Glass ionomer cement particles pre-reacted with chlorhexidine: Physical/chemical properties and antimicrobial activity.

OBJECTIVE: Analyze the effects of the functionalization of pre-functionalized GIC particles with chlorhexidine on the physicochemical properties and antimicrobial activity. MATERIALS AND METHODS: Four groups were prepared: (1) GIC (Bioglass R - Biodinamica) - control group; (2) GIC-CHX 1%: Group containing 1% pre-reacted CHX particles; (3) GIC-CHX 2.5%: Group containing 2.5% pre-reacted CHX particles; (4) GIC-CHX 5%: Group containing 5% pre-reacted CHX particles. Hourglass-shaped specimens (10 mm × 2 mm x 1 mm) were fabricated for mechanical tests including cohesive strength (n = 12), modulus of elasticity (n = 12) and microhardness (n = 10). Discs (10 mm × 2 mm) were prepared for the analysis of Ca+2, PO4- and F- ions release (n = 3), and roughness (n = 12). To evaluate the setting time, a Gilmore needle was used according to ISO 9917-1:2016. Disk-shaped specimens (5 × 1mm) were manufactured and subjected to bacterial activity (n = 9) (Streptococcus mutans ATCC 159). RESULTS: Modulus, roughness, setting time and ions release (Ca+2, PO4-, and F-) there were no statistically significant differences among the groups (p > 0.05). The setting time did not change with the incorporation of CHX. The GIC-CHX 2.5% and GIC-CHX 5% groups exhibited superior antibacterial activity compared to the control group and GIC-CHX 1% (p < 0.001). The GIC-CHX 5% group showed the highest microhardness values (p < 0.041), cohesive strength (p < 0.009) when compared to the control group. CONCLUSION: The pre-reacted CHX in GICs was able to confer antimicrobial activity, improve cohesive strength, microhardness, and did not impair ion release, setting time, and roughness.

Comparison of the physical properties of glass ionomer modified with silver phosphate/hydroxyapatite or titanium dioxide nanoparticles: in vitro study.

Glass ionomer cements (GICs) are the common materials employed in pediatric dentistry because of their specific applications in class I restorations and atraumatic restoration treatments (ART) of deciduous teeth in populations at high risk of caries. Studies show a limited clinical durability of these materials. Attempts have thus been made to incorporate nanoparticles (NPs) into the glass ionomer for improving resistance and make it like the tooth structure. An in vitro experimental study was conducted using the required samples dimensions and prepared based on the test being carried out on the three groups with or without the modification of light-cured glass ionomer. Samples were grouped as follows: control group (G1_C), 2% silver phosphate/hydroxyapatite NPs group (G2_SPH), and 2% titanium dioxide NPs group (G3_TiO2). The physical tests regarding flexural strength (n = 10 per group), solubility (n = 10 per group), and radiopacity (n = 3 per group) were performed. The data were analyzed by Shapiro Wilks test, and one-way analysis of variance (one-way ANOVA), and multiple comparisons by post hoc Tukey's test. The p-value of < 0.05 was considered significant. No statistically significant difference was observed between the control group (G1_C) and (G2_SPH) (p = 0.704) in the flexural strength test, however differences were found between G2_SPH and G3_TiO2 groups, ANOVA (p = 0.006); post hoc Tukey's test (p = 0.014). Pertaining to the solubility, G2_SPH obtained the lowest among the three groups, ANOVA (p = 0.010); post hoc Tukey's test (p = 0.009). The three study groups obtained an adequate radiopacity of >1 mm Al, respectively. The resin-modified glass ionomer cement (RMGIC) was further modified with 2% silver phosphate/hydroxyapatite NPs to improve the physical properties such as enhancing the solubility and sorption without compromising the flexural strength and radiopacity behavior of modified RMGIC. The incorporation of 2% titanium dioxide NPs did not improve the properties studied.

Clinical Effectiveness of Ion-Releasing Restorations versus Composite Restorations in Dental Restorations: Systematic Review and Meta-Analysis.

BACKGROUND: To compare the clinical effectiveness of ion-releasing restorations (IRR) vs. composite resin (CR) in dental restorations. METHODS: A systematic search was carried out from articles published until January 2024, in the biomedical databases: PubMed, Cochrane Library, Scielo, Scopus, Web of Science and Google Scholar. Randomized clinical trials were included, with a follow-up time greater than or equal to 1 year, without time and language limits and which reported the clinical effect of IRR compared to CR in dental restorations. The RoB 2.0 tool was used to assess the risk of bias of the included studies and the GRADEPro GDT tool was used to assess the quality of evidence and the strength of recommendation of the results. RESULTS: The search yielded a total of 1109 articles. After excluding those that did not meet the selection criteria, 29 articles remained for the quantitative synthesis. The analysis found no statistically significant difference when comparing the dental restorations with IRRs or CRs. CONCLUSION: The literature reviewed suggests that there are no differences between the IRRs and CRs in dental restorations.

Antimicrobial effects of surface pre-reacted glass-ionomer (S-PRG) eluate against oral microcosm biofilm.

This study investigated the antimicrobial activity of surface pre-reacted glass ionomer eluate (S-PRG) against oral microcosm biofilms collected from the oral cavity of patients. Dental biofilm samples were collected from three volunteers to form microcosm biofilms in vitro. Initially, screening tests were carried out to determine the biofilm treatment conditions with S-PRG eluate. The effects of a daily treatment for 5 min using three microcosm biofilms from different patients was then evaluated. For this, biofilms were formed on tooth enamel specimens for 120 h. Biofilms treated with 100% S-PRG for 5 min per day for 5 days showed a reduction in the number of total microorganisms, streptococci and mutans streptococci. SEM images confirmed a reduction in the biofilm after treatment. Furthermore, S-PRG also reduced lactic acid production. It was concluded that S-PRG eluate reduced the microbial load and lactic acid production in oral microcosm biofilms, reinforcing its promising use as a mouthwash agent.

Açaí juice stains a glazed resin-modified glass-ionomer cement.

Coloured compounds (anthocyanins) in açaí can stain resin-modified glass-ionomer cement (RMGIC) due to its low staining resistance. AIM: The aim of this study was to assess whether açaí compromises the surface colour and roughness of RMGIC in vitro. MATERIALS AND METHOD: Disc-shaped specimens (2 mm thick, 8 mm in diameter) of Vitremer™ (3M ESPE, St Paul, MN, USA) were prepared according to the manufacturer 's instructions. The mixture was inserted into a silicone mouldplaced between two mylar strips, and light cured. Specimens were randomly divided into three groups (n=25) according to the solutions to be used for chemical degradation: artificial saliva (control), açaí sorbet and açaí juice. A spectrophotometer CM-2600d/2500d (Konica Minolta, Tokyo, Japan) was used to analyse the colour (CIELa*b* scale). Surface roughness (Ra, mm) was measuredusing theprofilometer Surfcorder SE 1700 (Kosaka Corp, Tokyo, Japan). The specimens were subjected to three daily soaks (6 ml, 15 minutes) for 14 days at 37°C. They were washed in distilled water and placed in fresh saliva (30 minutes in the interval). After the third soak in a day, they were stored in fresh saliva overnight. Outcomes were analysed at baseline (L*, a*, b*, Ra) and after degradation (L'*, a'*, b'*, Ra'). RESULTS: The pH values of saliva, sorbet, and juice were 7.0, 3.8, and 4.9, respectively. ΔE* values were 6.6 for saliva, 6.9 for sorbet and 7.8 for juice. There was a significant ΔE* difference between saliva (p=0.005) and juice (p=0.002), and between juice and sorbet (p=0.019), but none between saliva and sorbet (p=0.401). There was no significant Δb* difference between the solutions. No difference between juice and sorbet was observed for Δa*, but they were significantly different from saliva (p<0.001). Brightness (L*) changed significantly. Juice showed the highest ΔE* (7.8) and ΔL* (7.7). No significant change was observed for roughness and there was no difference between the solutions for ARa. CONCLUSIONS: Açaí and saliva led to unacceptable staining, but no significant roughness changes in the resin-modified glass-ionomer cement.

As antocianinas presentes no açaí podem manchar o cimento de ionomero de vidro modificado por resina (CIVMR) devido a baixa resistencia ao manchamento do material. OBJETIVO: O objetivo desse estudo foi avaliar se o açaí compromete a cor e a rugosidade de superficie de um CIVMR in vitro. MATERIAIS E MÉTODOS: Amostras (2 mm de espessura, 8 mm de diámetro) de Vitremer™ (3M ESPE, St Paul, MN, USA) foram preparadas de acordo com as instrugoes do fabricante. O materialfoi espatulado, inserido em um molde de silicone colocado entre duas tiras de poliestireno e fotopolimerizado. Após, as amostras foram randomizadas e alocadas em tres grupos (n=25) de acordo com as solugoes usadas para a degradagao química: saliva artificial (controle) e sorbet de açaí e suco de açaí. Utilizou-se o espectrofotometro CM-2600d/2500d (Konica Minolta, Tokyo, Japan) para a análise da cor (escala CIELa*b*) e o rugosímetro Surfcorder SE 1700 (Kosaka Corp, Tokyo, Japan) para a rugosidade de superficie (Ra, mm). As amostras foram submetidas a tres imersoes diárias (6 ml, 15 minutos) em cada solugao por 14 dias a 37°C, tendo sido lavadas em água destilada e mantidas em saliva fresca (30 minutos) nos intervalos. Após a terceira imersao no dia, as amostras foram mantidas em saliva renovada até o dia seguinte. As variáveis foram analisadas antes (L*, a*, b*, Ra) e depois da degradagao química (L'*, a'*, b'*, Ra'). RESULTADOS: Os valores de pH da saliva, sorbet e suco foram, respectivamente 7,0, 3,8 e 4,9. Houve diferenga significante para ΔE* entre saliva (p=0.005) e suco (p=0.002) e entre suco e sorbet (p=0.019), mas nao entre saliva e sorbet (p=0.401). Nao foi observada diferenga significante para Δb* entre as solugoes. Nao houve diferenga significante para Δa* entre suco e sorbet, mas eles foram significativamente diferentes da saliva (p<0.001). A luminosidade (L*) mostrou alteragao significante. O suco mostrou os maiores valores de ΔE* (7,8) e ΔL* (7,7)". Nao houve mudanga significante para a rugosidade e nao foi observada diferenga significante entre as solugoes para ARa (p>0.05). CONCLUSÃO: O açaí e a saliva causaram manchamento inaceitável do glaze do CIVMR e insignificante alteragao da rugosidade.

2-year survival and cost analysis of occlusoproximal ART restorations using encapsulated glass ionomer cement in primary molars: a randomized controlled trial.

BACKGROUND: The survival of ART restorations can be influenced by the choice of the restorative material. The aim of this randomized non-inferiority controlled trial was to compare the 2-year survival rate and cost analysis of two encapsulated glass ionomer cements (GIC) as occlusoproximal restorative materials in primary molars. METHODS: Children from public schools in Tietê (Brazil), aged 4-8 years with occlusoproximal dentine carious lesions in primary molars were selected and randomly assigned to receive either Equia Forte (EF) or Riva Self Cure (RSC) as restorative materials. Treatment was carried out by two trained final-year dental students in schools following ART premises. Restorations were assessed by a trained and calibrated examiner after 2, 6, 12, 18, and 24 months. The primary outcome was restoration survival after 2 years, analyzed using Kaplan-Meier survival and Cox regression analysis (α = 5%). Professional and materials costs for each group were collected in Brazilian Reais (R$) and converted into US dollars (US$) and analyzed using Monte-Carlo simulation. RESULTS: A total of 152 children (76 per group) were included in the study, and 121 (79%) were evaluated after 2 years. The overall 2-year restoration survival rate was 39% (EF = 45%; RSC = 32%) with no difference between the groups. The baseline and 2-year total cost of restorations using RSC was lower when compared to EF (incremental cost: US$ 6.18). CONCLUSION: After two years of follow-up, Riva Self Cure shows comparable restoration survival rates to Equia Forte, being more cost-effective in the Brazilian perspective. TRIAL REGISTRATION: This randomized clinical trial was registered on ClinicalTrials.Gov - NCT02730000.

Titanium dioxide nanotubes applied to conventional glass ionomer cement influence the expression of immunoinflammatory markers: An in vitro study.

Objectives: To assess the impact of different concentrations TiO2-nt incorporated into a glass ionomer cement on the proliferation, mitochondrial metabolism, morphology, and pro- and anti-inflammatory cytokine production of cultured fibroblasts (NIH/3T3), whether or not stimulated by lipopolysaccharides (LPS-2 µg/mL, 24 h). Methods: TiO2-nt was added to KM (Ketac Molar EasyMix™, 3 %, 5 %, 7 % in weight); unblended KM was used as the control. The analyses included: Cell proliferation assay (n = 6; 24/48/72h); Mitochondrial metabolism assay (n = 6; 24/48/72h); Confocal laser microscopy (n = 3; 24/48/72h); Determination of biomarkers (IL-1ß/IL-6/IL-10/VEGF/TNF) by using both multiplex technology (n = 6; 12/18 h) and the quantitative real-time PCR assay (q-PCR) (n = 3, 24/72/120 h). The data underwent analysis using both the Shapiro-Wilk and Levene tests, and by generalized linear models (α = 0.05). Results: It demonstrated that cell proliferation increased over time, regardless of the presence of TiO2-nt or LPS, and displayed a significant increase at 72 h; mitochondrial metabolism increased (p < 0.05), irrespective of exposure to LPS (p = 0.937); no cell morphology changes were observed; TiO2-nt reverted the impact of KM on the secreted levels of the evaluated proteins and the gene expressions in the presence of LPS (p < 0.0001). Conclusions: TiO2-nt did not adversely affect the biological behavior of fibroblastic cells cultured on GIC discs.

Minimal intervention dentistry: What is its clinical application and effectiveness in different continents? - A scoping review.

The aim of minimal intervention dentistry (MID) is to maximize the preservation of dental tissues through the use of modern and effective techniques and procedures. The central objective of MID is to increase the functional life of dental elements and, consequently, the quality of life of the population. The present study aimed to analyze and map the diffusion and clinical application of MID in different continents around the world. To perform this scoping review, the PRISMA checklist was used, adopting the following: population - dentists; concept - effectiveness of MID; and context - continents. The following databases were used: PubMed, European Archives of Paediatric Dentistry, Scientific Electronic Library, Latin Literature American and Caribbean Association in Health Sciences, and SCOPUS. The following keywords were used in the searches: "pediatric dentistry," "atraumatic restorative treatment," "dental caries," "child health," and "glass ionomer cements" using "and" and "or" combined with "minimal intervention dentistry." Studies published before 2010 as well as theses, dissertations, opinion articles, editorials, and guidelines, were excluded from the study. A total of 160 articles were obtained, and 17 articles were screened and selected for full reading. The analysis of the studies reveals the disparity in the use of minimal intervention techniques among continents due to a lack of knowledge of these techniques or lack of confidence in changing professional approaches, thus emphasizing the need for the dissemination and teaching of MID.

Açaí juice stains a glazed resin-modified glass-ionomer cement / Suco de apaí provoca o manchamento do glaze do cimento de ionomero de vidro modificado por resina

ABSTRACT Coloured compounds (anthocyanins) in açaí can stain resin-modified glass-ionomer cement (RMGIC) due to its low staining resistance. Aim The aim of this study was to assess whether açaí compromises the surface colour and roughness of RMGIC in vitro. Materials and Method Disc-shaped specimens (2 mm thick, 8 mm in diameter) of Vitremer™ (3M ESPE, St Paul, MN, USA) were prepared according to the manufacturer 's instructions. The mixture was inserted into a silicone mouldplaced between two mylar strips, and light cured. Specimens were randomly divided into three groups (n=25) according to the solutions to be used for chemical degradation: artificial saliva (control), açaí sorbet and açaí juice. A spectrophotometer CM-2600d/2500d (Konica Minolta, Tokyo, Japan) was used to analyse the colour (CIELa*b* scale). Surface roughness (Ra, mm) was measuredusing theprofilometer Surfcorder SE 1700 (Kosaka Corp, Tokyo, Japan). The specimens were subjected to three daily soaks (6 ml, 15 minutes) for 14 days at 37°C. They were washed in distilled water and placed in fresh saliva (30 minutes in the interval). After the third soak in a day, they were stored in fresh saliva overnight. Outcomes were analysed at baseline (L*, a*, b*, Ra) and after degradation (L'*, a'*, b'*, Ra'). Results The pH values of saliva, sorbet, and juice were 7.0, 3.8, and 4.9, respectively. ΔE* values were 6.6 for saliva, 6.9 for sorbet and 7.8 for juice. There was a significant ΔE* difference between saliva (p=0.005) and juice (p=0.002), and between juice and sorbet (p=0.019), but none between saliva and sorbet (p=0.401). There was no significant Δb* difference between the solutions. No difference between juice and sorbet was observed for Δa*, but they were significantly different from saliva (p<0.001). Brightness (L*) changed significantly. Juice showed the highest ΔE* (7.8) and ΔL* (7.7). No significant change was observed for roughness and there was no difference between the solutions for ARa. Conclusions Açaí and saliva led to unacceptable staining, but no significant roughness changes in the resin-modified glass-ionomer cement.

RESUMO As antocianinas presentes no açaí podem manchar o cimento de ionomero de vidro modificado por resina (CIVMR) devido a baixa resistencia ao manchamento do material. Objetivo O objetivo desse estudo foi avaliar se o açaí compromete a cor e a rugosidade de superficie de um CIVMR in vitro. Materials e Método Amostras (2 mm de espessura, 8 mm de diámetro) de Vitremer™ (3M ESPE, St Paul, MN, USA) foram preparadas de acordo com as instrugoes do fabricante. O materialfoi espatulado, inserido em um molde de silicone colocado entre duas tiras de poliestireno e fotopolimerizado. Após, as amostras foram randomizadas e alocadas em tres grupos (n=25) de acordo com as solugoes usadas para a degradagao química: saliva artificial (controle) e sorbet de açaí e suco de açaí. Utilizou-se o espectrofotometro CM-2600d/2500d (Konica Minolta, Tokyo, Japan) para a análise da cor (escala CIELa*b*) e o rugosímetro Surfcorder SE 1700 (Kosaka Corp, Tokyo, Japan) para a rugosidade de superficie (Ra, mm). As amostras foram submetidas a tres imersoes diárias (6 ml, 15 minutos) em cada solugao por 14 dias a 37°C, tendo sido lavadas em água destilada e mantidas em saliva fresca (30 minutos) nos intervalos. Após a terceira imersao no dia, as amostras foram mantidas em saliva renovada até o dia seguinte. As variáveis foram analisadas antes (L*, a*, b*, Ra) e depois da degradagao química (L'*, a'*, b'*, Ra'). Resultados Os valores de pH da saliva, sorbet e suco foram, respectivamente 7,0, 3,8 e 4,9. Houve diferenga significante para ΔE* entre saliva (p=0.005) e suco (p=0.002) e entre suco e sorbet (p=0.019), mas nao entre saliva e sorbet (p=0.401). Nao foi observada diferenga significante para Δb* entre as solugoes. Nao houve diferenga significante para Δa* entre suco e sorbet, mas eles foram significativamente diferentes da saliva (p<0.001). A luminosidade (L*) mostrou alteragao significante. O suco mostrou os maiores valores de ΔE* (7,8) e ΔL* (7,7)". Nao houve mudanga significante para a rugosidade e nao foi observada diferenga significante entre as solugoes para ARa (p>0.05). Conclusao O açaí e a saliva causaram manchamento inaceitável do glaze do CIVMR e insignificante alteragao da rugosidade.

Effect of a calcium silicate cement and experimental glass ionomer cements containing calcium orthophosphate particles on demineralized dentin.

OBJECTIVE: The study aims to evaluate the effect of a glass ionomer cement (GIC; Fuji 9 Gold Label, GC) with added calcium orthophosphate particles and a calcium silicate cement (CSC; Biodentine, Septodont) regarding ion release, degradation in water, mineral content, and mechanical properties of demineralized dentin samples. METHODS: GIC, GIC + 5% DCPD (dicalcium phosphate dihydrate), GIC + 15% DCPD, GIC + 5% ß-TCP (tricalcium phosphate), GIC + 15% ß-TCP (by mass), and CSC were evaluated for Ca2+/Sr2+/F- release in water for 56 days. Cement mass loss was evaluated after 7-day immersion in water. Partially demineralized dentin disks were kept in contact with materials while immersed in simulated body fluid (SBF) at 37 °C for 56 days. The "mineral-to-matrix ratio" (MMR) was determined by ATR-FTIR spectroscopy. Dentin hardness and elastic modulus were obtained by nanoindentation. Samples were observed under scanning and transmission electron microscopy. Data were analyzed by ANOVA/Tukey test (α = 0.05). RESULTS: Ca2+ release from CSC and GIC (µg/cm2) were 4737.0 ± 735.9 and 13.6 ± 1.6, respectively. In relation to the unmodified GIC, the addition of DCPD or ß-TCP increased ion release (p < 0.001). Only the dentin disks in contact with CSC presented higher MMR (p < 0.05) and mechanical properties than those restored with a resin composite used as control (p < 0.05). Mass loss was similar for GIC and CSC; however, the addition of DCPD or ß-TCP increased GIC degradation (p < 0.05). CONCLUSION: Despite the increase in ion release, the additional Ca2+ sources did not impart remineralizing capability to GIC. Both unmodified GIC and CSC showed similar degradation in water. CLINICAL RELEVANCE: CSC was able to promote dentin remineralization.

Glass ionomer cement with calcium-releasing particles: Effect on dentin mineral content and mechanical properties.

OBJECTIVE: to evaluate the effect a glass ionomer cement (GIC) containing hydroxyapatite (HAp) or calcium silicate (CaSi) particles on mineral content and mechanical properties of demineralized dentin. Ion release and compressive strength (CS) of the cements were also evaluated. METHODS: GIC (Fuji 9 Gold Label, GC), GIC+ 5%HAp and GIC+ 5%CaSi (by mass) were evaluated. Ion release was determined by induced coupled plasma optical emission spectroscopy (Ca2+/Sr2+) or ion-specific electrode (F-) (n = 3). A composite (Filtek Z250, 3 M ESPE) was used as control in remineralization tests. Demineralized dentin discs were kept in contact with materials in simulated body fluid (SBF) at 37 °C for eight weeks. Mineral:matrix ratio (MMR) was determined by ATR-FTIR spectroscopy (n = 5). Dentin hardness (H) and elastic modulus (E) were determined by nanoindentation (n = 10). CS was tested after 24 h and 7d in deionized water (n = 12). Data were analyzed by ANOVA/Tukey test (α = 0.05). RESULTS: Ca2+ and Sr2+ release was higher for the modified materials (p < 0.05). Only GIC+ 5%HAp showed higher F- release than the control (p < 0.05). All groups showed statistically significant increases in MMR, with no differences among them after 8 weeks (p > 0.05). No differences in dentin H or E were observed among groups (p > 0.05). HAp-modified GIC showed increased initial CS, while adding CaSi had the opposite effect (p < 0.05). After 7 days, GIC+ 5%CaSi presented lower CS in relation to control and GIC+ 5%HAp (p < 0.05). SIGNIFICANCE: GIC modification with HAp or CaSi affected CS and increased ion release; however, none of the groups showed evidence of dentin remineralization in comparison to the negative control.

The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial

Abstract This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.

In vitro characterization of a novel resin-based restorative material containing alkaline fillers

Abstract Objective: In this study, a comparative evaluation of the physicochemical properties of Cention N and other direct restorative materials was performed. Three restorative materials—a resin-modified glass ionomer (Fuji II LC), an alkasite-based resinous material (Cention N), and a resin composite (Tetric N Ceram)—were characterized in terms of degree of conversion, Knoop hardness number (KHN) ratio, flexural strength, elastic modulus, water sorption, water solubility, microshear bond strength to dentin, immediate microleakage, and radiopacity. Methodology: The microshear bond strength to dentin and microleakage of Cention N were evaluated with and without the application of an adhesive system (Tetric N Bond Universal). A one-way ANOVA test was used to analyze the data in terms of degree of conversion, KHN ratio, water sorption, water solubility, microshear bond strength to dentin, and radiopacity. A two-way ANOVA test (carried out considering the material type and ethanol aging as factors) was used to analyze the data in terms of flexural strength and elastic modulus. The Kruskal-Wallis test was used to statistically analyze the data on microleakage. A significance level of α=0.05 was used for all tests. Results: Fuji II LC was found to have the highest degree of conversion, water sorption, and microleakage, as well as the lowest flexural strength. Cention N had the highest solubility; when used with an adhesive system, it achieved bond strength and microleakage similar to those of the Tetric N Ceram composite. Tetric N Ceram had the highest degree of conversion, KHN ratio, and radiopacity. Conclusion: The properties of Cention N validate its efficacy as an alternative direct restorative material when used in conjunction with an adhesive system.

Comparative study of physical-chemical properties of bioactive glass ionomer cement

Abstract This study analyzed the physical-chemical properties of bioactive ionomer materials. Cention N bioactive materials were evaluated chemically activated (CN) and light-cured (CN-LC), Equia Forte Fill (EQUI); conventional resin composite Filtek Z350 XT (Z350); resin glass ionomer cement Riva light Cure (RIVA) and flowable resin composite Filtek Bulk Fill Flow (BULK-F) were evaluated. Sixty specimens (n=10) were prepared for sorption (SR), solubility (SL), flexural strength (FS), shrinkage stress (SS), conversion degree (CD), microhardness (MI), and surface roughness (SR) tests. Non-cured and light-cured materials were assessed on FTIR. 30 human molar teeth were used in the bond strength test (BS). Data were subjected to ANOVA and post-hoc Tukey's test (5% of significance). EQUI showed more sorption in SR and no statistical difference from RIVA and CN-LC. CN group showed more solubility and EQUI presented less (p<0.05). BULK-F showed higher FS (MPa), without differences from CN and Z350, whereas EQUI presented the lowest FS not differing from RIVA. BULK-F and CN-LC showed more shrinkage stress differing from EQUI. CN-LC and CN showed higher CD differing from the other which showed no differences (p>0.05) between them. EQUI showed the highest hardness (p<0.05) in MI. There were no differences (p>0.05) in SR (µm). Z350 and BULK-F presented higher BS, whereas CN-LC showed the lowest, although not differing from EQUI and RIVA. Equia Forte's solubility and microhardness make it a good alternative as a restorative material. Cention N degree of conversion and flexural strength making it an esthetic option to amalgam.

Resumo Este estudo analisou as propriedades físico-químicas dos materiais de ionômero bioativo. Os materiais bioativos Cention N quimicamente ativados (CN) e fotopolimerizados (CN-LC), Equia Forte Fill (EQUI); resina composta convencional Filtek Z350 XT (Z350); resina de ionômero de vidro Riva light Cure (RIVA) e resina composta fluida Filtek Bulk Fill Flow (BULK-F) foram avaliados. Sessenta espécimes (n=10) foram preparados para testes de sorção (SR), solubilidade (SL), resistência à flexão (FS), tensão de contração (SS), grau de conversão (CD), microdureza (MI) e rugosidade da superfície (SR). Os materiais não curados e curados com luz foram avaliados por FTIR. 30 dentes molares humanos foram usados no teste de resistência de união (BS). Os dados foram submetidos a ANOVA e teste de post-hoc Tukey (5% de significância). O EQUI apresentou maior sorção no SR e não mostrou diferença estatística em relação aos grupos RIVA e CN-LC. O grupo CN apresentou maior solubilidade e o EQUI apresentou menor (p<0,05). O BULK-F apresentou maior FS (MPa), sem diferir do CN e do Z350, enquanto o EQUI apresentou o menor FS, não diferindo do RIVA. O BULK-F e o CN-LC apresentaram maior estresse de contração, diferindo do EQUI. O CN-LC e o CN apresentaram maior CD (%), diferindo dos demais, que não apresentaram diferenças (p>0,05) entre si. A EQUI apresentou a maior dureza (p<0,05) no MI. Não houve diferenças (p>0,05) na SR (µm). Z350 and BULK-F apresentaram BS, enquanto a CN-LC apresentou a menor, embora não diferindo da EQUI e da RIVA. A solubilidade e a microdureza do Equia Forte o tornam uma boa alternativa como material restaurador. O grau de conversão e a resistência à flexão do Cention N o tornam uma opção estética ao amálgama.

The Effect of Restoration Polymerization and Residual Dentine Thickness on Thermal Changes of Pulp Chamber of Immature Permanent Teeth

ABSTRACT Objective: To evaluate the pulpal temperature changes due to the polymerisation of resin and glass ionomer-based materials in dentine thicknesses in immature permanent teeth with open apices. Material and Methods: Forty extracted sound human third molar teeth with open apices were included. The width of the cavities prepared on the occlusal surface was 4×5 mm. The depth was 2 mm in the resin groups. 4 mm in the groups in which glass ionomer liner was applied before composite restoration. The coronal parts of the samples were then placed on an acrylic plate with three gaps for feeding-extraction needles and the thermocouple. The temperature changes were recorded. The data was analyzed by SPSS. Statistical significance was accepted as p<0.05. Results: The temperature increase in the group of 1 mm remaining dentin thickness revealed higher results than the values detected from the 2 mm group (1.01 °C) (p=0.00). The mean values (1.49 °C, 1mm) of temperature changes in only glass ionomer applied group were lower than the avarage values (2.210°C, 1mm) determined in the polymerization process of resin composites with light-emitting diode devices. Conclusion: In a remaining dentin thickness of 1 mm in teeth with open apices, using a glass ionomer liner might be a useful effort for protecting the pulp from the heat generated by polymerisation devices.

Restoration-repair potential of resin-modified glass ionomer cement

Abstract: This in vitro study aimed to evaluate the repair bond strength of resin-modified glass ionomer cement using either the same material or a universal adhesive in the etch-and-rinse and self-etch modes plus resin composite. Twenty-four resin-modified glass ionomer cement blocks were stored in distilled water for 14 d and thermocycled. Sandpaper ground specimens were randomly assigned to three experimental groups according to the repair protocol: resin-modified glass ionomer cement (Riva Light Cure, SDI) and universal adhesive (Scotchbond Universal Adhesive, 3M Oral Care) in etch-and-rinse or self-etch modes and nanohybrid resin composite (Z350 XT, 3M Oral Care). After 24 h of water storage, the blocks were sectioned, and bonded sticks were subjected to the microtensile bond strength (μTBS) test. One-way ANOVA and Tukey's test were used to analyze the data. The failure mode was descriptively analyzed. The highest μTBS values were obtained when the resin-modified glass ionomer cement was repaired using the same material (p < 0.01). In addition, the mode of application of the universal adhesive system did not influence the repair bond strength of the resin-modified glass ionomer cement. Adhesive/mixed failures prevailed in all groups. Repair of resin-modified glass ionomers with the same material appears to be the preferred option to improve bond strength.

Clinical performance of sealants under different humidity control conditions: a split-mouth 1-year randomized trial.

PURPOSE: Sealants are an effective method of prevention and treatment for early caries lesions. This study analyzed the 1-year clinical performance of resin-based and ionomeric sealants applied to permanent teeth under different humidity conditions. METHODS: The investigation was a triple-blind randomized clinical trial (RCT) with a four arms split-mouth design, divided according to the sealant protocol: (1) Resin-based sealant applied with rubber dam isolation, (2) Resin-based sealant applied with cotton rolls isolation, (3) Ionomeric sealant applied with rubber dam isolation and (4) Ionomeric sealant applied with cotton rolls isolation. Fifty-eight patients started the study (232 teeth), and 47 (188 teeth) remained until the 1-year recall. The modified USPHS criteria were used in the analyzes to investigate surface texture, retention and the presence of secondary caries lesions around the sealants; in the following periods: baseline, after 3, 6, 9, and 12 months by two calibrated examiners. Data were analyzed by the Mann-Whitney and Friedman tests. RESULTS: There was no difference between the types of sealants (p > 0.05). The type of humidity control influenced the superficial texture (p = 0.0012) and the retention of sealants (p = 0.0023). The sealant displacement was greater under cotton rolls isolation. Only one active caries lesion in enamel was found in the 9th month. CONCLUSION: It may be concluded that sealants effectively prevented caries, even when they were partially or totally lost, regardless of the material. The rubber dam isolation with a rubber dam promoted lower surface roughness and improved the retention rates. International Clinical Trials Registry Platform: #1111-1215-2832 (07/26/2018).

Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment.

Aim: This study evaluated the short-term clinical and microbiological performance of resin-modified glass ionomer cement (RM-GIC) cement containing chlorhexidine (CHX) for atraumatic restorative treatment (ART) in primary teeth. Materials and methods: The clinical trial was conducted in 36 children that received ART in primary molars either with GIC (group I, n = 18) or GIC containing 1.25% CHX (group II, n = 18). The survival rate of restorations was checked 7 days, 3, and 6 months after their application when saliva and biofilm were collected for microbiological assessment of mutans streptococci (MS) counts. Data were analyzed using the Kruskal-Wallis/Mann-Whitney U tests for clinical analysis and microbiological evaluations (p < 0.05). Results: The survival rate of restorations was similar comparing groups I with II. Microbiological analysis showed a significant reduction in MS levels 7 days after the treatment in both saliva and biofilm of children treated with RM-GIC containing CHX (group II); however, MS counts at 3 and 6 months did not differ from the initial counts. Conclusion: A total of 1.25% CHX improved the microbiological properties of GIC in the short term without impairing the clinical performance of ART restorations. Clinical significance: Glass ionomer cement (GIC) containing CHX could be an alternative in ART procedures with the objective of promoting an additional antimicrobial effect, which is interesting for children with high counts of MS during the initial phase of adaptation to dental treatment. How to cite this article: da Silva ME, de Sena MD, Colombo NH, et al. Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment. Int J Clin Pediatr Dent 2023;16(S-1):S27-S32.

Efficacy of bioactive materials in preventing Streptococcus mutans-induced caries on enamel and dentine.

The study investigated the ability of bioactive materials used to restore enamel and dentine specimens to prevent caries. Enamel (n = 50) and dentine (n = 50) specimens were obtained from bovine incisors, prepared, and randomly allocated to one of five groups according to the restorative treatment: alkasite without adhesive system; alkasite with adhesive system; high viscosity glass ionomer cement; resin composite; no restoration; negative control group. Specimens were restored, exposed to a thermal cycling aging protocol, sterilized, and exposed to a cariogenic challenge induced by Streptococcus mutans and then submitted to surface and subsurface microhardness tests and polarized light microscopy to verify the caries lesion development in enamel or dentine surrounding the restorative materials. Data were analyzed using one-way ANOVA. In enamel and dentine, glass ionomer cement, alkasite without and with adhesive system presented a lower percentage surface microhardness loss than resin composite and negative control. Enamel subsurface microhardness presented no statistically significant differences between glass ionomer cement, alkasite without and with adhesive system. Glass ionomer cement also did not present statistically significant differences from resin composite and the negative control. In dentine, glass ionomer cement showed the highest subsurface microhardness values. In conclusion, bioactive restorative materials provide greater protection to enamel and dentine against surface caries development than resin composite.

Insertion methods and gap/void formation in atraumatic restorative technique: A micro-CT analysis

Abstract Wetting the dentin is critical to atraumatic restorative treatment. The conventional insertion can be challenging when using high-viscosity glass-ionomer cement. This study evaluated the formation of gaps and voids after three insertion methods using micro-CT. Teeth underwent removal of occlusal and proximal caries through the atraumatic restorative treatment technique. Then, they were fixed in an artificial dental arch to simulate the clinical condition and were restored using three insertion methods: conventional, Centrix injection, and double-filling. Previous dentin conditioning procedures, steel matrix and wooden wedge application, and post-insertion procedures (digital compression and surface protection) were the same. The material was inserted using a manual instrument in the conventional technique and was inserted with a syringe in the Centrix injection group. In the double-filling technique, the tooth received a first layer of a flowable ionomer (through modifying the powder/liquid ratio), and a second layer (with standard ratio) was applied before the final set of the first one. A micro-CT unit scanned each tooth before and after restoration. Each cavity was defined as the volume of interest, and the volumes of gaps and voids were calculated. Data were analyzed using one-way ANOVA and Tukey posthoc test (p < .05). Double-filling had improved filling volume with lower values for gap volume, followed by Centrix injection. The conventional technique had the highest gap volume. No statistically significant difference was observed for void volume. Double-filling demonstrated fewer gaps, followed by Centrix injection, which is critical to obtain better adhesive, remineralizing, and antibacterial activities.

Resumo O molhamento da dentina parcialmente desmineralizada no fundo da cavidade dentária é fundamental para o sucesso do tratamento restaurador atraumático. No entanto, o método de inserção convencional pode ser desafiador ao usar cimento de ionômero de vidro de alta viscosidade. Este estudo avaliou a formação de gaps e vazios internos após três métodos de inserção de cimento de ionômero de vidro de alta viscosidade usando micro-CT. Dez terceiros molares foram submetidos à remoção de cárie oclusal através da técnica de tratamento restaurador atraumático e complementação proximal (com ou sem lesão pré-existente). Em seguida, foram fixados em uma arcada dentária artificial para simular a condição clínica. Os dentes foram restaurados usando a técnica de tratamento restaurador atraumático com três métodos de inserção: convencional, injeção Centrix e dupla inserção. Os procedimentos anteriores de condicionamento dentinário, inserção de matriz de aço, aplicação de cunha de madeira e procedimentos pós-inserção do material (como compressão digital e proteção de superfície) foram os mesmos para os três grupos testados. O material foi inserido com instrumento manual na técnica convencional, seguindo a metodologia clássica do tratamento restaurador atraumático. O material foi inserido com um dispositivo desenvolvido especificamente para esse fim na técnica de inserção com seringa tipo Centrix. Na técnica de dupla obturação, o dente recebeu uma primeira camada do cimento de ionômero de vidro mais fluido (obtido através da modificação da relação pó/líquido), e uma segunda camada (com relação pó/líquido padrão) foi aplicada antes da presa final da primeira. Um micro-CT escaneou cada dente antes e depois da restauração. Cada cavidade foi definida como o volume de interesse, e os volumes de gaps e vazios foram calculados. Os dados foram analisados por ANOVA one-way e teste post-hoc de Tukey com nível de significância de 5%. A dupla inserção melhorou significativamente o volume de preenchimento com valores percentuais mais baixos para o volume do gap, seguido pela injeção com seringa tipo Centrix. A técnica convencional apresentou o maior percentual de volume de gap. Nenhuma diferença estatisticamente significativa foi observada para o volume de vazios internos. O grupo de dupla inserção demonstrou menor formação de gaps, seguido pelo grupo de injeção com seringa tipo Centrix, que é fundamental para obter melhores atividades adesivas, remineralizantes e antibacterianas.