Search Results (44)

Objective: Due to the increasing esthetic demand among pediatric patients and different restorative materials, we focused on analyzing which of the options of restorations may provide superior clinical outcomes. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using PubMed and Cochrane databases. Results: Five articles met all inclusion criteria from an initial pool of 359 articles identified in the initial search. Greater bond strength was observed when pulpotomized teeth were restored with Biodentine^® and resin composites compared to resin-modified glass ionomer cements (RMGICs). When comparing pulpotomies in primary teeth with MTA and Biodentine^®, the fracture resistance values were higher in the pulpotomized teeth with Biodentine^® than with MTA. Additionally, following a narrative synthesis in MTA-treated teeth, a higher risk of failure was observed using RMGICs or composite instead of stainless-steel crowns (SCCs) as the final restorative material. Conclusions: Variables such as the type of final restoration can affect the survival of primary teeth after pulpotomy reconstruction. Regardless of the pulp material, survival with SSCs is higher, but resin composites appear to be a viable restorative material after Biodentine^® application. Full article

BioFlx crowns (BFCs) have been introduced in the dental market, combining the flexibility of stainless steel crowns (SSCs) with the esthetic appeal of preformed zirconia crowns. However, the existing literature does not provide adequate insights regarding the retentive strength of various types of luting cement with these newly developed BFCs. Therefore, this study aimed to evaluate and compare the retentive strength of BFCs and SSCs with different types of luting cement (glass ionomer cement [GIC], resin-modified glass ionomer cement [RMGIC], self-adhesive resin cement [SARC], and polycarboxylate cement [PXC]). A total of 160 standardized resin dies were fabricated and divided into two groups based on the type of crown (BFCs or SSCs). Each group was further subdivided into four subgroups (20/group) based on the luting cement used for cementing the crown on the die. A pullout test was performed using a universal testing machine to measure the retentive strength required for crown dislodgement. The residual cement in the crown was scored to determine the cement failure pattern. Data were analyzed using two-way analyses of variance (ANOVAs) to evaluate the interaction between the cement and the type of crown on retentive strength, followed by an independent t-test. Furthermore, Welch’s ANOVA and Dunnett’s T3 test were used to assess the impact of various types of luting cement on the retentive strength of each crown. The CFP was assessed by comparing the scores using descriptive statistics. Statistical significance was set at p < 0.05. The mean retentive strength of SSCs and BFCs was the highest with SARC (560.29 ± 8.74 N; 657.72 ± 20.60 N), followed by RMGIC (534.20 ± 22.84 N; 454.90 ± 7.95 N) and GIC (435.14 ± 8.66 N; 237.68 ± 9.37 N), while the lowest was with PXC (365.67 ± 19.11 N; 131.26 ± 5.37 N). A significant difference in retention was observed between the crowns (p < 0.05). Cement failure primarily manifested as adhesive failures in the SARC and RMGIC groups; however, both adhesive and cohesive failures occurred in the GIC and PXC groups. Thus, SSCs demonstrate significantly higher retention than BFCs across all types of luting cements, except when using SARC. Within the limitations of this in vitro study, SSCs emerge as the preferred choice for full-coverage restorations that require optimal retention and durability. Nevertheless, BFCs with SARC provide a viable alternative when esthetic considerations are prioritized. Full article

(1) Background: Alkasite is a novel restorative material that has attracted interest in recent years because of its distinctive characteristics, including its high translucency and excellent biocompatibility. It is comparable to glass ionomer cement (GIC) and resin-modified glass ionomer cement (RMGIC) due to its fluoride-release ability and usage in esthetically concerned areas. This study aimed to assess the shear bond strength (SBS) of Alkasite restorative material in comparison with GIC and RMGIC (2) Methods: The study sample included 120 extracted sound primary molars and was randomly split into three groups, including group 1: RMGIC; group 2: Alkasite; and group 3: GIC. Each group was then sub-grouped into immediate and delayed loading. SBS was measured for each group using a universal testing machine. One-way analysis of variance with Tukey’s post hoc test and an independent t-test were used for statistical analyses (3) Results: The immediate SBS was higher in Alkasite, followed by RMGIC and GIC, with means of 10.84 ± 1.96, 10.64 ± 1.74, and 6.09 ± 1.75, respectively. However, there was no significant difference between Alkasite and RMGIC (p = 0.94), whereas RMGIC and Alkasite showed significantly higher values than GIC, with p < 0.0001. Regarding delayed SBS, no significant difference was noted between Alkasite and RMGIC (p = 0.14), whereas both showed significantly higher values than GIC, with mean values of 6.30 ± 1.44, 5.556 ± 1.38, and 3.29 ± 0.61, respectively (p < 0.0001). (4) Conclusions: Our findings show that RMGIC and Alkasite have comparable outcomes to each other and better outcomes when compared with conventional GIC. Full article

Background: This study aims to compare the compressive strength and microhardness of four tooth-colored restorative materials: bulk fill glass hybrid (GH), resin-modified glass ionomer (RMGIC), conventional glass ionomer (CGIC), and resin-based composite (RBC). Methods: Stainless steel molds were used to prepare 20 specimens for each material. Half of the specimens were subjected to 10,000 thermal cycles; the materials were subjected to compressive strength and microhardness tests. Mean values were statistically compared using a one-way ANOVA Test and Bonferroni pairwise comparisons. Results: GH (147.03 ± 20.19 MPa) had lower compressive strength than RBC (264.82 ± 30.95 MPa) but showed no significant difference with CGIC (130.19 ± 30.38 MPa) and RMGIC (183.52 ± 18.45 MPa). RMGIC’s compressive strength also significantly fell short of RBC (p < 0.05), but it significantly increased after thermocycling (160.14 to 183.52 MPa). As for microhardness, no significant difference was found between the groups. Thermocycling significantly increased the microhardness of CGIC (from 24.27 to 31.8 ± 2.66). Conclusion: Resin-based materials outperformed the other materials. Glass hybrid restorative material performed as well as resin-modified glass ionomer regarding compressive strength; however, further studies are necessary before considering glass hybrids for use as a permanent restoration. Full article

The objective of this study was to evaluate the effect of incorporating different concentrations of graphene oxide (GO) nanoparticles on the mechanical properties of a resin-modified glass ionomer cement (RMGIC). A commercial RMGIC (Resiglass R, Biodinâmica) was modified by incorporating 0.1% and 0.5% (by weight) of GO into the powder’s material. An unmodified RMGIC was used as a control group. Powder samples were characterized using Scanning Electron Microscopy (SEM) and Energy Dispersive Spectroscopy (EDS). Specimens were fabricated and subjected to flexural strength (n = 15), modulus of elasticity (n = 15), Vicker’s microhardness (n = 10), and surface roughness tests (n = 10). Data were analyzed using one-way ANOVA and Tukey’s post hoc test (α = 5%). Experimental groups’ powder demonstrated a homogeneous dispersion of GO. No statistically significant difference was observed in flexural strength (p = 0.067) and modulus of elasticity (p = 0.143) tests. The groups containing 0.1% and 0.5% GO showed significantly higher microhardness and lower surface roughness values (p < 0.001) compared to the control group. The incorporation of GO nanoparticles at concentrations of 0.1% and 0.5% improved the microhardness and surface roughness without negatively affecting the flexural strength and modulus of elasticity of an RMGIC. Full article

This study aimed to perform a qualitative synthesis of the available in vitro evidence on the microleakage of commercially available conventional glass ionomer cements (GICs), resin-modified glass ionomer cements (RMGICs), and modified glass ionomer cements with nano-fillers, zirconia, or bioactive glasses. A systematic review was conducted according to the PRISMA 2020 (Preferred Reporting Items for Systematic Review and Meta-Analysis) statement standards. The literature search was performed in Medline (via PubMed), Embase, Web of Science, and Scopus to identify relevant articles. Laboratory studies that evaluated microleakage of GICs, RMGICs, and modified glass ionomer cements with nano-fillers, zirconia, or bioactive glasses were eligible for inclusion. The QUIN risk of bias tool for the assessment of in vitro studies conducted in dentistry was used. After the study selection process, which included duplicate removal, title and abstract screening, and full-text assessment, 15 studies were included. A qualitative synthesis of the evidence is presented, including author data, year of publication, glass ionomer materials used, sample characteristics, microleakage technique and values, and main outcome measures for primary and permanent teeth. Although no statistically significant differences were found in numerous studies, most results showed that RMGICs exhibited less leakage than conventional GICs. All studies agreed that leakage was significantly higher at dentin margins. It was also higher at the gingival margin than at the occlusal margin. Nano-filled RMGICs Ketac N100, Equia Forte, and Zirconomer appear to have less microleakage than conventional GICs and RMGICs. Further investigations using a standardized procedure are needed to confirm the results. Full article

The aim of this umbrella review was to evaluate the longevity of glass ionomer cement (GIC) as a restorative material for primary and permanent teeth. Research in the literature was conducted in three databases (MedLine/PubMed, Web of Science, and Scopus). The inclusion criteria were: (1) to be a systematic review of clinical trials that (2) evaluated the clinical longevity of GICs as a restorative material in primary and/or permanent teeth; the exclusion criteria were: (1) not being a systematic review of clinical trials; (2) not evaluating longevity/clinical performance of GICs as a restorative material; and (3) studies of dental restorative materials in teeth with enamel alterations, root caries, and non-carious cervical lesions. Twenty-four eligible articles were identified, and 13 were included. The follow-up periods ranged from 6 months to 6 years. Different types of GICs were evaluated in the included studies: resin-modified glass ionomer cement (RMGIC), compomers, and low- and high-viscosity glass ionomer cement. Some studies compared amalgam and composite resins to GICs regarding longevity/clinical performance. Analyzing the AMSTAR-2 results, none of the articles had positive criteria in all the evaluated requisites, and none of the articles had an a priori design. The criteria considered for the analysis of the risk of bias of the included studies were evaluated through the ROBIS tool, and the results of this analysis showed that seven studies had a low risk of bias; three studies had positive results in all criteria except for one criterion of unclear risk; and two studies showed a high risk of bias. GRADE tool was used to determine the quality of evidence; for the degree of recommendations, all studies were classified as Class II, meaning there was still conflicting evidence on the clinical performance/longevity of GICs and their recommendations compared to other materials. The level of evidence was classified as Level B, meaning that the data were obtained from less robust meta-analyses and single randomized clinical trials. To the best of our knowledge, this is the first umbrella review approaching GIC in permanent teeth. GICs are a good choice in both dentitions, but primary dentition presents more evidence, especially regarding the atraumatic restorative treatment (ART) technique. Within the limitation of this study, it is still questionable if GIC is a good restorative material in the medium/long term for permanent and primary dentition. Many of the included studies presented a high risk of bias and low quality. The techniques, type of GIC, type of cavity, and operator experience highly influence clinical performance. Thus, clinical decision-making should be based on the dental practitioner’s ability, each case analysis, and the patient’s wishes. More evidence is needed to determine which is the best material for definitive restorations in permanent and primary dentition. Full article

Background: To determine what thickness of 5 mol% yttria zirconia (5Y-Z) translucent crowns cemented with different cements and surface treatments would have equivalent fracture resistance as 3 mol% yttria (3Y-Z) crowns. Methods: The study included 0.8 mm, 1.0 mm, and 1.2 mm thickness 5Y-Z (Katana UTML) crowns and 0.5 and 1.0 mm thickness 3Y-Z (Katana HT) crowns as controls. The 5Y-Z crowns were divided among three treatment subgroups (n = 10/subgroup): (1) cemented using RMGIC (Rely X Luting Cement), (2) alumina particle-abraded then luted with the same cement, (3) alumina particle-abraded and cemented using a resin cement (Panavia SA Cement Universal). The 3Y-Z controls were alumina particle-abraded then cemented with RMGIC. The specimens were then loaded in compression at 30° until failure. Results: All 5Y-Z crowns (regardless of thickness or surface treatment) had a similar to or higher fracture force than the 0.5 mm 3Y-Z crowns. Only the 1.2 mm 5Y-Z crowns with resin cement showed significantly similar fracture force to the 1 mm 3Y-Z crowns. Conclusion: In order to achieve a similar fracture resistance to 0.5 mm 3Y-Z crowns cemented with RMGIC, 5Y-Z crowns may be as thin as 0.8 mm. To achieve a similar fracture resistance to 1.0 mm 3Y-Z crowns cemented with RMGIC, 5Y-Z crowns must be 1.2 mm and bonded with resin cement. Full article

Background: Permanent blackish discoloration of the tooth structure post application of silver diamine fluoride (SDF) is one of its drawbacks. Several restorative materials have been used to restore and mask the blackish discoloration of SDF-treated teeth. Recently, a new self-adhesive material has been introduced and is marketed as an all-in-one etchant, adhesive, and restorative material indicated for use in all clinical situations. This study aimed to assess the shear bond strength of the new self-adhesive restorative material and compare it with adhesive restorative materials- resin-based composite and resin-modified glass ionomer cement to dentin of extracted permanent teeth treated with 38% SDF. Methods: Thirty-nine caries-free extracted teeth (n = 39) were grouped into three groups. Following 38% SDF application, the specimens were loaded with resin-based (Group I), the new self-adhesive restorative material (SDR) Surefil (Group II), and resin-modified glass ionomer cement (RMGIC) (Group III). Shear bond strength (SBS) was calculated, and failure modes were evaluated using the universal testing device (3) Results: The composite showed the highest bond strength, followed by Group II while Group III had the lowest bond strength of all tested materials. Regarding failure type, the composite showed 100% adhesive failure, while Group III and Group II showed mostly adhesive failure with some combination. (4) Conclusions: RBC had a significantly stronger SBS to demineralized dentin surfaces of permanent molar teeth treated with SDF when compared to SDR Surefil and RMGIC. Full article

The aim of this retrospective study was to evaluate the clinical performance of glass-ionomer cement (GIC) and resin-modified glass-ionomer cement (RMGIC) materials in Class V carious cervical lesions restored by dental students. Ninety-six (96) restorations performed with either GIC (Fuji IX) (n = 39) or RMGIC (Fuji II LC) (n = 57) were evaluated using the modified USPHS criteria by two independent investigators at two follow-up evaluations (two years apart). The Fisher statistical test was used to compare USPHS criteria and examine significant differences, with a significance level set at p < 0.05. The Kaplan-Meier algorithm was used to calculate the survival probability. The overall success rate of Class V restorations was 72.9% at the second follow-up evaluation, with restorations ranging in age from 2.5 to 3.5 years. The RMGIC (Fuji II LC) restorations exhibited a significantly higher overall success rate compared to the GIC (Fuji IX) restorations (p = 0.0104). Significant differences were observed in retention (p = 0.0034) and color match (p = 0.0023). Full article

Dental cements are in a constant state of evolution, adapting to better align with the intricacies of tooth structure and the dynamic movements within the oral cavity. This study aims to evaluate the efficacy of zirconia-reinforced glass ionomer cement—an innovative variant of modified glass ionomer cements—in terms of its ability to withstand compressive forces and prevent microleakage during dental caries reconstruction. An extensive search was conducted across various databases, encompassing PubMed-MEDLINE, Scopus, Embase, Google Scholar, prominent journals, unpublished studies, conference proceedings, and cross-referenced sources. The selected studies underwent meticulous scrutiny according to predetermined criteria, followed by the assessment of quality and the determination of evidence levels. In total, 16 studies were incorporated into this systematic review and network meta-analysis (NMA). The findings suggest that both compomer and giomer cements exhibit greater compressive strength and reduced microleakage values than zirconia-reinforced glass ionomer cement. In contrast, resin-modified glass ionomer cement (RMGIC) and high-viscosity glass ionomer cement (GIC) demonstrate less favorable performance in these regards when compared with zirconia-reinforced glass ionomer cement. Full article

The development of biomaterials that are able to control the release of bioactive molecules is a challenging task for regenerative dentistry. This study aimed to enhance resin-modified glass ionomer cement (RMGIC) for the release of epidermal growth factor (EGF). This RMGIC was formulated from RMGIC powder supplemented with 15% (w/w) chitosan at a molecular weight of either 62 or 545 kDa with 5% bovine serum albumin mixed with the same liquid component as the Vitrebond. EGF was added while mixing. ELISA was used to determine EGF release from the specimen immersed in phosphate-buffered saline at 1 h, 3 h, 24 h, 3 d, 1 wk, 2 wks, and 3 wks. Fluoride and aluminum release at 1, 3, 5, and 7 d was measured by electrode and inductively coupled plasma optical emission spectrometry. Pulp cell viability was examined through MTT assays and the counting of cell numbers using a Coulter counter. The RMGIC with 65 kDa chitosan is able to prolong the release of EGF for significantly longer than RMGIC for at least 3 wks due to its retained bioactivity in promoting pulp cell proliferation. This modified RMGIC can prolong the release of fluoride, with a small amount of aluminum also released for a limited time. This biomaterial could be useful in regenerating pulp–dentin complexes. Full article

The association of the V-prep and a resin-modified glass ionomer cement (RMGIC) has shown to be a suitable alternative for the orthodontic bracket bonding procedure in vitro. The aim of this study was to evaluate over eighteen months the clinical bonding failure and survival rates of the conventional bonding technique using the Transbond XT (3M Unitek, Monrovia, CA, USA) and the RMGIC Fuji Ortho LC (GC Corporation, Tokyo, Japan) prepared with the V-prep. Therefore, one operator using the straight-wire technique bonded two hundred metallic brackets to upper and lower premolars of twenty-five patients requiring an orthodontic treatment. The randomized trial was a single-blind design in a split-mouth comparison. Each patient was randomly allocated one of the two bonding systems for each premolar on each side of the mouth. The bonding and rebonding techniques were standardized throughout the trial and bond failure was recorded each month for a period of eighteen months. The survival rates of the brackets were estimated by Kaplan–Meier and log-rank test (p < 0.05). A total of 200 orthodontic brackets were included in the study with a significant lower failure rate of 9.0% for the V-prep and RMGIC compared to 25.0% for the conventional bonding technique (p < 0.05). A higher survival rate was observed for the V-prep and RMGIC (16.36 months) over the conventional bonding technique (13.95 months) (p < 0.05). Lower premolar bonding failure was higher than upper premolar for both bonding techniques. The V-prep followed by RMGIC, with enamel surface protection abilities, can be used as an alternative bonding technique in an orthodontic treatment. Full article

The selective caries removal approach leads to the need to use materials with the ability to remineralize remaining partially demineralized dentin. Among the materials proposed are resin-modified glass ionomer cements (RMGICs). The aim of this systematic review was to evaluate, based on in vitro experimental studies, whether RMGICs are suitable for remineralizing affected dentin. A systematic literature search was performed in four databases, followed by article selection, data extraction, and quality assessment. Studies assessing the remineralizing potential of RMGICs on dentin were included in our review. Studies which compared such properties between different RMGICs or with other materials were also eligible. The studies report the remineralizing ability of RMGICs, albeit with differences between different commercial products. RMGICs show a similar ability to conventional GICs to remineralize affected dentin, fulfilling the function for which they are designed. Moreover, the incorporation of additives, such as bioactive glass (BAG) or CCP-ACP, improves their remineralizing potential. The results of this review support the use of RMGICs as restorative materials after selective caries removal. Full article

Purpose: This study evaluates the effects of different toothpastes on the nanohardness and chemical compositions of restorative materials and dental surfaces. Methods: Bovine enamel (n = 72) and dentin (n = 72) blocks were obtained and restored using RMGIC (n = 36) or CR (n = 36) to create the following surfaces: dentin adjacent to RMGIC (DRMGIC), enamel adjacent to RMGIC (ERMGIC), dentin adjacent to CR (DCR), and enamel adjacent to CR (ECR). After restoration, one hemiface of each specimen was coated with an acid-resistant varnish to facilitate the creation of control (C) and eroded (E) sides; the latter were achieved by erosion–abrasion cycles as follows: erosion with 1% citric acid: 5 days, four times for 2 min each day; 1% citric acid/abrasion, two times for 15 s, followed by immersion in a toothpaste slurry for 2 min. Toothpastes without fluoride (WF; n = 12), with sodium fluoride (NaF; n = 12), and with stannous fluoride (SnF₂; n = 12) were used for RMGIC or CR. The specimens were analyzed for nanohardness (H), and chemical composition using energy-dispersive X-ray spectroscopy and Raman microscopy. The data were statistically analyzed using two-way repeated measures ANOVA and Tukey’s test (α = 0.05). Results: Lower H values were obtained with NaF for DRMGIC-C, with a statistically significant difference from the H value obtained with WF (p < 0.05). The calcium and phosphorus concentrations in DCR-E were significantly lower with WF than with the other types of toothpaste (p < 0.05). Fluoride-containing toothpastes are capable of preserving the main chemical components of the dentin adjacent to the restorative materials under erosive–abrasive conditions. Full article