Fluoride-releasing dental restorative materials: An update

Objective: To compare the effect of different immersion regimes in a cola drink on surface microhardness of esthetic restorative materials. Subjects and Methods: Two hundred samples were grouped into four equal groups of fifty samples each: Group I - conventional glass ionomer, Group II – resin-modified glass ionomer, Group III - polyacid-modified resin composite, and Group IV - composite resin. Each group was further subdivided into five subgroups of ten samples each: Subgroup A - samples were kept immersed in artificial saliva. Subgroup B - samples were immersed in cola drink once a day. Subgroup C - samples were immersed in cola drink, three times a day. Subgroup D - Samples were immersed in cola drink five times a day. Subgroup E - samples were immersed in cola drink ten times a day. Each immersion lasted 5 min. The immersion protocol was repeated for 7 days. Results: Maximum microhardness was seen in composite resin samples followed by conventional glass ionomer, polyacid-modified resin composite, and least microhardness was seen in resin-modified glass ionomer. Conclusion: Resistance to change in surface microhardness was seen in the following sequence: Composite resin > polyacid-modified resin composite > resin-modified glass ionomer > conventional glass ionomer.

This study investigated the release and recharge of fluoride by restorative materials. Resin-modified glass ionomers (RGIs), polyacid-modified composite resins (PMCRs) and resin composite containing fluoride were used for comparison of fluoride release. Non-fluoride-releasing resin composite was used as a control. The amounts of fluoride release from RGIs and PMCRs remarkably increased in the citrate-phosphate acid buffer compared with distilled water. The amounts of fluoride recharged in RGIs increased with the concentration of NaF solution, but those of PMCRs exposed to all concentrations of NaF solutions were less than 1.5 ppm. Neither resin composite containing fluoride and non-fluoride-releasing resin composite gave any evidence of recharge. RGIs and PMCRs affected by acid buffer solution could not recharge much fluoride even if they were immersed in the 1000 ppmF NaF solution. The results suggested that the matrix of RGIs and PMCRs functioned as a reservoir of fluoride, but the functions were lost by acid attack.

Aim:The present study was conducted to determine and compare the shear bond strengths of Conventional glass ionomer; Resin-modified glass ionomer; Polyacid-modified composite and Composite Resin, and to assess and determine the mode of failure (adhesive, cohesive, mixed).Materials and Methods:Occlusal dentin of 40 extracted human teeth were randomly divided into four groups of ten teeth, each based on the restorative materials tested as follows: Group I: Conventional Glass Ionomer Cement (Control); Group II: Resin-modified Glass Ionomer Cement; Group III: Polyacid-modified Composite Resin; Group IV: Hybrid Composite Resin. The bonded materials were subjected to shear bond strength (SBS) testing in a Instron Universal Testing Machine (UTM) at a crosshead speed of 0.5 mm/min. The bond failure location was examined by the use of a stereomicroscope at 10× magnification. The mean SBS of Groups I–IV obtained was 3.81, 9.71, 11.96 and 18.16 MPa, respectively. Comparison of mean shear bond strengths of all groups was done by one way ANOVA test and comparison of means in between groups by the Student's t test.Conclusion:It is concluded that the compomer restorative materials show higher shear bond strength than conventional glass-ionomer and resin-modified glass-ionomer, but less than composite resin.

The recently developed hybrid restorative materials contain the essential components of conventional glass ionomers and light-cured resins. The objective of this study was to determine several physical and mechanical properties of eight such materials in comparison with two conventional glass ionomers, one micro-filled, and one ultrafine compact-filled resin composite. The two resin composites and two of the three polyacid-modified resin composites could be polished to a higher gloss than the conventional as well as the resin-modified glass ionomers. After abrasion, surface roughness increased for all materials, but not at the same extent, being the least for the conventional resin composites and one polyacid-modified resin composite, Dyract. In contrast to the later resin composites, of which the surface roughness is principally determined by the presence of protruding filler particles above the resin matrix, roughness of conventional and resin-modified glass ionomers results from both protruding filler particles and intruding porosities. The mean particle size of the hybrid restorative materials fell between the smaller mean particle size of the resin composites and the larger one of the conventional glass ionomers. The micro-hardness and Young's modulus values varied substantially among all eight hybrid restorative materials. For all the resin-modified glass-ionomer restorative materials, the Young's modulus reached a maximum value one month after mixing and remained relatively stable thereafter. The Young's modulus of the conventional and the polyacid-modified resin composites decreased slightly after one month. The conventional glass-ionomer materials undoubtedly set the slowest, since their Young's modulus took six months to reach its maximum. The flexural fatigue limit of the hybrid restorative materials is comparable with that of the micro-filled composite. From this investigation, it can be concluded that the physico-mechanical properties vary widely among the eight hybrid restorative materials, indicating that these materials probably have yet to achieve their optimum properties. Their mechanical strength is inadequate for use in stress-bearing areas, and their appearance keeps them from use where esthetics is a primary concern.

2 - Classification of restorative materials and clinical indications

INTRODUCTION. Several fluoride-containing dental restoratives are currently available, including glass ionomers (GIC), resin-modified glass ionomer cement (RMGIC), polyacid-modified composite resins (compomers), composites, and amalgams. The fluoride release capabilities of these materials differ due to their matrices and setting mechanisms, which in turn influence their antibacterial and cariostatic properties. Glass ionomer cements are particularly favored for their chemical bonding and fluoride release. However, their limitations include water sensitivity and reduced wear resistance, leading to the development of resinmodified glass ionomers. These materials aim to improve moisture sensitivity and mechanical strength while still providing fluoride release. Despite extensive research on fluoride release, comparative studies involving other fluoride-releasing materials are limited.AIM. This study aims to evaluate the fluoride release of two glass ionomer cements, a compomer, and a composite resin, and to assess the impact of topical fluorides on their fluoride-releasing abilities.MATERIALS AND METHODS. The present in-vitro comparative study was conducted at the College of Dental Sciences, Davangere, Karnataka. Four restorative materials were evaluated over 42 days: Conventional GlIC (GC Fuji II), RMGIC (Vitremer, 3M), Compomer (Dyract AP, Dentsply), and Composite (Tetric N Ceram, Vivadent). Specimens were prepared in disc-shaped molds, immersed in deionized water, and fluoride levels measured using a fluoride ion-selective electrode at various intervals. RESULTS. The study revealed distinct fluoride release patterns among the materials. Group I demonstrated the highest fluoride release on Day 1, significantly surpassing Groups II, III, and IV (p < 0.001). While Groups I and II showed a pronounced decrease in fluoride release by Day 2, all groups exhibited a consistent decline over time, with notable intergroup differences.CONCLUSIONS. The fluoride release characteristics of the evaluated restorative materials varied significantly, emphasizing the importance of material selection based on their fluoride-releasing capabilities to enhance dental health.

Background: Dental caries is one of the most significant problems in world health care. Restoring carious primary teeth is one of the major treatment goals for Children, and the light activated resin restoration materials like composite, resin-modified glass ionomer and polyacid-modified which was introduced in dentistry in 1970, widely used in clinical dentistry but its application increased dramatically in recent years because of its biocompatibility, color matching, good adhesive properties of its resemblance in physical and mechanical aspects to tooth. The aim of this study: To evaluate the microleakage of Polyacid-Modified Composite resin Compared to Flowable Hybrid Composite and Resin-Modified Glass ionomer cement. Materials and methods: Thirty extracted primary molar teeth and thirty extracted permenant premolar teeth were used in this study 20 for each material, then standardized Class V cavities of teeth was prepared in the buccal and lingual surfaces. Using Polyacid-modified composite Resin (Compomer), flowable composite resin and Resin-modified glass Ionomer RMGI. The samples will be divided into three groups according to type of restorative material used and light cured with a light cure device (Ivoclar Vivadent Bluephace), after complete curing the sample will examined by Scanning electron microscope (SEM) and then measure the microleakage. Results: The RMGI shows the statistically significantly lowest mean value of microleakage, followed by Compomer shows statistically significantly lower mean value. Flowable Composite shows the statistically significantly highest mean microleakage. There is no statistically significant difference in microleakage values between the permanent and primary teeth. Conclusion: The Resin-modified glass Ionomer is better in term of microleakage than Polyacid-modified composite Resin and Flowable Composite.

This study was carried out in order to determine the extent to which ions released from fluoride-containing dental restoratives migrated through the enamel and dentine of extracted teeth. A total of 40 permanent human 3rd molars were used. They were extracted for orthodontic reasons, and employed within 1month of extraction. A cervical (Class V) cavity was prepared in each tooth, then filled with one of: a conventional glass-ionomer, a resin-modified glass-ionomer, a polyacid-modified composite resin ("compomer") or a fluoride-releasing resin composite. Ten samples were prepared per material. After 1month, five specimens per material were prepared and examined under SEM/EDX. Concentrations of sodium, aluminium, strontium, fluorine, magnesium, silicon, phosphorus and calcium were determined within the tooth. After 18months, the remaining five specimens for each material were prepared and studied in the same way. The greatest extent of ion migration into the tooth was found with the conventional glass-ionomer and least migration was found for the fluoride-releasing composite, which showed no evidence of fluoride migration at all. Levels of migrating ions were generally higher in the 18month specimens than in the 1month specimens, and also higher in the dentine than in the enamel. Ions released by restorative dental materials have been shown conclusively for the first time to be capable of migrating into the enamel and dentine surrounding the restoration. The conventional glass-ionomer showed the highest level of ion migration whereas the fluoridated composite resin showed little if any ion migration. This suggests that the conventional glass-ionomer has the greatest caries inhibiting effects of all the materials tested, and the fluoridated composite the least.

The aim of this study is to compare the susceptibility to discoloration of dental restorative materials containing dimethacrylate resin after bleaching. In this study, resin-modified glass ionomer, polyacid-modified composite resin, giomer, posterior composite resin, anterior composite resin, bulk fill composite resin, flowable bulk fill composite resin, ormocer, indirect composite resin and hybrid ceramics were used as restorative material containing dimethacrylate resin. 20 samples were prepared from each material in accordance with the manufacturer's instructions. After the baseline colors are measured, the samples were randomly divided into four subgroups as office bleaching, home bleaching and a separate control group for each type bleaching method. Then, the samples were bleached and colored. Color measurements of the samples were repeated after exposure to bleaching and coloring. Then, ΔE00 and whiteness index (WID) were calculated. Data were analyzed using Paired-Samples T Test, two-way ANOVA, Repeated Measures ANOVA and Tukey post-hoc tests. Statistical significance level was taken as p < 0.05. In terms of bleaching systems, Opalescence Boost was found to cause more whitening in materials but more discoloration (p < 0.05). In terms of materials, it was found that the most susceptible materials to coloration were Clearfil Majesty Posterior, Filtek Bulk Fill Posterior Restorative, Filtek Bulk Fill Flowable and Fuji II LC, while the least susceptible materials were CAD/CAM materials (p < 0.05). The bleaching process increases the susceptibility to coloration of materials containing dimethacrylate resin.

Immediate versus one-month wet storage fatigue of restorative materials

The short and long-term fluoride release of 16 products (seven conventional glass-ionomers, five light-activated glass-ionomers, two polyacid-modified resin composites and two resin composites) commercialized as fluoride-releasing materials were measured. A potential link between the material type and its level of fluoride release was researched. The fluoride release was evaluated after different time intervals. Initial fluoride release from all materials was highest during the first 24 h and decreased sharply over the first week. Some groups of materials appeared to be significantly different after, respectively, 7 and 91 days. However, it was impossible to correlate the fluoride release of the materials by their type (conventional or resin-modified glass-ionomers, polyacid-modified resin composite and resin composite) except if we compared the products from the same manufacturer. The link between fluoride release and an acid-base reaction seems to be confirmed. The glass-ionomer composition (glass particles and polyacid's type, powder/liquid ratio) should have more influence on fluoride release than material type.

Marginal adaptation and retention of a glass-ionomer, resin-modified glass-ionomers and a polyacid-modified resin composite in cervical Class-V lesions

Dental caries is known as the destruction of dental hard tissues by acidic by-products from bacterial metabolism of dietary carbohydrates. Despite the great efforts in caries prevention, it is still one significant public health problem globally, and dental restorations are the most commonly used approach to restore decayed teeth. This chapter outlines essential features and problems of current restorative dental biomaterials on purpose to serve as a background for understanding the facing challenges in the field. Resin composites consist of three major components: initiator system, resin matrix, and filler. The modification of components in the composite has been the focus of intensive research in recent years, which yielded different classes of polymeric restorative materials with tuned formulations such as packable composites, flowable composites, polyacid modified resin composites (compomers), self-adhesive composites, infiltration resins, and bulk-fill resin composites. Bonding system is one of the branches of dental restorative dentistry, and its primary aim is to provide retention of restorations.

Replacement of restorations because of secondary caries is a continuing problem in restorative dentistry. This investigation assessed the capacity of fluoride-releasing restorative materials to resist caries in vitro when used in roots. Class 5 cavities were prepared in buccal and lingual surfaces of 30 extracted premolars and restored with one of three polyacid modified resin composites (F-2000, Hytac and Compoglass F), a resin modified glass-ionomer cement (Fuji II LC) a conventional glass ionomer (Ketac-Fil), and a resin composite (Z-100). After 5 weeks in an acid gel for caries-like lesion formation, the teeth were sectioned longitudinally and examined with polarized light. The results showed that restoration of caries with polyacid modified resin composites and resin modified glass ionomer cements may be of great importance in the prevention of secondary caries around the restorations in roots. Clinical Relevance Light cured fluoride-releasing restorations may inhibit caries-like lesions. Inhibition of demineralization in vitro around fluoride releasing materials.

The aim of this systematic review was to compare the success rate of five tooth-coloured materials, namely Glass Ionomer (GI), Resin-Modified Glass Ionomer (RMGI), Composite Resin (CR), Polyacid-Modified Composite Resin or Compomer (CO) and High-Viscosity Glass Ionomer (HVGI) in primary molar Class II restorations. Five databases were searched from inception to April 23, 2020 for randomized clinical trials comparing the failure rate of these materials. After duplicate study removal, data extraction and risk of bias assessment with the Cochrane tool, data synthesis was conducted, comparing all five tooth-coloured materials in pairs and computing the overall success rate for each one, respectively. A total of 5615 articles were obtained by electronic and hand literature search. After the application of the eligibility criteria, ten RCTs were included in this systematic review and six RCTs for meta-analysis. Their risk of bias was assessed to be high to moderate. Due to the small number of RCTs comparing the five restorative materials in pairs investigated in the same study, only three MAs were available for heterogeneity assessment. These were: (1) between CO-RMGI (RR 1.04 [0.59, 1.84]; p = 0.88; I2 = 1%), (2) CR-CO (RR 1.12 [0.41, 3.02]; p = 0.83; I2 = 57%), and (3) between CR-RMGI (RR 1.10 [0.74, 1.63]; p = 0.65; I2 = 0%). No statistically significant differences were found between the two materials in all three comparisons. CR, RMGI and CO presented no statistical differences. In comparison to other tooth-coloured materials, studies on GI were too few to allow recommendations about its use. More studies on HGVI are needed for evidence-based recommendations to be made. The evidence extracted from this meta-analysis was not strong enough (moderate), due to the small number of RCTs and the risk of bias ranging from high to moderate. More, well-designed RCTs comparing tooth-coloured materials for primary molar Class II restorations are necessary.