Effects of a bleaching agent on properties of commercial glass-ionomer cements

Fernanda Lúcia Lago de Camargo; Ailla Carla Lancellotti; Adriano Fonseca de Lima; Vinícius Rangel Geraldo Martins; Luciano de Souza Gonçalves

doi:10.5395/rde.2018.43.e32

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Camargo, Lancellotti, Lima, Martins, and Gonçalves: Effects of a bleaching agent on properties of commercial glass-ionomer cements

Research Article

Restor Dent Endod 2018;43(3):e32.

Published online: 4 August 2018

DOI: https://doi.org/10.5395/rde.2018.43.e32

Effects of a bleaching agent on properties of commercial glass-ionomer cements

Fernanda Lúcia Lago de Camargo¹, Ailla Carla Lancellotti², Adriano Fonseca de Lima³, Vinícius Rangel Geraldo Martins⁴, Luciano de Souza Gonçalves^5,^*

¹Department of Restorative Dentistry, Integrated School of Carajás School of Dentistry, Redenção, PA, Brazil

²Department of Restorative Dentistry, Piracicaba Dental School, Piracicaba, SP, Brazil

³Department of Restorative Dentistry, Paulista University School of Dentistry, São Paulo, SP, Brazil

⁴Department of Restorative Dentistry, Uberaba University School of Dentistry, Uberaba, MG, Brazil

⁵Department of Conservative Dentistry, Federal University of Rio Grande do Sul School of Dentistry, Porto Alegre, RS, Brazil

^*Correspondence to Luciano de Souza Gonçalves, DDS, MSc, PhD Adjunct Professor, Department of Conservative Dentistry, Federal University of Rio Grande do Sul School of Dentistry, Rua Ramiro Barcelos, 2492, Porto Alegre, RS 90035003, Brazil. E-mail: goncalves1976@yahoo.com.br

Received 13 March 2018 Accepted 26 May 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This study evaluated the effects of a bleaching agent on the composition, mechanical properties, and surface topography of 6 conventional glass-ionomer cements (GICs) and one resin-modified GIC.

Materials and Methods

For 3 days, the specimens were subjected to three 20-minute applications of a 37% H₂ O₂-based bleaching agent and evaluated for water uptake (WTK), weight loss (WL), compressive strength (CS), and Knoop hardness number (KHN). Changes in surface topography and chemical element distribution were also analyzed by energy-dispersive X-ray spectroscopy and scanning electron microscopy. For statistical evaluation, the Kruskal-Wallis and Wilcoxon paired tests (ɑ = 0.05) were used to evaluate WTK and WL. CS specimens were subjected to 2-way analysis of variance (ANOVA) and the Tukey post hoc test (α = 0.05), and KH was evaluated by one-way ANOVA, the Holm-Sidak post hoc test (ɑ = 0.05), and the t-test for independent samples (ɑ = 0.05).

Results

The bleaching agent increased the WTK of Maxxion R, but did not affect the WL of any GICs. It had various effects on the CS, KHN, surface topography, and the chemical element distribution of the GICs.

Conclusions

The bleaching agent with 37% H₂ O₂ affected the mechanical and surface properties of GICs. The extent of the changes seemed to be dependent on exposure time and cement composition.

Keywords: Dental materials, Glass-ionomer cement, Tooth whitening agents

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Figure 1.

Scanning electron microscopic images of glass-ionomer cements (×2,000): (A) Ketac Cem, (B) Ketac Molar, (C) Maxxion R, (D) Vitremer, (E) Vitro Fil, (F) Vitro Molar, and (G) Vidrion R. In the first column are shown the untreated specimens, followed by the treated groups, including the first (′), second (′′), and third (′′′) sessions, after 24, 48, and 72 hours, respectively.

Table 1.

Glass-ionomer cements (GICs) evaluated in the present study

GIC/batch No.	Composition^*	Manufacturer	P/L ratio	Mixing time (sec)
Ketac Molar EasyMix/56908	Powder: glass powder, polycarboxylic acid, pigments Liquid: water, tartaric acid, conservation agents	3M ESPE, St. Paul, MN, USA	1/1	60
Ketac Cem Easy Mix/56908	Powder: glass powder, polycarboxylic acid, pigments Liquid: water, tartaric acid, conservation agents	3M ESPE, St. Paul, MN, USA	1/2	60
Vitremer/544223	Powder: radiopaque fluoroaluminosilicate glass, microencapsulated potassium persulfate, ascorbic acid Liquid: aqueous solution of a polycarboxylic acid modified with pendant methacrylate groups, water, hydroxyethylmethacrylate, photoinitiators	3M ESPE, St. Paul, MN, USA	1/1	45
Vitro Fil/14111774	Powder: strontium aluminum silicate, dehydrated polyacrylic acid, iron oxide Liquid: polyacrylic acid, tartaric acid, distilled water	NOVA DFL, Rio de Janeiro, RJ, Brazil	1/1	60
Vitro Molar/15030424	Powder: barium aluminum silicate, dehydrated polyacrylic acid, iron oxide Liquid: polyacrylic acid, tartaric acid, distilled water	NOVA DFL, Rio de Janeiro, RJ, Brazil	1/1	20
Vidrion R/0321114	Powder: sodium-calcium-fluoroaluminosilicate glass, polyacrylic acid and pigments Liquid: tartaric acid, distilled water	SS White, Rio de Janeiro, RJ, Brazil	1/1	60
Maxxion R/031214	Powder: fluoroaluminosilicate glass, polycarboxylic acid, calcium fluoride, radiopacifiers Liquid: polyacrylic acid, tartaric acid, distilled water	FGM, Joinville, SC, Brazil	1/1	60

* This information was provided by the manufacturers in the Material Safety Data Sheet (MSDS) and instruction sheets.

Table 2.

Median, interquartile range, and percentages of water uptake (WTK) and weight loss (WL)

Group	WTK (µg)				WL (µg)
Group	Not treated	%	Treated	%	Not treated	%	Treated	%
Ketac Molar	1.3 (1.2–1.65) ^Aab	4.8	1.0 (1.0–1.1) ^Aa	4.3	0.9 (0.38–1.15) ^Aab	2.3	0.7 (0.45–0.83) ^Aab	2.6
Ketac Cem	0.5 (0.38–1.0) ^Aab	1.7	1.2 (1.15–1.55) ^Aa	5.2	0.8 (0.53–1.33) ^Aab	2.4	0.9 (0.18–2.85) ^Aab	5.5
Vitremer	3.6 (3.53–4.38) ^Aa	11.7	2.5 (2.38–2.6) ^Aa	11.1	0.1 (0.08–0.58) ^Ab	1.4	0.1 (0.0–0.23) ^Ab	0.5
Maxxion R	0.1 (0.1–0.85) ^Bb	2.2	4.7 (4.48–4.73) ^Aa	23.4	5.0 (2.0–5.4) ^Aa	19.3	3.0 (2.98–3.33) ^Aa	15.8
Vidrion R	0.4 (0.1–0.85) ^Ab	1.9	1.0 (1.0–1.1) ^Aa	5.2	0.8 (0.58–3.45) ^Aab	8.1	0.7 (0.45–0.83) ^Aab	3.3

WTK (M2–M3) and water solubility (M1–M3) of the specimens were calculated in micrograms (µg) from the differences in weight gain or loss during the immersion in water and drying cycles. Different uppercase superscript letters indicate a statistically significant difference within the row (p < 0.05). Different lowercase superscript letters indicate a statistically significant difference within the column (p < 0.05).

Table 3.

Compressive strength (MPa) of glass-ionomer cement (GIC) restoratives used in this study

GIC	Untreated	Treated
Vitremer	113.8 ± 8.1 ^Aa	92.9 ± 15.9 ^Ba
Ketac Molar	112.6 ± 15.1 ^Aa	72.7 ± 16.7 ^Bb
Ketac Cem	112.4 ± 12.6 ^Aa	55.4 ± 15.0 ^Bb
Vitro Molar	75.0 ± 8.5 ^Ab	64.9 ± 14.3 ^Ab
Vitro Fil	66.5 ± 7.5 ^bc	–^*
Maxxion R	50.9 ± 4.7^Ac	64.1 ± 17.5 ^Ab
Vidrion R	46.5 ± 14.9 ^c	–

Data are shown as means ± standard deviations. Different uppercase superscript letters indicate a statistically significant difference within the row (p < 0.05). Different lowercase superscript letters indicate a statistically significant difference within the column (p < 0.05).

* Vitro Fil and Vidrion R were not tested after the bleaching protocol because the specimens disintegrated.

Table 4.

Knoop hardness number of glass-ionomer cement (GIC) restoratives used in this study after different bleaching sessions

GIC	Bleaching treatment	Time (session)
GIC	Bleaching treatment	24 hr (before the protocol)	24 hr (first session)	48 hr (second session)	72 hr (third session)
Vidrion R	−	49.8 ± 5.4 ^Ba	53.4 ± 5.2 ^ABa	57.8 ± 3.3 ^Aa	49.8 ± 5.2 ^Ba
	+	53.1 ± 4.8 ^ABa	56.0 ± 5.2 ^ABa	58.1 ± 6.6 ^Aa	50.7 ± 6.1 ^Ba
Vitremer	−	96.8 ± 11.0 ^Aa	97.6 ± 12.3 ^Ab	91.2 ± 10.0 ^Aa	106.2 ± 10.7 ^Aa
	+	100.6 ± 9.8 ^Ba	119.5 ± 20.1 ^Aa	100.9 ± 19.8 ^Ba	113.1 ± 12.1 ^ABa
Vitro Molar	−	51.1 ± 5.2 ^Ca	57.1 ± 7.0 ^BCa	60.2 ± 5.9 ^Aa	60.5 ± 9.4 ^Aba
	+	51.0 ± 5.6 ^Ba	58.1 ± 5.9 ^ABa	63.7 ± 9.5 ^Aa	53.3 ± 8.6 ^Ba
Ketac Cem	−	74.1 ± 8.8 ^Ba	83.2 ± 10.6 ^ABa	77.2 ± 8.8 ^ABa	86.7 ± 8.3 ^Aa
	+	80.7 ± 11.1 ^Aa	87.3 ± 5.9 ^Aa	80.7 ± 7.6 ^Aa	82.9 ± 5.5 ^Aa
Ketac Molar	−	143.5 ± 25.6 ^Aa	86.6 ± 17.2 ^Bb	80.8 ± 11.2 ^Bb	77.1 ± 11.1 ^Bb
	+	148.9 ± 23.9 ^Aa	120.9 ± 16.6 ^Ba	119.9 ± 26.5 ^Ba	114.1 ± 10.9 ^Ba
Vitro Fil	−	49.5 ± 5.8 ^Ba	60.0 ± 7.2 ^Aa	51.8 ± 6.3 ^Ba	42.0 ± 4.5 ^Ca
	+	48.0 ± 2.7 ^Ba	60.0 ± 7.7 ^Aa	44.8 ± 6.1 ^Ba	37.2 ± 6.5 ^Ca
Maxxion R	−	41.7 ± 7.5 ^Aa	40.2 ± 2.2 ^Aa	40.1 ± 4.5 ^Aa	40.5 ± 4.5 ^Aa
	+	48.9 ± 6.2 ^Aa	41.1 ± 9.4 ^ABa	39.1 ± 4.8 ^Ba	38.2 ± 4.7 ^Ba

Data are shown as means ± standard deviations. Different uppercase superscript letters indicate a statistically significant difference within each row, that is, within each cement separately (p < 0.05). Different lowercase superscript letters indicate a statistically significant difference between the presence and absence of the application of each bleaching agent (p < 0.05).

Table 5.

Distribution of the chemical elements of the composition of the glass-ionomer cements (GICs) in relative percentage by weight (wt%).

GIC	Time (sessions)	Chemical elements (wt%)
GIC	Time (sessions)	C	O	F	Na	Al	Si	Ca	Nb	W	Ba-L
Vidrion R	Untreated	30.7	31.1	7.4	2.4	9.9	5.5	8.2	–	–	4.9
	24 hr	35.6	30.4	7.7	2.5	9.7	6.4	7.7	–	–	–
	48 hr	31.4	34.0	7.7	2.5	10.5	6.7	7.3	–	–	–
	72 hr	29.9	28.8	5.6	1.5	6.5	3.1	5.7	–	–	–
Vitremer	Untreated	46.5	25.2	8.9	1.4	6.6	11.5	–	26.7	–	–
	24 hr	46.7	16.1	3.3	0.9	2.6	3.7	–	26.7	–	–
	48 hr	47.2	21.1	4.3	0.7	4.0	4.2	–	18.6	–	–
	72 hr	35.0	23.7	4.7	0.8	5.3	9.0	–	21.5	–	–
Vitro Molar	Untreated	35.1	32.5	6.1	2.3	8.9	7.1	8.3	–	–	–
	24 hr	33.6	34.2	6.9	2.2	8.0	6.4	8.6	–	–	–
	48 hr	27.2	28.2	5.8	1.2	7.8	6.2	6.5	17.1	–	–
	72 hr	34.4	29.1	6.3	2.2	9.8	8.3	9.9	–	–	–
Ketac Cem	Untreated	27.6	32.4	10.3	2.7	7.9	9.1	9.9	–	–	–
	24 hr	26.3	34.3	8.9	2.3	9.2	9.7	9.2	22.3	–	–
	48 hr	29.9	32.4	8.7	2.4	9.0	10.6	6.9	18.3	–	–
	72 hr	25.3	30.1	6.0	1.4	5.4	7.7	2.4	19.1	–	–
Ketac Molar	Untreated	29.1	37.3	6.5	2.0	9.4	7.5	8.1	–	–	–
	24 hr	22.1	29.5	5.4	2.1	6.3	4.5	7.3	22.4	–	–
	48 hr	19.9	33.2	6.5	1.4	7.1	7.8	5.8	18.3	–	–
	72 hr	21.1	33.5	8.7	1.6	6.2	8.2	6.5	14.2	–	–
Vitro Fil	Untreated	28.8	25.7	4.3	1.6	5.4	7.2	1.9	12.1	11.9	–
	24 hr	20.2	22.4	5.4	1.5	6.0	5.4	1.8	17.6	14.0	–
	48 hr	43.5	18.2	3.1	1.1	3.6	4.6	–	19.8	–	–
	72 hr	22.5	23.8	6.5	1.2	8.4	6.3	–	–	33.3	–
Maxxion	Untreated	26.2	25.9	6.8	3.4	7.6	3.0	3.7	23.2	–	–
	24 hr	33.5	30.9	10.3	4.7	11.1	5.1	4.3	–	–	–
	48 hr	32.3	31.0	9.7	4.6	11.4	5.9	5.0	–	–	–
	72 hr	27.1	29.1	6.1	3.2	7.2	6.7	2.7	17.8	–	–

Although there are limitations of energy-dispersive X-ray spectroscopy in identifying and quantifying chemical elements with low atomic numbers, such as C, the relative quantities (wt%) of elements were obtained using the χ² test.

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