Physico-mechanical properties of a fast-set highly viscous GIC restorative

Comparative Evaluation of Compressive Strength and Diametral Tensile Strength of Conventional Glass Ionomer Cement and a Glass Hybrid Glass Ionomer Cement

Aim

The aim of this study is to compare and evaluate compressive strength (CS) and diametral tensile strength (DTS) of a conventional glass ionomer cement (GIC) and a glass hybrid GIC.

Materials and methods

Five samples each were prepared of GC Fuji IX and EQUIA Forte cements for CS testing and five samples of each material for tensile strength testing. Specimens were subjected to a universal testing machine. Comparison of CS and DTS among two study groups was made using an independent t-test for each. Level of significance was set at p ≤ 0.05.

Results

Both test values were on the higher side for EQUIA Forte cement as compared to conventional GIC (p ≥ 0.05). However, the differences in values were not statistically significant.

Conclusion

EQUIA Forte can serve as an alternative to conventional GIC in stress-bearing primary teeth areas. Considering several factors like cost-effectiveness, surface to be restored, moisture contamination, and time considerations, the material of choice can be tailored to one's needs.

Clinical significance

EQUIA Forte can serve as a viable alternative to conventional GIC because of its improved qualities.

How to cite this article

Kunte S, Shah SB, Patil S, et al. Comparative Evaluation of Compressive Strength and Diametral Tensile Strength of Conventional Glass Ionomer Cement and a Glass Hybrid Glass Ionomer Cement. Int J Clin Pediatr Dent 2022;15(4):398-401.

Compressive Strength of Conventional Glass Ionomer Cement Modified with TiO2 Nano-Powder and Marine-Derived HAp Micro-Powder

The aim of this research was to investigate the compressive strength (CS), breaking strength (BS), and compressive modulus (CM) of conventional glass ionomer cement (GIC) modified with TiO₂ nano particles, marine-derived hydroxyapatite (md-HAp) microparticles (<45 µm), and a combination of TiO₂ NP and md-HAp particles. The materials used in the study were conventional GIC Fuji IX GP Extra (GC Corporation, Tokyo, Japan), TiO₂ powder P25 (Degussa, Essen, Germany), and HAp synthesized from cuttlefish bone and ground in a mortar to obtain md-HAp powder. md-HAp was characterized using FTIR and SEM analysis. There were four groups of GIC samples: (i) Fuji IX control group, (ii) powder modified with 3 wt% TiO2, (iii) powder modified with 3 wt% HAp, and (iv) powder modified with 1.5 wt% TiO2 + 1.5 wt% HAp. Measurements were performed in a universal testing machine, and CS, BS, and CM were calculated. Statistical analysis was performed using ANOVA and Tukey’s tests. CS, BS, and CM differed significantly between the Fuji IX control group and all experimental groups while differences between the experimental groups were not statistically significant. The addition of TiO₂ NP, md-HAp micro-sized particles, and a combination of TiO₂ and md-HAp reduced the CS, BS, and CM of conventional GICs when mixed at the powder/liquid (p/l) ratio recommended by the manufacturer.

Dental Applications of Carbon Nanotubes

Glass ionomer cements and resin-based composites are promising materials in restorative dentistry. However, their limited mechanical properties and the risk of bulk/marginal fracture compromise their lifespan. Intensive research has been conducted to understand and develop new materials that can mimic the functional behavior of the oral cavity. Nanotechnological approaches have emerged to treat oral infections and become a part of scaffolds for tissue regeneration. Carbon nanotubes are promising materials to create multifunctional platforms for dental applications. This review provides a comprehensive survey of and information on the status of this state-of-the-art technology and describes the development of glass ionomers reinforced with carbon nanotubes possessing improved mechanical properties. The applications of carbon nanotubes in drug delivery and tissue engineering for healing infections and lesions of the oral cavity are also described. The review concludes with a summary of the current status and presents a vision of future applications of carbon nanotubes in the practice of dentistry.

Investigation of the structure and compressive strength of a bioceramic root canal sealer reinforced with nanomaterials

OBJECTIVES

A root canal sealer that can increase the resistance of endodontically treated teeth to compressive strength would be of great advantage. The purpose of this study is to use three different nanoparticles: multi-walled carbon nanotubes (MWCNTs), Titanium carbides (TC), and Boron nitrides (BN) into a bioceramic adhesive root canal sealer; BioRoot™ RCS, in an attempt to improve its structural and compressive strength properties.

METHODS

Three composites of two weight fractions (1- and 2-wt.%) were produced by mixing each nanomaterial separately with a pre-weighed mass of Bioroot powder. The microstructural properties and compressive strength of the different hardened composites obtained were investigated. The composites have been characterized by X-ray Diffraction, Fourier transform infrared spectroscopy, and scanning electron microscopy. Compression testing was performed.

RESULTS

The 1-wt.% composites, Bioroot/MWCNTs, and Bioroot/TC, except for the one reinforced with BN, displayed a significant improvement in the compressive strength compared to pristine BioRoot™ RCS. The 2-wt.% composites showed no significant improvement in the compressive strength.

CONCLUSION

The addition of 1-wt.% MWCNTs and TC nanomaterials can be considered in the future for enhancing the microstructure and compressive strength properties of pristine BioRoot™ RCS.

In Vitro Evaluation of the Stabilization Time of Chemical Bonds During Setting Reaction and Microhardness of Preheated Glass-Ionomer Cements

OBJECTIVES

To evaluate the effect of preheating glass-ionomer cement (GIC) restorative materials on stabilization time (ST) of their metal carboxylate bonds and on microhardness.

METHODS AND MATERIALS

Two conventional highviscosity GICs, Ketac Universal (3M ESPE) and Equia Forte (GC), were evaluated. The thermographic camera was used to measure the temperature inside the glass-ionomer cement capsules before and after heating. The preheating of capsules was performed at 54°C for 30 seconds in a commercial device. Characterization of ST in the GICs was determined by Fourier Transform Infrared (FTIR) spectroscopy. For this, 10 samples of each material were prepared, five in the non-preheated group (control) and five with preheating. FTIR spectra were obtained 10 minutes after mixing (control group) or after heating and then every 10 minutes for 120 minutes. For the microhardness test, 20 cylindrical specimens (3 mm height × 6 mm diameter) were prepared for each material (10 preheated, 10 control). The microhardness was determined at three time intervals: 10 minutes after mixing, after the ST as detected through the FTIR part of the study, and after one week. Knoop microhardness was assessed using a diamond indenter with a 25 g load and 15 seconds dwell time.

RESULTS

Ketac Universal showed an increase in temperatures of 15.7°C for powder and 3.6°C for liquid, while Equia Forte showed 16.4°C for powder and 8.5°C for liquid. FTIR spectra indicated that preheating reduced the ST for Equia Forte but increased it for Ketac Universal. Preheating increased the initial microhardness (T1) of Equia Forte. With maturation over one week, it was observed that preheating significantly improved the microhardness of both materials compared with the control specimens.

CONCLUSION

Preheating influenced the ST and the microhardness of Ketac Universal and Equia Forte. The ST and microhardness of Ketac Universal increased after seven days, whereas Equia Forte showed a reduced ST and increased microhardness from the outset.

Tooth-coloured materials for class II restorations in primary molars: systematic review and meta-analysis

PURPOSE

The aim of this systematic review was to compare the success rate of five tooth-coloured materials, namely Glass Ionomer (GI), Resin-Modified Glass Ionomer (RMGI), Composite Resin (CR), Polyacid-Modified Composite Resin or Compomer (CO) and High-Viscosity Glass Ionomer (HVGI) in primary molar Class II restorations.

METHODS

Five databases were searched from inception to April 23, 2020 for randomized clinical trials comparing the failure rate of these materials. After duplicate study removal, data extraction and risk of bias assessment with the Cochrane tool, data synthesis was conducted, comparing all five tooth-coloured materials in pairs and computing the overall success rate for each one, respectively.

RESULTS

A total of 5615 articles were obtained by electronic and hand literature search. After the application of the eligibility criteria, ten RCTs were included in this systematic review and six RCTs for meta-analysis. Their risk of bias was assessed to be high to moderate. Due to the small number of RCTs comparing the five restorative materials in pairs investigated in the same study, only three MAs were available for heterogeneity assessment. These were: (1) between CO-RMGI (RR 1.04 [0.59, 1.84]; p = 0.88; I² = 1%), (2) CR-CO (RR 1.12 [0.41, 3.02]; p = 0.83; I² = 57%), and (3) between CR-RMGI (RR 1.10 [0.74, 1.63]; p = 0.65; I² = 0%). No statistically significant differences were found between the two materials in all three comparisons.

CONCLUSION

CR, RMGI and CO presented no statistical differences. In comparison to other tooth-coloured materials, studies on GI were too few to allow recommendations about its use. More studies on HGVI are needed for evidence-based recommendations to be made. The evidence extracted from this meta-analysis was not strong enough (moderate), due to the small number of RCTs and the risk of bias ranging from high to moderate. More, well-designed RCTs comparing tooth-coloured materials for primary molar Class II restorations are necessary.

Effect of resin coating on highly viscous glass ionomer cements: A dynamic analysis

OBJECTIVES

This study determined the effects of self-adhesive resin coatings on viscoelastic properties of highly viscous glass ionomer cements (HVGICs) using dynamic mechanical analysis.

MATERIALS AND METHODS

The HVGICs evaluated were Zirconomer [ZR] (Shofu), Equia Forte [EQ] (GC) and Riva [RV] (SDI). Sixty specimens (12mm x 2mm x 2mm) of each material were fabricated using customized Teflon molds. After initial set, the specimens were removed from their molds, finished, measured and randomly divided into 3 groups of 20. Half the specimens in each group were left uncoated while the remaining half was covered with the respective manufacturers' resin coating. The specimens were subsequently conditioned in distilled water, artificial saliva or citric acid at 37°C for 7 days. The uncoated and coated specimens (n=10) were then subjected to dynamic mechanical testing in flexure mode at 37°C with a frequency of 0.1 to 10Hz. Storage modulus, loss modulus and loss tangent data were subjected to normality testing and statistical analysis using one-way ANOVA/Scheffe's post-hoc test and Ttest at significance level p<0.05.

RESULTS

Mean storage modulus ranged from 1.39 ± 0.36 to 10.80 ± 0.86 GPa while mean loss modulus varied from 0.13 ± 0.03 to 0.70 ± 0.14 GPa after conditioning in the different mediums. Values for loss tangent ranged from 39.4 ± 7.75 to 213.2 ± 20.11 (x10 -3 ). Significant differences in visco-elastic properties were observed between mediums and materials. When conditioned in distilled water and artificial saliva,storage modulus was significantly improved when ZR, EQ and RV were uncoated. Significantly higher values were, however, observed with resin coating when the materials were exposed to citric acid.

CONCLUSION

The visco-elastic properties of HVGICs were influenced by both resin coating and chemical environment.

Commercially Available Fluoride-Releasing Restorative Materials: A Review and a Proposal for Classification

Resin composite and glass ionomer cement (GIC) are the most commonly used dental materials to perform direct restorations. Both have specific characteristics that explain their popularity and their limits. More than 20 years ago, the first attempt (followed by others) to combine the advantages of these two families was performed with compomers, but it was not very successful. Recently, new formulations (also called 'smart materials') with claimed ion release properties have been proposed under different family names, but there are few studies on them and explanations of their chemistries. This comprehensive review aims to gather the compositions; the setting reactions; the mechanical, self-adhesive, and potential bulk-fill properties; and the ion release abilities of the large existing families of fluoride-releasing restorative materials and the new restorative materials to precisely describe their characteristics, their eventual bioactivities, and classify them for an improved understanding of these materials. Based on this work, the whole GIC family, including resin-modified and highly viscous formulations, was found to be bioactive. Cention N (Ivoclar Vivadent, AG, Schaan, Lietschentein) is the first commercially available bioactive resin composite.

Influence of external energy sources on the dynamic setting process of glass-ionomer cements

OBJECTIVE

To evaluate the influence of external energy sources on the dynamic setting process of glass-ionomer restorative materials.

METHODS

Eighteen brands of GIC were studied: Bioglass R (Biodinâmica; G1), Chemfil Rock (Dentsply; G2), Equia Forte (GC; G3), Gold Label 2 (GC; G4), Gold Label 9 (GC; G5), Glass Ionomer Cement Type II - (Shofu; G6), Ionglass R (Maquira; G7), Ion Z (FGM; G8), Ionomaster (Wilcos; G9), Ionofil Plus (Voco; G10), Ionostar Plus (Voco; G11), Ketac Molar easymix (3M ESPE; G12), Magic Glass R (Vigodent; G13), Maxxion R (FGM; G14), Riva Self Cure (SDI; G15), Vidrion R (SS White; G16), Vitro Fil R (Nova DFL; G17) and Vitro Molar (Nova DFL; G18). LED, halogen light or ultrasound (n=20 for each set) applied for 30s was used to activate setting, and a control group of each material was allowed to set without activation. Samples were analyzed by FTIR spectroscopy using the ratio of intensities of bands at 1637cm^-1 (carboxylate) and 1720cm^-1 (carbonyl) as a function of time. Means and standard deviations were subjected to ANOVA and Tukey tests (p<0.05).

RESULTS

All three activation modes significantly reduced the time at which the carboxylate content became stable in G2, G4, G5, G6, G8, G10, G14, G16, G17 and G18. By contrast, in G1, G7, G12 and G15 no activation source had any significant effect (p>0.05).

SIGNIFICANCE

External activation sources, namely LED, halogen light and ultrasound, typically but not always increase the setting rate of restorative GICs.

Microshear Bond Strength of High-viscosity Glass-ionomer to Normal and Caries-affected Dentin Under Simulated Intrapulpal Pressure

Objectives:

The use of high-viscosity glass-ionomer cements (HVGICs) for atraumatic restorative treatment (ART) restorations is widely practiced with the advent of various HVGICs. However, the bonding of the latter to caries-affected dentin (CAD) should be validated, especially because it is the common substrate left after conservative caries removal following the ART approach. Hence, this study was carried out to evaluate the microshear bond strength (μSBS) of three HVGICs to normal dentin (ND) and CAD under intrapulpal pressure (IPP) simulation.

Methods and Materials:

The occlusal enamel of 90 molars with mid-coronal caries was cut to expose flat dentin surfaces containing both ND and CAD. Dentin substrates (ND and CAD) were differentiated using visual, tactile, caries-detecting dye, and dye-permeability methods. Prepared crown segments were equally divided (n=30) according to the tested HVGICs into GC Fuji IX GP Fast, Fuji IX GP containing chlorhexidine, and zinc-reinforced ChemFil Rock HVGIC. Microcylinders of tested HVGICs were built up on both dentin substrates (n=30 for each tested HVGIC per each substrate) using starch tubes while the specimens were subjected to simulated IPP of 15 mm Hg. The μSBS test was conducted using a universal testing machine, and failure modes were determined using a scanning electron microscope. Data were statistically analyzed using two-way analysis of variance (ANOVA) with repeated measures, one-way ANOVA, and Bonferroni post hoc tests (α=0.05).

Results:

For both dentin substrates (ND and CAD), the μSBS values of ChemFil Rock were significantly higher than those recorded for the other HVGICs. The μSBS values of each tested HVGIC to ND and CAD were not statistically different. Failure modes were mainly mixed.

Conclusions:

Zinc-reinforced HVGIC ChemFil Rock showed superior bonding to ND and CAD compared to the GC Fuji IX GP Fast and Fuji IX with chlorhexidine. However, each of the tested HVGICs showed comparable bonding to both dentin substrates (ND and CAD).

Clinical wear of approximal glass ionomer restorations protected with a nanofilled self-adhesive light-cured protective coating

High viscous glass ionomer cement (GIC) has gained popularity as a restorative material; however, high wear is pointed as one of the major drawbacks of this material. Protective surface coatings were developed to protect GIC from water contamination with the additional advantage of occluding any surface cracks or porosities commonly found in this material, possibly resulting in an increased wear resistance of the restorations.

Thermo-setting glass ionomer cements promote variable biological responses of human dental pulp stem cells

OBJECTIVE

To evaluate the in vitro cytotoxicity of Equia Forte (GC, Tokyo, Japan) and Ionostar Molar (Voco, Cuxhaven, Germany) on human dental pulp stem cells (hDPSCs).

METHODS

hDPSCs isolated from third molars were exposed to several dilutions of Equia Forte and Ionostar Molar eluates (1/1, 1/2 and 1/4). These eluates were obtained by storing material samples in respective cell culture medium for 24h (n=40). hDPSCs in basal growth culture medium were the control. Cell viability and cell migration assays were performed using the MTT and wound-healing assays, respectively. Also, induction of apoptosis and changes in cell phenotype were evaluated by flow cytometry. Changes in cell morphology were analysed by immunocytofluorescence staining. To evaluate cell attachment to the different materials, hDPSCs were directly seeded onto the material surfaces and analyzed by scanning electron microscopy (SEM). The chemical composition of the materials was determined by energy dispersive X-ray (EDX) and eluates were analyzed by inductively coupled plasma-mass spectrometry (ICP-MS). Statistical analysis was performed with analysis of variance (ANOVA) and Student's t-test (α<0.05).

RESULTS

Undiluted Equia Forte extracts led to a similar cell proliferation rates than the control group from 72h onwards. There were no significance differences between Equia Forte and Ionostar Molar in terms of cell apoptosis and phenotype. However, in presence of Equia extracts the migration capacity of hDPSCs was higher than in presence of Ionostar Molar (p<0.05). Also, SEM studies showed a higher degree of cell attachment when Equia Forte extracts were used. Finally, EDX analysis pointed to different weight percentages of C, O and Ca ions in glass ionomer cements, while other elements such as La, Al, Si, W, Mo and F were also detected.

SIGNIFICANCE

In summary, Equia Forte promoted better biological responses in hDPSCs than Ionostar Molar.

Clinical Performance of Heat-Cured High-Viscosity Glass Ionomer Class II Restorations in Primary Molars: A Preliminary Study

OBJECTIVES

The present preliminary study evaluated the clinical and radiographic performances of heat-cured high viscosity glass ionomer (HCHVGI) in class II restorations of primary molars.

STUDY DESIGN

A retrospective study on a cohort of patients who had dental caries restored at a private practice was conducted. Restorations were evaluated radiographically and photographically by two separate examiners.

RESULTS

Ninety-three Class II restorations in 44 patients (average age: 108 months ± 25.3, 24 males, 20 females) were examined. Average recall time was 22.2 months ± 4.2. All but three restorations (96.8%) were present and intact, with no incidents of secondary caries. Three additional restorations had occlusal defects that required retreatment, resulting in an overall success rate of 93.5%. Ninety-seven percent of the restorations were rated optimal for marginal integrity with no staining of the restoration surfaces. No patients complained of post-operative sensitivity. The most common flaw found was a concavity on the proximal wall of the cavity box (27%, mean age 16 months ± 3.9).

CONCLUSION

The findings in this preliminary study suggest that heat cured high viscosity glass ionomer cement may be an effective restorative material for Class II restorations in primary molars that are a year or two from shedding.

Does Addition of Propolis to Glass Ionomer Cement Alter its Physicomechanical Properties? An In Vitro Study

Propolis is a natural resinous substance produced by honey bees. The antimicrobial effects of glass ionomer cement have been shown to improve with the addition of propolis; however its effect on the physicomechanical properties of the cement is not known.

AIM

The purpose of this study was to evaluate the compressive strength and solubility of conventional restorative glass ionomer cement following the addition of propolis.

STUDY DESIGN

Twenty half cylindrical samples were prepared with conventional restorative glass ionomer cement formed the control group. Another twenty samples were prepared with propolis added to conventional restorative glass ionomer cement formed the experimental group. The compressive strength was assessed using universal testing machine. To assess solubility, the samples were immersed in deionised water at room temperature, for 7 days. The solubility was measured as a difference in the weight of the sample; prior to immersion and following immersion at the end of each day.

RESULTS

The control group had a significantly higher mean compressive strength of 146.26 Mpa as compared to the experimental group (135.06 Mpa). The solubility between the groups was significant.

CONCLUSION

In comparison to the control group, incorporation of propolis to conventional restorative glass ionomer cement decreased the compressive strength significantly. The solubility of the cement in the experimental group increased significantly over 7day period as compared to the control group.

Incorporation of CPP-ACP into Luting and Lining GIC: Influence on Wear Rate (in the Presence of Artificial Saliva) and Compressive Strength

The improvement of mechanical and antibacterial properties of glass ionomer cements (GICs) is an important goal in dental research. In this way, modification of GIC with caries preventive and remineralizing materials such as casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is a new strategy to enhance its anticariogenic properties and the remineralization of teeth. However, one main concern is that adding CPP-ACP may have negative effects on the mechanical properties of GIC. This study investigated the influence of adding CPP-ACP on the wear rate (in the presence of artificial saliva) and compressive strength of luting and lining glass ionomer cement. CPP-ACP was incorporated into a luting and lining glass ionomer cement at different percentages (1, 1.56, and 2%). Wear rate and compressive strength were measured for each group using Pin-on-Disk tribometer device (in artificial saliva condition) and universal testing machine, respectively. The wear test was carried out in the presence of artificial saliva for better simulation of the oral environment. Our results demonstrated that increasing the percentage of CPP-ACP from 0 up to 1.56% (w/w), caused a decrease of 19% in the wear rate. However, at 2% (w/w) CPP-ACP, the wear rate increased. Compressive strength was improved by 31% when the CPP-ACP concentration was increased to 1.56% (w/w), but decreased when the concentration was raised to 2% (w/w). In conclusion, adding 1.56% CPP-ACP into luting and lining glass ionomer cement appears to provide an acceptable combination of two important mechanical properties, compressive strength and wear rate.

Glass-ionomer Cements in Restorative Dentistry: A Critical Appraisal

Glass-ionomer cements (GICs) are mainstream restorative materials that are bioactive and have a wide range of uses, such as lining, bonding, sealing, luting or restoring a tooth. Although the major characteristics of GICs for the wider applications in dentistry are adhesion to tooth structure, fluoride releasing capacity and tooth-colored restorations, the sensitivity to moisture, inherent opacity, long-term wear and strength are not as adequate as desired. They have undergone remarkable changes in their composition, such as the addition of metallic ions or resin components to their composition, which contributed to improve their physical properties and diversified their use as a restorative material of great clinical applicability. The light-cured polymer reinforced materials appear to have substantial benefits, while retaining the advantages of fluoride release and adhesion. Further research should be directed towards improving the properties, such as strength and esthetics without altering its inherent qualities, such as adhesion and fluoride releasing capabilities.

Effect of ultrasound application during setting on the mechanical properties of high viscous glass-ionomers used for ART restorations

This study was conducted to evaluate the effect of ultrasound application on the surface microhardness (VHN) and diametral tensile strength (DTS) of three high viscous glass-ionomer restorative materials (HVGIRMs). For each test (VHN and DTS), a total of 180 specimens were prepared from three HVGIRMs (Ketac-Molar Aplicap, Fuji IX GP Fast, and ChemFil Rock). Specimens of each material (n = 60) were further subdivided into three subgroups (n = 20) according to the setting modality whether ultrasound (20 or 40 s) was applied during setting or not (control). Specimens within each subgroup were then equally divided (n = 10) and tested at 24 h or 28 days. For the VHN measurement, five indentations, with a 200 g load and a dwell time for 20 s, were made on the top surface of each specimen. The DTS test was done using Lloyd Testing machine at a cross-head speed of 0.5 mm/min. Ultrasound application had no significant effect on the VHN. Fuji IX GP Fast revealed the highest VHN value, followed by Ketac-Molar Aplicap, and the least was recorded for ChemFil Rock. Fuji IX GP Fast and Ketac-Molar Aplicap VHN values were significantly increased by time. ChemFil Rock recorded the highest DTS value at 24 h and was the only material that showed significant improvement with both US application times. However, this improvement did not sustain till 28 days. The ultrasound did not enhance the surface microhardness, but its positive effect on the diametral tensile strength values was material and time dependent.

Dental glass ionomer cement reinforced by cellulose microfibers and cellulose nanocrystals

The aim of this work was to evaluate if the addition of cellulose microfibers (CmF) or cellulose nanocrystals (CNC) would improve the mechanical properties of a commercial dental glass ionomer cement (GIC). Different amounts of CmF and CNC were previously prepared and then added to reinforce the GIC matrix while it was being manipulated. Test specimens with various concentrations of CmF or CNC in their total masses were fabricated and submitted to mechanical tests (to evaluate their compressive and diametral tensile strength,modulus, surface microhardness and wear resistance) and characterized by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), transmission electron microscopy (TEM) and Fourier transform infrared spectroscopy (FTIR). The incorporation of CmF in the GIC matrix did not greatly improve the mechanical properties of GIC. However, the addition of a small amount of CNC in the GIC led to significant improvements in all of the mechanical properties evaluated: compressive strength (increased up to 110% compared with the control group), elastic modulus increased by 161%, diametral tensile strength increased by 53%, and the mass loss decreased from 10.95 to 3.87%. Because the composites presented a considerable increase in mechanical properties, the modification of the conventional GIC with CNC can represent a new and promising dental restorative material.

Chemical and structural characterization of glass ionomer cements indicated for atraumatic restorative treatment

Glass ionomer cements (GICs) are restorative materials, which clinical use has increased significantly during the last decade. The aim of the present study was to analyze the chemical constitution and surface morphology of four glass ionomer cements: Maxxion R, VitroFill, Vidrion R and Vitremer. Twelve polyethylene tubes with an internal diameter of 3 and 3 mm in length were prepared, filled and then transferred to a chamber with 95% relative humidity and a temperature of 37°C. The surface morphology of the tested materials was examined by scanning electron microscopy (SEM) and main components were investigated by energy-dispersive X-ray microanalysis (EDX). Scanning electron microscopy revealed irregular and rough external surface. Cracking was not observed. The main constituents were found to be aluminum, silicon, calcium, sodium and fluoride. Phosphorus, sulfur and barium were only observed in Vidrion R, while chlorine were only observed in Maxxion R. Elemental mapping of the outer surface revealed high concentration of aluminum and silicon. Significant irregularities on the surface of the tested materials were observed. The chemical constitution of all GIC was similar.

Initial sliding wear kinetics of two types of glass ionomer cement: a tribological study

The aim of this work was to characterize the initial wear kinetics of two different types of glass ionomer cement used in dentistry (the conventional glass ionomer cement and the resin-modified glass ionomer cement) under sliding friction after 28-day storing in distilled water or Ringer's solution. Sliding friction was applied through a pin-on-disk tribometer, in sphere-on-plane contact conditions, under 5 N normal load and 120 rotations per minute. The test lasted 7500 cycles and replicas were performed at 2500, 5000 and 7500 cycles. A profilometer was used to evaluate the wear volume. Data were analysed using Student's t-test at a significant level of 5%. There is no statistical significant difference between the results obtained for a given material with the maturation media (P > 0.05). However, for a given maturation medium, there are significant statistical differences between the data obtained for the two materials at each measurement (P < 0.0001). The wear rates of both materials decrease continuously during the running-in period between 0 and 2500 cycles. After 2500 cycles, the wear rate becomes constant and equal for both materials. The resin matrix contained in the resin-modified glass ionomer cement weakens the tribological behaviour of this material.

Biaxial flexural strength of high-viscosity glass-ionomer cements heat-cured with an LED lamp during setting

Adding heat to glass ionomers during setting might improve mechanical properties. The aim was to compare the biaxial flexural strength (BFS) between and within four glass ionomers, by time of exposure to a high-intensity LED light-curing unit. Materials and methods. Samples of Fuji 9 Gold Label, Ketac Molar Easymix, ChemFil Rock, and the EQUIA system were divided into three treatment groups (n = 30): without heating (Group 1), heated with LED lamp of 1400 mW/cm² for 30 s while setting (Group 2), and heated with LED lamp of 1400 mW/cm² for 60 s while setting (Group 3). Samples were stored for 48 hours in distilled water at 37°C until tested. BFS was tested, using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed, using ANOVA test with the Bonferroni correction (α = 0.05). Heating the glass-ionomer cements with an LED curing light of 1400 mW/cm² during setting for 30 s increased the BFS value of all GICs. No statistically significant difference in mean BFS scores was found between the EQUIA system and ChemFil Rock at 30 s and 60 s. The mean BFS value was statistically significantly higher for the EQUIA system and ChemFil Rock than for Fuji 9 Gold Label and Ketac Molar Easymix at all exposure times.

Resistência à tração diametral de cimentos de ionômero de vidro submetidos à aplicação de ondas de ultrassom

INTRODUÇÃO: O cimento de ionômero de vidro é um material odontológico que apresenta limitações de uso devido às suas propriedades mecânicas, como baixa resistência ao desgaste, microdureza, compressão e tração diametral. Com base nisso, este estudo investigou o efeito da excitação ultrassônica sobre o CIV, em diferentes tempos de aplicação, por meio da resistência à tração diametral. MATERIAL E MÉTODO: Os materiais utilizados foram o Ketac Molar Easymix (KME) e o Ketac Cem Easymix (KCE). Foram confeccionados 10 corpos de prova para cada condição estudada: grupo controle, e os grupos que receberam aplicação de ultrassom por 15s, 30s e 45s, para ambos materiais. A excitação ultrassônica foi aplicada durante a reação de presa inicial do CIV, logo após sua inserção na matriz de silicone. Os valores de resistência à tração diametral foram analisados pelo teste Shapiro Wilk e Anova (α = 0.05). RESULTADO: A aplicação de excitação ultrassônica não apresentou efeito estatisticamente significante na resistência à tração diametral dos materiais testados, independente do tempo de aplicação (p > 0,05). O KME apresentou resistência estatisticamente maior que o KCE (p = 0,023). CONCLUSÃO: A utilização das ondas ultrassônicas não influenciou na resistência à tração diametral dos CIV testados independentemente do seu tempo de aplicação.

Cytotoxicity evaluation of a new fast set highly viscous conventional glass ionomer cement with L929 fibroblast cell line

Aim:

This study aims to evaluate the cytotoxicity of a new fast set highly viscous conventional glass ionomer cement (GIC) with L929 fibroblasts.

Materials and Methods:

The cement capsule was mixed and introduced into a paraffin wax mould. After setting, the cement was incubated in Dulbecco's Modified Eagle's Medium. Six replicates of the material extract were added to the culture medium in 96-well plates. L929 mouse fibroblast cells were added into the wells and then incubated for 48 h. Dimethylthiazol diphenyltetrazolium bromide test was performed for cytotoxicity evaluation.

Results:

The results showed that this GIC brand did not yield a half-maximal inhibitory concentration value, IC50, as the cell viability was above 50% at all concentrations. Cell viability over 90% was observed at the concentrations of 3.125 and 1.5625 mg/ml. Maximum concentration of the material showed cell viability of 59.4%.

Conclusions:

This new fast set highly viscous conventional GIC showed low cytotoxicity to mouse fibroblast cells, and it can be suggested as a substitute for dental cements exhibiting a long setting time.

Micro energy-dispersive X-ray fluoresence mapping of enamel and dental materials after chemical erosion

Energy-dispersive X-ray fluorescence was employed to test the hypothesis that beverage consumption or mouthwash utilization will change the chemical properties of dental materials and enamel mineral content. Bovine enamel samples (n = 45) each received two cavity preparations (n = 90), each pair filled with one of three dental materials (R: nanofilled composite resin; GIC: glass-ionomer cement; RMGIC: resin-modified GIC). Furthermore, they were treated with three different solutions (S: saliva; E: erosion/Pepsi Twist®; or EM: erosion+mouthwash/Colgate Plax®). It was found that mineral loss in enamel was greater in GICE samples than in RE > RMGICE > RMGICEM > REM > GICEM. An increased percentage of Zr was found in REM indicating organic matrix degradation. Dental materials tested (R, GIC, and RMGIC) were not able to protect adjacent enamel from acid erosion by the soft drink tested. The use of mouthwash promoted protection of enamel after erosion by the soft drink. To avoid chemical dissolution by mouthwashes, protection by resin composites with surface sealants is recommended.

Influence of ultrasound or halogen light on microleakage and hardness of enamel adjacent to glass ionomer cement

BACKGROUND

The use of external sources of energy may accelerate the setting rate of glass ionomer cements (GICs) allowing better initial mechanical properties.

AIM

To investigate the influence of ultrasound and halogen light on the microleakage and hardness of enamel adjacent to GIC restorations, after artificial caries challenge.

DESIGN

Cavities were prepared in 60 primary canines, restored with GIC, and randomly distributed into three groups: control group (CG), light group (LG) - irradiation with a halogen light-curing unit for 60s, and ultrasonic group (UG) - application of ultrasonic scaler device for 15s. All specimens were then submitted to a cariogenic challenge in a pH cycling model. Half of sample in each group were immersed in methylene blue for 4h and sectioned for dye penetration analysis. The remaining specimens were submitted to Knoop cross-sectional microhardness assessments, and mineral changes were calculated for adjacent enamel.

RESULTS

Data were compared using Kruskal-Wallis test and two-way ANOVA with 5% significance. Higher dye penetration was observed for the UG (P<0.01). No significant mineral changes were observed between groups (P=0.844).

CONCLUSION

The use of halogen light-curing unit does not seem to interfere with the properties of GICs, whereas the use of ultrasound can affect its marginal sealing.

Normal mouth opening in an adult Indian population

BACKGROUND

Mouth opening among different population has been shown to vary considerably and its range is specific for a given population. The present study is an attempt to calculate the normal mouth opening in adult Indian population.

METHOD

A total of 894 adults, 463 males and 431 females, in the age range of 21 to 70 years were studied. The subjects were asked to open their mouth maximally till no further opening was possible. The distance from the incisal edge of the upper incisor teeth to the incisal edge of the lower incisor teeth was measured using a calibrated fiber ruler. To determine correlation of mouth opening with age a Pearson correlation analysis was performed and statistical significance was tested by the application of t test.

OBSERVATIONS

The mean maximal mouth opening for males was 51.3 mm (SD 8.3) (Range 39-70 mm). The mean maximal mouth opening for females was 44.3 mm (SD 6.7) (Range 36-56 mm). There was significant difference between the mouth opening of male and female in all the age groups with P value <0.05. A linear relationship was observed between the mouth opening and age in both males and females and the mouth opening decreased as the age increased.

CONCLUSION

The mean maximal mouth opening for Indian males is 51.3±8.3 mm and for females is 44.3±6.7 mm. The mouth opening seems to decrease with age. The mouth opening of females is significantly less than the males in all the age groups.

Effect of green propolis addition to physical mechanical properties of glass ionomer cements

Objective

This study investigated the mechanical properties of glass ionomer cements (GICs) combined with propolis as a natural antimicrobial substance

Material and Methods

Typified green propolis, as an ethanolic extract (EEP) or in the lyophilized form (powder), was incorporated to specimens of Ketac Fil Plus, ChemFlex and Ketac Molar Easymix GICs. For each test, 8 specimens of each material were prepared. For water sorption and solubility tests, specimens were subjected to dehydration, hydration and re-dehydration cycles until a constant mass was obtained for each step. Measurements were recorded using a digital balance of 10^-4 g precision. For the diametral tensile strength test, specimens were tested in a universal test machine at 0.5 mm/min crosshead speed after 24 h storage in deionized water. Data were evaluated by one-way ANOVA and Tukey’s tests (p<0.05).

Results

The addition of propolis to GIC clearly increased water sorption compared to pure material. Solubility was material-dependent and was not clearly evident. For the diametral tensile strength test, association with propolis altered negatively only Chemflex.

Conclusion

It may be concluded that incorporation of propolis to GICs alters some properties in a material-dependent condition.

Influence of powder/liquid ratio on the radiodensity and diametral tensile strength of glass ionomer cements

Clinicians tend to make reductions in glass ionomer power/liquid (P/L) ratios since some materials are difficult to mix and flow into small cavities, grooves or pits. In general, changing the P/L ratio decreases the physical and mechanical properties of conventional glass ionomer cements (GICs) and resin modified glass ionomer cements (RMGICs), but alterations seem to depend on their composition.

OBJECTIVE

To determine the influence of P/L ratio on the radiodensity and diametral tensile strength (DTS) of glass ionomer cements.

MATERIAL AND METHODS

There were 2 factors under study: P/L ratio (manufacturer's recommended P/L ratio and a 50% reduced P/L ratio), and materials (Vitro Molar, Vitro Fil, Vitro Cem conventional GICs and Vitro Fil LC, Ortho Glass LC RMGICs. Five 1-mm-thick samples of each material-P/L ratio were produced for radiodensity evaluation. Samples were x-ray exposed onto Digora phosphor plate and radiodensity was obtained using the software Digora for Windows 2.5 Rev 0. For DTS, five (4.0 x 8.0 mm) cylinder samples of each material were tested (0.5 mm/min). Data were subjected to one- and two-way ANOVA (5x2) followed by Tukey's HSD test, or Kruskal-Wallis and Dunn's method. For paired comparisons, t-test or Mann-Whitney test were used (α=0.05).

RESULTS

There was a significant interaction (P=0.001) for the studied factors (materials vs. P/L ratio). Reduced P/L ratio resulted in significantly lower DTS for the RMGICs, but radiodensity was affected for all materials (P<0.05).

CONCLUSIONS

Reduced P/L ratio affected properties of the tested glass ionomer cements. RMGICs were more susceptible to lower values of DTS, but radiodensity decreased for all materials following P/L ratio reduction.

Antibacterial activity and physical properties of conventional glass-ionomer cements containing chlorhexidine diacetate/cetrimide mixtures

STATEMENT OF THE PROBLEM

Hand excavation instruments are not as efficient as that with rotary burs in atraumatic restorative treatment (ART).

PURPOSE

To evaluate the antibacterial activity (ABA), microhardness numbers (VHN), and cumulative fluoride releasing (CFR) patterns of conventional GICs (Fuji IX (FX) and Ketac Molar (KM)) containing chlorhexidine diacetate/cetrimide mixtures (2.5%/2.5%) (AB).

MATERIALS AND METHODS

The powders of ABs were added to powders of FX and KM selected as experimental groups (EXPs). FX and KM were assigned as controls (CNTs). ABA against S.mutans (MS) and L.casei (LB) were examined between 1-90 days. VHN were calculated after 24 hours and CFR patterns measured between 1-30 days. Analysis of variance was used for comparison (p<0.05)

RESULTS

Differences were found between EXPs regarding MS levels at days 1, 7 and 60 as well as for LB at all time periods (p<0.05). VHN decreased in EXPs compared to CNTs (p<0.05), and no differences were found between EXPs (p>0.05). CFR patterns tended to decrease in EXPs compared to the CNTs, but no differences were found between EXPs (p>0.05) CLINICAL SIGNIFICANCE These mixtures could be recommended for ART procedures to provide beneficial antibacterial effects without seriously deteriorating the physical properties of selected GICs.

Influence of Salvadora persica (miswak) extract on physical and antimicrobial properties of glass ionomer cement

AIM

To investigate physical and antimicrobial properties of Glass Ionomer Cement (GIC) combined with Salvadora Persica Extract (SPE).

METHODS

SPE was added to GIC (Fuji IX) in concentrations of 1%, 2% and 4% w/w. The compressive strength and diametral tensile strength were measured at 1 h, 24 h and 7 days. The antimicrobial effect was tested in agar dilution assay in blood agar plates with Candida albicans, Streptococcus mutans, Streptococcus sanguis, Streptococcus mitis, Streptococcus salivarius and Actinomyces naeslundii as test organisms. GIC containing 5% chlorhexidine served as positive control.

RESULTS

Significant differences were found for the compressive strength and diametral tensile strength as a result of adding SPE to GIC (p<0.05). GIC with 2 or 4 % SPE was significantly weaker than the GIC control, while GIC with 1% SPE was not different from the control. The mean values for the 4% SPE-containing specimens and the GIC control group ranged from 108.7MPa to 141.1MPa for CS and from 8.2MPa to 12.5MPa for DTS. The 1% SPE-containing specimens were not different in physical properties compared to the control GIC specimens; the 2% SPE-containing specimens were statistically slightly less strong (p<0.05), but within an acceptable range. As compared with pure GIC the antimicrobial properties of the SPE-containing specimens were increased significantly (p<0.01). It has been found up to a 2-fold increased inhibition compared to the GIC with increasing concentrations of SPE. For most microorganisms tested the SPE group inhibited less than Chlorhexidine, but significantly better than pure GIC (p<0.01).

CONCLUSION

SPE could be a promising natural material as an additive to GICs. Further studies should include in vivo tests and other antimicrobial and physical properties of this combination.

Research proposal: evaluation of ART in adult patients

The primary objective of the Atraumatic Restorative Treatment (ART) is to reduce the indication of tooth extraction by means of a low-cost technique. Considering the difficulties of Brazilian public services to meet the demand of care of the low-income population, with lack of care to the adult population, which usually receives only emergency care, the aim of this study is to assess the performance of high-viscosity glass ionomer cements accomplished by the modified atraumatic restorative treatment in one- and multiple-surface cavities, compared to the conventional restorative approach. It will be analyzed the clinical performance of the materials; cost (material and human resources); patient satisfaction with the treatment received; and preventive effect of treatment.

Environmental degradation of glass-ionomer cements: A depth-sensing microindentation study

This study investigated the effects of various environmental conditions on the hardness and elastic modulus of restorative glass-ionomer cements (GICs). Two resin-modified GICs (RMGICs) (Fuji II LC [FL]; Photac-Fil Quick [PQ]) and three highly viscous GICs (HVGICs) (Fuji IX Fast [FN]; KetacMolar [KM]; KetacMolar Quick [KQ]) were evaluated in this study. Specimens were fabricated according to the manufacturers' instructions and stored under a variety of conditions (n = 7): 100% humidity, distilled water, pH 5 demineralization solution, and pH 7 remineralization solution. The hardness and elastic modulus were measured using a depth-sensing microindentation test after 4 weeks. The results were analyzed using the independent samples T-test and ANOVA/Scheffe's post hoc test (p < 0.05). HVGICs showed significantly higher hardness and elastic modulus than RMGICs under all storage conditions. Storage in distilled water significantly increased the hardness and elastic modulus of FN, but decreased that of PQ. All HVGICs and RMGICs stored in remineralization solution had hardness values and elastic moduli comparable to those stored in water. Compared to remineralization solution, demineralization solution had no significant effects on the modified GICs with the exception of KQ. The results suggest that the mechanical properties of glass-ionomer restoratives are material-type and storage condition dependent. Therefore, the clinical selection of a glass-ionomer material should be based on the oral environment to which it will be subjected.

In vitro microhardness of glass ionomer cements

This study evaluated the surface microhardness of four glass ionomer cements and a composite resin (Fuji IX, Ketac Molar, Vidrion R, Vitromolar and Z 250). Ten specimens of each glass ionomer cement with 8.0 mm diameter and 5.0 mm high dimensions were made and Vicker's microhardness measurements were taken at 1 day and 1 week after initial setting reaction. The results were analyzed using Student's T test and Tukey test (p < 0.05) and demonstrated that the values of microhardness increased after 1 week, with the exception of Fuji IX. Resin composite Z250 presented the greatest values for microhardness.

Compressive Strength, Surface Roughness, Fluoride Release and Recharge of Four New Fluoride-releasing Fissure Sealants

The aim of this study was to investigate the compressive strength and surface roughness of two glass ionomer cements and two resin-based fissure sealants before and after fluoride release and recharge. Twenty-one specimens were prepared and divided into three groups for each material. First group was loaded in compression until failure. Fluoride released was measured from the remaining specimens, and then the second group of seven specimens was loaded at 28th day. The remaining seven specimens were exposed to 0.05% NaF solution and 1.23% APF gel. Fluoride amount was measured, and the last group was loaded at 70th day. Surface roughness measurement of five more disk-shaped specimens from each material was also carried out. After exposure to APF gel, all materials were recharged. At the end of experimental period, it was found that surface roughness increased, whereas compressive strength decreased, over time. In conclusion, fluoride-releasing fissure sealants could act as show, rechargeable fluoride release systems. However, if a fissure sealant exhibited high fluoride release, it had inferior mechanical properties.

Effect of Early Water Exposure on the Strength of Glass Ionomer Restoratives

Modern day glass ionomer restoratives are not significantly weakened by early water exposure, after initial set.

An FTIR study of the effects of artificial saliva on the physical characteristics of the glass ionomer cements used for art

OBJECTIVE

To investigate the physical and chemical changes of five esthetic restorative materials in an artificial saliva using Fourier transform infrared spectroscopy (FTIR).

METHODS

The materials included two glass polyalkenoate (ionomer) cements, one polyacid-modified resin composite, and two resin composites. Five fresh and 20 aged specimens for each material were immersed in 2 ml of artificial saliva at 37 degrees C for 1 week, 2 weeks, 1 month, and 2 months. They were examined by laser surface profilometer and FTIR.

RESULTS

Surface roughness average (Ra) value showed significant differences among the physical properties of glass ionomers, polyacid-modified resin composite, and resin composites.

SIGNIFICANCE

FTIR spectra showed that a major chemical changes in Fuji IX GP Fast glass ionomer cement in P-NH2 group bonding (900-1000 cm(-1)) that may explain the previously reported increase in microhardness after immersion. There was no direct correlation between surface roughness and spectral changes of the materials tested.

Early and long-term wear of ‘Fast-set’ conventional glass–ionomer cements

OBJECTIVE

Fast setting high viscous glass-ionomer cements have been introduced to reach the set state sooner and to improve early mechanical properties. The aim of this study was to investigate whether 'fast-set' cements have improved the early three-body wear.

METHOD

The three-body wear of four glass-ionomer cements was measured after 1, 4, 7, 30, 90, and 365 days. The chemical composition of the cements was determined with EDAX. The particle size of the powders was determined with a Mastersizer 2000.

RESULTS

The three-body wear of Fuji IX Fast was only slightly less than that of 'regular-set' Fuji IX, but Ketac Molar Quick showed a higher wear compared to the regular-set Ketac Molar. The wear rate of all four glass-ionomer cements decreased over a period of 1 year and could be described by second order reaction kinetics and depended on polyalkenoic acid content, chemical composition, and the size of the glass particles.

SIGNIFICANCE

Based on the results of this laboratory study on long-term wear, the glass-ionomer cements investigated may compete with composites, but the early wear characteristics should be further improved. Furthermore, a better understanding of the wear and reaction behavior of glass-ionomer cements is obtained.

Compressive and diametral tensile strength of glass ionomer cements

The aim of this study was to compare, in different periods of time, the compressive and diametral tensile strength of a traditional high viscous glass ionomer cement: Fuji IX (GC Corporation), with two new Brazilian GIC's: Vitro-Molar (DFL) and Bioglass R (Biodinamica), all indicated for the Atraumatic Restorative Treatment (ART) technique. Fifteen disk specimens (6.0mm diameter x 3.0mm height) for the diametral tensile strength (DTS) test and fifteen cylindrical specimens (6.0mm diameter x 12.0mm height) for the compressive strength (CS) test were made of each GIC. Specimens were stored in deionized water at 37º C and 100% of humidity in a stove until testing. Five specimens of each GIC were submitted to CS and DTS test in each period, namely 1 hour, 24 hours and 7 days. The specimens were tested in a testing machine (Emic) at a crosshead speed of 1.0mm/min for CS and 0.5mm/min for the DTS test until failure occurred. The data were submitted to two-way ANOVA and Tukey tests (alpha=0.05). The mean CS values ranged from 42.03 to 155.47MPa and means DTS from 5.54 to 13.72 MPa, with test periods from 1h to 7 days. The CS and DTS tests showed no statistically significant difference between Fuji IX and Vitro Molar, except for CS test at 1-hour period. Bioglass R had lowest mean value for CS of the cements tested. In DTS test Bioglass R presented no statistically significant differences when compared with all others tested GICs at 1-hour period and Bioglass R presented no difference at 24-hour and 7-day periods when compared to Vitro-Molar. Further studies to investigate other physical properties such as fracture toughness and wear resistance, as well as chemical composition and biocompatibility, are now needed to better understand the properties of these new Brazilian GIC's.