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Hamdy TM. Effect of E-glass fibers addition on compressive strength, flexural strength, hardness, and solubility of glass ionomer based cement. BMC Oral Health 2024; 24:739. [PMID: 38937723 PMCID: PMC11210041 DOI: 10.1186/s12903-024-04447-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 06/05/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND In dentistry, glass-ionomer cements (GICs) are extensively used for a range of applications. The unique properties of GIC include fluoride ion release and recharge, chemical bonding to the tooth's hard tissues, biocompatibility, a thermal expansion coefficient like that of enamel and dentin, and acceptable aesthetics. Their high solubility and poor mechanical qualities are among their limitations. E-glass fibers are generally utilized to reinforce the polymer matrix and are identified by their higher silica content. OBJECTIVES The purpose of the study was to assess the impact of adding (10 wt% and 20 wt%) silane-treated E-glass fibers to traditional GIC on its mechanical properties (compressive strength, flexural strength, and surface hardness) and solubility. METHODS The characterization of the E-glass fiber fillers was achieved by XRF, SEM, and PSD. The specimens were prepared by adding the E-glass fiber fillers to the traditional GIC at 10% and 20% by weight, forming two innovative groups, and compared with the unmodified GIC (control group). The physical properties (film thickness and initial setting time) were examined to confirm operability after mixing. The evaluation of the reinforced GIC was performed by assessing the compressive strength, flexural strength, hardness, and solubility (n = 10 specimens per test). A one-way ANOVA and Tukey tests were performed for statistical analysis (p ≤ 0.05). RESULTS The traditional GIC showed the least compressive strength, flexural strength, hardness, and highest solubility. While the GIC reinforced with 20 wt% E-glass fibers showed the highest compressive strength, flexural strength, hardness, and least solubility. Meanwhile, GIC reinforced with 10 wt% showed intermediate results (P ≤ 0.05). CONCLUSION Using 20 wt% E-glass fiber as a filler with the traditional GIC provides a strengthening effect and reduced solubility.
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Affiliation(s)
- Tamer M Hamdy
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt.
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2
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Thomas HA, Singh N, Thomas AM, Masih S, Cherian JM, Varghese KG. Effect of protective coating agents on microleakage and flexural strength of glass ionomer cement and zirconomer. an in vitro study. Eur Arch Paediatr Dent 2024; 25:57-63. [PMID: 37991624 DOI: 10.1007/s40368-023-00853-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE The objective of this study was to assess the microleakage and flexural strength of glass ionomer cement (GIC) and modified GIC (Zirconomer) when coated with protective coating agents such as COAT-IT and G-COAT plus. METHODS Sixty tooth specimens were grouped into two groups based on the type of restorations (GIC (n = 30) and Zirconomer (n = 30)). The samples were further divided into three subgroups (n = 10) based on the protective coating agent (Petroleum jelly, G-COAT Plus, or COAT IT) applied. This study evaluated the microleakage at the occlusal and cervical margins of class V restoration after being subjected to dye penetration and sectioning. Each specimen was viewed under a 40 × microscope and was given scores based on the depth of dye penetration. They were statistically analyzed using the Kruskal-Wallis test and compared within the groups using the Mann- Whitney Test. In addition, flexural strength was assessed using standardized cuboid (25 × 2 × 2 mm) specimens of restorative materials with and without protective coating agents. The mean flexural strength data of all the subgroups were statistically evaluated using a one-way analysis of variance (ANOVA) and compared within the subgroups using the student t test. RESULTS A statistically significant difference was found when occlusal margin microleakage scores were evaluated with G-COAT Plus demonstrating the lowest occlusal margin microleakage when applied over GIC restoration. The increasing order of occlusal margin microleakage scores is as follows: GIC with G-COAT Plus, Zirconomer with COAT-IT, GIC with COAT-IT, GIC, Zirconomer with G-COAT Plus, and Zirconomer. However, the cervical margin microleakage scores revealed no significant difference. While flexural strength was found to be highest for the GIC group coated with G-COAT Plus, it was observed that there was a significant improvement in the flexural strength of both GIC and Zirconomer when coated with either of the protective coating agents. CONCLUSION Within the limitations of this in vitro study, it was observed that the application of protective coating agents can significantly reduce the potential microleakage and improve the flexural strength of the restorative material especially when zirconia-reinforced GIC is the restorative material.
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Affiliation(s)
- H A Thomas
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India.
| | - N Singh
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - A M Thomas
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - S Masih
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - J M Cherian
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - K G Varghese
- Department of Prosthodontics and Crown and Bridge, Christian Dental College, Ludhiana, Punjab, India
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3
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Hamdy TM. Evaluation of compressive strength, surface microhardness, solubility and antimicrobial effect of glass ionomer dental cement reinforced with silver doped carbon nanotube fillers. BMC Oral Health 2023; 23:777. [PMID: 37872523 PMCID: PMC10591371 DOI: 10.1186/s12903-023-03542-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/14/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Conventional glass ionomer cements (GICs) are currently the most widely used dental cements due to their chemical bonding into tooth structure, release of fluoride, and ease of manipulation and usage. One of their drawbacks is their low mechanical properties and high solubility. Carbon nanotubes (CNTs) could be utilized in dentistry due to their several potential applications. CNTs can be used as fillers to reinforce polymers or other materials. Additionally, silver (Ag) nanoparticles are highly effective at preventing dental biofilm and enhancing mechanical properties. OBJECTIVES The aim of the present in vitro study is to evaluate the compressive strength, surface microhardness, solubility, and antimicrobial effect of the conventional GIC reinforced with manual blending of 0.01 wt.% Ag doped CNT fillers. METHODS The control group was prepared by mixing dental GIC powder with their liquid. The innovatively reinforced dental GIC group was prepared by incorporating 0.01 wt.% Ag doped CNT fillers into the GIC powder prior to liquid mixing. Chemical characterization was performed by XRF. While, physical characterization was done by measuring film thickness and initial setting time. The compressive strength, surface microhardness, solubility, and antimicrobial effect against Streptococcus mutans bacteria using an agar diffusion test were measured. The data was statistically analyzed using independent sample t-tests to compare mean values of compressive strength, surface microhardness, solubility, and antimicrobial activity (p ≤ 0.05). RESULTS The results revealed that innovative reinforced GIC with 0.01 wt.% Ag doped CNT fillers showed higher mean compressive strength, surface microhardness, and antimicrobial effect values than the conventional GIC control group; there was no significant difference between different groups in relation to the solubility test (P ≤ 0.05). CONCLUSION The innovatively reinforced GIC with 0.01 wt.% Ag doped CNT fillers had the opportunity to be used as an alternative to conventional GIC dental cements.
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Affiliation(s)
- Tamer M Hamdy
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, 12622, Dokki, Egypt.
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4
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Łępicka M, Niewczas AM, Rodziewicz MU, Pikuła K, Kordos P, Gredes T, Kurzydłowski KJ. The influence of hydrothermal fatigue on the clinically relevant functional properties of conventional glass-ionomer cements. Sci Rep 2023; 13:8738. [PMID: 37253971 DOI: 10.1038/s41598-023-35880-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/25/2023] [Indexed: 06/01/2023] Open
Abstract
During their everyday service, the restorative dental materials are subjected to temperature changes which can be viewed as intensive in the context of the highest allowed temperatures for these materials. In this work, the effect of hydrothermal fatigue on the in vitro tribological performance, compression strength, microhardness, and surface roughness of glass-ionomer cements was studied. Samples of 3 commercially available cements were divided into the reference (aged 14 days) and thermocycled (20,000 cycles; 5-55 °C) groups. The results obtained show that functional properties of the specimens subjected to thermal fatigue significantly differ from the literature data on the cements aged at constant temperatures. The effect of hydrothermal fatigue on the functional properties of cements is discussed in the context of processes induced by exposure to variable temperatures.
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Affiliation(s)
- Magdalena Łępicka
- Faculty of Mechanical Engineering, Institute of Mechanical Engineering, Bialystok University of Technology, Wiejska 45C St., 15-352, Bialystok, Poland.
| | - Agata Maria Niewczas
- Department of Conservative Dentistry with Endodontics, Medical University of Lublin, W. Chodzki 6, 20-093, Lublin, Poland
| | - Magdalena Urszula Rodziewicz
- Faculty of Mechanical Engineering, Institute of Mechanical Engineering, Bialystok University of Technology, Wiejska 45C St., 15-352, Bialystok, Poland
| | - Konrad Pikuła
- Department of Conservative Dentistry with Endodontics, Medical University of Lublin, W. Chodzki 6, 20-093, Lublin, Poland
| | - Paweł Kordos
- Institute of Transport, Combustion Engines and Ecology, Lublin University of Technology, Nadbystrzycka 36, 20-618, Lublin, Poland
| | - Tomasz Gredes
- Department of Orthodontics, Technische Universität Dresden, Carl Gustav Carus Campus, Fetscherstr. 74, 01307, Dresden, Germany
- Department of Orthodontics and Temporomandibular Disorders, Poznan University of Medical Sciences, Bukowska 70, 60-812, Poznan, Poland
| | - Krzysztof Jan Kurzydłowski
- Faculty of Mechanical Engineering, Institute of Mechanical Engineering, Bialystok University of Technology, Wiejska 45C St., 15-352, Bialystok, Poland
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Maher YA, Rajeh MT, Hamooda FA, Zerain GO, Habis RM, Sulaimani RH, Albar ST, H Ali FM, Abdelaleem NA. Evaluation of the clinical impact and In Vitro antibacterial activities of two bioactive restoratives against S. mutans ATCC 25175 in class II carious restorations. Niger J Clin Pract 2023; 26:404-411. [PMID: 37203103 DOI: 10.4103/njcp.njcp_406_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Background Streptococcus mutans is a Gram-positive opportunistic bacterial pathogen and that causes dental caries and then restorative treatment remains the best clinical practice approach to repair and prevent dental caries. Aims This study compared the antimicrobial performance of resin modified glass ionomer cement (RM-GIC) and ACTIVA restoratives by evaluating the S. mutans count, pH levels, and plaque index (PI) scores before and on the 7th day of restoration, and then determined the antimicrobial activities against S. mutans ATCC 25175 in both restoratives in vitro. Materials and Methods Seventy-eight eligible Saudi female participants, with class II carious lesions, were randomly distributed into RM-GIC and ACTIVA restorative groups. We evaluated the S. mutans count by the serial dilution technique and salivary pH by using a portable pH meter. The PI scores were determined by Silness-Löe method and the antibacterial activity by the agar well diffusion method. Statistical analysis of normality distribution was performed with the Kolmogorov-Smirnov and the difference between groups was an analysis by paired t-test. In addition, the independent sample was compared with the independent samples t-test. Results Both groups reduced the S. mutans count, pH acidity, and PI scores, and this reduction was statistically significant on the 7th day of restoration (P < 0.05), preference for ACTIVA. The in vitro antibacterial activity against S. mutans ATCC 25175 showed a non-significant difference between both bioactive restorative materials (P < 0.05). Conclusion The novel application of ACTIVA restorative material is a promising option for patients at risk of caries.
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Affiliation(s)
- Y A Maher
- Department of Basic Oral Sciences, College of Dentistry - Umm Al-Qura University, Makkah, Saudi Arabia; Department of Microbiology, Faculty of Science, Al-Azhar University, Cairo, Egypt
| | - M T Rajeh
- Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia
| | - F A Hamooda
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - G O Zerain
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - R M Habis
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - R H Sulaimani
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - S T Albar
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - F M H Ali
- Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - N A Abdelaleem
- Department of Conservative and Restorative Dentistry, College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
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6
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Jaber GS, khashan KS, Abbas MJ, Ibrahim NA. Improvement of glass ionomer restoration by adding ZnO nanoparticles prepared by laser in (Vitro study). J INDIAN CHEM SOC 2023. [DOI: 10.1016/j.jics.2023.100879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Evaluation of the Mechanical Properties of Three Resin-Modified Glass-Ionomer Materials. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4690656. [PMID: 35958806 PMCID: PMC9363206 DOI: 10.1155/2022/4690656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/15/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022]
Abstract
This study is aimed at evaluating the flexural strength (FS), fracture toughness (FT), and diametral tensile strength (DTS) of three resin-modified glass-ionomer cements (RMGICs): Ketac Nano, Riva Light Cure, and Fuji II LC. One hundred twenty specimens were prepared from the RMGIC materials (
). The cements were mixed and inserted into different mould sizes according to the test performed: FS: rectangular Teflon mould (
); FT: notchless triangular prism (NTP) Teflon mould (
); and DTS: ring road stainless steel mould (
). Specimens were light cured for 20 seconds on each surface and stored in distilled water at
for seven days prior to tests. To evaluate the influence of storage in the mechanical properties of the RMGIs, specimens tested for DTS were stored in distilled water at
for 32 days prior to test. Data were analyzed by ANOVA and Tukey’s test (
). Fuji II LC presented significantly higher values for all tests employed when compared to Ketac Nano and Riva LC RMGIs. There was no significant difference on DTS before and after the 32-day storage for each material. Fuji II LC presented superior mechanical properties when compared to Ketac Nano, and Riva LC storage showed no influence on the mechanical properties of the RMGI materials tested.
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8
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Łępicka M, Rodziewicz M, Kawalec M, Nowicka K, Tsybrii Y, Kurzydłowski KJ. Diatomaceous earth as a drug-loaded carrier in a glass-ionomer cement. J Mech Behav Biomed Mater 2022; 133:105324. [PMID: 35738132 DOI: 10.1016/j.jmbbm.2022.105324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 10/18/2022]
Abstract
The effect of a natural filler (diatomaceous earth [DE], a promising drug-delivery agent) and its content was investigated on the performance of a model glass-ionomer cement (GIC). Three sample series, differing in DE content (0, 2.5 and 5 wt%), were prepared using a commercial GIC as a matrix (3M Ketac Molar Easymix). The resultant surface microhardness and roughness, wear performance, and compressive strength of the samples were measured after the samples had been stored in deionized water at 37°C for a fixed time. Moreover, the film thickness was tested for the freshly mixed samples. The numerical data was subjected to statistical analysis, in order to test the null hypotheses of the equality of the measured properties between the reference and the DE-modified samples. According to the results, diatomaceous earth particles are uniformly distributed in the GIC matrix, and the cavities of frustules tend to be filled with the GIC. This translates into the observed performance of the DE-loaded GIC. Compared with the reference material (0 wt% DE), the surface microhardness (2.5 wt% DE, p = 0.014; 5 wt% DE, p = 0.005) and roughness (e.g. Ra; 2.5 wt% DE, p = 0.003; 5 wt% DE, p < 0.001) are increased. No effect on the wear performance (p = 0.530 and 0.256, respectively) or compressive strength (p = 0.514) was noticed in the case of DE partially substituting the glass phase. Based on the study results, it is evidenced that diatom frustules are a suitable filler for application in conventional glass-ionomer cements as the glass-substituting drug-loaded carrier. Notably, however, the surface finish method of the DE-filled materials needs development.
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Affiliation(s)
- Magdalena Łępicka
- Institute of Mechanical Engineering, Faculty of Mechanical Engineering, Bialystok University of Technology, Wiejska 45C St., 15-352, Bialystok, Poland.
| | - Magdalena Rodziewicz
- Institute of Mechanical Engineering, Faculty of Mechanical Engineering, Bialystok University of Technology, Wiejska 45C St., 15-352, Bialystok, Poland
| | - Michał Kawalec
- Institute of Mechanical Engineering, Faculty of Mechanical Engineering, Bialystok University of Technology, Wiejska 45C St., 15-352, Bialystok, Poland
| | - Klaudia Nowicka
- Institute of Mechanical Engineering, Faculty of Mechanical Engineering, Bialystok University of Technology, Wiejska 45C St., 15-352, Bialystok, Poland
| | - Yurii Tsybrii
- Institute of Mechanics and Machine Design, Faculty of Mechanical Engineering and Ship Technology, Gdansk University of Technology, G. Narutowicza 11/12 St., 80-233, Gdansk, Poland
| | - Krzysztof Jan Kurzydłowski
- Institute of Mechanical Engineering, Faculty of Mechanical Engineering, Bialystok University of Technology, Wiejska 45C St., 15-352, Bialystok, Poland
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Lang S, Hao J, Mante F, Pavelic K, Ozer F. The effect of zeolite incorporation on the physical properties of silver-reinforced glass ionomer cement. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:38. [PMID: 35404019 PMCID: PMC9001213 DOI: 10.1007/s10856-022-06659-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/13/2022] [Indexed: 06/14/2023]
Abstract
Zeolite can impart antibacterial properties to dental materials in the long-term when incorporated with inorganic cations. However, due to its porosity, it may jeopardize the mechanical integrity of the dental material. The aim of this project was to determine the effect on physical properties when zeolite is added to commercially available Ag-reinforced Glass Ionomer Cement (GIC). Sample groups were prepared according to the percentage of zeolite-clinoptilolite (0% - control, 0.5%, 1%, 2%, and 4% wt) added to Ag-GIC. Water sorption, solubility, Vickers hardness, and flexural strength were determined. Specifically, 10 × 2 mm circular disks were fabricated for the Vickers hardness, water sorption, and water solubility tests and 25 × 5 × 2 mm bars were created for the flexural strength test. The results from the surface hardness, water sorption, and flexural strength tests suggested that adding 0.5-4% wt of zeolite to Ag-reinforced GIC did not diminish its physical properties. However, the water solubility results showed that higher concentrations (2-4% wt) of zeolite had a statistically significant increase in water solubility compared to the control. Up to 4% wt zeolite can be incorporated into Ag-reinforced GIC without compromising mechanical properties. Incorporation of 0.5-1% wt zeolite to Ag-reinforced GIC will maintain an adequate surface hardness, water sorption, and flexural strength without compromising water solubility. Further research is needed to determine the effects of higher water solubility on clinical efficacy of zeolite modified Ag-GIC. Graphical abstract.
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Affiliation(s)
- Spencer Lang
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jessica Hao
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biology, College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Francis Mante
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kresimir Pavelic
- Faculty of Medicine, Juraj Dobrila University of Pula, Pula, Croatia
| | - Fusun Ozer
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Borompiyasawat P, Putraphan B, Luangworakhun S, Sukarawan W, Techatharatip O. Chlorhexidine gluconate enhances the remineralization effect of high viscosity glass ionomer cement on dentin carious lesions in vitro. BMC Oral Health 2022; 22:60. [PMID: 35248048 PMCID: PMC8898514 DOI: 10.1186/s12903-022-02098-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To compare the mean mineral density (MMD) and examine the remineralization of carious dentin after cavity disinfection with chlorhexidine gluconate (CHX) and restoration with high viscosity glass ionomer cement (H-GIC) in vitro.
Methods
Selective caries removal to leathery dentin was performed in 40 extracted primary molars. The samples were scanned using micro-computed tomography (micro-CT) to determine the MMD baseline and randomly divided into 4 groups (n = 10): Equia™ group, applied dentin conditioner and restored with H-GIC (Equia Forte™), CHX-Equia™ group, disinfected the cavity with 2% CHX before applying dentin conditioner and restored with H-GIC (Equia Forte™), Ketac™ group, restored with H-GIC (Ketac Universal™) and CHX-Ketac™ group, disinfected the cavity with 2% CHX before restored with H-GIC (Ketac Universal™). The samples underwent micro-CT scanning post-restoration and post-pH-cycling to determine their respective MMDs. One sample from each group was randomly selected to analyze by scanning electron microscopy (SEM).
Results
The MMD gain in the 4 groups post-restoration was significantly different between the Equia™ and CHX-Ketac™ groups (oneway ANOVA with Post hoc (Tukey) test, P = 0.045). There was a significant difference in MMD gain post-restoration between the Equia™ and CHX-Equia™ groups (Independent t-test, P = 0.046). However, the Ketac™ and CHX-Ketac™ group’s MMD were similar. The SEM images revealed that the CHX-Ketac™ group had the smallest dentinal tubule orifices and the thickest intertubular dentin among the groups. However, the CHX-Equia™ group had thicker intertubular dentin than the Equia™ group.
Conclusion
Applying 2% CHX on demineralized dentin enhances the remineralization of the dentin beneath the restoration.
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Brushing Effect on the Properties of Glass Ionomer Cement Modified by Hydroxyapatite Nanoparticles or by Bioactive Glasses. Int J Dent 2022; 2022:1641041. [PMID: 35237327 PMCID: PMC8885199 DOI: 10.1155/2022/1641041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/26/2021] [Accepted: 01/27/2022] [Indexed: 11/17/2022] Open
Abstract
This study evaluated the physical and mechanical properties of glass ionomer cement (GIC) associated with 5% hydroxyapatite nanoparticles (NPHAps) and 10% bioactive glass (BAG) 45S5 before and after brushing at different storage times. Surface roughness was evaluated using a rugosimeter, Vickers hardness using a microdurometer, and mass variation measured in an analytical balance at 1, 7, 15, 30, and 60 days before and after the brushing test, with the aid of toothbrushing simulator and soft bristle toothbrushes. Nonnormal distribution was observed, and the nonparametric Wilcoxon and Kruskal–Wallis tests followed by Dunn's were performed, with a significance level of 5%. We observed higher values for mass loss on the first day for all groups. The surface roughness was lower in the control and NP groups, 30 days after brushing. Higher values for hardness were found in the control group and lower ones for NP, after brushing. The control and BAG groups presented a decrease in hardness over time. The NP group presented the highest values before brushing, while the control group had the highest values after brushing. The association of NPHPa with the GIC is the most promising combination, since it presented satisfactory values for surface hardness. However, conventional GIC not associated with NPHPa or BAG is still an option, since it is available in the market and the most economically viable option.
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12
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Malhotra S, Bhullar K, Kaur S, Malhotra M, Kaur R, Handa A. Comparative evaluation of compressive strength and flexural strength of GC Gold Hybrid, GIC conventional and resin-modified glass-ionomer cement. J Pharm Bioallied Sci 2022; 14:S214-S216. [PMID: 36110748 PMCID: PMC9469278 DOI: 10.4103/jpbs.jpbs_134_22] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/08/2022] [Accepted: 02/28/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose: The aim of the study was to emphasize the compressive strength and flexural strength of glass-ionomer cement (GIC)–gold hybrid, conventional GIC, and resin-modified GIC (RMGIC). Methodology: Three GIC materials were used in the study: group A: GC–gold hybrid (Gold Label hybrid Universal Restorative), group B: type II conventional GIC, and group C: RMGIC. A total of 120 cylindrical test specimens of dimensions 4 mm diameter × 6 mm height were prepared from a custom-made Teflon mold according to respective study groups. The specimens prepared were then stored in 20 mL of deionized water at 37°C for 3 h daily for 30 days, and the solutions were changed every week, after which they were tested for compressive strength and flexural strength by using a universal force testing machine. All the results were analyzed by SPSS software and were subjected to statistical analysis using ANOVA followed by the Bonferroni post-hoc test. Results: The mean compressive strength was the highest for group A and lowest for group B. Similarly, the mean flexural strength was the highest for group A and lowest for group B. Conclusion: The conclusions can be drawn from this in-vitro study that the compressive strength and flexural strength of GC–gold hybrid were greater than those of RMGIC and conventional GIC.
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Neves AB, Lopes LIG, Bergstrom TG, da Silva ASS, Lopes RT, Neves ADA. Porosity and pore size distribution in high-viscosity and conventional glass ionomer cements: a micro-computed tomography study. Restor Dent Endod 2021; 46:e57. [PMID: 34909421 PMCID: PMC8636077 DOI: 10.5395/rde.2021.46.e57] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/08/2021] [Accepted: 03/10/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives This study aimed to compare and evaluate the porosity and pore size distribution of high-viscosity glass ionomer cements (HVGICs) and conventional glass ionomer cements (GICs) using micro-computed tomography (micro-CT). Materials and Methods Forty cylindrical specimens (n = 10) were produced in standardized molds using HVGICs and conventional GICs (Ketac Molar Easymix, Vitro Molar, MaxxionR, and Riva Self-Cure). The specimens were prepared according to ISO 9917-1 standards, scanned in a high-energy micro-CT device, and reconstructed using specific parameters. After reconstruction, segmentation procedures, and image analysis, total porosity and pore size distribution were obtained for specimens in each group. After checking the normality of the data distribution, the Kruskal-Wallis test followed by the Student-Newman-Keuls test was used to detect differences in porosity among the experimental groups with a 5% significance level. Results Ketac Molar Easymix showed statistically significantly lower total porosity (0.15%) than MaxxionR (0.62%), Riva (0.42%), and Vitro Molar (0.57%). The pore size in all experimental cements was within the small-size range (< 0.01 mm3), but Vitro Molar showed statistically significantly more pores/defects with a larger size (> 0.01 mm3). Conclusions Major differences in porosity and pore size were identified among the evaluated GICs. Among these, the Ketac Molar Easymix HVGIC showed the lowest porosity and void size.
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Affiliation(s)
- Aline Borburema Neves
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Laísa Inara Gracindo Lopes
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Tamiris Gomes Bergstrom
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Aline Saddock Sá da Silva
- Laboratory of Nuclear Instrumentation, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil
| | - Ricardo Tadeu Lopes
- Laboratory of Nuclear Instrumentation, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Rio de Janeiro, RJ, Brazil
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Kumar A, Raj A, Singh DK, Donthagani S, Kumar M, Ramesh K. A New Zinc Reinforced Glass Ionomer Cement: A Boon in Dentistry. J Pharm Bioallied Sci 2021; 13:S272-S275. [PMID: 34447091 PMCID: PMC8375885 DOI: 10.4103/jpbs.jpbs_730_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/28/2020] [Accepted: 11/28/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Conventional glass ionomer cement (CGIC) has many beneficial properties, but it has poor physical and mechanical properties. Therefore, new glass ionomer cement (GIC) is manufactured by adding zinc to improve the mechanical properties of GIC ChemFil Rock. This material possesses better flexural tensile strength and compressive strength in comparison to conventional to CGIC. Objectives: The aim of this study was to compare four properties of ZRGI like fracture toughness, surface micro-hardness, abrasive wear, and roughness to other GIC material, which are commercially available as: resin-coated glass ionomer (EQUIA FIL). Materials and Methods: The study was done in dual phase. In phase-1, micro-hardness surface roughness, abrasion of four GIC and a composite resin as control was analyzed and in phase-2, fracture toughness of four GIC was done at 24 h interval so that all cement achieve its peak strength. Results: Micro-hardness value of ChemFil Rock was lowest among different GIC groups. All four GIC group exhibit similar abrasion capacities, while composite were more wear-resistant significantly. Roughness change was highest on ChemFil Rock compared to other GIC. EQUIA FIL has the highest fracture toughness, followed by ChemFil Rock. Conclusion: We can conclude that incorporating zinc in the matrix of chemfil rock increases fracture toughness and good abrasive wear, but it does not improve micro-hardness or surface roughness.
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Affiliation(s)
- Amit Kumar
- Consultant Endodontist, Patna, Bihar, India
| | - Anil Raj
- Department of Public Health Dentistry, Sarjug Dental College and Hospital, Darbhanga, Bihar, India
| | | | | | - Manoj Kumar
- Department of Prothodontics and Implantology, Rama Dental College and Hospital, Kanpur, Uttar Pradesh, India
| | - Kumar Ramesh
- Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India
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15
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Zandi Karimi A, Rezabeigi E, Drew RAL. Aluminum-free glass ionomer cements containing 45S5 Bioglass ® and its bioglass-ceramic. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:76. [PMID: 34156576 PMCID: PMC8219554 DOI: 10.1007/s10856-021-06553-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
Although the incorporation of bioactive glasses into glass ionomer cements (GICs) has led to promising results, using a bioactive glass as the only solid component of GICs has never been investigated. In this study, we developed an Al-free GIC with standard compressive strength using various combinations of 45S5 Bioglass® and its glass-ceramic as the solid component. The glass-ceramic particles with 74% crystallinity were used for this purpose as they can best act as both remineralizing and reinforcing agents. Strengthening mechanisms including crack deflection and crack-tip shielding were activated for the GICs containing 50-50 wt% bioglass and bioglass-ceramic as the optimum ratio. The progression of the GIC setting reaction at its early stages was also monitored and verified. We also discussed that our bimodal particle size distribution containing both micron- and nanosized particles may enhance the packing density and integrity of the structure of the cements after setting. In such GICs produced in this study, the toxic effects of Al are avoided while chemical bonds are expected to form between the cement and the surrounding hard tissue(s) through interfacial biomineralization and adhesion.
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Affiliation(s)
- Alireza Zandi Karimi
- Department of Mechanical, Industrial and Aerospace Engineering, Concordia University, Montréal, QC, H3G 1M8, Canada.
| | - Ehsan Rezabeigi
- Department of Mining and Materials Engineering, McGill University, Wong Building, 3610 Rue University, Montréal, QC, H3A 0C5, Canada
| | - Robin A L Drew
- Department of Mechanical, Industrial and Aerospace Engineering, Concordia University, Montréal, QC, H3G 1M8, Canada
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16
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Huang Y, Song B, Zhou X, Chen H, Wang H, Cheng L. Dental Restorative Materials for Elderly Populations. Polymers (Basel) 2021; 13:polym13050828. [PMID: 33800358 PMCID: PMC7962827 DOI: 10.3390/polym13050828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 01/26/2023] Open
Abstract
The incidence of dental caries, especially root caries, has risen in elderly populations in recent years. Specialized restorative materials are needed due to the specific site of root caries and the age-related changes in general and oral health in the elderly. Unfortunately, the restorative materials commonly used clinically cannot fully meet the requirements in this population. Specifically, the antibacterial, adhesive, remineralization, mechanical, and anti-aging properties of the materials need to be significantly improved for dental caries in the elderly. This review mainly discusses the strengths and weaknesses of currently available materials, including amalgam, glass ionomer cement, and light-cured composite resin, for root caries. It also reviews the studies on novel anti-caries materials divided into three groups, antimicrobial, remineralization, and self-healing materials, and explores their potential in the clinical use for caries in the elderly. Therefore, specific restorative materials for caries in the elderly, especially for root caries, need to be further developed and applied in clinical practice.
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Affiliation(s)
- Yuyao Huang
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610064, China; (Y.H.); (B.S.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bingqing Song
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610064, China; (Y.H.); (B.S.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610064, China; (Y.H.); (B.S.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hui Chen
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China;
| | - Haohao Wang
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610064, China; (Y.H.); (B.S.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (H.W.); (L.C.)
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610064, China; (Y.H.); (B.S.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (H.W.); (L.C.)
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Effect of Nano-Filled Protective Coating and Different pH Enviroment on Wear Resistance of New Glass Hybrid Restorative Material. MATERIALS 2021; 14:ma14040755. [PMID: 33562810 PMCID: PMC7915405 DOI: 10.3390/ma14040755] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/22/2021] [Accepted: 01/28/2021] [Indexed: 01/14/2023]
Abstract
The purpose of the study was to determine the wear rate of Equia Forte HT Fil with Equia Forte Coat or without coating and compare it with Fuji IX GP high-viscosity glass ionomer cement (GIC) in conditions with acid load or at neutral pH. The samples were stored for 7 days: (1) in artificial saliva, (2) in artificial saliva and cyclically exposed to low pH, and (3) in distilled water and cyclically exposed to low pH. Wear was determined by measuring the difference in mass before and after brushing in an abrasion testing device. The wear of Fuji IX GP was significantly higher than that of Equia Forte HT Fil with or without coating (p = 0.000). The difference between Equia Forte HT Fil with and without Coat was not statistically significant (p < 0.803). The differences in wear resistance between samples stored in saliva and in distilled water were not significant (p = 0.588). Periodic exposure to the low pH solution significantly affected the wear resistance of all materials (p = 0.000). Equia Forte HT Fil was more resistant to wear than Fuji IX GP in all storage conditions. A resinous coat did not significantly increase wear resistance.
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Ribeiro CS, Perez MM, Benitez-Sellan PL, Guaré RDO, Bresciani E, Diniz MB. Initial Mechanical Stabilization of Conventional Glass Ionomer Cements with Different Active Principles. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Evaluation of the Flexural Strength, Water Sorption, and Solubility of a Glass Ionomer Dental Cement Modified Using Phytomedicine. MATERIALS 2020; 13:ma13235352. [PMID: 33255839 PMCID: PMC7728315 DOI: 10.3390/ma13235352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 11/16/2022]
Abstract
Objectives: Various medicinal plant parts and extracts have been proven to be sources of biologically active compounds, many of which have been incorporated in the production of new pharmaceutical compounds. Thus, the aim of this study was to increase the antimicrobial properties of a glass ionomer cement (GIC) through its modification with a mixture of plant extracts, which were evaluated along with a 0.5% chlorohexidine-modified GIC (CHX-GIC) with regard to the water sorption, solubility, and flexural strength. Methods: Salvadora persica, Olea europaea, and Ficus carcia leaves were prepared for extraction with ethyll alcohol using a Soxhlet extractor for 12 h. The plant extract mixture (PE) was added in three different concentrations to the water used for preparation of a conventional freeze-dried GIC (groups 1:1, 2:1, and 1:2). Specimens were then mixed according to the manufacturer’s instructions and tested against the unmodified GIC (control) and a GIC modified with 0.5% chlorhexidine. Water sorption and solubility were evaluated after 7 days of immersion in distilled water. Flexural strength was evaluated in a three-point bending test after 24 h using a universal material testing machine at a crosshead speed of 1 mm/min. One-way analysis of variance (ANOVA) was used for comparison between the groups. Tukey’s post hoc test was used for pairwise comparison when the ANOVA test was significant. Results: There were no statistically significant differences between the control (M = 20.5%), CHX-GIC (M = 19.6%), 1:1 (M = 20.0%), 1:2 (M = 19.5%), and 2:1 (19.7%) groups with regard to the percentage of water sorption, while for water solubility the 2:1 (M = −0.39%) plant-modified group was significantly different from all of the other groups. Flexural strength test results showed that the 2:1 group (M = 26.1 MPa) recorded significantly higher mean values compared to all other tested groups. Conclusion and clinical relevance: The plant extracts did not negatively affect the water sorption and solubility of the GIC, while the flexural strength was improved by the addition of the plant extract at higher concentrations.
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Zafar MS, Amin F, Fareed MA, Ghabbani H, Riaz S, Khurshid Z, Kumar N. Biomimetic Aspects of Restorative Dentistry Biomaterials. Biomimetics (Basel) 2020; 5:biomimetics5030034. [PMID: 32679703 PMCID: PMC7557867 DOI: 10.3390/biomimetics5030034] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 12/15/2022] Open
Abstract
Biomimetic has emerged as a multi-disciplinary science in several biomedical subjects in recent decades, including biomaterials and dentistry. In restorative dentistry, biomimetic approaches have been applied for a range of applications, such as restoring tooth defects using bioinspired peptides to achieve remineralization, bioactive and biomimetic biomaterials, and tissue engineering for regeneration. Advancements in the modern adhesive restorative materials, understanding of biomaterial–tissue interaction at the nano and microscale further enhanced the restorative materials’ properties (such as color, morphology, and strength) to mimic natural teeth. In addition, the tissue-engineering approaches resulted in regeneration of lost or damaged dental tissues mimicking their natural counterpart. The aim of the present article is to review various biomimetic approaches used to replace lost or damaged dental tissues using restorative biomaterials and tissue-engineering techniques. In addition, tooth structure, and various biomimetic properties of dental restorative materials and tissue-engineering scaffold materials, are discussed.
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Affiliation(s)
- Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia;
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
- Correspondence: ; Tel.: +966-14-8618888
| | - Faiza Amin
- Science of Dental Materials Department, Dow Dental College, Dow University of Health Sciences, Karachi 74200, Pakistan;
| | - Muhmmad Amber Fareed
- Adult Restorative Dentistry, Dental Biomaterials and Prosthodontics Oman Dental College, Muscat 116, Sultanate of Oman;
| | - Hani Ghabbani
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia;
| | - Samiya Riaz
- School of Dental Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudia Arabia;
| | - Naresh Kumar
- Department of Science of Dental Materials, Dow University of Health Sciences, Karachi 74200, Pakistan;
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Kantovitz KR, Fernandes FP, Feitosa IV, Lazzarini MO, Denucci GC, Gomes OP, Giovani PA, Moreira KMS, Pecorari VGA, Borges AFS, Nociti FH, Basting RT, Lisboa-Filho PN, Puppin-Rontani RM. TiO2 nanotubes improve physico-mechanical properties of glass ionomer cement. Dent Mater 2020; 36:e85-e92. [DOI: 10.1016/j.dental.2020.01.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 11/27/2019] [Accepted: 01/14/2020] [Indexed: 10/25/2022]
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Garoushi S, He J, Obradovic J, Fardim P, Vallittu PK, Lassila L. Incorporation of cellulose fiber in glass ionomer cement. Eur J Oral Sci 2020; 128:81-88. [DOI: 10.1111/eos.12668] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Sufyan Garoushi
- Department of Biomaterials Science Turku Clinical Biomaterials Center – TCBC Institute of Dentistry University of Turku Turku Finland
| | - Jingwei He
- Department of Biomaterials Science Turku Clinical Biomaterials Center – TCBC Institute of Dentistry University of Turku Turku Finland
- College of Materials Science and Engineering South China University of Technology Guangzhou China
| | - Jasmina Obradovic
- Department of Fibre and Cellulose Technology Åbo Akademi Turku Finland
| | - Pedro Fardim
- Department of Fibre and Cellulose Technology Åbo Akademi Turku Finland
- Department of Chemical Engineering KU Leuven Belgium
| | - Pekka K. Vallittu
- Department of Biomaterials Science Turku Clinical Biomaterials Center – TCBC Institute of Dentistry University of Turku Turku Finland
- City of Turku Welfare Division Oral Health Care Turku Finland
| | - Lippo Lassila
- Department of Biomaterials Science Turku Clinical Biomaterials Center – TCBC Institute of Dentistry University of Turku Turku Finland
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Brzović Rajić V, Ivanišević Malčić A, Bilge Kütük Z, Gurgan S, Jukić S, Miletić I. Compressive Strength of New Glass Ionomer Cement Technology based Restorative Materials after Thermocycling and Cyclic Loading. Acta Stomatol Croat 2019; 53:318-325. [PMID: 32099257 PMCID: PMC6993471 DOI: 10.15644/asc53/4/2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/01/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The objective of the study was to compare compressive strengths of two glass ionomer-based materials, with and without a light-cured, nano-filled coating, after cyclic loading and thermocycling. MATERIALS AND METHODS To determine compressive strength of new restorative materials over a longer period of time, materials were analysed under simulated conditions where cyclic loading replicated masticatory loading and thermocycling simulated thermal oscillations in the oral cavity. Four groups of samples (n=7)-(1) Equia Fil (GC, Tokyo, Japan) uncoated; (2) Equia Fil coated with Equia Coat (GC, Tokyo, Japan); (3) Equia Forte Fil (GC, Tokyo, Japan) uncoated; and (4) Equia Forte Fil coated with Equia Forte coat (GC, Tokyo, Japan)-were subjected to cyclic loading (240,000 cycles) using a chewing simulator (MOD, Esetron Smart Robotechnologies, Ankara, Turkey). RESULTS Compressive strength measurements were performed according to ISO 9917-1:2007, using the universal mechanical testing machine (Instron, Lloyd, UK). Scanning electron microscope (SEM) analysis was performed after thermocycling. There were no statistically significant differences between Equia Fil and Equia Forte Fil irrespective of the coating (p<0.05), but a trend of increasing compressive strength in the coated samples was observed. CONCLUSIONS Coating increases the compressive strength of Equia Fil and Equia Forte Fil, but not significantly.
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Affiliation(s)
- Valentina Brzović Rajić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Ana Ivanišević Malčić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Zeynep Bilge Kütük
- Department of Restorative Dentistry, School of Dentistry, Hacettepe University, Ankara 06100, Turkey
| | - Sevil Gurgan
- Department of Restorative Dentistry, School of Dentistry, Hacettepe University, Ankara 06100, Turkey
| | - Silvana Jukić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Ivana Miletić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
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Hironaka NGL, Trizzi JQ, Yoshida NM, Cury JA, Tabchoury CPM, Botelho JN, Pini NIP, Pascotto RC. Use of sonic waves in bubble formation, microhardness and fluoride release of a high-viscosity glass-ionomer cement. JOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY 2019; 10:e12456. [PMID: 31486299 DOI: 10.1111/jicd.12456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/04/2019] [Accepted: 08/04/2019] [Indexed: 06/10/2023]
Abstract
AIM High-viscosity glass-ionomer cements (HV-GIC) are indicated for restorations but their viscosity favors the inclusion of bubbles within it. This study aimed to evaluate the use of ultrasonic and sonic waves in bubble formation, microhardness and fluoride release in a HV-GIC, also considering a different powder:liquid ratio (P/L). METHODS Twenty-four molars with occlusal cavities were divided into four groups (N = 6): CG, HV-GIC with manual insertion; UG, application of ultrasonic waves; SG, application of sonic waves; and FG, HV-GIC fluid (1:2 P/L) with manual insertion. After 24 hours, bubbles and microhardness (50 g/5 s) were measured. Fluoride release (N = 10) was evaluated in CG, SG and UG after cariogenic challenge for 11 days. Microhardness, total area and number of bubbles, and fluoride release were submitted to ANOVA and Tukey's test. The average size of bubbles was analyzed by Kruskal-Wallis test (α = 5%). RESULTS FG presented the lowest value of microhardness and higher average size for bubbles (P < .05). Differences concerning total number, total area occupied by bubbles and fluoride release were not found (P > .05). CONCLUSION The use of sonic and ultrasonic waves had no influence on bubble formation, microhardness and fluoride release of a HV-GIC. Changing the P/L is not recommended.
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Affiliation(s)
| | | | | | - Jaime Aparecido Cury
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Juliana Nunes Botelho
- Cariology Unit, Department of Oral Rehabilitation, University of Talca, Talca, Chile
| | - Nubia Inocencya Pavesi Pini
- State University of Maringá, Maringá, Brazil
- Department of Restorative Dentistry, Ingá University Center, Uningá, Brazil
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El-Deeb HA, Mobarak EH. Microshear Bond Strength of High-viscosity Glass-ionomer to Normal and Caries-affected Dentin Under Simulated Intrapulpal Pressure. Oper Dent 2018; 43:665-673. [DOI: 10.2341/17-154-l] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
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).
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Affiliation(s)
- HA El-Deeb
- Heba Ahmed El-Deeb, associate professor, BDS, MDS, DDSc, Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - EH Mobarak
- Enas Hussein Mobarak, professor, BDS, MDS, DDSc, Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Physical property investigation of contemporary glass ionomer and resin-modified glass ionomer restorative materials. Clin Oral Investig 2018; 23:1295-1308. [PMID: 29998443 DOI: 10.1007/s00784-018-2554-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The objective of this study was to investigate selected physical properties of nine contemporary and recently marketed glass ionomer cement (GIC) and four resin-modified glass ionomer cement (RMGI) dental restorative materials. MATERIALS AND METHODS Specimens (n = 12) were fabricated for fracture toughness and flexure strength using standardized, stainless steel molds. Testing was completed on a universal testing machine until failure. Knoop hardness was obtained using failed fracture toughness specimens on a microhardness tester, while both flexural modulus and flexural toughness was obtained by analysis of the flexure strength results data. Testing was completed at 1 h, 24 h, 1 week, and then at 1, 3, 6, and 12 months. Mean data was analyzed with Kruskal-Wallis and Mann-Whitney (p = 0.05). RESULTS Physical properties results were material dependent. Physical properties of the GIC and RMGI products were inferior at 1 h compared to that at 24 h. Some improvement in selected physical properties were noted over time, but development processes were basically concluded by 24 h. A few materials demonstrated improved physical properties over the course of the evaluation. CONCLUSIONS Under the conditions of this study: 1. GIC and RMGI physical property performance over time was material dependent; 2. Polyalkenoate maturation processes are essentially complete by 24 h; 3. Although differences in GIC physical properties were noted, the small magnitude of the divergences may render such to be unlikely of clinical significance; 4. Modest increases in some GIC physical properties were noted especially flexural modulus and hardness, which lends support to reports of a maturing hydrogel matrix; 5. Overall, GIC product physical properties were more stable than RMGI; 6. A similar modulus reduction at 6 months for both RMGI and GIC produced may suggest a polyalkenoate matrix change; and 7. Globally, RMGI products demonstrated higher values of flexure strength, flexural toughness, and fracture toughness than GIC materials. CLINICAL RELEVANCE As compared to RMGI materials, conventional glass ionomer restorative materials demonstrate more stability in physical properties.
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ROCHA MFED, FUJIMAKI M, PASCOTTO RC, MENDES LLC, LACERDA CM, PEREIRA OC, WERNECK RI, TERADA RSS. Survival analysis of ART restorations in primary molars of preschool children: 1 year follow-up. REVISTA DE ODONTOLOGIA DA UNESP 2018. [DOI: 10.1590/1807-2577.03318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Among the minimally invasive approaches available today, the atraumatic restorative treatment (ART) has demonstrated promising results both in the primary and permanent dentition. Objective To evaluate the survival of Class I ART restorations in preschoolers with two Brazilian brands of glass ionomer cements (GIC) in comparison with a reference GIC. Material and method The cavities of 49 preschool children (three to five years) with carious lesions in the posterior teeth (N=81) were filled by two experienced pediatric dentists according to the ART technique. The Brazilian GICs Maxxion-R (MR) and Vitro-Fil LC (VF), and the reference GIC Ketac-Molar (KM) were placed in a randomly pre-established sequence. Restorations were evaluated after 6 and 12 months by another investigator. Scores 0 and 1 were considered successful, while scores 3-9 were classified as failures. Kaplan-Meier survival analysis and the log-rank test were performed (p<0.05). Result No statistically significant differences in survival rates of the tested GIC were observed after 12 months. Conclusion The clinical performance the low-cost Brazilian GICs MR and VF observed after 12 months suggests that they may be an alternative for Class I ART restorations to safeguard the natural exfoliation of primary teeth. However, until further studies involving a larger number of restorations and longer follow-up periods are conducted, reference GIC such as KM should continue to be the material of choice for ART restorations.
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Dionysopoulos D, Tolidis K, Tortopidis D, Gerasimou P, Sfeikos T. Effect of a calcium chloride solution treatment on physical and mechanical properties of glass ionomer cements. Odontology 2018; 106:429-438. [PMID: 29356913 DOI: 10.1007/s10266-018-0338-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 01/08/2018] [Indexed: 11/25/2022]
Abstract
This paper details a novel method to improve wear resistance of dental glass ionomer cement (GIC) restorations. The purpose of this in vitro study was to evaluate the effect of a calcium chloride (CaCl2) solution treatment on surface hardness, surface roughness, compressive strength, water sorption and solubility of three conventional glass ionomer cements (GICs). Additionally, the changes of the Ca composition and morphology of the surface of the tested GICs were also investigated. The experimental groups of the study were: Group 1 (control) specimens after mixing were left in the mold to set without any treatment for 5 min; Group 2 specimens were left in the mold to set for 5 min and then each specimen was immersed in 10 ml of 42.7 wt% CaCl2 solution for 60 s. Statistical analysis was performed using one-way ANOVA and Tukey post hoc tests (a = 0.05). Calcium chloride solution treatment increased surface hardness of the GICs compared to control groups (P < 0.05), while surface roughness and compressive strength did not change after the treatment (P > 0.05). Reduction in water sorption and solubility was detected but not in all CaCl2 solution-treatment groups. No alterations were observed in surface morphology of the GICs, while surface calcium composition was increased after the treatment (P < 0.05). The use of a CaCl2 solution immediately after initial setting of GICs may be advantageous for some properties of the materials and possibly leads to improved prognosis and wear resistance of their restorations.
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Affiliation(s)
- Dimitrios Dionysopoulos
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Kosmas Tolidis
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Dimitrios Tortopidis
- Department of Fixed Prostheses and Implant Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Paris Gerasimou
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Thrasyvoulos Sfeikos
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
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Freitas MCCDA, Fagundes TC, Modena KCDS, Cardia GS, Navarro MFDL. Randomized clinical trial of encapsulated and hand-mixed glass-ionomer ART restorations: one-year follow-up. J Appl Oral Sci 2018; 26:e20170129. [PMID: 29364343 PMCID: PMC5777411 DOI: 10.1590/1678-7757-2017-0129] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 08/01/2017] [Indexed: 11/22/2022] Open
Abstract
Objective This prospective, randomized, split-mouth clinical trial evaluated the clinical performance of conventional glass ionomer cement (GIC; Riva Self-Cure, SDI), supplied in capsules or in powder/liquid kits and placed in Class I cavities in permanent molars by the Atraumatic Restorative Treatment (ART) approach. Material and Methods A total of 80 restorations were randomly placed in 40 patients aged 11-15 years. Each patient received one restoration with each type of GIC. The restorations were evaluated after periods of 15 days (baseline), 6 months, and 1 year, according to ART criteria. Wilcoxon matched pairs, multivariate logistic regression, and Gehan-Wilcoxon tests were used for statistical analysis. Results Patients were evaluated after 15 days (n=40), 6 months (n=34), and 1 year (n=29). Encapsulated GICs showed significantly superior clinical performance compared with hand-mixed GICs at baseline (p=0.017), 6 months (p=0.001), and 1 year (p=0.026). For hand-mixed GIC, a statistically significant difference was only observed over the period of baseline to 1 year (p=0.001). Encapsulated GIC presented statistically significant differences for the following periods: 6 months to 1 year (p=0.028) and baseline to 1 year (p=0.002). Encapsulated GIC presented superior cumulative survival rate than hand-mixed GIC over one year. Importantly, both GICs exhibited decreased survival over time. Conclusions Encapsulated GIC promoted better ART performance, with an annual failure rate of 24%; in contrast, hand-mixed GIC demonstrated a failure rate of 42%.
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Affiliation(s)
| | - Ticiane Cestari Fagundes
- UNESP - Univ. Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, São Paulo, Brasil
| | | | | | - Maria Fidela de Lima Navarro
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, São Paulo, Brasil
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Faridi MA, Khabeer A, Haroon S. Flexural Strength of Glass Carbomer Cement and Conventional Glass Ionomer Cement Stored in Different Storage Media over Time. Med Princ Pract 2018; 27:372-377. [PMID: 29723852 PMCID: PMC6167643 DOI: 10.1159/000489781] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 05/03/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Glass ionomer cement (GIC) is routinely placed as a restorative material in dentistry. However, due to its poor physical properties, its use is limited to cases where the level of stress on restoration is minimal. Improved formulations of GIC have been developed to overcome these drawbacks. The purpose of this study was to evaluate flexural strength of a conventional GIC (Fuji IX) against a newly developed glass carbomer cement (GCP). MATERIALS AND METHODS For Fuji IX and GCP, a total of 80 blocks were prepared and divided into 16 groups (n = 5). These groups were further categorized according to the storage medium (artificial saliva and Vaseline) and time intervals (24 h and 1, 2, and 4 weeks). A 3-point bending test was carried out, and statistical analysis was done using ANOVA and Tukey post hoc tests. RESULTS Fuji IX showed a mean flexural strength of 25.14 ± 13.02 versus 24.27 ± 12.57 MPa for GCP. There was no significant statistical difference between both materials when compared under storage media. Both materials showed the highest value for flexural strength at 2 weeks of storage and lowest at 4 weeks. CONCLUSION The storage media do not affect the flexural strength of the specimens with reference to time. Time is the unique factor with relative influence on mean resistance to fracture. Further testing is required to evaluate the true potential of the newly developed GCP.
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Affiliation(s)
- Muhammad Ali Faridi
- Department of Prosthodontics, Islamabad Medical and Dental College, Islamabad, Pakistan
| | - Abdul Khabeer
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- *Abdul Khabeer, College of Dentistry, Imam Abdulrahman Bin Faisal University, Room 3038, Dammam 31441 (Saudi Arabia), E-Mail
| | - Saad Haroon
- Department of Restorative Dentistry, Lolwa Al-Mohannadi Medical Center, Al Khor, Qatar
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Abstract
Introdução: Em âmbito odontológico ocorrem ações preventivas na tentativa de se evitar a instalação de cáries, doença que tem prevalência aumentada na população e que constitui um problema de Saúde Pública. Alguns recursos são empregados para tal, como: realização de diagnóstico precoce e a opção por tratamentos conservadores de mínima intervenção. O cimento de ionômero de vidro (CIV), advindo das suas características benéficas que vão de encontro às tendências atuais, mostra-se intimamente relacionado aos preceitos da Odontologia Preventiva e Minimamente Invasiva e as novas técnicas conservadoras preconizadas. Objetivo: O objetivo do presente artigo foi por intermédio da realização de um estudo de revisão de literatura, averiguar as características do CIV que detém papel de destaque no perfil da Odontologia Minimamente Invasiva. Resultados: O cirurgião dentista deve conscientizar-se da classificação, conforme sua composição e natureza físico-química: ionômeros convencionais; ionômeros reforçados por metais; de alta viscosidade e vários tipos de ionômeros de vidro modificados por resina para que escolha corretamente o CIV que será utilizado em suas intervenções clínicas, o que deve ocorrer baseado nas propriedades do material e em sua indicação clínica. Conclusão: Concluiu-se que a efetivação de técnicas preventivas com o CIV na assistência à saúde pública, tendem a minimizar os tratamentos curativos, valorizando concomitantemente os procedimentos odontológicos de baixa complexidade realizados na Atenção Básica, evitando os encaminhamentos para tratamento de casos de maior complexidade a nível da atenção secundária e terciária, economizando recursos.
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El-Wassefy NA, El-Mahdy RH, El-Kholany NR. The impact of silver nanoparticles integration on biofilm formation and mechanical properties of glass ionomer cement. J ESTHET RESTOR DENT 2017; 30:146-152. [DOI: 10.1111/jerd.12353] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/08/2017] [Accepted: 11/14/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Noha A. El-Wassefy
- Dental Biomaterials Department, Faculty of Dentistry; Mansoura University; Mansoura Egypt
| | - Rasha H. El-Mahdy
- Microbiology and Immunology Department, Faculty of Medicine; Mansoura University; Mansoura Egypt
| | - Naglaa R. El-Kholany
- Operative Dentistry Department; Faculty of Dentistry, Mansoura University; Mansoura Egypt
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Souza JCM, Silva JB, Aladim A, Carvalho O, Nascimento RM, Silva FS, Martinelli AE, Henriques B. Effect of Zirconia and Alumina Fillers on the Microstructure and Mechanical Strength of Dental Glass Ionomer Cements. Open Dent J 2016; 10:58-68. [PMID: 27053969 PMCID: PMC4797684 DOI: 10.2174/1874210601610010058] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 11/05/2015] [Accepted: 11/06/2015] [Indexed: 11/22/2022] Open
Abstract
Background: Glass-ionomer cements perform a protective effect on the dentin-pulp complex considering the F ions release and chemical bonding to the dental structures. On the other hand, those materials have poor physic-mechanical properties in comparison with the restorative resin composite. The main aim of this work was to evaluate the influence of zirconia and/or alumina fillers on the microstructure and strength of a resin modified glass-ionomer cement after thermal cycling. Methods: An in vitro experimental study was carried out on 9
groups (n = 10) of cylindrical samples (6 x 4 mm) made from resin
modified glass-ionomer (Vitremer, 3M, USA) with different contents of alumina
and/or zirconia fillers. A nano-hybrid resin composite was tested as a control
group. Samples were mechanically characterized by axial compressive tests and
electron scanning microscopy (SEM) coupled to energy dispersive X-ray
spectrophotometry (EDS), before and after thermal cycling. Thermal cycling
procedures were performed at 3000, 6000 and 10000 cycles in Fusayama´s
artificial saliva at 5 and 60 oC. Results: An improvement of compressive strength was noticed on glass-ionomer reinforced with alumina fillers in comparison with the commercial glass ionomer. SEM images revealed the morphology and distribution of alumina or zirconia in the microstructure of glass-ionomers. Also, defects such as cracks and pores were detected on the glass-ionomer cements. The materials tested were not affected by thermal cycling in artificial saliva. Conclusion: Addition of inorganic particles at nano-scale such as alumina can increase the mechanical properties of glass-ionomer cements. However, the presence of cracks and pores present in glass-ionomer can negatively affect the mechanical properties of the material because they are areas of stress concentration.
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Affiliation(s)
- Júlio C M Souza
- Center for Microelectromechanical Systems (CMEMS)-Uminho, Universidade do Minho, P-4800-058, Guimarães, Portugal; Post-Graduation Program in Dentistry (PPGO), Edif. CCS, School of Dentistry, Universidade Federal de Santa Catarina (UFSC), 88040-900, Florianópolis/SC, Brazil
| | - Joel B Silva
- School of Dentistry, School of Health Sciences (FCS), Universidade Fernando Pessoa (UFP), Porto, Portugal
| | - Andrea Aladim
- Department of Materials Engineering, Universidade Federal do Rio Grande do Norte (UFRN), 59072-970, Natal/RN, Brazil
| | - Oscar Carvalho
- Center for Microelectromechanical Systems (CMEMS)-Uminho, Universidade do Minho, P-4800-058, Guimarães, Portugal
| | - Rubens M Nascimento
- Post-Graduation Program in Dentistry (PPGO), Edif. CCS, School of Dentistry, Universidade Federal de Santa Catarina (UFSC), 88040-900, Florianópolis/SC, Brazil
| | - Filipe S Silva
- Center for Microelectromechanical Systems (CMEMS)-Uminho, Universidade do Minho, P-4800-058, Guimarães, Portugal
| | - Antonio E Martinelli
- Department of Materials Engineering, Universidade Federal do Rio Grande do Norte (UFRN), 59072-970, Natal/RN, Brazil
| | - Bruno Henriques
- Center for Microelectromechanical Systems (CMEMS)-Uminho, Universidade do Minho, P-4800-058, Guimarães, Portugal; Post-Graduation Program in Dentistry (PPGO), Edif. CCS, School of Dentistry, Universidade Federal de Santa Catarina (UFSC), 88040-900, Florianópolis/SC, Brazil; Ceramic and Composite Materials Research Group (CERMAT), Universidade Federal de Santa Catarina (UFSC), Campus Trindade, Florianópolis/SC, Brazil
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CALVO AFB, KICUTI A, TEDESCO TK, BRAGA MM, RAGGIO DP. Evaluation of the relationship between the cost and properties of glass ionomer cements indicated for atraumatic restorative treatment. Braz Oral Res 2016; 30:S1806-83242016000100201. [DOI: 10.1590/1807-3107bor-2016.vol30.0008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 05/27/2015] [Indexed: 11/22/2022] Open
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Hesse D, Bonifácio CC, Guglielmi CDAB, Franca CD, Mendes FM, Raggio DP. Low-cost glass ionomer cement as ART sealant in permanent molars: a randomized clinical trial. Braz Oral Res 2015; 29:S1806-83242015000100261. [PMID: 26039906 DOI: 10.1590/1807-3107bor-2015.vol29.0063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 01/02/2015] [Indexed: 11/22/2022] Open
Abstract
Clinical trials are normally performed with well-known brands of glass ionomer cement (GIC), but the cost of these materials is high for public healthcare in less-affluent communities. Given the need to research cheaper materials, it seems pertinent to investigate the retention rate of a low-cost GIC applied as atraumatic restorative treatment (ART) sealants in two centers in Brazil. Four hundred and thirty-seven 6-to-8-year-old schoolchildren were selected in two cities in Brazil. The children were randomly divided into two groups, according to the tested GIC applied in the first permanent molars. The retention rate was evaluated after 3, 6 and 12 months. Kaplan-Meier survival analysis and the log-rank test were performed. The variables were tested for association with sealant longevity, using logistic regression analyses (α = 5%). The retention rate of sealants after 12 months was 19.1%. The high-cost GIC brand presented a 2-fold-more-likely-to-survive rate than the low-cost brand (p < 0.001). Significant difference was also found between the cities where the treatments were performed, in that Barueri presented a higher sealant survival rate than Recife (p < 0.001). The retention rate of a low-cost GIC sealant brand was markedly lower than that of a well-known GIC sealant brand.
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Affiliation(s)
- Daniela Hesse
- Orthodontics and Pediatric Dentistry Department, Dental School, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Clarissa Calil Bonifácio
- Department of Conservative Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | | | - Carolina da Franca
- Department of Social Dentistry, Dental School, Universidade de Pernambuco, Recife, PE, Brazil
| | - Fausto Medeiros Mendes
- Orthodontics and Pediatric Dentistry Department, Dental School, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Daniela Prócida Raggio
- Orthodontics and Pediatric Dentistry Department, Dental School, Universidade de São Paulo, São Paulo, SP, Brazil
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Rodrigues DS, Buciumeanu M, Martinelli AE, Nascimento RM, Henriques B, Silva FS, Souza JCM. Mechanical Strength and Wear of Dental Glass-Ionomer and Resin Composites Affected by Porosity and Chemical Composition. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s40735-015-0025-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Baig MS, Dowling AH, Cao X, Fleming GJ. A discriminatory mechanical testing performance indicator protocol for hand-mixed glass-ionomer restoratives. Dent Mater 2015; 31:273-83. [DOI: 10.1016/j.dental.2014.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 11/19/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
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Kiri L, Boyd D. Predicting composition-property relationships for glass ionomer cements: a multifactor central composite approach to material optimization. J Mech Behav Biomed Mater 2015; 46:285-91. [PMID: 25828159 DOI: 10.1016/j.jmbbm.2015.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 02/06/2015] [Accepted: 02/09/2015] [Indexed: 11/29/2022]
Abstract
Adjusting powder-liquid ratio (P/L) and polyacrylic acid concentration (AC) has been documented as a means of tailoring the handling and mechanical properties of glass ionomer cements (GICs). This work implemented a novel approach in which the interactive effects of these two factors on three key GIC properties (working time, setting time, and compressive strength) were investigated using a central composite design of experiments. Using nonlinear regression analysis, formulation-property relationships were derived for each property, which enabled prediction of an optimal formulation (P/L and AC) through application of the desirability approach. A novel aluminum free GIC was investigated, as this material may present the first clinically viable GIC for use in injectable spinal applications, such as vertebroplasty. Ultimately, this study presents the first series of predictive regression models that explain the formulation-dependence of a GIC, and the first statistical method for optimizing both P/L and AC depending on user-defined inputs.
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Affiliation(s)
- Lauren Kiri
- Department of Applied Oral Sciences, Dalhousie University, 5981 University Avenue, Halifax, NS, Canada B3H 4R2.
| | - Daniel Boyd
- Department of Applied Oral Sciences, Dalhousie University, 5981 University Avenue, Halifax, NS, Canada B3H 4R2; School of Biomedical Engineering, Dalhousie University, 5981 University Avenue, Halifax, NS, Canada B3H 4R2.
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Korolenkova MV. [Microinvasive dental treatment in pre-school children]. STOMATOLOGII︠A︡ 2015; 94:91-94. [PMID: 26343410 DOI: 10.17116/stomat201594491-94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of the study was to assess the efficiency of atraumatic restorative treatment (ART) with cavity preparation by means of dental endo motor. ART method was applied in 94 children (50 females and 44 males, 301 teeth treated) aged 21-96 months. Wireless dental endo motor (Endo Mate TC2, NSK, Japan) was used for cavity preparation. The cavities (102 (33.9%) class I, 156 (51.8%) class V, 20 (6.6%) class II, 18 (6%) class III and 5 (1.7%) class IV) were then filled with glass-ionomer cement (Fuji IX, GC, Japan). Success rate was assessed 3, 6, 12 and 18 months after treatment. Overall ART procedure success rate (good marginal fit, no occlusal wearing or restoration fractures) at 18-month follow up was 88.7% (267 fillings out of 301) with the highest survival in class I (96.1%) and class V (96.2%) restoration and poorest in class II (50%), class III (44.4%) and class IV (20%) restorations. Cavity preparation with wireless dental endo motor was well tolerated even by infants (12 children were younger than 24 months), as it is noiseless and significantly faster than conventional manual preparation. ART method with the use of dental endo motor showed good success rate and proved to be highly efficient in small and apprehensive children. The method, however, should be avoided in class III and IV cavities as the success rate is poor mostly because of restoration fractures.
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Affiliation(s)
- M V Korolenkova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Ministry of Health of Russia, Moscow, Russia
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Shiozawa M, Takahashi H, Iwasaki N, Wada T, Uo M. Effect of immersion time of restorative glass ionomer cements and immersion duration in calcium chloride solution on surface hardness. Dent Mater 2014; 30:e377-83. [PMID: 25193782 DOI: 10.1016/j.dental.2014.08.366] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 03/25/2014] [Accepted: 08/08/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate the effect of immersion time of restorative glass ionomer cements (GICs) and immersion duration in calcium chloride (CaCl2) solution on the surface hardness. METHODS Two high-viscosity GICs, Fuji IX GP and GlasIonomer FX-II, were selected. Forty-eight specimens were randomly divided into two groups. Sixty minutes after being mixed, half of them were immersed in a 42.7wt% CaCl2 solution for 10, 30, or 60min (Group 1); the remaining specimens were immersed after an additional 1-week of storage (Group 2). The surface hardness of the specimens was measured and analyzed with two-way ANOVA and the Tukey HSD test (α=0.05). The surface compositions were examined using energy-dispersive X-ray spectroscopy and X-ray photoelectron spectroscopy. RESULTS The surface hardness of Group 1 significantly increased as the immersion duration in CaCl2 increased; that of Group 2 significantly increased only after 60-minute CaCl2 immersion. After CaCl2 immersion, the amounts of Ca increased as the immersion duration increased. The surface hardness after CaCl2 immersion significantly correlated with the amount of Ca in Group 1, but not in Group 2. The binding energy of the Ca2p peak was similar to that of calcium polyalkenoate. These findings indicated that the Ca ions from the CaCl2 solution created chemical bonds with the carboxylic acid groups in the cement matrix. SIGNIFICANCE Immersion of GICs in CaCl2 solution at the early stage of setting was considered to enhance the formation of the polyacid salt matrix; as a result, the surface hardness increased.
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Affiliation(s)
- Maho Shiozawa
- Removable Partial Prosthodontics, Department of Masticatory Function Rehabilitation, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hidekazu Takahashi
- Oral Biomaterials Engineering, Course of Oral Health Engineering, School of Oral Health Care Sciences, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Naohiko Iwasaki
- Oral Biomaterials Engineering, Course of Oral Health Engineering, School of Oral Health Care Sciences, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiro Wada
- Advanced Biomaterials, Department of Restorative Sciences, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motohiro Uo
- Advanced Biomaterials, Department of Restorative Sciences, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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S. Al-Angari S, T. Hara A, Chu TM, Platt J, Eckert G, Cook NB. Physicomechanical properties of a zinc-reinforced glass ionomer restorative material. J Oral Sci 2014; 56:11-6. [DOI: 10.2334/josnusd.56.11] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Molina GF, Cabral RJ, Mazzola I, Lascano LB, Frencken JE. Mechanical performance of encapsulated restorative glass-ionomer cements for use with Atraumatic Restorative Treatment (ART). J Appl Oral Sci 2013; 21:243-9. [PMID: 23857657 PMCID: PMC3881905 DOI: 10.1590/1679-775720130129] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 04/09/2013] [Indexed: 12/02/2022] Open
Abstract
The Atraumatic Restorative Treatment (ART) approach was suggested to be a suitable
method to treat enamel and dentine carious lesions in patients with disabilities. The
use of a restorative glass-ionomer with optimal mechanical properties is, therefore,
very important.
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Affiliation(s)
- Gustavo Fabián Molina
- Department of Dental Materials, School of Dentistry, National University of Córdoba, Córdoba, Argentina.
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Mechanical behavior of a bi-layer glass ionomer. Dent Mater 2013; 29:1020-5. [DOI: 10.1016/j.dental.2013.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 05/21/2013] [Accepted: 07/03/2013] [Indexed: 11/17/2022]
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Bonifácio CC, Hesse D, Raggio DP, Bönecker M, van Loveren C, van Amerongen WE. The effect of GIC-brand on the survival rate of proximal-ART restorations. Int J Paediatr Dent 2013; 23:251-8. [PMID: 22891625 DOI: 10.1111/j.1365-263x.2012.01259.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Laboratory studies show diverse behaviour of different brands of glass-ionomer cements (GIC). AIM This study investigated the clinical performance [survival rate (SR)] of three GIC brands applied to proximal atraumatic restorative treatment (ART) restorations. Additionally, the SR of the tooth was evaluated. DESIGN Proximal cavities of 262 primary molars were restored. The patients had been randomly allocated to two operators and three GIC brands: Fuji IX, Hi-Dense, and Maxxion R. Restorations were evaluated after 1, 6, 12, 18, 24, 30, and 36 months. Failed restorations were, if possible, repaired or replaced. Linear regression analyses were used to evaluate the effect of GIC brand, operator, and surface of restoration. Kaplan-Meier survival analysis and log-rank test were performed for both restoration survival and tooth survival (α = 5%). RESULTS After 3 years, 82.4% of the restorations were evaluated. The SR of the restorations was 24.4%, and there was no difference among GIC brands (log-rank test, P = 0.6). In the first 18 months, a significant operator effect and significantly higher failures in distal surfaces were found. The SR of the tooth was 81.7%. CONCLUSIONS The SR of proximal ART restorations was relatively low when compared with the SR of the tooth. There are no differences in the performance among the GIC brands used in the study.
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Affiliation(s)
- Clarissa Calil Bonifácio
- Departament of Conservative and Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
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Menne-Happ U, Ilie N. Effect of heat application on the mechanical behaviour of glass ionomer cements. Clin Oral Investig 2013; 18:643-50. [DOI: 10.1007/s00784-013-1005-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 05/22/2013] [Indexed: 11/29/2022]
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Bonifácio CC, Hesse D, Bönecker M, Van Loveren C, Van Amerongen WE, Raggio DP. A preliminary clinical trial using flowable glass-ionomer cement as a liner in proximal-ART restorations: the operator effect. Med Oral Patol Oral Cir Bucal 2013; 18:e529-32. [PMID: 23524424 PMCID: PMC3668884 DOI: 10.4317/medoral.18497] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 12/14/2012] [Indexed: 12/05/2022] Open
Abstract
Objectives: This in vivo study was carried out to assess the influence of the operator experience on the survival rate of proximal-ART restorations using a two-layer technique to insert the glass-ionomer cement (GIC).
Study Design: Forty five proximal cavities in primary molars were restored in a school setting according to the ART technique. The cavities were restored by two operators with Ketac Molar Easymix, and received a flowable layer of GIC prior to a second GIC layer with a regular consistency. The operators had different clinical experiences with ART (no experience or two years of experience), but both completed a one-week training to perform the restorations and the GIC mixing in this study.
Results: After a 12-month follow-up, 74% of the restorations survived; the main reason for failure was bulk fracture or total loss of the restoration.There was no operator influence (log-rank test p=0.2)
Conclusion: The results encourage future well designed controlled clinical trials using the two-layer technique for insertion of GIC in proximal-ART restorations, after training the operators.
Key words:Atraumatic Restorative Treatment (ART), Glass-ionomer, proximal restorations.
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Affiliation(s)
- Clarissa-Calil Bonifácio
- Department of Conservative and Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan, 3004, 1081LA Amsterdam, The Netherlands.
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de Amorim RG, Leal SC, Mulder J, Creugers NHJ, Frencken JE. Amalgam and ART restorations in children: a controlled clinical trial. Clin Oral Investig 2013; 18:117-24. [DOI: 10.1007/s00784-013-0955-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 02/14/2013] [Indexed: 10/27/2022]
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SHIOZAWA M, TAKAHASHI H, IWASAKI N, UO M. Effect of calcium chloride solution immersion on surface hardness of restorative glass ionomer cements. Dent Mater J 2013; 32:828-33. [DOI: 10.4012/dmj.2013-143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
OBJECTIVES The objective of this study was to investigate the effect of a nanofilled resin coat on the flexural strength (FS) and the early wear (after 50,000 and 200,000 cycles) of the glass-ionomer cements Fuji IX GP Extra (FIXE) and Ketac Molar Aplicap (KM). MATERIALS AND METHODS Specimens were prepared and half of them were coated with G-Coat plus. The uncoated specimens were used as controls. Flexural strength (n = 10) was evaluated after 24 h using a 3-point bending test on a universal testing machine (ISO 9917-2). Wear (n = 20) was evaluated after 50,000 and 200,000 cycles using the ACTA wear machine. One-way, two-way ANOVA and Tukey post-hoc tests were used to analyze differences in FS and wear. RESULTS For FIXE the coat significantly increased the FS and the wear along the two time spans. KM did not show a significant difference in FS with the coat. Improvements in wear were observed only after 50,000 cycles. CONCLUSION Based on these laboratory results, it is concluded that G-coat Plus is indicated in association with GP IX Extra with the aim to improve the mechanical properties of the former. However, this study is limited to a short-term observation.
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Affiliation(s)
- Clarissa Calil Bonifácio
- Department of Cariology, Endodontology and Pedodontology, Academic Center for Dentistry Amsterdam, The Netherlands.
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Binus S, Koch A, Petschelt A, Berthold C. Restoration of endodontically treated teeth with major hard tissue loss--bond strength of conventionally and adhesively luted fiber-reinforced composite posts. Dent Traumatol 2012; 29:339-54. [PMID: 23171162 DOI: 10.1111/edt.12013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2012] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the influence of the luting system on the pull-out bond strength of conventionally and adhesively luted fiber-reinforced composite posts (FRCPs). MATERIAL AND METHODS One hundred extracted bovine teeth (Di 3) were endodontically treated and randomly assigned to nine test groups and one control group (n = 10) according to luting system. After preparing the post cavities (8 mm), the custom-made FRCPs were inserted using conventional glass-ionomer cement (Ketac Cem), resin-reinforced glass-ionomer cement (Meron Plus and Fuji Plus), self-adhesive resin cement (RelyX Unicem and BisCem), self-conditioning adhesive and resin cement [Multilink Primer + Multilink and AdheSE + DC Activator + MultiCore Flow, or etch-and-rinse adhesive and resin cement (SealBond Ultima + CoreCem, and LuxaBond + LuxaCore Z). As a control, custom-made titanium posts were inserted with Ketac Cem. After water storage (37°C, 24 h, dark), the pull-out test was performed, followed by failure mode evaluation. The data were statistically analyzed (α = 0.05) using analysis of variance and the Dunnett T3 post hoc test. RESULTS Luting system type and identity significantly influenced bond strength (P < 0.001); the bond strengths of all luting systems except Ketac Cem, MeronPlus, and BisCem were significantly higher than the control (4.4 ± 1.1 MPa). RelyX Unicem (12.0 ± 3.0 MPa) and LB + LCZ (14.8 ± 2.3 MPa) generated the highest bond strengths. The clinical application was demonstrated by restoring a traumatized tooth with extensive coronal destruction and thin root canal walls, using a FRCP combined with direct composite build-up. CONCLUSION Luting system selection significantly influenced the bond strength of conventionally and adhesively luted FRCPs to bovine root canal dentin.
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Affiliation(s)
- Stefanie Binus
- Dental Clinic 1 - Operative Dentistry and Periodontology, Friedrich-Alexander-University, Erlangen, Germany
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