Epidemiologiska aspekter på amalgamets möjliga påverkan på hälsan. (Epidemiological aspects of the possible effects of amalgam on health.) : Ahlquist M, Bengtsson C and Lapidus L. Tandläkartidningen 1994; 86: 184–188

Abstract

A nanofilled, resin-based light-cured coating (G-Coat Plus, GC America, Alsip, Ill.) may reduce water absorption by glass ionomers. The authors investigated this possibility by measuring cuspal flexure caused by swelling of glass ionomer–restored teeth.The authors cut large mesio-occlusodistal slots (4-millimeter wide, 4-mm deep) in 12 extracted premolars and restored them with a glass ionomer cement (Fuji IX GP Extra, GC America). Six teeth were coated, and the other six were uncoated controls. The authors digitized the teeth in three dimensions by using an optical scanner after preparation and restoration and during an eight-week storage in water. They calculated cuspal flexure and analyzed the results by using an analysis of variance and Student-Newman-Keuls post hoc tests (significance level .05). They used dye penetration along the interface to verify bonding.Inward cuspal flexure indicated restoration shrinkage. Coated restorations had significantly higher flexure (mean [standard deviation], -11.9 [3.5] micrometers) than did restorations without coating (-7.3 [1.5] μm). Flexure in both groups decreased significantly (P < .05) during water storage and, after eight weeks, it changed to expansion for uncoated control restorations. Dye penetration along the interfaces was not significant, which ruled out debonding as the cause of cuspal relaxation.Teeth restored with glass ionomer cement exhibited shrinkage, as seen by inward cuspal flexure. The effect of the protective coating on water absorption was evident in the slower shrinkage compensation.The study results show that teeth restored with glass ionomers exhibited setting shrinkage that deformed tooth cusps. Water absorption compensated for the shrinkage. Although the coating may be beneficial for reducing water absorption, it also slows the shrinkage compensation rate (that is, the rate that hygroscopic expansion compensates for cuspal flexure from shrinkage).