Biomaterials 24 (2003) 2451–2461

Compressive strength, fluoride release and recharge
of fluoride-releasing materials
Xiaoming Xu*, John O. Burgess
Department of Operative Dentistry and Biomaterials, School of Dentistry, Louisiana State University Health Science Center,
1100 Florida Ave., New Orleans, LA 70119, USA
Received 29 November 2002; accepted 17 December 2002

The compressive strength, fluoride releases and recharge profiles of 15 commercial fluoride-releasing restorative materials have
been studied. The materials include glass ionomers (Fuji IX, Ketac Molar, Ketac Silver, and Miracle Mix), resin-modified glass
ionomers (Fuji II LC Improved, Photac-Fil, and Vitremer), compomers (Compoglass, Dyract AP, F2000, and Hytac) and
composite resins (Ariston pHc, Solitaire, Surefil and Tetric Ceram). A negative linear correlation was found between the
compressive strength and fluoride release (r2 ¼ 0:7741), i.e., restorative materials with high fluoride release have lower mechanical
properties. The fluoride-releasing ability can be partially regenerated or recharged by using a topical fluoride agent. In general,
materials with higher initial fluoride release have higher recharge capability (r2 ¼ 0:7088). Five equations have been
pffiffi used in curve
fitting to describe the cumulative fluoride release from different materials. The equation ½Fc ¼ ½FI ð1  ebt Þ þ b t best describes
the cumulative fluoride release for most glass ionomers, resin-modified glass ionomers, and some high fluoride-releasing compomers
and composites, whereas ½Fc ¼ ½FI =ðt1=2 þ tÞ þ at best describes the cumulative fluoride release for most compomers and composite
resins. The clinic applications of different fluoride-releasing materials have also been discussed.
r 2003 Elsevier Science Ltd. All rights reserved.
Keywords: Compressive strength; Fluoride release; Recharge; Restorative materials

1. Introduction
Fluoride is well documented as an anticariogenic
agent. Fluoride-releasing restorative materials may be
able to reduce the recurrent caries at the restoration
margins [1–5]. Recurrent caries is the most frequent
cause for the failure of dental restorations [6,7]. A
variety of mechanisms are involved in the anticariogenic
effects of fluoride, including the formation of fluorapatite that has lower solubility than the original carbonated apatite, the enhancement of remineralization,
interference of ionic bonding during pellicle and plaque
formation, and the inhibition of microbial growth and
metabolism [8–10]. Fluoride released from restorative
materials can inhibit caries through all these mechanisms although it seems likely that the enhancement
of remineralization is the major mechanisms by
which fluoride released from restorative materials is
*Corresponding author. Fax: +1-504-619-8654.
E-mail address: (X. Xu).

effective [8,9]. These anticariogenic and bacteriostatic
effects vary widely among different materials and largely
depend upon the amount of fluoride the material
A continuum of fluoride-releasing restorative materials has been previously described [11–17] as a means of
defining different categories of fluoride releasing materials. In this continuum fluoride-releasing composite
resins are placed at one end of the continuum, and
conventional glass ionomer restorative materials are at
the other end. Compomers and resin modified glass
ionomers are placed in the middle. The mechanical
properties, bonding properties, and fluoride release
abilities vary substantially across the continuum [14–
17]. Since compomers, glass ionomers, and resinmodified glass ionomers are weaker than composite
resins, the clinical application of fluoride-releasing
materials is usually limited to nonload-bearing areas.
The amount of fluoride released from a restorative
material usually declines sharply after 3 days. The
fluoride-releasing ability can be partially regenerated or

0142-9612/03/$ - see front matter r 2003 Elsevier Science Ltd. All rights reserved.

Specimens The materials used in this study are listed in Table 1. TEGDMA Tetric Ceram Vivadent P-BisGMA. compomers and composite resins. microencapsulated redox catalysts Fluoroaluminosilicate glass 71 51 3 Resinmodified glass ionomer 76–77 25–26 5–7 Resinmodified glass ionomer 1.X. Except for self-cured glass Table 1 Fluoride releasing restorative materials used in this study Materials Manufacturer Resin or liquid composition Filler composition Filler (wt%) Fuji IX Miracle Mix GC America GC America PAA. glyceryl dimethacrylate.4. YbF3. SiO2. MPAE. Burgess / Biomaterials 24 (2003) 2451–2461 2452 recharged by using a topical fluoride agent or fluoridecontaining toothpaste. BisGA. (2) materials with high fluoride release have high fluoride recharge. resin-modified glass ionomers. P-BisGMA. cycloaliphatic dicarboxylic acid dimethacrylate. The material was infused into the Teflon mold and pressed between two microscope glass slides. tartaric acid. H2O poly(acrylic-itaconic acid) with pendent methacrylate. UDMA MPAE. Ba–glass. propoxylated BisGMA. TCB. YbF3 Alkaline glass. DCDMA.8 Compomer 5 Compomer Ca–Al–F–silicate glass 76 Ba–Al–F–silicate glass. HEMA. bisphenol A glycidyl diacrylate. H2O PAA. UDMA. TEGDMA DCDMA. TiO2. CDMA. dimethacrylate functional oligomer of citric acid.1. methacrylated phosphoric acid esters. YbF3. The clinic application of different fluoride-releasing materials will also be discussed. . In this study. UDMA. 2. Ba–Al–F–silicate glass.6 Resinmodified glass ionomer Compomer 3 Compomer 0. P-BisGMA.2–1. SiO2 Ba–B–Al–F–silicate. Our hypotheses were (1) high fluoride-releasing materials have lower mechanical properties than low fluoride-releasing materials. HEMA. However. H2O. tartaric acid. Poly(co-acrylic acid/ maleic acid). GI compatible monomers PAA. PAA. UDMA.8 0. UDMA Filler (vol%) Mean filler size (mm) Classification Glass ionomer Glass ionomer 73–74 23–24 4.4 4. H2O Poly(co-acrylic acid/ maleic acid). TEGDMA Surefil Solitaire Caulk/ Densply Kulzer Urethane-modified BisGMA Bis-GA. H2O HEMA.8 Composite 90 65 2–20 Composite 78 60 0. sintered Ag 78–79 17–19 4–5 Cermet glass ionomer Fluoroaluminosilicate glass. AgSnCu alloy Ca–Al–F–silicate glass Compoglass Vivadent F2000 3M ESPE Dyract AP Hytac Densply/ Caulk 3M ESPE Ariston pHc Vivadent BisGMA. the authors will report the compressive strengths. polyacrylic acid. urethane dimethacrylate. and fluoride recharge profiles of 15 commercial fluoride-releasing materials across the continuum: conventional glass ionomers. Ba–B–Al–F–silicate glass. Xu. bisphenol A glycidyl dimethacrylate. YbF3 73 56 84 47 81 Glass ionomer 79 59 1. tartaric acid. H2O 74 83 Ketac-Molar Aplicap 3M ESPE Ketac-Silver Aplicap 3M ESPE Vitremer 3M ESPE Photac-Fil Quick Aplicap 3M ESPE Fuji II LC Improved GC America Poly(co-acrylic acid/ maleic acid). SrF2 Zn–Ca–Al–F–silicate glass.O. HEMA. J. GDMA. glass.6 Composite BisGMA. fluoride release. Al–F–silicate glass. SrF2 Ba–Al–F–silicate glass. hydroxyl ethyl methacrylate. TEGDMA CDMA oligomer GDMA TCB. fumed SiO2 Porous SiO2. the recharge varies widely among different classes of fluoride-releasing materials [18]. All cylindrical specimens (4 mm diameter and 9 mm height) of each material were prepared in a split Teflon mold following manufacturers’ directions. mixed oxides Al–F–silicate glass 79 Sr–F–silicate glass.3 Composite 82 66 0. 23 (metal) 2–3 Ca–Al–F–silicate glass. TEGDMA. H2O TEGDMA Ca–Al–F–silicate glass Ca–Al–F–silicate glass. a reaction product of butane tetracarboxylic acid and hydroxyl methyl methacrylate. triethylene glycol dimethacrylate. Materials and methods 2. UDMA. The objective of this study is to determine if a correlation between mechanical properties and fluoride release or between the fluoride release and recharge ability exists.

all specimens were light-cured through the glass slides for 40 s on top and bottom surfaces. After curing. and adjust the solution pH. The best fitting equations for each material and its parameters are displayed in Table 4. Then the specimens were ‘‘recharged’’ by applying Oral-B Neutra-Foam 3. However.1. Then the specimens were taken out of the Teflon mold and light cured 40 s on each cylindrical side surface. The linear regression and nonlinear curve fitting were performed using SigmaPlot 4. The materials with the same group letter have no significant difference. The concentration (ppm) of each solution was directly read out on the instrument display and printed out on a 900A printer (Thermo-Orion). decomplex fluoride. The TISAB was added to provide constant background ionic strength. there are some exceptions for this trend.).0.2-cyclohexylenedinitrolotetraacetic acid) (Thermo-Orion) was added to each solution. Compressive strength was determined by dividing the failure load with the specimen cross-section area. J. Before measurement.0 (SPSS Inc. Compressive strengths As we move across the continuum from glass ionomers and resin-modified glass ionomers. Fluoride release experiment The specimens of each material (n ¼ 5) were placed in plastic test tubes containing 3 ml deionized water immediately after fabrication and curing. see Discussion below) Figs. 7 demonstrates that a negative linear correlation exists between the compressive strengths and cumulative fluoride releases (correlation coefficient r2 ¼ 0:7741). The selfcuring specimens were allowed to set in the mold between the glass slides. a fluoride release baseline was measured daily for 2 or 3 days after the specimens had been stored in ionized water for 3 months during which the solution was replenished weekly. Fluoride released from the specimens was measured daily for a total of 21 days using a fluoride ion selective electrode (model 96-09. Recharge was repeated three times for each material. has a higher compressive strength than some of resin-modified glass ionomers (Vitremer and . The instrument was calibrated each day with five standard fluoride solutions containing 0.5.3 ml of TISAB III (Total ionic strength adjustment buffer) concentrate with CDTA (1. Discussions 4. 8 and 9 show the results of the fluoride recharge experiment. Fluoride recharge experiment Before recharge.00. The final results were reported as fluoride release rate (mg/cm2/day) and cumulative fluoride release (mg/cm2) taking into account the surface area and solution volume of each specimen. Ketac-Molar. for example. Compressive strength experiment The specimens (n ¼ 10) were stored under 37 C for 24 h.X. 1.2. Fig.01 mm with a MAX-CAL electronic digital caliper (Fowler & NSK). Figs. 5 and 6 display the cumulative fluoride releases of each material as a function of time and their best-fitted curves. and 100 ppm F.100. One of the reasons is that the resin contents of each class of materials increase in the same trend. A linear correlation exists between the fluoride release and fluoride recharge capabilities (r2 ¼ 0:7088) as Fig. Data analysis The comparison of compressive strengths and fluoride release data was performed using ANOVA and Duncan test (a ¼ 0:05). The dimensions were used to calculate precisely the cross-section area and surface area. and 0.3. each specimen was measured for its diameter and length to 0. The fluoride release profiles of the studied materials are shown in Figs. UEDMA and TEGMA) generally have higher strength and toughness than the gel network formed by acid– base reaction in glass ionomers. 2. 2 shows the correlation between compressive strengths and the filler content (wt%) (r2 ¼ 0:2353). An Optilux 500 curing light (DenMat/Kerr) was used throughout the study. Fig. Burgess / Biomaterials 24 (2003) 2451–2461 ionomers. 10 shows. to compomers and composite resins. 4. the compressive strengths generally increase.010. 10. Thermo-Orion) and Orion 920A PH/ISE meter (Thermo-Orion). 2. 3 and 4.0% NaF) for one minute and rinsed with running deionized water for 1 min. 0.4.. Each specimen was loaded in compression until failure using an Instron 4411 mechanical testing machine (Instron Co.O. The data used are listed in Table 2 (except Ariston. respectively. 2. Table 3 lists the equations used in curve fitting.7 ml of each sample solution was pipetted into a clean plastic test tube. 2453 sodium fluoride foaming solution (containing 2. 1. 2. The crosslinked polymer matrices in compomers and composite (typically copolymers of Bis-GMA. Xu. 2. Fluoride release from these recharged samples was measured daily for 4 days. Results The compressive strengths of fluoride-releasing materials are in Table 2 and displayed in Fig.) with a crosshead speed of 1 mm/min.

For the same type of materials.8) 51 (10) 8.2) 21 (1.0) A B D D. As Table 1 shows.) (mg/cm2) Ducan groupinga (a ¼ 0:05) Miracle Mix Ketac-Silver Fuji IX Ketac-Molar Photac-Fil Vitremer Fuji II LC Improved Compoglass F2000 Dyract AP Hytac Ariston Solitaire Surefil Tetric Ceram Glass ionomer Glass ionomer Glass ionomer Glass ionomer Resin modified G. om er po gl as s F2 00 D 0 yr ac tA P H yt ac Su re f Ar il is to n S Te olit ai tri re c C er am 0 Materials Fig. It initiates the reaction with the acids or polyacids to form crosslinked gel network. however. This partially contributes to the lower mechanical properties of glass ionomers and resin-modified glass ionomers.O.I. I A G. fluoroaluminosilicate glass is the major component of the filler in all fluoride-releasing materials in this study.1) (14) (14) (12) (18) (11) (11) (18) (16) (20) (18) (45) (22) (26) The values within the same letter group have no significant difference.I. F F.0 (2. Dev. F Release 300 250 200 150 100 50 M ira c Ke le M ta c. Compomer Compomer Compomer Compomer Composite resin Composite resin Composite resin Composite resin 117 127 168 184 150 154 166 227 231 262 254 285 290 265 286 A A B. Resin modified G. mechanical properties generally increase with the increase of the filler load. Resin modified G.) (MPa) Ducan groupinga (a ¼ 0:05) Cumulative fluoride release in 21 Days (Std. composite resins often contain hard. Dev. Burgess / Biomaterials 24 (2003) 2451–2461 2454 Table 2 Compressive strengths and cumulative fluoride release of fluoride releasing materials Materials Classification Compressive strength (Std. which are not present in glass . When comparing different type of materials. J.4) 80 (4. Compressive strengths and cumulative fluoride release (in 21 days) of fluoride-releasing materials.ix Si lv er F Ke uj ta i IX cM Ph ola ot r ac Fu -F ji i Il LC l I m Vi p C trem . C D D E E F F E F 398 (32) 318 (47) 160 (10) 132 (75) 374 (6. H G. Filler load and composition may have significant influence on the mechanical properties. Fig. C C B B B. 2 shows a poor correlation between the compressive strength and the filler wt% (r2 ¼ 0:2353). In addition. Compressive Strength (MPa) and Cumulative Fluoride Release (µg/cm2) 450 400 Compressive Strength 350 Cum. but resin-modified glass ionomers generally have higher toughness and better esthetics than conventional glass ionomers.0) 422 (35) 51 (2. the relationship becomes complicated.6) 162 (11) 230 (11) 198 (14) 108 (8.I. Calcium is the essential part of the glass filler particles in glass ionomers and resin-modified glass ionomers. Photac-Fil). The Ca–Al–F–silicate glass fillers are more soluble and weaker than those fillers used in composites that do not contain calcium. H I a (22) (7. E A D C C E. Xu. G H.X. insoluble silica (SiO2) particles. 1. The composition of the fillers may be more important.

X. Filler composition and particle size also have significant influence on the fluoride release. the fluoride release generally decreases because resin contents increase. In many compomers and composites. As mentioned before. . Xu. immediately after restoration. Fluoride release profile of glass ionomers and resin-modified glass ionomers. Ariston (so-called ‘‘smart material’’) contains alkaline glass in its filler that 90 Fuji IX Miracle Mix Ketac-Molar 70 Ketac-Silver 2 Fluoire Release Rate ( µ g/cm /day) 80 60 Fuji II LC Imp. The Ca–Al–F–silicate glass fillers in glass ionomers and resin-modified glass ionomers are more soluble and thus release more fluoride. Some materials like Compoglass and Ariston have sustained fluoride release at a higher level (10– 20 mg/cm2/day). 2455 and Photac Fil) have longer time (at least 10 days) of fluoride release above 10 mg/cm2/day than conventional glass ionomers (Fuji IX. The burst effect of fluoride release in glass ionomers and resin-modified glass ionomers may have some beneficial biological effects.. Burgess / Biomaterials 24 (2003) 2451–2461 ionomers and resin-modified glass ionomers. This also leads to the higher strength of composite resins. the fluoride release sustains at a lower level for a relatively long time. 1.e. The cumulative fluoride release for 21 days is shown in Table 2 and Fig. Fluoride release profiles As we can see in Figs. the so-called ‘‘burst effect’’).2353 Compressive Strength (MPa) 300 250 200 150 100 50 70 75 80 85 90 95 Filler Load (wt%) Fig. After that. Most of the compomers and composites initially release a low level of fluoride (less than 10 mg/ cm2/day) and sustain this release at the similar level for a long time. Ketac-Silver) and resin-modified glass ionomers (Fuji II LC Improved 350 2 r =0. Vitremer 50 Photac-Fil 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 Time (day) Fig. Correlation between compressive strength and filler load. barium or strontium are added in the filler glass to increase radiopacity. such as bactericide. which have only 3 days of fluoride release above 10 mg/cm2/day. 3 and 4. But Photac-Fil and Ariston are exceptions because they release an equivalent or even higher amount of fluoride than some of the conventional glass ionomers. As we move across the continuum from glass ionomer to composite resins. but then it declines rapidly after the first 3 days (i. Some metalreinforced glass ionomer (Miracle Mix. J. all glass ionomers and resin-modified glass ionomers have an initially high (40 mg/cm2/day or above) fluoride release. 4. Ketac-Molar).2. Fluoroaluminosilicate glass is the major component of the filler and the main source of fluoride in all fluoride-releasing materials in this study. 3. Ytterbium trifluoride (YbF3) is used in Compoglass and Tetric Ceram to increase fluoride release as well as radiopacity.O. 2.

As a result. Xu. with time. [19] reported that 20 part per million. The question still remains however. and several equations have been suggested to describe the cumulative fluoride release as a . Burgess / Biomaterials 24 (2003) 2451–2461 2456 90 Compoglass Fluoire Release Rate (µg/cm2/day) 80 Dyract AP F2000 70 Hytac Ariston 60 Surefil 50 Solitaire Tetric Ceram 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 Time (day) Fig. We believe that the more important effect of fluoride is remineralization of enamel and dentin. Dyract has a mean particle size 2. Dyract AP has higher fluoride release as well as higher compressive strength than Dyract [16. Solitaire also contains more soluble strontium fluoride (SrF2) salt to enhance its fluoride release but this soluble salt has adverse effect on the mechanical properties (this will be further discussed later). the main ‘‘improvement’’ of Fuji II LC Improved over Fuji II LC is that the former has smaller filler particle size thus higher fluoride release. By extrapolating data. It not only releases high amount of fluoride. J. 1 2 3 4 5 Equation ½Fc ½Fc ½Fc ½Fc ½Fc pffiffi pffi ¼ a þ b t þ ct pffiffi bffiffi t ¼ ½FI ð1  eb t Þ þp bt ¼ ½FI ð1  e Þ þ b ptffiffi ¼ ½FI =ðt1=2 þ tÞ þ b t ¼ ½FI =ðt1=2 þ tÞ þ at References [19. Fluoride release kinetics The kinetics and mechanism of the fluoride release process of fluoride-releasing materials. Table 3 Equations describing the fluoride release kinetics Equation no. Because fluoride releasing materials release reduced amounts of fluoride and other ions. bacteria and plaque accumulate on the restorations. For example.20] [21] [22] [24] [25] is more soluble under lower pH conditions. how much fluoride release from restorative materials is enough to inhibit recurrent or secondary caries? While important clinically. Reducing the filler particle size can increase fluoride release because smaller particles have larger surface areas. Fluoride release profile of compomers and composite resins. 4. Also based on the manufacturer’s information. 4. [21] have demonstrated that enamel demineralization decreased as fluoride release from a composite resin restorative material increased. No glass ionomers maintains its acidity for periods past 48 h. particularly glass ionomers and resin-modified glass ionomers.4 mm while Dyract AP has a mean particle size 0.O. DeSchepper et al. Others have reported that a minimum inhibitory concentration of 100–200 mg/ml of NaF is required to inhibit the growth of oral streptococci [20] while concentrations up to 30-fold were necessary to be bactericidal. A more detailed study of bactericidal effect and remineralization effect of fluoride is beyond the scope of this article.X. this question has not had a definite answer yet. the authors concluded that a composite releasing 200–300 mg/cm2 fluoride over a 1-month period would completely inhibit secondary caries. Naturally occurring fluoride at concentrations as high as 21 mg/ml do not produce any obvious effects on the composition of supragingival plaque.8 mm. have been extensively studied. Dijkman et al.3. Therefore the direct bactericidal effect of fluoride released from restorative materials is very limited and is due to combination of fluoride and acidity. fluoride released from restorative materials seems to kill bacteria directly although this kill rate seems to be a function of low pH (B5) and fluoride release.17]. but also release calcium and phosphate ions.

3045 0. Those equations are listed in Table 3. (3) Eq.997925 12.082 456.49618 0.5616 0.997650 6. The authors used the SigmaPlot curve fitter (SPSS.00 98.999840 4.999750 19.90 11.5651 3 Dyract AP r2 N 0.999839 1.649 22. function of time [22–28].40 0.1174 5 F2000 r2 N 0.880 310.0021 0.3705 0.223 0.999733 2.999831 3.20239 0.86 0.999931 1.999002 7.4747 3 Ketac-Silver r2 N 0.230 0.45 248.465 107.9187 0.5505 0.59 0.993989 31.999967 2.5167 0.996477 63.998777 8.997919 6.4161 0.999595 10.27 24.53 5.997444 22.999939 0.2339 0.999825 0. (2) Eq. (3)–(5) and used them to describe wide range of materials.29.999890 1.63618 0.2059 0.140 2. This algorithm seeks the values of the parameters that minimize the sum of the squared differences between the observed values and predicted values of the dependent variable. (5) was best for compomers and composite resins.970003 1.5764 0.4224 5 Solitaire r2 N 0.536 188.999327 3.043 29.5505 0. Fuji IX 2 r N 0.996717 16.5129 0. They concluded [30] that Eq.5384 0.6474 0.0286 0.4054 0. Co.70309 0.82 29.999770 5.996724 27.999610 0.9994285 0.70 0.973497 23.987785 20. 5 0.999517 7.993686 44. J.999043 3.824 2.30] proposed Eqs.03692 0.7071 0.1445 0.999391 3.0432 0.996260 19.6169 0.33299 0.998977 9.206 65.049 27.37E-08 11. whereas Eq.25 2.159 0.999410 3. which have been used by other researchers [23.4000 0.12328 3 Tetric Ceram r2 N 0.183217 4.92 0.815 28.9545 5 Surefil r2 N 0.80407 0. (1) Eq.999513 0.140 7.11 0.9940878 7. Burgess / Biomaterials 24 (2003) 2451–2461 2457 Table 4 Comparison of the equations given in Table 3 for their adequacy of presenting cumulative fluoride release Materials Eq.0144 0.517 5.031 2.19228 0.2761 0.999949 2.2836 0. r2 N 0. (4) Eq.999415 3.999171 3.088 29.183217 0.999564 2.3084 0.5651 0.33299 0. the better the fitting).996566 24.990834 11.07 3 Compoglass r2 N 0.4101 3 Ketac-Molar r2 N 0.564 3 Photac-Fil r2 N 0.47515 0.10 0.998988 7.654639 0.2466 0.999149 3. (4) was best for glass ionomers whether resinmodified or not.996690 20.999127 3.9989835 0.9993948 0.4388 0.984465 6.999268 3.90 0.993 51. (5) Best eq.940 188.999800 7.999289 3.984027 30.990748 5.994528 100.999610 0.11 0.656 0.71985 0.10 4.999280 12.999477 3.999474 5.28].690 33. The curve fitter uses the Marquardt–Levenberg algorithm to find the coefficients (parameters) of the independent variable(s) that gives the best fit between the equation and the data.2622 0.786 2.997004 6. Verbeeck and co-workers [27.995800 43.998612 18.8505 0.0106 0.4353 0.6195 0.9973767 1. 1 in Table 3).5791 0.033 1.997139 7.990956 13. Xu.62541 5 Hytac r2 N 0.64 4.4200 5 Fuji II LC Imp.92673 0.3357 2 Miracle Mix r2 N 0.23E-10 r2 is correlation coefficient and N is normalized residuals (norm) (The smaller the N.999945 3.999630 8.4603 0. The adequacy of these equations was determined based on the correlation coefficient (r2 ) and normalized residuals or norm (N).998871 9.O. (2) to describe the fluoride release of glass ionomers and resin-modified glass ionomers.980646 1.03692 0.2897 3 Vitremer r2 N 0.4831 0.999248 11.932 29.X. Wilson and co-workers proposed the wellknown equation (No.999497 6.999925 6.121 7.86127 3 Ariston r2 N 0. The results are shown .380 5. The best values of r2 and N are displayed in bold.8471 0.7323 0.01589 Parameter Value ½FI b b ½FI b b ½FI b b ½FI t1=2 a ½FI b b ½FI b b ½FI b b ½FI b b ½FI t1=2 a ½FI t1=2 a ½FI b b ½FI t1=2 a ½FI t1=2 a ½FI b b ½FI t1=2 a 33.36055 0. Tay [26] used Eq.7053 0.999417 3.745 63.) to apply these equations to the experimental data.984022 34.

Xu. Dyract AP-fit. Cumulative Fluoride Release (µg/cm2) 400 Dyract AP-exp. 350 Miracle Mix-fit. Surefil-exp. Burgess / Biomaterials 24 (2003) 2451–2461 2458 450 Fuji IX-exp. 350 F2000-exp. (5). Figs. 5. the best equation was Eq. 6. Miracle Mix-exp. Solitaire-Exp. 300 Hytac-exp. J. This indicates that materials with high fluoride release have lower compressive strengths. which is in agreement with Verbeeck and co-workers [30]. (3). such as glass ionomers . 100 Vitremer-fit Photac-Fil-exp. For most compomers and composites.. Curve fitting of cumulative fluoride release from glass ionomers and resin-modified glass ionomers. Correlation between the compressive strengths and fluoride release As we can see from Fig. the barrier through which water and fluoride to diffuse also increases. a negative linear correlation exists between the two properties (correlation coefficient r2 ¼ 0:7741). Hytac-fit Ariston-exp. and ytterbium trifluoride) are usually less soluble than those (Ca–Al–F–silicate glass) in glass ionomers and resin-modified glass ionomers. For most glass ionomers and resin-modified glass ionomers.exp. 5. 5 and 6. 300 Ketac-Molar-fit. 450 Compoglass-exp. Ketac-Molar-exp.O. the best equation to describe their cumulative fluoride release was Eq. Compoglass-fit. On the other hand. 200 Surefil-fit. 150 Solitaire-fit Tetric Ceram-exp. Fuji II LC Imp. F2000-fit. As mentioned before. 100 Tetric Ceram -fit 50 0 0 2 4 6 8 10 12 14 16 18 20 22 Time (day) Fig. 250 Ketac-Silver-exp. which leads to the decrease in fluoride release. Cumulative Fluoride Release (µg/cm2) 400 Fuji IX-fit. 7. the resin contents of each class of materials increase and so do the compressive strengths. Curve fitting of cumulative fluoride release from compomers and composite resins. when we move across the continuum. in Table 4. 250 Ariston-fit. Ba–Al–fluorosilicate glass. from glass ionomers to composite resins. Ketac-Silver-fit. 200 Fuji II LC Imp. and some high fluoridereleasing compomers (Compoglass) and composite (Solitaire). high fluoride-releasing materials. 50 Ph Fil fi 0 0 2 4 6 8 10 12 14 16 18 20 22 Time (day) Fig. Besides.-fit 150 Vitremer-exp. the filler particles in compomers and composites (typically a mixture of fumed silica. Therefore.X.

Fluoride recharge profile of glass ionomers and resin-modified glass ionomers. . However. If Ariston is included. Fluoride Release Rate (µg/cm2/day) 25 20 Fuji IX Ketac-Molar Ketac-Silver 15 Miracle Mix Vitremer Fuji II LC Imp Photac Fil 10 5 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Time (day) Fig. The porosity of the materials may have a great influence on the amount of fluoride released before and after recharge. Xu. However. J. some studies indicated that Ariston could not bond properly with adhesives and tooth structures [34]. Ariston has been withdrawn from US market.X. r =0. This indicates that only a superficial part of the sample has been recharged due to a short recharge time (1 min).7741 95% Confidence level 400 2459 300 200 100 0 100 120 140 160 180 200 220 240 260 280 300 Compressive Strength (MPa) Fig. and some compomers can serve as a fluoride reservoir and have higher recharge capabilities while composite resins have little recharge abilities. have higher Cumulative Fluoride Release (µg/cm 2) 500 Experimental Value Linear Regression 2 Y=547-1. Recently. Correlation between compressive strength and fluoride release (excluding Ariston pHc). In general. 8. This indicates that the material with higher initial fluoride release also has a higher fluoriderecharge capability. Fluoride recharge For all materials the fluoride release increase substantially 1 day after recharge but declines rapidly to the baseline level after 2–3 days. the correlation coefficient is r2 ¼ 0:3244: The in vitro studies have indicated that Ariston can reduce secondary caries and inhibit enamel and dentin demineralization [31–33]. such as glass ionomers and resin modified glass ionomers. 10 shows. 7. Materials with less resin content. A linear correlation exists between the fluoride release and fluoride recharge capabilities (r2 ¼ 0:7088) as Fig.O. It releases a high amount of fluoride and also has a relatively high initial strength probably because of its alkaline glass filler. glass ionomers. resinmodified glass ionomers.86X. Increasing recharge time may increase the amount of fluoride release after recharge by allowing more time for the fluoride to diffuse into the materials. and resin-modified glass ionomers are not suitable clinically for load bearing area. Obviously higher porosity will allow deeper diffusion of the recharge agent into the sample and result in a higher amount of fluoride storage and release. Its clinic applicability remains 6. Burgess / Biomaterials 24 (2003) 2451–2461 a question. As mentioned above. Ariston is an exception. it is clinically impractical to increase the recharge time beyond a few minutes when applying a topical fluoride agent or fluoride-containing toothpaste to a patient.

Voids are left after the fluoride salt leaches out. though mechanically stronger. the polymer matrices that have fluoride exchange capability are highly desirable [35–38].e. they may not be as durable clinically as lower fluoride-release materials. On the other hand. Thus far. usually release only a small amount of fluoride. its mechanical properties are drastically deteriorated. which does not contain soluble fluoride salt and therefore has improved mechanical properties. Fluoride recharge profile of compomers and composite resins. Correlation between fluoride release and recharge abilities. high porosity has adverse effects on the mechanical properties. recharge. Glass ionomers and resinmodified glass ionomers have higher porosity and thus lower strength than compomers and composite resins. high . Some composite resin. 10. resin-modified glass ionomers seem to offer the best balance of fluoride release.g. Hytac). particularly in loadbearing areas.X. Therefore. Fluoride release from even the highest fluoride-releasing materials declines rapidly. Solitaire has recently been replaced by Solitaire 2. In order to enhance the fluoride recharge capability without increasing porosity. Our study shows that its strength decreased about 48% after Current restorative materials with a high fluoride release generally have lower mechanical properties.056X. r =0. Therefore. Burgess / Biomaterials 24 (2003) 2451–2461 2460 25 F2000 Compoglass Fluoride Release Rate (µg/cm2/day) Dyract AP 20 Hytac Ariston Tetric 15 Solitaire Surefil 10 5 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Time (day) Fig. Conclusions 0 0 100 200 300 400 500 2 Cumulative Fluoride Release in 21 days (µg/cm ) Fig. Xu. The probable reason is that this material contains soluble strontium fluoride (SrF2) salt. they exhibit higher fluoride recharge capabilities. Therefore. storing in water for 2 months.O. has initially high compressive strength and moderate fluoride release. i. Materials that have high fluoride release. and clinical durability for the high-caries-risk patients although compomers continue to develop and have increased fluoride release and mechanical properties. like Solitaire.7088 95% Confidence Level 30 25 20 15 10 5 7. Composite resin and some compomers (e. 9.. porosity. Fluoride Release in 3 days after Recharge (µg/cm2) 40 35 Experimental Value Linear Regression 2 Y=4. which cannot be dispersed homogeneously in the polymer matrix.934+0. it forms conglomerates. Frequent external application of neutral fluoride is necessary to maintain the high fluoride release and provide protection against future carious attacks. J.

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