Determination of chemical species of fluoride during uptake mechanism of glass-ionomer cements with NMR spectroscopy

ObjectiveThe aim of the present study was to determine the chemical species formed inside glass-ionomer cements after fluoride uptake and to investigate the depth of penetration of fluoride ions within the cement matrix.MethodsAn experimental fluoride-free glass with composition 2SiO₂–AlO₃–CaO was produced. The glass powder was mixed with aqueous poly(acrylic acid) (PAA), and allowed to set. The resulting specimens were stored in 20 ml KF solution with 1000 ppm fluorine for 24 h and then placed into the same amount of water as for 24 h. A fluoride selective electrode was used to give the F concentration of the respective solutions. ¹⁹F MAS-NMR spectra were recorded on powdered cement specimens using a Bruker AVANCE-NEO 600 spectrometer. In addition, SEM observation and EDX chemical analysis were conducted on the cross-section of a carefully fractured specimen.ResultsFluoride was shown to be mainly present in the surface layers of the specimen after placement in the KF solution, and only a small fraction was re-released into water. ¹⁹F NMR spectroscopy showed that AlF complexes were formed within the cement.SignificanceThe fluoride taken up by a free-fluoride glass ionomer cement mostly occupies surface layers and is retained because it bonds to aluminum within the matrix. This finding explains why the majority of fluoride taken up by conventional glass ionomer cements is retained.     

Sodium fluoride effect on erosion–abrasion under hyposalivatory simulating conditions

ObjectivesTo investigate the effect of fluoride (0, 275 and 1250 ppm F; NaF) in combination with normal and low salivary flow rates on enamel surface loss and fluoride uptake using an erosion–remineralization–abrasion cycling model.DesignEnamel specimens were randomly assigned to 6 experimental groups (n = 8). Specimens were individually placed in custom made devices, creating a sealed chamber on the enamel surface, connected to a peristaltic pump. Citric acid was injected into the chamber for 2 min followed by artificial saliva at 0.5 (normal flow) or 0.05 (low flow) ml/min, for 60 min. This cycle was repeated 4×/day, for 5 days. Toothbrushing with abrasive suspensions containing fluoride was performed for 2 min (15 s of actual brushing) 2×/day. Surface loss was measured by optical profilometry. KOH-soluble fluoride and enamel fluoride uptake were determined after the cycling phase. Data were analysed by two-way ANOVA.ResultsNo significant interactions between fluoride concentration and salivary flow were observed for any tested variable. Low caused more surface loss than normal flow rate (p < 0.01). At both flow rates, surface loss for 0 was higher than for 275, which did not differ from 1250 ppm F. KOH-soluble and structurally-bound enamel fluoride uptake were significantly different between fluoride concentrations with 1250 > 275 > 0 ppm F (p < 0.01).ConclusionsSodium fluoride reduced enamel erosion/abrasion, although no additional protection was provided by the higher concentration. Higher erosion progression was observed in low salivary flow rates. Fluoride was not able to compensate for the differences in surface loss between flow rates.     

Novel fluoride rechargeable dental composites containing MgAl and CaAl layered double hydroxide (LDH)

ObjectiveThis study aims to incorporate 2:1 MgAl and 2:1 CaAl layered double hydroxides (LDHs) in experimental dental-composites to render them fluoride rechargeable. The effect of LDH on fluoride absorption and release, and their physico-mechanical properties are investigated.Methods2:1 CaAl and 2:1 MgAl LDH-composite discs prepared with 0, 10 and 30 wt% LDH were charged with fluoride (48 h) and transferred to deionized water (DW)/artificial saliva (AS). Fluoride release/re-release was measured every 24 h (ion-selective electrodes) with DW/AS replaced daily, and samples re-charged (5 min) with fluoride every 2 days. Five absorption-release cycles were conducted over 10 days. CaAl and MgAl LDH rod-shaped specimens (dry and hydrated; 0, 10 and 30 wt%) were studied for flexural strength and modulus. CaAl and MgAl LDH-composite discs (0, 10, 30 and 45 wt% LDH) were prepared to study water uptake (over 7 weeks), water desorption (3 weeks), diffusion coefficients, solubility and cation release (ICP-OES).ResultsCaAl LDH and MgAl LDH-composites significantly increased the amount of fluoride released in both media (P < 0.05). In AS, the mean release after every recharge was greater for MgAl LDH-composites compared to CaAl LDH-composites (P < 0.05). After every recharge, the fluoride release was greater than the previous release cycle (P < 0.05) for all LDH-composites. Physico-mechanical properties of the LDH-composites demonstrated similar values to those reported in literature. The solubility and cation release showed a linear increase with LDH loading.SignificanceLDH-composites repeatedly absorbed/released fluoride and maintained desired physico-mechanical properties. A sustained low-level fluoride release with LDH-composites could lead to a potential breakthrough in preventing early stage carious-lesions.     

Effects of risedronate on osteoblastic cell cultures

ObjectiveBisphosphonates (BPs) have been widely used in the treatment of bone disorders due to their ability to modulate bone turnover. The biological mechanisms through BFs exert their effects on osteoclasts are well established. However, the role of BFs on the osteoblasts is controversial. The present study aimed to evaluate the effects of risedronate on osteoblastic cells.DesignMC3TE-E1 cells were exposed to risedronate at 0, 10⁻⁸, 10⁻⁶, 10⁻⁴, and 10⁻³ M. The following parameters were assayed: (1) cell proliferation by hemocytometer counting after 24, 48 and 72 h, (2) cell viability by MTT assay after 24, 48 and 72 h, (3) Type I Collagen quantification by ELISA after 24, 48 and 72 h, (3) alkaline phosphatase activity after 7 and 10 days and (4) matrix mineralization after 14 days.ResultsAfter 24 h, risedronate did not affect both cell proliferation and viability (p > 0.05). However, after 48 and 72 h, a decrease in cell proliferation and viability was detected in osteoblastic cultures exposed to risedronate at 10⁻⁴ and 10⁻³ M (p < 0.05). After 48 and 72 h, Type I Collagen synthesis was stimulated by risedronate at 10⁻⁴ M (p < 0.05). High levels of ALP activity were detected in cultures exposed to risedronate at 10⁻⁴ M after 7 and 10 days (p < 0.05). After 14 day, high calcium content was observed in cultures exposed to risedronate at 10⁻⁴ M (p > 0.05).ConclusionThese results indicated that risedronate can promote osteoblast differentiation.     

Ion release and physical properties of CPP–ACP modified GIC in acid solutions

A new glass-ionomer cement (GIC) (Fuji VII? EP) includes 3% (w/w) casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) to enhance ion release.ObjectivesTo assess this new GIC compared with a GIC without CPP–ACP (Fuji VII?) with respect to ion release, changes in surface hardness and in mass under a variety of acidic and neutral conditions.MethodsEighty blocks of Fuji VII? (F7) and Fuji VII? EP (F7EP) were subjected to three acidic solutions (lactic and citric acids pH 5.0, hydrochloric acid pH 2.0) and water (pH 6.9) over a three-day period. Ion release, surface hardness and weight measurements were carried out every 24 h.ResultsHigher calcium ion release from F7EP was observed under all acidic conditions. Increased inorganic phosphate ion release was observed for F7EP in hydrochloric and citric acids. Fluoride ion release was similar between F7 and F7EP under all conditions but was significantly higher in acids compared with water. After three days there was no significant difference in surface hardness (p > 0.05) between the two materials under all conditions except hydrochloric acid. Minimal change in mass was observed for F7 and F7EP in water, lactic and hydrochloric acids, however citric acid caused significantly more mass loss compared with water (p < 0.001).ConclusionIncorporation of 3% (w/w) CPP–ACP into F7 enhanced calcium and phosphate ion release, with no significant change in fluoride ion release and no adverse effects on surface hardness or change in mass.Clinical significance statementGICs have the potential to release fluoride ions particularly under acidic conditions associated with dental caries and erosion. A new GIC containing CPP–ACP and fluoride releases not only fluoride ions but also calcium and phosphate ions under acidic conditions which should help to inhibit demineralisation associated with caries and erosion.     

Antibacterial and antibiofilm efficacy of k21-E in root canal disinfection

ObjectivesThe aim of the current project was to study the antimicrobial efficacy of a newly developed irrigant, k21/E against E. faecalis biofilm.MethodsRoot canals were instrumented and randomly divided into the following groups: irrigation with saline, 6% NaOCl (sodium hypochlorite), 6% NaOCl + 2% CHX (Chlorhexidine), 2% CHX, 0.5% k21/E (k21 - quaternary ammonium silane) and 1% k21/E. E. faecalis were grown (3-days) (1 × 10⁷ CFU mL⁻¹), treated, and further cultured for 11-days. Specimens were subjected to SEM, confocal and Raman analysis and macrophage vesicles characterized along with effect of lipopolysaccharide treatment. 3T3 mouse-fibroblasts were cultured for alizarin-red with Sortase-A active sites and Schrödinger docking was performed. TEM analysis of root dentin substrate with matrix metalloproteinases profilometry was also included. A cytotoxic test analysis for cell viability was measured by absorbance of human dental pulp cells after exposure to different irrigant solutions for 24 h. The test percentages have been highlighted in Table 1.ResultsAmong experimental groups, irrigation with 0.5% k21/E showed phase separation revealing significant bacterial reduction and lower phenylalanine 1003 cm⁻¹ and Amide III 1245 cm⁻¹ intensities. Damage was observed on bacterial cell membrane after use of k21/E. No difference in exosomes distribution between control and 0.5%k21/E was observed with less TNFα (*p < 0.05) and preferential binding of SrtA. TEM images demonstrated integrated collagen fibers in control and 0.5%k21/E specimens and inner bacterial membrane damage after k21/E treatment. The k21 groups appeared to be biocompatible to the dental pulpal cells grown for 24 h.SignificanceCurrent investigations highlight potential advantages of 0.5% k21/E as irrigation solution for root canal disinfection.     

Fluoride released from glass-ionomer cement is responsible to inhibit the acid production of caries-related oral streptococci

ObjectivesGlass-ionomer cements (GICs) are known to have inhibitory effects on bacterial growth, but the biochemical mechanism of this property has not been fully understood. This study aimed to evaluate inhibitory effects of GIC on the acid production of caries-related oral streptococci, and to identify the components responsible for the inhibition.MethodsAn eluate was prepared by immersing set GIC in phosphate-buffered saline at 37 °C for 24 h. Fluoride and other elements in the eluate were quantified by fluoride ion electrode and atomic absorption photometry, respectively. Streptococcus mutans NCTC 10449 and Streptococcus sanguinis NCTC 10556 were used to evaluate the pH fall and the rate of acid production after the addition of glucose in the presence or absence of the eluate. Acidic end products from glucose were also assayed by carboxylic acid analyzer.ResultsThe eluate contained silicon (1.24 ± 0.26 mM), fluoride (0.49 ± 0.02 mM) and aluminum (0.06 ± 0.00 mM), and inhibited the pH fall and the acid production rate of both streptococci at acidic pH, with a concomitant decrease in lactic acid production. These effects were comparable to those of a potassium fluoride solution containing the same concentration of fluoride as the eluate.SignificanceThese results indicate that the GIC eluate inhibits the acid production of caries-related oral streptococci at acidic pH and that the effect is due to fluoride derived from the GIC. Thus, adjacent to GIC fillings, bacterial acid production and the subsequent bacterial growth may decrease, establishing a cariostatic environment.     

Mathematical model for assessing true irradiance received by luting materials while curing through modern CAD/CAM resin composites

Statement of problemMeasurement of irradiance passing through a dental restoration for properly curing a dual- or light-polymerized luting composite is imprecise due to surface reflection.ObjectiveTo provide a mathematical correction of measured transmitted irradiance for predicting true transmitted light intensity through CAD/CAM restorations.MethodsA total of 432 specimens were fabricated. Seven modern CAD/CAM resin-based composites (RBCs) and one CAD/CAM glass-ceramic (control group) were sectioned and polished into specimens of 0.5–5 mm thickness (in 0.5 mm steps, n = 6). Irradiance of a violet-blue LED light curing unit (LCU) (power modes: Standard, High and Plasma) was measured after passing through each specimen with a spectrometer. Data was compared based on 95% confidence intervals and using univariate ANOVA followed by Tukey HSD (α = 0.05).ResultsThe measured transmitted irradiance passing through the specimens decreased exponentially. Significantly highest values of transmitted irradiance were measured for 0.5 mm thick specimens for all materials (p < 0.05). The decadic absorption coefficient for CAD/CAM-RBCs ranged from 0.292 mm⁻¹ to 0.387 mm⁻¹ while the control group (glass-ceramic) reached a significantly lower value of 0.283 mm⁻¹. The reflection ratio for all materials ranged from 12.6% to 18.5%.SignificanceA correction can be implemented to predict the true transmitted irradiance after passing through a dental restoration as function of initial irradiance, specimen thickness and material specific parameters. For a practitioner, this model may be applied depending on the specific treatment conditions, the individual LCU's radiant emittance and restoration thickness for the tested materials.     

The effect of excitation laser power in Raman spectroscopic measurements of the degree of conversion of resin composites

ObjectivesTo evaluate the effect of excitation laser power in Raman spectrometry by comparing the spectra and the degree of conversion (DC) values obtained using excitation powers between 300 and 1000 mW.MethodsFive commercial and three experimental resin composites were light cured at 1200 mW/cm² for 10–20 s from a commercial blue-violet LED dental curing unit. Raman spectra were collected from composite specimens within 9 min after light-curing. The excitation laser (1064 nm) was focused on the spot of 0.4 mm in diameter. The following powers were used for specimen excitation (mW): 300, 400, 600, 800, and 1000. From Raman spectra, the DC values were calculated and compared among different laser powers. Also, vector-normalized Raman spectra collected using the lowest excitation power (300 mW) were compared to those collected using the maximum excitation power (1000 mW).ResultsVarying the excitation laser power between 300 and 1000 mW resulted in statistically significant differences in both the DC values and the intensity of particular spectral features. The effect of varying laser power on Raman spectra and obtained DC values was material-dependent. The DC values measured within an individual material using different laser powers varied between 3.2 and 7.2% (absolute DC difference). The spectral bands affected by variations in laser power were assigned to symmetric and asymmetric stretching of −CH₂ (2900-3100 cm⁻¹), symmetric stretching of aliphatic CC (1640 cm⁻¹) and scissoring of C–H (1458 cm⁻¹).SignificanceThe DC can be artificially elevated through increasing excitation laser power. This effect should be considered in Raman spectroscopic evaluations of DC in specimens during ongoing post-cure polymerization.     

Development and characterisation of dental composites containing anisotropic fluorapatite bundles and rods

ObjectivesTo develop dental composites incorporating fluorapatite (FA) crystals as a secondary filler and to characterise degree of conversion, key mechanical properties and fluoride release.MethodsFA rod-like crystals and bundles were hydrothermally synthesised and characterised by scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS), X-ray diffraction (XRD) and ¹⁹F MAS-NMR. Composites were formulated containing BisGMA/TEGDMA/BisEMA and barium-aluminium-silicate glass (0FA). FA crystals were incorporated at 10 (10FA), 20 (20FA), 30 (30FA) and 40 wt% (40FA) maintaining a filler content of 80 wt% (63–67 vol%). Degree of conversion (DC), flexural strength (FS), flexural modulus (FM), fracture toughness (K_1C), Vickers hardness (HV) and 2-body wear were measured. Fluoride release was measured in neutral and acidic buffers.ResultsXRD and ¹⁹F MAS-NMR confirmed that only FA was formed, whilst SEM revealed the presence of single rods and bundles of nano-rods. DC ranged between 56–60% (p > 0.05). FA composites showed lower FM and lower FS (p < 0.05), but comparable wear resistance and HV (p > 0.05) to 0FA. 30FA and 40FA showed similar K_1C to 0FA (p > 0.05), with SEM showing evidence of toughening mechanisms, whereas 10FA and 20FA showed lower K_1C (p < 0.05). FA containing composites released fluoride that was proportional to the amount of FA incorporated (p < 0.05) but only under acidic conditions.SignificanceThe addition of FA to the experimental composites reduced strength and stiffness but not the DC, hardness or wear rate. 30FA and 40FA had a higher K_1C compared to other FA groups. Fluoride release occurred under an accelerated acidic regime, suggesting potential as a bioactive ‘smart’ composite.     

Effect of biomimetic mineralization on enamel and dentin: A Raman and EDX analysis

ObjectiveTo investigate the effect of an experimental biomimetic mineralization kit (BIMIN) on the chemical composition and crystallinity of caries-free enamel and dentin samples in vitro.MethodsEnamel and dentin samples from 20 human teeth (10 for enamel; 10 for dentin) were divided into a control group without treatment and test samples with BIMIN treatment. Quantitative analysis of tissue penetration of fluoride, phosphate, and calcium was performed using energy-dispersive X-ray spectroscopy (EDX). Mineralization depth was measured by Raman spectroscopy probing the symmetric valence vibration near 960 cm⁻¹ as a marker for crystallinity. EDX data was statistically analyzed using a paired t-test and Raman data was analyzed using the Student’s t-test.ResultsEDX analysis demonstrated a penetration depth of fluoride of 4.10 ± 3.32 μm in enamel and 4.31 ± 2.67 μm in dentin. Calcium infiltrated into enamel 2.65 ± 0.64 μm and into dentin 5.58 ± 1.63 μm, while the penetration depths for phosphate were 4.83 ± 2.81 μm for enamel and 6.75 ± 3.25 μm for dentin. Further, up to 25 μm of a newly mineralized enamel-like layer was observed on the surface of the samples. Raman concentration curves demonstrated an increased degree of mineralization up to 5–10 μm into the dentin and enamel samples.SignificanceBiomimetic mineralization of enamel and dentin samples resulted in an increase of mineralization and a penetration of fluoride into enamel and dentin.     

The effects of fluoride,strontium, theobromine and their combinations on caries lesion rehardening and fluoridation

ObjectiveThe aim was to investigate the effects of fluoride, strontium, theobromine and their combinations on caries lesion rehardening and fluoridation (EFU) under pH cycling conditions.DesignHuman enamel specimens were demineralized at 37 °C for 24 h using a pH 5.0 solution containing 50 mM lactic acid and 0.2% Carbopol 907 which was 50% saturated with respect to hydroxyapatite. Lesions were assigned to nine treatment groups (n = 16) based on Knoop surface microhardness indentation length.Treatmentaqueous solutions were: placebo, 11.9 mM sodium fluoride (F), 23.8 mM sodium fluoride (2 × F), 1.1 mM strontium chloride hexahydrate (Sr), 1.1 mM F theobromine, Sr + theobromine, F + Sr, F + theobromine, F + Sr + theobromine. Lesions were pH cycled for 5d (daily protocol: 3 × 1min-treatment; 2 × 60min-demineralization; 4 × 60 min & overnight-artificial saliva). Knoop indentation length was measured again and%surface microhardness recovery (%SMHr) calculated. EFU was determined using the acid-etch technique. Data were analysed using ANOVA.ResultsModel showed fluoride dose-response for both variables (2 × F > F > placebo). For%SMHr, F + Sr+/−theobromine resulted in more rehardening than F, however less than 2 × F. F + theobromine was similar to F. For EFU, F + Sr was inferior to F, F + theobromine and F + Sr + theobromine which were similar and inferior to 2 × F. In absence of fluoride, Sr, theobromine or Sr + theobromine were virtually indistinguishable from placebo and inferior to F.ConclusionsIt can be concluded that a) strontium aids rehardening but not EFU and only in presence of fluoride; b) theobromine does not appear to offer any anti-caries benefits in this model; c) there are no synergistic effects between strontium and theobromine in the presence or absence of fluoride.     

Evaluation of physical properties of fiber-reinforced composite resin

ObjectivesThis study aimed to investigate physical properties of a fiber-reinforced CAD/CAM resin disc, which included woven layers of multi-directional glass fibers.MethodsFiber orientations of CAD/CAM specimens (TRINIA, SHOFU) were specified as longitudinal (L), longitudinal-rotated (LR), and anti-longitudinal (AL). A fiber-reinforced composite (everX posterior, GC (E)) and a conventional composite (Beauti core flow paste, SHOFU (B)) were also tested.A three-point bending test and a tensile test with notchless prism-shaped specimens were conducted using a universal testing machine (AUTOGRAPH AG-IS, Shimadzu). A water absorption test was also carried out after the specimens were stored in water for 24 h or 1 week. Flexural strength and fracture toughness were obtained by conducting a three-point bending test.ResultsTRINIA L and LR groups showed significantly high flexural strength (254.2 ± 22.3 and 248.8 ± 16.7 MPa, respectively). Those were approximately 2.5 times higher than those in AL, E, and B groups (96.8–98.0 MPa) (p < 0.05, ANOVA and Tukey HSD test). No significant difference was shown in flexural modulus among the experimental groups. The fracture toughness in L group (9.1 ± 0.4 MPa/m^1/2) was found to be significantly higher than those in other groups (1.9–3.0 MPa/m^1/2; p < 0.05). TRINIA group demonstrated significantly lower water absorption (4.7 ± 1.9 μg/mm³) than did E (16.1 ± 3.1 μg/mm³) and B (17.3 ± 3.7 μg/mm³) groups (p < 0.05).SignificanceTRINIA demonstrated distinct anisotropy. TRINIA can be used as a superior restorative material when specifying directions of its fiber mesh layers.     

Contributions of stress corrosion and cyclic fatigue to subcritical crack growth in a dental glass-ceramic

ObjectiveThe objective of this study was to test the following hypotheses: (1) both cyclic degradation and stress-corrosion mechanisms result in subcritical crack growth (SCG) in a fluorapatite glass-ceramic (IPS e.max ZirPress, Ivoclar-Vivadent) and (2) there is an interactive effect of stress corrosion and cyclic fatigue to accelerate subcritical crack growth.MethodsRectangular beam specimens were fabricated using the lost-wax process. Two groups of specimens (N = 30/group) with polished (15 μm) or air-abraded surface were tested under rapid monotonic loading. Additional polished specimens were subjected to cyclic loading at two frequencies, 2 Hz (N = 44) and 10 Hz (N = 36), and at various stress amplitudes. All tests were performed using a fully articulated four-point flexure fixture in deionized water at 37 °C. The SCG parameters were determined using the ratio of inert strength Weibull modulus to lifetime Weibull modulus. A general log-linear model was fit to the fatigue lifetime data including time to failure, frequency, peak stress, and the product of frequency and logarithm of stress in ALTA PRO software.ResultsSCG parameters determined were n = 21.7 and A = 4.99 × 10⁻⁵ for 2 Hz, and n = 19.1 and A = 7.39 × 10⁻⁶ for 10 Hz. After fitting the general log-linear model to cyclic fatigue data, the coefficients of the frequency term (α₁), the stress term (α₂), and the interaction term (α₃) had estimates and 95% confidence intervals of α₁ = −3.16 (−15.1, 6.30), α₂ = −21.2 (−34.9, −9.73), and α₃ = 0.820 (−1.59, 4.02). Only α₂ was significantly different from zero.Significance(1) Cyclic fatigue does not have a significant effect on SCG in the fluorapatite glass-ceramic evaluated and (2) there was no interactive effect between cyclic degradation and stress corrosion for this material.     

Mineralization-defects are comparable in fluorotic impacted human teeth and fluorotic mouse incisors

ObjectiveFluoride excess of 0.05–0.07 mg F/kg bw/day in water or food additives like salt is the principal cause of endemic dental fluorosis. How fluoride causes these defects is not clear yet. Recent studies in rodents suggest that development of enamel fluorosis is associated with insufficient neutralization of protons released during the formation of hypermineralized lines.DesignHere we examined whether hypermineralization could also be assessed by MicroCT in developing molar enamel of humans exposed to fluoride.ResultMicro-CT analysis of hypomineralized enamel from human fluorotic molars graded by the Thylstrup–Fejerskov (TF) Index as III–IV showed weak hypermineralized lines and hypermineralized patches not seen in TF-I/II grade enamel. The mesio-distal sides of these molar teeth were significantly smaller (∼18%, p = 0.02) than in TF-I/II teeth.ConclusionThe patterns of changes observed in human fluorotic teeth were similar to those in fluorotic rodent incisors. The data are consistent with the hypothesis that also in developing human teeth fluoride-stimulated local acidification of enamel could be a mechanism for developing fluorotic enamel.     

Effect of time on the post-irradiation curing of six resin-based composites

ObjectivesTo evaluate the effect of time on the Vickers microhardness (VH) at the top and bottom surfaces of six conventional resin-based composites (RBCs) up to twelve weeks after light curing.MethodsFive specimens of Filtek Supreme Ultra, Herculite Ultra, Mosaic Ultra, Tetric EvoCeram, TPH Spectra HV, and Venus Pearl were packed into opaque molds that were 2.3 mm in diameter and 2.5 mm deep. The uncured RBC specimens were covered by a polyester strip and photo-cured with an Elipar DeepCure-S light-curing unit (LCU) according to the manufacturer's instructions. After irradiation, the polyester strip was removed, and the Vickers microhardness was measured immediately at top and bottom surfaces. The hardness measurements were repeated after 30 min, 1 h, 2 h, 4 h, 24 h, 1 week, 4 weeks, and 12 weeks. In between, the specimens were stored in dry and dark conditions at 37 °C. Two-way ANOVA (α = 0.05) followed by Tukey–Kramer post hoc multiple comparison tests were used to determine where statistically significant differences existed.ResultsThe micro-hardness values at the top surface always exceeded those at the bottom surface. A significant logarithmic increase of the micro-hardness due to post-irradiation curing took place between 30 min and 24 h (p < 0.05). There was no significant increase in the VH after 24 h. Depending on the RBC, compared to the immediate values the hardness 24 h post-irradiation had increased by 11–27% at the top surface and by 21–58% at the bottom.SignificanceEven after 12 weeks, the bottom hardness values never reached the top microhardness values. The results of studies that wait 24 h or longer before measuring the properties of RBC specimens will be significantly enhanced by the impact of post-irradiation curing. Especially within the first 4 h, the time when specimens are measured is critical information and should be reported.     

Hertzian load-bearing capacity of a ceramic-reinforced glass ionomer cement stored wet and dry

ObjectiveTo investigate the development of the load-bearing capacity of a ceramic-reinforced glass ionomer cement (GIC), stored dry or wet, using Hertzian indentation.MethodsGIC discs 2 mm thick and 10 mm in diameter were made (Amalgomer CR, Advanced Healthcare, Tonbridge, Kent, UK), randomly divided into 8 groups and stored at 37 °C in air or artificial saliva (AS) for 1, 7, 30 and 90 days. Discs were tested by loading centrally using a 20 mm diameter hard steel ball while resting freely on a filled-nylon substrate (E: 10 GPa), at 23 °C in air. The failure load at the first bottom-initiated radial crack was detected acoustically.ResultsAll the failure loads of air-stored specimens were higher than those of AS-stored specimens. The failure load was relatively stable for air-stored specimens but showed a significant decreasing tendency for AS-stored specimens.SignificanceZirconia-reinforced GIC is sensitive to moisture. Artificial saliva storage has a detrimental effect on the failure load of ceramic-reinforced GIC that may indicate long-term deterioration in service.     

Compressive strength of two newly developed glass-ionomer materials for use with the Atraumatic Restorative Treatment (ART) approach in class II cavities

ObjectivesThe null-hypotheses tested were that no difference in compressive strength of ART class II cavities exists between those restored with (1) glass-carbomer and a commonly used glass-ionomer; (2) KMEM and the commonly used glass-ionomer and; (3) glass-carbomer and KMEM.Methods100 molar teeth, stratified by size, were randomly allocated to the four test groups. Large ART class II cavities were drilled and restored with Clearfil photoposterior (negative control), Fuji IX (positive control), Glass-carbomer and Ketac? Molar Easymix (KMEM) (experimental groups). Half of the samples in each test group were 5000 times thermocycled between 5 °C and 55 °C, with a 30 s dwell time in each bath and a transfer time of 10 s. The restorations were statically tested at the marginal ridge until failure, using a rounded rectangular testing rod at crosshead speed of 1.0 mm/min. ANOVA and Student's t-test were applied to test for differences between the dependent variable (compressive strength at the final breaking point) and the independent variables (thermocycling and restorative material).ResultsRestorations of Clearfil photoposterior had a statistically significant higher mean compressive strength value at final breaking point than those of the three glass-ionomers tested (p = 0.0001). No thermocycling effect was observed (p = 0.19). ANOVA between the three glass-ionomer materials and mean compressive strength at final breaking point showed no statistically significant difference (p = 0.09).SignificanceClass II ART cavities restored with the newly launched Glass-carbomer and Ketac? Molar Easymix were not significantly more fracture resistant than comparable restorations using the conventional glass-ionomer Fuji IX.     

Mechanical properties of new self-adhesive resin-based cement

PurposeThe aim of this study was to compare the bonding strength, flexural strength, elastic modulus, water absorption and the expansion after water storage of new self-adhesive resin cements to commercially available dental cements.MethodsTwo types (hand-mix and auto-mix) of new self-adhesive resin cements (SAC-H and SAC-A, Kuraray Medical), one conventional resin cement (Panavia F2.0), three self-adhesive resin cements (Relyx Unicem, Maxcem and G-Cem), and two resin-modified glass-ionomer cements (Fuji Luting S and Vitremer) were used. Shear bond strengths, flexural strengths and elastic moduli (ISO 4049), water absorption (ISO 4049), and the expansion rate after water storage were investigated.ResultsBoth SAC-H and SAC-A provided adhesion to enamel and dentin, and had the same bond strength to gold alloy and zirconia as conventional resin cements. SAC-H and SAC-A had greater flexural strengths (86.4–93.5 MPa) than commercial self-adhesive resin cements or glass-ionomer cements. The elastic moduli of self-adhesive and glass-ionomer cements were 5.2–7.4 GPa and 2.3–3.4 GPa, respectively. The water absorption of SAC-H and SAC-A (26.3–27.7 μg/mm³) were significantly lower than commercial self-adhesive resin cements. SAC-H and SAC-A showed significantly lower expansion rates (0.17–0.26%) than commercial self-adhesive cements and glass-ionomer cements after 4 weeks water storage.ConclusionsIt is suggested that the new self-adhesive resin cements exhibited a favorable bonding capability and mechanical properties.     

Inhibition of enamel mineral loss by fissure sealant: An in situ study

ObjectivesThis study evaluated the effect of fluoride and non-fluoride sealants on hardness decrease (HD) and marginal adaptation (MA) on enamel substrates after cariogenic challenge.MethodsOcclusal enamel blocks, from human third molars, were randomly divided into six groups (n = 12), according to occlusal fissures condition (S – sound; C – caries-like lesion; CF – caries-like lesion + topical fluoride) and sealants (F – FluroShield; H – Helioseal Clear Chroma). Lesion depths were 79.3 ± 33.9 and 61.3 ± 23.9 for C and CF groups, respectively. Sealants were placed on occlusal surface and stored at 100% humidity (37 °C; 24 h/d). HD was measured by cross-sectional microhardness analysis at the sealant margin distances: ?1 (under sealant), 0 (sealant margin), 1, 2 (outer sealant). Sealant MA was observed by polarized light microscopy and scored according to: 0 – failure (no sealant MA or total sealant loss); 1 – success (sealant MA present). MA and HD were analysed by ANOVA-R and mixed model analysis, respectively.ResultsFor HD (ΔS), F values (6900.5 ± 3686.6) were significantly lower than H values (8534.6 ± 5375.3) regardless of enamel substrates and sealant margin distances. Significant differences were observed among sealant margin distances: ?1 (5934.0 ± 3282.6) < 0 (8701.5 ± 6175.7) = 1 (8473.2 ± 4299.4) = 2 (7761.5 ± 4035.1), regardless of sealant and substrate. MA was similar for all groups (p ≥ 0.05).ConclusionMA was not affected by sealant type or substrate condition, whereas enamel HD was favourably impacted by fluoride in the sealant. In addition, sealants were more effective as a physical barrier than as its chemical potency in reducing enamel HD.Clinical significanceSealing with a fluoride material is a recommended procedure to prevent caries of occlusal permanent molars in high-caries-risk patients, even though those exhibiting white spot lesions, since the enamel hardness decrease when fluoride sealant was used in vitro.