The relationship between water absorption characteristics and the mechanical strength of resin-modified glass-ionomer cements in long-term water storage

Long-Term Assessment of Contemporary Ion-Releasing Restorative Dental Materials

The objective was to evaluate new commercially available ion-releasing restorative materials and compare them to established anti-cariogenic materials. Four materials were tested: alkasite Cention (Ivoclar Vivadent) in self-cure or light-cure mode, giomer Beautifil II (Shofu), conventional glass-ionomer Fuji IX (GC), and resin composite Tetric EvoCeram (Ivoclar Vivadent) as a control. Flexural strength, flexural modulus, and Weibull modulus were measured one day, three months, and after three months with accelerated aging in ethanol. Water sorption and solubility were evaluated for up to one year. Degree of conversion was measured during 120 min for self-cured and light-cured Cention. In this study, Beautifil II was the ion-releasing material with the highest flexural strength and modulus and with the best resistance to aging. Alkasite Cention showed superior mechanical properties to Fuji IX. Weibull analysis showed that the glass-ionomer had the least reliable distribution of mechanical properties with the highest water sorption. The solubility of self-cured alkasite exceeded the permissible values according to ISO 4049. Degree of conversion of light-cured Cention was higher than in self-cure mode. The use of alkasite Cention is recommended only in the light-cure mode.

Restorative Materials Exposed to Acid Challenge: Influence of Temperature on In Vitro Weight Loss

Consumption of acidic beverages and foods could provoke erosive damage, both for teeth and for restorative materials. Temperatures of consumption could influence the erosive effects of these products. The aim of this in vitro study is to assess the influence of an acidic challenge on the weight loss of different restorative materials. Resin composites and glass-ionomer cements (GIC) were tested. The medium of storage was Coca-Cola (Coca-Cola, Coca-Cola Company, Milano, Italy) at two different temperatures, 4 and 37 °C, respectively for Group A and Group B. For each group, nine specimens were prepared for each material tested. After 7 days, weight was assessed for each sample, and the percentage weight loss was calculated. For all the resin composites (Groups 1−13), no significant weight losses were noticed. (<1%). Conversely, GICs (Groups 14 and 15) showed significant weight loss during the acidic challenge, which was reduced in the case of these materials that included a protective layer applied above. Significant differences were registered with intra-group analysis; weight loss for specimens immersed in Coca Cola at 37 °C was significantly higher for almost all materials tested when compared to specimens exposed to a cooler medium. In conclusion, all the resin composites showed reliable behaviour when exposed to acidic erosion, whereas glass-ionomer cements generally tended to solubilize.

Long-Term Water Balance Evaluation in Glass Ionomer Restorative Materials

The complex role of water in glass ionomer cement (polyalkenoate) dental restorative materials has been studied, but much of the present understanding concerning water balance within these materials is based on very early studies and short-term experiments. This study evaluated the nature of the water species of six conventional and four resin modified glass ionomer restorative materials over 3 years using thermogravimetric analysis techniques. Materials were prepared, placed in crucibles, and stored in physiologic phosphate buffered saline and evaluated at 24 h, 1 week, and then at 1, 3, 6, 9, 12, 18, 24, 30 and 36 months. All materials demonstrated a significant increase in unbound water percentage content but except for the resin modified materials, the enthalpy required to remove the unbound water species did not significantly change over 36 months. Also, bound water content percentage and removal enthalpy was established at 24 h, as no significant increase was noted in both bound water content and removal enthalpy over the course of this evaluation. This study suggests that unbound water species may increase with time and is loosely held except for the resin modified materials. Protective coatings placement and re-evaluation are prudent to prevent unbound water loss.

Comparative evaluation of color stability of three commercially available provisional restorative materials: An in vitro study

Aim:

Esthetics of the provisional restorations is of prime importance to the patients especially in long term in the esthetic zone. Discolouration of these restorations may result in patient dissatisfaction and an additional expense for their replacement. LuxaCrown provisional material being new in market and claimed to be semi-permanent by the company needs to be evaluated for its colour stability. This in vitro study was aimed to evaluate and compare the colour stability of three provisional restorations using three pigmented solutions.

Setting and Design:

In vitro - comparative study.

Materials and Methods:

LuxaCrown, Protemp4, Heat cure PMMA were evaluated. 40 specimens of each material were divided into four groups of ten specimens each. Each group was stored in three staining solutions and artificial saliva. Colour values of each specimen were measured before immersion, after one day, one week, one month, three months and six months with a spectrophotometer.

Stastistical Analysis Used:

One way ANOVA, Post Hoc Tukey Test, Bonferonni Test.

Results:

Least colour change was seen in Heat Cure PMMA followed by Protemp4 and highest colour change was seen in LuxaCrown when immersed in artificial saliva, tea and coffee. Whereas in turmeric, Heat Cure PMMA showed the least colour change followed by LuxaCrown and highest colour change was seen in Protemp4 at all time intervals except day one, where LuxaCrown was higher than Protemp4.

Conclusion:

Heat cure showed the best results as compared to Protemp4 and LuxaCrown in terms of colour stability at all time periods.

Mechanical properties and water-aging resistance of glass ionomer cements reinforced with 3-aminopropyltriethoxysilane treated basalt fibers

In order to improve interfacial adhesion between basalt fibers (BF) and glass ionomer cement (GIC) matrix, a silane named 3-aminopropyltriethoxysilane (APS) was used to modify the surface of BF. APS treated BF (APS-BF) was characterized by Fourier transform infrared spectroscopy (FT-IR), X-ray photoelectron spectroscopy (XPS), and scanning electron microscopy (SEM). The influence of APS concentration on mechanical properties of APS-BF reinforced GIC (APS-BF-GIC) was investigated, and water aging resistance of optimum APS-BF-GIC was also studied. The results showed that 5 wt% of APS was the optimum concentration for BF modification, for 5%APS-BF-GIC had the best comprehensive mechanical properties in all of APS-BF-GICs. Though 5%APS-BF-GIC had higher water sorption than BF-GIC and GIC, it still had higher flexural strength and exhibited better water-aging resistance.

Color stability of provisional restorative materials with different fabrication methods

PURPOSE

The aim of this study was to investigate and compare the color stability of provisional restorative materials fabricated by 3D printing, dental milling, and conventional materials.

MATERIALS AND METHODS

For the experimental groups, two commercially available 3D-printing provisional resins (E-Dent 100; EnvisionTEC GmbH, Germany & VeroGlaze™; Stratasys®, USA), two dental milling blocks (PMMA Disk; Yamahachi Dental Co., Japan & Telio®CAD; Ivoclar Vivadent AG, Liechtenstein), and two conventional materials (Alike™; GC Co., Japan & Luxatemp automix plus; DMG, Germany) were used. The water sorption and solubility test were (n=10, respectively) carried out according to ISO4049:2000 (International Standards Organization, Geneva, Switzerland). For the color stability test (n=10), coffee and black tea were used as staining solutions, and the specimens were stored for 12 weeks. Data were analyzed by one-way ANOVA and Tukey's HSD using SPSS version 22.0 (SPSS Inc. Chicago, IL, USA) (P<.05).

RESULTS

Alike and Veroglaze showed the highest values and Luxatemp showed the lowest water sorption. In the color stability test, the ΔE of conventional materials varied depending on the staining solution. PMMA milling blocks showed a relatively low ΔE up to 4 weeks, and then significantly increased after 8 weeks (P<.05). 3D-printed materials exhibited a high ΔE or a significant increase over time (P<.05).

CONCLUSION

The degree of discoloration increased with time, and a visually perceptible color difference value (ΔE) was shown regardless of the materials and solutions. PMMA milled and 3 D-printed materials showed more rapid change in discoloration after 8 weeks.

Effects of vancomycin, cefazolin and test conditions on the wear behavior of bone cement

Antibiotic cement has been recommended in the treatment of prosthetic infections. The purpose of this study was to investigate the mechanical behavioral changes in cement loaded with two antibiotics, vancomycin and cefazolin, in dry and liquid medium. Six groups and four study conditions were established according to the doses of antibiotic used and the ageing (immersion in phosphate buffered saline) of the samples. Properties evaluated were friction coefficient and wear. Samples in dry medium showed higher wears than in liquid. Antibiotic selection did not influence wear properties tested in dry conditions, however, in liquid medium, there were higher frictional coefficients and wear for cefazolin loaded cement after one week and for vancomycin and cefazolin after one month. The results suggest that antibiotic cements behave differently in liquid and that the molecular characteristics of antibiotics are essential for determining this influence.

[Influence of the physiological medium on the mechanical properties of bone cement: can current studies be extrapolated?]

PURPOSE

The use of bone cement is widespread in orthopaedic surgery. Most of the mechanical tests are performed in dry medium, making it difficult to extrapolate the results. The objective of this study is to assess if the mechanical properties of polymethylmethacrylate (PMMA), obtained in previous reports, are still present in a liquid medium.

MATERIAL AND METHOD

An experimental study was designed with antibiotic (vancomycin) loaded PMMA. Four groups were defined according to the medium (dry or liquid) and the pre-conditioning in liquid medium (one week or one month). Wear and flexural strength tests were performed according to ASTM and ISO standards. Volumetric wear, friction coefficient, tensile strength, and Young's modulus were analyzed. All samples were examined by scanning electron microscopy.

RESULTS

The samples tested in liquid medium showed lower wear and flexural strength values (P<.05). The kind of wear was modified from abrasive to adhesive in those samples studied in liquid medium. The samples with a pre-conditioning time showed lower values of wear (P<.05).

CONCLUSIONS

Caution is recommended when extrapolating the results of previous PMMA results. The different mechanical strength of the cement in a liquid medium, observed in saline medium, is much closer to the clinical situation.

A comparison of resin-modified glass-ionomer and resin composite polymerisation shrinkage stress in a wet environment

OBJECTIVE

The aim of this study was to investigate the polymerisation shrinkage stress under water of four resin-modified glass-ionomers and three resin composite materials.

METHODS

Transparent acrylic rods (5mm diameter×30mm) were prepared and secured into drill chucks connected to a universal testing machine. A plastics cup was placed around the lower rod and a distance of 1.00mm was established between the prepared surfaces which provided a C-factor of 2.5. For composite only, an adhesive layer (Scotchbond Universal Adhesive) was placed on the rod ends and cured to achieve a bond with the rod end. Materials were placed between the rods and a strain gauge extensometer was installed. Materials were light cured for 40s and the plastics cup was filled with ambient temperature water. To determine polymerisation shrinkage stress (σpol) three specimens of each material were tested for a 6-h period to determine mean maximum σpol (MPa), σpol rate (MPa/s) and final σpol (MPa). ANOVA and post hoc Tukey tests were used to determine significant differences between means.

RESULTS

The highest mean maximum σpol of (5.4±0.5) MPa was recorded for RMGIC and (4.8±1.0) MPa for composite. The lowest mean final σpol of (0.8±0.4) MPa was recorded for RMGIC. For mean maximum σpol,σpol rate and final σpol there were significant differences between materials within groups, although no significant difference (p>0.05) was observed when comparing the RMGIC group to the composite group.

CONCLUSION

When comparing mean σpol, maximum σpol, and σpol rates between individual RMGIC and composite materials significant differences (p<0.05) were observed. However when comparing the group RMGIC to composite no significant differences (p>0.05) were observed. The null hypothesis that there is no difference in the short term σpol of RMGIC materials when compared to composite materials is only partly rejected.

RELEVANCE

Limited information is available on the comparison of RMGIC and resin composite σpol levels. This study provides information on the short term levels in a wet environment and will assist in understanding the initial σpol rates RMGIC place in cavities.

Acrylic bone cements: influence of time and environment on physical properties

Acrylic bone cements are in extensive use in joint replacement surgery. They are weight bearing and load transferring in the bone-cement-prosthesis complex and therefore, inter alia, their mechanical properties are deemed to be crucial for the overall outcome. In spite of adequate preclinical test results according to the current specifications (ISO, ASTM), cements with inferior clinical results have appeared on the market. The aim of this study was to investigate whether it is possible to predict the long term clinical performance of acrylic bone cement on the basis of mechanical in vitro testing. We performed in vitro quasistatic testing of cement after aging in different media and at different temperatures for up to 5 years. Dynamic creep testing and testing of retrieved cement were also performed. Testing under dry conditions, as required in current standards, always gave higher values for mechanical properties than did storage and testing under more physiological conditions. We could demonstrate a continuous increase in mechanical properties when testing in air, while testing in water resulted in a slight decrease in mechanical properties after 1 week and then levelled out. Palacos bone cement showed a higher creep than CMW3G and the retrieved Boneloc specimens showed a higher creep than retrieved Palacos. The strength of a bone cement develops more slowly than the apparent high initial setting rate indicates and there are changes in mechanical properties over a period of five years. The effect of water absorption is important for the physical properties but the mechanical changes caused by physical aging are still present after immersion in water. The established standards are in need of more clinically relevant test methods and their associated requirements need better definition. We recommend that testing of bone cements should be performed after extended aging under simulated physiological conditions. Simple quasistatic and dynamic creep tests seem unable to predict clinical performance of acrylic bone cements when the products under test are chemically very similar. However, such testing might be clinically relevant if the cements exhibit substantial differences.

Performance of bone cements: are current preclinical specifications adequate?

BACKGROUND

Current specifications (standards) for preclinical testing of bone cements (ISO 5833: 2002, ASTM F451-99a) require simple mechanical testing after ageing for 24 h under dry conditions at 23 degrees C. Some bone cements have fulfilled the requirements in the specifications, and yet had inferior clinical results. Clinically, bone cements are subjected to complex loading patterns in a moist or wet environment at 37 degrees C. Thus, both the validity and the robustness of current standard testing protocols can be questioned.

METHODS

We examined the influence of temperature and storage medium on the properties of bone cement. We also compared the results of storage and testing under standard conditions of 23 degrees C in dry air, with the results obtained at 37 degrees C in water or plasma.

RESULTS

The dry specimens showed an increase in strength and elastic modulus with time, while the values of the wet ones decreased. There was no difference between specimens stored in water or in plasma. Ultimate compressive strength of dry specimens after 24 h was 1.16 times higher than that of the ones stored wet, increasing to 1.34 times after 1 month, and 1.46 times after 6 months (p<0.001 for all comparisons).

INTERPRETATION

Testing under dry conditions-as required in current standards-always gave higher values for mechanical properties than did storage and testing under more physiological conditions. The sensitivity of test values to different environments implies that testing conditions for bone cements should be scrutinized in order to develop more relevant testing protocols that reflect the in vivo environment more closely.

Time dependent mechanical properties of bone cement. Anin vitro study over one year

Changes in mechanical properties of bone cements over time are of clinical importance, but not well documented. Specifications for testing do not address the time factor. This study recorded changes in compressive properties and microstructure of one bone cement stored under simulated physiological conditions (water at 37 degrees C) from 20 min up to 1 year and in dry air at 37 degrees C for comparison. Compressive strength increased within the first week (p < 0.001), decreased at 1 month (p < 0.001), and remained at that level at 1 year. Elastic modulus showed a similar development. Maximum strain values, indicating plastic deformability, increased continuously over 1 year. Microscopy revealed microcracks between the pre-polymer beads and the matrix in specimens tested after 20 min, whereas there were less cracks in 1 year specimens. Increase in strength during the first week is due to polymerization and formation of interpenetrating molecular networks. The subsequent decrease could be due to the plasticizing effect of water uptake, as supported by higher values for dry specimens. It can be speculated that microcracks which could be initiated while reducing an arthroplasty at 15 min, acting as initiators for fatigue fractures in the cement mantle, contribute to cement failure. It is recommended that testing of bone cements should be performed after extended ageing at simulated physiological conditions, for the present cement at least 5 weeks. Results obtained at less than one week could be influenced by ongoing polymerization, as well as microcracks and lower coherence between the prepolymer beads and the matrix.

Compressive strength of resin-modified glass ionomer restorative material: effect of P/L ratio and storage time

The aim of this study was to evaluate the compressive strength of resin-modified glass ionomer cement Fuji II LC and Vitremer, in powder/liquid ratios of 1:1, 1:2 and 1:3, at three periods (24 hours, 7 and 28 days) of storage in distilled water at 37ºC. For each material, P/L ratio and storage time, 5 cylindrical specimens were prepared, with 4mm diameter and 6mm height, in silicon moulds. Specimens were light-cured for 40 seconds at each extremity, removed from the moulds and laterally light-cured (perpendicular to long axis) for 40 seconds, protected as recommended by the manufacturers and immersed for the time tested. The specimens were submitted to compressive strength testing in an Instron machine at a crosshead speed of 1.0mm/min until failure. Data were submitted to ANOVA and Tukey's test (5%), and showed that the compressive strength of resin-modified glass ionomer cement was reduced when P/L ratio was reduced and that the storage in water had little influence on compressive strength.

Compound changes and tooth mineralization effects of glass ionomer cements containing bioactive glass (S53P4), an in vivo study

In this study, modifications of glass ionomer cements (GICs) were made by adding bioactive glass (BAG) to GIC to obtain bioactive restorative materials. This study used SEM, EDS and visual analysis to examine the bioactivity and the ability of the study materials to mineralize dentin. Conventional cure and resin-modified light-curing GIC were used. The materials consisted of powder and liquid. Three experimental materials were made by mixing 10-30 wt% of BAG powder with GIC powders. Commercially available GIC without BAG were used as controls. Class III restorations were made in altogether 62 intact beagle dog teeth, and the operation was performed under general anesthesia. The restorations were followed clinically for 1, 3 or 6 weeks. Resin-modified GIC containing BAG showed uniform CaP surface formation on the restorations. Mineral depositions in the close vicinity of the restoration-dentin interface and in deeper parts of dentin tubules were also noticed in resin-modified GIC containing BAG particles. It can be concluded that resin-modified GIC containing BAG have good potential in clinical applications where enhanced mineralization is expected.

Compressive strength and surface characterization of glass ionomer cements modified by particles of bioactive glass

OBJECTIVES

The aim of this study was to determine compressive strength, Young's modulus of elasticity, and Vickers' surface hardness, of conventional cure and resin-modified glass ionomer cements after the addition of bioactive glass (BAG) particles into the cements.

METHODS

Experimental glass ionomer cement (GIC)-BAG materials were made by mixing 10- or 30-wt% of BAG particles with conventional cure and resin-modified GIC powders. Materials were processed into cylindrical specimens and immersed in water for 1, 3, 7, 14, 30 and 180 days before mechanical tests. SEM and EDS analysis was used to characterize the changes in surface topography and the main elemental composition.

RESULTS

The compressive strength of the test specimens decreased with the increasing amount of BAG. The compressive strength of resin-modified GIC increased during the immersion, but remained at a lower level than that of the other materials. The conventional cure GIC-based materials had on average 55% higher surface microhardness than the resin-modified materials. In the elemental composition, more Ca was detected in the BAG-containing materials than in the pure GICs. The amount of F was significantly higher (p < 0.001) on all resin-modified materials, being highest on resin-modified GIC with 30-wt% of BAG after 180d of immersion.

SIGNIFICANCE

The addition of BAG to GIC compromises the mechanical properties of the materials to some extent. Thus, their clinical use ought to be restricted to applications where their bioactivity can be beneficial, such as root surface fillings and liners in dentistry, and where high compressive strength is not necessarily needed.

Hydrolytic degradation and cracks in resin-modified glass-ionomer cements

Water-absorption affects the basic properties of resin-modified glass-ionomer cements (RMGICs). Fick's law is usually invoked to explain the absorption process. The purpose of this study is to show that the absorption in accordance with the Fickian model cannot be extended to the whole of the specimen, and that microcrack formation is the main degradation mechanism for specimens cured in a closed environment. For this purpose, flat disk-shaped paste specimens 1.5 mm thick (aspect ratio 4), irradiated in closed conditions between two glass slides and stored in water for approximately 20 months, were analyzed periodically gravimetrically and under confocal fluorescence microscopy, with absorbed eosin used as the fluorescent probe. At pH 7.0, the specimen surface (10-20 micrometers in depth) absorbed water rapidly, swelled, and disintegrated in 20-40 days. Long-term storage produced isolated cracks and grains, no progress in the swelling, and a slow weight decrease. A lower pH (pH 3.5) produced a significant increase of the number of microcracks. The decrease in the irradiation time (30 s or less) enhanced the erosion process, producing very broad cracks. It was concluded that the prevalent mechanism of long-term hydrolytic degradation was based on the slow formation of cracks, whereas only in the early stage of storage did absorption occur quickly in accordance with the Fickian diffusion.

Effect of bifunctional comonomers on mechanical strength and water sorption of amorphous calcium phosphate- and silanized glass-filled Bis-GMA-based composites

This study seeks to elucidate structure-property relationships in a series of unfilled dental copolymers and their composites. The copolymers/composites were derived from photo-activated binary monomer systems based on 2,2-bis[p-2'-hydroxy-3'-methacryloxypropoxy)phenyl] propane (Bis-GMA) and equimolar amounts of a bifunctional, surface-active comonomer, i.e., 2-hydroxyethyl methacrylate (HEMA), glycerol dimethacrylate (GDMA) or ethylene glycol methacrylate phosphate (PHEMA). Triethyleneglycol dimethacrylate, a widely used comonomer for Bis-GMA, was used as a control. Two types of fillers were investigated: (1) a hydrophilic, silica-modified amorphous calcium phosphate (Si-ACP) and (2) a more hydrophobic, silanized nanosized silica (n-SiO(2)). Both the unfilled copolymers and their composites were evaluated for biaxial flexure strength (BFS), both dry and wet after 30 days immersion in buffered saline, and for water sorption (WS) and their WS kinetic profiles. The Bis-GMA copolymers and composites derived from HEMA and GDMA had BFS and WS values, as well as WS kinetic profiles, similar to the controls. Copolymers and composites based on Bis-GMA/PHEMA had lower BFS and higher WS values. Si-ACP composites had significantly lower BFS values (that were further diminished on soaking) than their copolymers. WS increased as the level of this filler was increased except for Bis-GMA/PHEMA composites. With n-SiO(2) as the filler, a more moderate reduction in BFS occurred compared to the unfilled copolymers. By contrast to Si-ACP composites, the WS of all the n-SiO(2) composites decreased with increasing filler level. From this study it is evident that both the chemical structure of the polymer matrix and the type of filler system can have significant effects on the strength and water-related properties of dental composites.