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.

bisphenol A glycidyl diacrylate. cycloaliphatic dicarboxylic acid dimethacrylate. resin-modified glass ionomers. a reaction product of butane tetracarboxylic acid and hydroxyl methyl methacrylate. Burgess / Biomaterials 24 (2003) 2451–2461 2452 recharged by using a topical fluoride agent or fluoridecontaining toothpaste. GI compatible monomers PAA. HEMA.1. triethylene glycol dimethacrylate. SrF2 Zn–Ca–Al–F–silicate glass. Ba–Al–F–silicate glass. UDMA.8 Composite 90 65 2–20 Composite 78 60 0.3 Composite 82 66 0.8 0. methacrylated phosphoric acid esters. the authors will report the compressive strengths. GDMA. . dimethacrylate functional oligomer of citric acid. CDMA. 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. TEGDMA DCDMA.2–1. H2O Poly(co-acrylic acid/ maleic acid). UDMA. Poly(co-acrylic acid/ maleic acid). H2O HEMA. 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).6 Resinmodified glass ionomer Compomer 3 Compomer 0. All cylindrical specimens (4 mm diameter and 9 mm height) of each material were prepared in a split Teflon mold following manufacturers’ directions. polyacrylic acid. MPAE. (2) materials with high fluoride release have high fluoride recharge. YbF3. TEGDMA CDMA oligomer GDMA TCB. tartaric acid. Specimens The materials used in this study are listed in Table 1. P-BisGMA. SrF2 Ba–Al–F–silicate glass. Xu. However. BisGA. and fluoride recharge profiles of 15 commercial fluoride-releasing materials across the continuum: conventional glass ionomers.6 Composite BisGMA. HEMA. fumed SiO2 Porous SiO2. AgSnCu alloy Ca–Al–F–silicate glass Compoglass Vivadent F2000 3M ESPE Dyract AP Hytac Densply/ Caulk 3M ESPE Ariston pHc Vivadent BisGMA.O. Al–F–silicate glass. Our hypotheses were (1) high fluoride-releasing materials have lower mechanical properties than low fluoride-releasing materials. Materials and methods 2.4. DCDMA. hydroxyl ethyl methacrylate. glyceryl dimethacrylate. propoxylated BisGMA. UDMA. microencapsulated redox catalysts Fluoroaluminosilicate glass 71 51 3 Resinmodified glass ionomer 76–77 25–26 5–7 Resinmodified glass ionomer 1. PAA. J. SiO2. UDMA. H2O TEGDMA Ca–Al–F–silicate glass Ca–Al–F–silicate glass. urethane dimethacrylate. compomers and composite resins. the recharge varies widely among different classes of fluoride-releasing materials [18]. UDMA Filler (vol%) Mean filler size (mm) Classification Glass ionomer Glass ionomer 73–74 23–24 4. The material was infused into the Teflon mold and pressed between two microscope glass slides.4 4. YbF3.X. H2O PAA. fluoride release. glass. SiO2 Ba–B–Al–F–silicate. 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. mixed oxides Al–F–silicate glass 79 Sr–F–silicate glass. bisphenol A glycidyl dimethacrylate. Ba–B–Al–F–silicate glass. sintered Ag 78–79 17–19 4–5 Cermet glass ionomer Fluoroaluminosilicate glass. TEGDMA. tartaric acid. tartaric acid. The clinic application of different fluoride-releasing materials will also be discussed. P-BisGMA. In this study. YbF3 Alkaline glass. 23 (metal) 2–3 Ca–Al–F–silicate glass. HEMA. H2O.8 Compomer 5 Compomer Ca–Al–F–silicate glass 76 Ba–Al–F–silicate glass. UDMA MPAE. 2. TCB. YbF3 73 56 84 47 81 Glass ionomer 79 59 1. TEGDMA Surefil Solitaire Caulk/ Densply Kulzer Urethane-modified BisGMA Bis-GA. H2O poly(acrylic-itaconic acid) with pendent methacrylate. Ba–glass. TEGDMA Tetric Ceram Vivadent P-BisGMA. TiO2.

for example.O. 2. 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 release from these recharged samples was measured daily for 4 days. 2453 sodium fluoride foaming solution (containing 2. Data analysis The comparison of compressive strengths and fluoride release data was performed using ANOVA and Duncan test (a ¼ 0:05). each specimen was measured for its diameter and length to 0. 10 shows. Burgess / Biomaterials 24 (2003) 2451–2461 ionomers. Recharge was repeated three times for each material. and 0. The TISAB was added to provide constant background ionic strength.100. 2. Then the specimens were taken out of the Teflon mold and light cured 40 s on each cylindrical side surface.0% NaF) for one minute and rinsed with running deionized water for 1 min. Fig.01 mm with a MAX-CAL electronic digital caliper (Fowler & NSK). to compomers and composite resins.010. An Optilux 500 curing light (DenMat/Kerr) was used throughout the study. 2 shows the correlation between compressive strengths and the filler content (wt%) (r2 ¼ 0:2353). 10. Ketac-Molar. 2. The data used are listed in Table 2 (except Ariston. The dimensions were used to calculate precisely the cross-section area and surface area. 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. 3 and 4.00. all specimens were light-cured through the glass slides for 40 s on top and bottom surfaces. the compressive strengths generally increase. 4. Then the specimens were ‘‘recharged’’ by applying Oral-B Neutra-Foam 3. Compressive strength was determined by dividing the failure load with the specimen cross-section area. 1. and adjust the solution pH. and 100 ppm F. Discussions 4. decomplex fluoride. J. A linear correlation exists between the fluoride release and fluoride recharge capabilities (r2 ¼ 0:7088) as Fig..2-cyclohexylenedinitrolotetraacetic acid) (Thermo-Orion) was added to each solution.1. Fluoride released from the specimens was measured daily for a total of 21 days using a fluoride ion selective electrode (model 96-09. 2. The best fitting equations for each material and its parameters are displayed in Table 4.3 ml of TISAB III (Total ionic strength adjustment buffer) concentrate with CDTA (1.) with a crosshead speed of 1 mm/min. Before measurement. there are some exceptions for this trend. The instrument was calibrated each day with five standard fluoride solutions containing 0.0.0 (SPSS Inc.3.). Results The compressive strengths of fluoride-releasing materials are in Table 2 and displayed in Fig. 0. Each specimen was loaded in compression until failure using an Instron 4411 mechanical testing machine (Instron Co. The concentration (ppm) of each solution was directly read out on the instrument display and printed out on a 900A printer (Thermo-Orion). 7 demonstrates that a negative linear correlation exists between the compressive strengths and cumulative fluoride releases (correlation coefficient r2 ¼ 0:7741). see Discussion below) Figs. The selfcuring specimens were allowed to set in the mold between the glass slides. Figs. Xu. respectively. Table 3 lists the equations used in curve fitting. Fluoride recharge experiment Before recharge. The crosslinked polymer matrices in compomers and composite (typically copolymers of Bis-GMA. 2.2. One of the reasons is that the resin contents of each class of materials increase in the same trend. has a higher compressive strength than some of resin-modified glass ionomers (Vitremer and .X. The materials with the same group letter have no significant difference.7 ml of each sample solution was pipetted into a clean plastic test tube. The fluoride release profiles of the studied materials are shown in Figs.5. 5 and 6 display the cumulative fluoride releases of each material as a function of time and their best-fitted curves. Compressive strengths As we move across the continuum from glass ionomers and resin-modified glass ionomers.4. Thermo-Orion) and Orion 920A PH/ISE meter (Thermo-Orion). Fig. After curing. 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. However. 8 and 9 show the results of the fluoride recharge experiment. Compressive strength experiment The specimens (n ¼ 10) were stored under 37 C for 24 h. The linear regression and nonlinear curve fitting were performed using SigmaPlot 4. UEDMA and TEGMA) generally have higher strength and toughness than the gel network formed by acid– base reaction in glass ionomers. 1.

In addition. I A G. Calcium is the essential part of the glass filler particles in glass ionomers and resin-modified glass ionomers.0) 422 (35) 51 (2. F F.I. fluoroaluminosilicate glass is the major component of the filler in all fluoride-releasing materials in this study. 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. composite resins often contain hard.I.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. which are not present in glass . Xu. Burgess / Biomaterials 24 (2003) 2451–2461 2454 Table 2 Compressive strengths and cumulative fluoride release of fluoride releasing materials Materials Classification Compressive strength (Std. Compressive Strength (MPa) and Cumulative Fluoride Release (µg/cm2) 450 400 Compressive Strength 350 Cum. It initiates the reaction with the acids or polyacids to form crosslinked gel network.O. E A D C C E. H I a (22) (7.0 (2. As Table 1 shows. Resin modified G. 1. C C B B B. the relationship becomes complicated.I. mechanical properties generally increase with the increase of the filler load.) (MPa) Ducan groupinga (a ¼ 0:05) Cumulative fluoride release in 21 Days (Std. Compressive strengths and cumulative fluoride release (in 21 days) of fluoride-releasing materials. F Release 300 250 200 150 100 50 M ira c Ke le M ta c. The composition of the fillers may be more important. This partially contributes to the lower mechanical properties of glass ionomers and resin-modified glass ionomers.) (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. Dev.X.0) A B D D.6) 162 (11) 230 (11) 198 (14) 108 (8. J. Filler load and composition may have significant influence on the mechanical properties. 2 shows a poor correlation between the compressive strength and the filler wt% (r2 ¼ 0:2353). When comparing different type of materials. however. C D D E E F F E F 398 (32) 318 (47) 160 (10) 132 (75) 374 (6. For the same type of materials. Resin modified G. G H.2) 21 (1. Fig. Dev. H G.4) 80 (4. The Ca–Al–F–silicate glass fillers are more soluble and weaker than those fillers used in composites that do not contain calcium. insoluble silica (SiO2) particles. Photac-Fil). but resin-modified glass ionomers generally have higher toughness and better esthetics than conventional glass ionomers. 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.8) 51 (10) 8.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 .

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

Xu. Because fluoride releasing materials release reduced amounts of fluoride and other ions. Also based on the manufacturer’s information. Table 3 Equations describing the fluoride release kinetics Equation no. [21] have demonstrated that enamel demineralization decreased as fluoride release from a composite resin restorative material increased. 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. this question has not had a definite answer yet. 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. Dyract AP has higher fluoride release as well as higher compressive strength than Dyract [16. 4. For example. We believe that the more important effect of fluoride is remineralization of enamel and dentin. As a result. have been extensively studied. how much fluoride release from restorative materials is enough to inhibit recurrent or secondary caries? While important clinically. 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). Reducing the filler particle size can increase fluoride release because smaller particles have larger surface areas. J. 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. DeSchepper et al. Dijkman et al. Fluoride release profile of compomers and composite resins. 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. It not only releases high amount of fluoride. but also release calcium and phosphate ions. particularly glass ionomers and resin-modified glass ionomers. the authors concluded that a composite releasing 200–300 mg/cm2 fluoride over a 1-month period would completely inhibit secondary caries. 4. By extrapolating data.20] [21] [22] [24] [25] is more soluble under lower pH conditions.4 mm while Dyract AP has a mean particle size 0. No glass ionomers maintains its acidity for periods past 48 h. bacteria and plaque accumulate on the restorations. and several equations have been suggested to describe the cumulative fluoride release as a .3. A more detailed study of bactericidal effect and remineralization effect of fluoride is beyond the scope of this article.8 mm.17]. with time. Fluoride release kinetics The kinetics and mechanism of the fluoride release process of fluoride-releasing materials. 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. The question still remains however. Dyract has a mean particle size 2.O.X. Therefore the direct bactericidal effect of fluoride released from restorative materials is very limited and is due to combination of fluoride and acidity. Naturally occurring fluoride at concentrations as high as 21 mg/ml do not produce any obvious effects on the composition of supragingival plaque. [19] reported that 20 part per million.

9973767 1.4353 0.4054 0.380 5. 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.27 24.999967 2.5791 0. the better the fitting). The results are shown .465 107.9994285 0.984022 34.5616 0. (5) was best for compomers and composite resins.999417 3.47515 0.59 0.86127 3 Ariston r2 N 0.999595 10.999171 3.880 310.223 0.6195 0.2622 0. (5) Best eq.40 0.997925 12.999513 0.64 4.0286 0.996566 24.999630 8.999415 3.999410 3. The adequacy of these equations was determined based on the correlation coefficient (r2 ) and normalized residuals or norm (N).999931 1.999149 3. Tay [26] used Eq.49618 0.8471 0.999610 0.997139 7.33299 0.10 4. function of time [22–28].6169 0.4224 5 Solitaire r2 N 0.999002 7. 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.11 0.2466 0. r2 N 0.9989835 0.4101 3 Ketac-Molar r2 N 0.970003 1.082 456.999289 3. The authors used the SigmaPlot curve fitter (SPSS.996260 19.140 7.2836 0.9940878 7. J.121 7.998612 18.0432 0.53 5.940 188.28]. Xu.999733 2.0144 0.4747 3 Ketac-Silver r2 N 0. (2) Eq.1445 0.999770 5. (2) to describe the fluoride release of glass ionomers and resin-modified glass ionomers.11 0.999043 3.183217 0.7323 0.4161 0. Wilson and co-workers proposed the wellknown equation (No.19228 0.999477 3.815 28.23E-10 r2 is correlation coefficient and N is normalized residuals (norm) (The smaller the N.999497 6.999925 6.8505 0.824 2.999949 2.206 65.70 0.999280 12.999840 4.5167 0.70309 0.2897 3 Vitremer r2 N 0. Those equations are listed in Table 3.049 27.3705 0.20239 0.973497 23.) to apply these equations to the experimental data.183217 4.5651 3 Dyract AP r2 N 0.043 29.999839 1.745 63.03692 0.517 5.0021 0.5505 0.990834 11.999268 3. (4) was best for glass ionomers whether resinmodified or not. (3) Eq.998977 9.994528 100.9187 0. (4) Eq.987785 20.996690 20.786 2.92673 0.999474 5.932 29.10 0.997004 6.998988 7.993686 44.999610 0. 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.3357 2 Miracle Mix r2 N 0.033 1.999825 0.2059 0.63618 0.92 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 33.999127 3.90 11.230 0.5651 0.30] proposed Eqs.990956 13.6474 0.4603 0. which have been used by other researchers [23. (3)–(5) and used them to describe wide range of materials. Fuji IX 2 r N 0.03692 0.X.140 2.80407 0.62541 5 Hytac r2 N 0.088 29.995800 43.998871 9.2761 0.07 3 Compoglass r2 N 0.999800 7.980646 1.999327 3.5505 0.997444 22.564 3 Photac-Fil r2 N 0.90 0.4831 0.993989 31.5384 0. (1) Eq. 1 in Table 3).996717 16.999391 3.159 0.984465 6.996724 27.7071 0.4000 0. Verbeeck and co-workers [27.45 248.7053 0.3084 0.29.71985 0. The best values of r2 and N are displayed in bold.993 51.690 33.0106 0.999939 0.12328 3 Tetric Ceram r2 N 0.999890 1.649 22.990748 5.36055 0.86 0.998777 8.25 2.00 98.9993948 0.5764 0.9545 5 Surefil r2 N 0.656 0.997650 6.4200 5 Fuji II LC Imp.999750 19.997919 6.999248 11.999517 7.4388 0. whereas Eq.536 188. Co.654639 0.5129 0.999564 2.031 2.1174 5 F2000 r2 N 0.37E-08 11.996477 63.3045 0.984027 30.999945 3.82 29.999831 3.33299 0. They concluded [30] that Eq.O. 5 0.2339 0.

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

X. 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. Fluoride recharge profile of glass ionomers and resin-modified glass ionomers. 8. As mentioned above. This indicates that only a superficial part of the sample has been recharged due to a short recharge time (1 min). resinmodified glass ionomers. glass ionomers. J. In general. Burgess / Biomaterials 24 (2003) 2451–2461 a question. Correlation between compressive strength and fluoride release (excluding Ariston pHc). Ariston has been withdrawn from US market. . 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]. and some compomers can serve as a fluoride reservoir and have higher recharge capabilities while composite resins have little recharge abilities. However. However. This indicates that the material with higher initial fluoride release also has a higher fluoriderecharge capability. A linear correlation exists between the fluoride release and fluoride recharge capabilities (r2 ¼ 0:7088) as Fig. The porosity of the materials may have a great influence on the amount of fluoride released before and after recharge. If Ariston is included.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. 7. Materials with less resin content. some studies indicated that Ariston could not bond properly with adhesives and tooth structures [34]. Ariston is an exception. 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. 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. and resin-modified glass ionomers are not suitable clinically for load bearing area.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. such as glass ionomers and resin modified glass ionomers. Xu. 10 shows. Its clinic applicability remains 6.O. r =0. Recently. 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. have higher Cumulative Fluoride Release (µg/cm 2) 500 Experimental Value Linear Regression 2 Y=547-1. It releases a high amount of fluoride and also has a relatively high initial strength probably because of its alkaline glass filler.

Fluoride release from even the highest fluoride-releasing materials declines rapidly. In order to enhance the fluoride recharge capability without increasing porosity. Thus far. r =0. Frequent external application of neutral fluoride is necessary to maintain the high fluoride release and provide protection against future carious attacks. the polymer matrices that have fluoride exchange capability are highly desirable [35–38]. particularly in loadbearing areas. resin-modified glass ionomers seem to offer the best balance of fluoride release. storing in water for 2 months. Hytac).O. which does not contain soluble fluoride salt and therefore has improved mechanical properties. Fluoride recharge profile of compomers and composite resins. they may not be as durable clinically as lower fluoride-release materials.934+0. Voids are left after the fluoride salt leaches out. they exhibit higher fluoride recharge capabilities. it forms conglomerates. 10. Therefore. like Solitaire. Glass ionomers and resinmodified glass ionomers have higher porosity and thus lower strength than compomers and composite resins. Composite resin and some compomers (e. and clinical durability for the high-caries-risk patients although compomers continue to develop and have increased fluoride release and mechanical properties. 9.g. Correlation between fluoride release and recharge abilities. Materials that have high fluoride release. though mechanically stronger. Some composite resin.e. usually release only a small amount of fluoride.X. On the other hand. 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..7088 95% Confidence Level 30 25 20 15 10 5 7.056X. high porosity has adverse effects on the mechanical properties. Solitaire has recently been replaced by Solitaire 2. has initially high compressive strength and moderate fluoride release. Therefore. i. The probable reason is that this material contains soluble strontium fluoride (SrF2) salt. which cannot be dispersed homogeneously in the polymer matrix. Therefore. J. Fluoride Release in 3 days after Recharge (µg/cm2) 40 35 Experimental Value Linear Regression 2 Y=4. its mechanical properties are drastically deteriorated. Xu. recharge. high . porosity. Conclusions 0 0 100 200 300 400 500 2 Cumulative Fluoride Release in 21 days (µg/cm ) Fig. Our study shows that its strength decreased about 48% after Current restorative materials with a high fluoride release generally have lower mechanical properties.

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