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Department of Biomaterials and Experimental Dentistry, University of Medical Sciences, ul Bukowska 70,
Poland
60-812 Poznan,
b School of Sport, Health & Applied Science, St Marys University College, Twickenham, Middlesex TW1 4SX,
United Kingdom
a r t i c l e
i n f o
a b s t r a c t
Article history:
Objective. To study the interfaces between model cavities prepared in teeth and four glass
Methods. Ten non-cavitated molars and premolars were used and, in each, two 3 mm deep
9 October 2013
slot preparations were created on opposing sides of the tooth. The teeth were conditioned as
appropriate, then restored using the open sandwich technique, using a conventional glass
ionomer (Fuji IX, Ketac Molar) or resin modied glass ionomer (Fuji II LC or N100), followed
by completion with composite resin. The teeth were then embedded in a transparent acrylic
Keywords:
resin and cut parallel to the long axis through both restorations, using a low speed diamond
Glass-ionomer
wheel saw. Samples were evaluated using a metallographic light microscope (100). Three
Bonding
areas were assessed: the axial wall, the axial gingival line angle and the cavo-surface line
Adhesion
angle. Bonding was categorized as inadequate or adequate based on the appearance and
Tooth fracture
inadequate bonding was further studied and classied. Data were analysed statistically
using the McNamara analysis.
Results. The majority of materials failed to make adequate contact with the axial wall, and
there were also aws at the axial/gingival line angle in several samples. By contrast, the cavosurface line angle was generally soundly lled and the materials showed intimate contact
with the tooth surface in this region. The most serious inadequacy, though, was not lack of
intimate contact and/or adhesive bond, but the presence of perpendicular cracks in 30% of
the Fuji II LC samples which extended into the underlying dentin.
Signicance. The problems of placement and dentin cracking experienced with these materials demonstrate that adhesive bond strength alone cannot be used as the criterion of success
for restorative materials. In fact good adhesion can, in certain cases, promote cracking of
the dentin due to stresses within the material, an outcome which is undesirable.
2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
Corresponding author.
E-mail address: john.nicholson@smuc.ac.uk (J.W. Nicholson).
http://dx.doi.org/10.1016/j.dental.2014.05.008
0109-5641/ 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
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1.
d e n t a l m a t e r i a l s 3 0 ( 2 0 1 4 ) e301e305
Introduction
Manufacturer
Fuji IX
Fuji II LC
Ketac Molar
N100
GC (Japan)
GC (Japan)
3M ESPE (USA & Germany)
3M ESPE (USA & Germany)
Type
Conventional
RMGIC
Conventional
RMGIC (nano-ionomer)
2.
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d e n t a l m a t e r i a l s 3 0 ( 2 0 1 4 ) e301e305
round bur (ISO 806 314 001 524 016, Lot D-5113 at 280 000 RPM)
and a high speed rose bur (ISO 500 314 001 001 016, Lot D434040 at 280 000 RPM). The depth of each preparation was
3 mm, (the gingival wall of the box is designed so it extends
1 mm below the cervical line of the tooth, into the root). Following cavity preparation, the teeth were stored in saline solution
at a temperature of 8 C for 7 days.
The ten teeth were divided, at random, into two groups:
Group A (prepared using the two 3M ESPE products) and Group
B (the GC products). In each group, one slot in a particular tooth was lled with conventional glass ionomer cement
(Ketac Molar or Fuji IX) and the other slot in the same tooth
was lled with resin modied glass ionomer (N100 or Fuji II
LC). Materials used are listed in Table 1.
Having prepared the tooth, the material was placed in a
thin layer along the axial wall and gingival oor of the cavity
preparation, after which the lling of the cavity was completed
by placement of composite material. In this way, four different
sample groups were compared for their ability to bind to tooth
structure.
The cavities designated for conventional glass ionomer
samples were conditioned for 10 s prior to restoration with 20%
polyacrylic acid, followed by a 10 s water rinse and drying with
cotton pellets. The glass ionomer cements were mixed according to the manufacturers instructions, in a 1:1 powder to liquid
ratio and condensed into the cavity to a depth of 1 mm on both
axial and gingival walls. The cement was allowed to set for
5 min after which the cavity was etched, primed, bonded then
restored with composite resin (Filtek Z250, ex 3M; shade A2).
The resin modied glass ionomer slot for Group A (N100)
was primed with Ketac N100 primer for 15 s, air thinned for
10 s and light cured for 10 s. The resin modied glass ionomer
was dispensed using the Ketac Clicker dispenser and mixed for
20 s, followed by placement into the cavity (using the dispenser
provided by 3M), along axial and pulpal walls to a thickness
of 1 mm, followed by light curing. For group B, the dentin
was conditioned with 20% polyacrylic acid for 10 s, rinsed
with water for 10 s and cotton dried. The resin-modied glass
ionomer (Fuji II LC) was mixed on a glass slab and placed using
a plugger, followed by light curing for 20 s. Lastly, the cavity
was etched, prime and bonded and restored with composite
resin as for Group A.
Following restoration, each group was stored in saline solution in a tightly sealed container for 1 week, at a temperature
of 37 C. The teeth were then embedded in a transparent
acrylic resin (Duracryl) and were cut parallel to the long axis
of the tooth, through both restorations, using a low speed diamond wheel saw (model 650). Each tooth yielded two slices,
which were polished prior to microscopic evaluation. Samples
were then evaluated using a metallographic light microscope
(Nikon Eclipse LV 100) under a magnication of 100. In each
tooth, there were three areas of observation: the axial wall (A),
the axial gingival line angle (B) and the cavo-surface line angle
(C) (see Fig. 1).
In the initial assessment, bonding was categorized as inadequate or adequate based on the appearance of the region
between the dentin and glass ionomer cement. Inadequate
bonding was further studied, and details of the inadequacies
recorded. Data were further analysed statistically using the
McNamara analysis.
Adequate
(out of 30)
Inadequate
(out of 30)
Fuji IX GIC
Fuji II RMGIC
Ketac Molar GIC
N100 RMGIC
18/30 = 60%
21/30 = 70%
14/30 = 47%
15/30 = 50%
12/30 = 40%
9/30 = 30%
16/30 = 53%
15/30 = 50%
3.
Results
4.
Discussion
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d e n t a l m a t e r i a l s 3 0 ( 2 0 1 4 ) e301e305
Table 3 Inadequate bonding of material to tooth structure according to location and type of inadequacy.
Material
Detachment
(interfacial failure)
Fuji IX
Fuji II LC
Ketac Molar
N100
7/12 = 58%
0
6/16 = 38%
8/15 = 53%
Transverse crack
within glass ionomer
Detach + T-crack
3/12 = 25%
3/9 = 33%
0
4/15 = 27%
2/12 = 17%
1/9 = 11%
10/16 = 63%
3/15 = 20%
0
5/9 = 56%
0
0
Table 4 Number of adequate (A) and inadequate (I) bonding sites according to location within the cavity preparation.
Location
Axial wall
Axial/gingival line-angle
Cavo-surface line-angle
Fuji IX
Fuji II LC
Ketac Molar
N100
4
5
9
6
5
1
4
7
10
6
3
0
1
4
9
9
6
1
3
6
6
7
4
4
5.
Conclusions
This study has shown that the use of glass ionomer materials,
both conventional and resin-modied, for the repair of model
cavities using sandwich technique is very satisfactory in the
majority of cases. However it has been shown to be capable
of leading to problems of adhesion. In a number of instances,
there were problems in establishing contact between the
material and the furthest axial wall of the cavity, which may
arise from problems in handling the placement of a thin layer
of unset cement. In addition, for one of the resin-modied
glass ionomers (Fuji II LC), in a small but important proportion
of the samples (16%), the material caused a perpendicular
d e n t a l m a t e r i a l s 3 0 ( 2 0 1 4 ) e301e305
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