Evaluation of Microleakage in Zirconomer®: A Zirconia Reinforced Glass Ionomer Cement

Clinical Performance of Zirconia Reinforced versus Conventional Viscous Glass Ionomer in Class I Cavities of Geriatric Patients: A 1-year Randomized Controlled Clinical Trial

Background

For the elderly population, efforts are made to simplify the restorative procedure while maintaining good clinical performance. Glass ionomer (GI) cements are showing signs to fulfill many of these qualities. With their new properties and ease of use, they can be developed further to become a useful group of materials to overcome the problems of elderly patients.

Aim

The aim of the study was to evaluate the clinical performance of zirconia-reinforced versus conventional viscous GI restorations in Class I cavities of geriatric patients.

Setting and Design

The study design was in vivo randomized clinical trial, parallel-arms, allocation ratio: 1:1.

Subjects and Methods

A total of 28 Class I carious lesions in 21 geriatric patients were restored randomly either by zirconomer-improved or Ketac Molar Quick Aplicap (n = 14) each. Restorations were evaluated for 1 year by modified USPHS criteria.

Statistical Analysis

Data were analyzed with the Chi-square test and Cochran's Q-test. Survival rate was analyzed using the Kaplan-Meier and log-rank test.

Results

Twenty-four restorations were evaluated in 19 patients with a recall rate of 85.7% at 12 months. Significant differences were found in marginal integrity and marginal discoloration within both restorative materials between different time intervals (P < 0.05). However, none of the materials were superior to another regarding all assessed criteria.

Conclusions

Both zirconia-reinforced GI and conventional highly viscous GI have acceptable clinical performance.

A Comprehensive Evaluation of Zirconia-Reinforced Glass Ionomer Cement's Effectiveness in Dental Caries: A Systematic Review and Network Meta-Analysis

Dental cements are in a constant state of evolution, adapting to better align with the intricacies of tooth structure and the dynamic movements within the oral cavity. This study aims to evaluate the efficacy of zirconia-reinforced glass ionomer cement-an innovative variant of modified glass ionomer cements-in terms of its ability to withstand compressive forces and prevent microleakage during dental caries reconstruction. An extensive search was conducted across various databases, encompassing PubMed-MEDLINE, Scopus, Embase, Google Scholar, prominent journals, unpublished studies, conference proceedings, and cross-referenced sources. The selected studies underwent meticulous scrutiny according to predetermined criteria, followed by the assessment of quality and the determination of evidence levels. In total, 16 studies were incorporated into this systematic review and network meta-analysis (NMA). The findings suggest that both compomer and giomer cements exhibit greater compressive strength and reduced microleakage values than zirconia-reinforced glass ionomer cement. In contrast, resin-modified glass ionomer cement (RMGIC) and high-viscosity glass ionomer cement (GIC) demonstrate less favorable performance in these regards when compared with zirconia-reinforced glass ionomer cement.

Clinical comparison of different glass ionomer-based restoratives and a bulk-fill resin composite in Class I cavities: A 48-month randomized split-mouth controlled trial

OBJECTIVE

The aim of this study is to compare the retention rates (primary outcome) of high-viscosity glass ionomer (GI), glass carbomer (GC), zirconia-reinforced GI (ZIR), and bulk-fill (BF) composite resin restorations. Secondary outcomes included anatomical form, marginal adaptation, marginal discoloration, color match, surface texture, post-operative sensitivity and secondary caries.

METHODS

Two calibrated operators placed 128 restorations in 30 patients with a mean age of 21 years. The restorations were evaluated by one examiner at baseline and at 6, 12, 18, 24, and 48 months using the modified US Public Health Service criteria. The data were statistically analyzed using Friedman test. Differences between restorations were analyzed using Kruskal-Wallis test.

RESULTS

After 48 months, 23 patients and 97 restorations (23 GI, 25 GC, 24 ZIR, and 25 BF) were evaluated. Patient recall rate was 77%. No significant difference was observed between the retention rates of the restorations (p > 0.05). GC showed significantly lower results than the other three fillings in terms of anatomical form (p < 0.05). There was no significant difference in the anatomical form and retention between GI, ZIR, and BF (p > 0.05). No significant change was observed in the postoperative sensitivity or secondary caries for any of the restorations (p > 0.05).

CONCLUSIONS

GC restorations showed statistically lower anatomical form values, indicating lower wear resistance than the other materials. However, no significant difference was observed in the retention rates (as primary outcome) as well as the other secondary outcomes of the four different restorative materials after 48 months.

CLINICAL SIGNIFICANCE

GI-based restorative materials and BF composite resin restorations in Class I cavities yielded satisfactory clinical performance after 48 months.

Comparative evaluation of microleakage and hardness of newer posterior restorative materials

Background

The physical properties of restorative materials are critical when restoring posterior teeth. Restorative materials are continuously evolving in the quest for creating long lasting restorations.

Aim and objective

To compare and evaluate microleakage and hardness of three different posterior restorative materials: Cention N, Zirconomer Improved and Solare Sculpt.

Materials and methods

For micro leakage evaluation, 40 extracted human third molars were randomly divided into three experimental groups of 10 teeth each and two control group of 5 teeth each. Standardized box shaped class II cavity preparation was done in Group I, II, III and V. In Group V, cavity was prepared but left unrestored. No cavities were prepared in Group IV. Cavities in Group I, II, and III were restored with Cention N, Zirconomer Improved, Solare Sculpt respectively. Teeth were thermocycled together for 500 cycles. All the samples were placed in 2% methylene blue for 24 h. Microleakage evaluation was done using stereomicroscope. For hardness evaluation ten standardized discs of each material were prepared and evaluated using vicker's hardness test.

Results

All the groups showed some amount of microleakage. The mean micro-leakage score was significantly more among Group II compared to Group I. There was no significant difference in mean micro-leakage score between Groups I and III. The mean hardness value was significantly more among Groups I and II compared to Group III.

Conclusion

No material was able to completely eliminate microleakage. Cention N showed high hardness among the materials tested.

Coronal Restoration as a Predictor of Periapical Disease in Non-Endodontically Treated Teeth

Objectives

To compare the frequency of apical periodontitis (AP) in non-endodontically treated teeth restored with full coverage crowns, amalgam and resin composite fillings, and to disclose the association of type and quality of coronal restoration with periapical disease.

Material and Methods

The cross-sectional study involved 597 subjects who attended the Dental Clinic of the Clinical Hospital Centre, Rijeka, Croatia for the first time. Data were collected by means of a clinical and radiological survey. The following data were recorded for all permanently restored non-endodontically treated teeth: the type, the quality of coronal restoration according to clinical and radiographic criteria for marginal integrity as well as the recurrent caries presence, periapical status and marginal bone loss. Chi-square tests were used to analyze the difference in periapical status regarding the type and the quality of restoration. The multivariate logistic regression analysis was used to assess the effect of explanatory tooth-specific variables on periapical status.

Results

There was no significant difference in the proportion of AP with regards to the type and material of adequate quality coronal restorations (χ²=5.000, P=0.082). The regression analysis revealed significant positive associations with outcome variable (AP) for crowns (OR=3.39; P<0.001), recurrent caries (OR=4.67; P<0.001) and premolar teeth (OR=1.73; P=0.002).

Conclusion

If the quality of restorations is adequate, there is no difference in the periapical status of non-endodontically treated teeth regarding the type and material of coronal restoration.

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.

Comparative Analysis of Microleakage of Zirconia-infused Glass Ionomer Cement with Miracle Mix and Amalgam: An In Vitro Study

Context

Various restorative materials are introduced in dentistry to achieve adequate strength and restore aesthetics. Dental amalgam is a versatile material with self-sealing property, but is unaesthetic. Other restorative materials like composites require conservative preparation, but exhibit polymerisation shrinkage resulting in microleakage. To overcome these drawbacks, a high strength restorative material reinforced with ceramic and zirconia fillers known as Zirconomer (Shofu Inc., Japan) has been introduced.

Aims

This in vitro study aims to evaluate and compare the microleakage of zirconia-infused glass ionomer cement (Zirconomer) with Miracle Mix (GC Fuji Miracle Mix, Japan) and amalgam.

Materials and methods

In this in vitro study, 30 non-carious premolar teeth were randomly divided into three groups (n=10) depending on the restorative material used—Silver Amalgam (DPI, India), Miracle Mix, and Zirconomer. Standard Class V cavities were prepared on the buccal surface of 30 non-carious extracted premolars. The restored teeth were thermocycled and then immersed in 2% methylene blue dye for 24 hours. All teeth were bisected longitudinally in a buccolingual direction and observed under a stereo microscope at 40X magnification for the evidence of dye penetration. The data were analyzed using one-way analysis of variance (ANOVA) and Kruskal-Walis tests (p<0.01).

Results

Zirconomer showed the least microleakage in Class V cavity restoration with a statistically significant difference to amalgam and Miracle Mix.

Conclusions

Zirconomer has proven to be an excellent restorative material as it showed the least microleakage followed by Miracle Mix and amalgam. Zirconomer raises the bar for restorative reinforced glass ionomers by outperforming conventional glass ionomers and amalgam restoration.