Flouride release from various restorative materials

Enamel remineralization by fluoride-releasing materials: proposal of a pH-cycling model

This study proposes a pH-cycling model for verifying the dose-response relationship in fluoride-releasing materials on remineralization in vitro. Sixty bovine enamel blocks were selected for the surface microhardness test (SMH1). Artificial caries lesions were induced and surface microhardness test (SMH2) was performed. Forty-eight specimens were prepared with Z 100, Fluroshield, Vitremer and Vitremer ¼ diluted - powder/liquid, and subjected to a pH-cycling model to promote remineralization. After pH-cycling, final surface microhardness (SMH3) was assessed to calculate percent recovery of surface microhardness (%SMHR). Fluoride present in enamel (μg F/mm3) and in the pH-cycling solutions (μg F) was measured. Cross-sectional microhardness was used to calculate mineral content (∆Z). There was no significant difference between Z 100 and control groups on analysis performed on - %SMHR, ∆Z, μg F and mg F/mm3 (p>0.05). Results showed a positive correlation between %SMHR and μg F/mm3 (r=0.9770; p=0.004), %SMHR and μg F (r=0.9939; p=0.0000001), ∆ and μg F/mm3 (r=0.9853; p=0.0002), ∆ and μg F (r=0.9975; p=0.0000001) and between μg F/mm3 and μg F (r=0.9819; p=0.001). The pH-cycling model proposed was able to verify in vitro dose-response relationship of fluoride-releasing materials on remineralization.

Fluoride release of six restorative materials in water and pH-cycling solutions

The fluoride release of restorative materials in deionized water has been the subject of many studies, but the behavior of these materials under conditions of acid challenge that simulates the oral cavity, needs to be further explored. Therefore, the aim of this study was to evaluate the fluoride release of restorative materials in two storage protocols: deionized water and pH-cycling system (demineralizing solution-pH 4.3 and remineralizing solution-pH 7.0) for 15 days. Eight disks of each material (Vitremer-positive control, Dyract AP, Ariston pHc, Definite, TetricCeram and Z100-negative control) were prepared (11.0 mm x 1.5 mm) and suspended individually in 4.0 mL of each solution, which were daily changed. Daily fluoride release was analyzed with an ion specific electrode (Orion 9609) by the direct method or after HMDS-facilitated diffusion, following 1, 7 and 15 days. The values obtained were converted into microgF/mm(2) and the data analyzed by ANOVA and Tukey's test (p< 0.05). The results showed that all materials released more fluoride in the pH-cycling system, except for Ariston pHc which maintained a constant release during the experiment. The highest fluoride release was presented by the positive control, Vitremer in pH-cycling and by Ariston pHc, in deionized water. The negative control Z100 and the resins Definite and TetricCeram did not present statistically significant differences.

Effect of alcoholic and low-pH soft drinks on fluoride release from compomer

PURPOSE

The purpose of this study was to evaluate the amount of fluoride released from compomer restorative materials after immersion in various media.

MATERIALS AND METHODS

In this test, four materials were used: three compomers (Dyract, Dentsply, Konstanz, Germany; Compoglass, Vivadent, Schaan, Principality of Liechtenstein; and Xeno, Sankins, Tochigi, Japan) and one resin-modified glass ionomer cement (Fuji II LC, GC, Tokyo, Japan). There were four test solutions: one alcoholic (whiskey), two low-pH drinks (Coca-Cola, orange juice), and one deionized water. Over a period of 60 days, the tested specimens were immersed in the test solution for 3 hours every day, then kept in deionized water. The fluoride released was detected by using a fluoride ion selective electrode connected to a microprocessor ion analyzer. The fluoride ion concentration (ppm) of the test solutions and deionized water was recorded after 1, 2, 3, 4, 7, 30, and 60 days. Electron probe microanalysis was used for surface analysis of the fluoride released.

RESULTS

When immersed in low-pH soft drinks, compomer showed a significantly higher fluoride release than when immersed in deionized water (p < .0001). For specimens immersed in Coca-Cola, the fluoride release levels (microgram/cm2, mean +/- SD) at 1, 7, and 60 days for Dyract (91.6 +/- 1.8, 39.3 +/- 3.1, 10.5 +/- 0.9), Compoglass (129.5 +/- 0.9, 66.5 +/- 2.7, 19.0 +/- 0.3), Fuji II LC (147.0 +/- 4.2, 50.8 +/- 3.1, 27.6 +/- 3.0), and Xeno (73.6 +/- 3.2, 27.3 +/- 2.1, 6.6 +/- 0.6) demonstrated the trend of significantly lower releases with time in water solution. Over a 60-day period, materials immersed in 100% orange juice released the highest amount of fluoride, which could be attributable to the erosive effect of the medium. Materials immersed in deionized water released the least amount of fluoride. Among the tested compomers, Compoglass released the most fluoride.

Cytotoxicity of dental glass ionomers evaluated using dimethylthiazol diphenyltetrazolium and neutral red tests

The purpose of this study was to assess the cytotoxicity of some commonly used glass ionomers. Three chemically cured glass ionomers (Fuji II, Lining cement, and Ketac Silver) and one light-cured (Fuji II LC) were tested. Extracts of mixed non-polymerized materials and polymerized specimens were prepared in accordance with ISO standard 10993-12. The polymerized specimens were cured and placed either directly in the medium (freshly cured), left for 24 h (aged), or aged plus ground before being placed in the medium. The cytotoxicity of extracts was evaluated on mouse fibroblasts (L, 929), using dimethylthiazol diphenyltetrazolium (MTT) and neutral red (NR) assays. Further, the concentrations of aluminum, arsenic and lead were analyzed in aqueous extracts from freshly cured and aged samples, and the fluoride levels analyzed in aqueous extracts from freshly cured samples. All extracts except that of non-polymerized Ketac Silver were rated as severely cytotoxic in both assays. Extracts of polymerized material were significantly more cytotoxic than extracts of non-polymerized material. All freshly cured glass ionomers released aluminum and fluoride concentrations far above what is considered cytotoxic (aluminum >0.2 ppm and fluoride >20 ppm). Extracts from freshly cured Lining Cement contained the highest concentrations of aluminum and fluoride (215 ppm and 112 ppm). Extracts from freshly cured Ketac Silver had the lowest concentrations of aluminum and fluoride but the highest of lead (100 ppm). It can be concluded that all extracts from non-cured, freshly cured, and aged glass ionomers contained cytotoxic levels of substances. Curing did not reduce the toxicity significantly.

In vitro investigation of aluminum and fluoride release from compomers, conventional and resin-modified glass-ionomer cements: a standardized approach

The amount of fluoride release from dental cements necessary for an anticariogenic effect is not established: moreover, the possible toxic effects due to high fluoride and aluminum release are not well known and the results are still controversial. The aim of our study was to evaluate fluoride (F) and aluminum (Al) release from dental cements using a 'standardized approach' according to the end-use of the materials, i.e. biocompatibility testing. Two polyacid-modified resin composites of recent application, commonly called compomers (Dyract and Dyract Cem), were compared with two conventional acid-based (Fuji I, Ketac-Cem) and two resin-modified (Vitremer, Vitrebond) glass-ionomer cements (GICs). All types of cement are used in dentistry and are commercially available. Extracts of the cements into minimum essential medium, after setting over a 1-h (group A) and 1-week (group B) period, were performed. The extraction conditions were rigorously standardized. Mean values +/- standard deviation of F- and Al-levels in such extracts were measured and were expressed as microg g(-1) (micrograms of ions per gram of cement). A great difference in the amount of ion release, both F and Al, was shown among the tested materials. The GICs, as well as Ketac-Cem, released more F and Al than the compomers. All of the materials released the greatest proportion of ions when the extraction was performed in the first hour after mixing (group A). Al- and F-values showed a highly significant positive correlation, independently from the curing time. We conclude that the biological assessment of dental cements can be performed only if a pre-evaluation of the leachables is obtained by applying a standardized protocol which allows a useful comparison between the different materials.

Cytotoxic effects of extracts of compomers

We have studied the cytotoxicity of 10 commercially available compomers. Extracts were taken in cell culture medium of non-cured, freshly-cured, and aged samples. Murine L-929 fibroblasts were exposed to the extracts for 24 h and the cytotoxicity was evaluated using dimethylthiazol diphenyltetrazolium (MTT) assay and neutral red uptake (NRU). Extracts were rated as severely, moderately, or slightly cytotoxic when the activity relative to controls was less than 30%, between 30% and 60%, or greater than 60%, respectively. Extracts of non-cured materials were rated severely toxic with both methods, with one exception. All but one freshly-cured material exhibited moderate to severe toxicity in both assays. Aged test specimens were rated moderately to severely toxic. Non-cured materials were generally more toxic than cured, with two exceptions. Aging and polishing the samples to remove non-polymerized surface film affected cytotoxicity to a varying degree. Curing reduced cytotoxicity in the MTT test from severe to moderate in 7 of 9 materials, but had relatively little effect in the NRU assay. Aging and polishing, however, had little effect on cytotoxicity evaluated by the MTT test, but markedly reduced cytotoxicity in NRU in 6 of 8 extracts. To conclude, extracts made from compomers used for dental fillings were found to be cytotoxic both before and after setting.