One year comparative clinical evaluation of EQUIA with resin-modified glass ionomer and a nanohybrid composite in noncarious cervical lesions

Sixty-month comperative evaluation of a glass hybrid restorative and a composite resin in non-carious cervical lesions of bruxist individuals

OBJECTIVE

To compare the clinical performance of a glass hybrid (GH) restorative and a nano-ceramic composite resin (CR) in the restoration of non-carious cervical lesions (NCCLs) of bruxist individuals in a 60-month randomized clinical trial.

MATERIALS AND METHODS

Twenty-five bruxist candidates having NCCLs were recruited in this clinical study. The depth, height (cervico-incisal), width (mesio-distal), internal angles of the NCCLs, degree of tooth wear (TWI) and gingival index (GI) were measured. One hundred-and-forty-eight NCCLs were restored either with a GH restorative (Equia Forte Fil) or a CR (Ceram.X One Universal). Modified USPHS criteria was used to evaluate restorations after 1 week and 12, 24, 36 and 60 months. Pearson's Chi-Square, Fisher's Exact and Cochran Q tests were run for analysis. Survival rates of the restorations were compared with Kaplan-Meier analysis (p < 0.05).

RESULTS

After 60 months, 97 restorations in 15 patients were examined. The recall rate was 60.0%. Retention rates were 73.5% for CR and 66.7% for GH. A total of 29 restorations were lost (13CR (26.5%), 16GH (33.3%)). There was not a significant difference between tested restoratives in retention (p = 0.464), marginal adaptation (p = 0.856) and marginal discoloration (p = 0.273). There was no relationship between internal angle, depth, height or width and retention of the GH or CR restorations (p > 0.05). The increase in retention loss and marginal discoloration of both restorations over time were significant (p < 0.001). Sensitivity or secondary caries were not detected after 60 months.

CONCLUSION

GH and nano-ceramic CR showed similar clinical performances in NCCLs after 60 months in patients with bruxism.

CLINICAL SIGNIFICANCE

After 60 months, CR and GH materials showed clinically acceptable performances in restoration of NCCLs in patients with bruxism.

Evaluation of Giomer Using Eighth Generation Bonding Agent and Resin-Modified Glass Ionomer Cement Restoration in Non-Carious Cervical Lesions

INTRODUCTION

Non-carious cervical lesions (NCCL) raise a considerable restorative challenge for the dentist in bonding, as adhesion is not as strong and predictable as enamel bonding. A critical factor for restorative success is the selection of restorative material. Clinicians have tried many restorative materials and techniques to obtain the best performance. The aim of the present study was to evaluate and compare the clinical outcome of a Giomer and Resin modified glass ionomer cement (RMGIC) restoration in NCCL using united states public health service (USPHS) criteria at baseline, 3, 6 and 12 months.

MATERIALS AND METHOD

Patients from age 25 - 50 years having non-carious cervical lesions on both the sides and requiring restorations were screened. 20 patients were selected and further divided into 2 groups using simple random sampling technique. Group A- Beautifil II restoration using G-Premio bond (n = 10) and Group B- Ketac N100 restoration (n = 10). Restorations were done according to manufacturer's instructions and consequently evaluated at baseline, 3, 6 and 12 months using the USPHS criteria for marginal discolouration, marginal integrity, surface texture, colour match, gross fracture and post-operative sensitivity.

RESULTS

Giomer restorations showed better results than RMGIC. There was decrease in alpha ratings in both the study groups i.e., Giomer and RMGIC from 6 to 12 months.

DISCUSSION

The overall findings suggest that both Giomer and RMGIC gave satisfactory clinical results when used to restore non-carious cervical lesions. Both the materials can successfully be used since there was no statistically significant difference in the clinical outcome.

Comparative Evaluation of Compressive Strength of Self-cure, Dual-cure, and Light-cure Glass Ionomer Cements in a Simulated Oral Environment: An In Vitro Study

Background

In primary dentition, glass ionomer cements (GICs) have unique benefits as a restorative material. Various types of GICs are available in the market. In pediatric dentistry, the choice of GI materials is generally focused on handling convenience with adequate consideration for mechanical qualities, including compressive strength to withstand occlusal stresses in the oral environment.

Aim of the study

To evaluate the compressive strength of self-cure, dual-cure, and light-cure GI-based cements using a universal testing machine.

Materials and methods

The study population comprised 30 cylindrical restorative blocks for compressive strength assessment. The restorative materials used for the studies were self-cure GIC (ChemFil Rock and GC Fuji IX GP Fast GIC), dual-cure GIC (Equia Forte and Ionolux GIC), and light-cure GIC (GC Fuji II LC and Ketac N 100 GIC). The cylindrical blocks were prepared using prefabricated Teflon mold measuring 4 mm diameter and 6 mm height from respective restorative materials and divided into three major groups and were subdivided into six groups comprising two materials in each group. Using an Instron universal testing machine, compressive strength was assessed. Data obtained were tabulated, and statistical analysis was done using Statistical Package for the Social Sciences (SPSS v22.0) software.

Results

On individual comparison of GI-based types of cement, Ketac N100 GIC showed the highest compressive strength, and Fuji IX GP Fast GIC showed the least compressive strength.

Conclusion

Light-cure GIC exhibited the highest compressive strength in comparison to dual-cure and self-cure GICs with regard to the nature of curing.

How to cite this article

Chandru TP, Chandran S, Peedikayil FC, et al. Comparative Evaluation of Compressive Strength of Self-cure, Dual-cure, and Light-cure Glass Ionomer Cements in a Simulated Oral Environment: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(5):707-710.

Assessment of Flexural and Compressive Strengths of EQUIA, GC Gold Hybrid, and Conventional GIC Restorative Materials

Objectives

This in vitro research was performed to assess the flexural and compressive strengths of EQUIA, GC Gold Hybrid (GH), and conventional glass ionomer cement (GIC) restorative materials. Materials and methods: This study compares three restorative.

Materials

group I-EQUIA Forte GIC, group II-GC GH, and group III-conventional GIC for compressive and flexural strength evaluation. With a specially made Teflon mold, thirty-six cylindrical test specimens measuring 4 mm × 5 mm in dimension were created. They were then placed in 20 mL of deionized water and kept at 37°C for 3 hours every day for 30 days. Later, they were subjected to compressive strength and flexural strength using the universal testing machine. Statistics were used to examine each and every result.

Result and Conclusion

EQUIA had the highest average compressive strength and flexural strength, whereas traditional GIC restorative material had the lowest.

Glass hybrid versus composite for non-carious cervical lesions: Survival, restoration quality and costs in randomized controlled trial after 3 years

OBJECTIVE

This study compared survival, restoration quality and costs of glass hybrid (GH; EQUIA Forte Fil/EQUIA Forte Coat) and resin composite restorations (RC; OptiBond FL/Filtek Supreme XTE) of sclerotic non-carious cervical lesions.

METHODS

This is a cluster-randomized trial (ClinicalTrials.gov: NCT02631161). 88 patients (50-70 years) with 175 sNCCLs were randomized to receive GH or RC. Restorations were placed without mechanical cavity preparation and followed for a mean 36 (min/max: 31/55) months (variable follow-up due to COVID-19 lockdown). Restoration quality was re-evaluated at 1-, 18- and 36-months using FDI-criteria. Survival was assessed using multi-level Cox-regression analysis. Costs were estimated from a payer's perspective in Germany. Initial costs were determined based on micro-costing using time recordings and hourly costs, and follow-up costs based on statutory insurance fee-item-catalogues.

RESULTS

88 patients (175 restorations) were treated; 43 received GH (83 restorations), 45 RC (92 restorations). 17  GH and 19 RC showed total retention loss, 5  GH were partially lost (p = 0.396/Cox). FDI ratings were not sufficiently different for any domain except surface luster, where RC showed higher score (p < 0.001). Costs were initially lower for GH (32.57; SD 16.36 €) than RC (44.25; SD 21.40 €), while re-treatment costs were similar (GH: 9.15; SD 15.70 €; RC: 7.35; SD 14.51 €), resulting in significantly lower costs for GH (GH: 41.72; SD 25.08 €) than RC (51.60; 26.17 €) (p < 0.001/GLM).

CONCLUSIONS

While survival was not significantly different, GH was significantly less costly both initially and long-term than RC for restoring non-carious cervical lesions.

CLINICAL SIGNIFICANCE

Within this trial, survival was not significantly different between GH and RC to restore sclerotic NCCLs. As GH was significantly less costly both initially and long-term than RC, using RC was only cost-effective for payers willing to invest high additional expenses per minimal survival gains.

In vitro wear of (resin-coated) high-viscosity glass ionomer cements and glass hybrid restorative systems

OBJECTIVES

The aim of the present study was to investigate the volumetric abrasive wear of a high-viscosity glass ionomer cement (hvGIC; Equia Fil) and a glass hybrid restorative system (ghRS; Equia Forte), each being recommended as amalgam alternatives. Both materials were applied with or without their respective resinous coating, and were compared with a conventional GIC (Ketac Fil) and a hybrid composite resin (CR; G-ænial Posterior).

METHODS

78 standardized occlusal Class I cavities were restored with the various materials (n = 13 per group). Before and after chewing simulation (30,000 cycles at 40 N), each sample underwent optical scanning procedures (Omnicam). A comparison of the total wear using a fluorescence-aided identification technique (OraCheck) followed, and differences (α = 5%) between groups were compared by means of MANOVA.

RESULTS

Regarding the wear rates of hvGIC and ghRS, no differences could be observed (p > .050), and this was not affected by the resinous coating. All hvGIC and ghRS restorations showed significantly higher abrasive wear than CR (p < .001), while the conventional GIC displayed a significant underperformance compared with any other material (p < .001).

CONCLUSIONS

Resinous coating of hvGIC or ghRS does not appear to exert an effective long-term protection against advanced abrasive wear. Compared to the conventional GIC showing a considerable substance loss, both hvGIC and ghRS materials revealed an improved abrasion resistance, but clearly failed to meet the excellent values of the CR.

CLINICAL SIGNIFICANCE

Occlusal loading should be carefully considered when using hvGIC or ghRS as amalgam (or composite resin) alternatives for the restoration of posterior teeth.

One-year evaluation of a new restorative glass ionomer cement for the restoration of non-carious cervical lesions in patients with systemic diseases: a randomized, clinical trial

OBJECTIVE

This randomized and clinical trial aimed to evaluate the performance of a new restorative Glass Ionomer Cement (GIC) for the restoration of non-carious cervical lesions (NCCLs) of patients with systemic diseases compared with a posterior resin composite after 12 months.

METHODOLOGY

134 restorations were placed at 30 patients presenting systemic diseases by a single clinician. NCCLs were allocated to two groups according to restorative system used: a conventional restorative GIC [Fuji Bulk (GC, Tokyo Japan) (FB)] and a posterior resin composite [G-ænial Posterior (GC, Tokyo Japan) (GP)] used with a universal adhesive using etch&rinse mode. All restorative procedures were conducted according to manufacturer's instructions. Restorations were scored regarding retention, marginal discoloration, marginal adaptation, secondary caries, surface texture, and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after 1 week (baseline), 6, and 12 months. Descriptive statistics were performed using chi-square tests. Cochran Q and Mc Nemar's tests were used to detect differences over time.

RESULTS

After 12 months, recall rate was 93% and the rates of cumulative retention failure for FB and GP were 4.9% and 1.6% respectively. Both groups presented similar alpha rates for marginal adaptation (FB 86.2%, GP 95.5%) and marginal discoloration (FB 93.8%, GP 97%) at 6-month recall, but FB restorations showed higher bravo scores than GP restorations for marginal adaptation and marginal discoloration after 12 months (p<0.05). Regarding surface texture, 2 FB restorations (3.1%) were scored as bravo after 6 months. All restorations were scored as alpha for secondary caries and postoperative sensitivity after 12 months.

CONCLUSION

Although the posterior resin composite demonstrated clinically higher alpha scores than the conventional GIC for marginal adaptation and discoloration, both materials successfully restored NCCLs at patients with systematic disease after a year.

CLINICAL RELEVANCE

Due to its acceptable clinical results, the tested conventional restorative GIC can be used for the restoration of NCCLs of patients with systemic diseases.

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.

Comparative evaluation of compressive strength and surface microhardness of EQUIA Forte, resin-modified glass-ionomer cement with conventional glass-ionomer cement

PURPOSE

The study aimed to evaluate and compare the compressive strength and surface microhardness of EQUIA Forte, light cure, and conventional glass-ionomer cement (GIC).

METHODOLOGY

Fifty-four pellets of G-Coat (GC) Gold Label 2, GC Gold Label light-cured universal restorative material, and EQUIA Forte GIC were prepared of dimensions (6 × 4) mm and were divided into three groups (18) each and were stored at 37°C for 1 h and then immersed in 20 ml of deionized water, artificial saliva, and lactic acid six each, respectively, over 30 days. Samples were subjected to surface microhardness and compressive strength test on the 1^st day, 7^th day, and 30^th day. Results were subjected to ANOVA and Bonferroni post hoc test.

RESULTS

Comparing the compressive strength of EQUIA Forte from day 1 to 30 when placed in artificial saliva, there was a significant increase on day 30 (P = 0.007); compared to other groups. The surface microhardness of EQUIA Forte from day 1 to 30 when placed in artificial saliva nonsignificantly decreased comparing to other groups.

CONCLUSION

Surface microhardness and compressive strength of EQUIA Forte were significantly high in comparison to the other groups.

Comparative Evaluation of Postoperative Sensitivity in Bulk Fill Restoratives: A Randomized Controlled Trial

Aim

Comparative evaluation of postoperative sensitivity (POS) among three bulk fill restorative materials (Cention N, Equia Forte, Activa™ Bioactive restorative) in Class I posterior restorations.

Materials and Methods

One hundred and forty-four patients having occlusal caries were arbitrarily selected and divided into three groups. Standardized Class I cavity was prepared and restored with Cention N, Equia forte, and Activa™ Bioactive restorative material. POS of restored tooth was assessed with a standardized cold test and air stimulus by air blow from the air syringe. Patient responses were assessed at an interval of 24 h, 1 week, and 1 month using a visual analog scale. Statistical analysis was performed using paired t-test, independent t-test, one-way ANOVA test, and Tukey's post hoc test using SPSS 11.0 program (SPSS Inc., Chicago, IL, USA) for windows.

Results

The statistical analysis showed a significant difference in the clinical evaluation of POS at 24 h interval among three groups (Cention N, Activa™ Bioactive Restorative, Equia forte). However, following 1 week and 1 month, there is no significant difference in Group C (Activa™ Bioactive Restorative).

Conclusion

POS was seen more in Cention N contrast to Equia forte and Activa™ bioactive restorative material.

Three-year clinical evaluation of high-viscosity glass ionomer restorations in non-carious cervical lesions: a randomised controlled split-mouth clinical trial

OBJECTIVE

To compare the 3-year clinical performance of high-viscosity glass ionomer restorations with that of composite restorations in non-carious cervical lesions (NCCLs).

MATERIALS AND METHODS

One hundred thirty-four NCCLs were randomised into two groups according to a split-mouth design. In the experimental group (Hv-GIC), lesions were restored with a high-viscosity glass ionomer (EQUIA Fil, GC), whereas a composite resin (G-aenial, GC) was applied in the control group (E&Ra/comp). All restorative materials were used according to the manufacturers' instructions. Clinical evaluations were performed after 1 week, 6 months, 1 year, 2 years, and 3 years using FDI (World Dental Federation) criteria. Data were analysed using Friedman's ANOVA and Mann-Whitney U tests (α = 0.05).

RESULTS

While retention rates of the Hv-GIC group were 98.5%, 96%, 91%, and 87% in respective evaluation periods, no retention loss was observed in the E&Ra/comp group at any time. There was a statistically significant difference between study groups regarding the retention criterion in both the second and third years (p = 0.008 and p = 0.003, respectively). Furthermore, there was a statistically significant difference between the groups in terms of surface lustre at the third-year recall, in favour of the E&Ra/comp group (p = 0.022).

CONCLUSIONS

The 3-year clinical performance of E&Ra/comp restorations in NCCLs was better than that of Hv-GIC restorations. The most common problems in Hv-GIC restorations were a loss of retention and reduction in surface lustre.

CLINICAL RELEVANCE

Although the 3-year clinical performance of Hv-GIC restorations in non-retentive lesions was acceptable, it was worse than in composites. The operator should consider the benefit/loss ratio of Hv-GIC when he/she decides to use this material in non-retentive cavities, especially those that are shallow.

One-year comparative evaluation of Ketac Nano with resin-modified glass ionomer cement and Giomer in noncarious cervical lesions: A randomized clinical trial

Aim:

The purpose of this study was to evaluate the clinical performance of Ketac Nano (Ketac™ N100), RMGIC (Fuji Filling™ LC), and Giomer (Beautifil^® II) in noncarious cervical lesions (NCCLs).

Materials and Methods:

One operator restored 120 NCCLs in 20 subjects, with at least two lesions restored with one of the restorative materials: RMGIC (control group), Giomer and Ketac Nano (experimental groups). Two observers evaluated retention, marginal discoloration, marginal adaptation, color match, surface roughness, and postoperative sensitivity using modified USPHS criteria at baseline, 6, and 12 months.

Study Design:

Double-blinded randomized clinical trial (RCT).

Statistical Analysis:

Kruskal–Wallis test, Mann–Whitney U-test, Wilcoxon matched-pairs test.

Results:

There was statistically significant difference observed between Giomer, Ketac Nano and RMGIC after 12 months (P < 0.05). There was a significant decrease in retention rates for Giomer (P = 0.0050), increased marginal discoloration and color mismatch for Ketac Nano (P = 0.0025, P = 0.0053), increased surface roughness and color mismatch with RMGIC (P = 0.0022, P = 0.0077) from baseline to 12 months.

Conclusion:

Within the limitations of this RCT of 12 months, Ketac Nano and RMGIC restorations were better retained in NCCLs while superior color match and surface finish were observed with Giomer restorations.