Development of a novel aluminum-free glass ionomer cement based on magnesium/strontium-silicate glasses

Multi-doped glasses with Mg2+ and Zn2+ ions in glass-ionomer cements

OBJECTIVE

To develop a new, biocompatible glass-ionomer cement (GIC) with improved antibacterial activity and physical properties through multiple ionic substitutions of strontium with magnesium and zinc.

METHODS

A fluoro-alumino-silicate glass (LG99Sr) with composition 4.5SiO₂-3Al₂O₃-1.5 P₂O₅-3SrF₂-2SrO was synthesized using the melt-quench technique. LG99Sr was modified by partially substituting SrO with MgO and ZnO, yielding a new composition 4.5SiO₂-3Al₂O₃-1.5 P₂O₅-3SrF₂-0.5SrO-1MgO-0.5ZnO (LG99Sr-Mg-Zn). Following glass characterization, GICs were prepared using Fuji IX (GC Corporation, Tokyo, Japan) as a reference. Physical properties, antimicrobial activity (against Streptococcus mutans, Streptococcus mitis/oralis, and Lactobacillus paracasei), and in vitro cytocompatibility were evaluated. Data were analysed using two-way ANOVA and Tukey-Kramer HSD post-hoc tests to determine the differences in properties between groups (p < 0.05).

RESULTS

The presence of magnesium and zinc in LG99Sr-Mg-Zn was validated via EDS analysis, with ICP-MS confirming their release upon immersion. All GICs demonstrated similar fluoride release profiles; notably, LG99Sr-Mg-Zn exhibited a higher initial fluoride release. Mechanical properties at 24 hours were comparable; however, LG99Sr-Mg-Zn and Fuji IX showed significant improvements (p < 0.05) post-maturation compared to LG99Sr. After 1-month maturation, compressive strength, flexural strength, and Vickers microhardness were significantly higher (p < 0.05) for Fuji IX and LG99Sr-Mg-Zn, and microhardness remained significantly higher at 90 days. Agar diffusion, biofilm inhibition, and XTT tests revealed enhanced antibacterial activity (p < 0.05) for LG99Sr-Mg-Zn. MTT and alamarBlue assays confirmed zinc concentration in LG99Sr-Mg-Zn was not cytotoxic.

SIGNIFICANCE

Ionic substitution of magnesium and zinc in fluoro-alumino-silicate glass significantly enhanced fluoride release and antibacterial properties, improved mechanical properties upon maturation, and maintained cell viability, making it a promising restorative material.

Root-filling materials for endodontic surgery: biological and clinical aspects

The placement of root filling materials aims to prevent the occurrence of post-treatment apical periodontitis following completion of endodontic treatment. Materials should possess properties that will not permit bacterial invasion and infection, namely excellent sealing ability and/or antibacterial properties. In root-end filling procedures or repair of root perforations, the root filling materials are placed in a particularly challenging clinical environment, as they interface with a relatively large area with the periradicular tissues. The biological properties of these materials are therefore of significant importance. The current review discusses the most widely used materials for endodontic surgery (i.e., root-end filling and perforation repair), with particular focus on their biological characteristics, namely antibacterial properties and interactions with host tissue cells, together with clinical studies. Properties of amalgam, glass ionomer cements (GICs), resin systems, zinc oxide eugenol-based cements and hydraulic calcium silicate cements (HCSCs), together with representative and well-researched commercial materials in the context of their use in endodontic surgery are presented. While the use of HCSCs seems to offer several biological advantages, together with addressing issues with the initial formulation in the most recent versions, materials with different chemical compositions, such as zinc oxide eugenol-based cements, are still in use and appear to provide similar clinical success rates to HCSCs. Thus, the significance of the currently available materials on clinical outcomes remains unclear.

Bioactive ceramic-based materials: beneficial properties and potential applications in dental repair and regeneration

Bioactive ceramics, primarily consisting of bioactive glasses, glass-ceramics, calcium orthophosphate ceramics, calcium silicate ceramics and calcium carbonate ceramics, have received great attention in the past decades given their biocompatible nature and excellent bioactivity in stimulating cell proliferation, differentiation and tissue regeneration. Recent studies have tried to combine bioactive ceramics with bioactive ions, polymers, bioactive proteins and other chemicals to improve their mechanical and biological properties, thus rendering them more valid in tissue engineering scaffolds. This review presents the beneficial properties and potential applications of bioactive ceramic-based materials in dentistry, particularly in the repair and regeneration of dental hard tissue, pulp-dentin complex, periodontal tissue and bone tissue. Moreover, greater insights into the mechanisms of bioactive ceramics and the development of ceramic-based materials are provided.

Efficacy and bone-contact biocompatibility of glass ionomer cement as a biomaterial for bone regeneration: A systematic review

Bone regeneration is a rapidly growing field that seeks to develop new biomaterials to regenerate bone defects. Conventional bone graft materials have limitations, such as limited availability, complication, and rejection. Glass ionomer cement (GIC) is a biomaterial with the potential for bone regeneration due to its bone-contact biocompatibility, ease of use, and cost-effectiveness. GIC is a two-component material that adheres to the bone and releases ions that promote bone growth and mineralization. A systematic literature search was conducted using PubMed-MEDLINE, Scopus, and Web of Science databases and registered in the PROSPERO database to determine the evidence regarding the efficacy and bone-contact biocompatibility of GIC as bone cement. Out of 3715 initial results, thirteen studies were included in the qualitative synthesis. Two tools were employed in evaluating the Risk of Bias (RoB): the QUIN tool for assessing in vitro studies and SYRCLE for in vivo. The results indicate that GIC has demonstrated the ability to adhere to bone and promote bone growth. Establishing a chemical bond occurs at the interface between the GIC and the mineral phase of bone. This interaction allows the GIC to exhibit osteoconductive properties and promote the growth of bone tissue. GIC's bone-contact biocompatibility, ease of preparation, and cost-effectiveness make it a promising alternative to conventional bone grafts. However, further research is required to fully evaluate the potential application of GIC in bone regeneration. The findings hold implications for advancing material development in identifying the optimal composition and fabrication of GIC as a bone repair material.

Evaluation of the Mechanical Properties of Three Resin-Modified Glass-Ionomer Materials

This study is aimed at evaluating the flexural strength (FS), fracture toughness (FT), and diametral tensile strength (DTS) of three resin-modified glass-ionomer cements (RMGICs): Ketac Nano, Riva Light Cure, and Fuji II LC. One hundred twenty specimens were prepared from the RMGIC materials ( $n=10$ ). The cements were mixed and inserted into different mould sizes according to the test performed: FS: rectangular Teflon mould ( $32\text{mm}\times 3.15\text{mm}\times 2\text{mm}$ ); FT: notchless triangular prism (NTP) Teflon mould ( $6\text{mm}\times 6\text{mm}\times 6\text{mm}\times 12\text{mm}$ ); and DTS: ring road stainless steel mould ( $6\text{mm}\times 3\text{mm}$ ). Specimens were light cured for 20 seconds on each surface and stored in distilled water at ${37}^{°}\text{C}\pm 2^{°}\text{C}$ for seven days prior to tests. To evaluate the influence of storage in the mechanical properties of the RMGIs, specimens tested for DTS were stored in distilled water at ${37}^{°}\text{C}\pm 2^{°}\text{C}$ for 32 days prior to test. Data were analyzed by ANOVA and Tukey’s test ( $\alpha =0.05$ ). Fuji II LC presented significantly higher values for all tests employed when compared to Ketac Nano and Riva LC RMGIs. There was no significant difference on DTS before and after the 32-day storage for each material. Fuji II LC presented superior mechanical properties when compared to Ketac Nano, and Riva LC storage showed no influence on the mechanical properties of the RMGI materials tested.

Aluminum-free glass ionomer cements containing 45S5 Bioglass® and its bioglass-ceramic

Although the incorporation of bioactive glasses into glass ionomer cements (GICs) has led to promising results, using a bioactive glass as the only solid component of GICs has never been investigated. In this study, we developed an Al-free GIC with standard compressive strength using various combinations of 45S5 Bioglass® and its glass-ceramic as the solid component. The glass-ceramic particles with 74% crystallinity were used for this purpose as they can best act as both remineralizing and reinforcing agents. Strengthening mechanisms including crack deflection and crack-tip shielding were activated for the GICs containing 50-50 wt% bioglass and bioglass-ceramic as the optimum ratio. The progression of the GIC setting reaction at its early stages was also monitored and verified. We also discussed that our bimodal particle size distribution containing both micron- and nanosized particles may enhance the packing density and integrity of the structure of the cements after setting. In such GICs produced in this study, the toxic effects of Al are avoided while chemical bonds are expected to form between the cement and the surrounding hard tissue(s) through interfacial biomineralization and adhesion.

Investigating the effect of germanium on the structure of SiO2-ZnO-CaO-SrO-P2O5 glasses and the subsequent influence on glass polyalkenoate cement formation, solubility and bioactivity

A series of germanium (Ge)-containing glasses were synthesized based on a starting glass composition of SiO₂-ZnO-CaO-SrO-P₂O₅. Additions of GeO₂ (6 and 12 mol%) were incorporated at the expense of SiO_2, which retained the amorphous character, and each glass was processed to present similar particle size and surface area. Glass characterization using x-ray photoelectron spectroscopy (XPS) and magic angle spinning nuclear magnetic resonance (MAS-NMR) determined that the addition of GeO₂ increased the fraction of lower Q-speciation and subsequently the concentration of non-bridging oxygens (NBO). Glass Polyalkenoate Cements (GPC) were formulated from each glass with 40, 50 and 60 wt% PAA, and presented time dependent solubility profiles (1, 10, 100, 1000 h) for the release of Si⁴⁺ (4-140 mg/l), Ca²⁺ (1-8 mg/l), Zn²⁺ (<6 mg/l), Sr²⁺ (2-37 mg/l), PO₄^3- (2-43 mg/l) and Ge⁴⁺ (20-911 mg/l) and attained pH values close to 7.5 after 1000 h. Ge-GPCs containing 40 wt% polyacrylic acid (PAA) presented appropriate working time (T_w) and setting times (T_s), and the corresponding compressive strengths ranged from (14-30 MPa). The Ge-GPCs (40, 50 wt%) presented a linear increase (R²-0.99) with respect to time. Simulated Body Fluid (SBF) testing resulted in the Ge-GPCs encouraging the precipitation of crystalline hydroxyapatite on the GPC surface, more evidently after 100 and 1000 h incubation.

Modifications of Glass Ionomer Cement Powder by Addition of Recently Fabricated Nano-Fillers and Their Effect on the Properties: A Review

The aim of this article is to provide a brief insight regarding the recent studies and their recommendations related to the modifications to glass ionomer cement (GIC) powder in order to improve their properties. An electronic search of publications was made from the year 2000 to 2018. The databases included in the current study were EBSCOhost, PubMed, and ScienceDirect. The inclusion criteria for the current study include publication with abstract or full-text articles, original research, reviews or systematic reviews, in vitro, and in vivo studies that were written in English language. Among these only articles published in peer-reviewed journals were included. Articles published in other languages, with no available abstract and related to other nondentistry fields, were excluded. A detailed review of the recent materials used as a filler phase in GIC powder has revealed that not all modifications produce beneficial results. Recent work has demonstrated that modification of GIC powder with nano-particles has many beneficial effects on the properties of the material. This is due to the increase in surface area and surface energy, along with better particle distribution of the nano-particle. Therefore, more focus should be given on nano-particle having greater chemical affinity for GIC matrix as well as the tooth structure that will enhance the physicochemical properties of GIC.

Exploring the unexpected influence of the Si:Ge ratio on the molecular architecture and mechanical properties of Al-free GICs

Germanium (Ge)-based glass ionomer cements have demonstrated the ability to balance strength with extended setting times, a unique set of characteristics for aluminum-free glass ionomer cements. However, the mechanical properties of current Ge-based glass ionomer cements significantly deteriorate over time, which jeopardizes their clinical potential. This work explores the effect of incrementally decreasing the Si:Ge ratio in the glass phase of zinc-silicate glass ionomer cements to identify potential mechanisms responsible for the time-induced mechanical instability of Ge-based glass ionomer cements. The influence of Ge was evaluated on the basis of changes in mechanical properties and molecular architecture of the cements over a 180-day period. It was observed that the compressive strength and modulus of the cements were sustained when Si:Ge ratios were ≥1:1, but when Si:Ge ratios are <1:1 these properties decreased significantly over time. These mechanical changes were independent of structural changes in the glass ionomer cement matrices, as the level of metal–carboxylate crosslinks remained constant over time across the various Si:Ge ratios explored. However, it was noted the temporal decline of mechanical properties was proportional to the increased release of degradation byproducts, in particular Ge that was released from the cements in substantially greater quantities than other glass constituents. Unexpectedly, the slowest setting cement (Si:Ge 1:1) was also the strongest; behavior that is uncommon in Si-based glass ionomer cements, supports the potential of Ge-containing glass ionomer cements as injectable bone cements in applications such as percutaneous vertebroplasty.

Influence of niobium pentoxide addition on the properties of glass ionomer cements

Objective: To determine the influence of niobium pentoxide (Nb₂O₅) addition on the physical and chemical properties of glass ionomer cements (GICs).

Materials and methods: Five, 10 or 20 wt.% of Nb₂O₅ were incorporated into commercial GICs (Maxxion R, Vitro Molar, Vitro Fil R) and one group of each GIC remained without Nb₂O₅ (control groups). The GICs were evaluated by Knoop hardness, compressive strength, acid erosion, particle size and radiopacity. Data were analyzed by two-way ANOVA followed by Tukey's test.

Results: The addition of 10% and 20% reduced the microhardness of two GICs (p < .05). Compressive strength showed no difference among groups (p > .05). Nb₂O₅ did not influence Maxxion R and Vitro Fil R regarding the acid erosion test (p > .05). Vitro Molar increased its acid erosion with 10% of Nb₂O₅ (p < .05). Maxxion R presented 15.78 μm, while Vitro Molar and Vitro Fil R showed 5.14 μm and 6.18 μm, respectively. As the Nb₂O₅ concentration increased, the radiopacity increased for all groups. Vitro Molar and Vitro Fil R did not present significant difference to at least 1 mm aluminum (p > .05).

Conclusion: The addition of 5 wt.% Nb₂O₅ did not affect the tested physical and chemical properties of the GICs and improved the radiopacity of one of the cements. These materials are therefore suitable for further testing of biomimetic remineralization properties.

Glass Polyalkenoate Cements Designed for Cranioplasty Applications: An Evaluation of Their Physical and Mechanical Properties

Glass polyalkenoate cements (GPCs) have potential for skeletal cementation. Unfortunately, commercial GPCs all contain, and subsequently release, aluminum ions, which have been implicated in degenerative brain disease. The purpose of this research was to create a series of aluminum-free GPCs constructed from silicate (SiO₂), calcium (CaO), zinc (ZnO) and sodium (Na₂O)-containing glasses mixed with poly-acrylic acid (PAA) and to evaluate the potential of these cements for cranioplasty applications. Three glasses were formulated based on the SiO₂-CaO-ZnO-Na₂O parent glass (KBT01) with 0.03 mol % (KBT02) and 0.06 mol % (KBT03) germanium (GeO₂) substituted for ZnO. Each glass was then mixed with 50 wt % of a patented SiO₂-CaO-ZnO-strontium (SrO) glass composition and the resultant mixtures were subsequently reacted with aqueous PAA (50 wt % addition) to produce three GPCs. The incorporation of Ge in the glass phase was found to result in decreased working (142 s to 112 s) and setting (807 s to 448 s) times for the cements manufactured from them, likely due to the increase in crosslink formation between the Ge-containing glasses and the PAA. Compressive (σc) and biaxial flexural (σf) strengths of the cements were examined at 1, 7 and 30 days post mixing and were found to increase with both maturation and Ge content. The bonding strength of a titanium cylinder (Ti) attached to bone by the cements increased from 0.2 MPa, when placed, to 0.6 MPa, after 14 days maturation. The results of this research indicate that Germano-Silicate based GPCs have suitable handling and mechanical properties for cranioplasty fixation.

Biological and mechanical properties of an experimental glass-ionomer cement modified by partial replacement of CaO with MgO or ZnO

Some weaknesses of conventional glass ionomer cement (GIC) as dental materials, for instance the lack of bioactive potential and poor mechanical properties, remain unsolved.

Dental glass ionomer cement reinforced by cellulose microfibers and cellulose nanocrystals

The aim of this work was to evaluate if the addition of cellulose microfibers (CmF) or cellulose nanocrystals (CNC) would improve the mechanical properties of a commercial dental glass ionomer cement (GIC). Different amounts of CmF and CNC were previously prepared and then added to reinforce the GIC matrix while it was being manipulated. Test specimens with various concentrations of CmF or CNC in their total masses were fabricated and submitted to mechanical tests (to evaluate their compressive and diametral tensile strength,modulus, surface microhardness and wear resistance) and characterized by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), transmission electron microscopy (TEM) and Fourier transform infrared spectroscopy (FTIR). The incorporation of CmF in the GIC matrix did not greatly improve the mechanical properties of GIC. However, the addition of a small amount of CNC in the GIC led to significant improvements in all of the mechanical properties evaluated: compressive strength (increased up to 110% compared with the control group), elastic modulus increased by 161%, diametral tensile strength increased by 53%, and the mass loss decreased from 10.95 to 3.87%. Because the composites presented a considerable increase in mechanical properties, the modification of the conventional GIC with CNC can represent a new and promising dental restorative material.