A Scanning Electron Microscope Evaluation of the Efficacy of Different Fluoride-releasing Dental Restorative Materials to Prevent Enamel Demineralization: An In Vitro Study
Kiran M Dhananjaya, Mrinmoy Chakraborty, Garima Sinha, Tanya Verma, Saikat Deb
Citation Information :
Dhananjaya KM, Chakraborty M, Sinha G, Verma T, Deb S. A Scanning Electron Microscope Evaluation of the Efficacy of Different Fluoride-releasing Dental Restorative Materials to Prevent Enamel Demineralization: An In Vitro Study. J Contemp Dent Pract 2021; 22 (11):1292-1296.
Aim: Aim of the present research was to investigate the effectiveness of various fluoride-releasing dental restorative agents in preventing demineralization of enamel.
Materials and methods: Eighty human mandibular permanent molar teeth constituted the study group. All samples were subjected to storage in thymol, after which they were taken out to prepare alike proximal box in each. Inductions of artificial enamel surface lesions were done by placing the teeth in demineralizing solution for 96 hours. Subsequently, all 80 molars were randomly assigned to any of the four groups (i.e., 20 in every individual group) according to the restoration as group A: giomer (composite resin containing surface pre-reacted glass-ionomer fillers), group B: compomer (polyacid-modified composite resin), group C: resin-modified glass-ionomer cement (RMGIC), group D: fluoride-releasing composite. After this, the pH cycling was performed, and the samples were subjected to examination beneath scanning electron microscope (SEM).
Results: Higher mean areas of remineralization were noted when RMGIC (96.34 ± 0.06) was used followed by the compomer (109.52 ± 0.17), giomer (118.39 ± 0.82), and the fluoride-releasing composite group (129.27 ± 0.31) in that order. A statistically significant difference was seen amid the investigational groups that utilized different restorative agents (p <0.001). A pairwise evaluation that was performed revealed that except for the giomer group and the compomer group, a statistically significant difference (p <0.001) was found among the experimental groups.
Conclusion: This research infers that the RMGIC-treated samples exhibited significantly superior performance in preventing enamel demineralization in comparison to compomer, giomer as well as fluoride-releasing composites.
Clinical significance: One among the highly frequently employed anticariogenic materials is fluorides. Owing to this characteristic, they are integrated into numerous restorative substances. Nevertheless, the quantity and speed of fluoride release differ in different agents, which translates to the efficacy of the restorative agent in avoiding demineralization about the restoration.
Ten Cate JM. Contemporary perspective on the use of fluoride products in caries prevention. Br Dent J 2013;214(4):161–167. DOI: 10.1038/sj.bdj.2013.162.
Lamont RJ, Egland PG. Dental caries. In: Molecular medical microbiology. 2nd ed. Academic Press; 2015. p. 945–955. Available from: https://www.elsevier.com/books/molecular-medical-microbiology/tang/978-0-12-397169-2.
Evans CA, Kleinman DV, The surgeon general's report on America's oral health: opportunities for the dental profession. J Am Dent Assoc 2000;131(12):1721–1728. DOI: 10.14219/jada.archive.2000.0118.
Savarino L, Breschi L, Tedaldi M, et al. Ability of restorative and flouride releasing materials to prevent marginal dentine demineralization. Biomaterials 2004;25(6):1011–1017. DOI: 10.1016/s0142-9612(03)00628-8.
Gjorgievska E, Nicholson WJ, Iljovska S, et al. The potential of fluoride-releasing dental restoratives to inhibit enamel demineralization: an SEM study. Prilozi 2009;30(1):191–204. PMID: 19736541.
Joshi C, Gohil U, Parekh V, et al. Comparative evaluation of the remineralizing potential of commercially available agents on artificially demineralized human enamel: an in vitro study. Contemp Clin Dent 2019;10(4):605–613. DOI: 10.4103/ccd.ccd_679_18.
Chandru TP, Yahiya MB, Peedikayil FC, et al. Comparative evaluation of three different toothpastes on remineralization potential of initial enamel lesions: a scanning electron microscopic study. Indian J Dent Res 2020;31(2):217–223. DOI: 10.4103/ijdr.IJDR_745_18.
Freedman R, Diefenderfer KE. Effects of daily fluoride exposures on fluoride release by glass ionomer-based restoratives. Oper Dent 2003;28(2):178–185. PMID: 12670074.
Yli-Urpo H, Vallittu PK, Narhi TO, et al. Release of silica, calcium, phosphorus and fluoride from glass ionomer cement containing bioactive glass. J Biomater Appl 2004;19(1):5–20. DOI: 10.1177/0085328204044538.
Hayacibara MF, Ambrozano GM, Cury JA. Simultaneous release of fluoride and aluminum from dental materials in various immersion media. Oper Dent 2004;29(1):16–22. PMID: 14753327.
Ulukapi H, Benderli Y, Soyman M. Determination of fluoride release from light–cured glass-ionomers and a fluoridated composite resin from the viewpoint of curing time. J Oral Rehabil 1996;23(3):197–201. DOI: 10.1111/j.1365-2842.1996.tb01233.x.
Baliga MS, Bhat SS. Effect of fluorides from various restorative materials on remineralization of adjacent tooth: an in vitro study. J Indian Soc Pedod Prev Dent 2010;28(2):84–90. DOI: 10.4103/0970-4388.66742.
Dionysopoulos P, Kotsanos N, Koliniotou-Koubia, et al. Secondary caries formation in vitro around fluoride releasing restorations. Oper Dent 1994;19(5):183–188. PMID: 8700758.
Temin SC, Csuros Z, Mellberg JR. Fluoride uptake from a composite restorative by enamel. Dent Mater 1989;5(1):64–65. DOI: 10.1016/0109-5641(89)90096-1.
Wiegand A, Buchalla W, Attin T. Review on fluoridereleasing restorative materials–fluoride release and uptake characteristics, antibacterial activity and influence on caries formation. Dent Mater 2007;23(3):343362. DOI: 10.1016/j.dental.2006.01.022.
Preston AJ, Agalamanyi EA, Higham SM, et al. The recharge of esthetic dental restorative materials with fluoride in vitro two years’ results. Dent Mater 2003;19(1):32–37. DOI: 10.1016/s0109-5641(02)00011-8.
Takahashi K, Emilson CG, Birkhed D. Fluoride release in vitro from various glass ionomer cements and resin composites after exposure to NaF solutions. Dent Mater 1993;9 (6):350–354. DOI: 10.1016/0109-5641(93)90055-u.
Albers HF. Resin ionomers. In: Tooth coloured restoratives: principles and techniques. 9th ed. BC Decker Inc; 2002. p. 57–67. Available from: https://www.worldcat.org/title/tooth-colored-restoratives-principles-and-techniques/oclc/48417407.
Dionysopoulos D, Koliniotou-Koumpia E, Helvatzoglou-Antoniades M, Kotsanos N. In vitro inhibition of enamel demineralisation by fluoride-releasing restorative materials and dental adhesives. Oral Health Prev Dent 2016;14(4):371–380. DOI: 10.3290/j.ohpd.a35747.
Ikemura K, Tay FR, Kouro Y, et al. Optimizing filler content in an adhesive system containing pre-reacted glass-ionomer fillers. Dent Mater 2003;19(2):137–146. DOI: 10.1016/s0109-5641(02) 00022-2.
Tantbirojn D, Douglas WH, Versluis A. Inhibitive effect of a resin-modified glass ionomer cement on remote enamel artificial caries. Caries Res 1997;31(4):275–280. DOI: 10.1159/000262411.
Ferracane JL, Mitchem JC, Adey JD. Fluoride penetration into the hybrid layer from a dentin adhesive. Am J Dent 1998;11(1):23–28. PMID: 9823082.
Yip HK, Smales RJ. Fluoride release from a polyacid-modified resin composite and 3 resin-modified glass-ionomer materials. Quintessence Int 2000;31(4):261–266. PMID: 11203934.