Ion release by endodontic grade glass-ionomer cement

Cylindrical specimens (6 mm high x 4 mm diameter) of the endodontic grade glass-ionomer (Ketac Endo) were exposed to various media for 1 week, after which changes in their mass, pH of storage medium, and ion release were determined. In water, this cement was shown to release reasonable amounts of sodium, aluminium and silicon, together with smaller amounts of calcium and phosphorus, as well as taking up 2.41% by mass of water. A comparison with the restorative grade materials (Ketac Molar, ex 3M ESPE and Fuji IX, ex GC) showed both ion release and water uptake to be greater. All three cements shifted pH from 7 to around 6 with no significant differences between them. Other storage media were found to alter the pattern of ion release. Lactic acid caused an increase, whereas both saturated calcium hydroxide and 0.6% sodium hypochlorite, caused decreases. This suppression of ion-release may be significant clinically. Aluminium is the most potentially hazardous of the ions involved but amounts released were low compared with levels previously reported to show biological damage.

Kinetic studies of the effect of varnish on water loss by glass-ionomer cements

OBJECTIVES: This paper reports a study of the water loss behaviour of two commercial glass-ionomer cements coated with varnishes. METHODS: For each cement (Fuji IX Fast or Chemflex), specimens (6mmdiameterx2mm depth) were prepared and cured for 10min at 37 degrees C. They were exposed to a desiccating environment over H(2)SO(4) either uncoated or coated with the appropriate varnish (Fuji Varnish, a solvent-based lacquer, or Fuji Coat, a light-cured varnish). Four specimens were prepared for each material. They were weighed at hourly intervals for 6h, daily for up to 5 days, then weekly thereafter until equilibration. RESULTS: Unlike the uncoated specimens, water loss from varnished cements was not Fickian, but followed the form: mass loss=A/t+B, where t is time, A and B are constants specific to each cement/varnish combination. A varied from 1.22 to 1.30 (mean 1.26, standard deviation 0.04), whereas B varied from 1.54 to 2.09 (mean -1.83, standard deviation 0.29). At equilibrium, varnished specimens lost much less water than unvarnished ones (p>0.01) but there was no significant difference between the solvent-based and the light-cured varnishes. SIGNIFICANCE: Varnishes protect immature glass-ionomer cements from drying out by altering the mechanism of water loss. This slows the rate of drying but does not necessarily change the total amount of water retained. It confirms that, in clinical use, glass-ionomer restoratives should be varnished to allow them to mature satisfactorily.

Fluoride-releasing composite resins

This paper reviews the literature on fluoride-releasing composite resins. These materials have been available for several years, with fluoride release being achieved by adding soluble or sparingly soluble fluoride salts to the formulation. However, this has been shown to lead to a gradual reduction in the mechanical properties. These materials are also unable to undergo "fluoride recharge". Experimental fluoride-releasing composites have been prepared which supply fluoride by alternative mechanisms that do have the potential for fluoride recharge but, so far, these materials have not been made available for use in patients. Fluoride-releasing composite resins have been shown to be effective in preventing secondary caries in vitro. They have also been shown to reduce the size and depth of carious lesions. However, information on their clinical effectiveness is limited and the paper concludes that there is an urgent need for research on this topic.

Water transport in zinc oxy-chloride cements

The water uptake and water loss behaviour in three different formulations of zinc oxy-chloride cement have been studied in detail. Specimens of each material were subjected to a high humidity atmosphere (93% RH) over saturated aqueous sodium sulfate, and a low humidity desiccating atmosphere over concentrated sulfuric acid. In high humidity, the cement formulated from the nominal 75% ZnCl2 solutions gained mass, eventually becoming too sticky to weigh further. The specimens at 25% and 50% ZnCl2 by contrast lost mass by a diffusion process, though by 1 week the 50% cement had stated to gain mass and was also too sticky to weigh. In low humidity, all three cements lost mass, again by a diffusion process. Both water gain and water loss followed Fick's law for a considerable time. In the case of water loss under desiccating conditions, this corresponded to values of Mt/MĄ well above 0.5. However, plots did not go through the origin, showing that there was an induction period before true diffusion began. Diffusion coefficients varied from 1.56 x 10-5 (75% ZnCl2) to 2.75 x 10-5 cm2/s (50% ZnCl2), and appeared to be influenced not simply by composition. The drying of the 25% and 50% ZnCl2 cements in high humidity conditions occurred at a much lower rate, with a value of D of 2.5 x 10-8 cm2/s for the 25% ZnCl2 cement. This cement was found to equilibrate slowly, but total water loss did not differ significantly from that of the cements stored under desiccating conditions. Equilibration times for water loss in desiccating conditions were of the order of 2-4 hours, depending on ZnCl2 content; equilibrium water losses were respectively 28.8 [25% ZnCl2], 16.2 [50%] and 12.4 [75%] which followed the order of ZnCl2 content. It is concluded that the water transport processes are strongly influenced by the ZnCl2 content of the cement.

Fluoridation for dental public health

This article reviews the means by which fluoride is supplied to populations. Many public health authorities provide fluoridated drinking water, with typical concentrations of fluoride of between 0.5 and 1.0 ppm. This has been found to be safe and effective, though differences in caries incidence between fluoridated and non-fluoridated regions are less than they were 50 years ago, because of the wider availability of fluoridated products to the whole population. Concerns about the effect of fluoride on bone density and associated conditions are reviewed and the general conclusion from considering the literature on fluoride is that there is almost no cause for concern. Alternatives to water as a means of delivering fluoride to the general public that are being used in a number of countries are salt and milk. These alternatives are also reviewed and have been shown to give satisfactory levels of protection against caries, though milk is shown to be less satisfactory than water as a vehicle for fluoride delivery. Milk is also less effective in providing fluoride to individuals in the population, and is less likely to be consumed by people in lower socio-economic groups, precisely those who suffer most from dental caries. This study concludes that mass water fluoridation remains an important contribution to good oral health throughout the community.