Abstract
The Atraumatic Restorative Treatment (ART) approach was suggested to be a suitable method to treat enamel and dentine carious lesions in patients with disabilities. The use of a restorative glass-ionomer with optimal mechanical properties is, therefore, very important.Objective:To test the null-hypotheses that no difference in diametral tensile, compressive and flexural strengths exists between: (1) The EQUIA system and (2) The Chemfil Rock (encapsulated glass-ionomers; test materials) and the Fuji 9 Gold Label and the Ketac Molar Easymix (hand-mixed conventional glass-ionomers; control materials); (3) The EQUIA system and Chemfil Rock. Material and Methods:Specimens for testing flexural (n=240) and diametral tensile (n=80) strengths were prepared according to standardized specifications; the compressive strength (n=80) was measured using a tooth-model of a class II ART restoration. ANOVA and Tukey B tests were used to test for significant differences between dependent and independent variables. Results:The EQUIA system and Chemfil Rock had significantly higher mean scores for all the three strength variables than the Fuji 9 Gold Label and Ketac Molar Easymix (α=0.05). The EQUIA system had significant higher mean scores for diametral tensile and flexural strengths than the Chemfil Rock (α=0.05). Conclusion:The two encapsulated high-viscosity glass-ionomers had significantly higher test values for diametral tensile, flexural and compressive strengths than the commonly used hand-mixed high-viscosity glass-ionomers.
Highlights
Managing dentine carious lesions in patients with physical and/or intellectual disabilities represents a challenge
Pilot studies and power calculation Because of the unavailability of information regarding the mechanical properties of the two developed encapsulated glass-ionomers, a pilot study was carried out in order to calculate the sample size required for the assessment of diametral WHQVLOH ÀH[XUDO DQG FRPSUHVVLYH VWUHQJWKV %DVHG on these test results, 20 specimens of each test material were required for carrying out the Diametral Tensile Strength (DTS) test, Product name Manufacturer
The EQUIA system showed the highest mean scores in all WKH WKUHH WHVWV IROORZHG E\ WKRVH RI WKH &KHP¿O Rock, while the Fuji 9 Gold Label and Ketac Molar Easymix had the lowest mean test scores. Both the (48,$ V\VWHP DQG &KHP¿O 5RFN KDG VWDWLVWLFDOO\ VLJQL¿FDQWO\ KLJKHU PHDQ VFRUHV IRU DOO WKH WKUHH strength variables than the Fuji 9 Gold Label and Ketac Molar Easymix (α 7KH (48,$ KDG VWDWLVWLFDOO\ VLJQL¿FDQW KLJKHU PHDQ VFRUHV IRU '76 DQG )6 WKDQ WKH &KHP¿O 5RFN α 0HDQ '76 )6 &6 YDOXHV RI WKH (48,$ V\VWHP DQG &KHP¿O Rock were higher than those obtained with the Fuji 9 Gold Label and Ketac Molar Easymix; the difference varied between 11.2% and 72.3% (Table 2)
Summary
Managing dentine carious lesions in patients with physical and/or intellectual disabilities represents a challenge These populations present characteristics WKDW DUH GLI¿FXOW WR GHDO ZLWK WKURXJK DSSOLFDWLRQ of conventional restorative treatment approaches using rotary driven equipment. Before such a study can commence, the availability of a glass-ionomer able to withstand the effect of the grinding of teeth, often observed in people with disabilities, is needed Such a glass-ionomer should consist of properties like fast setting and high resistance against material fracturing and it needs to show high compressive DQG ÀH[XUDO VWUHQJWKV after initial setting. Such a restorative would be suitable for providing restorative care in people with disabilities but could improve the survival rates of multiple-surface ART glass-ionomer restorations in primary and permanent teeth, which are not currently meeting the American Dental Association (ADA) standard for unconditional use of dental materials
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