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

OBJECTIVES

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

DATA

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

SOURCES

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

STUDY SELECTION

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

CONCLUSION

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

CLINICAL SIGNIFICANCE

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

Synthesis of poly(alkenoic acid) with L-leucine residue and methacrylate photopolymerizable groups useful in formulating dental restorative materials

To develop resin-modified glass ionomer materials, we synthesized methacrylate-functionalized acrylic copolymer (PAlk-LeuM) derived from acrylic acid, itaconic acid and N-acryloyl-L-leucine using (N-methacryloyloxyethylcarbamoyl-N'-4-hydroxybutyl) urea as the modifying agent. The spectroscopic (proton/carbon nuclear magnetic resonance, Fourier transform infrared spectroscopy) characteristics, and the gel permeation chromatography/Brookfield viscosity measurements were analysed and compared with those of the non-modified copolymer (PAlk-Leu). The photocurable copolymer (PAlk-LeuM, ~14 mol% methacrylate groups) and its precursor (PAlk-Leu) were incorporated in dental ionomer compositions besides diglycidyl methacrylate of bisphenol A (Bis-GMA) or an analogue of Bis-GMA (Bis-GMA-1), triethylene glycol dimethacrylate and 2-hydroxyethyl methacrylate. The kinetic data obtained by photo-differential scanning calorimetry showed that both the degree of conversion (60.50-75.62%) and the polymerization rate (0.07-0.14 s(-1)) depend mainly on the amount of copolymer (40-50 wt.%), and conversions over 70% were attained in the formulations with 40 wt.% PAlk-LeuM. To formulate light-curable cements, each organic composition was mixed with filler (90 wt.% fluoroaluminosilicate/10 wt.% hydroxyapatite) into a 2.7:1 ratio (powder/liquid ratio). The light-cured specimens exhibited flexural strength (FS), compressive strength (CS) and diametral tensile strength (DTS) varying between 28.08 and 64.79 MPa (FS), 103.68-147.13 MPa (CS) and 16.89-31.87 MPa (DTS). The best values for FS, CS and DTS were found for the materials with the lowest amount of PAlk-LeuM. Other properties such as the surface hardness, water sorption/water solubility, surface morphology and fluorescence caused by adding the fluorescein monomer were also evaluated.

New polymeric materials for use in glass-ionomer cements

The polymeric materials currently used in GIC are based on poly(acrylic acid), poly(acrylic acid-co-itaconic acid), or poly(acrylic acid-co-maleic acid). For the visible light cured (VLC) type GIC, the polymeric material is chemically modified to have pendant free-radical polymerizable double bonds, with the aqueous formulation solution also containing a monomer having methacrylate groups. Exploring ways to improve both conventional and VLC GIC, routes to new acrylic acid copolymers have been explored, where acid groups are made more available for salt-bridge formation. In particular, amino acid modified acrylic acid copolymers have been prepared and shown to provide improved GIC. Also, it was discovered that the monomer N-vinylpyrrolidone (NVP) could be used to modify acrylic acid copolymers to provide a path to improved GIC. A new route to develop VLC GIC, based on the reaction of the acid copolymer, in water, with a cyclic imino ether (oxazoline) functionalized methacrylate monomer was developed. Looking for ways to change the microstructure of the acrylic acid copolymers, as a possible route to improve GIC, acrylic acid copolymers have been prepared under super critical conditions. A review of the aforesaid areas of research is provided in this manuscript.

An amino acid-modified and non-HEMA containing glass-ionomer cement

It is known that unreacted 2-hydroxyethyl methacrylate (HEMA) in current resin modified glass ionomer cements (RMGICs) shows potential cytotoxicity to pulp and surrounding tissues. Elimination of HEMA could make RMGICs more attractive for dental applications. In this research, novel six acrylate and methacrylate derivatives of amino acids were synthesized, characterized and used for replace HEMA in RMGICs. The experimental RMGICs were formulated with vinyl-containing polymer, amino acid derivative, water, and commercial Fuji II LC glass. Among all the derivatives, methacryloyl beta-alanine (MBA) was selected for further formulations due to its relatively low solution viscosity and high CS. Effects of polymer content and powder/liquid, P/L, ratio were significant. The formulation with liquid composition of 50/25/25 (polymer/MBA/water) and P/L ratio of 2.7/1 was found the optimal. It appears that this novel non-HEMA-containing RMGIC system based on amino acid derivatives will be a better dental restorative because it demonstrated improved mechanical strengths and may eliminate potential cytotoxicity in current RMGICs caused by leached HEMA. The optimal MBA-modified GIC were 20% higher in CS, 70% higher in DTS and 93% higher in FS, compared to Fuji II LC.

Synthesis and evaluation of HEMA-free glass-ionomer cements for dental applications

OBJECTIVE

The objective of this study was to synthesize and characterize amino acid acrylate and methacrylate derivatives, use them to formulate light-cured glass-ionomer cements (LCGICs), and evaluate their mechanical strengths.

MATERIALS AND METHODS

Acrylate and methacrylate derivatives of six amino acids were synthesized and characterized using FT-IR and 1HNMR spectroscopy. The LCGICs were formulated using a newly synthesized polymer having pendant methacrylate groups (in other words, a methacryloyl derived polymer or MDP), amino acid derivatives, water, and Fuji II LC glass. Compressive strength of the cements and viscosities of the resin liquids were used as screening tools in order to determine the optimal formulation. The specimens were conditioned in distilled water at 37 degrees C for 24 h prior to testing.

RESULTS

The measured compressive strengths (MPa) of the cements were found to depend on the amino acid derivative used: acryloyl aspartic acid (268.5) > methacryloyl beta-alanine (259.1) = methacryloyl glutamic acid (254.5) = acryloyl beta-alanine (251.9) > acryloyl glutamic acid (238.8) > methacryloyl aspartic acid (210.9). Methacryloyl beta-alanine (MBA) was selected for further formulations due to its relatively low solution viscosity and high compressive strength. Effects of MDP content and power/liquid (P/L) ratio were significant. The formulation with a liquid composition of 50/25/25 (MDP/MBA/water) and P/L ratio of 2.7/1 was found to give optimal properties and handling of all the formulations studied.

CONCLUSIONS

A novel HEMA-free LCGIC system based on amino acid derivatives has been developed. This system may eliminate potential cytotoxicity in current LCGICs caused by leached 2-hydroxyethyl methacrylate (HEMA). The optimal MBA-modified cements were 20% higher in compressive strength, 70% higher in diametral tensile strength (DTS) and 93% higher in flexure strength (FS), as compared to Fuji II LC cement.