreover, natural plant extracts have shown to be very effective in the green synthesis of metal ion nanoparticles in an ecological, and easy way with the additional advantage of a synergistic effect between metal ions and the phytotherapeutic agents. Medicinal plants are considered an abundant, cheap source of biologically active compounds and many of these phytotherapeutics have been the base for the development of new lead pharmaceuticals. Further research is required to assess the safety and the importance of regulation of phytotherapeutics to expand their use in medicine.

Assessment of Occlusal Load Strength of Glass Ionomer Cement and Composite in Class V Cavities: An In-Vitro Study

BACKGROUND

 Glass ionomer cement (GIC) is widely used in dentistry due to its chemical adhesion to dental tissues, biocompatibility, and anti-cariogenic potential but they have relatively weak mechanical properties. Resin composites have been widely regarded as the first choice for direct restorations but their polymerization shrinkage has remained a major problem. It has the potential to cause tooth debonding. The composite interface leads to postoperative sensitivity, secondary caries, enamel cracks, and microleakage. A restorative material's capacity to withstand occlusal stresses and support the remaining tooth structure depends on this property. Although class V restorations are predominantly done with GIC, this study was done to compare the strength of composite with the same. The GIC restore glass which is commonly used was tested against restofill composite. The main objective of conducting the study was to compare the compressive strength of the composite vs GIC in cervical cavities. So the aim of the study is to assess the occlusal load strength of GIC and composite in class V cavities using the universal testing machine.

MATERIALS AND METHODS

 This study was employed as an in vitro study involving 20 natural central incisor teeth without any carious lesions. Class V cavity preparation was done and the selected teeth were divided into two groups of ten each. The cavities were filled with D Tech Restore GIC and composite restorations (restofill), respectively, polished, and then subjected to testing. An eccentric load was applied to the tooth structure using an Instron (Instron E3000 Electropuls, Instron, Norwood, United States) - Universal testing machine with a cross-head speed of 1mm per minute, and the stresses were further analyzed in the presence of an occlusal loading test using a stainless steel jig of 1mm diameter which led to the sectioning of the tooth buccolingually under the applied load.

RESULTS

 An independent t-test was used to assess the results, and it was concluded that the results were statistically significant (p<0.05) at p=0.034.

CONCLUSION

 Conclusively, the results suggested that the occlusal load strength of the composite is greater when compared to GIC.

Effect of incorporating silica-hydroxyapatite-silver hybrid nanoparticles into the resin-modified glass ionomer on the adhesive remnant index score and shear bond strength of orthodontic metal brackets: An in vitro study

OBJECTIVES

This study aimed to assess the effect of addition of silica-hydroxyapatite-silver (Si-HA-Ag) hybrid nanoparticles to light-cure glass ionomer (GI) on shear bond strength (SBS) of metal brackets bonded with this adhesive and the adhesive remnant index (ARI) score.

MATERIAL AND METHODS

In this in vitro experimental study, 50 sound extracted premolars were assigned to 5 groups (n=10) for orthodontic metal bracket bonding with BracePaste® composite, Fuji ORTHO™ pure resin modified GI (RMGI), and RMGI reinforced with 2wt%, 5wt% and 10wt% Si-HA-Ag nanoparticles. The SBS of brackets was measured by a universal testing machine. Debonded specimens were inspected under a stereomicroscope at×10 magnification to determine the ARI score. Data were analyzed by one-way ANOVA, Scheffe test, Chi-square test, and Fisher's exact test (alpha=0.05).

RESULTS

The maximum mean SBS was recorded in BracePaste® composite followed by 2% RMGI, 0% RMGI, 5% RMGI and 10% RMGI. Only the difference between the BracePaste® composite and 10% RMGI was significant in this regard (P=0.006). The groups were not significantly different regarding the ARI scores (P=0.665). All the SBS values were within the clinically acceptable range.

CONCLUSION

Addition of 2wt% and 5wt% Si-HA-Ag hybrid nanoparticles to RMGI as orthodontic adhesive caused no significant change in SBS of orthodontic metal brackets while addition of 10wt% hybrid nanoparticles significantly decreased the SBS. Nonetheless, all the SBS values were within the clinically acceptable range. Addition of hybrid nanoparticles had no significant effect on the ARI score.

Comparative evaluation of shear bond strength of three different glass ionomer cement (conventional, zirconium-reinforced and advanced glass hybrid) in primary molars: an in vitro study

PURPOSE

The success of restorative materials is largely dependent on their capacity to adhere to the tooth structure and withstand the various forces present in the oral cavity. So, the aim of present study was to evaluate and compare the shear bond strength (SBS) of Type IX Glass Ionomer Cement (GIC), Zirconomer, and Gold Label Hybrid GIC in primary molars.

METHODS

Thirty primary molars were selected based on inclusion and exclusion criteria. The molars were polished to provide a flat dentin surface after being inserted in auto polymerizing acrylic resin. The samples were randomly divided into three groups, equally and were bonded to GIC. On the dentin surface, restoration cylinders were made using a plastic mould that had an internal diameter and height of 5 mm and 3 mm, respectively. The cement was manipulated according to the manufacturer's directions through the plastic mould. Then, the samples were stored at room temperature for 10 days to mimic oral conditions. The Universal Testing Machine was used to test SBS. One-way ANOVA and the post hoc Tukey test were used to statistically assess the collected data.

RESULTS

A statistically significant difference was found in all three groups (p < 0.01), with Zirconomer demonstrating highest SBS, followed by Type IX GIC and Gold Label Hybrid GIC.

CONCLUSION

The SBS value of Zirconomer was better when compared to Type IX GIC and Gold Label Hybrid GIC.

Evaluation of Mechanical Properties of Glass Ionomer Cements Reinforced with Synthesized Diopside Produced via Sol-Gel Method

This study aimed to fabricate a glass ionomer cement/diopside (GIC/DIO) nanocomposite to improve its mechanical properties for biomaterials applications. For this purpose, diopside was synthesized using a sol-gel method. Then, for preparing the nanocomposite, 2, 4, and 6 wt% diopside were added to a glass ionomer cement (GIC). Subsequently, X-ray diffraction (XRD), differential thermal analysis (DTA), scanning electron microscopy (SEM), and Fourier transform infrared spectrophotometry (FTIR) analyses were used to characterize the synthesized diopside. Furthermore, the compressive strength, microhardness, and fracture toughness of the fabricated nanocomposite were evaluated, and a fluoride-releasing test in artificial saliva was also applied. The highest concurrent enhancements of compressive strength (1155.7 MPa), microhardness (148 HV), and fracture toughness (5.189 MPa·m^1/2) were observed for the glass ionomer cement (GIC) with 4 wt% diopside nanocomposite. In addition, the results of the fluoride-releasing test showed that the amount of released fluoride from the prepared nanocomposite was slightly lower than the glass ionomer cement (GIC). Overall, the improvement in mechanical properties and optimal fluoride release of prepared nanocomposites can introduce suitable options for dental restorations under load and orthopedic implants.

Update on Dental Luting Materials

A dental luting material aids in the retention and stability of indirect restorations on the prepared tooth structure. In dentistry, clinicians are using a wide range of luting materials for the cementation of indirect restorations. Zinc oxide eugenol and non-eugenol cements, zinc phosphate cement, zinc polycarboxylate cement, glass ionomer cement and resin cements are common dental cements used in dentistry. Each luting material or cement possesses unique properties and clinical implications. An ideal luting cement should be biocompatible, insoluble, resistant to thermal and chemical assaults, antibacterial, aesthetic, simple and easy to use. It should have high strength properties under tension, shear and compression to resist stress at the restoration-tooth interface, as well as adequate working and setting times. So far, no luting material possesses all of these properties of an ideal cement. Scientists have been modifying the conventional luting cements to improve the material's clinical performance and developing novel materials for clinical use. To achieve the best clinical outcome, clinicians should update their knowledge and gain a good understanding of the luting materials so that they can make a wise clinical decision on the material selection and obtain an insight into the development of luting cements. Therefore, the objective of this study is to provide a discussion on the physical, chemical, adhesive and aesthetic properties of common luting materials. The clinical indications of these luting materials are suggested based on their properties. In addition, overviews of the modification of the conventional luting materials and the newly developed luting materials are provided.

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.

Effects of Nanohydroxyapatite Incorporation into Glass Ionomer Cement (GIC)

Glass ionomer cement (GIC) or polyalkenoate cement is a water-based cement that is commonly used in clinical dentistry procedures as a restorative material. It exhibits great properties such as fluoride-ion release, good biocompatibility, ease of use and great osteoconductive properties. However, GIC’s low mechanical properties have become a major drawback, limiting the cement’s usage, especially in high stress-bearing areas. Nanohydroxyapatite, which is a biologically active phosphate ceramic, is added as a specific filler into glass ionomer cement to improve its properties. In this review, it is shown that incorporating hydroxyapatite nanoparticles (nHA) into GIC has been proven to exhibit better physical properties, such as increasing the compressive strength and fracture toughness. It has also been shown that the addition of nanohydroxyapatite into GIC reduces cytotoxicity and microleakage, whilst heightening its fluoride ion release and antibacterial properties. This review aims to provide a brief overview of the recent studies elucidating their recommendations which are linked to the benefits of incorporating hydroxyapatite nanoparticles into glass ionomer cement.

Mechanical, antibacterial, biocompatible and microleakage evaluation of glass ionomer cement modified by nanohydroxyapatite/polyhexamethylene biguanide

This study aims to look for the best concentration of nanohydroxyapatite (NHA) and polyhexamethylene biguanide (PHMB) incorporated into glass ionomer cement (GIC) in accordance with ISO:9917-1 and evaluate its mechanical, antibacterial, biocompatible and microleakages properties. NHA was incorporated into Fuji Ⅱ GIC powder at 0-8.00 wt% concentration and specimens were prepared; the best concentration was sifted out according to ISO9917-1. Based on best NHA proportion, 0-0.80% PHMB was dispersed into powder and samples were respectively prepared. Mechanical properties include net setting time (ST), compressive strength (CS), microhardness (VNH), solubility and scanning electron microscopy (SEM) observation. Those met ISO standard were qualified to continue microleakage observation, antibacterial activity, and biocompatibility test. The results suggested that GIC/6%NHA/0.2% PHMB and GIC/6%NHA/0.4%PHMB showed great performances in mechanical, antibacterial, and microleakage improvements, and the cytotoxicity of modified GIC showed no statistical difference with pure GIC.

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.

Evaluation of Adhesive Bond Strength, and the Sustained Release of Fluoride by Chitosan-infused Resin-modified Glass Ionomer Cement: An In Vitro Study

Aim and objective

To evaluate the adhesive bond strength, and sustained release of fluoride in chitosan (CH)-infused RMGIC.

Materials and methods

Twenty caries-free human permanent premolar teeth, extracted for orthodontic purposes, were cleaned and stored in thymol solution. The crown of each tooth was cut into two halves and RMGIC (n = 10) and CH-infused RMGIC (n = 10) was placed between the two halves of the crown. The tooth was then stored in 10 mL of artificial saliva for a period of 30 days. The fluoride levels of the saliva were checked on the 15th- and the 30th-day using ion chromatography. The adhesive bond strength was checked on the 30th day using a universal testing machine.

Results

This study has shown that the bond strength of RMGIC was not affected by the inclusion of CH in it. Whereas, the sustained fluoride release of CH-modified RMGIC indicated that the fluoride release of CH-RMGIC was 8.47% >RMGIC at the end of 15 days, and, 39.68% >RMGIC at the end of 30 days.

Conclusion

The inclusion of CH in RMGIC does not alter its bond strength, while it does cause a greater release of fluoride.

Clinical significance

In progression with these results, the inclusion of CH in RMGIC could provide desirable properties like mechanical reinforcement effects and catalytic effects on the fluoride release and growth factors.

How to cite this article

Patel A, Dhupar JKMS, Jajoo SS, et al. Evaluation of Adhesive Bond Strength, and the Sustained Release of Fluoride by Chitosan-infused Resin-modified Glass Ionomer Cement: An In Vitro Study. Int J Clin Pediatr Dent 2021;14(2):254–257.

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.

Shear Bond Strength and Film Thickness of a Naturally Antimicrobial Modified Dental Luting Cement

Although several natural plants and mixtures have been known and used over the centuries for their antibacterial activity, few have been thoroughly explored in the field of dentistry. Thus, the aim of this study was to enhance the antimicrobial activity of a conventional glass ionomer cement (GIC) with natural plant extracts. The effect of this alteration on the bond strength and film thickness of glass ionomer cement was evaluated and related to an 0.5% chlorohexidine modified GIC. Olive leaves (Olea europaea), Fig tree (Ficus carica), and the leaves and roots of Miswak (Salvadora persica) were used to prepare an alcoholic extract mixture. The prepared extract mixture after the evaporation of the solvent was used to modify a freeze-dried glass ionomer cement at three different extracts: water mass ratios 1:2, 1:1, and 2:1. An 0.5% chlorhexidine diacetate powder was added to a conventional GIC for the preparation of a positive control group (CHX-GIC) for comparison. The bond strength to dentine was assessed using a material-testing machine at a cross head speed of 0.5 mm/min. Failure mode was analyzed using a stereomicroscope at 12× magnification. The cement film thickness was evaluated in accordance with ISO standard 9917-1. The minimum number of samples in each group was n = 10. Statistical analysis was performed using a Kruskal–Wallis test followed by Dunn’s post hoc test for pairwise comparison. There was a statistically insignificant difference between the median shear bond strength (p = 0.046) of the control group (M = 3.4 MPa), and each of the CHX-GIC (M = 1.7 MPa), and the three plant modified groups of 1:2, 1:1, 2:1 (M = 5.1, 3.2, and 4.3 MPa, respectively). The CHX-GIC group showed statistically significant lower median values compared to the three plant-modified groups. Mixed and cohesive failure modes were predominant among all the tested groups. All the tested groups (p < 0.001) met the ISO standard of having less than 25 µm film thickness, with the 2:1 group (M = 24 µm) being statistically the highest among all the other groups. The plant extracts did not alter either the shear bond strength or the film thickness of the GIC and thus might represent a promising additive to GICs.

Early Odontogenic Differentiation of Dental Pulp Stem Cells Treated with Nanohydroxyapatite-Silica-Glass Ionomer Cement

This study aimed to investigate the effects of nanohydroxyapatite–silica–glass ionomer cement (nanoHA–silica–GIC) on the differentiation of dental pulp stem cells (DPSCs) into odontogenic lineage. DPSCs were cultured in complete Minimum Essential Medium Eagle—Alpha Modification (α-MEM) with or without nanoHA–silica–GIC extract and conventional glass ionomer cement (cGIC) extract. Odontogenic differentiation of DPSCs was evaluated by real-time reverse transcription polymerase chain reaction (rRT–PCR) for odontogenic markers: dentin sialophosphoprotein (DSPP), dentin matrix protein 1 (DMP1), osteocalcin (OCN), osteopontin (OPN), alkaline phosphatase (ALP), collagen type I (COL1A1), and runt-related transcription factor 2 (RUNX2) on day 1, 7, 10, 14, and 21, which were normalized to the house keeping gene glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Untreated DPSCs were used as a control throughout the study. The expressions of DSPP and DMP1 were higher on days 7 and 10, that of OCN on day 10, those of OPN and ALP on day 14, and that of RUNX2 on day 1; COL1A1 exhibited a time-dependent increase from day 7 to day 14. Despite the above time-dependent variations, the expressions were comparable at a concentration of 6.25 mg/mL between the nanoHA–silica–GIC and cGIC groups. This offers empirical support that nanoHA–silica–GIC plays a role in the odontogenic differentiation of DPSCs.

Glass Ionomer Cement Modified by Resin with Incorporation of Nanohydroxyapatite: In Vitro Evaluation of Physical-Biological Properties

Resin-modified glass ionomer cement (RMGIC) has important properties. However, like other restorative materials, it has limitations such as decreased biocompatibility. The incorporation of nanoparticles (NP) in the RMGIC resulted in improvements in some of its properties. The aim of this study was to evaluate the physical-biological properties of RMGIC with the addition of nanohydroxyapatite (HANP). Material and Methods: Vitremer RMGIC was used, incorporating HANP by amalgamator, vortex and manual techniques, totaling ten experimental groups. The distribution and dispersion of the HANP were evaluated qualitatively by field emission scanning electron microscope (SEM-FEG). The evaluation of image porosity (SEM-FEG) with the help of imageJ. Cell viability 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl tetrazoline bromide (MTT) and cell morphology analyses were performed on MDPC-23 odontoblastoid cells at 24 and 72 h. Results: It was possible to observe good dispersion and distribution of HANP in the samples in all experimental groups. The incorporation of 5% HANP into the vortex stirred RMGIC resulted in fewer pores. The increase in the concentration of HANP was directly proportional to the decrease in cytotoxicity. Conclusions: It is concluded that the use of a vortex with the incorporation of 5% HANP is the most appropriate mixing technique when considering the smallest number of pores inside the material. A higher concentration of HANP resulted in better cell viability, suggesting that this association is promising for future studies of new restorative materials.

Current aspects and prospects of glass ionomer cements for clinical dentistry

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

Comparison of Shear Bond Strength of Three Types of Glass Ionomer Cements Containing Hydroxyapatite Nanoparticles to Deep and Superficial Dentin

Statement of the Problem

The clinical success of glass ionomer cement (GIC) restorations depends on the strength of its bonding to dentin, yet the bond strength of nanohydroxyapatite (nHAp) added GIC to dentin needs to be investigated.

Purpose

This study aimed to assess if the type of GIC containing nHAp and dentin depth could affect the shear bond strength (SBS).

Materials and Method

In this experimental study, 60 freshly extracted intact third molars were randomly divided into two main groups of flat occlusal dentin with different cuts as superficial (S); just below the dentinoenamel junction (DEJ) and deep (D); 2mm below DEJ. After conditioning with 20% polyacrylic acid, each group were randomly assigned to the tested GIC (n=10) subgroups as (1) Fuji IX Extra+nHAp, (2) Fuji II LC+nHAp and (3) Zirconomer+nHAp. Plastic tubes were placed on the pre-treated surfaces and filled with one of the GIC, then stored in an incubator at 37 oC and 100% humidity for 24hr. The specimens were thermocycled at5/55 oC for 500 cycles and subjected to SBS test using a universal testing machine (1 mm/min). The data analyzed by Mann-Whitney and Kruskal-Wallis test (p< 0.05).

Results

The means of SBS of Fuji II LC+nHAp was significantly higher than Fuji IX+nHAp and Zirconomer+nHAp both in superficial and deep dentin (p< 0.05). The means of SBS of Fuji IX Extra+nHAp and Zirconomer+nHAp subgroups in superficial dentin were higher than deep dentin, this differences was statistically significant (p= 0.0001 and p= 0.009, respectively).

Conclusion

It can conclude that SBS was influenced by type of GIC and depth of dentin.

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.

Osteoblast behaviours on nanorod hydroxyapatite-grafted glass surfaces

Background

The goal of this study is to obtain basic information to improve the bone adhesion of silica components, which are used as the main ingredient in glass ionomer cement (GIC). To achieve this, nanorod hydroxyapatite (nHA) was grafted to the surface of silica cover glass. Surface analysis confirmed nHA was joined to the glass surface and biocompatibility with osteoblasts was investigated.

Results

The grafting of nHA on the surface of slide cover glass (Glass) was confirmed by X-ray photoelectron spectroscopy (XPS) and contact angle (θ) measurement. MC3T3-E1 cells were more stretched out on the nHA-grafted cover glass (Glass-nHA) in comparison to the Glass. In addition, the Glass-nHA was more bioactive in supporting the proliferation of MC3T3-E1 cells in comparison to cells seeded on the Glass.

Conclusion

The Glass-nHA was to be highly bioactive and this might be useful information for property modification of GIC.

Mechanical and Functional Properties of a Novel Apatite-Ionomer Cement for Prevention and Remineralization of Dental Caries

Especially in pediatric dentistry, prevention by the control of initial lesions prior to cavitation is very important, and application of a pit and fissure sealant is essential to achieve this. Numerous reports have suggested that resin-based sealants are inferior to sealants based on glass-ionomer cement (GIC), because of GIC's many advantages, such as fluoride ion release properties and its good adhesion to tooth structures. However, the use of GIC is impeded due to its low flexural strength and fracture toughness. In this paper, we developed and characterized an apatite-ionomer cement (AIC) that incorporates hydroxyapatite (HAp) into the GIC; this development was aimed at not only reinforcing the flexural and compressive strength but also improving some functional properties for the creation of the material suitable for sealant. We examined the influence of differences in the compounding conditions of GIC powder, liquid, and HAp on flexural and compressive strengths, fracture toughness, fluoride ion release property, shear bond strength to bovine enamel, surface pH of setting cements, and acid buffer capability. These methods were aimed at elucidating the reaction mechanism of porous spherical-shaped HAp (HApS) in AIC. The following observations were deduced. (1) HAp can improve the mechanical strengths of AIC by strengthening the cement matrix. (2) The functional properties of AIC, such as acid buffer capability, improved by increasing the releasing amounts of various ions including fluoride ions. The novel AIC developed in this study is a clinically effective dental material for prevention and remineralization of tooth and initial carious lesion.

The effect of gastric acid on chitosan modified glass ionomer cement: SEM-EDS

This study aimed to use scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS) to examine the elements that passed into the gastric acid solution after the application of a gastric acid erosive cycle to chitosan modified glass ionomer cement (GIC). Chitosan modified GIC samples were obtained by adding chitosan (vol/vol) of 5 and 10% to GIC for the experimental groups. These two experimental groups and a control group were subjected to gastric acid erosive treatment for 60 s six times a day for 10 days. The sample surfaces were coated with approximately 1 nm of gold to increase conductivity with the Q 150R ES device (Quorum Technologies, East Sussex, England). Surface topography images were obtained with a SEM. Besides, EDS analysis was also determined the number of elements graphically in the region where the fast electron beam hit. In the samples examined, the amount of element was determined. After gastric acid application, cracks and voids were observed on the surfaces of the samples. In the EDS analysis of the 5 and 10% chitosan modified GIC and control groups, Si, Al, Na, and F was found. It is necessary to investigate the antibacterial properties and physical properties of chitosan modified glass ionomer-free elements and fluorine ions using advanced techniques.

Evaluation of the effect of micro-hydroxyapatite incorporation on the diametral tensile strength of glass ionomer cements

Aim:

The aim of this study was to evaluate the effect of micro-hydroxyapatite (micro-HAP) incorporation on the diametral tensile strengths (DTSs) of a conventional glass ionomer cement (GIC) and a resin-modified glass ionomer cement (RMGIC).

Materials and Methods:

Forty disc-shaped specimens (diameter: 6.5 mm, height: 2 mm) were prepared into four groups (n = 10) as follows: group 1, conventional GIC; Group 2, GIC + micro-HAP (15 wt %); Group 3, RMGIC; and Group 4, RMGIC + micro-HAP (15 wt %). All the specimens were stored in distilled water for 24 h at room temperature. The DTSs of the specimens were measured using a universal testing machine. Data analysis was performed using one-way ANOVA and Tukey's test (P < 0.05).

Results:

No significant difference was found in the DTS of conventional GIC with and without micro-HAP incorporation (P > 0.05). Moreover, the DTS of RMGIC incorporated with micro-HAP was significantly lower than that of RMGIC without micro-HAP incorporation (P < 0.05).

Conclusions:

Micro-HAP incorporation did not affect the DTS of conventional GIC. The DTS of RMGIC was negatively influenced by the micro-HAP incorporation. Conventional GIC (with and without hydroxyapatite) exhibited a lower DTS than RMGIC (with or without hydroxyapatite).

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.

The Biological Evaluation of Conventional and Nano-Hydroxyapatite-Silica Glass Ionomer Cement on Dental Pulp Stem Cells: A Comparative Study

BACKGROUND

Despite their lower strength, glass ionomer cements (GICs) are widely used as restorative materials because of their anti-cariogenic properties, direct adhesion to tooth structure and good biocompatibility. Recently, the addition of nano-hydroxyapatite (nano-HA)-silica to conventional GIC (cGIC) has been shown to improve the strength of cGIC. However, the biocompatibility and cell attachment properties of this material are unknown.

AIMS

This study aims to evaluate and compare the cytotoxicity and cell attachment properties of cGIC and nano-HA-silica-GIC on dental pulp stem cells (DPSCs).

METHODS AND MATERIALS

Material extracts of nano-HA-silica-GIC and cGIC were prepared into seven serial dilutions and applied to 96 well plates seeded with DPSCs. After 72 h, the cell viability was determined using MTT assay. The DPSCs cell attachment properties were examined under scanning electron microscope (SEM) after 24 and 72 h. Kruskal-Wallis test was used to analyse the data for MTT assay (P < 0.05). SEM images of cell attachment properties were also described.

RESULTS

Nano-HA-silica-GIC and cGIC was shown to be slight to non-cytotoxic at all concentrations, except 200 mg/ml. Moderate cytotoxicity has been observed at 200 mg/ml concentration where nano-HA-silica-GIC and cGIC revealed cell viability values of 44.38 and 42.15%, respectively. Nano-HA-silica-GIC demonstrated better cell viability values than cGIC at all concentrations except for 6.25 and 12.5 mg/ml. Nevertheless, the results were not statistically significant (P > 0.05). SEM examination revealed the increasing numbers of DPSCs attached to both groups with prominent filopodia, especially after 72 h.

CONCLUSIONS

Nano-HA-silica-GIC exhibited good biocompatibility which is comparable to cGIC and favoured the attachment of DPSCs.

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.

Biological, thermal and mechanical characterization of modified glass ionomer cements: The role of nanohydroxyapatite, ciprofloxacin and zinc l-carnosine

The study evaluated the effects of 4 wt% nanohydroxyapatite (HA), 6 wt% zinc l-carnosine (MDA) and 1.5 wt% Ciprofloxacin (AB) on the mechanical, thermal and biological properties of glass ionomer cements (GIC). Filler and additive concentrations were selected after a previous study had tested single components and different percentages. Specimens included five silicon molds of each GIC cement for all tests. They were stored at room temperature for 24 h from specimen collection to analysis. Mechanical tests, calorimetric analysis, morphological investigation, antibacterial and cell viability assays were conducted. One-way analysis of variance (ANOVA) was used for data analysis with significance set at p < 0.05. Adding HA, MDA and AB to GICs modified their thermal, mechanical and microbiological properties. Polymerization increased. A slight decrease in the compressive strength of modified GICs was observed in dry condition (p < 0.05). Cement extracts affected cell viability in relation to extract dilution. Mechanical behavior improved in modified glass ionomer cements, especially with the powder formulated antibiotic. Overall cytotoxicity was reduced. Therefore adding nanohydroxyapatite, antibiotic and a mucosal defensive agent to conventional glass ionomer cement in special need patients could improve the clinical, preventive and therapeutic performance of the cements, without altering their mechanical properties.

The implications and applications of nanotechnology in dentistry: A review

The emerging science of nanotechnology, especially within the dental and medical fields, sparked a research interest in their potential applications and benefits in comparison to conventional materials used. Therefore, a better understanding of the science behind nanotechnology is essential to appreciate how these materials can be utilised in our daily practice. The present paper will help the reader understand nanoscience, and the benefits and limitations of nanotechnology by addressing its ethical, social, and health implications. Additionally, nano-applications in dental diagnostics, dental prevention, and in dental materials will be addressed, with examples of commercially available products and evidence on their clinical performance.

Effects of Different Percentages of Microhydroxyapatite on Microhardness of Resin-modified Glass-ionomer and Zirconomer

Background

Hydroxyapatite (HA) is the main mineral component of the tooth structure, which exhibits considerable biological behavior and its incorporation might improve microhardness of dental materials. Microhardness of restorative materials, like glass-ionomer, is critical for the clinical longevity of restorations. The aim of this study was to evaluate the microhardness of two glass-ionomers types by incorporating different percentages of microhydroxyapatite.

Material and Methods

In this study, 80 disc-shaped experimental specimens (6 mm in diameter, 2 mm in height) were prepared in 8 groups, including resin-modified glass-ionomer (RMGI, GC, Gold Label, Japan), zirconia-reinforced glass-ionomer (Zirconomer, Shofu, Kyoto, Japan), and their mixture with 0, 5, 15 and 25 wt% of microhydroxyapatite (Sigma-Aldrich, Germany). All the specimens were stored in deionized water at 37ºC for 24 hours. Then Vickers microhardness test was carried out on the both sides of specimens and data were analyzed using two-way ANOVA and paired t-test (P<0.05).

Results

Microhardness of Zirconomer and RMGI increased significantly due to adding 5 and 15 wt% of micrhydrox-yapatite (P<0.001). The highest Vickers hardness number (VHN) was recorded in the RMGI group with 5 wt% of microhydroxyapatite. In addition, in all the study groups RMGI exhibited higher microhardness values than Zirconomer (P<0.001). However, microhardness values decreased significantly after adding 25 wt% of microhydroxyapatite to Zirconomer (P<0.001). Similarly, VHN decreased in RMGI groups containing 25 wt% of HA compared to control groups (without HA) (P<0.001).

Conclusions

Incorporation of 5 and 15 wt% of microhydroxyapatite to RMGI and Zirconomer improved microhardness, while adding 25 wt% of HA decreased hardness with both experimental materials compared to the control groups (without HA).

Key words:Microhardness, Resin-modified glass-ionomer, Zirconia-reinforced glass ionomer, Microhydroxyapatite.

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.

Nanochitosan modified glass ionomer cement with enhanced mechanical properties and fluoride release

Conventional glass-ionomer cements (GIC) are one of the most prevalent dental restorative materials, but their use is limited by their relatively low mechanical strength. Efforts have been made to improve the mechanical properties by addition of various fillers of which nano-sized particles appears to be a promising strategy. In the current study, effect of addition of nanochitosan particles in GIC (NCH-GIC) on compressive strength, flexural strength, wear resistance and fluoride release has been evaluated and compared with conventional GIC (C-GIC). Nanochitosan was synthesized by ionic cross linking method and its particle size was found to be 110-235nm. Nanochitosan was mixed with glass ionomer powder at a concentration of 10wt.% and cement samples were prepared. NCH-GIC had significantly higher compressive strength values which could be attributed to early formation of aluminium polysalts. Similarly, flexural strength of NCH-GIC (21.26MPa) was significantly higher than C-GIC (12.67MPa). Wear resistance was also found to increase due to better integrated interface between the glass particle and polymer matrix bonding in NCH-GIC. Fluoride release was significantly higher in NCH-GIC compared to C-GIC for 7 days. It can be anticipated that addition of nanochitosan to GIC will improve the anti-cariogenic and mechanical properties for high strength applications.

In Vitro Cytotoxicity Evaluation of Novel Nano-Hydroxyapatite-Silica Incorporated Glass Ionomer Cement

INTRODUCTION

Glass Ionomer Cements (GIC) are among the most popular restorative materials, but their use in dentistry is limited due to their physical properties. The hardness of GIC was improved by incorporation of nano-hydroxyapatite-silica into GIC, to expand its applicability.

AIM

To evaluate the cytotoxic effects of nano-hydroxyapatite-silica incorporated glass ionomer cement (HA-SiO₂-GIC) on human Dental Pulp Stem Cells (DPSC) and compare it with conventional GIC and resin modified GIC.

MATERIALS AND METHODS

Material extracts of Fuji IX, Fuji II LC and HA-SiO₂-GIC were prepared into seven serial concentrations and applied to 96-well-plates seeded with DPSC. The 96-well-plates were incubated for 24 and 72 hours. The morphology of DPSC was observed under the inverted phase contrast microscope, and the cell viability was determined using MTT assay at both time intervals. Kruskal-Wallis test was performed for statistical analysis.

RESULTS

At maximum concentration, DPSC appeared fewer in number, but the normal spindle morphology was maintained in all groups except for Fuji II LC. At lower concentrations, DPSC appeared normal and more confluent in all groups. The cytotoxic effects of all groups were dose dependent. Fuji IX demonstrated the lowest cytotoxicity, followed by HA-SiO₂-GIC. Fuji II LC demonstrated the highest cytotoxicity. The difference was significant between all groups at 200 mg/ml concentration (p<0.05). At concentration <100 mg/ml, cytotoxicity of HA-SiO₂-GIC was comparable to that of Fuji IX and lower than that of Fuji II LC.

CONCLUSION

HA-SiO₂-GIC showed a favourable cytotoxicity response and thus holds promise as a future potential restorative material in clinical dentistry.

Evaluation of the effect of adding micro-hydroxyapatite and nano-hydroxyapatite on the microleakage of conventional and resin-modified Glass-ionomer Cl V restorations

Background

Pulpal reaction to restorative materials depends on marginal microleakage, which is a dynamic phenomenon that allows bacteria and fluids to traverse across the tooth-restoration interface. Glass-ionomer cement (GIC) exhibits low microleakage due to direct bonding to tooth structures. Hydroxyapatite (HAP) based on the similarity with tooth structure may decrease the microleakage. The aim of this in vitro study was to evaluate marginal microleakage of a mixture of conventional and resin-modified glass-ionomer (RMGI) with micro- and nano-HAP.

Material and Methods

In this in vitro study, 30 non-carious extracted human third molar teeth were used. Standard Cl V cavities were prepared on the buccal and lingual surfaces. The cavities were restored in six experimental groups as follows: group 1, conventional glass-ionomer cement (CGIC); group 2, CGIC with micro-HAP; group 3, CGIC with nano-HAP; group 4, RMGI; group 5, RMGI with micro-HAP; group 6, RMGI with nano-HAP. The restorations were finished and polished. The teeth were coated with nail polish, sealed with sticky wax, thermocycled and placed in a solution of 2% basic fuchsine for 24 hours. The teeth were sectioned and microleakage was measured. Kruskal-Wallis, Man-Whitney and Wilcoxon tests were used for data analysis (P<0.05).

Results

The data analysis revealed significantly lower microleakage in groups 5 and 6 at both occlusal and gingival margins. Also in these two groups the gingival microleakage was significantly lower than occlusal margin (P=0.009 and P=0.001 respectively), but in groups 1(CGIC) and 3(CGIC+ nano-HAP) and 4(RMGI) the microleakage of occlusal margin were significantly lower than that of gingival margin (P=0.001, P=0.007 and P=0.001 respectively).

Conclusions

Mixing RMGI with nano-HAP and micro-HAP resulted in lower microleakage.

Key words:Glass-ionomer, micro-hydroxyapatite, microleakage, nano-hydroxyapatite.

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

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

Modifications in Glass Ionomer Cements: Nano-Sized Fillers and Bioactive Nanoceramics

Glass ionomer cements (GICs) are being used for a wide range of applications in dentistry. In order to overcome the poor mechanical properties of glass ionomers, several modifications have been introduced to the conventional GICs. Nanotechnology involves the use of systems, modifications or materials the size of which is in the range of 1–100 nm. Nano-modification of conventional GICs and resin modified GICs (RMGICs) can be achieved by incorporation of nano-sized fillers to RMGICs, reducing the size of the glass particles, and introducing nano-sized bioceramics to the glass powder. Studies suggest that the commercially available nano-filled RMGIC does not hold any significant advantage over conventional RMGICs as far as the mechanical and bonding properties are concerned. Conversely, incorporation of nano-sized apatite crystals not only increases the mechanical properties of conventional GICs, but also can enhance fluoride release and bioactivity. By increasing the crystallinity of the set matrix, apatites can make the set cement chemically more stable, insoluble, and improve the bond strength with tooth structure. Increased fluoride release can also reduce and arrest secondary caries. However, due to a lack of long-term clinical studies, the use of nano-modified glass ionomers is still limited in daily clinical dentistry. In addition to the in vitro and in vivo studies, more randomized clinical trials are required to justify the use of these promising materials. The aim of this paper is to review the modification performed in GIC-based materials to improve their physicochemical properties.

Invitro Evaluation of Fluoride Release from Hydroxyapatite Reinforced Glass Ionomer with or without Protective Coating

INTRODUCTION

Glass Ionomer Cement (GIC) is well known for its fluoride releasing property but has its own drawbacks of poor mechanical properties, sensitivity to initial desiccation and moisture contamination. To overcome these, search led to the reinforcement of hydroxyapatite and application of surface coating agent but their effect on fluoride release is still not clear.

AIM

To evaluate and compare the release of fluoride from Hydroxyapatite Reinforced Glass Ionomer (HA-GIC) with and without protective coating.

MATERIALS AND METHODS

Specimens were prepared as follows- Eight percent by weight conventional glass ionomer was replaced by hydroxyapatite powder (HA) and an indigenous product was prepared (HA-GIC). This powder was mixed with liquid of conventional GIC and allowed to set, then G coat plus coating agent was applied in surface coated group and light cured. Fluoride release of the sample was measured every 24 hrs for seven days and weekly from 7(th) to 21(st) day using combination ion selective electrode.

RESULTS

Mean values clearly reveal a significant decrease in the fluoride release from day 1 to day 21 for both the groups. Results of repeated measure ANOVA revealed statistically significant difference between two groups (p <0.001).

CONCLUSION

Coating the hydroxyapatite reinforced glass ionomer will allow for slow and steady release of fluoride for a long period of time into oral environment.

Influence of Restoration Type on the Cytotoxicity of a 35% Hydrogen Peroxide Bleaching Gel

OBJECTIVES

The tooth/restoration interface may act as a pathway for hydrogen peroxide (H2O2) diffusion into the pulp chamber. Therefore, the influence of resin-modified glass ionomer cement (RMGIC) and resin composite simulated restorations on the cytotoxicity of an in-office bleaching gel was assessed in vitro.

MATERIALS AND METHODS

Cavities in enamel/dentin discs restored with RMGIC Vitremer (3M ESPE) or Single Bond/Filtek Z350 (3M ESPE) resin composite (RC) were subjected or not subjected to hydrolytic degradation (HD). A 35%-H2O2 bleaching gel was applied to simulated restored and nonrestored enamel surfaces, and culture medium in contact with the dentin substrate (extract) was collected and applied to MDPC-23 cells. Nonrestored discs subjected or not subjected to bleaching were used as positive and negative controls, respectively. Cell viability, oxidative stress, interleukin (IL)-1β expression, alkaline phosphatase (ALP) activity, and mineralized nodule deposition were evaluated. The H2O2 in the extracts was quantified. Data were subjected to statistical analysis.

RESULTS

Higher oxidative stress associated with reduced cell viability, ALP activity, and mineralized nodule deposition was observed for all bleached groups compared with the negative control group. The RMGIC/HD group, which presented the highest H2O2 diffusion, had the lowest values of cell viability, ALP activity, and mineralized nodule deposition, as well as significantly increased IL-1β expression.

CONCLUSIONS

Dental cavities restored with the RMGIC subjected to hydrolytic degradation allowed for more intense diffusion of H2O2 into the pulp chamber, intensifying the toxicity of a 35%-H2O2 bleaching gel to pulp cells.