Influence of glass composition on the properties of glass polyalkenoate cements. Part I: influence of aluminium to silicon ratio

Solution photo-copolymerization of acrylic acid and itaconic acid: The effect of polymerization parameters on mechanical properties of glass ionomer cements

OBJECTIVE

To synthesize a series of poly (acrylic acid-co-itaconic acid) (P(AA-co-IA)) copolymers with different molecular weights (MWs) through a facile water-based solution photopolymerization and to investigate the operational and mechanical properties of the experimental glass-ionomer (GI) cements made of the ionomers.

METHODS

Thioglycolic acid (TGA) was used as a chain transfer agent to synthesize P(AA-co-IA) ionomers with different MWs through the solution photopolymerization. The chemical structure, MWs, and rheological properties of the copolymers were fully characterized. The GI cements were prepared using the ionomer solutions in different MWs and concentrations. Finally, the operating and mechanical properties of the experimental GI cements were investigated and compared with those of a commercially available GI cement.

RESULTS

The synthesis and composition of the P(AA-co-IA) were approved by spectroscopy analyses. The results revealed that by increasing the TGA content, MW and polydispersity index (PDI) of the synthesized copolymers demonstrate a decreasing trend from 4.5 × 104 g/mol (PDI of 2.45) to 7.4 × 103 g/mol (PDI of 1.62). Accordingly, the viscosity of copolymers decreased with increasing the TGA concentration in the polymerization recipes. Setting times of the cements increased with reducing the MWs and ionomer concentration. The compressive and flexural strengths of GI cements were improved by increasing the MWs, ionomers concentration, and storage time.

SIGNIFICANCE

The solution photopolymerization provides a facile and environmentally safe method to synthesize P(AA-co-IA) copolymers with controlled MWs. The structure-property relationships presented in the study also provide valuable information in the production and improvement of the GI cements.

Comparative Evaluation of Two Glass Polyalkenoate Cements: An In Vivo Pilot Study Using a Sheep Model

Poly(methyl methacrylate) (PMMA) is used to manage bone loss in revision total knee arthroplasty (rTKA). However, the application of PMMA has been associated with complications such as volumetric shrinkage, necrosis, wear debris, and loosening. Glass polyalkenoate cements (GPCs) have potential bone cementation applications. Unlike PMMA, GPC does not undergo volumetric shrinkage, adheres chemically to bone, and does not undergo an exothermic setting reaction. In this study, two different compositions of GPCs (GPCA and GPCB), based on the patented glass system SiO₂-CaO-SrO-P₂O₅-Ta₂O₅, were investigated. Working and setting times, pH, ion release, compressive strength, and cytotoxicity of each composition were assessed, and based on the results of these tests, three sets of samples from GPCA were implanted into the distal femur and proximal tibia of three sheep (alongside PMMA as control). Clinical CT scans and micro-CT images obtained at 0, 6, and 12 weeks revealed the varied radiological responses of sheep bone to GPCA. One GPCA sample (implanted in the sheep for 12 weeks) was characterized with no bone resorption. Furthermore, a continuous bone-cement interface was observed in the CT images of this sample. The other implanted GPCA showed a thin radiolucent border at six weeks, indicating some bone resorption occurred. The third sample showed extensive bone resorption at both six and 12 weeks. Possible speculative factors that might be involved in the varied response can be: excessive Zn²⁺ ion release, low pH, mixing variability, and difficulty in inserting the samples into different parts of the sheep bone.

Antibacterial effects and physical properties of a glass ionomer cement containing BioUnion filler with acidity-induced ability to release zinc ion

BioUnion filler is a bioactive glass particle that releases Zn²⁺ in an acidic environment. In this study, the ion release, antibacterial, and physical properties of a glass ionomer cement (GIC) incorporating BioUnion filler (CA) were assessed in vitro. The concentration of Zn²⁺ released from CA into acetic acid was higher than that released into water and its minimum inhibitory concentrations against six oral bacterial species. Moreover, the concentration of Zn²⁺-release was maintained during all the seven times it was exposed to acetic acid. Compared to a conventional cement and resin composite, CA significantly inhibited the growth of oral bacteria and hindered their adhesion on the material surface. Thus, our study outcomes show that the release of Zn²⁺ from CA in the acidic environment does not affect its compressive strength.

Comparative Evaluation of the Mechanical Properties of Zinc-reinforced Glass Ionomer Cement and Glass Ionomer Type IX Cement: An In Vitro Study

Aims and objectives

The aims and objectives of this study were to evaluate and compare the flexural strength and microhardness of zinc reinforced glass ionomer cement and glass ionomer type IX cement.

Materials and methods

The sample size of twenty each of group I (zinc-reinforced glass ionomer cement) and group II (glass ionomer type IX cement) were selected. The samples were prepared in the customized steel molds and subjected to test for flexural strength and microhardness. The flexural strength was determined by the three-point bending test. After determining the flexural strength, the fragments were used to determine Vickers Hardness by means of an automatic microhardness indenter. The flexural strength and microhardness was calculated for all samples and subjected to statistical analysis. Two sample t-test with unequal variances were used, as the data are found to be from the same material. The normality was checked by using the usual normal probability plot. For flexural strength, p value was found to be 0.007530. Hence, zinc-reinforced glass ionomer cement was superior to glass ionomer type IX cement. For microhardness the p value was found to be 0.0023. So, glass ionomer type IX cement was superior to zinc reinforced glass ionomer cement.

Conclusion

The zinc-reinforced glass ionomer cement showed enhanced flexural strength when compared to glass ionomer type IX cement, thus increasing the longevity whereas glass ionomer type IX cement had a better microhardness than zinc-reinforced glass ionomer cement. Hence, the mechanical properties of various materials should be considered for the long-term clinical success by selecting the appropriate material based on the clinical condition.

How to cite this article

Patil K, Patel A, Kunte S, et al. Comparative Evaluation of the Mechanical Properties of Zinc-reinforced Glass Ionomer Cement and Glass Ionomer Type IX Cement: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(4):381–389.

Physical property investigation of contemporary glass ionomer and resin-modified glass ionomer restorative materials

OBJECTIVES

The objective of this study was to investigate selected physical properties of nine contemporary and recently marketed glass ionomer cement (GIC) and four resin-modified glass ionomer cement (RMGI) dental restorative materials.

MATERIALS AND METHODS

Specimens (n = 12) were fabricated for fracture toughness and flexure strength using standardized, stainless steel molds. Testing was completed on a universal testing machine until failure. Knoop hardness was obtained using failed fracture toughness specimens on a microhardness tester, while both flexural modulus and flexural toughness was obtained by analysis of the flexure strength results data. Testing was completed at 1 h, 24 h, 1 week, and then at 1, 3, 6, and 12 months. Mean data was analyzed with Kruskal-Wallis and Mann-Whitney (p = 0.05).

RESULTS

Physical properties results were material dependent. Physical properties of the GIC and RMGI products were inferior at 1 h compared to that at 24 h. Some improvement in selected physical properties were noted over time, but development processes were basically concluded by 24 h. A few materials demonstrated improved physical properties over the course of the evaluation.

CONCLUSIONS

Under the conditions of this study: 1. GIC and RMGI physical property performance over time was material dependent; 2. Polyalkenoate maturation processes are essentially complete by 24 h; 3. Although differences in GIC physical properties were noted, the small magnitude of the divergences may render such to be unlikely of clinical significance; 4. Modest increases in some GIC physical properties were noted especially flexural modulus and hardness, which lends support to reports of a maturing hydrogel matrix; 5. Overall, GIC product physical properties were more stable than RMGI; 6. A similar modulus reduction at 6 months for both RMGI and GIC produced may suggest a polyalkenoate matrix change; and 7. Globally, RMGI products demonstrated higher values of flexure strength, flexural toughness, and fracture toughness than GIC materials.

CLINICAL RELEVANCE

As compared to RMGI materials, conventional glass ionomer restorative materials demonstrate more stability in physical properties.

Addition of bioactive glass to glass ionomer cements: Effect on the physico-chemical properties and biocompatibility

OBJECTIVES

Glass ionomer cements (GICs) are a subject of research because of their inferior mechanical properties, despite their advantages such as fluoride release and direct bonding to bone and teeth. Recent research aims to improve the bioactivity of the GICs and thereby improve mechanical properties on the long term. In this study, two types of bioactive glasses (BAG) (45S5F and CF9) are combined with GICs to evaluate the physico-chemical properties and biocompatibility of the BAG-GIC combinations. The effect of the addition of Al³⁺ to the BAG composition and the use of smaller BAG particles on the BAG-GIC properties was also investigated.

MATERIALS AND METHODS

Conventional aluminosilicate glass (ASG) and (modified) BAG were synthesized by the melt method. BAG-GIC were investigated on setting time, compressive strength and bioactivity. Surface changes were evaluated by Fourier transform infrared (FT-IR), scanning electron microscopy (SEM), EDS and PO₄^3- -and Ca²⁺ uptake in SBF. Biocompatibility of selected BAG-GICs was determined by a direct toxicity assay.

RESULTS

The addition of BAG improves the bioactivity of the GIC, which can be observed by the formation of an apatite (Ap) layer, especially in CF9-containing GICs. More BAG leads to more bioactivity but decreases strength. The addition of Al³⁺ to the BAG composition improves strength, but decreases bioactivity. BAGs with smaller particle sizes have no effect on bioactivity and decrease strength. The formation of an Ap layer seems beneficial to the biocompatibility of the BAG-GICs.

SIGNIFICANCE

Bioactive GICs may have several advantages over conventional GICs, such as remineralization of demineralized tissue, adhesion and proliferation of bone- and dental cells, allowing integration in surrounding tissue. CF9 BAG-GIC combinations containing maximum 10mol% Al³⁺ are most promising, when added in ≤20wt% to a 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.

Simulations reveal the role of composition into the atomic-level flexibility of bioactive glass cements

Bioactive glass ionomer cements (GICs), the reaction product of a fluoro-alumino-silicate glass and polyacrylic acid, have been in effective use in dentistry for over 40 years and more recently in orthopaedics and medical implantation. Their desirable properties have affirmed GIC's place in the medical materials community, yet are limited to non-load bearing applications due to the brittle nature of the hardened composite cement, thought to arise from the glass component and the interfaces it forms. Towards helping resolve the fundamental bases of the mechanical shortcomings of GICs, we report the 1st ever computational models of a GIC-relevant component. Ab initio molecular dynamics simulations were employed to generate and characterise three fluoro-alumino-silicate glasses of differing compositions with focus on resolving the atomic scale structural and dynamic contributions of aluminium, phosphorous and fluorine. Analyses of the glasses revealed rising F-content leading to the expansion of the glass network, compression of Al-F bonding, angular constraint at Al-pivots, localisation of alumino-phosphates and increased fluorine diffusion. Together, these changes to the structure, speciation and dynamics with raised fluorine content impart an overall rigidifying effect on the glass network, and suggest a predisposition to atomic-level inflexibility, which could manifest in the ionomer cements they form.

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.

Characterization of Y2O3 and CeO2 doped SiO2-SrO-Na2O glasses

The structural effects of yttrium (Y) and cerium (Ce) are investigated when substituted for sodium (Na) in a 0.52SiO2–0.24SrO–(0.24−x)Na2O–xMO (where x = 0.08; MO = Y2O3 and CeO2) glass series. Network connectivity (NC) was calculated assuming both Y and Ce can act as a network modifier (NC = 2.2) or as a network former (NC up to 2.9). Thermal analysis showed an increase in glass transition temperature (Tg) with increasing Y and Ce content, Y causing the greater increase from the control (Con) at 493∘C to 8 mol% Y (HY) at 660∘C. Vickers hardness (HV) was not significantly different between glasses. 29Si Magic Angle Spinning-Nuclear Magnetic Resonance (MAS-NMR) did not show peak shift with addition of Y, however Ce produced peak broadening and a negative shift in ppm. The addition of 4 mol% Ce in the YCe and LCe glasses shifted the peak from Con at −81.3 ppm to −82.8 ppm and −82.7 ppm respectively; while the HCe glass produced a much broader peak and a shift to −84.8 ppm. High resolution X-ray Photoelectron Spectroscopy for the O 1s spectral line showed the ratio of bridging (BO) to non-bridging oxygens (NBO), BO:NBO,was altered,where Con had a ratio of 0.7, HY decreased to 0.4 and HCe to 0.5.

Influence of zinc and magnesium substitution on ion release from Bioglass 45S5 at physiological and acidic pH

Ion release of Mg- and Zn-substituted Bioglass 45S5 (46.1 SiO2-2.6 P2O5-26.9 CaO-24.3Na2O; mol%; with 0, 25, 50, 75 or 100% of calcium replaced bymagnesium/zinc) was investigated at pH 7.4 (Tris buffer) and pH 4 (acetic acid/sodium acetate buffer) in static and dynamic dissolution experiments. Despite Mg2+ and Zn2+ having the same charge and comparable ionic radii, they influenced the dissolution behaviour in very different ways. In Tris, Mgsubstituted glasses showed similar ion release as 45S5, while Zn-substituted glasses showed negligible ion release. At low pH, however, release behaviour was similar, with all glasses releasing large percentages of ions within a few minutes. Precipitation of crystalline phases also varied, as Mg- and Zn-substitution inhibited apatite formation, and Zn-substitution resulted in formation of zinc phosphate phases at low pH. These results are relevant for glasses used in aluminium-free glass ionomer bone cements, as they show that Zn/Mg-substituted glasses release ions similarly fast as glasses containing no Zn/Mg, suggesting that these ions are no prerequisite for ionomer glasses. Zn-substituted glasses may potentially be used as controlled-release materials, which release antibacterial zinc ions when needed only, i.e. at low pH conditions (e.g. bacterial infection), but not at normal physiological pH conditions.

Chemical and structural characterization of glass ionomer cements indicated for atraumatic restorative treatment

Glass ionomer cements (GICs) are restorative materials, which clinical use has increased significantly during the last decade. The aim of the present study was to analyze the chemical constitution and surface morphology of four glass ionomer cements: Maxxion R, VitroFill, Vidrion R and Vitremer. Twelve polyethylene tubes with an internal diameter of 3 and 3 mm in length were prepared, filled and then transferred to a chamber with 95% relative humidity and a temperature of 37°C. The surface morphology of the tested materials was examined by scanning electron microscopy (SEM) and main components were investigated by energy-dispersive X-ray microanalysis (EDX). Scanning electron microscopy revealed irregular and rough external surface. Cracking was not observed. The main constituents were found to be aluminum, silicon, calcium, sodium and fluoride. Phosphorus, sulfur and barium were only observed in Vidrion R, while chlorine were only observed in Maxxion R. Elemental mapping of the outer surface revealed high concentration of aluminum and silicon. Significant irregularities on the surface of the tested materials were observed. The chemical constitution of all GIC was similar.

The influence of particle size and fluorine content of aluminosilicate glass on the glass ionomer cement properties

OBJECTIVE

Glass ionomer cements (GIC) are clinically accepted dental restorative materials mainly due to their direct chemical adhesion to both enamel and dentin and their ability to release fluoride. However, their mechanical properties are inferior compared to those of amalgam and composite. The aim of this study is to investigate if combinations of nano- and macrogranular glass with different compositions in a glass ionomer cement can improve the mechanical and physical properties.

METHODS

Glasses with the composition 4.5 SiO2-3 Al2O3-1.5 P2O5-(5-x) CaO-x CaF2 (x=0 and x=2) were prepared. Of each type of glass, particles with a median size of about 0.73 μm and 6.02 μm were made.

RESULTS

The results show that the setting time of GIC decreases when macrogranular glass particles are replaced by nanogranular glass particles, whereas the compressive strength and Young's modulus, measured after 24 h setting, increase. The effects are more pronounced when the nanogranular glass particles contain fluoride. After thermocycling, compressive strength decreases for nearly all formulations, the effect being most pronounced for cements containing nanogranular glass particles. Hence, the strength of the GIC seems mainly determined by the macrogranular glass particles. Cumulative F--release decreases when the macrogranular glass particles with fluoride are replaced by nanogranular glass particles with(out) fluoride.

SIGNIFICANCE

The present study thus shows that replacing macro- by nanogranular glass particles with different compositions can lead to cements with approximately the same physical properties (e.g. setting time, consistency), but with different physicochemical (e.g. F--release, water-uptake) and initial mechanical properties. On the long term, the mechanical properties are mainly determined by the macrogranular glass particles.

An in vitro study on the maturation of conventional glass ionomer cements and their interface to dentin

The objective of the study was to investigate the influence of long-term storage (up to 1 year) and coating on the variation of micro-mechanical properties of four conventional restorative glass ionomer cements (GICs) within 3.5 mm deep class I cavities. Four commercially available GICs (Riva Self Cure (SDI), ChemFil Rock (Dentsply), Fuji IX Fast and Fuji IX GP Extra/Equia (GC)) were applied to 100 teeth. In each tooth, two similar 3.5 mm deep class I cavities were prepared and filled with the GICs, with and without resin coating. The samples were stored in artificial saliva at 37 °C for 1 week, 1 month, 3 months, 6 months and 1 year. The variation in mechanical properties (indentation modulus (E) and Vickers hardness (HV)) were determined in 100 μm steps starting from the filling surface, through the intermediate layer in between dentine and GIC, and ending 100 μm in dentin. HV and E were strongly influenced by the material (P<0.05, partial eta-squared ηP(2) = 0.31 and 0.23) but less by aging duration (P<0.05, ηP(2) = 0.02 and 0.12) and resin coating (P<0.05, ηP(2) = 0.02 and 0.03). The depth of measurement (0-2 mm) has no influence on HV (P = 0.789). HV shows a gentle increase over the 1 year storage period (P = 0.002). A ∼300 μm GIC zone at the areas close to dentin with weaker properties as those measured in dentin or GIC was identified in all fillings, irrespective of the presence of coating, and at all storage periods. The thickness of this zone is more strongly influenced by storage (P<0.05, ηP(2) = 0.081) than by material type (P<0.05, ηP(2) = 0.056), while coating showed no influence (P = 0.869). Filler morphology and dimension were similar to upper parts of the GIC filling; however, the amount of low cations was higher. We concluded that the development of an intermediate layer in between dentine and GIC with lower mechanical properties might be responsible for the bond quality of GIC to dentine. Moreover, class I GIC restorations are unlikely to feature constant mechanical properties throughout the cavity, regardless of conditions such as aging and coating.

Comparison of a SiO₂-CaO-ZnO-SrO glass polyalkenoate cement to commercial dental materials: ion release, biocompatibility and antibacterial properties

Ion Release and biocompatibility of a CaO-SrO-ZnO-SiO₂ (BT 101) based glass polyalkenoate cement (GPC) was compared against commercial GPCs, Fuji IX and Ketac Molar. The radiopacity (R) was similar for each material, 2.0-2.8. Ion release was evaluated on each material over 1, 7, 30 and 90 days. BT 101 release included Ca (23 mg/L), Sr (23 mg/L) Zn (13 mg/L), Si (203 mg/L). Fuji IX release includes Ca (0.7 mg/L), Al (3 mg/L) Si (26 mg/L), Na (60 mg/L) and P (0.5 mg/L) while Ketac Molar release includes Ca (1 mg/L), Al (0.6 mg/L) Si (23 mg/L), Na (76 mg/L) and P (0.7 mg/L). Simulated body fluid trials revealed CaP surface precipitation on BT 101. No evidence of precipitation was found on Fuji IX or Ketac Molar. Cytotoxicity testing found similar cell viability values for each material (~60 %, P = 1.000). Antibacterial testing determined a reduced CFU count with BT 101 (2.5 × 10³) when compared to the control bacteria (2.4 × 10⁴), Fuji IX (1.5 × 10⁴) and Ketac Molar (1.2 × 10⁴).

Evaluation of a conventional glass ionomer cement with new zinc formulation: effect of coating, aging and storage agents

OBJECTIVE

The study focused on a recently launched conventional glass ionomer cement (GIC) with a particular chemical formulation of both, filler and acrylic liquid, by analysing its mechanical behaviour in comparison to three conventional GICs. Furthermore, the effect of resin coating and storage conditions was evaluated.

MATERIALS AND METHODS

Three commercially available GICs were chosen: Riva Self Cure (SDI), Fuji IX Fast (GC) and Fuji IX GP Extra/Equia (GC). Additionally a newly developed zinc-containing GIC--ChemFil Rock (Dentsply)--was tested. Mechanical properties were determined at macro- [flexural strength (FS) and modulus of elasticity (E (flexural))] and micro-scale [Vickers hardness (VH) and indentation modulus (E)] after storing coated and uncoated specimens in artificial saliva and distilled water for 7 and 30 days.

RESULTS

ChemFil Rock revealed the highest FS, but the lowest VH and E. The micro-mechanical properties of the analysed GICs did neither benefit from the new zinc formulation nor from resin coating. A resin coating is nevertheless a valuable support for GIC fillings, since it offers the absence of visible surface defects like crazing and voids, and thus, it led to significant improvements in flexural strength. This statement is also valid for ChemFil Rock, contrary to manufacture recommendation. The impact of storage agent and storage duration on the measured properties was low.

CONCLUSIONS

The new development (ChemFil Rock) might represent a promising approach regarding longevity of GIC fillings in molar regions, due to the high flexural strength and the absence of visible surface defects like crazing and voids.

CLINICAL RELEVANCE

All GICs should receive surface protection in order to perform their maximum in stability.

Enhancement effect of pre-reacted glass on strength of glass-ionomer cement

In this paper, we report on the enhanced strength of glass ionomer cement (GIC) by using the process of pre acid-base reaction and spray drying in glass preparation. The pre acid-base reaction was induced by prior mixing of the glass powder with poly(alkenoic acid). The weight ratios of glass powder to poly(alkenoic acid) were varied to investigate the extent of the pre acid-base reaction of the glass. The effect of the spray drying process which produced spherical glass particles on cement strength was also studied and discussed. The results show that adding 2%-wt of poly(alkenoic acid) liquid in the pre-reacted step improved cement strength. GICs prepared using a mixture of pre-reacted glass with both spherical and irregular powders at 60:40 by weight exhibited the highest compressive strength at 138.64±7.73 MPa. It was concluded that glass ionomer cements containing pre-reacted glass with mixed glass morphology using both spherical and irregular forms are promising as restorative dental materials with improved mechanical properties and handling characteristics.

Impedance methodology: A new way to characterize the setting reaction of dental cements

OBJECTIVES

Impedance spectroscopy is a non-destructive, quantitative method, commonly used nowadays for industrial research on cement and concrete. The aim of this study is to investigate the interest of impedance spectroscopy in the characterization of setting process of dental cements.

METHODS

Two types of dental cements are used in this experiment: a new Calcium Silicate cement Biodentine™ (Septodont, Saint Maur-des Fossés, France) and a glass ionomer cement resin modified or not (Fuji II(®) LC Improved Capsules and Fuji IX(®) GP Fast set Capsules, GC Corp., Tokyo, Japan). The conductivity of the dental cements was determined by impedance spectroscopy measurements carried out on dental cement samples immersed in a 0.1M potassium chloride solution (KCl) in a "like-permeation" cell connected to a potentiostat and a Frequency Response Analyzer. The temperature of the solution is 37°C. From the moment of mixing of powder and liquid, the experiments lasted 2 weeks.

RESULTS

The results obtained for each material are relevant of the setting process. For GIC, impedance values are stabilized after 5 days while at least 14 days are necessary for the calcium silicate based cement.

SIGNIFICANCE

In accordance with the literature regarding studies of cements and concrete, impedance spectroscopy can characterize ion mobility, porosity and hardening process of dental hydrogel materials.

Dental Glass Ionomer Cements as Permanent Filling Materials? – Properties, Limitations and Future Trends

Glass ionomer cements (GICs) are clinically attractive dental materials that have certain unique properties that make them useful as restorative and luting materials. This includes adhesion to moist tooth structures and base metals, anticariogenic properties due to release of fluoride, thermal compatibility with tooth enamel, biocompatibility and low toxicity. The use of GICs in a mechanically loaded situation, however, has been hampered by their low mechanical performance. Poor mechanical properties, such as low fracture strength, toughness and wear, limit their extensive use in dentistry as a filling material in stress-bearing applications. In the posterior dental region, glass ionomer cements are mostly used as a temporary filling material. The requirement to strengthen those cements has lead to an ever increasing research effort into reinforcement or strengthening concepts.

Comparison of failure mechanisms for cements used in skeletal luting applications

Glass Polyalkenoate Cements (GPCs) based on strontium calcium zinc silicate (Sr-Ca-Zn-SiO(2)) glasses and low molecular weight poly(acrylic acid) (PAA) have been shown to exhibit suitable compressive strength (65 MPa) and flexural strength (14 MPa) for orthopaedic luting applications. In this study, two such GPC formulations, alongside two commercial cements (Simplex P and Hydroset) were examined. Fracture toughness and tensile bond strength to sintered hydroxyapatite and a biomedical titanium alloy were examined. Fracture toughness of the commercial Poly(methyl methacrylate) cement, Simplex P, (3.02 MPa m(1/2)) was superior to that of the novel GPC (0.36 MPa m(1/2)) and the commercial calcium phosphate cement, Hydroset, for which no significant fracture toughness was obtained. However, tensile bond strengths of the novel GPCs (0.38 MPa), after a prolonged period (30 days), were observed to be superior to commercial controls (Simplex P: 0.07 MPa, Hydroset: 0.16 MPa).

Antibacterial coatings for medical devices based on glass polyalkenoate cement chemistry

A biofilm is an accumulation of micro-organisms and their extracellular products forming a structured community on a surface. Biofilm formation on medical devices has severe health consequences as bacteria growing in this lifestyle are tolerant to both host defense mechanisms and antibiotic therapies. However, silver and zinc ions inhibit the attachment and proliferation of immature biofilms. The objective of this study is to evaluate whether it is possible to produce silver and zinc-containing glass polyalkenoate cement (GPC) coatings for medical devices that have antibacterial activity and which may therefore inhibit biofilm formation on a material surface. Two silver and zinc-containing GPC coatings (A and B) were synthesised and coated onto Ti6Al4V discs. Their handling properties were characterised and atomic absorption spectrometery was employed to determine zinc and silver ion release with coating maturation up to 30 days. The antibacterial properties of the coatings were also evaluated against Staphylococcus aureus and a clinical isolate of Pseudomonas aeruginosa using an agar diffusion assay method. The majority of the zinc and silver ions were released within the first 24 h; both coatings exhibited antibacterial effect against the two bacterial strains, but the effect was more intense for B which contained more silver and less zinc than A. Both coatings produced clear zones of inhibition with each of the two organisms tested. In this assay, Ps. aeruginosa was more sensitive than S. aureus. The diameters of these zones were reduced after the coating had been immersed in water for varying periods due to the resultant effect on ion release.

The processing, mechanical properties and bioactivity of strontium based glass polyalkenoate cements

The suitability of zinc-based glass polyalkenoate cements (GPCs) for use in orthopaedics can be improved by the substitution of strontium into the glass phase which should impart improved radiopacity and bone forming properties to the cements without retarding strength. The purpose of this research was to produce novel GPCs based on calcium-strontium-zinc-silicate glasses and to evaluate their mechanical properties and biocompatibility with the ultimate objective of developing a new range of cements for skeletal applications. Three glass compositions, based on incremental substitutions of strontium for calcium, were synthesized; BT100 (0.16CaO, 0.36ZnO, 0.48SiO2), BT101 (0.04SrO, 0.12CaO, 0.36ZnO, 0.48SiO2) and BT102 (0.08SrO 0.08CaO, 0.36ZnO, 0.48SiO2). Each glass was then mixed with varying concentrations and molecular weights of polyacrylic acids in order to determine the working times, setting times, compressive strengths and biaxial flexural strengths of the novel cements. The maximum working time and setting time achieved was 29 and 110 s respectively; which, at present is inadequate for current clinical procedures. However, the optimum compressive and biaxial flexural strengths were up to 75 and 34 MPa respectively indicating that these formulations have potential in load bearing applications. Importantly, the substitution of Ca with Sr in the glasses did not have a deleterious effect on strengths or working times. Finally, the bioactivity of the best performing cements was determined in vitro using simulated body fluid. It was found that all cements facilitate the formation of an amorphous calcium phosphate at their surface which increases in density and coverage with time, indicating that these cement will bond directly to bone in vivo.

The role of Sr2+ on the structure and reactivity of SrO-CaO-ZnO-SiO2 ionomer glasses

The suitability of Glass Polyalkenoate Cements (GPCs) for use in orthopaedics is retarded by the presence in the glass phase of aluminium, a neurotoxin. Unfortunately, the aluminium ion plays an integral role in the setting process of GPCs and its absence is likely to hinder cement formation. However, the authors have previously shown that aluminium free GPCs may be formulated based on calcium zinc silicate glasses and these novel materials exhibit significant potential as hard tissue biomaterials. To further improve their potential, and given that Strontium (Sr) based drugs have had success in the treatment of osteoporosis, the authors have substituted Calcium (Ca) with Sr in the glass phase of a series of aluminium free GPCs. However to date little data exists on the effect SrO has on the structure and reactivity of SrO-CaO-ZnO-SiO(2) glasses. The objective of this work was to characterise the effect of the Ca/Sr substitution on the structure of such glasses, and evaluate the subsequent reactivity of these glasses with an aqueous solution of Polyacrylic acid (PAA). To this end (29)Si MAS-NMR, differential scanning calorimetry (DSC), X-ray diffraction, and network connectivity calculations, were used to characterize the structure of four strontium calcium zinc silicate glasses. Following glass characterization, GPCs were produced from each glass using a 40 wt% solution of PAA (powder:liquid = 2:1.5). The working times and setting times of the GPCs were recorded as per International standard ISO9917. The results acquired as part of this research indicate that the substitution of Ca for Sr in the glasses examined did not appear to significantly affect the structure of the glasses investigated. However it was noted that increasing the amount of Ca substituted for Sr did result in a concomitant increase in setting times, a feature that may be attributable to the higher basicity of SrO over CaO.

Ion leaching of a glass-ionomer glass: an empirical model and effects on setting characteristics and strength

The release of ions from a glass-ionomer glass, which in the polyacid matrix effects the cross-linking and setting of a cement, can be modelled and initiated by acid-treatment in a dilute acid. This study examined the effect of time of acetic acid leaching on the working time, setting time, and strength of a model GIC. A reactive fluoride glass was immersed in hot acetic acid for 0 (control), 5, 15, 35, 65, 95 and 125 min, filtered and dried. The glass was mixed with an experimental GI liquid in a capsule system and the mixed pastes assessed for working and initial setting time. Compressive strength testing was undertaken according to ISO9917:2003. Immersion time had a significant effect on both working and setting time of the resultant pastes only up to 65 min of immersion, and corresponded with a thin-film ion diffusion model. Compressive strength did not vary significantly with immersion time. The glass-ionomer setting reaction can be conveniently retarded by immersion of the powder in acetic acid, without affecting strength. A reactivity model was developed, whereby the effects of various changes to the leaching process may be usefully examined.

MAS-NMR spectroscopy studies in the setting reaction of glass ionomer cements

OBJECTIVES

The main objective is the characterisation of the setting reaction in glass ionomer cements based on experimental ionomer glasses with different fluorine content and a commercial glass ionomer cement liquid by using 13C CP/MAS-NMR, 29Si, 27Al and 31P MAS-NMR spectroscopy in order to receive information specifically about the cross-linking process.

METHODS

Different fluorine containing glass compositions based on 4.5SiO2-3Al2O3-1.5P2O5-(5-z)CaO-zCaF(2) where z=0-3, were mixed with a commercially available polymer liquid to form glass ionomer cements. The cements were subjected to 27Al, 13C CP/MAS, 29Si, and 31P MAS-NMR analysis.

RESULTS

The 27Al spectra showed clearly the formation of six-fold coordinate Al(VI), that may crosslink the carboxyl groups in the poly-acid molecules. A shift towards to more positive values of the carboxyl peak in the 13C CP/MAS-NMR spectra showed clearly the proton dissociation of the carboxyl groups. A shift towards more negative values was observed in the 29Si MAS-NMR spectra, suggesting formation of hydrated silica gel and consequently formation of additional Si-O-Si bonds. 31P MAS-NMR spectra also reflected changes in the coordination state around a PO4(3-) tetrahedron. Increasing the fluorine content of the glasses resulted generally in increased reactivity during setting, due to promoting cross-linking and repolymerisation of the silicate phase, followed by clear changes in the MAS-NMR spectra.

CONCLUSIONS

The cross-linking process during the setting reaction of glass ionomer cements can be followed by MAS-NMR spectroscopy observing the conversion of Al(IV) to Al(VI). The acid base setting reaction is completed in 1 day and no further significant changes in the MAS-NMR spectra can be observed. Further study is required in order to understand the role of phosphorus.

An investigation into the structure and reactivity of calcium-zinc-silicate ionomer glasses using MAS-NMR spectroscopy

The suitability of Glass Polyalkenoate Cements (GPCs) for orthopaedic applications is retarded by the presence in the glass phase of aluminium, a neurotoxin. Unfortunately, the aluminium ion plays an integral role in the setting process of GPCs and its absence is likely to hinder cement formation. However, the authors have previously shown that aluminium-free GPCs may be formulated based on calcium zinc silicate glasses and these novel materials exhibit significant potential as hard tissue biomaterials. However there is no data available on the structure of these glasses. (29)Si MAS-NMR, differential thermal analysis (DTA), X-ray diffraction (XRD), and network crosslink density (CLD) calculations were used to characterize the structure of five calcium zinc silicate glasses and relate glass structure to reactivity. The results indicate that glasses capable of forming Zn-GPCs are predominantly Q(2)/Q(3) in structure with corresponding network crosslink densities greater than 2. The correlation of CLD and MAS-NMR results indicate the primary role of zinc in these simple glass networks is as a network modifier and not an intermediate oxide; this fact will allow for more refined glass compositions, with less reactive structures, to be formulated in the future.

Characterisation of fluorine containing glasses by 19F, 27Al, 29Si and 31P MAS-NMR spectroscopy

OBJECTIVE

The aim of this study is to characterise a range of model and commercially available glasses used to form glass (ionomer) polyalkenoate cements.

METHODS

A range of model fluoro-alumino-silicate glasses that form the basis of glass (ionomer) polyalkenoate cements and five commercial glasses have been characterised by 29Si, 27Al, 31P and 19F Magic Angle Spinning Nuclear Magnetic Resonance (MAS-NMR).

RESULTS

The 29Si spectra indicate a predominantly Q33Al and Q44Al structure where the Q33Al species represents a silicon with one non-bridging oxygen and three Si-O-Al linkages and the Q44Al species a silicon with four Si-O-Al bonds. Aluminium was found in predominantly four coordinate sites, but glasses with high fluorine contents showed an increasing proportion of five and six coordinate aluminium. In phosphate containing glasses the phosphorus was present as Al-O-PO3(2-) type species indicating local charge compensation of Al3+ and P5+ in the glass structure. 19F MAS-NMR indicated the presence of F-Ca(n), Al-F-Ca(n), F-Sr(n), Al-F-Sr(n) and Al-F-Na(n) species where F-M(n) indicates a fluorine surrounded by n next nearest neighbour cations and Al-F-M(n) represents a fluorine bonded to aluminium with the metal, M in close proximity charge balancing the tetrahedral AlO3F species. The proportion of Al-F-M(n) species increased with increasing fluorine content of the glass and lower non-bridging oxygen contents. There was no evidence of Si-F bonds in any of the glasses.

CONCLUSIONS

The local structure of the phosphate containing glasses with regard to fluorine, calcium, strontium and phosphate is similar to that of fluorapatite the mineral phase of tooth. This may explain the ease with which these glasses crystallize to fluorapatites and the recently observed mineralization of glass polyalkenoate cements found in vivo.

The processing, mechanical properties and bioactivity of zinc based glass ionomer cements

The suitability of Glass Ionomer Cements (GICs) for use in orthopaedics is retarded by the presence in the glass phase of aluminium, a neurotoxin. Unfortunately, the aluminium ion plays an integral role in the setting process of a GIC and its absence is likely to hinder cement formation. However, zinc oxide, a bacteriocide, can act both as a network modifying oxide and an intermediate oxide in a similar fashion to alumina and so ternary systems based on zinc silicates often have extensive regions of glass formation. The purpose of this research was to produce novel GICs based on calcium zinc silicate glasses and to evaluate their rheological, mechanical and biocompatible properties with the ultimate objective of developing a new range of cements for skeletal applications. The work reported shows that GICs based on two different glasses, A and B (0.05CaO.0.53ZnO.0.42SiO2 and 0.14CaO.0.29ZnO.0.57SiO2, respectively), exhibited handling properties and flexural strengths comparable to conventional GICs. Upon immersion in simulated body fluid of a GIC based on glass B, an amorphous calcium phosphate layer nucleated on the surface of the cement indicating that these cements are bioactive in nature.

The effect of mixing time on the handling and compressive strength of an encapsulated glass-ionomer cement

OBJECTIVES

The effects of varying mixing times on the properties of glass-ionomer cements have been poorly investigated, and many clinicians are uninformed about the potential changes in handling achieved by this. This study aims to explore the effects of mixing time variation.

METHODS

An experimental glass-ionomer system was dosed into a capsule, activated, and triturated for varying lengths of time, from 2 to 14 s. Measurements were made of working time, initial setting time, compressive strength and compressive modulus, and a subjective assessment of handling conducted.

RESULTS

The working time and initial setting time decreased as mixing time increased, while compressive strength and compressive modulus increased to a maximum at 12 s mixing time. The material essentially pre-gelled after 14 s of mixing, which resulted in breaking of the gel matrix and poorer properties.

SIGNIFICANCE

Clinicians should feel confident, within limits, of varying mixing times of glass ionomer cements to improve properties or to slow the reaction.

Characterisation of commercial ionomer glasses using magic angle nuclear magnetic resonance (MAS-NMR)

Five commercial ionomer glasses (Fuji IX, Ketac Molar, G338, G2, and G2SR) used to produce glass (ionomer) polyalkenoate dental cements were studied. 29Si, 27Al, 31P and 19F magic angle spinning nuclear magnetic resonance (MAS-NMR) Spectroscopy was used to characterise the glasses and the resulting spectra compared with previous studies of model glasses. The 29Si NMR spectra were consistent with Q4(3Al) and Q4(4Al) units being present and agreed with the low non-bridging oxygen contents calculated from the elemental composition. The 27Al NMR spectra typically exhibited three distinct sites at 45-60, 20 and 0 ppm which have been attributed to Al(IV), Al(V) and Al(VI) coordinate aluminium. The presence of Al(V) and Al(VI) are consistent with previous studies of model ionomer glasses. The 31P spectra all exhibited a chemical shift between -8 and -23 ppm with the exception of the Ketac Molar glass, which exhibited a peak at 2-3 ppm consistent with orthophosphate. The chemical shift of 31P in the range -8 to -23 ppm indicates a PO(4) tetrahedra surrounded by 1-4 Al moieties. The (19)F NMR spectra indicated the presence of Al-F-Ca(n) in the G2 and G338 glasses, Al-F-Sr(n) in the G2SR and Fuji IX glasses and crystalline CaF2, LaF3, Al-F-Ca(n) in the Ketac Molar glass. The G338 glass with a high non-bridging oxygen content showed the presence of a F-Ca(n) species. There was also present in all the glasses a peak corresponding to Al-F-Na(n). The intensity of this peak was approximately proportional to the sodium content.

Effects of added bioactive glass on the setting and mechanical properties of resin-modified glass ionomer cement

In this study, the effects of added bioactive glass on the basic setting properties of a commercially available resin-modified glass ionomer cement were investigated with respect to setting time, mechanical strength, and setting mechanism. It was found to be clinically acceptable whether the setting time was extended or shortened depending on the type of bioactive glass added. The compressive strength of the set cement containing the bioactive glass decreased and was much higher when compared with the conventional type glass ionomer cement containing bioactive glass. The Fourier-transform infrared and 13C CP/MAS-NMR spectroscopies revealed that the extent of the acid-base reaction was larger in the cements containing bioactive glass than in the commercial resin-modified glass ionomer cement because of its high basicity in the bioactive glass. The 27Al MAS-NMR showed that crosslinking of the carboxylates in the polymeric acid by Al proceeded less in the cement containing the bioactive glass.

Strengthening of glass-ionomer cement by compounding short fibres with CaO-P2O5-SiO2-Al2O3 glass

The purpose of this study was to determine if short fibres of CaO-P2O5-SiO2-Al2O3 (CPSA) glass possessing a particular aspect ratio (length/diameter) could be used as a reinforcing agent for glass-ionomer cement. The powder of a commercial glass-ionomer cement (not resin modified) was mixed with variously sized CPSA glass short fibres before mixing with the liquid of the glass-ionomer cement. The mixed powders containing 60 mass% CPSA glass short fibres (diameter, 9.7 +/- 2.1 microm, aspect ratio, 5.0 +/- 0.9) obtained maximum values of 18 and 35 MPa for the diametral tensile strength (DTS) and flexural strength (FS) of set cements, respectively, after 24 h. These DTS and FS values were 1.8 and 4.5 times larger, respectively, than those of the set glass-ionomer cement not containing short fibres. Moreover, it was found that the addition of CPSA glass short fibres was remarkably more effective in the strengthening than electric glass (a typical glass fibre) short fibres. The results suggested that the CPSA glass short fibres acted as a reinforcing agent for strengthening the glass-ionomer cement, because of the shape of short fibres and reactivity between the mixing liquid and short fibres.

Influence of glass composition on the properties of glass polyalkenoate cements. Part III: influence of fluorite content

The influence of fluorite content of the glass on the formation and properties of glass polyalkenoate cements was investigated. A series of glass powders based on 1.5SiO2 x 0.5P2O5 x Al2O3 x CaO x XCaF2 were synthesised. The glass transition temperature of the glass fell with increasing fluorite content. Setting and working times of the cement pastes decreased with increasing fluorite content of the glass. Compressive strength and un-notched fracture strength increased with increasing fluorite content of the glass. Fracture toughness and toughness of the cements were relatively insensitive to fluorite content.

Influence of glass composition on the properties of glass polyalkenoate cements. Part II: influence of phosphate content

The influence of phosphate content of the glass on the formation of glass polyalkenoate cements was investigated. Glasses were synthesised based on (4.5 - 2X)SiO2-3.0 Al2O3-(3.0 - X)CaO-(1.5 + X)P2O5-2.0 CaF2 and X was varied from -1.5 to 0.8. The setting and working time of the cement pastes increased with the phosphate content of the glass (X). Increasing the phosphate content resulted in an initial increase in compressive strength followed by a sharp reduction in strength. Young's modulus and un-notched fracture strength exhibited a maximum at intermediate phosphate contents. Fracture toughness reduced at high phosphate contents, whilst toughness increased. Phosphate in the glass is thought to aid glass degradation by providing additional phosphorus-oxygen bonds for hydrolysis, but may also reduce the amount of aluminium released by reducing the susceptibility of aluminium-oxygen-silicon bonds to acid hydrolysis. The released phosphate may also compete with the carboxylate groups in the polysalt matrix cement for cations inhibiting the crosslinking reaction.