Abstract
Literature lacks sufficient data regarding addition of natural antibacterial agents to glass ionomer cement (GICs). Hence, the aim of the study was to increase the antimicrobial properties of GICs through its modification with mixture of plant extracts to be evaluated along with an 0.5% chlorohexidine-modified GIC (CHX-GIC) with regard to biological and compressive strength properties. Conventional GIC (freeze-dried version) and CHX were used. Alcoholic extract of Salvadora persica, Olea europaea, and Ficus carcia leaves were prepared using a Soxhlet extractor for 12 h. The plant extract mixture (PE) was added in three different proportions to the water used for preparation of the dental cement (Group 1:1 PE, 2:1 PE, and 1:2 PE). Specimens were then prepared and tested against the unmodified GIC (control) and the 0.5% CHX-GIC. Chemical analysis of the extract mixture was performed using Gas chromatography–mass spectrometry. Antimicrobial activity was evaluated using agar diffusion assay against Micrococcus luteus and Streptoccocus mutans. Compressive strength was evaluated according to ISO 9917-1:2007 using a Zwick testing machine at a crosshead speed of 0.5 mm/min. Antimicrobial activity against Streptoccocus mutans was significantly increased for all the extract-modified materials compared to the unmodified cement, and the highest concentration was comparable to the CHX-GIC mixture. The activity against Micrococcus luteus was also significantly increased, but only for the material with the highest extract concentration, and here the CHX-GIC group showed statistically the highest antimicrobial activity. Compressive strength results revealed that there was no statistically significant difference between the different mixtures and the control except for the highest tested concentration that showed the highest mean values. The plant extracts (PEs) enhanced the antimicrobial activity against S. mutans and also against M. luteus in the higher concentration while compressive strength was improved by addition of the PE at higher concentrations.
Highlights
Glass ionomer cements (GICs) belong to a group of materials known as acid-base cements
Salvadora persica, Ficus carcia, and Olea europaea were extracted using alcohol to prepare extract mixtures of the three plants. This extract mixture was used to modify a conventional freeze-dried GIC by adding it to the water used for the final mixture at three different volume ratios of extract to water (1:1 plant extract mixture (PE), 1:2 PE, 2:1 PE)
The antibacterial effect of CHX is concentration dependent, whereas high concentrations of CHX might negatively affect the physical and mechanical properties of GIC [28, 29]. 0.5% of CHX (w/w) was chosen in the current study to be added to GIC powder, based on studies reporting that this percentage might be the best option for incorporation of CHX into GIC, since antibacterial activity increased and the physical–mechanical properties were not compromised [30,31,32]
Summary
Glass ionomer cements (GICs) belong to a group of materials known as acid-base cements. The proper name for them, according to the International Organization for Standardization (ISO) is “glass polyalkenoate cement”, but the term “glass ionomer” is recognized as an acceptable trivial name, and is widely used within the dental community [1]. GICs have been the most commonly used water-based cements for final cementation of dental crowns, bridges, orthodontic brackets and atraumatic restorative treatment [2]. There are several properties that make glass ionomer a material of choice among which are their ability to bond adhesively to enamel and dentin, their biocompatibility and their ability to release fluoride ions over a prolonged period of time. GICs were shown to be rechargeable with fluoride ions [3, 4]
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