Resin-modified glass-ionomer setting reaction competition

Assessing the Impact of Nano-Graphene Oxide Addition on Surface Microhardness and Roughness of Glass Ionomer Cements: A Laboratory Study

Background

Nanomaterials, including nano-graphene oxide (nGO), have emerged as promising modifiers for dental materials. Therefore, this study investigated the effect of incorporating nGO into conventional glass ionomer cement (CGIC) and resin-modified glass ionomer cement (RMGIC) on surface roughness and hardness.

Methods

Sixty disk-shaped specimens (2 × 6 mm) were divided into six groups: CGIC, RMGIC, CGIC with 1 wt.% nGO, CGIC with 2 wt.% nGO, RMGIC with 1 wt.% nGO, and RMGIC with 2 wt.% nGO. Surface roughness (Ra) and Vickers microhardness (VHN) were measured using a surface profilometer and Vickers microhardness tester, respectively. Statistical analysis employed the Kruskal-Wallis and Mann-Whitney tests (p <0.05).

Results

The microhardness of RMGICs significantly increased with 1% and 2% nGO (p=0.017, P=0.001, respectively), while CGICs showed a significant decrease in VHN with nGO incorporation (p=0.001). VHN values of all CGIC groups were significantly higher than those of all RMGIC groups (p=0.001). Mean surface roughness values for all CGICs were significantly higher than those of RMGIC groups (p=0.001). Within the RMGIC groups, mean Ra values of RMGIC + 1 wt.% nGO and RMGIC + 2 wt.% nGO groups decreased significantly compared to the RMGIC control group (p=0.001, p=0.001, respectively). Among CGIC groups, mean Ra values of 1 wt.% and 2 wt.% nGO/CGIC groups were significantly higher than the CGIC control group (p=0.016, p=0.001).

Conclusion

Incorporating nGO into RMGICs increased surface microhardness while reducing surface roughness, offering potential advantages for clinical applications. Conversely, adding nGO to CGICs increased surface roughness and decreased surface hardness. These findings emphasize the potential benefits of utilizing nGO in RMGICs and their implications in clinical practice.

Assessment of the Micro-Tensile Bond Strength of a Novel Bioactive Dental Restorative Material (Surefil One)

OBJECTIVES

The aim of this study is to assess the micro-tensile bond strength and the mode of failure of a bioactive hybrid self-adhesive composite (Surefil one) under various dentin conditions.

METHODS

Thirty-two extracted human molar teeth were used to test the micro-tensile bond strength of Surefil one under different dentine conditions (no treatment, 37% phosphoric acid etching, and universal adhesive) in comparison with a resin-modified glass ionomer (RIVA). All restorations were light cure-bonded onto flat dentine and then sectioned into beams. Then, fractured specimens were observed under a light microscope to evaluate the mode of failure.

RESULTS

The Surefil one no-treatment group (NTG) exhibited the highest micro-tensile bond strength. Furthermore, there was no statistically significant difference observed between the Surefil one adhesive group (EAG) and the Surefil one acid etch group (EG). However, compared to other groups, the resin-modified glass ionomer (RIVA) produced the lowest results, which are statistically significant.

CONCLUSION

Surefil one offers superior bond strength values when compared to resin-modified glass ionomers. Furthermore, Surefil one requires no dentin condition and has more straightforward clinical steps.

Effect of Luting Materials on the Accuracy of Fit of Zirconia Copings: A Non-Destructive Digital Analysis Method

The marginal accuracy of fit between prosthetic restorations and abutment teeth represents an essential aspect with regard to long-term clinical success. Since the final gap is also influenced by the luting techniques and materials applied, this study analyzed the accuracy of the fit of single-tooth zirconia copings before and after cementation using different luting materials. Forty plaster dies with a corresponding zirconia coping were manufactured based on a single tooth chamfer preparation. The copings were luted on the plaster dies (n = 10 per luting material) with a zinc phosphate (A), glass-ionomer (B), self-adhesive resin (C), or resin-modified glass-ionomer cement (D). The accuracy of fit for each coping was assessed using a non-destructive digital method. Intragroup statistical analysis was conducted using Wilcoxon signed rank tests and intergroup analysis by Kruskal-Wallis and Mann-Whitney U tests (α = 0.05). Accuracy of fit was significantly different before/after cementation within A (0.033/0.110 µm) and B (0.035/0.118 µm; p = 0.002). A had a significantly increased marginal gap compared to C and D, and B compared to C and D (p ≤ 0.001). Significantly increased vertical discrepancies between A and B versus C and D (p < 0.001) were assessed. Of the materials under investigation, the zinc phosphate cement led to increased vertical marginal discrepancies, whereas the self-adhesive resin cement did not influence the restoration fit.

Could bulk fill glass hybrid restorative materials replace composite resins in treating permanent teeth? A randomized controlled clinical trial

OBJECTIVE

This study aims to compare the clinical and radiographic efficacy of Equia system bulk fill glass hybrid material with composite resins in the permanent restoration of pediatric patients' permanent teeth.

MATERIALS AND METHODS

The study included 44 pediatric patients aged 8-16 who applied to Necmettin Erbakan University Pediatric Dentistry Department. The groups were formed as symmetrical teeth in the same patient using the split-mouth design. The study included class I caries lesions of 144 permanent teeth. Group 1 was restored with the Equia system bulk fill glass hybrid material (Equia Forte HT + Equia Forte Coat [GC, Co, Tokyo, Japan]) (n = 72) and Group 2 with the Charisma Smart universal composite resin (Kulzer, Gmbh, Hanau, Germany) + Clearfil SE Bond (Kuraray, Noritake, Sakazu, Okayama) (n = 72). Evaluations were performed clinically and radiographically by two physicians in 2nd week, 3rd month, 6th month, and 12th month and the results were recorded. Clinical evaluation was carried out using modified-USPHS criteria. Obtained data were statistically analyzed using Kendall's W test and Cochran's Q test for the comparison within the group, and the Chi-square test for the comparison between groups.

RESULTS

Among the materials utilized in the study, there was no statistically significant difference in marginal adaptation, marginal discoloration, retention, anatomical form, postoperative sensitivity, and secondary caries according (p > 0.05). Group 2 outperformed statistically significant Group 1 in terms of color match in all periods (p < 0.05). While there was no statistically significant difference in surface structure between the groups in 2nd week and 3rd month (p > 0.05), there was a statistically substantial difference in 6th, and 12th months (p < 0.05). No secondary caries or periapical lesions were found in any restorations during radiographic evaluation.

CONCLUSION

After a year, the clinical performance of both Equia and composite resins was equivalent and successful in the majority of the measures against which they were evaluated.

CLINICAL SIGNIFICANCE

Based on the results of the research, Equia system bulk fill glass hybrid restorations are considered a viable alternative to composite resins in class I permanent teeth restorations.

Acemannan-containing bioactive resin modified glass ionomer demonstrates satisfactory physical and biological properties

Background/purpose

Resin-modified glass ionomers (RMGIs) have been recommended as liner and cement to provide the teeth with mechanical support, a chemical barrier, and thermal insulation. Acemannan, the main polysaccharide extracted from Aloe vera, is a promising inductive material in vitro and in vivo. This study aimed to develop acemannan-containing bioactive resin-modified glass ionomers (RMGIs).

Materials and methods

Acemannan (3%, 5%, and 10%) was added to the three types of RMGIs (RU-HBM1/Fuji II LC/Vitrebond) to generate 3%, 5%, and 10% aceRMGIs (aceRU/aceFuji/aceVB). The materials were evaluated for depth of cure/flexural strength/cumulative fluoride ion release. Cell viability and vascular endothelial growth factor (VEGF) and bone morphogenetic protein-2 (BMP-2) secretion were determined using MTT/apoptosis/necrosis assays, and ELISA kits, respectively. RMGI without acemannan were used as controls.

Results

The aceRMGIs met the ISO requirements for depth of cure and flexural strength. Adding 10% acemannan increased the cumulative fluoride release in the RU and FJ groups, but slightly decreased it in the VB group (P < 0.05). The MTT assay revealed 10% aceRU and all aceFJ groups significantly increased cell viability compared with each control group (P < 0.05). Apoptosis/necrosis assay showed the biocompatibility of all aceRMGIs. Adding acemannan to RMGIs significantly induced VEGF expression in a dose dependent manner while 5% and 10% aceRU significantly induced BMP-2 expression compared with RU group (P < 0.05).

Conclusion

We conclude that 5-10% acemannan in RMGI is the optimal concentration based on its physical properties and ability to induce pulp cell proliferation and growth factor secretion.

Comparative study of two bioactive dental materials

OBJECTIVES

New bioactive materials were introduced to not only restore the lost dental hard tissue but also to release fluoride that inhibits demineralization and occurrence of secondary caries. The current study thus aims to assess Fluoride release as well as the mechanical and physical properties of two new commercially available bioactive restorative materials.

METHODS

Two materials, Cention® Forte (CF) (Ivoclar Vivadent), Surefil one™ (SO) (Denstply Sirona), were evaluated in terms of fracture toughness (FT), flexural strength (FS), flexural modulus (FM) (ISO 4049), compressive strength (CS), and Vickers hardness (VH). In addition, thermogravimetric analysis (TGA) was performed, as well as pH measurements and quantification of Fluoride release after immersion in distilled water at times of 0, 7, 14 and 21 days. The sealing ability was evaluated using silver nitrate dye penetration on natural teeth. Finally, Energy-Dispersive X-Ray Spectroscopy (EDX) was used to investigate the surface composition of the two studied material surfaces. The data were statistically analyzed using Independent T-Tests; the chosen significance level was α = 0.05.

RESULTS

CF had significantly higher FT values compared to SO (p = 0.001). Also the FS results showed that CF had significantly higher values (90.11 MPa), followed by SO (22.15 MPa). The CS values showed the same order with significantly higher values for CF (231.79 MPa). While the FM and VH showed the reverse order with SO having significantly higher values than CF. pH measurements showed that CF evolved towards significantly higher pH values after 3 weeks in distilled water, while thermal properties showed more stability and higher resistance to degradation for CF compared to SO. The silver nitrate penetration results showed significantly better sealing ability for CF compared to the self-adhesive SO. Finally, EDX surface analysis results were consistent with the release profiles and confirmed the composition of the two tested materials.

SIGNIFICANCE

Both materials, demonstrated enhanced Fluoride release ability, and hence good remineralisation potential in vitro that could prevent recurrent carious lesions in vivo. The composition based on acrylic polymerization showed better mechanical resistance to bending and fracture, and higher sealing ability than those based on acid base reaction.

The preventive effect of glass ionomer cement restorations on secondary caries formation: A systematic review and meta-analysis

OBJECTIVE

The objective is to compare the preventive effect on secondary caries of glass ionomer cement (GIC) restorations with amalgam or resin-composite restorations.

METHODS

Two independent researchers conducted a systematic search of English publications in PubMed, Web of Science, Cochrane and Scopus. They selected randomized clinical trials comparing secondary caries incidences around GIC restorations (conventional GIC or resin-modified GIC) with amalgam or resin-composite restorations. Meta-analysis of the secondary-caries incidences with risk ratio (RR) and 95% confidence interval (95% CI) as the effect measure was performed.

RESULTS

This review included 64 studies. These studies included 8310 GIC restorations and 5857 amalgam or resin-composite restorations with a follow-up period from 1 to 10 years. Twenty-one studies with 4807 restorations on primary teeth and thirty-eight studies with 4885 restorations on permanent teeth were eligible for meta-analysis. The GIC restorations had a lower secondary caries incidence compared with amalgam restorations in both primary dentition [RR= 0.55, 95% CI:0.41-0.72] and permanent dentition [RR= 0.20, 95% CI:0.11-0.38]. GIC restorations showed similar secondary caries incidence compared with resin-composite restorations in primary dentition [RR= 0.92, 95% CI:0.77-1.10] and permanent dentition [RR= 0.77, 95% CI:0.39-1.51]. Conventional GIC restorations showed similar secondary caries incidence compared with resin-modified GIC-restored teeth in both primary dentition [RR= 1.12, 95% CI:0.67-1.87] and permanent dentition [RR= 1.63, 95% CI:0.34-7.84].

CONCLUSIONS

GIC restorations showed a superior preventive effect against secondary caries compared to amalgam restorations, and a similar preventive effect against secondary caries compared to resin-composite restorations in both primary and permanent teeth. [PROSPERO Registration ID: CRD42022380959].

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

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

Concept of a Novel Glass Ionomer Restorative Material with Improved Mechanical Properties

The objective of this study was to transfer the concept of ductile particle reinforcement to restorative dentistry and to introduce an innovative glass ionomer material that is based on the dispersion of PEG-PU micelles. It was hypothesized that reinforcing a conventional glass ionomer in this way increases the flexural strength and fracture toughness of the material. Flexural strength and fracture toughness tests were performed with the novel reinforced and a control glass ionomer material (DMG, Hamburg, Germany) to investigate the influence of the dispersed micelles on the mechanical performance. Transmission electron microscopy was used to identify the dispersed micelles. Fracture toughness and flexural strength were measured in a 3-point-bending setup using a universal testing machine. Before performing both tests, the specimens were stored in water at 37 °C for 23 h. The fracture toughness (MPa∙m0.5) of the novel glass ionomer material (median: 0.92, IQR: 0.89-0.94) was significantly higher than that of the control material (0.77, 0.75-0.86, p = 0.0078). Significant differences were also found in the flexural strength (MPa) between the reinforced (49.7, 45.2-57.8) and control material (41.8, 40.6-43.5, p = 0.0011). Reinforcing a conventional glass ionomer with PEG-PU micelles improved the mechanical properties and may expand clinical applicability of this material class in restorative dentistry.

Dental Resin-Based Luting Materials-Review

As cementation represents the last stage of the work involved in making various indirect restorations (metal ceramic crowns and bridges, full ceramic crowns and bridges, inlays, onlays, and fiber posts), its quality significantly contributes to the clinical success of the therapy performed. In the last two decades, the demand for ceramic indirect restorations in everyday dental practice has considerably increased primarily due to the growing significance of esthetics among patients, but also as a result of hypersensitivity reactions to dental alloys in some individuals. In this context, it is essential to ensure a permanent and reliable adhesive bond between the indirect restoration and the tooth structure, as this is the key to the success of aesthetic restorations. Resin-based luting materials benefit from excellent optical (aesthetic) and mechanical properties, as well as from providing a strong and durable adhesive bond between the restoration and the tooth. For this reason, resin cements are a reliable choice of material for cementing polycrystalline ceramic restorations. The current dental material market offers a wide range of resin cement with diverse and continually advancing properties. In response, we wish to note that the interest in the properties of resin-based cements among clinicians has existed for many years. Yet, despite extensive research on the subject and the resulting continued improvements in the quality of these materials, there is still no ideal resin-based cement on the market. The manuscript authors were guided by this fact when writing the article content, as the aim was to provide a concise overview of the composition, properties, and current trends, as well as some future guidelines for research in this field that would be beneficial for dental practitioners as well as the scientific community. It is extremely important to provide reliable and succinct information and guidelines for resin luting materials for dental dental practitioners.

Effect of Storage Temperature on Selected Strength Parameters of Dual-Cured Composite Cements

Direct restorations are currently the most popular restorations used in dental prosthodontics. Due to the increased requirements for materials used in the fabrication of fixed restorations, there is a need for evaluation of strength parameters of these materials, including dental cements. The present study investigated the change in selected strength parameters of four dual-cured composite cements as a function of storage temperature. The following were investigated: three-point flexural strength (FS), flexural modulus in bending (FM), diametral tensile strength (DTS) and Vickers hardness (HV). Four dual-cured composite cements were tested, i.e., Multilink Automix (Ivoclar Vivadent), seT PP (SDI), MaxCem (Kerr), and Bifix Hybrid Abutment (VOCO). Each of the tested cements was stored for 7 days at one of the selected temperatures: 8 °C, 15 °C, 25 °C, or 35 °C, before the samples were made. Strength properties (DTS, FS) are not strongly dependent on the storage temperature in the range of 8-35 °C. Some statistical differences were observed between the hardness of MaxCem and Multilink Automix storage in various temperatures. FS and FM were lowest for Bifix Hybrid Abutment, MaxCem and Multilink Automix storage at 25 °C, and highest for Bifix Hybrid Abutment, MaxCem, and seT PP stored in 35 °C. The cement with the highest filler content (70% by weight) showed the highest FS and HV.

Short-Term Fluoride Release from Ion- Releasing Dental Materials

Objective

To compare short-term release of fluoride ions from ion-releasing dental restorative materials.

Material and methods

Seven experimental groups were prepared using the following six different materials: alkasite (Cention Forte), resin-modified glass ionomer cement (Fuji II LC), bioactive composite (ACTIVA BioACTIVE-RESTORATIVE), fluoride-containing nano-hybrid composite (Luminos UN), coat-free glass hybrid (EQUIA Forte HT), coat-applied glass hybrid (EQUIA Forte HT), and glass ionomer cement (Fuji IX). A total of 40 samples for each group (n=40) were prepared in Teflon molds (8 mm x 2 mm) and placed in polyethylene vials with 5 ml of deionized water. Fluoride release was measured after 6, 24, 48 hours, and for 5 weeks using an ion-selective electrode. The results were expressed in mg/l and the data were statistically analyzed using ANOVA.

Results

Significant differences in fluoride release were observed within the first 6 hours (ANOVA p<0.001). EQUIA Forte HT had the highest release, while the other materials showed no significant differences. After 24 hours, EQUIA Forte HT (p<0.001) and Luminos UN (p<0.05) exhibited significantly higher releases, compared to other tested materials. EQUIA Forte HT maintained the highest release at 48 hours (p<0.001), followed by Cention Forte (p<0.05) and Luminos UN (p<0.05). All material pairs showed significant differences in fluoride release at 5 weeks (p<0.001).

Conclusion

Coat-free EQUIA Forte HT had the overall highest fluoride release, while Cention Forte demonstrated the greatest increase over time. ACTIVA BioACTIVE-RESTORATIVE exhibited the lowest fluoride release in this study.

Fluoride exchange by glass-ionomer dental cements and its clinical effects: a review

The topic of fluoride release and uptake by glass-ionomer (glass polyalkenoate) dental cements is reviewed. The study was based on a literature search carried out using PubMed. The main key words used were glass-ionomer and fluoride, and further refinements were made by adding the keywords anti-microbial, anti-caries and remineralization. Papers were selected from the initial search, which concentrated on fundamental aspects of fluoride release, including kinetics and the influence of the cement composition, and resulting clinical performance against caries. Other relevant papers were cited where they added useful and relevant data. From these published papers, it was possible to explain the detailed mechanism of fluoride release by glass-ionomer cements and also its uptake. Fluoride release has been shown to be a two-step process. In neutral solutions, the steps can be divided into early wash-out and long-term diffusion. In acid conditions, the early wash-out remains, though with greater amounts of fluoride released, and the long-term release becomes one of slow dissolution. The effect of fluoride on the viability of oral micro-organisms has been described, and glass-ionomers have been shown to release sufficient fluoride to reduce the size and viability of adjacent populations of oral bacteria. The effect of low levels of fluoride on the remineralization of tooth tissue has been considered. Levels needed to increase remineralization are much lower than those needed to adversely affect oral bacteria, from which we conclude that glass-ionomers release sufficient fluoride to promote remineralization. Despite this, there remains uncertainty about their overall contribution to sound oral health, given the widespread use of other sources of fluoride, such as toothpastes.

Remineralizing Ability of Resin Modified Glass Ionomers (RMGICs): A Systematic Review

The selective caries removal approach leads to the need to use materials with the ability to remineralize remaining partially demineralized dentin. Among the materials proposed are resin-modified glass ionomer cements (RMGICs). The aim of this systematic review was to evaluate, based on in vitro experimental studies, whether RMGICs are suitable for remineralizing affected dentin. A systematic literature search was performed in four databases, followed by article selection, data extraction, and quality assessment. Studies assessing the remineralizing potential of RMGICs on dentin were included in our review. Studies which compared such properties between different RMGICs or with other materials were also eligible. The studies report the remineralizing ability of RMGICs, albeit with differences between different commercial products. RMGICs show a similar ability to conventional GICs to remineralize affected dentin, fulfilling the function for which they are designed. Moreover, the incorporation of additives, such as bioactive glass (BAG) or CCP-ACP, improves their remineralizing potential. The results of this review support the use of RMGICs as restorative materials after selective caries removal.

The In-Vitro Effect of Silver and Zinc Oxide Nanoparticles on Fluoride Release and Microhardness of a Resin-Modified Glass Ionomer Cement

Reinforcement of nanoparticles into existing restorative biomaterials in dentistry is an area of interest. The aim of the current investigation was to incorporate silver nanoparticles (SNP) and zinc oxide nanoparticles (ZnONP) into a commercially available resin-modified glass ionomer cement (RMGIC). Their effects on the fluoride (F-) release from RMGIC were also investigated over a period of 14-days. Nanoparticles were incorporated at a loading concentration of 5 wt%, either individually or in a combination of both. Scanning electron microscopy (SEM), Fourier Transform infrared spectroscopy (FTIR), Nanocomputerized tomography (NanoCT), and the Vickers microhardness tester were used to examine the specimens. The fluoride release was analyzed by high performance liquid chromatography (HPLC). Data were analysed using ANOVA and Tukey’s test. RMGIC containing 5% ZnONP and 5% SNP + 5% ZnONP showed significant alterations in the surface ultrastructure with pores being evident in the surface. Fluoride release in parts per million (ppm) was highest in the 5% SNP and 5% ZnO-NP incorporated RMGIC compared to the control group and 5% SNP-incorporated RMGIC. RMGIC, as well as change in color observed in the 5% SNP incorporated RMGIC.

Remineralization Potential of Three Restorative Glass Ionomer Cements: An In Vitro Study

The aim of this in vitro study was to evaluate the remineralizing ability of three glass ionomers on demineralized dentin with different thicknesses and time periods. Fifty third molars were obtained and were sectioned into 1-, 2-, and 3-mm thick slices (n = 36 for each thickness). The specimens were demineralized with 18% EDTA for 2 h. From the glass ionomer cements (GICs) under study (Ketac Molar Aplicap, Equia Forte, or Riva Light Cure), 1 mm was placed over each slice, set, and preserved in PBS until observation after 1, 7, 14, and 28 days after placement. For each material, thickness, and time, three samples were prepared. Using Fourier Transform Infrared Spectrometry (FTIR), apatite formation was determined on the side opposite to that on which the material had been placed. By means of Energy Dispersive Spectroscopy (EDX), the changes in the Calcium/Phosphate (Ca/P) ratio were evaluated. These changes were compared between the different materials by means of a two-way ANOVA test, considering time and dentin thickness, for a significance level of p < 0.05. Results: FTIR showed a peak at 1420 cm^-1, evidencing the presence of carbonated hydroxyapatite in all the materials after 14 days, which indicates that a remineralization process occurred. Riva Light Cure showed the most homogeneous results at all depths at 28 days. The Ca/P ratio was maximum at 7 days in 2 mm of dentin for Riva Light Cure and Equia Forte HT (3.16 and 3.07; respectively) and for Ketac Molar at 14 days in 1 mm (3.67). All materials induced remineralization. Equia Forte achieved the greatest effect at 2 mm and Ketac Molar at 1 mm, whereas Riva Light Cure showed similar results at all depths. In terms of Ca/P ratio, Equia Forte and Riva Light Cure remineralized best at 2 mm, whereas for Ketac Molar, it was 1 mm. Carbonate apatite formation was higher at 24 h and 7 days for Ketac Molar, whereas it decreased at 14 days for Ketac Molar and peaked in Riva Light Cure and Equia Forte.

Leaching components and initial biocompatibility of novel bioactive restorative materials

OBJECTIVES

Bioactive restorative materials were developed on the premise that direct restorations should not only serve the purpose of reconstructing dental hard tissue defects but also exhibit biological features that prevent secondary caries development, without having adverse effects on the host cells. This study focuses on assessing the in vitro biocompatibility of two novel bioactive restorative materials.

METHODS

Specimens of the bioactive restorative materials, Cention Forte (CF) and ACTIVA BioACTIVE RESTORATIVE (AB), a glass ionomer cement/glass hybrid (EQUIA Forte HT, EF) and an established nanohybrid composite (Venus Diamond, VD) were produced and finished. The specimens were eluted in water and methanol and the resulting eluates were analyzed via gas chromatography-mass spectrometry. hGF-1 cells were exposed to eluates prepared in cell culture medium. Cellular ATP levels, oxidized glutathione concentration, caspase-3/7 activity and the inflammatory response (IL-6 and PGE₂ levels) were determined. Microscopic images were taken to examine the cell morphology.

RESULTS

Methyl methacrylate and 2-Hydroxyethyl methacrylate were the main monomers detected in CF and AB eluates. All materials inhibited cell proliferation and led to significantly reduced ATP-levels. The cells exhibited a healthy morphology in the presence of CF and AB. Cells exposed to VD showed increased oxidized glutathione levels. Only EF led to enhanced caspase-3/7 activity. CF and AB caused IL-6 levels to increase, while EF and AB led to enhanced PGE₂ levels.

SIGNIFICANCE

CF and AB are promising materials from a biological point of view and seem to have improved bioactive properties compared to glass ionomer cements.

Zirconia Nanoparticles as Reinforcing Agents for Contemporary Dental Luting Cements: Physicochemical Properties and Shear Bond Strength to Monolithic Zirconia

Nanofillers in resin materials can improve their mechanical and physicochemical properties. The present work investigated the effects of zirconia nanoparticles (NPs) as fillers in commercial dental luting cements. Two dual-cured self-adhesive composites and one resin modified glass ionomer (RMGI) luting cement were employed. Film thickness (FT), flexural strength (FS), water sorption (W_sp), and shear bond strength (SBS) to monolithic zirconia were evaluated according to ISO 16506:2017 and ISO 9917-2:2017, whereas polymerization progress was evaluated with FTIR. Photopolymerization resulted in double the values of DC%. The addition of 1% wt NPs does not significantly influence polymerization, however, greater amounts do not promote crosslinking. The sorption behavior and the mechanical performance of the composites were not affected, while the film thickness increased in all luting agents, within the acceptable limits. Thermocycling (TC) resulted in a deteriorating effect on all composites. The addition of NPs significantly improved the mechanical properties of the RMGI cement only, without negatively affecting the other cements. Adhesive primer increased the initial SBS significantly, however after TC, its application was only beneficial for RMGI. The MDP containing luting cement showed higher SBS compared to the RMGI and 4-META luting agents. Future commercial adhesives containing zirconia nanoparticles could provide cements with improved mechanical properties.

Polybetaine-enhanced hybrid ionomer cement shows improved total biological effect with bacterial resistance and cellular stimulation

Hybrid ionomer cements (HICs) are aesthetic polyelectrolyte cements that have been modified with a resin. The setting of HICs occurs by both monomer polymerization and an acid-base reaction. In addition, HICs contain a resin, which is substituted for water. Thus, the competition between the setting reactions and reduced water content inherently limits polysalt formation and, consequently the bioactive interactions. In this study, we explored the effects of polybetaine zwitterionic derivatives (mZMs) on the augmentation of the bioactive response of HICs. The polybetaines were homogenized into an HIC in different proportions (α, β, and γ) at 3% w/v. Following basic characterization, the bioactive response of human dental pulp stem cells (hDPSCs) was evaluated. The augmented release of the principal constituent ions (strontium, silica, and fluoride) from the HIC was observed with the addition of the mZMs. Modification with α-mZM elicited the most favorable bioactive response, namely, increased ion elution, in vitro calcium phosphate precipitation, and excellent biofouling resistance, which deterred the growth of the bridging species of Veillonella. Moreover, α-mZM resulted in a significant increase in the hDPSC response, as confirmed by a significant increase (p < 0.05) in alizarin red staining. The results of mRNA expression tests, performed using periodically refreshed media, showed increased and early peak expression levels for RUNX2, OCN, and OPN in the case of α-mZM. Based on the results of the in vitro experiments, it can be concluded that modification of HICs with polybetaine α-mZM can augment the overall biological response.

Evaluation of a Method to Determine Wear Resistance of Class I Tooth Restorations during Cyclic Loading

The aim of this study was the development of a test regime to determine the wear resistance and predict the clinical performance of conventional glass ionomer cement (GIC) restorations in Class I tooth cavities. Cavities were prepared in excised human teeth and restored using three conventional glass ionomer restorative materials: DeltaFil, Fuji IX GP and Ketac Universal. The restored teeth were mechanically and thermally stressed using a chewing simulator with a maximum number of 1,200,000 load cycles. Besides determining the number of cycles achieved, the abrasion volume after termination of the chewing simulation was calculated using µCT images. All teeth restored with DeltaFil reached 1,200,000 cycles without any restoration failure. Only 37.5% of the restorations each with Ketac Universal and Fuji IX GP were able to achieve the maximum cycle number. A significant lower abrasion volume for restorations with DeltaFil compared to Ketac Universal (p = 0.0099) and Fuji IX GP (p = 0.0005) was found. Laboratory chewing simulations are a useful tool to study basic wear mechanisms in a controlled setting with in-vivo related parameters. DeltaFil shows an improved wear resistance compared to other conventional GICs, indicating the high potential of this material for long-lasting Class I restorations.

Long-Term Water Balance Evaluation in Glass Ionomer Restorative Materials

The complex role of water in glass ionomer cement (polyalkenoate) dental restorative materials has been studied, but much of the present understanding concerning water balance within these materials is based on very early studies and short-term experiments. This study evaluated the nature of the water species of six conventional and four resin modified glass ionomer restorative materials over 3 years using thermogravimetric analysis techniques. Materials were prepared, placed in crucibles, and stored in physiologic phosphate buffered saline and evaluated at 24 h, 1 week, and then at 1, 3, 6, 9, 12, 18, 24, 30 and 36 months. All materials demonstrated a significant increase in unbound water percentage content but except for the resin modified materials, the enthalpy required to remove the unbound water species did not significantly change over 36 months. Also, bound water content percentage and removal enthalpy was established at 24 h, as no significant increase was noted in both bound water content and removal enthalpy over the course of this evaluation. This study suggests that unbound water species may increase with time and is loosely held except for the resin modified materials. Protective coatings placement and re-evaluation are prudent to prevent unbound water loss.

Dental Restorative Materials for Elderly Populations

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.

Comparison of microleakage between different restorative materials to restore marginal gap at crown margin

Background

An occurrence of secondary caries around the indirect restoration margin is reported to remain a leading cause of failures.

Objective

This study aimed to test the interfacial microleakage of conventional glass-ionomer (CGI), resin-modified glass ionomer (RMGI) and Nano-hybrid composite (CR) restorations at a full veneer margin crown.

Methods

Ninety human extracted molar teeth were divided into three groups (n = 30). Each group was subdivided into three subgroups (n = 10) according to the extent of the structural defects; The structural defect in G1 had a depth of 1.5 mm, width and length at 2 mm and 1 mm intrusion within the crown cervical margin. The corresponding structural defect dimension values for G2 were 2, 5, 4 and 2 mm with defects extending onto the root structure. Meanwhile, G3: structural deficiency of 2 mm depth, 3 mm width and 3 mm length and with 1.5 mm extension into the prepared teeth. These structural defects in each subgroup were restored with CGI, RMGI and CR. Artificial carious lesion formation was induced at the cervical finish line with a demineralizing solution. The artificial carious lesions were restored as per the group distribution. Subsequently, teeth samples were prepared and cemented with Nickel-chromium full coverage restorations utilizing glass-ionomer luting cement. Teeth samples were thermocycled, isolated with nail varnish, and immersed in 0.1% methylene blue for 24 h. The teeth samples were sectioned longitudinally, dye penetration was evaluated with a stereomicroscope. The data were analyzed with Kruskal–Wallis and Mann–Whitney U tests.

Results

CGI-G1 recorded the highest micro-leakage score at 1.450; while CR-G3 recorded the least score (0.350). At a cementum-restoration interface, CR-G1 (0.850) documented the lowest micro-leakage; RMGI-G3 had a greater value at 1.700.

Conclusions

The hybrid CR could be effectively used to restore the restoration of a marginal gap around crown margins.

Surface roughness and chemical composition changes of resin-modified glass ionomer immersed in 0.2% sodium fluoride solution

BACKGROUND/PURPOSE

Glass ionomers undergo degradation when exposed to fluoride, which changes the physico-chemical characteristics of the materials. The purpose of this study was to evaluate the surface changes of resin-modified glass ionomer (RMGI) when immersed in a sodium fluoride (NaF) solution according to pH and time.

MATERIALS AND METHODS

120 RMGI specimens were prepared, and 30 specimens were placed in four types of storage solutions for four weeks; pH 7 artificial saliva with or without 0.2% NaF (As7 and NaF7), pH 5 artificial saliva with or without 0.2% NaF (As5 and NaF5). Interferometry and microscopy were performed to evaluate the surface roughness and topography, while spectroscopy was used to analyze the chemical composition changes.

RESULTS

Rougher topography and increased roughness was exhibited in NaF groups, owing to the disintegration of the polysalt matrix. Reduced Sr and F was exhibited in all groups, whereas NaF group showed a decrease in Al and inorganic components.

CONCLUSION

This study suggest that excessive use of fluoride therapy could lead to severe degradation of RMGI.

Effect of different polishing techniques on surface roughness and bacterial adhesion of three glass ionomer-based restorative materials: In vitro study

Background

Although many reports concluded that polishing of glass ionomers is crucial for smoother surface and limiting the adhesion of cariogenic bacteria, there is no specific surface treatment protocol recommended. A novel material in the same category was released recently claimed to have surface smoothness comparable to resin composite and bacterial adhesion less than other types of glass ionomers. In this study, different polishing systems were tested with three glass ionomers one of them is the novel material to find the most appropriate polishing protocol. Objectives: To evaluate and compare the surface roughness and bacterial adhesion to resin modified glass ionomer, bioactive ionic resin and conventional glass ionomer restorative materials after different polishing protocols in vitro.

Material and Methods

The materials tested includes resin modified glass ionomer, bioactive ionic resin, and conventional glass ionomer. The polishing protocols were divided into four groups: group 1 = (Mylar matrix strips, Control), group 2 = (one-step, PoGo), group 3 = (two-step, Prisma Gloss) and group 4 = (three-step, Sof-Lex). From each material, eleven cylindrical specimens were prepared for each group according to the manufacturers' instructions. The surface roughness for all specimens was measured using atomic force microscope in tapping mode. the same specimens were subjected to bacterial adhesion testing after being coated with artificial saliva. Data were analyzed with two-way analysis of variance followed by Post hoc multiple comparisons.

Results

The highest Ra and S. mutans adhesion values were recorded for all materials in two-step group. The lowest Ra and S. mutans adhesion values were seen in one-step and three step groups.

Conclusions

One-step polishing system was more effective and may be preferable for polishing of the three studied glass ionomer-based materials compared to two-step and three-step systems. Key words:Activa bioactive restorative, glass ionomer, surface roughness, bacterial adhesion, surface treatment.

Effect of Tack Cure on Polymerization Shrinkage of Resin-based Luting Cements

CLINICAL RELEVANCE

Self-cure after tack cure could result in a lower polymerization shrinkage in some resin-based luting cements, which is closely related to lower degree of cure.

SUMMARY

Influence of ultrasonic excitation on microhardness of glass ionomer cement

BACKGROUND

Numerous researchers have attempted to improve the mechanical properties of glass ionomer cement since 1972. In this study, ultrasonic curing treatment was introduced during the mixing of glass ionomer cement (GC Fuji IX) to facilitate intimate mixing, compaction and adaptation of residual glass particle which consequently improves densification of the material.

OBJECTIVE

To assess the influence of ultrasonic treatment on the microhardness of glass ionomer cement (GC Fuji IX) and compare it with the conventionally cured method.

METHODS

A total of 40 specimens (2 × 2 mm) were fabricated and equally divided into two groups: Group I (conventional curing method) and Group II (ultrasonically cured). For Group II, an ultrasonic scaler was used which provides energy to ensure proper mixing of material without leaving any air bubbles or unmixed particles. Vicker's hardness test was employed to generate the average microhardness values by making three indentations at different points on each specimen. Statistical Package for Social Sciences (SPSS) Version 17 was used, employing independent samples T test to compare the difference in microhardness values between two curing groups.

RESULTS

The average surface hardness value for conventional cured GIC was 62.21 ± 13.61 while ultrasonically cured GIC exhibited a higher mean microhardness value of 66.37 ± 12.83. Additionally, the average microhardness values produced by the two groups showed statistically significant differences (p value < 0.035).

CONCLUSION

Ultrasonic excitation treatment leads to intimate mixing and accelerated hardening of glass ionomer cement thereby enhancing its microhardness and reducing early weakness.

Enhancing the Mechanical Properties of Glass-Ionomer Dental Cements: A Review

This paper reviews the strategies that have been reported in the literature to attempt to reinforce glass-ionomer dental cements, both conventional and resin-modified. These cements are widely used in current clinical practice, but their use is limited to regions where loading is not high. Reinforcement might extend these applications, particularly to the posterior dentition. A variety of strategies have been identified, including the use of fibres, nanoparticles, and larger particle additives. One problem revealed by the literature survey is the limited extent to which researchers have used International Standard test methods. This makes comparison of results very difficult. However, it does seem possible to draw conclusions from this substantial body of work and these are (1) that powders with conventional particle sizes do not reinforce glass-ionomer cements, (2) certain fibres and certain nanoparticles give distinct improvements in strength, and (3) in the case of the nanoparticles these improvements are associated with differences in the morphology of the cement matrix, in particular, a reduction in the porosity. Despite these improvements, none of the developments has yet been translated into clinical use.

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

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

Effect of smear layer deproteinization with HOCl solution on the dentin bonding of conventional and resin-modified glass-ionomer cements

The effect of smear layer-deproteinizing pretreatment using hypochlorous acid (HOCl) on the micro-shear bond strengths (μSBS) of conventional and resin-modified glass-ionomer cements (GIC) to dentin was investigated and compared with demineralizing pretreatment with polyacrylic acid (PAA). Three GICs: Fuji IX GP Extra (restorative conventional GIC), GC Fuji II LC EM (restorative resin-modified GIC), and GC Fuji Luting EX (luting resin-modified GIC), were used. One hundred fifty human molars were divided into groups (n = 10) according to the cements and dentin pretreatments; no pretreatment (control), 10 s PAA pretreatment, and HOCl pretreatment for 5, 15, or 30 s. After 24 h, μSBS was tested and the data were statistically analyzed using a two-way ANOVA, followed by Tukey's post-hoc test. HOCl pretreatment significantly increased μSBS of conventional GIC compared to the control group. For resin-modified restorative GIC, 5 s HOCl deproteinization significantly increased μSBS, while longer application times did not. There was no significant difference between HOCl-pretreated and control groups of resin-modified luting GIC. PAA pretreatment increased the μSBS of all cements significantly. In conclusion, smear layer deproteinization with HOCl can enhance the dentin bonding of conventional GIC. However, the residual radicals may adversely affect the polymerization of resin-modified GICs.

Effects of Curing Modes on the Microhardness of Resin-modified Glass Ionomer Cements

Objective

This study evaluated the effects of curing modes on surface microhardness of visible light-cured resin-modified glass ionomer cements (VLC RMGIC) and a giomer after different storage periods in comparison to auto-cured resin-modified glass ionomer cements (AC RMGIC).

Materials and Methods

The following materials were used: VLC RMIC: Fuji II LC Improved, Photac Fil Quick Aplicap, AC RMGIC: Fuji Plus, Fuji VIII and Giomer: Beautifil II. The measurements of microhardness were performed using a Vickers test (100 g loads were applied for 10 s) in the following time intervals: immediately after the recommended cure and after 1, 7 and 14 days of immersion in distilled water. Five samples (d=4 mm, h=2 mm) were prepared for each combination of curing mode and tested material.

Results

After 14 days, an improvement of microhardness was evident in all tested materials. The full factorial ANOVA identified a highly significant (p<0.001) effect of the factors “material”, “time” and “curing mode (“low”, “soft“, „high”) for the light-cured materials Beautifil II, Fuji II LC and Photac Fil Quick. There was a statistically significant difference in the microhardness between different material types (Beautifil II˃Fuji II LC˃Photac Fil Quick˃Fuji Plus˃Fuji VIII) and curing modes (low ˂soft ˂high).

Conclusions

Material type had the greatest impact on microhardness, followed by the factor of time, while curing modes showed a considerably smaller influence on microhardness of the light-cured materials.

Modification of glass ionomer cements on their physical-mechanical and antimicrobial properties

OBJECTIVE

The aim of this review was to provide an insight about the factors affecting the properties of glass ionomer cements and provides a review regarding studies that are related to modification of glass ionomer cements to improve their properties, particularly on physical-mechanical and antimicrobial activity.

METHODS

PubMed and Science Direct were searched for papers published between the years 1974 and 2018. The search was restricted to articles written in English related to modification of glass ionomer cements. Only articles published in peer-reviewed journals were included. The search included literature reviews, in vitro, and in vivo studies. Articles written in other languages, without available abstracts and those related to other field were excluded. About 198 peer-review articles in the English language were reviewed.

CONCLUSION

Based on the finding, most of the modification has improved physical-mechanical properties of glass ionomer cements. Recently, researchers have attempted to improve their antimicrobial properties. However, the attempts were reported to compromise the physical-mechanical properties of modified glass ionomer cements.

CLINICAL SIGNIFICANCE

As the modification of glass ionomer cement with different material improved the physical-mechanical and antimicrobial properties, it could be used as restorative material for wider application in dentistry.

Structural and long-term mechanical properties from a resin-modified glass ionomer cement after various delays of light-activation

This study aimed, after various delays of light-activation, to examine the microstructure of a resin-modified glass ionomer cement (RMGIC) by scanning electron microscopy (SEM) and to test its mechanical properties in short and long term. Five groups of Fuji II LC were investigated with different light-curing protocols. For each, SEM observations were undertaken with etched samples to selectively observe the organic polymer phase. Flexural strength and microhardness were also tested after 24 h and 12 months storage. SEM examination showed different images of the material according to the delay of light-activation. At 24 h, there was a delay with maximal mechanical properties: 5 min for flexural strength, 10 min for microhardness. However, at 12 months, maximal mechanical properties were reached for the shortest delay. The competition between the acid-base and polymerization reactions results in the formation of a structurally and mechanically different material according to the delay of light-activation. This delay should be adapted to the clinical situation.

Physical property investigation of contemporary glass ionomer and resin-modified glass ionomer restorative materials

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.

Effect of a filled adhesive as the desensitizer on bond strength of "Self-Adhesive Cements To" differently severity of fluorosed dentin

The objectives were to evaluate the efficacy of a filled adhesive named Prime & Bond NT (P&B NT) as the dentin desensitizer in occluding fluorosis dentinal tubules and compare the shear bond strength (SBS) of RelyX U200 self-adhesive resin cement (RXU) and RelyX Luting self-adhesive resin-modified glass ionomer cement (RMGIC) before and after P&B NT pretreatment. 176 non-carious fluorosis were classified into four subgroups by the Thylstrup and Fejerskov index (TFI): normal group (TFI = 0), mild group (TFI = 1-3), moderate group (TFI = 4-5), severe group (TFI = 6-9). 160 composite cylinders (4 × 5 mm) were fabricated, then every severity of fluorosed dentin was subjected to four treatments: P&B NT + RXU (n = 40), RXU (n = 40), P&B NT + RMGIC (n = 40), RMGIC (n = 40). The specimens were immersed in water at 37°C for 24 hr first and half of them underwent 5,000 thermocycling before shear bond strength test. A factorial design (factorial 4 × 2 × 2 × 2) was developed to make statistical analysis. Scanning electron microscope (SEM) analysis (n = 16) in cross section and longitudinal section view characterized the occlusion situation of dentinal tubules. P&B NT might occlude dentinal tubules as the dentin desensitizer for normal teeth and mild-moderate fluorosis. P&B NT significantly increased the SBS of RXU (p < .05) but had no statistical significance on the SBS of RMGIC (p > .05). RXU could benefit from P&B NT desensitization to achieve a better quality of adhesion.

Nanoscale Mobility of Aqueous Polyacrylic Acid in Dental Restorative Cements

Hydrogen dynamics in a time range from hundreds of femtoseconds to nanoseconds can be directly analyzed using neutron spectroscopy, where information on the inelastic and quasi-elastic scattering, hereafter INS and QENS, can be obtained. In this study, we applied these techniques to understand how the nanoscale mobility of the aqueous solution of polyacrylic acid (PAA) used in conventional glass ionomer cements (GICs) changes under confinement. Combining the spectroscopic analysis with calorimetric results, we were able to separate distinct motions within both the liquid and the GICs. The QENS analysis revealed that the self-diffusion translational motion identified in the liquid is also visible in the GIC. However, as a result of the formation of the cement matrix and its setting, both translational diffusion and residence time differed from the PAA solution. When comparing the local diffusion obtained for the selected GIC, the only noticeable difference was observed for the slow dynamics associated with the polymer chain. Additionally, over short-term aging, progressive water binding to the polymer chain occurred in one of the investigated GICs. Finally, a considerable change in the density of the GIC without progressive water binding indicates an increased polymer cross-linking. Taken together, our results suggest that accurate and deep understanding of polymer-water binding, polymer cross-linking, as well as material density changes occurring during the maturation process of GIC are necessary for the development of advanced dental restorative materials.

Calcium hydroxide liners: a literature review

OBJECTIVE

This review integrates the literature on cavity liners and current concepts of pulp protection with the aim of establishing a better understanding of the role of calcium hydroxide as a cavity liner.

MATERIALS AND METHODS

A search was conducted through PubMed, MEDLINE, and Ovid for articles with the criteria for the following terms: cavity liners and bases, pulp protection, and calcium hydroxide liners. No specific inclusion or exclusion criteria were applied as to what articles would be included in this review. It was hoped that the extent of the literature reviewed would be as comprehensive as possible.

CONCLUSION

This review underlines the fact that calcium hydroxide liners should only be used in the deepest spots in the cavity where the remaining dentine thickness is ≤0.5 mm. A protective layer of resin-modified glass ionomer should always follow the application of calcium hydroxide liners.

In vitro Evaluation of Stainless Steel Crowns cemented with Resin-modified Glass Ionomer and Two New Self-adhesive Resin Cements

AIMS

To assess and compare the retentive strength of two dual-polymerized self-adhesive resin cements (RelyX U200, 3M ESPE & SmartCem2, Dentsply Caulk) and a resin-modified glass ionomer cement (RMGIC; RelyX Luting 2, 3M ESPE) on stainless steel crown (SSC).

MATERIALS AND METHODS

Thirty extracted teeth were mounted on cold cured acrylic resin blocks exposing the crown till the cemento-enamel junction. Pretrimmed, precontoured SSC was selected for a particular tooth. Standardized tooth preparation for SSC was performed by single operator. The crowns were then luted with either RelyX U200 or SmartCem2 or RelyX Luting 2 cement. Retentive strength was tested using Instron universal testing machine. The retentive strength values were recorded and calculated by the formula: Load/Area.

STATISTICAL ANALYSIS

One-way analysis of variance was used for multiple comparisons followed by post hoc Tukey's test for groupwise comparisons. Unpaired t-test was used for intergroup comparisons.

RESULTS

RelyX U200 showed significantly higher retentive strength than rest of the two cements (p < 0.001). No significant difference was found between the retentive strength of SmartCem2 and RelyX Luting 2 (p > 0.05).

CONCLUSION

The retentive strength of dual-polymerized self-adhesive resin cements was better than RMGIC, and RelyX U200 significantly improved crown retention when compared with SmartCem2 and RelyX Luting 2.

HOW TO CITE THIS ARTICLE

Pathak S, Shashibhushan KK, Poornima P, Reddy VVS. In vitro Evaluation of Stainless Steel Crowns cemented with Resin-modified Glass Ionomer and Two New Self-adhesive Resin Cements. Int J Clin Pediatr Dent 2016;9(3):197-200.

A Comparative Analysis of Different Finishing and Polishing Devices on Nanofilled, Microfilled, and Hybrid Composite: A Scanning Electron Microscopy and Profilometric Study

The continuous development of esthetically acceptable adhesive restorative material has made a variety of tooth-colored materials available for clinical use. The advent of visible light polymerizing resin and the use of finer filler particles permit resin composites to be polished to higher degree. The effect of polishing systems on surface finish has been reported to be material-dependent, and the effectiveness of these systems was mostly product-dependent. Hence, the purpose of this study was to evaluate the efficiency of finishing and polishing systems on the surface roughness of nanofilled, microfilled, and hybrid composite restorative materials available in the market.

HOW TO CITE THIS ARTICLE

Yadav RD, Raisingani D, Jindal D, Mathur R. A Comparative Analysis of Different Finishing and Polishing Devices on Nanofilled, Microfilled, and Hybrid Composite: A Scanning Electron Microscopy and Profilometric Study. Int J Clin Pediatr Dent 2016;9(3):201-208.

Sealing Ability of Nano-ionomer in Primary Teeth: Anex vivoStudy

Introduction

Microleakage is an important consideration in primary dentition because the floor of the cavity preparation may be close to the pulp. The added insult to the pulp caused by seepage of irritants around the restoration and through the thin dentin may produce irreversible pulp damage.

Aim

The objective of this study was to evaluate and compare the sealing ability of three light cured (LC) resin-modified glass-ionomer cements (RMGICs) in primary anterior teeth.

Materials and methods

Class V cavity was prepared on the labial surface of extracted primary anterior teeth which were then grouped and restored with Ketac N100, Fuji II LC, or Vitremer. Dye penetration test with methylene blue stain was used to record the microleakage. Depth of dye penetration was recorded in millimeters at the incisal and gingival margin using computer software.

Results

The depth of dye penetration at the incisal margin in the three groups was comparable, but at the gingival margin, Vitremer showed the least dye penetration, followed by Fuji II LC, and Ketac N100. The depth of dye penetration at the gingival margin was higher than the incisal margins in all the three groups.

Conclusion

Among the three RMGICs, Vitremer can be considered as the material of choice for restoring class V cavities in primary anterior teeth. Periodic recall and recare is necessary when any of the three materials are used in clinical practice.

How to cite this article

Siddiqui F, Karkare S. Sealing Ability of Nano-ionomer in Primary Teeth: An ex vivo Study. Int J Clin Pediatr Dent 2016;9(3):209-213.

A Review of Glass-Ionomer Cements for Clinical Dentistry

This article is an updated review of the published literature on glass-ionomer cements and covers their structure, properties and clinical uses within dentistry, with an emphasis on findings from the last five years or so. Glass-ionomers are shown to set by an acid-base reaction within 2–3 min and to form hard, reasonably strong materials with acceptable appearance. They release fluoride and are bioactive, so that they gradually develop a strong, durable interfacial ion-exchange layer at the interface with the tooth, which is responsible for their adhesion. Modified forms of glass-ionomers, namely resin-modified glass-ionomers and glass carbomer, are also described and their properties and applications covered. Physical properties of the resin-modified glass-ionomers are shown to be good, and comparable with those of conventional glass-ionomers, but biocompatibility is somewhat compromised by the presence of the resin component, 2 hydroxyethyl methacrylate. Properties of glass carbomer appear to be slightly inferior to those of the best modern conventional glass-ionomers, and there is not yet sufficient information to determine how their bioactivity compares, although they have been formulated to enhance this particular feature.

In vitro comparative assessment of the mechanical properties of PMMA cement and a GPC cement for vertebroplasty

AIMS

To develop a Glass Polyalkenoate Cement that is suitable for vertebroplasty.

METHODS

Testing was carried out to assess the effect of gamma irradiation used for sterilisation, on the glass transition temperature as well as its mechanical properties, including compressive strength and biflexural strength in vivo as well as testing GPC and PMMA cements post injection in cadaveric human vertebral bone.

RESULTS

There was a trend to a higher failure load required for the GPC cement group compared to the current standard PMMA injected group but this was not statistically significant with this small sample size.

CONCLUSION

The results are encouraging for future research to continue on GPC cements for use in vertebroplasty.

Design and development of self-healing dental composites

The purpose of this project is to design and develop a clinically applicable self-healing dental composite (SHDC). The value of resin-based dental restorations could be improved by increasing their service lives. One way to improve longevity is to obturate micro-cracks that form during or after the composite hardens in the dental cavity. Toward this end, we introduce here a new type of SHDC made with contemporary dental components plus two additional ingredients: a healing powder (HP, strongtium fluoroaluminosilicate particles) and a healing liquid (HL, aqueous solutions of polyacrylic acids) that is enclosed within silica microcapsules. As micro-cracks develop, they will break the microcapsules in their propagation path, thereby releasing HL. This liquid will then react with particles of HP exposed by the crack formation, forming an insoluble reaction product that fills and seals the cracks. The key factors to achieve this self-healing of cracks are discussed. The elastic modulus of a SHDC appeared to be satisfactory. The healing process was confirmed by means of mechanical, morphological, and chemical methods. The SHDC restored micro-cracks without external intervention, thereby showing potential for increasing the service lives of dental restorations. Importantly, this SHDC contains only clinically-tested, biocompatible materials, making it readily applicable.

Marginal microleakage of a resin-modified glass-ionomer restoration: Interaction effect of delayed light activation and surface pretreatment

BACKGROUND

Despite widespread clinical uses of resin-modified glass-ionomers (RMGIs), their sealing ability is still a concern. This study evaluated the effect of delayed light activation (DLA) of RMGI on marginal sealing in differently pretreated cavities.

MATERIALS AND METHODS

In this in vitro study, two standardized Class V cavities were prepared on the buccal and lingual surfaces of 56 sound maxillary premolars at the cementoenamel junction. The cavities were randomly divided into eight equal groups. In groups 1-4 (immediate light activation [ILA]), no pretreatment (negative control [NC]) and three surface pretreatments were used, respectively as follows: Cavity conditioner, Vitremer primer, cavity conditioner plus and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). Fuji II LC (GC, Japan) was prepared and placed in the cavities and immediately light-cured according to manufacturer's instructions. In groups 5-8 (DLA), the same pretreatments were applied, respectively. After placing Fuji II LC in the cavities, the restorations were light-cured after a 3-min delay. After finishing the restorations, the specimens were placed in water for 1-week and thermocycled. Microleakage scores were determined using the dye penetration technique. Kruskal-Wallis test and Mann-Whitney U-test were used to analyze the obtained data (α = 0.05).

RESULTS

At the dentin margins, DLA resulted in a lower microleakage for no treatment (NC), cavity conditioner and cavity conditioner plus ACP-CPP pretreatments groups (P ≤ 0.004); however, no difference was observed for Vitremer group (P > 0.05). At the enamel margins, no difference was observed between DLA and ILA for all groups (P > 0.05); only NC group exhibited a lower microleakage in case of DLA (P = 0.007).

CONCLUSION

Delayed light activation of RMGI may lead to different effects on marginal sealing, depending on pretreatment procedures used in the cavity. It might improve dentin sealing when no treatment and conditioner alone or with CCP-ACP is used.

Composition-structure-property relationships for non-classical ionomer cements formulated with zinc-boron germanium-based glasses

Non-classical ionomer glasses like those based on zinc-boron-germanium glasses are of special interest in a variety of medical applications owning to their unique combination of properties and potential therapeutic efficacy. These features may be of particular benefit with respect to the utilization of glass ionomer cements for minimally invasive dental applications such as the atruamatic restorative treatment, but also for expanded clinical applications in orthopedics and oral-maxillofacial surgery. A unique system of zinc-boron-germanium-based glasses (10 compositions in total) has been designed using a Design of Mixtures methodology. In the first instance, ionomer glasses were examined via differential thermal analysis, X-ray diffraction, and 11B MAS NMR spectroscopy to establish fundamental composition – structure-property relationships for the unique system. Secondly, cements were synthesized based on each glass and handling characteristics (working time, Wt, and setting time, St) and compression strength were quantified to facilitate the development of both experimental and mathematical composition-structure-property relationships for the new ionomer cements. The novel glass ionomer cements were found to provide Wt, St, and compression strength in the range of 48–132 s, 206–602 s, and 16–36 MPa, respectively, depending on the ZnO/GeO2 mol fraction of the glass phase. A lower ZnO mol fraction in the glass phase provides higher glass transition temperature, higher N4 rate, and in combination with careful modulation of GeO2 mol fraction in the glass phase provides a unique approach to extending the Wt and St of glass ionomer cement without compromising (in fact enhancing) compression strength. The data presented in this work provide valuable information for the formulation of alternative glass ionomer cements for applications within and beyond the dental clinic, especially where conventional approaches to modulating working time and strength exhibit co-dependencies (i.e. the enhancement of one property comes at the expense of the other) and therefore limit development strategies.

Evaluation of effect of ultrasonic scaling on surface roughness of four different tooth-colored class V restorations: An in-vitro study

AIMS

This study evaluated the effect of ultrasonic scaling on surface roughness of four different tooth-colored class V restorations.

MATERIALS AND METHODS

Out of 100 human extracted teeth, 20 were randomly selected for each group, marked with the outline of class V cavity. Class V cavities were prepared on facial surface of teeth of all groups except control group. These cavities were then restored with GC 2, GC 9, GC 2 LC, and Filtek Z 250 XT. All the specimens were stored in artificial saliva at 37°C for 1 month. Initial surface roughness values (Ra in μm) of restorations were evaluated with the surface roughness tester. Ultrasonic instrumentation was then carried out for 60 s on the restoration surface and final roughness values were evaluated. Data were analyzed with Paired t-test, One-way ANOVA, Tukey's test.

RESULTS

Mean Pre-instrumentation surface roughness was highest with GC 2, whereas it was least in case of Filtek Z 250 XT. Mean post-instrumentation surface roughness was highest with GC 2, whereas it is least in case of Filtek Z 250 XT.

CONCLUSION

GC 2 LC showed highest and Filtek Z 250 XT showed least susceptibility to ultrasonic scaling.