Antibacterial and physical properties of resin modified glass‐ionomers combined with chlorhexidine

Abstract

The purpose of this study was to determine the effect on mechanical properties and antimicrobial activity of the addition of chlorhexidine (CHX) to a resin modified glass-ionomer (Photac-fil, ESPE, Norristown, PA, USA). Chlorhexidine diacetate was combined with a resin modified glass-ionomer material at a concentration of 5%. The samples were tested for hardness, tensile strength and erosion at 24 h and 6-week intervals and for elution of CHX and antimicrobial activity weekly for 6 weeks. At 24 h there was no significant difference in hardness between the two groups, but at 6 weeks the resin modified glass-ionomer group was significantly harder than the CHX groups (P < 0.05). The diametral tensile strength test indicated no difference between the control and CHX groups at 24 h or at 6 weeks. The jet erosion test demonstrated significantly less erosion with the CHX group at 24 h but at 6 weeks the CHX group showed significantly more erosion than the control group. The chemical assay data demonstrated a peak elution of CHX at week 1 with residual amounts at weeks 2 and 3. The microbial data demonstrated that the CHX group had a significant reduction in Streptococcus mutans numbers for weeks 1-3, but after week 4 there was no difference between the glass-ionomer with and without CHX. The addition of CHX to resin modified glass-ionomer altered hardness and erosion of the resin-modified glass-ionomer, but because there are no material specifications, it is difficult to determine clinical implications. Chlorhexidine did significantly improve the antimicrobial effect of the glass-ionomer which was consistent with the chemical assay data. The results indicated that the addition of CHX to resin modified glass-ionomer material (Photac-fil) did not seriously degrade the physical properties during the time period tested and that the addition of CHX resulted in a greater reduction in S. mutans when compared with glass-ionomer alone.

Antibacterial effects of conventional glass ionomer cement

“…The largest number of studies analyse the antimicrobial effect of the chlorhexidine compound in the form of diacetate, gluconate, digluconat, hydrochloride or dihydrochloride, incorporated in conventional and modifi ed glass-ionomer cements, most often in the powder of the glass-ionomer cements (14,16,17,18,29,31). The antimicrobial effect against the cariogenic microorganisms Streptococcus mutans, Lactobacillus casei and Actinomyces viscosus is most often analysed (16,18,29,31).…”

“…In order to improve the antimicrobial characteristics of both conventional and resin-modifi ed glass ionomer cements (RMGIC), antimicrobial compounds have been added. In a number of studies the most frequently analyzed antimicrobial agent is chlorhexidine (14)(15)(16)(17)(18), although there are few data about incorporation of other antimicrobials. Cetylpirydinium Chloride (C 21 H 38 NCl) (CPC), as an active component of oral antiseptics has a broad antimicrobial spectrum, with strong bactericidal effect on Gram-positive pathogens and a fungicidal effect on fungi.…”

Effect of chlorhexidine gluconate on porosity and compressive strength of a glass ionomer cement

“…This association is aimed at reducing severity and frequency of secondary caries by decreasing failures and unsuccessful use of these restorative materials 6,7,12,25 . Based on the observation of the presence of viable bacteria in the remaining dentin after removal of the infected layer and proper sealing of the cavity researchers observed that under in vitro conditions the addition of CHX to the GIC showed favorable antibacterial effect against microorganisms such as Streptococcus mutans, Lactobacillus spp., Candida albicans and Actinomyces naeslundii, acts on the biofilm act on the biofilm, which begins to show less pathogenic composition compared to acidogenic biofilm with a predominance of S. mutans, which would be formed without the presence of the antibacterial agent 3,9,[11][12][13][14]23,25 Türkün et al 3 demonstrated that GIC and CHX at a concentration of 0.5% have a long-term antibacterial effect without compromising the physical properties of the restorative material. However, concentrations at 1.25 and 2% weaken the material by compromising its physical properties, such as resistance to erosion, compression, diametrical traction, flexion, setting time, and surface hardness 3 .…”

“…Studies have been carried out in order to incorporate antibacterial agents to GICs 3,5,6,7,[11][12][13][14] , such as CHX at different concentrations, showing effective results for certain microorganisms under in vitro conditions (Streptococcus mutans) 3,6,12 . Nevertheless, the incorporation of antibacterial agents into restorative materials can result in changes in their physical properties depending the concentration used 3,5,6 .…”

Study on antibacterial dental resin using tri-n-butyl(4-vinylbenzyl)phosphonium chloride

“…When the tissue conditioners were immersed in heart infusion agar medium, the bamboo extracts scarcely eluted, and the adhesion of Candida albicans to tissue conditioners containing 10 wt% bamboo extracts was significantly inhibited. The antimicrobial activity of resin modified glass-ionomer material combined with chlorhexidine at a concentration of 5% was studied 7) . The material exhibited a significant reduction in Streptococcus mutans numbers for 1−3 weeks, but after four weeks there was no difference between glass-ionomers with and without chlorhexidine.…”