Development of novel dental cements. II. Cement properties

Conventional glass-ionomer materials: A review of the developments in glass powder, polyacid liquid and the strategies of reinforcement

OBJECTIVES

The development of glass-ionomers (GIs) from the earliest experimental GI formulations to the modern day commercially available GIs was reviewed. The aim of the review was to identify the developments in the glass powder and polyacid liquid constituents of GIs since their inception in the late 1960s.

DATA

The glass powder has undergone major changes from the earliest GI powder formulation (G200) in an effort to enhance the reactivity with the polyacid liquid. The GI liquids have also been optimised by the manufacturers in terms of polyacid composition, molecular weight and concentration to improve the handling characteristics. Despite these developments in the glass powder and polyacid liquid constituents, GIs cannot 'truly' be advocated for the restoration of posterior dentition due to the poor mechanical properties when compared with dental amalgam and resin-based composites (RBCs).

SOURCES

Various attempts to improve the mechanical properties of GIs through substitution of reinforcing fillers to the GI powder or modification of the GI liquid were identified in the dental literature. Despite the claimed improvements in mechanical properties of the modified GIs, a wide variation in mixing and testing conditions was identified which prevented a valid assessment of the reported reinforcement strategies. When investigating a GI reinforcement strategy it is crucial that the mixing and testing conditions are standardised to allow a valid comparison between studies.

STUDY SELECTION

The dental literature reporting the earliest experimental GIs to modern day commercially available GIs (1969-2015) was reviewed. In addition, full-text publications and abstracts published in English reporting various GI reinforcement strategies were included.

CONCLUSION

Nevertheless, major improvements in GI formulations through a reinforcement strategy have yet to be made to enable clinical usage of GIs for the restoration of posterior dentition.

CLINICAL SIGNIFICANCE

GIs chemically are inherently weak but bond to sound tooth structure without the need for preconditioning or removal of sound tooth structure such that improvements in the mechanical properties of GIs would be desirable. Although advances have been made through different GI glass powder and polyacid liquid formulations over the past 40 years, further improvements in the mechanical properties of the current GIs are required to be indicated for the restoration of posterior dentition. The literature is replete with reports on GI reinforcement, however, improved reporting and control of mixing and testing conditions are required for a valid assessment of the reinforcement strategies.

Degradable borate glass polyalkenoate cements

Glass polyalkenoate cements (GPCs) containing aluminum-free borate glasses having the general composition Ag2O-Na2O-CaO-SrO-ZnO-TiO2-B2O3 were evaluated in this work. An initial screening study of sixteen compositions was used to identify regions of glass formation and cement compositions with promising rheological properties. The results of the screening study were used to develop four model borate glass compositions for further study. A second round of rheological experiments was used to identify a preferred GPC formulation for each model glass composition. The model borate glasses containing higher levels of TiO2 (7.5 mol %) tended to have longer working times and shorter setting times. Dissolution behavior of the four model GPC formulations was evaluated by measuring ion release profiles as a function of time. All four GPC formulations showed evidence of incongruent dissolution behavior when considering the relative release profiles of sodium and boron, although the exact dissolution profile of the glass was presumably obscured by the polymeric cement matrix. Compression testing was undertaken to evaluate cement strength over time during immersion in water. The cements containing the borate glass with 7.5 mol % TiO2 had the highest initial compressive strength, ranging between 20 and 30 MPa. No beneficial aging effect was observed-instead, the strength of all four model GPC formulations was found to degrade with time.

Changes in compressive strength on ageing in glass polyalkenoate (glass-ionomer) cements prepared from acrylic/maleic acid copolymers

Previous studies have shown that glass-ionomers made from acrylic/maleic copolymers stored in water reach a maximum strength at about 1 week, and after 4 months have become significantly weaker. This finding, which contrasts with the behaviour of glass-ionomers based on poly(acrylic acid), was originally attributed to hydrolytic instability. This interpretation has been tested in the current work. Specimens of glass-ionomer prepared from acrylic/maleic acid copolymer have been stored for up to 4 months in different media, namely deionized water, dry air and vegetable oil, then tested for compressive strength. Specimens were in the form of cylinders of dimensions 6 mm high x 4 mm diameter, and storage temperature was 37 degrees C. Data were analysed using two-way analysis of variance (ANOVA) and in all three media specimens became weaker at 4 months than they had been at 1 week (P < 0.05). However, for the specimens stored in dry air and in water, the 1-week values were not the maximum. The fact that there was a loss of strength under all conditions led to the conclusion that it is not, after all, due to hydrolysis.

The effect of glass heat treatment on the properties of a novel polyalkenoate cement

The effect of heat treating the glass component of a novel glass-ionomer (polyalkenoate) cement on cement properties has been determined, with specific reference to the reactivity of the glass, and the mechanical properties of the resultant cement. It has been shown that heat treatment is a suitable method of decreasing the glass reactivity and improving the handling characteristics of the mixed cement. Under some conditions, an increase in compressive strength was found, although the effect on tensile properties was not significant.