The Effect of Glass-Ionomer Cement on Carious Dentine: An in vivo Study

Abstract

The effect of a glass-ionomer cement sealant on carious dentine was investigated clinically and bacteriologically. The study group consisted of 24 molar teeth, with small clinical visible occlusal dentine lesions, in 13 children (aged 7–18 years). Twenty of these molars were filled and sealed with a glass-ionomer cement (Fuji Ionomer Type III®) and 4 with a resin sealant (Delton®). From each molar, two dentine samples were collected aseptically with a time interval of 7 months. The first sample was taken after opening the lesion just beneath the dentino-enamel junction before application of the filling material (sample A), and the second beneath the removed filling material (sample B) 7 months later. Before collecting sample B the sealant was clinically evaluated and impressions were prepared in order to (re)evaluate the sealants later by scanning electron microscopy (SEM). After taking the second sample, the remaining fissures were opened to a standard depth, the caries which was still present was removed, and a composite resin restoration was applied. In all teeth, more glass-ionomer cement material was found by SEM compared to the clinical evaluation. In both the glass-ionomer- and the resin sealant-treated group, the median value of the total number of microorganisms (CFU) on blood agar was 100 times smaller in the B sample. Microorganisms were found in 90% of the B samples in the group treated with glass-ionomer cement; hard dentine was also found in 45% of the B samples from this group. No significant differences were found between the groups in terms of dentine colour, hardness, or numbers and types of microorganisms (Fisher’s exact test, p > 0.05). There appears to be some evidence of an effect by glass-ionomer cement on the consistency of remaining carious dentine. However, it would be premature to conclude from the results obtained in this study that complete removal of carious dentine need not be carried out when using glass-ionomer cement.

Atraumatic Restorative Treatment: Clinical, Ultrastructural and Chemical Analysis

“…Concerning the GIC, its antimicrobial effect, mainly attributed to the fluoride release, probably contributed significantly to arrest caries progression [Benelli et al, 1993;Weerheijm et al, 1993;Bertacchini et al, 1999;Francci et al, 1999]. On the other hand, its physicochemical bonding to dentin could have inhibited bacterial percolation through the tooth/restoration interface [Dionysopoulos et al, 1994;ten Cate and van Duinen, 1995;ten Cate et al, 1995;Mertz-Fairhurst et al, 1995;Francci et al, 1999].…”

Adhesive restorative materials: A review

“…[36][37][38][39][40][41][42] Clinical studies have shown an effect of GIC on salivary fluoride levels, 43 acidogenic bacteria 44 and on demineralized dentine restored with GIC and worn in removable appliances. 45 There is anecdotal clinical evidence that secondary caries in association with GIC is at a very low level. This has been supported by one retrospective study, 46 but significantly contradicted by a cross-sectional study, 47 and one five-year prospective study was inconclusive.…”

Antibacterial Activity and Physical Properties of Glass-ionomer Cements Containing Antibiotics

“…3 During the ART procedures, dental hand instruments alone do not remove carious dentin as effectively as rotary burs, and cariogenic bacteria can survive remaining under restorations. [4][5][6] The caries process may progress in the course of time and cause failure of the restoration. 7 This problem may be solved with the use of dental materials that inhibit bacterial growth.…”