In Vivo Biodegradation of bisGMA and Urethane-Modified bisGMA-Based Resin Composite Materials.

The aim of this study was to compare the levels of in vivo chemical degradation sustained by bisphenyl-glycidyl-dimethacrylate (bisGMA)-based and urethane-modified bisGMA-based resin composites. A cohort of 58 patients was recruited for the study. Human salivary esterase activity (HSDE) was measured for each patient prior to restoration placement. Class V or III composite restorations without occlusal contacts were placed in adult patients using a 3-step adhesive (Scotchbond MP, 3M) and 1 of 2 resin composites: a traditional bisGMA-based (Z250; 3M) ( n = 28) or a urethane-modified bisGMA-based composite (TPH Spectra, Dentsply) ( n = 30). Patients followed a 2-min rinse (saline containing 20% ethanol) protocol before, immediately after, and 7 days after restoration placement. The rinse samples were analyzed for the presence of bisphenol A (BPA) and bishydroxypropoxyphenylpropane (bisHPPP), a bisGMA breakdown product, using high-performance liquid chromatography in combination with mass spectrometry. The overall mean ± standard error (SE) HSDE activity was 23.4 ± 1.9 U/mL, with no statistical difference between the Z250 (22.6 ± 2.8 U/mL) and TPH (24.1 ± 2.1 U/mL) groups ( P = 0.69). BPA was not detected from any rinse samples. BisHPPP was detected from both composites only in rinse samples immediately after resin composite placement (0.59 µg/mm2 ± 0.16 and 0.68 µg/mm2 ± 0.16 for Z250 and TPH, respectively, P = 0.767). There was no statistically significant correlation between HSDE and amount of bisHPPP obtained from the saliva for the Z250 group ( r = 0.071, P = 0.723), TPH group ( r = 0.266, P = 0.155), and both groups combined ( r = 0.080, P = 0.549). Conventional commercial resin composite materials used in the current study did not release any detectable amount of BPA and only showed detectable levels of bisHPPP for a short term after placement, suggesting that hydrolytic consumption of any available resin substrate is fast and the generated products are rapidly diluted below the detection level limit (<20 ppb) in the oral cavity. This short-term release of bisHPPP was not significantly affected by material type or esterase level in the saliva. Knowledge Transfer Statement: This clinical study demonstrated that the duration and degree of biodegradation of 2 representative formulations of resin composites was limited in both duration and amounts of detectable matrix derived degradation products. No significant level of potential biohazards was released following the application of the resin composites. The results of this study can help oral care professionals address concerns from their patients about possible health issues regarding the application of resin composite restorative materials.

Effect of 10% and 15% carbamide peroxide on fracture toughness of human dentin in situ.

PURPOSE: Although damage to the structural integrity of the tooth is not usually considered a significant problem associated with tooth bleaching, there have been some reported negative effects of bleaching on dental hard tissues in vitro. More studies are needed to determine whether the observed in vitro effects have practical clinical implications regarding tooth structural durability. OBJECTIVES: This in situ study evaluated the effect of 10% and 15% carbamide peroxide (CP) dental bleach, applied using conventional whitening trays by participants at home, on the fracture toughness of dentin. METHODS: Ninety-one adult volunteers were recruited (n ≈ 30/group). Compact fracture toughness specimens (approximately 4.5 × 4.6 × 1.7 mm) were prepared from the coronal dentin of recently extracted human molars and gamma-radiated. One specimen was fitted into a prepared slot, adjacent to a maxillary premolar, within a custom-made bleaching tray that was made for each adult participant. The participants were instructed to wear the tray containing the dentin specimen with placebo, 10% CP, or 15% CP treatment gel overnight for 14 nights and to store it in artificial saliva when not in use. Pre-bleach and post-bleach tooth color and tooth sensitivity were also evaluated using ranked shade tab values and visual analogue scales (VASs), respectively. Within 24-48 hours after the last bleach session, the dentin specimens were tested for fracture toughness using tensile loading at 10 mm/min. Analysis of variance, Kruskal-Wallis, χ (2) , Tukey's, and Mann-Whitney U tests were used for statistical analysis. The level of significance was set at p<0.05 for all tests, except for the Mann-Whitney U tests, which used a Bonferroni correction for post hoc analyses of the nonparametric data (p<0.017). Results : The placebo, 10% CP, and 15% CP groups contained 30, 31, and 30 participants, respectively. Mean fracture toughness (+ standard deviation) for the placebo, 10% CP, and 15% CP groups were 2.3 ± 0.9, 2.2 ± 0.7, and 2.0 ± 0.5 MPa*m(1/2) respectively. There were no significant differences in mean fracture toughness results among the groups (p=0.241). The tooth sensitivity VAS scores indicated a significantly greater incidence (p=0.000) and degree of tooth sensitivity (p=0.049 for VAS change and p=0.003 for max VAS) in the bleach groups than in the placebo group. The color change results showed generally greater color change in the bleach groups than in the placebo group (p=0.008 for shade guide determination and p=0.000 for colorimeter determination). CONCLUSIONS: There were no significant differences in in situ dentin fracture toughness results among the groups. The results of this study provide some reassurance that dentin is not overtly weakened by the bleaching protocol used in this study. However, the lack of a statistically significant difference cannot be used to state that there is no effect of bleach on dentin fracture toughness.

Effects of direct and indirect bleach on dentin fracture toughness.

There are concerns that tooth-whitening procedures irreversibly damage tooth structure. We investigated the hypothesis that dental bleaches significantly affect dentin structural integrity. The objective was to evaluate the effects of peroxide bleaches on dentin fracture toughness. Compact test specimens, composed of human dentin, were used (n = 10/group). Bleach (16% or 10% carbamide peroxide or 3% hydrogen peroxide) or control material, containing 0.1% sodium fluoride, was applied directly or indirectly to dentin through enamel (6 hrs/day) for 2 or 8 weeks. Fracture toughness results were analyzed by ANOVA and Fisher's LSD test (p < 0.05). There were significant decreases in mean fracture toughness after two- and eight-week direct (19-34% and 61-68%, respectively) and indirect (up to 17% and 37%, respectively) bleach application. The in vitro reduction in dentin fracture toughness caused by the application of peroxide bleaches was greater for the direct application method, longer application time, and higher bleach concentration.

Bond failure at dentin-composite interfaces with 'single-bottle' adhesives.

OBJECTIVES: Significant differences in interfacial fracture toughness (intK(1c)) among six dentinal adhesives have been reported. Resulting fractured test specimens were examined under SEM to determine differences in micromorphology, which might account for the respective intK(1c) results. METHODS: Interfacial fracture toughness specimens were assembled from bovine dentin and P50 resin composite under moist conditions, using one of five 'single-bottle' adhesives; either Single Bond, One Step, Optibond Solo, Prime & Bond 2.1, Bond 1 or a resin-modified glass ionomer, Fuji Bond LC. After fracture toughness testing, four fractured specimens from each group were sectioned transversely, critical-point dried and examined under SEM. RESULTS: Most bond failures occurred at the interface between adhesive resin and the top of the hybrid layer. Single Bond and One Step gave the highest intK(1c) results and showed good resin infiltration at this interface. Average film thickness of unfilled adhesives was 30 microm. When this intermediate adhesive layer was too thin, resin infiltration was poor and associated with low fracture toughness. Filled adhesives, Optibond Solo and Fuji Bond LC, formed thick films varying from 60 to 250 microm which failed cohesively, effectively sealing the dentin surface despite moderate fracture toughness results. CONCLUSIONS: Most bond failures occurred between the adhesive and hybrid layers. Good resin infiltration at the top of the hybrid layer combined with an intermediate adhesive layer of adequate width produced a fracture-resistant interface. Filled adhesives failed cohesively, providing a good dentin seal, despite material fracture.

Diagnosis of occlusal caries: Part I. Conventional methods.

Accurate diagnosis of the presence or absence of disease is a fundamental requirement in health care. The diagnosis of non-overt occlusal decay is challenging and can be highly subjective, and its inherent uncertainties can lead to widely differing treatment decisions. The development of more sensitive, specific and reproducible diagnostic tools for occlusal surfaces would contribute greatly to more precise planning of preventive and operative therapy. The purpose of this 2-part paper is to review current knowledge concerning conventional and new diagnostic methods for occlusal caries. Part I looks at established diagnostic methods for occlusal surfaces. Conventional visual, tactile and radiographic examinations provide less-than-ideal diagnostic sensitivity. Neither fissure discolouration (black or brown) nor the use of an explorer has been shown to improve diagnostic accuracy. However, the combination of careful visual examination with optimal radiographic examination affords better diagnostic performance. The best visual indicators involve precise features associated with the presence of disease, such as opaque fissure demineralization and the presence and extent of localized breakdown of the enamel. For best results, teeth should be clean, thoroughly dry and well illuminated. Part II will examine new and emerging technologies, including the DIAGNOdent laser fluorescence device, which are being developed for the diagnosis of occlusal decay.

Diagnosis of occlusal caries: Part II. Recent diagnostic technologies.

Accurate diagnosis of the presence or absence of disease is a fundamental requirement in health care. The diagnosis of non-overt occlusal decay is challenging and can be highly subjective, and its inherent uncertainties can lead to widely differing treatment decisions. The purpose of this 2-part paper is to review current knowledge concerning conventional and new diagnostic methods for occlusal caries. Part I looked at established methods for diagnosing occlusal decay. These methods have several limitations, particularly in their ability to diagnose early carious lesions. Part II examines new and emerging technologies that are being developed for the diagnosis of occlusal decay. Electrical conductance measurements and quantitative laser- or light-induced fluorescence represent significant improvements over conventional diagnostic methods, especially for in vitro applications and particularly with regard to sensitivity and reproducibility. Proponents of the DIAGNOdent laser fluorescence system claim that it evaluates the fluorescence that develops when laser light is incident on areas of demineralization. This noninvasive device is simple to use and provides quantitative data. Studies supporting its validity are limited but do suggest good sensitivity and excellent reproducibility. However, the DIAGNOdent system requires more scientific scrutiny. Although it offers a high rate of disease detection, it has little ability to indicate the extent of decay. In all treatment decisions, clinicians must be aware of the limitations of the diagnostic methods that have been used. Clinical judgment based on the patient s case history, visual cues, review of radiographs and probability of disease is still the most important aspect of optimum patient care. New technologies may provide supplemental information, but they cannot yet replace established methods for the diagnosis of occlusal caries.

Fracture resistance of dentin-composite interfaces using different adhesive resin layers.

OBJECTIVES: The objective of this study was to study the effect of different adhesive layers on the interfacial fracture toughness (K(ICi)) of dentin-resin composite interfaces. METHODS: Miniature short-rod fracture toughness specimens containing a chevron-shaped dentin-bonded interface along their midplane were used for testing. Each interface zone contained a thinned (one coat of unfilled adhesive resin, air-thinned), one-layer (one coat of unfilled adhesive resin, brush-thinned), two-layer (two coats of unfilled adhesive resin, brush-thinned), 10% filled or 45% filled adhesive resin layer. After storage in distilled water at 37 degrees C for 24h, the fracture toughness test specimens were loaded in tension at an extension rate of 0.5mm/min until fracture and the K(ICi) were determined. The results were analysed by ANOVA and Fisher's LSD test (p<0.05). Scanning electron microscopy was used to examine representative fracture surfaces. RESULTS: There were no significant differences in mean K(ICi) among the different unfilled adhesive resin layer groups. SEM examination of these specimens showed that fracture generally occurred between the resin-infiltrated layer and adhesive resin layer during interfacial fracture toughness testing. The mean K(ICi) for the 10% filled groups was not significantly different from the unfilled groups. The 45% filled group, however, demonstrated the highest K(ICi) values, the thickest adhesive resin layer under SEM examination, and a fracture path through the adhesive resin layer. CONCLUSIONS: There were no significant differences in K(ICi) when the unfilled adhesive resin was used despite different application methods. The 45% filled adhesive resin improved the properties of the dentin-composite interface with respect to both interfacial fracture resistance and dentinal seal after fracture.

The effect of interface stiffness on dentin-composite interfacial fracture resistance.

OBJECTIVES: The dentin-composite interface should withstand stresses that develop initially during composite polymerization and later during clinical function. The elastic behavior of the dentin-composite interface, which could be represented by an interfacial stiffness parameter, is not completely understood. The purpose of this study was to measure the relative interfacial stiffness of dentin-composite interfaces formed using commercially available dentin bonding agents and to relate these relative interfacial stiffness results to previously reported interfacial fracture toughness (K(ICi)) values. METHODS: The miniature short-rod fracture toughness specimen geometry containing a dentin-composite interface was used for testing. Specimens were aged in distilled water at 37 degrees C for 180days prior to tensile loading at an extension rate of 0.5mm/min. The relative interfacial stiffness was determined from the initial slope of the force-displacement curve that was obtained from each fracture toughness test. ANOVA, Fishers LSD, and linear regression tests were used for statistical analyses (p<0.05). RESULTS: The relative interfacial stiffnesses ranged from 16 to 92N/mm. The groups containing dentin-composite interfaces with greater depths of surface dentin demineralization generally exhibited higher interfacial stiffness than those with less dentin demineralization. Bonding to "wet" dentin produced higher relative interfacial stiffness results than bonding to "dry" dentin. A significant positive linear relationship was found among the individual (p=0.0001,r(2)=0.58) and the mean (p=0.0004,r(2)=0.97) relative interfacial stiffness and K(ICi) results. CONCLUSIONS: The significant positive relationship between the relative interfacial stiffness and K(ICi) results suggest a benefit (increased interfacial fracture resistance) of a relatively stiff dentin-composite interface.

Effect of dentine depth on the fracture toughness of dentine-composite adhesive interfaces.

OBJECTIVES: The fracture toughness test was recently introduced as a clinically relevant method for assessing the fracture resistance of the dentine-composite interface. The objective of this study was to evaluate the effect of dentine depth on the interfacial fracture toughness test of several dentine-composite interfaces using some new proprietary dentine bonding agents. METHODS: Miniature short rod fracture toughness specimens containing a chevron-shaped dentine-composite-bonded interface were prepared for each group (n = 12). Six different dentine bonding agents and two dentine depths were the variables assessed at the dentine-composite interfaces. After 24 h at 37 degrees C in water, the specimens were tested by loading at 0.5 mm/min in the Instron Universal Testing Machine. The interfacial KIC results were analysed by ANOVA, unpaired Student's t-tests and Fisher's LSD test (P < 0.05). RESULTS: The interfacial KIC results in MN.m-3/2 (S.D.) on superficial and deep dentine, respectively, were: All-Bond 2, 0.80 (0.21), 0.44 (0.13); Bond-lt, 0.75 (0.20), 0.38 (0.19); Prime and Bond, 0.56 (0.11), 0.28 (0.10); Scotchbond Multi-Purpose, 0.45 (0.23), 0.26 (0.15); One-Step and OptiBond, insufficient results due to premature specimen failures. CONCLUSIONS: The results from this study should contribute to the development of the fracture toughness test as a method for assessing the integrity of the dentine-composite interface. The interfacial fracture toughness test determined significant differences among the different dentine bonding agents and between the superficial and deep dentine substrates. The dentine bonding agents showed significantly reduced interfacial fracture toughness results when bonding to deep versus superficial dentine.

In vitro caries inhibition effects by conventional and resin-modified glass-ionomer restorations.

The ability of a material to inhibit recurrent caries formation is an important clinical therapeutic property. The objectives of this study were to develop an initial anticariogenicity profile (from fluoride release, to fluoride uptake, to resistance to an artificial caries challenge), testing the ability of conventional versus resin-modified glass-ionomer restorations to resist decay, and to study the effect of using intermediary dentin bonding agent components on the development of surface and wall carious lesions adjacent to a resin-modified glass-ionomer restoration. Cumulative fluoride release was measured from the immersion of disk-shaped specimens into deionized distilled water for 24 hours, 1, 2, 4, and 10 weeks. For the fluoride uptake and artificial caries test, standardized restorations were placed along the cementoenamel junction of extracted human molars. Secondary ion mass spectroscopy was used to determine the depth of fluoride uptake into the adjacent axial dentin from the restoration after 1 and 10 weeks. For the artificial caries test, the teeth were immersed into an acidified gelatin gel, pH 4.0, for 10 weeks. The development of recurrent decay was assessed using polarizing light microscopy. Statistical analyses were conducted using ANOVA and Fishers' LSD test (P < or = 0.05). There was generally greater fluoride release and uptake from the conventional glass ionomers, equivalent or less from the resin-modified glass ionomers, and none from the resin composite restorations. The use of an acid conditioner and primer from a dentin bonding system significantly increased the depth of fluoride uptake at 1 week. The additional use of an intermediary adhesive resin layer, however, significantly decreased the depth of fluoride uptake. The maximum depth of fluoride uptake into dentin was 300 microns at 10 weeks. Both conventional and resin-modified glass-ionomer restorations imparted resistance to dentin against the development of recurrent wall carious lesions in vitro. This was attributed to material fluoride release and uptake.

Fracture toughness ov conventional or photopolymerized glass ionomer/dentin interfaces.

Several new light-cured glass-ionomer materials have been developed for restorative use. It is not yet clear, however, whether the ability of the conventional glass ionomers to bond chemically to dentin has been preserved in the new light-cured glass ionomers whose chemical compositions have been modified. The fracture toughness test was recently introduced as an appropriate method of measuring the fracture resistance of an interface. We have applied this test to the glass ionomer/dentin interface for the first time. Ten mini short-rod fracture-toughness specimens were fabricated for each group. Each specimen contained a chevron-shaped glass ionomer/dentin interface along its midplane. After 24 hours in 37 degrees C water, the specimens were tested by loading at 0.5 mm/min. The interfacial Kic results (MPa X m (1/2)) (SD), analyzed by ANOVA and Fisher's LSD test (P<0.05), were: Chem-fil II, 0.17 (0.04); Vitremer, 0.18 (0.15); Fuji II LC, 0.33 (0.16). There were no significant differences in interfacial Kic between the conventional and light-cured glass ionomers. Interfacial Kic's for a light-cured glass ionomer were, however, significantly higher when an intermediary dentin bonding agent was used. SEM examinations of the fractured surfaces indicated that crack propagation generally occurred along the bond interface, and indicated the formation of a resin-infiltrated layer when the dentin bonding agents were used. It was concluded that the fracture-toughness test could be a useful measure of the integrity of the glass ionomer/dentin interface. The clinical effect of an intermediary layer between the glass ionomer and the tooth structure is, however, unknown and requires further investigation.

Effects of dentin surface treatments on the fracture toughness and tensile bond strength of a dentin-composite adhesive interface.

It has been proposed that the fracture toughness test provides an appropriate method for assessing the fracture resistance of the dentin-composite interface. The plane-strain fracture toughness test was therefore applied to a dentin-composite interface, with use of a specific dentinal adhesive, so that the effects of various dentin surface treatments on dentin-bond integrity could be studied. Interfacial fracture toughness (KIC) values were determined following 24h and 180 days of specimen aging in distilled water at 37 degrees C. Tensile bond strength (TBS) results following 24-hour aging were also obtained for comparison with the 24-hour KIC results. In general, the fracture resistance of the dentin-composite interface was highest when the dentin surface was conditioned with acid but not air-dried, intermediate when the dentin surface was conditioned with acid and subsequently air-dried, and lowest when the dentin was not conditioned with acid. The tensile bond strength results differed from the fracture toughness results in indicating differences in surface preparation effects and the type of interfacial failure observed.

Fracture surface characterization of dentin-bonded interfacial fracture toughness specimens.

Although the current trend in dentin bonding favors the development of a hybrid layer interdiffusion zone for micromechanical bonding, the exact nature of the dentin-composite bond is still unclear. The objective of this study was to characterize the fracture surfaces of specimens used to measure interfacial fracture toughness. Morphological (SEM) and chemical (EDS and XPS) surface analyses were used for characterization. Fracture toughness specimens generally failed along the dentin-bonded interface in agreement with observed clinical failure modes. Four sites of bond failure were identified within the dentin-composite interfaces when All-Bond 2, Scotchbond Multi-Purpose, and Scotchbond 2 were used as the dentinal adhesives. These were located within (1) the smear layer, (2) a resin-modified layer between the interdiffusion zone and the adhesive resin, (3) a well-infiltrated hybrid interdiffusion zone, and (4) a non-infiltrated unsupported collagen layer. The interfacial region had a complex architecture which varied with the nature of the dentin, the dentin surface treatment, and the dentin bonding system. The sites of bond failure appeared to correlate with the interfacial fracture toughness and the extent to which polymerized resin infiltrated and acted to support the organic dentinal structures.

Fracture toughness of dentin/resin-composite adhesive interfaces.

The reliability and validity of tensile and shear bond strength determinations of dentin-bonded interfaces have been questioned. The fracture toughness value (KIC) reflects the ability of a material to resist crack initiation and unstable propagation. When applied to an adhesive interface, it should account for both interfacial bond strength and inherent defects at or near the interface, and should therefore be more appropriate for characterization of interface fracture resistance. This study introduced a fracture toughness test for the assessment of dentin/resin-composite bonded interfaces. The miniature short-rod specimen geometry was used for fracture toughness testing. Each specimen contained a tooth slice, sectioned from a bovine incisor, to form the bonded interface. The fracture toughness of an enamel-bonded interface was assessed in addition to the dentin-bonded interfaces. Tensile bond strength specimens were also prepared from the dentin surfaces of the cut bovine incisors. A minimum of ten specimens was fabricated for each group of materials tested. After the specimens were aged for 24 h in distilled water at 37 degrees C, the specimens were loaded to failure in an Instron universal testing machine. There were significant differences (p < 0.05) between the dental adhesives tested. Generally, both the fracture toughness and tensile bond strength measurements were highest for AllBond 2, intermediate for 3M MultiPurpose, and lowest for Scotchbond 2. Scanning electron microscopy of the fractured specimen halves confirmed that crack propagation occurred along the bond interface during the fracture toughness test. It was therefore concluded that the mini-short-rod fracture toughness test provided a valid method for characterization of the fracture resistance of the dentin-resin composite interface.

Physical properties of proprietary light-cured lining materials.

Physical parameters of four photopolymerized lining materials were evaluated for comparative purposes and to contribute to the understanding of these novel materials. Properties investigated included compressive, diametral and flexural strength, modulus of elasticity, fluoride and calcium release for four weeks, and pH values for 24 hours. In general Cavalite and TimeLine were significantly stronger than Vitrabond and XR-lonomer and were essentially neutral in pH. All the materials exhibited a yield upon compressive strength testing. The fluoride release was intermediate for TimeLine and negligible with Cavalite. Vitrabond and XR-lonomer released significant amounts of fluoride at all time periods. XR-lonomer was the only material investigated to have significant calcium release, and this may have been related to its visible dissolution in water. This material also showed a low initial pH of 2.2. It, along with Vitrabond, demonstrated a gradual increase in pH over time. The behavior of TimeLine and Cavalite is therefore more consistent with that of a modified composite resin, whereas Vitrabond and XR-lonomer are similar in nature to glass-ionomer liners.

Shear bond strengths of resin luting cements to laboratory-made composite resin veneers.

Retention problems have been reported with the clinical use of indirect microfilled resin veneers. This study used 24-hour shear tests to assess the bond strengths of such a resin veneer compared with other veneer types. The effect of different resin luting cements and resin veneer surface treatments were analyzed to elucidate factors by which retention could be increased. The six resin luting systems investigated showed a range of bond values. Debonding occurred primarily at the veneer/cement interface. G-Cera material produced the weakest bonds to Isosit-N resin. Surface treatment of Isosit-N veneers resulted in bond strength changes. Sandblasting reduced the force required for bond failure; Special Bond resin increased it slightly. Improving retention of prefabricated resin veneers proved difficult. Etched hybrid resin veneers delivered higher bond strengths than micro-filled resin veneers but not significantly. Etched porcelain veneers, however, provided consistently the strongest bond strengths with cohesive, as opposed to adhesive, bond failure.

The tear resistance of various impression materials with and without modifiers.

In this study, we measured the tear resistance of several commonly used impression materials. In the first part, a trouser-leg tear test was used to determine tear energies for 15 impression materials in three major groups (polysulfides, addition-reaction silicones, and polyethers). One brand of polysulfide demonstrated the highest tear resistance. In general, generic types of impression material could not be ranked according to tear energy. In the second part of the study, we measured the effect of the addition of a system modifier (retarder/thinner) on the tear resistance of four addition-reaction silicones and two polyethers. Retarder/thinners significantly reduced the tear resistance of five of the six materials tested.

Physical properties of calcium hydroxide and glass-ionomer base and lining materials.

Compressive, diametral tensile and flexural strengths, moduli of elasticity, pH, and acid solubility values were compared for six calcium hydroxide cements, seven glass-ionomer cements, and one calcium aluminate cement. Results indicated that the glass-ionomer materials were generally stronger than the calcium hydroxide liners. Prisma VLC Dycal showed the lowest value for modulus of elasticity and the least acid solubility. The glass-ionomer materials were initially acidic, reaching a final pH between 5.4 and 7.3, whereas the calcium hydroxide and calcium aluminate cements were strongly alkaline at all time intervals.