Clinical and Microbiological Evaluation of a Chlorhexidine-Modified Glass Ionomer Cement (GIC-CHX) Restoration Placed Using the Atraumatic Restorative Treatment (ART) Technique

Organic antibacterial modifications of high-viscosity glass ionomer cement for atraumatic restorative treatment: A review

High viscosity glass ionomer cement (HVGIC) has been employed as a restorative material for Atraumatic Restorative Treatment (ART). As residual caries persist after caries removal in ART, the antibacterial activity of HVGIC gains importance. Organic and inorganic substances with antibacterial properties have been incorporated into HVGIC over the years, and their effects on the antibacterial and physical properties have been studied. The objective of this paper is to review the various alterations made to HVGIC using organic compounds, their effect on the antibacterial activity, and the physical properties of the cement. Various in vitro investigations have been conducted by adding antiseptics, antibiotics, and naturally occurring antibacterial substances. Most of these compounds render superior antibacterial properties to HVGIC, but higher concentrations affect physical properties in a dose-dependent manner. However, some naturally occurring antibacterial substances, such as chitosan, improve the physical properties of HVGIC, as they enhance cross-linking and polysalt bridging. There is potential for clinical benefits to be gained from the addition of organic antibacterial compounds to HVGIC. In-depth research is required to determine the optimum concentration at which the antibacterial effect is maximum without affecting the physical properties of the cement.

Clinical Performance of Glass Ionomer Cement in Load-Bearing Restorations: A Systematic Review

Glass ionomer cement (GIC) is a self-adhesive dental restorative material composed of a polyacrylic acid liquid and fluoro-aluminosilicate glass powder. It is commonly used for cementation during dental restoration. This study aimed to systematically review the existing literature regarding the clinical performance of GIC in load-bearing dental restorations. A comprehensive literature search was conducted in EBSCO, PubMed, Embrace, and Cochrane databases. Only randomized controlled trials (RCTs) were included in the search, and a broad search technique was used, where inclusion and exclusion criteria were applied. After a thorough evaluation, 12 RCTs were extensively reviewed, and whether GIC is suitable for load-bearing restorations was determined. Significant variations in staining surface or margin, color match, translucency, esthetic anatomical form, retention, material fracture, marginal adaptation, surface luster, occlusal contour, wear, and approximal anatomical form indicated the unsuitability of GIC. By contrast, significance differences in patient view and periodontal response indicated that GIC is suitable. No significant differences in postoperative sensitivity, recurrence of caries, or tooth integrity were observed. Nevertheless, the results of the review demonstrated that the clinical performance of GIC is comparable to that of traditional restorative materials with regard to the parameters analyzed. GIC is a suitable restorative material for load-bearing restorations regarding surface margin, esthetic anatomical form, material retention and fracture, marginal adaptation, occlusal contour, wear, and approximal anatomical form. It reduces other parameters, such as postoperative sensitivity, recurrence of caries, and tooth integrity.

Herbalism and glass-based materials in dentistry: review of the current state of the art

Half a million different plant species are occurring worldwide, of which only 1% has been phytochemically considered. Thus, there is great potential for discovering novel bioactive compounds. In dentistry, herbal extracts have been used as antimicrobial agents, analgesics, and intracanal medicaments. Glass-ionomer cement (GIC) and bioactive glass (BAG) are attractive materials in dentistry due to their bioactivity, adhesion, and remineralisation capabilities. Thus, this review summarizes the evidence around the use of phytotherapeutics in dental glass-based materials. This review article covers the structure, properties, and clinical uses of GIC and BAG materials within dentistry, with an emphasis on all the attempts that have been made in the last 20 years to enhance their properties naturally using the wisdom of traditional medicines. An extensive electronic search was performed across four databases to include published articles in the last 20 years and the search was concerned only with the English language publications. Publications that involved the use of plant extracts, and their active compounds for the green synthesis of nanoparticles and the modification of GIC and BAG were included up to May 2023. Plant extracts are a potential and effective candidate for modification of different properties of GIC and BAG, particularly their antimicrobial activities. Moreover, natural plant extracts have shown to be very effective in the green synthesis of metal ion nanoparticles in an ecological, and easy way with the additional advantage of a synergistic effect between metal ions and the phytotherapeutic agents. Medicinal plants are considered an abundant, cheap source of biologically active compounds and many of these phytotherapeutics have been the base for the development of new lead pharmaceuticals. Further research is required to assess the safety and the importance of regulation of phytotherapeutics to expand their use in medicine.

Evaluation of Mechanical Properties of Glass Ionomer Cements Reinforced with Synthesized Diopside Produced via Sol-Gel Method

This study aimed to fabricate a glass ionomer cement/diopside (GIC/DIO) nanocomposite to improve its mechanical properties for biomaterials applications. For this purpose, diopside was synthesized using a sol-gel method. Then, for preparing the nanocomposite, 2, 4, and 6 wt% diopside were added to a glass ionomer cement (GIC). Subsequently, X-ray diffraction (XRD), differential thermal analysis (DTA), scanning electron microscopy (SEM), and Fourier transform infrared spectrophotometry (FTIR) analyses were used to characterize the synthesized diopside. Furthermore, the compressive strength, microhardness, and fracture toughness of the fabricated nanocomposite were evaluated, and a fluoride-releasing test in artificial saliva was also applied. The highest concurrent enhancements of compressive strength (1155.7 MPa), microhardness (148 HV), and fracture toughness (5.189 MPa·m^1/2) were observed for the glass ionomer cement (GIC) with 4 wt% diopside nanocomposite. In addition, the results of the fluoride-releasing test showed that the amount of released fluoride from the prepared nanocomposite was slightly lower than the glass ionomer cement (GIC). Overall, the improvement in mechanical properties and optimal fluoride release of prepared nanocomposites can introduce suitable options for dental restorations under load and orthopedic implants.