The interaction of polyacid-modified composite resins ("compomers") with aqueous fluoride solutions

OBJECTIVE: The aim of this study was to investigate how the release of fluoride from two compomers and a fluoridated composite resin was affected by exposure to KF solution. MATERIAL AND METHODS: Two compomers (Dyract AP and Compoglass F) and one fluoridated composite (Wave) were prepared as discs (6 mm diameter and 2 mm thick), curing with a standard dental lamp. They were then stored in either water or 0.5% KF for 1 week, followed by placement in water for periods of 1 week up to 5 weeks total. Fluoride was determined with and without TISAB (to allow complexed and decomplexed fluoride to be determined), and other ion release (Na, Ca, Al, Si, P) was determined by ICP-OES. RESULTS: Specimens were found not to take up fluoride from 100 ppm KF solution in 24 h, but to release additional fluoride when stored for up to five weeks. Compomers released more fluoride cumulatively following exposure to KF solution (p<0.001), all of which was decomplexed, though initial (1 week) values were not statistically significant for Dyract AP. Other ions showed no variations in release over 1 week, regardless of whether the specimens were exposed to KF. Unlike the compomers, Wave showed no change in fluoride release as a result of exposure to KF. CONCLUSIONS: Compomers are affected by KF solution, and release more fluoride (but not other ions) after exposure than if stored in water.

Water sorption/desorption in polyacid-modified composite resins for dentistry

The water sorption and desorption behaviour of three commercial polyacid-modified composite resins used in clinical dentistry have been studied in detail. Cured specimens of each material were subjected to two successive water uptake cycles in an atmosphere of 93% relative humidity, with one intervening desorption cycle in a desiccating atmosphere over concentrated sulfuric acid. Specimens were found to absorb and desorb water according Fick's law until Mt/M(infinity) values of approximately 0.5. Diffusion rates for uptake varied between cycles, ranging from 2.37-4.53 x 10(-9 )cm(2) s(-1) for 1st cycle to 0.85-2.72 x 10(-8 )cm(2 )s(-1) for 2nd cycle. Desorption rates were similar to those for 2nd cycle sorption, and ranged from 0.86 to 5.47 x 10(-8 )cm(2 )s(-1). Equilibration times for 1st cycle water uptake were greater than for 2nd cycle sorption and for desorption and overall the behaviour of polyacid-modified composites in a high humidity atmosphere was similar to that of conventional composites in water. It is concluded that the hydrophilic components of the former do not bring about an enhanced rate of water transport.

Polyacid-modified composite resins ("compomers") and their use in clinical dentistry

OBJECTIVES: This paper describes the chemistry and properties of polyacid-modified composite resins ("compomers") designed for use in clinical dentistry, and reviews the literature in this area. METHODS: Information has been obtained from over 50 published articles appearing in the dental and biomaterials literature, with studies being principally identified through MedLine. RESULTS: Published work shows that polyacid-modified composite resins constitute a discrete class of polymeric repair material for use in dentistry. Their distinction is that they contain hydrophilic components, and these cause water to be drawn into the material following cure. This triggers an acid-base reaction, and gives the materials certain clinically-desirable properties (fluoride release, buffering capability) that are also associated with glass-ionomer cements. The water uptake leads to a decline in certain, though not all, physical properties. However, clinical studies have shown these materials to perform acceptably in a variety of applications (Class I, Class II and Class V cavities, as fissure sealants and as orthodontic band cements), especially in children's teeth. CONCLUSIONS/SIGNIFICANCE: Polyacid-modified composite resins constitute a versatile class of dental repair material, whose bioactivity confers clinical advantages, and which are particularly useful in children's dentistry.

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.

A revised classification for direct tooth-colored restorative materials

Composite resins and glass-ionomer cements were introduced to dentistry in the 1960s and 1970s, respectively. Since then, there has been a series of modifications to both materials as well as the development other groups claiming intermediate characteristics between the two. The result is a confusion of materials leading to selection problems. While both materials are tooth-colored, there is a considerable difference in their properties, and it is important that each is used in the appropriate situation. Composite resin materials are esthetic and now show acceptable physical strength and wear resistance. However, they are hydrophobic, and therefore more difficult to handle in the oral environment, and cannot support ion migration. Also, the problems of gaining long-term adhesion to dentin have yet to be overcome. On the other hand, glass ionomers are water-based and therefore have the potential for ion migration, both inward and outward from the restoration, leading to a number of advantages. However, they lack the physical properties required for use in load-bearing areas. A logical classification designed to differentiate the materials was first published by McLean et al in 1994, but in the last 15 years, both types of material have undergone further research and modification. This paper is designed to bring the classification up to date so that the operator can make a suitable, evidence-based, choice when selecting a material for any given situation.