High-viscosity Glass Ionomer Research Articles

Comparison of high viscosity glass Ionomer cement and Alkasite as restorative material for atraumatic restorative treatment - a randomized controlled trial with split mouth design

Background. Atraumatic Restorative Treatment (ART) is widely used for managing dental caries, emphasizing minimal intervention and adhesive restorative materials. High Viscosity Glass Ionomer Cement (HV-GIC) and Alkasite an emerging material, warrant clinical evaluation to determine their performance in long-term. Objectives. To evaluate the clinical performance of Alkasite and High Viscosity Glass Ionomer Cement (HV-GIC) as restorative materials in Atraumatic Restorative Treatment for primary molars. Materials and methods. Thirty children with bilateral class I cavities (n-60) were allocated in random into Group-1 Alkasite and Group-2 High Viscosity-Glass Ionomer Cement (HV-GIC). Restoration were evaluated at the 3rd and 6th months through Modified USPHS criteria (1980) and Modified Clinical Criteria for ART (1996). Fisher's exact test and Kaplan-Meier survival analysis were used which was carried out using IBM SPSS Statistics for Windows, Version 26.0. Results. Restorations evaluated using modified USPHS criteria scored either Alpha (successful) or Bravo (clinically acceptable). At the 6th month follow-up 100% (n = 30) alpha score was obtained in criteria like Fracture, Secondary Caries, Post-operative sensitivity, Surface roughness, and Retention. Under Anatomic form and Marginal adaptation categories, the HV-GIC group scored 100% (n = 30) alpha and the Alkasite group scored 90% (n = 27) alpha at both 3rd and 6th month follow-up but this difference was statistically insignificant (p >0.05). Additionally, score 0 (restorations present and good) was obtained in Modified Clinical Criteria for Evaluations of ART for all 30 (100%) restorations in HV-GIC group and 27 restorations (90%) in the Alkasite group at the end of 6 months (p >0.05). Conclusions. This study demonstrated that both HV-GIC and Alkasite had clinically acceptable outcomes in restoring dental cavities using Atraumatic Restorative Treatment for primary molars.

An In-vitro Evaluation of the Shear Bond Strength to Dentin and Microhardness of Different Restorative Materials Placed by Different Techniques.

The mentioned advantages of bulk-fill composite resin and high-viscosity glass ionomer restorative materials have increased their use in restorative dentistry in recent years; accordingly, the bonding of these materials to dental tissues and their mechanical properties have become more important. This study aimed to evaluate the effects of different application methods on Vicker's hardness and shear bond strength of three different restorative materials. In this in-vitro study; Teflon molds were used for the microhardness test. In the control group, reinforced high-viscosity glass ionomer, high-viscosity glass ionomer, and flowable bulk-fill composite resin were applied by the manufacturer's instructions. In other groups, preheating, ultrasonic activation, and both preheating and ultrasonic activation were applied, respectively (n = 14). Microhardness values of the upper surfaces of the specimens were measured with Vicker's hardness measuring device. For the shear bond strength test, 84 intact human molar teeth were used. The teeth were sectioned two in the mesiodistal direction (n = 14). The materials were applied to the dentin using the same placement protocols as those used in the hardness test. After the specimens were maintained at 37°C for 24 h, the shear bond strength test was performed using a universal test device. The data were analyzed using SPSS 26.0 at a 95% confidence level. The Mann-Whitney test was also used for the statistical analysis of the data (P = 0.05). Preheating the restorative materials significantly decreased the shear bond strength in the flowable bulk-fill composite resin group (11.77 ± 4.46 MPa) compared with that in the control group (12.14 ± 4.23 MPa) (P < 0.05) but significantly increased the shear bond strength in the reinforced high-viscosity glass ionomer group (3.91 ± 2.93 MPa) (P < 0.05). It can be concluded that preheating before application may increase the shear bond strength of reinforced high-viscosity glass ionomer.

Evaluation of fracture resistance of composite resin and glass ionomer in beveled versus non beveled class II restorations in primary molars: In vitro comparative study

Introduction: The high viscosity Bulk-Fill composite (Tetric N ceram) and high viscosity glass ionomer cement (Equia Forte GIC) are the most used materials in class II cavities of primary molars. They have the advantages of being placed in a single layer of 4mm and therefore allow better ergonomics and speed of use. Until now, we find failures of restorations at the level of class II cavities of temporary teeth and many authors have tested the role of the bevel in improving the mechanical strength of restorations. Objectives: The objectives of this study are: to test the role of the bevel in improving the fracture resistance of Bulk Fill composite restorations versus GIC of class II restorations in primary molars, and to test which material has better resistance to fracture. Methods: One hundred temporary extracted molars are collected and randomly divided into four groups: Group I (non-beveled) and II (beveled) filled with Equia forte. Group III (non-beveled) and IV (beveled) filled with Bulk Fill Ivoclar Tetric N Ceram. The specimens were subjected to thermocycling from 5 to 55° for 10000 cycles. After artificial aging, an axial loading at a speed of 1 mm/min was applied until the specimens fractured. Results: The statistical analysis reveals the following: an average of 442.2 N for group I and 498.80 N for group II. Thus, no statistical difference was observed between the groups restored with Equia Forte (p-value&gt;0.05). Whereas, the resistance to fracture for groups III (901.80N) and IV (2438.33N) with a p-value&lt;0.001 so there is significant difference between the two groups. Conclusions: The bevel improves the fracture resistance of the BulkFilll Ivoclar restorations. Whereas, it does not influence the fracture resistance of the Equia Forte group. Bulk Fill Ivoclar Tetric N ceram has better resistance to fracture than Equia Forte GIC restorations.

Effect of Surface Treatments on Shear-bond Strength of Glass Ionomer Cements to Silver Diamine Fluoride-treated Simulated Carious Dentin.

This study investigated the effect of different surface treatments on the shear bond strength (SBS) and failure modes of self-cured (SC) and light-cured (LC) high-viscosity glass ionomer cements (HVGICs) to silver diamine fluoride (SDF)-treated simulated carious dentin (SCD). Extracted human premolars were sectioned and pH cycled for 10 days to simulate carious dentin. The demineralized specimens were treated with 38% SDF (Riva Star) for 2 minutes, washed, stored in deionized distilled water at 37°C for 2 weeks, and subjected to the following surface treatments (n=14): T1 - no treatment (control); T2 - 10 seconds polyacrylic acid (PAA); T3 - 5 seconds phosphoric acid (PPA); T4 - 5 seconds PPA plus universal adhesive (Zipbond); and T5 - 5 seconds PPA plus resin-modified GIC adhesive (Riva bond LC). SC (Riva Self-cure HV) and LC (Riva Light-cure HV) HVGICs were applied to the conditioned specimens and stored in artificial saliva at 37°C for 1 week. SBS and failure modes were subsequently determined. Statistical analyses were performed using Kruskal-Wallis/post-hoc Mann-Whitney U and Chi-square tests (α=0.05). The highest SBS was observed when SC and LC were restored with T2 and T5, respectively. Significant differences in SBS were as follows: SC - T2, T1 > T5, T3; LC - T5, T4, T3 > T2. SC generally exhibited adhesive failures, while LC presented both adhesive and mixed failures. The preferred method for preparing SDF-treated carious dentin before restoration application is PAA for SC and PPA plus RMGIC adhesive for LC HVGICs.

"Evaluation of Silver Diamine Fluoride Modified Atraumatic Restorative Treatment (SMART) on hypomineralized first permanent molar"- a randomized controlled clinical study.

Restoring first permanent molars affected with molar incisor hypomineralization (MIH) is challenging. Focusing on improving the quality of life for children affected by MIH, at least until the complete eruption of first permanent molars to receive full coverage, to decrease the hypersensitivity and to be able to perform proper oral hygiene measures, the purpose of this study was to compare silver modified atraumatic restorative technique (SMART) versus the conventional restoration and fluoride varnish application on moderate to severe hypomineralized molars. The comparison considered the restoration survival, hypersensitivity, and digital surface area changes after one year follow up. Twenty-eight children were selected (20 girls and 8 boys) with at least 2 MIH molars with the same defect severity. The study comprised 2 groups; MOD group (moderate hypomineralized molar severity) and SEV group (Severe hypomineralized molar severity) (n = 28 tooth). Each group was further subdivided into 2 subgroups according to the technique of restoration: SMART subgroup and CONV subgroup (high viscosity glass ionomer restoration and fluoride varnish application) (each = 14 tooth). Evaluation was done in terms of the restoration survival (6 months and 12 months), hypersensitivity at 1 weak, 6 months and 12 months and occlusal surface area changes at 12 months). Professional Fluoride varnish application and home prophylaxis using MI paste were the protocol for each child patient. There was no significant difference between the 4 subgroups, regarding tooth restoration integrity at 6-months vs. 12-months. However, a statistically significant difference in tooth restoration integrity between the 4 subgroups at 12-months (P = .049). Also, the hypersensitivity score, there was a statistically significant difference between the 4-time intervals (P < .001) and a statistically significant difference in surface area changes between the 4 subgroups. Selective removal of carious tissue and SMART restoration, combined with dental home and professional preventive measures every 3 months maintained the integrity of restorations in severely and moderately affected permanent molars up to 1 year. The study protocol was retrospectively registered on Clinical Trials (NCT05931822-05/ 07/2023).

Comparison of Class II Bulk-Fill, Self-Adhesive Composites, Alkasite, and High-Viscosity Glass Ionomer Restorations in Terms of Marginal and Internal Adaptation.

(1) Background: Restoring decayed teeth in young patients can be challenging. This calls for a simplification of the protocols through new biomaterials. Therefore, the aim of this study was to compare the marginal adaptation delivered by restorative materials applied on class II cavities by using a simplified protocol, before and after fatigue test, followed by the assessment of the internal adaptation. (2) Methods: Forty-eight human teeth were divided into six groups (n = 8). Dentinal fluid simulation was performed before restoring the class II cavities: Gr 1-adhesive (Clearfil Universal Bond Quick) and nanohybrid flowable composite (Clearfil Majesty ES Super Low Flow), Gr 2-adhesive (Clearfil Universal Bond Quick) and nanohybrid composite (Clearfil Majesty ES standard), Gr 3-bulk fill self-adhesive composite (Surefil One), Gr 4-bioactive powder-liquid filling material (Cention Forte), Gr 5-universal adhesive (Adhese Universal) and nanohybrid composite resin (Tetric Powerfill); and control group (CT)-high-viscosity glass ionomer (Equia Forte). Marginal adaptation was observed with scanning electron microscopy (SEM) and compared before and after a fatigue test consisting of repeated thermal and mechanical cycles. The specimens were then cut mesio-distally, and internal adaptation was undertaken using SEM again. Repeated measures and one way ANOVA followed by a Fisher's LSD test and Fisher's LSD post hoc test were used in order to compare the statistically significant differences among groups. (3) Results: As for the marginal adaptation after loading, Cention Forte (58%) and Equia Forte HT (53%) were statistically equivalent and presented the highest results, followed by Clearfil Majesty ES Standard (32%) and Tetric Powerfill (27%), with Surefil One (8%) and Clearfil Majesty ES Flow Super Low (7%) showing the worst results. In terms of internal adaptation, Cention Forte (85%) and Clearfil Majesty ES Standard (74%) had the highest percentages of continuous margins. Tetric powerfill (56%) and Equia Forte HT (44%) showed statistically significantly lower results, followed by Clearfil Majesty ES Flow Super Low (33%) and eventually Surefil One (17%). (4) Conclusions: This in vitro study showed promising results for the marginal and internal adaptation of alkasite dual cured Cention Forte in the restoration of class II cavities. This material could be considered an interesting restorative alternative for the restoration of deciduous teeth.

A Bibliometric Analysis of the 100 Most-Cited Articles concerning Atraumatic Restorative Treatment.

The present study aimed to identify the 100 most-cited articles concerning Atraumatic Restorative Treatment (ART) through a bibliometric analysis. The search was conducted in the Web of Science database in December 2023. Scopus and Google Scholar were used to compare the number of citations. The following data were extracted from the articles: title, authors, number of citations, access type, institution, country, continent, year of publication, journal, keywords, study design, and theme. Collaborative networks were generated using the VOSviewer software. Google Trends was used to investigate the global popularity of "atraumatic restorative treatment" research. The 100 selected articles, published between 1996 and 2019, were cited 5,092 times, ranging from 21 to 239 citations. Caries Research (12%) and Community Dentistry and Oral Epidemiology (12%) published the highest number of articles. Clinical study (52%) was the most prevalent study design. The main theme addressed was restoration longevity (43%). Conventional high-viscosity glass ionomer was the most used restorative material (69%). The country with the highest number of articles was the Netherlands (33%) and Europe was the continent with most publications (38%). The Rabboud University of Nijmegen had the highest number of articles (25%). Frencken JE was the most prominent author (38%). The most common keyword was "atraumatic restorative treatment" (n=60). According to Google Trends, Tanzania was the country that searched the most about ART. The 100 most cited articles on ART were mainly composed of clinical studies focusing on the longevity of restorations and originated in Europe.

Effect of Radiotherapy on the Adhesive Interface of Caries-affected Dentin and Bioactive Restorations: A Micro-CT Analysis.

This study aimed to analyze the presence of defects within the adhesive interface formed with five bioactive dental materials and caries-affected dentin concerning the timing of radiotherapy (before or after the restorative procedures) by micro-CT. A total of 96 carious human molars were randomly allocated into the following groups based on the timing of the radiotherapy sequence: radiotherapy followed by restoration (RT1) or restoration followed by radiotherapy (RT2). Then, six subgroups were established within these groups based on the type of materials used (n=8). Following cavity preparation and caries removal, a universal adhesive (G-Premio Bond) was administered in self-etch mode or accompanied by applying suitable cavity conditioners according to the manufacturers' guidelines. Subsequently, restorations were performed using five bioactive restorative materials (resin-modified glass-ionomer [Fuji II LC], high-viscosity glass-ionomer hybrid [EQUIA Forte HT], giomer [Beautifil II], alkasite [Cention N], and dual-cure bulk-fill composite [Activa Bioactive Restorative]) and a conventional microhybrid resin composite (Filtek Z250). The radiotherapy regimen encompassed 60 Grays (Gy) administered at a rate of 2 Gy/day over 6 weeks, 5 days a week. Micro-CT analysis was employed to assess adhesive defects at the interface between caries-affected dentin and the restorations. The data were analyzed using Kruskal-Wallis, Mann-Whitney U, and Dunn tests (α=0.05). RT2 caused significantly higher adhesive defects than RT1 for the Filtek Z250 and Activa Bioactive Restorative subgroups (p<0.05). For RT1, no significant differences were found in adhesive defects among all tested subgroups (p>0.05). By contrast, for RT2, adhesive defects were significantly higher for the Activa Bioactive Restorative and Cention N subgroups than for the EQUIA Forte HT and Beautifil II subgroups (p<0.05). When using most bioactive restorative materials, the timing of radiotherapy had no significant influence on the adhesive interface. Regarding restoration following a radiotherapy protocol, a favorable impact was identified with high-viscosity glass ionomer hybrid cement and giomer bioactive restorations compared with dual-cure bioactive bulk-fill composite and alkasite restorations.

The effect of simulated food liquids on the surface structure and solubility of various esthetic restorations

Aims: The aim of this study is to investigate the surface roughness and solubility of restorative materials when exposed to foodstuffs in the oral environment using simulated food liquids as defined by the Food and Drug Administration. Methods: In this study, a total of four esthetic restorative materials were used: one universal compomer (Dyract XP, Dentsply), one conventional microhybrid composite (FiltekTM Z250, 3M ESPE), one nanofilled, and one high-viscosity glass ionomer cement (ChemFil Rock, Dentsply). A total of 160 samples, each 8 mm in diameter and 2 mm in thickness, were prepared using molds. The initial weights of the samples were recorded in micrograms using a precision balance to determine solubility values. Initial surface roughness values were measured using an atomic force microscope device. The samples were immersed in four different simulated food liquids (ethanol, heptane, citric acid, and distilled water) for a period of 7 days. After removal from the solutions, the samples were desiccated to a constant weight, and the second set of weights was recorded. Subsequently, the second surface roughness values were measured Results: Among the materials immersed in the simulated food solutions, ChemFil Rock exhibited the highest solubility and increase in surface roughness. Citric acid was found to be the solution that caused the highest increase in surface roughness values and solubility for this material (p

Radiopacity and Microleakage Evaluation of Different Intermediate Materials

Objective: The aim of this study is to compare the radiopacities of different types of materials with indications for application as a base under restorations and the microleakage of the final restorations with these materials applied as bases. Methods: Standart Class I cavities were prepared in 90 caries-free molar teeth. The cavities were randomly divided into 9 groups according to the type of intermediate material to be applied (n=10): 1. High flowable composite, 2. Low flowable composite, 3. Fiber reinforced composite, 4. Giomer, 5. Ormocer, 6. Alkasite, 7. Bioactive composite, 8. High viscosity glass ionomer, 9. Glass carbomer. The base materials in each group were applied to the cavity floor and restoration was completed using a nanohybrid composite resin and an universal adhesive system. To evaluate radiopacity, radiographic images were taken using direct digital system and mean gray values were measured with ImageJ software. To analyse microleakage, specimens were subjected to thermocycling, immersed in 2% methylene blue solution for 24 hours, sectioned buccolingually and leakage values observed on the half-piece surfaces were examined under a stereomicroscope and recorded. Data were analysed using One-way Analysis of Variance, Tukey HSD Test and Pearson Chi-Square with Bonferroni-corrected Z Test (p˂0.05). Results: In terms of radiopacity, while alkasite and low flowable composite showed the highest radiopacity, glass carbomer gave the lowest (p

Comparative Evaluation of the Fluoride Releasing Ability and Microbial Attachment of Glass-Hybrid Restorative Material

This study aimed to compare the fluoride-releasing ability and degree of microbial attachment of a newly developed glass-hybrid restorative material (GH) with those of a high-viscosity glass ionomer (HvGIC), resin-modified glass ionomer (RMGI), and composite resin (CR). In addition, the correlation between fluoride-releasing ability and microbial attachment between materials was evaluated. Specimens were prepared in a disc shape and divided into 4 groups according to the materials (GH, HvGIC, RMGI, and CR). The fluoride release experiments were performed in each group (n = 15). The amount of fluoride released was measured on days 1, 3, 7, 14, 28, and 42 after storage. For the microbial attachment experiment, 12 specimens were produced per group using &lt;i&gt;Mutans Streptococci&lt;/i&gt; (&lt;i&gt;S.mutans&lt;/i&gt; ), a cariogenic microorganism. &lt;i&gt;S. mutans&lt;/i&gt; was cultured on the specimens for 24 hours, and the number of bacteria was measured. GH had the highest cumulative fluoride release and showed a significant difference when compared with RMGI (&lt;i&gt;p&lt;/i&gt; = 0.001) and CR (&lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Microbial attachment was the lowest in GH; however, no significant difference was observed between the materials (&lt;i&gt;p&lt;/i&gt; = 0.169). There was no significant correlation between fluoride release from materials and microbial attachment (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). From this perspective, remineralization of low-mineralized areas could be expected due to the high fluoride release of GH, and the effect of delaying the progression of dental caries could be predicted from the low cariogenic microbial attachment. Therefore, GH might be a useful restorative material for treating immature permanent teeth with hypomineralized enamel. However, further studies are needed about the degree of remineralization of hypomineralized areas after restoration and the capacity to recharge fluoride.

In-vitro evaluation of fracture resistance of teeth restored with different high-viscosity glass ionomer restorative materials and bulk-fill composite resins

ObjectivesThis study aimed to evaluate the effect of restorations made with a glass-hybrid restorative system (GHRS), a high-viscosity glass ionomer restorative material (HVGIC), a high-viscosity bulk-fill composite resin (HVB), a flowable bulk-fill composite resin (FB), and a nanohybrid composite resin (NH), which are commonly preferred in clinical applications on the fracture resistance of teeth in-vitro.Materials and methodsOne hundred intact human premolar teeth were included in the study. The teeth were randomly divided into ten groups (n = 10). No treatment was applied to the teeth in Control group. Class II cavities were prepared on the mesial surfaces of the remaining ninety teeth in other groups. For restoration of the teeth, a GHRS, a HVGIC, a HVB, a FB, and a NH were used. Additionally, in four groups, teeth were restored using NH, GHRS, and HVGIC with open and closed-sandwich techniques. After 24 h, fracture resistance testing was performed. One-way ANOVA and Tukey HDS tests were used for statistical analysis of the data.ResultsThe fracture resistance values of Control group were statistically significantly higher than those of GHRS, HVGIC, FB, NH, HVGIC-CS, GHRS-OS, and HVGIC-OS groups(p < 0.05). There was no statistically significant difference observed between the fracture resistance values of Control, HVB, and GHRS-CS groups (p > 0.05).ConclusionIt can be concluded that the use of HVB and the application of GHRS with a closed-sandwich technique may have a positive effect on the fracture resistance of teeth in the restoration of wide Class II cavities.Clinical relevanceThe use of high-viscosity bulk-fill composite resin and the application of glass-hybrid restorative system with the closed-sandwich technique in the restoration of teeth with wide Class II cavities could increase the fracture resistance of the teeth.

In Vitro Evaluation of Mechanical, Surface, and Optical Properties of Restorative Materials Applied with Different Techniques.

(1) Background: currently, the advantages of bulk-fill resin composite and high-viscosity glass ionomer materials have increased their use in dentistry; accordingly, their mechanical, surface, and optical properties have become more important. This study aimed to evaluate the mechanical, surface, and optical properties of three different restorative materials (a high-viscosity bulk-fill resin composite (TNC), a flowable bulk-fill resin composite (EBF), and a high-viscosity glass ionomer (FIX)) after application using different techniques (control, heat application, and ultrasonic activation). (2) Methods: specimens were prepared to assess the color stability and surface roughness (n = 12). The specimens were immersed in two different solutions for 14 days. For the compressive strength test, specimens were prepared using a Teflon mold (n = 12). (3) Results: among the specimens applied according to the manufacturer's instructions and immersed in distilled water, it was observed that the surface roughness values of FIX on the 7th day were statistically significantly higher than the other materials (p < 0.05). The compressive strength values of EBF applied using ultrasonic activation were significantly lower than those of EBF applied using the other techniques (p < 0.05). (4) Conclusions: coffee can negatively affect the color stability of restorative materials, but discoloration may vary depending on differences in the content of the material. All materials evaluated in this study exhibited clinically acceptable surface roughness values. It can be concluded that flowable bulk-fill resin composite is the most durable material in terms of compressive strength, so it can be used in the restoration of posterior teeth, especially those exposed to intensive stress.

Addition of nisin to high-viscosity glass-ionomer cement: a comparative in vitro study on antibacterial and physical properties

PurposeNisin is a lantibiotic effective against Gram-positive microorganisms such as Streptococcus mutans. The study aimed to determine the effect of the addition of nisin to high-viscosity glass-ionomer cement (HVGIC) on its antibacterial activity, setting time, surface microhardness, and compressive strength.Methods1 and 3% w/w nisin were added to HVGIC before mixing. Unmodified HVGIC was the control. Agar disc diffusion, direct contact test, and scanning electron microscopy (SEM) analysis were used to evaluate antibacterial activity against S. mutans. Setting time, surface microhardness, and compressive strength were measured using Gilmore needle apparatus, digital microhardness tester, and universal testing machine, respectively. Statistical analysis included Student’s t test, one-way ANOVA with Tamhane’s post hoc test, and repeated-measures ANOVA.ResultsAs evidenced by the agar disc diffusion (p < 0.001), direct contact tests (p = 0.025), and SEM analysis of the S. mutans cell count and cell surface area (p = 0.049 and 0.003), 3% nisin had the strongest antibacterial activity. There was a dose-dependent increase in setting time (p = 0.005) and surface microhardness (p = 0.006), with no significant difference in compressive strength compared to control.ConclusionThe addition of 3% nisin to HVGIC enhances the antibacterial action against S. mutans and surface microhardness without adversely affecting setting time and compressive strength.

Cost-effectiveness of restorative treatments for permanent molars with severe molar incisor hypomineralization: perspectives for the Brazilian public health system.

To undertake a cost-effectiveness analysis of restorative treatments for a first permanent molar with severe molar incisor hypomineralization from the perspective of the Brazilian public system. Two models were constructed: a one-year decision tree and a ten-year Markov model, each based on a hypothetical cohort of one thousand individuals through Monte Carlo simulation. Eight restorative strategies were evaluated: high viscosity glass ionomer cement (HVGIC);encapsulated GIC; etch and rinse adhesive + composite; self-etch adhesive + composite;preformed stainless steel crown; HVGIC + etch and rinse adhesive + composite; HVGIC + self-etch adhesive + composite, and encapsulated GIC + etch and rinse adhesive + composite. Effectiveness data were sourced from the literature. Micro-costing was applied using 2022 USD market averages with a 5% variation. Incremental cost-effectiveness ratio (ICER), net monetary benefit (%NMB), and the budgetary impact were obtained. Cost-effective treatments included HVGIC (%NMB = 0%/0%), encapsulated GIC (%NMB = 19.4%/ 19.7%), and encapsulated GIC + etch and rinse adhesive + composite (%NMB = 23.4%/ 24.5%) at 1year and 10years, respectively. The benefit gain of encapsulated GIC + etch and rinse adhesive + composite in relation to encapsulated GIC was small when compared to the cost increase at 1year (gain of 3.28% and increase of USD 24.26) and 10years (gain of 4% and increase of USD 15.54). Within the horizon and perspective analyzed, the most cost-effective treatment was encapsulated GIC restoration. This study can provide information for decision-making.

Evaluation of the Effect of Different Bonding Systems and Restorative Materials on Shear Bond Strength in the Repair of High-Viscosity Glass Ionomer Cement

Aim: High viscosity glass ionomer cements have been produced to increase the mechanical properties of glass ionomer cements. The aim of this study is to determine the appropriate adhesive system and restorative material that can be used in fracture repair of high viscosity glass ionomer cements. Material and Methods: A total of 140 standard size acrylic blocks were used in the study. 14 groups were formed from randomly selected acrylic blocks, with 10 samples in each group. High viscosity glass iomomer cement was placed in the first 13 groups, and resin-modified glass ionomer cement was placed in the last group. After the thermal cycle aging process was applied to all samples, repair restorations were performed with 4 different adhesive systems, 2 different composite resins and 2 different restorative types of glass ionomer cement. After the repair restorations, thermal cycle aging was applied again and the shear bond strengths were evaluated. One-way analysis of variance and Duncan multiple comparison test were used for statistical analysis. Results: The highest shear bond strength values were obtained by the total etch adhesive system (p&lt;0.001). The lowest shear bond strength values were obtained when high-viscosity glass-iomomer cement without adhesive system was restored with high-viscosity glass iomomer cement (p&lt;0.001). Conclusion: For higher shear bond strength values in the repair of high-viscosity glass ionomer cements should use to total etch adhesive systems and composite resin.

Clinical Effectiveness of High-viscosity Glass Ionomer Cement and Composite Resin as a Restorative Material in Primary Teeth: A Systematic Review of Clinical Trials.

This systematic review was designed to compare the clinical effectiveness of high-viscosity glass ionomer cement (HVGIC) restorations to direct composite resin (CR) restorations in single- or multisurface cavities in primary teeth. Restorative procedures are typically used to treat caries in primary teeth. Due to their improved preservation of the natural tooth structure and their adhesion to the remaining tooth structure, CR and GIC have drawn attention as the preferred restorative materials. In the literature, over the past 20 years, the term HVGIC has developed. Compared to C-GICs, HVGICs appear to have a higher survival rate. However, isolated studies provide contradictory findings regarding the durability of restorations in primary teeth. Major electronic databases were thoroughly searched to find publications from the years 2000 to 2021. Studies included were randomized and nonrandomized clinical trials on children aged 3-13 years, in which restoration of primary teeth using HVGIC and CR was performed. This systematic review includes four studies [three randomized controlled trials (RCTs) and one nonrandomized controlled trial]. No statistically significant difference between these materials was seen in any of the included studies. This systematic review of findings supports the assertion that both HVGIC and CR restorations deliver satisfactory outcomes in terms of clinical efficacy and overall survivability. It was found that, for both materials, class I restorations had statistically higher survival rates than class II restorations. Long-term studies are essential to evaluate the clinical efficacy of both restorations. This systematic review outlines the application of HVGIC and CR as restorative materials for pediatric dentists to use in their everyday dental practices. Krishnakumar K, Kalaskar R, Kalaskar A, et al. Clinical Effectiveness of High-viscosity Glass Ionomer Cement and Composite Resin as a Restorative Material in Primary Teeth: A Systematic Review of Clinical Trials. Int J Clin Pediatr Dent 2024;17(2):221-228.

Clinical comparison of high-viscosity glass-hybrid systems with a sculptable bulk-fill composite resin in different cavity types.

This randomized, double-blind clinical investigation assessed the performance of two high-viscosity glass-ionomer systems and a bulk-fill composite in different cavity types. In 146 participants, 360 (class I, II, and V) cavities were restored using three different materials (Equia Forte HT, Chemfill Rock, and SonicFill 2) with equal allocation. Using modified World Dental Federation criteria, restorations were assessed after 1 week, 6 months, and 18 months by an experienced examiner. Statistical analysis was conducted using Fisher's exact and Wilcoxon signed rank tests (α = 0.05). After 18 months, 267 restorations were assessed in 116 participants. After 18 months, 5 Equia Forte HT restorations failed due to debonding and fracture. Only one loss was observed in the Chemfill Rock restorations. Equia Forte HT exhibited significantly lower retention than SonicFill 2 after 18 months (p = 0.019), irrespective of cavity type. At 1 week, 3 Class I restorations with SF showed postoperative sensitivity. The type of cavity did not affect the performance of the restorative materials used (p > 0.05). Equia Forte HT and Chemfill Rock presented similar clinical performance regardless of color match. Equia Forte HT showed a lower performance compared to SonicFill 2. Glass-hybrid materials presented a lower performance in terms of color match or retention when compared to a sculptable bulk-fill composite resin.

Adhesion of glass ionomer cements to primary dentin using a universal adhesive.

Glass ionomers are widely used for restoring carious primary teeth. However, their ability to bond to primary dentin is considered a challenge in pediatric dentistry. The study aimed to evaluate the microshear bond strength (μSBS) of a resin-modified glass ionomer (RMGI) and a high-viscosity glass ionomer cement (Hv-GIC) to primary dentin using a universal adhesive. Thirty human primary maxillary canines were cut in half and prepared for the μSBS test. The specimens (N = 60) were assigned to 6 groups. Three groups were defined for RMGI (FUJI II LC) and 3 groups for Hv-GIC (EQUIA Forte): with an immediately curing adhesive (G-Premio); with a delayed curing adhesive; and without an adhesive (control group). After preparing the dentin surfaces, the glass ionomers were bonded using Tygon® tubes with an internal diameter of 0.7 mm. The μSBS test was performed, and the data was analyzed using two-way analysis of variance (ANOVA) followed by Tukey's post hoc test. Additionally, the failure modes were determined using a stereomicroscope. Six specimens, one for each study group, were prepared for scanning electron microscopy (SEM) analysis to observe the glass ionomer-dentin interface. The type of glass ionomer did not have a significant effect on the μSBS (p = 0.305). Groups that received universal adhesive application prior to glass ionomer exhibited a significantly higher μSBS (p < 0.0001). However, there was no significant difference between the immediately curing and delayed curing groups (p = 0.157). The predominant failure mode was mixed failure. Higher bond strength of glass ionomers to primary teeth can be achieved by using universal adhesives, which, in addition to the proven benefits of glass ionomers, can improve their clinical success.

Assessing the impact of dental restorative materials on fibroblast cells: an immunohistochemical and ELISA analysis.

In this study, our aim was to investigate the effects of restorative materials such as composite, compomer and high viscosity glass ionomer, which are frequently used in dentistry, on L929 fibroblast cells by evaluating the oxidative stress parameters, pro- and anti-inflammatory cytokines, and apoptosis markers. L929 fibroblast cells were cultured, and dental filling materials were applied in two doses (50 and 100µl). Immunohistochemical staining was performed for experimental groups with Anti-Bax and Anti-Caspase 9 antibodies. Then, ELISA technique was used to detect the level of TNF-alpha, TGF-beta, IL-1-beta, IL-6, IL-10, LPO and CAT. In the light of the data, the examined dental filling materials were effective on increasing the TGF-beta, IL-10, LPO and CAT levels, and decreasing the TNF-alpha, IL-1-beta, and IL-6 levels. The histological micrographs were also support the issues. When the levels of H-score in Caspase 9 labeled micrographs were evaluated, the mean of the control group was lower than the mean of the experimental groups. Biocompatibility varies according to the content of the material, the amount of residual monomer, and its solubility. Although all the experimental groups have cytotoxic effects, the least effect is seen in the Omnichroma group.