Fluoride-containing restorative materials

A comparative evaluation of fluoride release and rechargeability in conventional GIC (type II), pediatric GIC (type IX), and Cention-N: an in vitro study

PURPOSE

A comparative evaluation of fluoride release and re-chargeability in conventional glass ionomer cement (GIC) (type II), Pediatric GIC (type IX), and Cention-N-an in vitro study at an interval of first, fourteenth, and twenty first days.

METHODS

Three groups of test materials, each with twenty samples, were prepared. Measurements of the cumulative fluoride release [parts per million (ppm)] and re-release measured on the first, fourteenth, and twenty first days. Analysis of variance (ANOVA) was used to compare the means for different readings, and Tukey's post hoc analysis was used to compare each group with each other.

RESULTS

Initial and subsequent fluoride release of Cention-N at days one, fourteen, and twenty-one were all noticeably higher than those of conventional and pediatric GIC.

CONCLUSION

Compared to the Conventional and Pediatric GIC restorative materials, Cention-N was more effective in the initial and fluoride re-release.

The effect of three dental cement types on the corrosion of dental implant surfaces

Statement of problem

One of the main challenges facing dental implant success is peri-implantitis. Recent evidence indicates that titanium (Ti) corrosion products and undetected-residual cement are potential risk factors for peri-implantitis. The literature on the impact of various types of dental cement on Ti corrosion is very limited.

Purpose

This study aimed to determine the influence of dental cement on Ti corrosion as a function of cement amount and type.

Materials and methods

Thirty commercially pure Ti grade 4 discs (19 × 7mm) were polished to mirror-shine (Ra ≈ 40 nm). Samples were divided into 10 groups (n = 3) as a cement type and amount function. The groups were no-cement as control, TempBond NE (TB3mm, TB5mm, and TB8mm), FujiCEM-II (FC3mm, FC5mm, and FC8mm), and Panavia-F-2.0 (PC3mm, PC5mm, and PC8mm). Tafel's method estimated corrosion rate (icorr) and corresponding potential (Ecorr) from potentiodynamic curves. Electrochemical Impedance Spectroscopy (EIS) data was utilized to obtain Nyquist and Bode plots. An equivalent electrical circuit estimated polarization resistance (Rp) and double-layer capacitance (Cdl). Inductively coupled plasma mass spectrometry (ICP-MS) analysis was conducted to analyze the electrolyte solution after corrosion. pH measurements of the electrolyte were recorded before and after corrosion tests. Finally, the corroded surface was characterized by a 3D white-light microscope and scanning electron microscope. Statistical analysis was conducted using either one-way ANOVA followed by Tukey's Post Hoc test or Kruskal-Wallis followed by Dunn's test based on data distribution.

Results

Based on cement amount, FC and PC significantly increased icorr in higher amounts (FC8mm-icorr = 8.22 × 10-8A/cm2, PC8mm-icorr = 5.61 × 10-8A/cm2) compared to control (3.35 × 10-8A/cm2). In contrast, TB3mm decreased icorr significantly compared to the control. As a function of cement type, FC increased icorr the most. EIS data agrees with these observations. Finally, corroded surfaces had higher surface roughness (Ra) compared to non-corroded surfaces.

Conclusion

The study indicated that cement types FC and PC led to increased Ti-corrosion as a function of a higher amount. Hence, the implant stability could be impacted by the selection, excessive cement, and a potentially increased risk of peri-implantitis.

Retrospective Clinical Evaluation of RMGIC/GIC Class V Restorations

The aim of this retrospective study was to evaluate the clinical performance of glass-ionomer cement (GIC) and resin-modified glass-ionomer cement (RMGIC) materials in Class V carious cervical lesions restored by dental students. Ninety-six (96) restorations performed with either GIC (Fuji IX) (n = 39) or RMGIC (Fuji II LC) (n = 57) were evaluated using the modified USPHS criteria by two independent investigators at two follow-up evaluations (two years apart). The Fisher statistical test was used to compare USPHS criteria and examine significant differences, with a significance level set at p < 0.05. The Kaplan-Meier algorithm was used to calculate the survival probability. The overall success rate of Class V restorations was 72.9% at the second follow-up evaluation, with restorations ranging in age from 2.5 to 3.5 years. The RMGIC (Fuji II LC) restorations exhibited a significantly higher overall success rate compared to the GIC (Fuji IX) restorations (p = 0.0104). Significant differences were observed in retention (p = 0.0034) and color match (p = 0.0023).

Dental Restorations

Fulfilling a patient's request for a healthy, functional and esthetic smile represents a daily challenge for dental practitioners [...].

Novel bioactive dental restorations to inhibit secondary caries in enamel and dentin under oral biofilms

OBJECTIVE

To provide the first review on cutting-edge research on the development of new bioactive restorations to inhibit secondary caries in enamel and dentin under biofilms. State-of-the-art bioactive and therapeutic materials design, structure-property relationships, performance and efficacies in oral biofilm models.

DATA, SOURCES AND STUDY SELECTION

Researches on development and assessment new secondary caries inhibition restorations via in vitro and in vivo biofilm-based secondary caries models were included. The search of articles was carried out in Web of Science, PubMed, Medline and Scopus.

CONCLUSIONS

Based on the found articles, novel bioactive materials are divided into different categories according to their remineralization and antibacterial biofunctions. In vitro and in vivo biofilm-based secondary caries models are effective way of evaluating the materials efficacies. However, new intelligent and pH-responsive materials were still urgent need. And the materials evaluation should be performed via more clinical relevant biofilm-based secondary caries models.

CLINICAL SIGNIFICANCE

Secondary caries is a primary reason for dental restoration failures. Biofilms produce acids, causing demineralization and secondary caries. To inhibit dental caries and improve the health and quality of life for millions of people, it is necessary to summarize the present state of technologies and new advances in dental biomaterials for preventing secondary caries and protecting tooth structures against oral biofilm attacks. In addition, suggestions for future studies are provided.

Synthesis and characterization of luminescent Cu2+-doped fluorapatite nanocrystals as potential broad-spectrum antimicrobial agents

Nanomaterials based on metal-doped fluorapatite (FAP) have attracted considerable interest as potential next-generation antimicrobial agents. In this study, Cu²⁺-doped FAP nanocrystals have been successfully synthesized by a neutralization method at room temperature. Their structural, optical, antimicrobial, and hemcompatible properties have been investigated. XRD, FTIR, FESEM, and N₂ adsorption-desorption studies indicate the formation of single-phase FAP mesoporous nanopowders, composed of rod-like particles. TEM images confirmed the formation of nanorodes with a length of 60 nm and a width of about 18 nm. Rietveld analysis shows that the Cu²⁺ ions preferentially substitute Ca2 (6 h) sites in the hexagonal fluorapatite crystal structure. Fluorescence spectroscopy accompanied by MCR-ALS method confirms substitution of Cu²⁺ ions in FAP crystal lattice with extracting additional d-d band transition at green color from FAP broadband self-activated luminescence in violet-blue color. Antimicrobial studies conducted on Staphylococcus aureus, Escherichia coli and Micrococcus lysodeikticus showed that FAP nanopowder with the highest Cu²⁺ content have strong bacteriostatic action on Staphylococcus aureus bacterial strain in mediums containing nutrition matters. In addition, this sample in comparison to pure FAP achieved a high percentage of relative reduction of bacterial population for all three species, being >90% in most cases. Fungistatic action is noticed too, throwgh the slowing down mycelium growth of fungus Aspergillus niger, Aspergillus flavus and Penicillium roqueforti and reduction of sporulation of Aspergillus niger species. Cu²⁺-doped FAP nanocrystals shows a synergistic antimicrobial effect with Cu²⁺ and F^- ions. Concerning the potential biomedical applications, the hemolysis ratios of the Cu²⁺-doped FAP samples were below 5%. The obtained results pointed out the possible use of the synthesized nanocrystals as broad-spectrum antimicrobial agents for various biomedical and health care preparations.

Novel Dental Restorative Solutions for Natural Teeth and Implants

The long-term survival of restorations in the oral cavity has always been one of the most significant challenges in modern dental practice [...].

Comparative Evaluation of Bond Strength and Microleakage of Three Ion-Releasing Restorative Materials at Various pH Levels

The aim of this study was a comparison of the micro-tensile bond strength (μTBS) to dentin and microleakage of in vitro class V restorations of three different ion-releasing restorative materials under various pH conditions: giomer, a resin-modified glass ionomer (RMGI), and a new alkasite material. A μTBS test was performed using a universal testing machine, immediately and after storage at different pH (4, 7, and 10) buffer solutions (n = 15) over 24 h, and the failure mode was analyzed. For microleakage analysis, class V restorations were performed on extracted premolars, which were sectioned and stored in pH 4-, 7-, and 10-buffered fluorescent 0.02% rhodamine B dye. The specimens were observed under a confocal laser scanning microscope (CLSM) and scored using the acquired images. There were no significant differences in the μTBS according to the type of material (p = 0.518). The giomer showed a decreased bond strength under the pH 4 condition compared with the immediately tested or pH 7-stored specimens (p ≤ 0.043). In the microleakage analysis, the class V restoration with giomer showed a higher microleakage than RMGI or alkasite (p = 0.001). For RMGI and alkasite, the specimens stored at pH 4 showed a significantly lower microleakage than those stored at pH 7 (p = 0.028). RMGI and alkasite can be adopted as restorative materials in generalized or localized low-pH conditions.

Study on antibacterial and fluoride-releasing properties of a novel composite resin with fluorine-doped nano-zirconia fillers

OBJECTIVE

A novel composite resin (CR) with fluorine-doped nano-zirconia (F-ZrO₂) fillers was developed as an antibacterial restorative material. This article described the synthesis and investigated the fluoride release, antibacterial property and cytotoxicity of the novel CR.

METHODS

F-ZrO₂ powders with different fluorine contents (0% F-ZrO₂, 5% F-ZrO₂, 10% F-ZrO₂ or 20% F-ZrO₂) were synthesized by chemical precipitation method and characterized by XRD, SEM and TEM-EDS. The content and release of fluoride were also determined. 20% F-ZrO₂ powers were selected to develop the novel CRs (FZ-25, FZ-50, and FZ-75). The fluoride release from the novel CRs during 28 days was recorded. The antibacterial property of the novel CRs was investigated with direct contact test (DCT) and metabolic activity test (CCK8). The cytotoxicity of the CRs was also evaluated here.

RESULTS

F-ZrO₂ powders with different fluorine contents were obtained. The fluoride release increased with increasing of the fluoride content. Through the antibacterial performance evaluation, 20% F-ZrO₂ powders, which exhibiting the best antibacterial property, were selected as the fillers for preparing the novel CR. The novel CR with F-ZrO₂ fillers exhibited an effective antibacterial effect. Compared with the control group, the antibacterial rates of FZ-25, FZ-50 and FZ-75 were 51.65%, 54.14% and 66.80% (p<0.05), respectively. No obvious cytotoxicity of the novel CR was detected in this study.

CLINICAL SIGNIFICANCE

The novel CR with continuous fluoride release and proper antibacterial property is expected to be used as an antibacterial material to reduce secondary caries.

Fluoride-Releasing Self-Etch Adhesives Create Thick ABRZ at the Interface

A fluoride-releasing adhesive system is expected to promote mineralization of demineralized dentin/enamel around a composite restoration, thereby contributing to the longevity of the restoration. Scanning electron microscopic (SEM) and transmission electron microscopic (TEM) observations revealed the formation of an “acid–base resistant zone” (ABRZ) beneath the hybrid layer when dentin was treated with a self-etch adhesive system. A thicker ABRZ was formed from the upper slope to the end of the outer lesion, indicating greater resistance against an acid-base challenge, when a fluoride-releasing self-etch adhesive system was used. The slope formation of a fluoride-releasing adhesive is believed to be due to fluoride-release from the adhesive. Quantitative assessment of the acid resistance was performed at the interface using the region of interest (ROI) mode of a digital image analysis software package. The area of the ABRZ is influenced by the concentration of fluoride release from the adhesive resin. The threshold of fluoride concentration in the adhesive may exist to influence the morphology of the ABRZ. X-ray absorption fine structure (XAFS) analysis of the dentin treated with different concentrations of NaF-mouth rinses suggested that different fluoride concentrations result in the formation of different chemical compounds, such as fluorapatite and CaF₂-like structures, on the dentin surface. This may explain the differences in μTBS values and morphological appearance of the ABRZ. NaF is effective in enhancing the enamel/dentin bond durability and also helps create a high quality of ARBZ to improve the clinical success of restorations.

Low-temperature flow-synthesis-assisted urethane-grafted zinc oxide-based dental composites: physical, mechanical, and antibacterial responses

A novel way was adopted to graft zinc oxide (ZnO) with urethane-modified dimethacrylate (UDMA) in order to utilize them as reinforcing agents in resin-based dental composites. Experimental novel composites were synthesized having UDMA-grafted and nongrafted ZnO, at a concentration of 0 wt.%, 5 wt.%, and 10 wt.%. The same concentrations of ZnO were also incorporated in Filtek Z250 XT (3 M ESPE, USA). The antibacterial behavior was evaluated against Streptococcus mutans by direct-contact test at one, three, and seven days of incubation. The compressive strength and Vickers microhardness were tested as per ISO 9917 and ISO/CD6507-1, respectively. For abrasive wear resistance, mass loss and roughness average after tooth-brushing cycles of 24,000 at custom-made tooth-brushing simulator were evaluated using noncontact profilometer. Data analysis was carried out using post hoc Tucky's test and nonparametric Kruskal-Wallis test. Direct contact test revealed that the antibacterial potential of novel and commercial composites was increased with an increase in the concentration of grafted ZnO as compared with nongrafted, whereby the potential was the highest at day seven. There was a significant decrease in compressive strength and Vickers hardness of commercial composites on addition of grafted ZnO while there was no significant difference in the strength of experimental novel composite. The abrasive wear of commercial and experimental composites was within clinical limits. Low-temperature flow-synthesis method was successfully employed to synthesize grafted and nongrafted ZnO. The UDMA-grafted ZnO can be incorporated into dental composites without decreasing their strength and these composites can be used to combat secondary caries.

Antibacterial and Mechanical Properties of Pit and Fissure Sealants Containing Zinc Oxide and Calcium Fluoride Nanoparticles

Context

Pit and fissure sealants (PFSs) are the most effective preventive materials in dentistry. Secondary caries around the sealed pits and fissures at the material-tooth interface and the wear of the material remains the common problems. To address these problems, efforts have been made by incorporating zinc oxide (ZnO) and calcium fluoride (CaF₂) nanoparticles (NPs) into the sealants to develop caries-inhibiting and stress-bearing sealants.

Aim

Evaluation of antibacterial and mechanical properties of PFS containing ZnO and CaF₂ NPs.

Settings and Design

This was an in vitro study.

Materials and Methods

A total of 196 fissure sealant samples were divided into six test groups and a control group. The test group samples were prepared by incorporating two concentrations (0.5 wt% and 1 wt%) of ZnO and CaF₂ NPs into the sealants. The antibacterial activity was evaluated by direct contact test; compressive and flexural strengths were evaluated by a universal testing machine.

Statistical Analysis Used

Statistical analysis was done by one-way ANOVA and post hoc Tukey test.

Results

Sealants containing 1 wt% ZnO and CaF₂ NPs and their mixture exhibited significantly higher antibacterial activity against Streptococcus mutans and Lactobacillus acidophilus when compared to control group (P < 0.001). Samples with ZnO NPs exhibited similar mechanical properties as conventional sealant (control group); however, the samples with CaF₂ NPs showed inferior mechanical properties (P < 0.05).

Conclusion

The observations of the study infer that sealants containing 1 wt% ZnO and CaF₂ NPs and their mixture exhibited superior antibacterial activity. The mechanical properties of samples containing ZnO and mixture of ZnO and CaF₂ particles remained comparable to the conventional sealants.

Resistance to demineralisation of adjacent enamel and dentine, fluoride release and dentine bond strength of fluoride-containing self-etch adhesive systems

BACKGROUND

The current study aimed to assess the amount of fluoride released from fluoride-containing dental adhesives and its effect on micro-tensile bond strength (µTBS) and on resistance to demineralisation of dentine and enamel.

MATERIAL AND METHODS

Two fluoride-containing dental adhesives, and a fluoride-free adhesive were used as experimental adhesives. After thermal cycling the µ-TBS of adhesives to dentine and the failure mode were assessed. The fluoride release and cross-sectional microhardness (CSMH) of specimens were measured before and after one day, 7 and 28 days of pH-cycling. The data were analysed using one-way ANOVA, Weibull statistics and repeated measures ANOVA.

RESULTS

The results indicated a significant difference between the group of FL and both the SE and LBF groups (p≤0.001). The CSMH values of both the dentine and enamel underneath the adhesives was reduced at 28 th day of the pH-cycling compared to the baseline (p≤0.001). From day 1 to day 28, the released fluoride declined in both the fluoride containing dental adhesives (p≤0.001).

CONCLUSIONS

Based on the results, the released fluoride from dental adhesives may adversely influence the bond strength and durability of the resin/dentine interface. Moreover, the released fluoride didn't improve the resistance to demineralisation of adjacent enamel and dentine to bond interface. Key words:Fluoride release, micro-tensile bond strength, microhardness, fluoride-containing adhesives.

Effect of high-fluoride dentifrice and bracket bonding composite material on enamel demineralization in situ

OBJECTIVE

This in situ study evaluated the effect of high-fluoride dentifrice (5000 μg F^-/g) and fluoride-containing bonding composite resin on enamel demineralization adjacent to orthodontic brackets.

METHODS

Ten volunteers wore palatal appliances containing bovine enamel blocks with metallic brackets bonded with fluoride-free or fluoride-containing composite resin. During three phases of 14 days each, three dentifrices with different fluoride concentrations (0, 1100, and 5000 μg F^-/g) were tested. The cariogenic challenge consisted of 20% sucrose solution dripped 8x/day onto the dental blocks. At the end of each phase, biofilm formed was collected for fluoride analysis. Cross section hardness was performed in enamel blocks, and the lesion area was calculated. Data were analyzed by two-way ANOVA followed by Tukey post hoc test (α = 5%).

RESULTS

The only signicant factor for all the variables under study was the dentifrice. Smaller lesion area and higher fluoride concentration on biofilm were found in 5000 μg F^-/g group, irrespective of bonding composite resin (p < 0.001). Neither bracket-bonding composite resin nor the interaction between the factors was statistically significant (p > 0.05) for all the variables.

CONCLUSION

High-fluoride dentifrice is effective in reducing demineralization on enamel adjacent to orthodontic brackets, while the fluoride-containing bonding composite resin does not influence it.

CLINICAL SIGNIFICANCE

Since high-fluoride dentifrice was able to reduce demineralization adjacent to brackets, it can be an option to caries management in orthodontics patients.

Does recharging dental restorative materials with fluoride influence biofilm formation?

OBJECTIVES

To investigate the influence of recharging dental restorative materials with fluoride on biofilm formation.

METHODS

Specimens produced from a high-viscosity glass ionomer cement (HVGIC), a resin-modified glass ionomer cement (RMGIC), and a resin-based composite (RBC) were randomly allotted to incubation in artificial saliva either for one week (AS-1), for five weeks (AS-5), for five weeks including twice/day brushing with 1450ppm NaF toothpaste (AS-5-brush), or one-time exposition to 5000ppm NaF after five weeks of incubation (AS-5-exp). Human enamel was used as reference. Surface roughness and the release of fluoride from the specimens was determined; biofilm formation was simulated using mono- or multispecies microbiological models and analysed employing an MTT-based approach and confocal laser-scanning microscopy.

RESULTS

Monospecies biofilm formation was significantly reduced on HVGIC in comparison to RMGIC and RBC. It was also reduced on HVGIC and enamel after treatment with fluoride in groups AS-5-brush and AS-5-exp in comparison to AS-5. These effects were particularly pronounced after 24h, and less pronounced after 48h of biofilm formation. In the multispecies microbiological model, similar observations were identified for HVGIC, while for enamel a significant reduction in biofilm formation was observed in groups AS-5-brush and AS-5-exp. No significant effect of fluoride treatments was identified for RMGIC and RBC, regardless of the microbiological model applied.

SIGNIFICANCE

These data indicate that biofilm formation on the surfaces of a glass ionomer cement and enamel can be relevantly influenced by treatment with fluoride. Enamel may serve as a fluoride reservoir which requires regular recharge.

Fluoride Ion Release of Self-Adhesive Resin Cements and Their Potential to Inhibit In Situ Enamel and Dentin Demineralization

Objective

This study evaluated in situ the potential of a glass ionomer and self-adhesive resin cements to inhibit enamel and dentin demineralization around indirect restorations exposed to cariogenic challenge. The cumulative fluoride release (CFR) of materials was measured in water and acid. Methods: Seventy blocks cut from human molars received two indirect composite restorations (one in enamel and another in dentin) luted with Ketac Cem EasyMix (GIC, positive control), SeT (SeT), Maxcem Elite (Max), Smart Cem2 (Smart), and RelyX Unicem 2 (Unicem2). Fourteen volunteers wore palatal appliances containing five blocks exposed to a cariogenic challenge (20% sucrose solution, eight times per day, seven days). Knoop microhardness (KH) at two distances from the margins and three depths from the outer surface determined enamel and dentin demineralization. Disc-shape specimens of materials were immersed in daily-replaced deionized water or lactic acid solutions. KH and CFR data were analyzed by analysis of variance, Games-Howell test, and Tukey test (α=0.05). Results: The overall KH ranking was GIC &gt; SeT &gt; Max &gt; Smart = Unicem2 in both enamel and dentin (“&gt;” means p&lt;0.05). SeT was the only resin cement that resulted in enamel and dentin KH comparable to that of GIC at most distances and depths. In water, CFR rank of materials was GIC &gt; SeT = Max &gt; Smart = Unicem2. In acid, the rank was similar, except that Set was significantly superior to Max. Conclusion: SeT inhibited demineralization in enamel and dentin quite comparably to GIC. All resin cements released lower cumulative amounts of fluoride than the glass ionomer cement.

Antibacterial, physical and mechanical properties of flowable resin composites containing zinc oxide nanoparticles

OBJECTIVES

The aim of this study is evaluating the antibacterial activity of resin composites containing ZnO nanoparticles against Streptococcus mutans and examining their physical and mechanical properties.

METHODS

The properties of flowable resin composites containing 0-5wt.% nano-ZnO are investigated using different tests:

RESULTS

Although the agar diffusion test reveals no significant difference between the groups, the direct contact test demonstrates that by increasing the nanoparticle content, the bacterial growth is significantly diminished (p<0.05). In the aging test, however, the antibacterial properties reduce significantly (p<0.05). The flexural strength and compressive modulus remains unchanged by incorporation of nanoparticles (p>0.05) while the compressive strength and flexural modulus significantly increase (p<0.05). The ZnO containing resins show significantly lower depth of cure (p<0.05), and higher bond strength (p<0.05). There is no significant difference between the degrees of conversion, measured by FTIR technique, of the groups (p>0.05).

SIGNIFICANCE

Production of a dental resin composite with antibacterial activity without significant sacrificing effect on the mechanical properties is desirable in dental material science.

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

BACKGROUND

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

AIM

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

DESIGN

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

RESULTS

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

CONCLUSION

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

The upregulation of tumour necrosis factor-α and surface antigens expression on macrophages by bisphenol A-glycidyl-methacrylate

AIM

To evaluate the expression of tumour necrosis factor-α and surface antigens by bisphenol A-glycidyl-methacrylate (BisGMA) on murine macrophage cell line RAW264.7.

METHODOLOGY

Cytotoxicity was measured by tetrazolium bromide reduction assay. Tumour necrosis factor (TNF)-α was analysed by enzyme-linked immunosorbent assay. Cell surface antigens were investigated by flowcytometry. Statistical analyses were performed using anova followed by the Bonferroni's t-test for multigroup comparisons.

RESULTS

BisGMA exhibited cytotoxicity to RAW264.7 in a dose-dependent manner (P < 0.05) during 2-h incubation period. BisGMA was found to increase TNF-α secretion in a dose-dependent manner (P < 0.05). In addition, CD11, CD14, CD45, CD54, CD40, CD80, and MHC II were significantly stimulated by BisGMA in a dose-dependent manner (P < 0.05). However, MHC I expression was not affected by BisGMA (P > 0.05).

CONCLUSIONS

Taken together, the ability of macrophages to induce an appropriate immune response when exposed to BisGMA has the potential to upregulate TNF-α production and expression of surface antigens.

In vitro study of the effects of fluoride-releasing dental materials on remineralization in an enamel erosion model

OBJECTIVES

This study was conducted to compare the remineralization effects of five regimens on the loss of fluorescence intensity, surface microhardness, roughness and microstructure of bovine enamel after remineralization. We hope that these results can provide some basis for the clinical application of these materials.

METHODS

One hundred bovine incisors were prepared and divided into the following five groups, which were treated with distinct dental materials: (1) Clinpro™ XT varnish (CV), (2) F-varnish (FV), (3) Tooth Mousse (TM), (4) Fuji III LC(®) light-cured glass ionomer pit and fissure sealant (FJ) and (5) Base Cement(®) glass polyalkenoate cement (BC). Subsequently, they were detected using four different methods: quantitative light-induced fluorescence, microhardness, surface 3D topography and scanning electron microscopy (SEM).

RESULTS

The loss of fluorescence intensity of CV, BC and FJ groups showed significant decreases after remineralization (p<0.05). The microhardness values of the BC group were significantly higher than those of the other groups (p<0.05) after 6 weeks of remineralization. The CV group's surface roughness was significantly lower than those of the other groups after 6 weeks of remineralization (p<0.05). Regarding microstructure values, the FV group showed many round particles deposited in the bovine enamel after remineralization. However, the other four groups mainly showed needle-like crystals.

CONCLUSIONS

Glass ionomer cement (GIC)-based dental materials can promote more remineralization of the artificial enamel lesions than can NaF-based dental materials. Resin-modified GIC materials (e.g., CV and FJ) have the potential for more controlled and sustained release of remineralized agents. The effect of TM requires further study.

Novel dental composites reinforced with zirconia-silica ceramic nanofibers

OBJECTIVE

To fabricate and characterize dental composites reinforced with various amounts of zirconia-silica (ZS) or zirconia-yttria-silica (ZYS) ceramic nanofibers.

METHODS

Control composites (70 wt% glass particle filler, no nanofibers) and experimental composites (2.5, 5.0, and 7.5 wt% ZS or ZYS nanofibers replacing glass particle filler) were prepared by blending 29 wt% dental resin monomers, 70 wt% filler, and 1.0 wt% initiator, and polymerized by either heat or dental curing light. Flexural strength (FS), flexural modulus (FM), energy at break (EAB), and fracture toughness (FT) were tested after the specimens were stored in 37°C deionized water for 24h, 3 months, or 6 months. Degree of conversion (DC) of monomers in composites was measured using Fourier transformed near-infrared (FT-NIR) spectroscopy. Fractured surfaces were observed by field-emission scanning electron microscope (FE-SEM). The data were analyzed using ANOVA with Tukey's Honestly Significant Differences test used for post hoc analysis.

RESULTS

Reinforcement of dental composites with ZS or ZYS nanofibers (2.5% or 5.0%) can significantly increase the FS, FM and EAB of dental composites over the control. Further increase the content of ZS nanofiber (7.5%), however, decreases these properties (although they are still higher than those of the control). Addition of nanofibers did not decrease the long-term mechanical properties of these composites. All ZS reinforced composites (containing 2.5%, 5.0% and 7.5% ZS nanofibers) exhibit significantly higher fracture toughness than the control. The DC of the composites decreases with ZS nanofiber content.

SIGNIFICANCE

Incorporation of ceramic nanofibers in dental composites can significantly improve their mechanical properties and fracture toughness and thus may extend their service life.

Remineralizing efficacy of silver diamine fluoride and glass ionomer type VII for their proposed use as indirect pulp capping materials - Part II (A clinical study)

Aim:

To evaluate in vivo the remineralizing efficacy of silver diamine fluoride (SDF), glass ionomer Type VII (GC VII) and calcium hydroxide (Dycal).

Materials and Methods:

60 subjects in the age group of 18-35 years, matching the inclusion criteria and having deep carious lesions in the permanent first and second molars were selected. The teeth were aseptically opened under rubber dam and after gross caries removal, approximately 0.4mg of soft discolored dentin was removed with a sharp spoon excavator from the mesial or distal aspect of the cavity. The test material was randomly selected and applied in a thickness of 1.5-2mm and the cavity sealed with cavit. The patients were followed up at regular intervals with radiographic evaluation at 12 weeks. At 3 months the temporary restoration was removed and dentin samples were collected from the other half of the cavity which was left in the first appointment. Atomic absorption spectrophotometry, Colorimetric test using UV-vis spectrometer and potentiometric titration were used for determining calcium, phosphorous and fluoride respectively.

Results:

Almost equivalent rise in the percentage of calcium level was seen in GC VII and Ca(OH)₂ groups, followed by SDF group. Highest percentage rise in phosphate ions was seen in GC VII group followed by SDF group and Ca(OH)₂ group. Highest percentage of fluoride rise was seen in GC VII group followed by SDF group and Ca(OH)₂ group.

Conclusions:

The results indicated that both GC VII and SDF can be potential indirect pulp capping materials.

Influence of the curing mode on fluoride ion release of self-adhesive resin luting cements in water or during pH-cycling regimen

This study evaluated the effects of curing modes and storage conditions on fluoride release of resin cements. In phase 1, the cumulative fluoride release rate from samples of the resin cements (Panavia F 2.0, RelyX Unicem, MaxCem, and BisCem) was quantified after 15 days storage in water (n=4). In phase 2, the fluoride release profiles from the same materials were analyzed during pH cycling (n=4). In this second phase, fluoride was measured at specific times (one, two, three, five, eight, and 15 days). Disk-shaped specimens were prepared (10 mm × 0.5 mm), and the materials were either light activated or allowed to autopolymerize. For both phases, the fluoride release was measured using a fluoride ion-specific electrode. The fluoride release in water was not affected by the curing mode of RelyX Unicem and Maxcem resin cements. Panavia F. 2.0 and BisCem resin cements, either light cured or autopolymerized modes, released higher amounts of fluoride in water than the other self-adhesive cements. In phase 2, the concentration of fluoride released decreased from the first day of pH cycling until the 15th day for all resin cements, for both curing modes, regardless of the storage solution used (demineralizing/remineralizing). The fluoride release rate during pH cycling by Panavia F 2.0 and MaxCem was not affected by the curing mode. The effect of the curing mode on fluoride ion release in water or during pH cycling was product dependent.

Detection of ions released from S-PRG fillers and their modulation effect

The purpose of this study was to analyze the ions released from a surface pre-reacted glass ionomer (S-PRG) filler in distilled water or lactic acid solution. S-PRG filler was mixed with either solution at 1000:1, 100:1, 10:1, and 1:1 ratios by weight. By means of inductively coupled plasma atomic emission spectroscopy and a fluoride electrode, elements released from S-PRG filler were identified to be Al, B, Na, Si, Sr, and F. To investigate the effect of solution pH on ion release, the pH values of the solutions before mixing and after 24 hours' mixing with S-PRG were measured. After 24 hours' mixing, the pH values of solutions at all ratios became more neutral or weakly alkaline regardless of their initial pH levels before mixing. In conclusion, results showed that S-PRG filler released several types of ions, and that ion release was influenced by the mixing ratio of the solution rather than the initial pH of the solution.

Update on Dental Nanocomposites

Dental resin-composites are comprised of a photo-polymerizable organic resin matrix and mixed with silane-treated reinforcing inorganic fillers. In the development of the composites, the three main components can be modified: the inorganic fillers, the organic resin matrix, and the silane coupling agents. The aim of this article is to review recent studies of the development of dental nanocomposites and their clinical applications. In nanocomposites, nanofillers are added and distributed in a dispersed form or as clusters. For increasing the mineral content of the tooth, calcium and phosphate ion-releasing composites and fluoride-releasing nanocomposites were developed by the addition of DCPA-whiskers or TTCP-whiskers or by the use of calcium fluoride or kaolinite. For enhancing mechanical properties, nanocomposites reinforced with nanofibers or nanoparticles were investigated. For reducing polymerization shrinkage, investigators modified the resin matrix by using methacrylate and epoxy functionalized nanocomposites based on silsesquioxane cores or epoxy-resin-based nanocomposites. The effects of silanization were also studied. Clinical consideration of light-curing modes and mechanical properties of nanocomposites, especially strength durability after immersion, was also addressed.

Strong nanocomposites with Ca, PO(4), and F release for caries inhibition

This article reviews recent studies on: (1) the synthesis of novel calcium phosphate and calcium fluoride nanoparticles and their incorporation into dental resins to develop nanocomposites; (2) the effects of key microstructural parameters on Ca, PO(4), and F ion release from nanocomposites, including the effects of nanofiller volume fraction, particle size, and silanization; and (3) mechanical properties of nanocomposites, including water-aging effects, flexural strength, fracture toughness, and three-body wear. This article demonstrates that a major advantage of using the new nanoparticles is that high levels of Ca, PO(4), and F release can be achieved at low filler levels in the resin, because of the high surface areas of the nanoparticles. This leaves room in the resin for substantial reinforcement fillers. The combination of releasing nanofillers with stable and strong reinforcing fillers is promising to yield a nanocomposite with both stress-bearing and caries-inhibiting capabilities, a combination not yet available in current materials.

Does fluoride in compomers prevent future caries in children?

Compomer restorations release fluoride to help prevent future caries. We tested the hypothesis that compomer is associated with fewer future caries compared with amalgam. The five-year New England Children's Amalgam Trial recruited 534 children aged 6-10 yrs with >or= 2 carious posterior teeth. Children were randomized to receive compomer or amalgam restorations in primary posterior teeth, placed with a fluoride-releasing bonding agent. The association between restorative material and future caries was assessed by survival analysis. Average follow-up of restorations (N = 1085 compomer, 954 amalgams) was 2.8 + 1.4 yrs in 441 children. No significant difference between materials was found in the rate of new caries on different surfaces of the same tooth. Incident caries on other teeth appeared slightly more quickly after placement of compomer restorations (p = 0.007), but the difference was negligible after 5 yrs. Under the conditions of this trial, we found no preventive benefit to fluoride-releasing compomer compared with amalgam.

Novel F-releasing composite with improved mechanical properties

In recent years, the authors have been developing novel fluoride-releasing dental composites containing ternary zirconium fluoride chelates. The aim of this study was to improve the physical and mechanical properties of these composites by improving the formulation of the monomers and photoinitiators. The hypothesis was that reduction of hydrophilic monomers and improvement of the photoinitiators could reduce water sorption and significantly increase the mechanical properties of the composite. The degree of conversion of the composites containing different compositions of photoinitiators was studied by Fourier transform near-infrared spectroscopy (FT-NIR). Ten experimental composites containing different compositions of ethoxylated bisphenol-A dimethacrylate (EBPADMA), 1,6-hexanediol dimethacrylate (HDDMA), triethylene glycol dimethacrylate (TEGDMA), and 2,2-bis[4-(2-hydroxy-3-methacryloyloxypropoxy) phenyl]-propane (BisGMA) were tested for flexural strength, viscosity, and water sorption. The experimental composite containing 20% synthesized fluoride-releasing monomer, 30% BisGMA, 30% EBPADMA, and 20% HDDMA showed significantly higher fluoride release and recharge, but physical and mechanical properties similar to those of the control composite containing 40% BisGMA, 40% EBPADMA, and 20% HDDMA.

Effects of glass ionomer and microfilled composite subgingival restorations on periodontal tissue and subgingival biofilm: a 6-month evaluation

BACKGROUND

This 6-month study evaluated the effects of resin-modified glass-ionomer cement (RMGI) and microfilled composite (MC) subgingival restorations on periodontal tissues and subgingival biofilm.

METHODS

Fifty-four periodontally healthy patients were assigned as follows: group 1 (N = 18), root exposure (RE) without non-carious cervical lesions (NCCL) treated with coronally positioned flap (CPF); group 2 (N = 18), RE with NCCL treated RMGI restorations plus CPF; group 3 (N = 18), RE with NCCL treated with MC restorations plus CPF. Probing depth (PD), visible local plaque score (PL), and local bleeding on probing (BOP) were assessed at baseline and 6 months after surgeries. Restored and non-restored root recoverage (RR) was assessed at 6 months. Each experimental tooth was subgingivally sampled (baseline and 6 months) and analyzed by checkerboard DNA-DNA hybridization.

RESULTS

Clinical results showed no significant differences among the groups regarding PL, BOP, and PD at baseline and 6 months. The RR means were similar among the groups at 6 months. Intragroup analyses revealed that the proportions of 10 periodontopathogens decreased at 6 months for the control group. For the RMGI group, there was a significant decrease in the proportions of nine periodontopathogens. For the MC group, there was a significant increase in the proportions of Fusobacterium nucleatum polymorphum and Gemella morbillorum and a decrease in five periodontopathogens. Intergroup analyses showed an increase in the proportion of F. nucleatum polymorphum for the MC group.

CONCLUSIONS

In a 6-month evaluation, well-finished RMGI or MC subgingival restorations did not negatively affect periodontal health. Furthermore, RMGI seems to exert more positive effects on the subgingival biofilm composition than MC.

Effect of acetic NaF solutions on fluoride-containing dental restorative materials

The aim of this study was to evaluate the effect of acetic NaF solutions on fluoride-containing restorative materials. As the pH value of solution decreased, the degree of microhardness change in restorative materials increased- regardless of product. Dyract AP (DA) and F2000 (F2) (polyacid-modified resin composites) showed the greatest decrease in microhardness after immersion for three days. Similarly, as the pH value decreased, volumetric weight change (loss) increased in all products. DA and F2 showed the greatest--but similar-weight change in pH 3.5 solution among the products. In terms of color change, most specimens showed a slight color change after immersion for one and three days-regardless of pH value. However, F2 in pH 3.5 solution showed a noticeable color change (deltaE*=2.1). In terms of surface morphology, specimens in distilled water showed only minor surface modification. However, in pH 3.5 solution, DA and F2 showed randomly propagating cracks, while Solitaire 2 and Tetric Ceram (resin composites) lost many fillers less than 2 microm in size.

An overview of treatment considerations for esthetic restorations: a review of the literature

Controversy persists regarding the treatment planning criteria for esthetic restorations. This article reviews the literature regarding the biocompatibility, marginal adaptation, color matching, patient selection, technique sensitivity, and mode and rate of failure of tooth-colored restorations. A Medline search was completed for the period from 1986 to 2006, along with a manual search, to identify pertinent English peer-reviewed articles and textbooks. The key words used were amalgam, posterior composite resin, ceramic inlays/onlays, CEREC, porcelain laminate veneers, all-ceramic crowns, and all-ceramic fixed partial dentures.

Coronally Positioned Flap for Treatment of Restored Root Surfaces: A 6-Month Clinical Evaluation

BACKGROUND

The aim of this study was to evaluate clinically the treatment of gingival recession associated with non-carious cervical lesions (NCCLs) by resin modified glass ionomer cement (RMGI) or microfilled resin composite (MRC) and coronally positioned flap (CPF) at 6 months following surgery.

METHODS

Fifty-nine patients were assigned to one of three treatments: root exposure without NCCL treated with CPF (group 1); root exposure with NCCL treated with RMGI restoration plus CPF (group 2); or root exposure with NCCL treated with MRC restoration plus CPF (group 3). Clinical measurements that were assessed at baseline and at 3 and 6 months after surgery included plaque index (PI), bleeding on probing (BOP); probing depth (PD), recession reduction (RR), clinical attachment level gain (CALG), keratinized tissue height (KTH), keratinized tissue thickness (KTT), percentage of root coverage (RC), and percentage of restored root coverage (RRC).

RESULTS

Intra- and intergroup analyses demonstrated no significant differences in PI, BOP, PD, RR, CALG, KTH, or KTT (P >0.05) among the groups at any time. At 6 months, the mean RC was 80.83% +/- 21.08% for group 1; the mean RRCs were 71.99% +/- 18.69% and 74.18% +/- 15.02% for groups 2 and 3, respectively. There were no statistically significant differences in RRC between groups 2 and 3.

CONCLUSION

All treatments showed root coverage improvement without damage to periodontal tissues, supporting the use of CPF for treatment of root surfaces restored with RMGI or MRC as being effective over the 6-month period.