Evaluation of the antibacterial and physical properties of glass ionomer cements containing chlorhexidine and cetrimide: An in-vitro study

Effect of ethanolic extract of propolis on antibacterial and microshear bond strength of glass-ionomer restorations to dentin

Objectives

This study was conducted to evaluate the effect of ethanolic extract of propolis on antibacterial and microshear bond strength of glass ionomer restorations to dentin.

Materials and methods

Conventional glass ionomer cement (Equia forte, GC Tokyo, Japan), resin-modified glass ionomer (Fuji II LC, GC Tokyo, Japan) and propolis powder (dried extract from honey bees) materials were used in this study. Both conventional glass ionomer and resin-modified glass ionomer were modified by two different concentrations of ethanolic extract of propolis (10 % and 25 % EEP). For antibacterial test, Streptococcus mutans strain was spread on agar petri dishes using a sterile swab. Discs of both glass ionomer restorative materials (without adding EEP, with 10 % EEP and with 25 % EEP) were fabricated within the agar plates. Antibacterial activity was evaluated by measuring the inhibition zones around each disc. For microshear bond strength test, 60 healthy human permanent molars were prepared by cutting occlusal surface and expose the dentin at the height of contour of all teeth then conditioned using poly acrylic acid conditioner, both glass ionomer restorative materials (without adding EEP, with 10 % EEP and with 25 % EEP) were mixed and applied on conditioned dentin surface by using tygon tube. Microshear bond strength was evaluated by the universal testing machine.

Results

Two-way ANOVA test revealed that both glass ionomer type and different concentrations of EEP had significant effect on the antibacterial test results and microshear bond strength values (p < 0,05). Glass ionomer restorative material with 25%EEP had the highest antibacterial values whereas glass ionomer restorative material without modifications (control groups) had the lowest values. Resin-modified glass ionomer without any modification (control group) had the highest bond strength while resin-modified glass ionomer with 25%EEP had the lowest bond strength.

Conclusions

Incorporation of ethanolic extract of propolis to glass ionomer restorative material increases the antibacterial effects of both conventional GIC and RMGI. Inspite of this advantage, it seems that it has deleterious effect on microshear bond strength to dentin.

Biological considerations of dental materials as orifice barriers for restoring root-filled teeth

There is ample published literature regarding the technical aspects of restoring root-filled teeth, but little concerning the biological impacts, consequences, and criteria for the selection of direct restorative materials following endodontic treatment. The provision of an effective coronal seal in addition to a sound root filling is known to be important in the prevention of root canal infection. This review seeks to explore the evidence concerning the selection of dental materials in the restoration of root-filled teeth, specifically with a close examination of the properties of commonly used materials as orifice barriers. © 2023 Australian Dental Association.

Comparative Evaluation of Antibacterial Effect of GIC Containing Chlorhexidine and Miswak on Streptococcus mutans and Streptococcus sobrinus in Early Childhood Caries Children: A PCR Study

Background and aim

The therapeutic procedures used in the treatment of caries do not always eliminate all the microorganisms. Persisting cariogenic bacteria can cause recurrent caries and failure of restoration. Incorporation of an antimicrobial agent in the restorative material may be of paramount significance. The purpose of this study was to evaluate and compare the antibacterial effect of glass ionomer cement (GIC) containing CHX and miswak extract on Streptococcus mutans and Streptococcus sobrinus in ECC children using polymerase chain reaction (PCR).

Materials and methods

Forty-five children with ECC in the age-group 3–6 years were selected. The children were randomly allocated into three groups. Supragingival plaque samples (S1) were collected from sound buccal or labial surfaces of primary teeth. Cavity preparation was done and the teeth were restored according to the group to which the child had been allotted. The second plaque sample (S2) was collected 1 month and the final sample after 3 months of restoring all the decayed teeth. All the samples were sent for PCR analysis.

Results

Intergroup analysis was done using Kruskal–Wallis test followed by Mann–Whitney post hoc test showed statistically significant difference in S. mutans and S. sobrinus count between group I (CHX) and group III (control) and group II (miswak) and group III (control) but no statistically significant difference between group I (CHX) and group II (miswak) in S. mutans and S. sobrinus count.

Conclusion

1% chlorhexidine digluconate and aqueous extract of miswak are equally effective against S. mutans and S. sobrinus. Miswak can be used as an alternative herbal antimicrobial that can be incorporated in anhydrous GIC.

How to cite this article

Kalpavriksha AJ, Siddaiah SB, Bilichodmath S, et al. Comparative Evaluation of Antibacterial Effect of GIC Containing Chlorhexidine and Miswak on Streptococcus mutans and Streptococcus sobrinus in Early Childhood Caries Children: A PCR Study. Int J Clin Pediatr Dent 2021;14(2):229–234.

Shear Bond Strength and Film Thickness of a Naturally Antimicrobial Modified Dental Luting Cement

Although several natural plants and mixtures have been known and used over the centuries for their antibacterial activity, few have been thoroughly explored in the field of dentistry. Thus, the aim of this study was to enhance the antimicrobial activity of a conventional glass ionomer cement (GIC) with natural plant extracts. The effect of this alteration on the bond strength and film thickness of glass ionomer cement was evaluated and related to an 0.5% chlorohexidine modified GIC. Olive leaves (Olea europaea), Fig tree (Ficus carica), and the leaves and roots of Miswak (Salvadora persica) were used to prepare an alcoholic extract mixture. The prepared extract mixture after the evaporation of the solvent was used to modify a freeze-dried glass ionomer cement at three different extracts: water mass ratios 1:2, 1:1, and 2:1. An 0.5% chlorhexidine diacetate powder was added to a conventional GIC for the preparation of a positive control group (CHX-GIC) for comparison. The bond strength to dentine was assessed using a material-testing machine at a cross head speed of 0.5 mm/min. Failure mode was analyzed using a stereomicroscope at 12× magnification. The cement film thickness was evaluated in accordance with ISO standard 9917-1. The minimum number of samples in each group was n = 10. Statistical analysis was performed using a Kruskal–Wallis test followed by Dunn’s post hoc test for pairwise comparison. There was a statistically insignificant difference between the median shear bond strength (p = 0.046) of the control group (M = 3.4 MPa), and each of the CHX-GIC (M = 1.7 MPa), and the three plant modified groups of 1:2, 1:1, 2:1 (M = 5.1, 3.2, and 4.3 MPa, respectively). The CHX-GIC group showed statistically significant lower median values compared to the three plant-modified groups. Mixed and cohesive failure modes were predominant among all the tested groups. All the tested groups (p < 0.001) met the ISO standard of having less than 25 µm film thickness, with the 2:1 group (M = 24 µm) being statistically the highest among all the other groups. The plant extracts did not alter either the shear bond strength or the film thickness of the GIC and thus might represent a promising additive to GICs.

Physical and mechanical properties of conventional glass ionomer cement incorporated with cationic substances

Background: The effect of the antimicrobial agents benzalkonium chloride (BC) and cetylpyridinium chloride (CPC) on the restorative glass ionomer tooth cement (GIC) Fuji IX was investigated. Aim of the study: The aim of the study was to determine whether the addition of antimicrobial compounds impairs the physical and mechanical properties of the commercial GIC Fuji IX. Materials and Methods: The concentrations of 1%, 2% and 3% of antimicrobial agentsBC and CPC, by weight of the cement, were added during the mixing phase and different effects were studied. In most samples, there was a slight change in setting time. Samples with 4 mm diameter and 6 mm height were used to measure compressive strength and release. The release of antimicrobial compounds was analysed by UV-visible spectrophotometry at a wavelength of 259 nm for CPC and 214 nm for BC, in deionized water. Results: The obtained results showed that the release takes place through the diffusion mechanism in the first 2-3 hours, and the diffusion coefficients vary depending on the concentration. The values range is from 1.97 x 10-14 -1.78 x 10-12 m2 s-1. Release of antimicrobial compound had ceased after seven days, with total release representing between 2.15 and 4.84% of the initial additive loading. Conclusion: Both compounds have minor effect on the setting time of the GIC. The reduction of compressive strength is not statistically significant. CPC containing cements (1 and 2%), were statistically significantly weaker, than those containing BC (p<0.05).Both antimicrobial compounds have shown constant release from the GIC with values which are directly proportional both to the time and to the concentration.

Preparation of glass-ionomer cement containing ethanolic Brazilian pepper extract (Schinus terebinthifolius Raddi) fruits: chemical and biological assays

Plants may contain beneficial or potentially dangerous substances to humans. This study aimed to prepare and evaluate a new drug delivery system based on a glass-ionomer-Brazilian pepper extract composite, to check for its activity against pathogenic microorganisms of the oral cavity, along with its in vitro biocompatibility. The ethanolic Brazilian pepper extract (BPE), the glass-ionomer cement (GIC) and the composite GIC-BPE were characterized by scanning electron microscopy, attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR), and thermal analysis. The BPE compounds were identified by UPLC–QTOF–MS/MS. The release profile of flavonoids and the mechanical properties of the GIC-BPE composite were assessed. The flavonoids were released through a linear mechanism governing the diffusion for the first 48 h, as evidenced by the M_t/M_∞ relatively to \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\sqrt t$$\end{document}t, at a diffusion coefficient of 1.406 × 10^–6 cm² s⁻¹. The ATR-FTIR analysis indicated that a chemical bond between the GIC and BPE components may have occurred, but the compressive strength of GIC-BPE does not differ significantly from that of this glass-ionomer. The GIC-BPE sample revealed an ample bacterial activity at non-cytotoxic concentrations for the human fibroblast MRC-5 cells. These results suggest that the prepared composite may represent an alternative agent for endodontic treatment.

Evaluation of Preventive Antibacterial Properties of a Glass-Ionomer Cement Containing Purified Powder of Salvia officinalis: An In vitro Study

Background

In this study, the anti-Streptococcus mutans and anti-Lactobacillus casei properties of a restorative glass-ionomer cement (GIC) modified with extract powder of Salvia officinalis as a safe and effective herbal extract at weight concentration levels of 0.5%, 0.75%, 1%, and 1.25% are investigated.

Methods

The S. officinalis extract powder is provided by doing a multistep laboratory procedure and is filtered to obtain particles smaller than 50 μ. The GIC powder is modified by adding extract powder in weight concentrations of 0.5% (Group II), 0.75% (Group III), 1% (Group IV), and 1.25% (Group V) to form experimental groups, each of 1 g. Five disk-shaped samples, 1 cm in diameter and 2 mm height, of each group (including control group [Group I]) are prepared for each bacterial category of S. mutans and L. casei. The twenty-five samples for each category are tested in vitro against strains of S. mutans and L. casei. Following Agar diffusion tests, the inhibition zone diameters are recorded. The data are tested for normality by means of Kolmogorov-Smirnov procedure. The Kruskal-Wallis and Mann-Whitney tests are used to perform a one-way ANOVA and to do pair-wise comparisons, respectively, at 5% significance level.

Results

The mean diameter of the inhibition zones are significantly different among the test groups and also the test groups and the control group except for the group with 0.5% in L. casei category which shows no significant difference with the control group.

Conclusions

The present study revealed direct inhibitory activities of S. officinalis-containing GIC against S. mutans and L. casei in a dose-response manner.

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.

Antibacterial potency and fluoride release of a glass ionomer restorative material containing different concentrations of natural and chemical products: An in-vitro comparative study

BACKGROUND

This study investigated the antibacterial efficacy against Streptococcus mutans and fluoride release of a conventional glass ionomer (GI) contained natural and chemical agents.

MATERIAL AND METHODS

Two hundred and ten GI specimens were divided into ten groups (n=21) according to the concentrations of the additives as; Propolis extract containing GI (Groups 1, 2, 3) with concentrations of 0.25%, 0.75% and 1.25% respectively, Miswak extract containing GI (Groups 4, 5, 6) and Chlorhexidine containing GI (Groups 7, 8, 9) with the same concentrations. The prepared specimens were subjected to antimicrobial activity by well diffusion, bacterial adherence, and fluoride release (from 2 to 72 hours) assessments.

RESULTS

A higher statistically significant antibacterial activity was found in (Groups 2, 3) compared to (Groups 8, 9), while (Groups 1, 4, 5, 6, 7, 10) no antibacterial efficacy was reported. For (Groups 2, 3) had a higher statistically significant anti-adherence effect compared to the other tested groups. Enhanced ascending increase in fluoride release was observed for (Groups 3, 4) compared to (GI).

CONCLUSIONS

The increased concentration of propolis extract had a synergistic effect on the antimicrobial activity of the tested GI. Additive concentrations of 0.25% Miswak and 1.25% propolis could enhance the fluoride-releasing ability of the tested GI. Key words:Propolis, miswak, chlorhexidine, glass ionomer, fluoride.

Comparative evaluation of compressive strength, diametral tensile strength and shear bond strength of GIC type IX, chlorhexidine-incorporated GIC and triclosan-incorporated GIC: An in vitro study

Aim:

To comparatively evaluate the compressive strength, diametral tensile strength, and shear bond strength of glass ionomer cement type IX, chlorhexidine-incorporated glass ionomer cement, and triclosan-incorporated glass ionomer cement.

Materials and Methods:

In this study, glass ionomer cement type IX was used as a control. Chlorhexidine diacetate, and triclosan were added to glass ionomer cement type IX powder, respectively, in order to obtain 0.5, 1.25, and 2.5% concentrations of the respective experimental groups. Compressive strength, diametral tensile strength, and shear bond strength were evaluated after 24 h using Instron Universal Testing Machine. The results obtained were statistically analyzed using the independent t-test, Dunnett test, and Tukey test.

Results:

There was no statistical difference in the compressive strength, diametral tensile strength, and shear bond strength of glass ionomer cement type IX (control), 0.5% triclosan-glass ionomer cement, and 0.5% chlorhexidine-glass ionomer cement.

Conclusion:

The present study suggests that the compressive strength, diametral tensile strength, and shear bond strength of 0.5% triclosan-glass ionomer cement and 0.5% chlorhexidine-glass ionomer cement were similar to those of the glass ionomer cement type IX, discernibly signifying that these can be considered as viable options for use in pediatric dentistry with the additional value of antimicrobial property along with physical properties within the higher acceptable range.

Comparative Evaluation of Shear Bond Strength and Fluoride Release of Conventional Glass Ionomer with 1% Ethanolic Extract of Propolis Incorporated Glass Ionomer Cement -Invitro Study

INTRODUCTION

Atraumatic restorative treatment is a minimal intervention approach which involves manual removal of caries followed by restoration using adhesive restorative material. Due to incomplete manual caries excavation, there is a high chance of secondary caries under the restoration. Hence, many antibacterial agents have been incorporated in cement to enhance their antibacterial effect. Propolis is one of the natural medicines that has highlighted application in dentistry.

AIM

The current study evaluated the shear bond strength and fluoride release of Glass Ionomer Cement (GIC) combined with 1% Ethanolic Extract of Propolis (EEP). The research hypothesis was that the incorporation of 1% EEP in GIC has an effect on shear bond strength and fluoride release.

MATERIALS AND METHODS

A study was conducted among two groups. Group A conventional GIC (control), Group B GIC incorporated with 1% EEP (experimental). Shear bond strength: Thirty samples were prepared. Dentinal surface was restored and bond strength was assessed using a universal testing machine. Fluoride release: Thirty samples were prepared and stored in distilled water at a constant temperature until the time of measurement. The fluoride release was assessed by ion selective electrode after 1(st) day and 7(th) day. Data obtained by shear bond strength analysis was subjected to statistical analysis using an unpaired t-test and the data obtained by the fluoride release analysis was subjected to an unpaired t-test and paired t-test.

RESULTS

Result showed that there was no statistically significant difference in shear bond strength between the groups (p-value 0.77). A statistically significant difference was noticed in fluoride release among the groups after 1(st) and 7(th) day (p-0.001). However, the release was lesser in both the groups after the 1(st) day.

CONCLUSION

A 1% EEP incorporated GIC enhanced the fluoride release without causing a significant effect on shear bond strength of GIC.

Restorative materials containing antimicrobial agents: is there evidence for their antimicrobial and anticaries effects? A systematic review

The aim of this systematic literature review was to investigate whether the incorporation of antimicrobial agents into dental restorative materials truly exerts an antimicrobial effect against common cariogenic bacteria (primary outcome), and whether the inclusion of antimicrobial agents is able to prevent caries around restorations (secondary outcome). MEDLINE, via PubMed, was searched for papers published between 1980 and 30 November 2014. A total of 1126 articles were retrieved. After inclusion/exclusion assessment, 147 full text articles were read and included in the review, comprising 130 in vitro, 1 in situ, and 4 in vivo studies, as well as 12 literature reviews. In about 78% of in vitro studies, and in all identified in situ and in vivo studies, a positive antimicrobial effect had been found. However, the anticaries effect had not been tested in any of the selected studies. It was concluded that there is indeed evidence that restorative dental materials containing antimicrobial agents exert an antimicrobial effect, both in laboratory and in clinical studies. However, no evidence has been found regarding the role of these agents in preventing or controlling dental caries, or in preventing caries around restorations.

Effect of One Percent Chlorhexidine Addition on the Antibacterial Activity and Mechanical Properties of Sealants: An in vitro Study

AIM

The aim of the study was to evaluate the effect of addition of 1% chlorhexidine digluconate solution on the antibacterial activity and mechanical properties of glass ionomer and resin based sealant.

MATERIALS AND METHODS

Conventional glass ionomer sealant (GIS) (Fuji VII, Japan) and resin sealant (Clinpro 3M ESPE, USA) were used in this study. Chlorhexidine digluconate (CHX) (20%) liquid was added to both the sealants, and the concentration of chlorhexidine in sealants was adjusted to 1%. The sealants were divided into four groups as: group A (GIS), group B (GIS + 1% CHX), group C (resin sealant), group D (resin sealant + 1% CHX). Five cylindrical specimens were prepared in each group. Their antibacterial activity against Streptococcus mutans and Lactobacillus acidophilus, and their mechanical properties (compressive strength and diametrical tensile strength) were assessed. Mann-Whitney and Wilcoxon signed rank test were used appropriately for statistical analysis (SPSS version 19).

RESULT

Addition of one percent chlorhexidine significantly increased the antibacterial activity of both the sealants. There was a significant difference between groups A and B (p < 0.009), and groups C and D (p < 0.008). There was no significant difference in the mechanical properties of the sealants.

CONCLUSION

Addition of one percent chlorhexidine to the glass ionomer and resin based sealants provided sufficient antibacterial activity, without significantly affecting the mechanical property of the sealants. How to cite this article: Shanmugaavel AK, Asokan S, John JB, Geetha Priya PR, Gnana Devi J. Effect of one percent Chlorhexidine Addition on the Antibacterial Activity and Mechanical Properties of Sealants: An in vitro Study. Int J Clin Pediatr Dent 2015;8(3):196-201.

Comparative evaluation of the antibacterial and physical properties of conventional glass ionomer cement containing chlorhexidine and antibiotics

Objective:

To evaluate the antimicrobial efficacy and compressive strength of conventional glass ionomer cement (GIC) containing chlorhexidine and antibiotics at varying concentrations.

Materials and Methods:

Chlorhexidine diacetate and antibiotics (ciprofloxacin, metronidazole, and minocycline) were incorporated into GIC Fuji IX at 1.5% and 3% w/w ratio to form the experimental groups. The experimental GIC specimens were placed on brain heart infusion agar plates inoculated with Streptococcus mutans, and the area of inhibition was measured after 48 h. The 24-h compressive strength of the set specimens was evaluated using a Universal Testing Machine.

Results:

The control group demonstrated no zone of inhibition. All experimental groups showed inhibition against S. mutans (P < 0.05), with larger zones of inhibition found in the higher concentration groups. Compressive strength at the end of 24 h decreased in the experimental groups as compared to the control group (P < 0.05), but no difference was found between the experimental groups (P > 0.05).

Conclusion:

The present study demonstrated that experimental GICs containing chlorhexidine diacetate and antibiotics were effective in inhibiting S. mutans, and incorporation of 1.5% ABX was optimal to give the appropriate antibacterial and physical properties.

Biocompatibility of glass ionomer cements with and without chlorhexidine

Objective:

The aim of the present study is to evaluate the biocompatibility of glass ionomer cements (GICs) with and without chlorhexidine (CHX) as well as coated with varnish or not using in vitro cytotoxicity test.

Materials and Methods:

Biocompatibility of Fuji IX, Fuji IX with varnish, Fuji IX with 1% CHX diacetate and Fuji IX with 1% CHX diacetate with varnish was determined with in vitro cytotoxicity assay by using L929 mouse connective tissue fibroblasts. After 72 h, cell viabilities were evaluated by MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] assay to determine the effects of the cements on the mitochondrial function and microscopic images were taken by scanning electron microscopy.

Results:

Statistical analysis was performed by one-way analysis of variance followed by the Bonferroni post-hoc test at a significance level of P < 0.05. 72 h after treatment, there were statistically significant differences between Fuji IX and Fuji IX-CHX (P < 0.001). In addition, the reduction of the cytotoxicity by coating the GICs with varnish was indicative and increased the cell viability ratio (P < 0.001).

Conclusions:

Fuji IX coated with varnish was found to be the most biocompatible one among others. Thus adding CHX significantly reduced the cell viability, it is assumed that, due to the leakage of CHX and the other components of the GICs to the cell culture medium, the cell viabilities were decreased, so it is highly recommended to use varnish not only to reduce the water loss from the GICs, but also to reduce the cytotoxicity of the GICs.

Comparative evaluation of microleakage in conventional glass ionomer cements and triclosan incorporated glass ionomer cements

Aim and Objective:

The aim of the following study is to comparatively evaluate the microleakage of triclosan incorporated GIC with conventional restorative GIC.

Materials and Methods:

Triclosan in powder form was added to conventional GIC to formulate a concentration of 2.5%. Class five cavities were prepared in non-carious extracted molars and were respectively restored with conventional restorative GIC and triclosan incorporated GIC. Samples were kept in 10% methylene blue dye. Ground sections were obtained and were observed under a binocular microscope for dye penetration.

Result:

No significant difference was found in the microleakage of two groups.

Conclusion:

Triclosan incorporated GIC can be considered as an alternative to GIC with enhanced antibacterial property.