Microscopic evaluation of the interface between glass-ionomer cements and tooth structures prepared using conventional instruments and the atraumatic restorative treatment (ART) technique.

OBJECTIVE: The purpose of this study was to evaluate the effect of cavity preparation using hand instruments and conventional rotary instruments on the bonding of glass-ionomer cements to formerly carious teeth. METHOD AND MATERIALS: In 2 experimental groups (12 teeth each with primary caries) caries was removed and cavities prepared using hand instruments according to the atraumatic restorative treatment (ART) technique or conventional rotary instruments. In the control group (12 caries-free teeth) Class 1 cavities were prepared using conventional instrumentation. Cavities in all teeth were restored with 1 of the commercial glass-ionomer cements designed for use with the ART technique, either Fuji IX (GC) or Ketac Molar (3M Espe). After 21 days of storage in physiologic saline at 37 degrees C, 3 400-microm-thick slices from each tooth were stained using the Mallory method and evaluated using a light transmitting microscope. RESULTS: In all samples, a region of interaction was observed between the cement and dentin and enamel. However, the interface in teeth from which caries had been removed was different from that in the control group. All were stained using Mallory staining, but only teeth which had been carious showed coloration. No differences were found in intensity of color or appearance between the cavity preparation techniques. CONCLUSION: The occurrence of caries in a tooth alters the bonding behavior of glass ionomers to that tooth. The method of caries removal (ART or conventional preparation) does not influence the quality of the interface between a glass ionomer and either dentin or enamel.

A preliminary study of the effect of glass-ionomer and related dental cements on the pH of lactic acid storage solutions.

Glass-ionomer cements, both self-hardening and resin-modified, have been shown to increase the pH of lactic acid solutions in which they are stored. Similar results have been obtained for a zinc phosphate and a zinc polycarboxylate cement. The pH was increased over a period of 7 days by between 1.54 and 2.65 pH units from an initial value of pH of 2.60, depending on the cement. It is concluded that, as a result of this ability to neutralize surrounding aqueous solutions, these materials may have the beneficial effect in vivo of inhibiting caries development. In the case of glass-ionomers, this mechanism might complement that of fluoride release.

The rate of change of pH of lactic acid exposed to glass-ionomer dental cements.

The rate of change of pH of aqueous lactic acid at pH 4.2-4.5 (i.e. a little below that of active caries in vivo) in contact with disks of various commercial glass-ionomer cements has been determined in two configurations. In the first of them, a thin film set-up, 20 microl of solution was spread across the surface of a cement disk (diameter: 13 mm), and its pH determined by pressing a flat-ended electrode against the film at varying time intervals. In the second, a similar disk was immersed in 1.5 ml of solution, removed after varying time intervals, after which the pH of the solution was measured using a round-ended electrode. The latter measurement was more reliable, in that the pH electrode had time to equilibrate, whereas the former was more realistic because the film was approximately the same thickness as that of saliva on a tooth surface. Both series of experiments showed measurable differences in pH after only 30 s, with the thin-film configuration showing a range of pH changes of 0.5-1.2 units depending on the cement and the small volume configuration showing a range of 0.1-0.5 units, also depending on the cement. After 10 min, in the small volume experiments, the pH had generally increased further. The extent and speed of the change in pH led to the conclusion that ability of glass-ionomers to increase pH is likely to be an important mechanism of caries protection under clinical conditions.

Storage of polyacid-modified resin composites ("compomers") in lactic acid solution.

OBJECTIVES: The aim of this study was to determine the interaction of four polyacid-modified resin composites with aqueous lactic acid solutions, and to compare changes with those for a glass-ionomer cement and a conventional resin composite. METHODS: For each material, namely Compoglass F, Dyract AP, Hytac and Ana Compomer, plus AquaCem (glass-ionomer cement) and Pekafil (conventional composite resin), five cylindrical specimens of 4 mm diameter x 6 mm height were prepared and weighed. They were stored individually in 2.0 cm3 of 0.02 mol l-1 lactic acid solution for 1 week then the pH was determined and the specimens reweighed. The lactic acid solution was replenished, and the specimens were stored for a further week, after which the pH and specimen weights were again measured. This was repeated at 1 week intervals until the specimens were 6 weeks old. Differences were analysed by ANOVA followed by Newman-Keuls post hoc analysis. RESULTS: All four polyacid-modified composites increased the pH of the solutions at all time intervals by at least 0.26 pH units (significant to at least p < 0.01). This effect was similar to that of the glass-ionomer (but significantly less, p < 0.05) while significantly greater (p < 0.05) than that for the composite, Pekafil, which, by contrast, had no effect on pH. The observed rise in pH reduced significantly over time (ANOVA, p < 0.05). After 1 week, all pH changes were accompanied by net reductions in specimen mass, indicating susceptibility to acid erosion. Hytac was significantly more resistant to this erosion than the other materials; conversely, it had the least effect on solution pH. SIGNIFICANCE: These results show that polyacid-modified resin composites neutralise lactic acid in vitro but suffer erosion in the process.

The long-term interaction of dental cements with lactic acid solutions.

A study of the interaction of dental cements with lactic acid solutions has been carried out in which individual cement specimens were repeatedly exposed to 20 mmol dm(-3) lactic acid for periods of a week. After each week of storage, the mass of the specimens was recorded and the pH of the solution determined. The glass-ionomers showed an initial increase in mass, followed by a decline that became steady from 6 weeks. Zinc polycarboxylate and zinc phosphate cements, by contrast, showed no early gain in mass, but eroded steadily more or less from the start of their exposure to lactic acid. For all cements, acid erosion followed linear kinetics, at rates ranging from 0.5%/week for the zinc phosphate to 0.28%/week for one of the glass-ionomers, Chelonfil (ESPE, Germany). At the end of six months, the zinc phosphate had lost 14.2% of its initial mass, the zinc polycarboxylate 9.9% and the glass-ionomers between 6.2 and 7.2%. Erosion was accompanied on every occasion by neutralization of the acid solution. Both erosion and neutralization continued steadily throughout the experiment. The effectiveness of neutralization was in the following order: zinc polycarboxylate>zinc phosphate>glass-ionomer. The pH change in Week 1 was much greater for the glass-ionomers and the zinc polycarboxylate than in all subsequent weeks.

The interaction of glass-ionomer cements containing vinylphosphonic acid with water and aqueous lactic acid.

A glass-ionomer cement containing an acrylic acid/vinyl phosphonic acid copolymer, has been investigated for its interaction with water and with aqueous lactic acid and the results compared with those from conventional glass-ionomers based on polyacrylic acid. Cylindrical specimens (12 mm high x 6 mm diameter) were placed in 8 cm3 of aqueous lactic acid (20 mmol dm(-3); pH 2.7) for 1 week, at the end of which the pH was determined. Each specimen was then placed in a fresh 8 cm3 volume of lactic acid and the pH determined after a further week. This procedure was continued for a total of 13 weeks for each specimen. Experiments were also carried out on similar specimens exposed to 8 cm3 of water for 1 week only. Further experiments were carried out in which discs of cement were exposed to thin films (0.15 mm) of lactic acid at pH 4.5, with pH values determined at 30 s, 1, 2, 5 and 10 min. After 1 week, cements had changed the pH of the lactic acid to a mean value of 3.63 (SD 0.08) while in weeks 2-13 they changed it to a mean value of 3.31 (SD 0.11). After 1 week in aqueous lactic acid the cements had gained mass by a mean of 1.26% (SD 0.59%) compared with 1.22% (SD 0.14%) in water. After 13 weeks in lactic acid, cements had lost a mean of 2.83% (SD 0.74%) in mass. Thin films of aqueous lactic acid changed from pH 4.5-5.1 at 30 s and to a steady value of 5.6 (SD 0.3) between 2 and 10 min. These results were similar to those for conventional glass-ionomer cements based on carboxylic acid polymers. Hence, it was concluded that the presence of the vinylphosphonic acid units made no significant difference to the interaction of cements with aqueous solutions.