The effect of powder to liquid ratio on physical properties and fluoride release of glass ionomer cements containing pre-reacted spherical glass fillers

Evaluation of Physical Properties in Carboxymethyl Chitosan Modified Glass Ionomer Cements and the Effect for Dentin Remineralization: SEM/EDX, Compressive Strength, and Ca/P Ratio

OBJECTIVE

 The aim of this article was to evaluate the effects of modifying glass ionomer cement (GIC) with carboxymethyl chitosan (CMC) on surface morphology and remineralization outcomes by examining dentin morphology and calcium ion composition changes.

MATERIALS AND METHODS

 Thirty holes in a cylindrical acrylic mold were filled with three groups of restorative materials: GIC, GIC modified with CMC (GIC-CMC) 5%, and GIC-CMC10%. The surface morphology of each group's materials was observed using scanning electron microscopy (SEM). The compressive strength measurement was performed using a universal testing machine. The dentin remineralization process was performed by applying GIC, GIC-CMC5%, and GIC-CMC10% materials for 14 days on demineralized dentin cavities treated with 17% ethylenediamine tetraacetic acid (EDTA) for 7 days. A morphological evaluation was conducted using SEM. The calcium ion composition and calcium-to-phosphorous (Ca/P) ratio were examined using an energy-dispersive X-ray (EDX).

STATISTICAL ANALYSIS

 The one-way ANOVA and post-hoc Bonferroni test were used to evaluate the compressive strength within the three groups (p < 0.05). The Kruskal-Wallis and subsequent Mann-Whitney U tests were conducted to compare the four groups of calcium ions (p < 0.05).

RESULTS

 The modification of GIC with CMC affected the morphological changes in the materials in the form of reduced porosity and increased fractures. A significant difference was found in compressive strength between the GIC-CMC modification materials of GIC-CMC5% and GIC-CMC10% and the GIC control group. The dentin tubule morphology and surface changes were observed after applying GIC, GIC-CMC5%, and GIC-CMC10% materials for 14 days, as evaluated by SEM. The EDX examination showed an increase in calcium ion content and hydroxyapatite formation (Ca/P ratio) after applying the GIC-CMC10% material.

CONCLUSION

 The surface porosity of the GIC modification material with the addition of CMC tended to decrease. However, an increase in cracked surfaces that widened, along with the rise in CMC percentage, was found. This modification also reduced the compressive strength of the materials, with the lowest average yield at 10% CMC addition. Therefore, the modification of GIC with CMC affects changes in morphology, calcium ion composition, and Ca/P ratio in demineralized dentin.

The development of resin-coating materials for enhancing elemental release of coated glass ionomer cements

This study aimed to develop resin coatings containing monocalcium phosphate monohydrate (MCPM), Sr/F-doped bioactive glass (Sr/F-BAGs), and pre-reacted glass ionomer fillers (SPG) that enhance ion release without detrimentally affecting the mechanical properties of GIC. The objective of this study was to evaluate the degree of monomer conversion (DC), biaxial flexural strength, surface microhardness, and ion release of the GICs coated with experimental coating materials compared to a commercial product (EQUIA Coat, EC). Four experimental resin coating materials containing 10-20 wt% of MCPM with Sr/F-BAGs and 5-10 wt% SPG were prepared. The DC of the coating material was determined using ATR-FTIR. The flexural strength and surface microhardness of the coated GICs were assessed. Fluoride and elemental (Ca,P,Sr,Si,Al) release were measured using fluoride-specific electrodes and ICP-OES. The DC of the experimental coating material (60-69 %) was higher than that of EC (55 %). The strength of GICs coated with experimental materials (35-40 MPa) was comparable to EC (37 MPa). However, their surface microhardness (13-24 VHN) was lower than EC (44 VHN). The experimental coating materials reduced fluoride release by ∼43 %, similar to EC (∼40 %). However, experimental coating materials promoted higher P and Sr release than EC. In conclusion, GICs coated with the experimental resin coating containing ion-releasing additives exhibited mechanical properties similar to those of the commercial product. The new coating materials promoted a higher level of ion release for GICs. These properties could potentially enhance remineralizing actions for the coated GICs.

Evaluation of setting kinetics, mechanical strength, ion release, and cytotoxicity of high-strength glass ionomer cement contained elastomeric micelles

BACKGROUND

Low mechanical properties are the main limitation of glass ionomer cements (GICs). The incorporation of elastomeric micelles is expected to enhance the strength of GICs without detrimentally affecting their physical properties and biocompatibility. This study compared the chemical and mechanical properties, as well as the cytotoxicity, of elastomeric micelles-containing glass ionomer cement (DeltaFil, DT) with commonly used materials, including EQUIA Forte Fil (EF), Fuji IX GP Extra (F9), and Ketac Molar (KT).

METHOD

Powder particles of GICs were examined with SEM-EDX. Setting kinetics were assessed using ATR-FTIR. Biaxial flexural strength/modulus and Vickers surface microhardness were measured after immersion in water for 24 h and 4 weeks. The release of F, Al, Sr, and P in water over 8 weeks was analyzed using a fluoride-specific electrode and ICP-OES. The toxicity of the material extract on mouse fibroblasts was also evaluated.

RESULTS

High fluoride levels in the powder were detected with EF and F9. DT demonstrated an initial delay followed by a faster acid reaction compared to other cements, suggesting an improved snap set. DT also exhibited superior flexural strength than other materials at both 24 h and 4 weeks but lower surface microhardness (p < 0.05). EF and F9 showed higher release of F, Al, and P than DT and KT. There was no statistically significant difference in fibroblast viability among the tested materials (p > 0.05).

CONCLUSIONS

Elastomeric micelles-containing glass ionomer cement (DT) exhibited satisfactory mechanical properties and cytocompatibility compared with other materials. DT could, therefore, potentially be considered an alternative high-strength GIC for load-bearing restorations.

Cell viability assessment and ion release profiles of GICs modified with TiO2- and Mg-doped hydroxyapatite nanoparticles

OBJECTIVES

To assess and compare the cell viability and ion release profiles of two conventional glass ionomer cements (GICs), Fuji IX and Ketac Molar EasyMix, modified with TiO2 and Mg-doped-HAp nanoparticles (NPs).

METHODS

TiO2 NPs, synthesized via a sol-gel method, and Mg-doped hydroxyapatite, synthesized via a hydrothermal process, were incorporated into GICs at a concentration of 5 wt.%. The biocompatibility of prepared materials was assessed by evaluating their effects on the viability of dental pulp stem cells (DPSCs), together with monitoring ion release profiles. Statistical analysis was performed using One-way analysis of variance, with significance level p < 0.05.

RESULTS

The addition of NPs did not significantly affect the biocompatibility of GICs, as evidenced by comparable decreased levels in cell viability to their original formulations. Distinct variations in cell viability were observed among Fuji IX and Ketac Molar, including their respective modifications. FUJI IX and its modification with TiO2 exhibited moderate decrease in cell viability, while other groups exhibited severe negative effects. While slight differences in ion release profiles were observed among the groups, significant variations compared to original cements were not achieved. Fluoride release exhibited an initial "burst release" within the initial 24 h in all samples, stabilizing over subsequent days.

CONCLUSIONS

The addition of NPs did not compromise biocompatibility, nor anticariogenic potential of tested GICs. However, observed differences among FUJI IX and Ketac Molar, including their respective modifications, as well as induced low viability of DPSC by all tested groups, suggest the need for careful consideration of cement composition in their biological assessments.

CLINICAL SIGNIFICANCE

The findings contribute to understanding the complex interaction between NPs and GIC matrices. However, the results should be interpreted recognizing the inherent limitations associated with in vitro studies. Further research avenues could explore long-term effects, in vivo performance, and potential clinical applications.

Usefulness of conventional glass ionomer cements in an environment of insufficient moisture exclusion

PURPOSE

Moisture exclusion while treating dental caries can be challenging, and the glass ionomer cements (GICs) used for these procedures are susceptible to water. Few studies have examined the effects of the powder/liquid ratio (PLR) on the physical properties of GICs exposed to water. In this study, the hardness and thickness of the water-susceptible surface layer of three GICs were evaluated.

METHODS

Three conventional GICs were mixed in increasing PLRs, and hardness over time was measured under conditions of no water exposure, distilled water exposure, and saliva exposure. Furthermore, the thickness of the water-susceptible layer for each GIC was determined.

RESULTS

A water-susceptible layer of approximately 250 μm was evident for all GICs, and the thickness decreased with increasing PLR. GIC hardness increased with increasing PLR in conditions without water for all GIC types. Furthermore, the removal of the water-susceptible layer restored the physical properties of each GIC.

CONCLUSION

Overall, the results indicate that conventional GIC restoration with the removal of the water-susceptible surface layer is a feasible strategy for treating dental caries in individuals for whom exclusion of moisture can be difficult.

Effect of the Addition of Varying Concentrations of Silver Nanoparticles on the Fluoride Uptake and Recharge of Glass Ionomer Cement

This study aimed to compare the amount of fluoride uptake and the recharge and release characteristics of conventional glass ionomer cement (GIC) without any additives in comparison to conventional glass ionomer cement supplemented with silver nanoparticles (AgNPs) at two concentrations: 0.1% and 0.2% (w/w). A total of 60 specimens were used in this in vitro study. The sample was divided into six groups—including three groups without fluoride charge: Group 1 (conventional GIC), Group 2 (GIC with 0.1% silver nanoparticles), and Group 3 (GIC with 0.2% silver nanoparticles; and three groups with fluoride charge: Group 4 (conventional GIC with fluoride); Group 5 (GIC with 0.1% silver nanoparticles with fluoride); Group 6 (GIC with 0.2% silver nanoparticles with fluoride), where Group 1 is considered the control group and the other five groups are used as the test groups. The amount of fluoride released was measured on days 1, 2, 7, 15, and 30. The comparisons were made between the groups with and without fluoride and among all the groups. A significant difference in the amount of fluoride released was observed between the groups, with the highest amount occurring in Group 1, followed by Group 2; the lowest amount of fluoride released was observed in Group 3 (p < 0.05). The groups with fluoride recharge (Groups 4, 5, and 6) exhibited a higher amount of fluoride release than the groups with no recharge (Groups 1, 2, and 3); however, Group 1 has more fluoride release compared to all other groups on days 1, 2, 7, 15, and 30 (p < 0.05). The amount of released fluoride decreased from day 1 to day 30 in all of the groups in the study. Despite the antimicrobial and anticariogenic benefits of adding silver nanoparticles to GIC, it seems that fluoride release characteristics are significantly affected by the addition of this material. This may force the clinician to a compromise between the antimicrobial benefit of silver nanoparticles and the remineralizing advantage of fluoride.

An alkasite restorative material effectively remineralized artificial interproximal enamel caries in vitro

OBJECTIVE

To evaluate the remineralization of artificial interproximal enamel caries (AIEC) adjacent to alkasite, high viscous glass ionomer cement (HVGIC), and resin composite in class II restorations.

MATERIALS AND METHODS

Human enamel specimens were randomly assigned to 3 groups (n = 22): Filtek™ Z350, EQUIA Forte^®, and Cention N^®. The baseline hardness was determined using a Knoop microhardness assay. AIEC was formed in the specimens, and they were placed in contact with the proximal restorative materials then subjected to a 7-day pH cycling. Microhardness was determined post-artificial caries formation and post-pH cycling. The differences in the percentage of surface hardness recovery (%SHR) between the groups were compared using the Kruskal-Wallis test. The Dunn's test was used for between-group comparisons (p < 0.05). Specimen surface morphology was evaluated using scanning electron microscopy (SEM), and the calcium, phosphorus, and fluoride contents were analyzed by energy-dispersive spectroscopy (EDS). ANOVA with the post hoc Tukey multiple comparison test was used to evaluate the differences between groups (p < 0.05).

RESULTS

The Cention N^® %SHR was the highest, followed by EQUIA Forte^®, and Filtek™ Z350. There was a significant difference in the %SHR between Cention N^® and Filtek™ Z350 (p < 0.05). In contrast, there were no significant difference between Cention N^® and EQUIA Forte^®. Significantly increased enamel surface fluoride content was observed in the Cention N^® compared with Filtek™ Z350 specimens (p < 0.05). The SEM image of the Cention N^® specimens demonstrated the greatest mineral deposition.

CONCLUSIONS

Cention N^® markedly increased the surface hardness and fluoride content of adjacent AIEC compared with Filtek™ Z350 restorations.

CLINICAL RELEVANCE

Cention N^® is a promising alternative restorative material to remineralize initial enamel lesions in approximal adjacent surfaces, especially in high-risk caries patients.

Monomer Conversion, Dimensional Stability, Biaxial Flexural Strength, Ion Release, and Cytotoxicity of Resin-Modified Glass Ionomer Cements Containing Methacrylate-Functionalized Polyacids and Spherical Pre-Reacted Glass Fillers

The aim of this study was to prepare RMGICs for pulp protection that contain polyacids functionalized with methacrylate groups (CMs) to enable light-activated polymerization without the need for toxic 2-hydroxyethyl methacrylate (HEMA) monomers. The effects of using CM liquids with 0 or 5 wt% HEMA on the physical/mechanical properties and cytotoxicity of the experimental RMGICs were assessed. Spherical pre-reacted glass fillers (SPG) were used as the powder phase. The experimental RMGICs were prepared by mixing SPG with CM liquid (0 wt% HEMA, F1) or CMH liquid (5 wt% HEMA, F2). Commercial materials (Vitrebond, VB; TheraCal LC, TC) were used for the comparisons. The degree of monomer conversion and fluoride release of both F1 and F2 were significantly lower than those of VB. F1 showed comparable biaxial flexural strength with VB but higher strength than TC. The dimensional stability (mass/volume changes) of the experimental materials was comparable with that of the commercial materials. F1 and F2 exhibited higher Sr/Ca ion release and relative cell viability than VB. The use of CMH liquid reduced the strength but enhanced the fluoride release of the experimental RMGICs. In conclusion, the experimental RMGICs showed comparable strength but lower cytotoxicity compared to the commercial RMGICs. These novel materials could be used as alternative materials for pulp protection.

Rheological Properties, Surface Microhardness, and Dentin Shear Bond Strength of Resin-Modified Glass Ionomer Cements Containing Methacrylate-Functionalized Polyacids and Spherical Pre-Reacted Glass Fillers

The aim of this study was to prepare experimental resin-modified glass ionomer cements (RMGICs) containing low levels of hydroxyethyl methacrylate (HEMA) for pulp protection. Liquid and powder phases of the experimental RMGICs were polyacid functionalized with methacrylate groups and spherical pre-reacted glass fillers (SPG). Two types of liquid phase containing 0 wt. % HEMA (CM liquid) or 5 wt. % HEMA (CMH liquid) were formulated. The experimental RMGICs were prepared by mixing SPG fillers with CM liquid (F1) or CMH liquid (F2). Rheological properties were examined using a strain-controlled rheometer (n = 5). The Vickers microhardness (n = 5) and dentin shear bond strength (SBS) (n = 10) of the materials were tested. Commercial pulp protection materials (Vitrebond and TheraCal LC) were used as comparisons. The viscosity and surface microhardness of F1 (22 m Pa·s, 18 VHN) and F2 (18 m Pa·s, 16 VHN) were significantly higher than those of Vitrebond (6 mPa·s, 6 VHN) and TheraCal (0.1 mPa·s, 7 VHN). The SBS of F1 (10.7 MPa) and F2 (11.9 MPa) was comparable to that of Vitrebond (15.4 MPa) but higher than that of TheraCal LC (5.6 MPa). The addition of 5 wt. % HEMA showed no significant effect on viscosity, surface microhardness, or SBS of the experimental RMGICs. The experimental materials showed higher viscosity and microhardness but similar SBS when compared with the commercial RMGIC.

Comprehensive characterisation of flexural mechanical properties and a new classification for porosity of 11 contemporary ion-leaching dental restorative materials

The objectives of this study were to evaluate 4 aspects of ion-leaching restorative materials (ILMs): 4-point bending flexural strength (4 PB-FS) and relative mechanical properties; biaxial flexural strength (B-FS) in relation to 4 PB-FS; porosity; and surface morphology. Eleven ILMs were used for the 4-point bending test. Bar-shaped (n = 15) samples were fabricated, stored in distilled water for 7 days. Then 4 PB-FS and the other mechanical properties were determined. Five ILMs were selected for the B-FS test using disk specimens (n = 15). The correlation between 4 PB-FS and B-FS was addressed. After the 4 PB test, 5 randomised fragments from each material were used to make 0.5 mm-thick sections for light microscopy to investigate the degree of porosity using reflected and transmitted lights. Eight ILMs were selected for quantitative analysis of the fractional % pore volume (PV%) due to their relative pore prominence using ImageJ software. One-way ANOVA/Dunnett's T3 was used to test for significance. Resin-based ILMs (RB-ILMs) were ranked first (p < 0.05) for 4 PB-FS values (53.3-110.2 MPa) followed by resin-modified glass-ionomer cements (RMGICs; 30.9-44.3 MPa) and high-viscosity glass-ionomer cements (HVGICs; 12.9-19.6 MPa), respectively. 'Flexural modulus' (4 PB-E) and 'flexural toughness' (4 PB-T) of ILMs varied even though similar 4 PB-FS values were observed. There was a positive correlation (p < 0.001) between 4PB-FS and B-FS (R² = 0.992) with B-FS>4 PB-FS. There was no correlation between PV% and 4 PB-FS. In summary, material type played a major role in 4 PB-FS outcomes, whereas PV% seemed to have a minor effect when evaluating each material group of ILMs. Brittleness/ductility of ILMs was observed when determining 4 PB-E and 4 PB-T relative to 4 PB-FS. When selecting materials for posterior load-bearing dental restorations in high-caries risk patients, RB-ILMs or RMGICs would be more appropriate due to their superior flexural properties compared with recently introduced HVGICs. The decision for each situation will also be dependent on further evidence of the ion-leaching capacity.

Monomer conversion, biaxial flexural strength, apatite forming ability of experimental dual-cured and self-adhesive dental composites containing calcium phosphate and nisin

The aim was to develop dual-cured, self-adhesive composites containing monocalcium phosphate monohydrate (MCPM, 8 or 4 wt%) and nisin (6 or 3 wt%) with added adhesive monomer. The effect of additives on monomer conversion (MC), biaxial flexural strength (BFS), dentin shear bond strength (SBS), and surface apatite formation were examined. All experimental composites showed light-activated MC (70-75%) higher than the commercial self-adhesive composite (Vertise Flow; VF, 65%). The additives reduced BFS of the composites from 217 to 133 MPa. SBS of the experimental composites (2-6 MPa) was lower than that of VF (12 MPa). Rising MCPM level enabled apatite-like crystals precipitated on the surface of composites after immersion in simulated body fluid for 4 weeks. The additives showed negligible effect on MC and SBS. Rising level of additives reduced strength of the composites but the values were still higher than that required by the standard.