Fluoride exchange by glass-ionomer dental cements and its clinical effects: a review

Abstract

The topic of fluoride release and uptake by glass-ionomer (glass polyalkenoate) dental cements is reviewed. The study was based on a literature search carried out using PubMed. The main key words used were glass-ionomer and fluoride , and further refinements were made by adding the keywords anti-microbial , anti-caries and remineralization . Papers were selected from the initial search, which concentrated on fundamental aspects of fluoride release, including kinetics and the influence of the cement composition, and resulting clinical performance against caries. Other relevant papers were cited where they added useful and relevant data. From these published papers, it was possible to explain the detailed mechanism of fluoride release by glass-ionomer cements and also its uptake. Fluoride release has been shown to be a two-step process. In neutral solutions, the steps can be divided into early wash-out and long-term diffusion. In acid conditions, the early wash-out remains, though with greater amounts of fluoride released, and the long-term release becomes one of slow dissolution. The effect of fluoride on the viability of oral micro-organisms has been described, and glass-ionomers have been shown to release sufficient fluoride to reduce the size and viability of adjacent populations of oral bacteria. The effect of low levels of fluoride on the remineralization of tooth tissue has been considered. Levels needed to increase remineralization are much lower than those needed to adversely affect oral bacteria, from which we conclude that glass-ionomers release sufficient fluoride to promote remineralization. Despite this, there remains uncertainty about their overall contribution to sound oral health, given the widespread use of other sources of fluoride, such as toothpastes.

Evaluation of setting kinetics, mechanical strength, ion release, and cytotoxicity of high-strength glass ionomer cement contained elastomeric micelles

“…This was in accordance with a previous study [ 52 ] and a consensus that ranked EF and F9 as the first and third materials of choice among conventional GICs for long-term restorative materials [ 53 ]. The level of fluoride release was governed by several key factors, such as the composition of the glass, the porosity and solubility of materials, the molecular weight of a polyacid, and the powder-to-liquid ratio [ 35 , 54 , 55 ]. EDX analysis of the powder phase showed that EF and F9 contained higher levels of fluoride compared with other materials., which may partly explain the higher level of fluoride release observed with EF and F9.…”

“…It was, however, suggested that fluoride at a concentration of 0.03–0.7 ppm could inhibit mineral loss and enhance remineralization in dentin [ 10 ]. This may be associated with the reduction of S. mutans and inhibits the bacteria from metabolizing carbohydrates [ 55 , 61 ]. Furthermore, all tested materials provided elemental release other than fluoride, such as Al, Sr, and P. A high level of elemental release was generally observed in EF.…”

Mechanical Properties and Ion Release from Fibre-Reinforced Glass Ionomer Cement

“…Two distinct factors seem to be critical for the clinical efficacy of GIC materials: the release of ions [ 14 ] and the mechanical properties [ 15 ]. Although the minimum local concentration of fluoride release required to inhibit the progression of caries has not been determined, reinforcement with various particles alters the composition of GIC and may affect the potential for ion release [ 16 ].…”

A Comprehensive Evaluation of Zirconia-Reinforced Glass Ionomer Cement’s Effectiveness in Dental Caries: A Systematic Review and Network Meta-Analysis

“…Dental cements represent restorative materials composed of small biomolecules that demonstrate biocompatibility and contribute positively to tooth structure. These materials ideally possess qualities such as tooth adhesion, antimicrobial attributes, and resilience against masticatory forces during normal function and parafunction [ 5 ]. Glass ionomer cement (GIC), also known as “polyalkenoate cement”, is among the earliest dental cements with the unique attributes of fluoride release and adherence to tooth structure [ 6 , 7 ].…”