An integrated multifunctional hybrid cement (pRMGIC) for dental applications

Abstract

Objective: Glass-ionomer and resin-modified glass-ionomer cements are versatile materials with the ability to form a direct bond with tooth tissues. The aim of this study was to formulate a novel class of dental bio-interactive restorative material (pRMGIC) based on resin-modified glass-ionomer cements via the inclusion of an organophosphorus monomer, ethylene glycol methacrylate phosphate, with a potential to improve the mechanical properties and also function as a reparative restorative material.

Methods: pRMGIC was formulated with modification of the resin phase by forming mixes of ethylene glycol methacrylate phosphate (EGMP; 0-40%wt) and 2-hydroxyethyl methacrylate monomer into the liquid phase of a RMGIC (Fuji II LC, GC Corp.). The physical properties of the cements were determined including setting characteristics, compressive strength and modulus (CS &CM), microhardness (MH) and biaxial flexural strength (BFS). Fluid uptake and fluoride release were assessed up to 60 days storage. Adhesion to sound dentine was measured using micro-tensile bond strength and surface integrity was analysed using SEM coupled with EDX. Statistical analysis was performed using ANOVA and Bonferroni post-hoc tests.

Results: The pRMGIC cements exhibited an increase in working time with increasing EGMP concentration however were within the limits of standard clinical requirements. Although the compressive strength of pRMGIC cements were comparable to control cements in the early stages of maturation, the higher EGMP-containing cements (EGMP30 and 40) exhibited significantly greater values (p < 0.05) after 4 weeks storage (141.0 ± 9 and 140.4 ± 8 MPa, respectively), in comparison to EGMP0 (128.8 ± 7 MPa). A dramatic two fold increase in biaxial flexural strength (p < 0.001) was observed for the pRMGIC's. Furthermore, the ability to decalcify tooth apatite resulted in enhanced interfacial adhesion due to chelation with calcium ions of tooth apatite. The inclusion of EGMP encouraged formation of reinforcing complexes within the RMGIC, thus improving physical properties, decreasing solubility and lower fluoride release. A dense microstructure was observed with increasing EGMP content.

Significance: A novel universal bio-interactive adhesive repair material will enable clinicians to offer more effective repair of the tooth-restoration complex, thus future treatments will benefit both patient and a severely constrained healthcare budget.

Keywords: Adhesive dental cements; Dental reparative biomaterial; Ethylene glycol methacrylate phosphate; Minimally invasive dentistry; Resin modified glass ionomer cements.