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Purpose: The aim of this study was to evaluate the effect of adding 10-MDP to resin-modified glass ionomer on its dentin bond strength and fluoride release.
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Tahereh  Parhizkar
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Annali di stomatologia
fluoride release
Evaluating the effect of adding 10-MDP to resin-modified glass ionomer on its dentin bond strength and fluoride release
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Original Article
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Tahereh  Parhizkar
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DDS, MScD Student Postgraduate student, Department of Operative Dentistry, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
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fluoride release
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Evaluating the effect of adding 10-MDP to resin-modified glass ionomer on its dentin bond strength and fluoride release
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                                                                                                  Original Article


Evaluating the effect of adding 10-MDP
to resin-modified glass ionomer on its dentin bond
strength and fluoride release


Sara Majidinia*                                            trode. The data were analyzed by one-way and repeated
Mahboobe Noori°                                            measures ANOVA, Tukey and LSD tests (α = 0.05).
Hossein Bagheri§
Maryam Hosseini^                                           Results
Farzaneh Rakhshan”                                         Shear bond strength in the RMGI + 10% 10-MDP group
Tahereh Parhizkar<                                         was significantly higher than that in the control group
                                                           (P<0.05). There was a significant difference in the
*Dental Research Center, Mashhad University of Medi-       amount of fluoride released in the three groups on days
cal Sciences, Mashhad, Iran                                7, 14 and 28, which was higher in the control group than
°Assistant professor of restorative dentistry, Zahedan     other groups.
university of medical sciences, Zahedan, Iran
§
  Dental Materials Research Center, Mashhad University
of Medical Sciences, Mashhad, Iran
                                                           Conclusion
^Dentist, Mashhad University of Medical Sciences,          The addition of 10% vol of 10-MDP to the resin-modi-
Mashhad, Iran                                              fied glass ionomer significantly improves its dentin bond
”Post graduate student of esthetic and restorative den-    strength, although its long-term fluoride release is lower
tistry, Mashhad University of Medical Sciences, Mash-      than conventional RMGI.
had, Iran
<
  DDS, MScD Student
Postgraduate student, Department of Operative Dentist-     Introduction
ry, Mashhad Dental School, Mashhad University of Med-
                                                           Glass ionomers are one of the dental materials that were
ical Sciences, Mashhad, Iran
                                                           introduced in 1972 [1]. Advantages such as biocom-
                                                           patibility, chemical adhesion, fluoride release, thermal
Corresponding author: Tahereh Parhizkar                    expansion coefficients similar to that of tooth, and the
E-mail: Tahereh_parhizkar@yahoo.com                        absence of shrinkage during polymerization have made
                                                           glass ionomers one of the most important restorative
                                                           materials [3]. However, disadvantages such as low bond
Abstract                                                   strength to tooth, long setting time, dehydration during
Purpose: The aim of this study was to evaluate the         the initial setting, rough surface texture, and low initial
effect of adding 10-MDP to resin-modified glass iono-      strength limit their widespread clinical use [4].
mer on its dentin bond strength and fluoride release.      Resin-modified glass ionomers (RMGI) are a hybrid of
                                                           glass ionomer and composite resin [2] that were first in-
Keywords: Resin-modified glass ionomer, 10-MDP,            troduced in 1989 by adding a small amount of light-acti-
bond strength, fluoride release.                           vated resin to overcome the disadvantages of traditional
                                                           glass ionomers. [5]. These materials, along with the de-
                                                           sirable properties of conventional glass ionomers such
Materials and Methods                                      as chemical bonding to tooth structure and fluoride re-
The occlusal surfaces of thirty caries-free human third    lease, have more benefits, including: decreased setting
molars were ground flat to expose dentin and randomly      time, having higher initial strength, being more durable
divided into three groups (n=10) according to different    and improved appearance [7].
concentrations of 10-MDP used with RMGI. Group 1:          Adhesion of the RMGI to dental hard tissues occurs
(RMGI+0% vol 10MDP), group2: (RMGI+ 5% 10MDP)              through 2 different mechanisms:
and group3: (RMGI+10% 10MDP). In each group a              1) a chemical bonding between polyalkenoic acid chains
cylinder of modified RMGI was bonded on each flat sur-     and calcium ions in hydroxyapatite,
face. Shear bond strength test was carried out using       2) a micro-mechanical retention by the infiltration of the
the universal testing machine (1 mm/min). The mode of      organic components into a partially demineralized den-
failures was examined using a stereo microscope. Five      tin surface created by the self-etching characteristic of
disc-shaped samples were prepared from each group          RMGIC [8].
and the amount of fluoride released was measured on        Various studies have recommended different methods
days 1, 7, 14 and 28 using a specific fluoride ion elec-   of improving RMGI bonding to dental tissues, most of



10.59987/ads/2023.3.11-15                                                                                                11
     Evaluating the effect of adding 10-MDP to resin-modified glass ionomer on its dentin bond strength and fluoride release

     which involve surface pretreatment prior to the appli-          were used for testing. The teeth were randomly divided
     cation of glass ionomer. Previous studies concluded             into three groups(n=10):
     that the use of a polyacrylic-acid conditioner before the       Group 1: RMGI standard (Fuji II LC GC Inc., Tokyo, Ja-
     application of RMGIC provided stronger dentin bond              pan). This group was classified control group.
     strength. It cleans the surface, generates micro-poros-         Group 2: RMGI involving 5% volume of 10-MDP mono-
     ities and improve the micromechanical bond, as well as          mer.
     react chemically with hydroxyapatite on the tooth sur-          Group 3: RMGI involving 10% volume of 10-MDP mono-
     face [9,10]. Although, Surface conditioning especially          mer.
     with polyacrylic acid, is an accepted method, it has not        For placing the material on teeth, a tygon tube with an in-
     found widespread clinical use because of adding more            ner diameter of 1.5 mm and a height of 2mm was placed
     steps to the clinical procedure.                                on dentin surface next to DEJ. In each group, the materi-
     Some studies that evaluated chemical bond using X-ray           al was placed inside the tube and cured from the occlusal
     have shown that the ionic bond between some function-           surface for 20 seconds by Bluephase light cure device
     al resin monomers and calcium ions on the tooth surface         (Ivoclarvivadent. Schaan, Liechtenstein) at an intensity
     may be stronger than the hydrogen and van der Waals             of 1200 mw/cm2. After removing the tube with a razor
     bonds due to the mechanical integration of collagen fi-         blade, the samples were incubated at 37 °C and 100%
     brils by resin polymerization [11,12].                          humidity for 24 hours. Then the samples were examined
                                                                     with a 10x magnification microscope (XTL-ST2FF,Blue
     The most common functional monomers used in com-
                                                                     light USA) and those which had cracks, bubbles and de-
     mercial adhesives are phosphate monomers such as
                                                                     fects were replaced with new ones.
     10-MDP and Phenyl-P [13], which react chemically with
                                                                     The shear bond strength test was carried out using a uni-
     hydroxyapatite [14]. The 10-MDP monomer etches sur-
                                                                     versal testing machine (Santam, STM 20, Tehran, Iran)
     face due to the presence of hydrogen phosphate groups
                                                                     at a speed of 1 mm/min. For this purpose, each tooth
     that form two cationic waters [15]. The ionic bond formed
                                                                     was placed in device, and a force perpendicular to the
     with 10-MDP is stable in aqueous media. Compared to             junction of RMGI and tooth was applied using the de-
     4-META and Phenyl-P, 10-MDP is considered to be the             vice’s chisel until the samples were separated from the
     best monomer for chemical bonding to dentin and enam-           tooth. The amount of force through fracture was record-
     el hydroxyapatite [16,17].                                      ed. After the test, the failure mode of each sample was
     The use of functional monomers in bonding has become            determined under stereoscopic microscope.
     common today and has greatly reduced the limitations of         To evaluate fluoride release, five disc-shaped samples
     dentin bonding. Their improved performance has been             (3*10mm) of each material were divided into 3 groups,
     reported in various studies.                                    each of them was placed in a sealed plastic container
     Yoshida et al. (2004) conducted a comparative study on          with 7 ml of double distilled water.
     the performance of functional adhesives and concluded           All samples were kept in an incubator at 37°C during the
     that 10-MDP reacted with hydroxyapatite and the bond            study and released fluoride amount was measured on days
     appeared to be very stable [18]. Another study (2005)           1, 7, 14, and 28. Prior to each measurement, the samples
     on the hydrolytic stability of self-etched adhesives bond-      were removed from the container and were washed twice
     ing to dentin found that the bond strength of adhesives         with 1 ml of distilled water. Then this water was added to
     containing 10-MDP did not decrease after thermocycling          previous solution, and the samples were transferred to a
     [19]. Li et al. (2010) also stated in their study that the      new container of fresh solution. 7 ml of solution for each
     interface formed with adhesive systems containing 10-           sample, along with 1 ml of water used for washing, was
     MDP remained stable after acid and base changes [14].           mixed with 4 ml of TISAB II buffer solution and examined
     Therefore, the aim of this study was to evaluate the effect     for released fluoride amount. A potentiometer measured
     of adding 10-MDP to resin-modified glass ionomer on its         Fluoride releases. The electrode (WTW, Multi 9420, Ger-
     bond strength and fluoride release. The null hypothesis         many) was immersed in solution for measurement, while
     was that the addition of 10-MDP to the resin-modified           the container was shaken to achieve a uniform dispersion
     glass ionomer has no effect on bond strength and fluo-          of fluoride ions in solution. The number was recorded as
     ride release.                                                   soluble fluoride amount in ppm. At last, fluoride released
                                                                     in each period was determined in mg/cm2.
     Materials and Methods
     This study was approved by local Ethics committee of            Statistical analysis
     school of dentistry Mashhad university, Iran with code          Shapiro-Wilk test was used to determine normal distri-
     IR.MUMS.DENTISTRY.REC.1397.020. Thirty human                    bution of data. One factor analysis of variance as well as
     third molars without crack, decay or previous restoration       Tukey test were used to analyze the data obtained from
     were obtained and stored in 0.5% chloramine T solution          bond strength assessment. Variance analysis for repeat-
     until use. Using periodontal scaler debris and inorganic        ed measures, as well as LSD, was used to assess the
     remnants were cleaned. To obtain a smooth dentin sur-           fluoride release. The significance level was set to 0.05.
     face, the teeth were horizontally cut from 1.5 mm of their
     occlusal surface’s central groove, by a water-cooled di-
     amond saw. They were embedded in a self-cure acrylic            Results
     resin vertically till cementoenamel junction.                   Based on the results, the mean shear bond strength in
     The teeth surface was abraded by paper discs up to 600          the group 3 (10% 10-MDP monomer) was higher than
     grits, to create a smear layer. An alcoholic solution of        other groups, and it was significantly different from the
     10-MDP (Watson International, China) was mixed with             control group (P<0/05). There was no significant differ-
     RMGI liquid in a volume ratio of 5% and 10%, which              ence between the control group and the group 2 in terms



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S. Majidinia et al.

of bond strength. The mean shear bond strength values                 Discussion
of all groups and the standard deviations are presented
in Table 1. The frequency of failure modes in each group              The results of the present study showed that the addition
are shown in Table 2. Most failures were recorded as                  of 10-MDP monomer by 5% and 10% volumes to RMGI
adhesive failures.                                                    increases its bond strength to human dentin. There was
According to the results, fluoride release was higher                 a significant difference between the 10% volume group
in the control group than the other two groups on all                 and the control group, while the different between the
days. There was no significant difference between the                 5% volume group and the control group was not signifi-
three groups in terms of fluoride release on the first day            cant. In terms of fluoride release, the amount was higher
(p>0.05). On days 7,14 and 28, the difference between                 in the control group than that in the other two groups.
the control group and the other groups was significant                This difference was not significant on the first day, while
(p<0.05) , while there was no significant difference be-              it was significant on days 7, 14 and 28. Therefore, the
tween group1 and group2(p<0.05). The fluoride release                 null hypothesis of the study was rejected and Addition of
chart for all groups is shown in Figure 1.                            10-MDP to RMGI increases bond strength and decreas-
                                                                      es fluoride release.
                                                                      The ability to chemically bond with specific chemical
                                                                      monomers including 10-MDP with hydroxyapatite has
Table 1. Mean bond strengths (standard deviation) in                  been demonstrated [20].10-MDP forms an electrostatic
MPa for different materials. (a Means followed by differ-             bond with hydroxyapatite, which results in a long-term
ent lowercase letters are significantly different by Tukey
                                                                      stable bond [21].Yoshihara et al. found that the bond
test at 5% confidence level.)
                                                                      between this monomer and hydroxyapatite was accom-
          GROUP                        MEAN (SD)                      panied by a self-assembled Nano-layering feature. XRD
                                                                      and high-resolution TEMs of hydroxyapatite crystals at-
            RMGI                      6.43 (2/12)a                    tached to 10- MDP showed the formation of a 4nm layer,
                                                                      each layer of which contained two 10-MDP molecules
   RMGI + 5% 10-MDP                   7.40 (1/78)ab                   with their methacrylate heads facing each other and their
                                                                      functional hydrogen phosphate groups were far apart
   RMGI + 10% 10-MDP                  9.57 (2/65)b                    and deposition of the Calcium salts between these lay-
                                                                      ers hold them together [22]. This Nano-layering property



Table 2. Frequency of failure mode.

           GROUP                         ADHESIVE                             COHESIVE                         MIXED

            RMGI                              10                                   0                              0

    RMGI + 5% 10-MDP                           9                                   1                              0

   RMGI + 10% 10-MDP                           8                                   2                              0




Figure 1. Fluoride release of different materials on different days



10.59987/ads/2023.3.11-15                                                                                                           13
     Evaluating the effect of adding 10-MDP to resin-modified glass ionomer on its dentin bond strength and fluoride release

     has not been observed in other functional monomers              as the flexural strength of an RMGI is almost twice than
     such as 4-MET and Phenyl-P and other experimental               that of conventional glass ionomer due to the addition of
     phosphate monomers [21].                                        the HEMA resin monomer, therefore the cohesive frac-
     Since phosphate ester monomers contain methacry-                ture was rare.
     loxy functional groups, they can also support the adhe-         Since this study was primarily performed in the laborato-
     sion of methacrylate-based resins to the tooth structure        ry, it is recommended that RMGI with 10-MDP be tested
     [21,23,24]. Therefore, there is a growing interest in de-       in clinical trials for more reliable results. It is also rec-
     veloping of new phosphate ester monomers for use in             ommended in future studies to check the strength of the
     restorative dentistry.                                          material itself to make sure that the internal strength of
     The beneficial effect of functional monomers on bond-           RMGI is improved by adding 10-MDP.Furthermore, be-
     ing, especially universal and self-etch bonds, has been         cause the 10-MDP monomer creates a stable bond to
     proven. Cristina et al. reported that universal Scotch          dentin, we also suggest investigating the durability of the
     bond provides acceptable bonding performance due to             RMGI bond to dentin in future studies.
     the presence of 10-MDP monomer, which is an acidic
     monomer that stimulates demineralization and infiltration
     of monomers and chemically establishes bonds with the           Conclusion
     mineral tissue of the tooth. Scotchbond also contains a         The present study showed that the addition of 10%
     polyalkenoic acid polymer (Vitrebond™ Copolymer) and            volume of 10-MDP to the resin-modified glass ionomer
     is in fact a glass ionomer-based bonding which, accord-         significantly improved its dentin bond strength, although
     ing to the manufacturer, provides a satisfactory bond to        its long-term fluoride release is less than that of conven-
     dentin in dry and humid environments [25,26].                   tional RMGI.
     Adper™ Easy Bond Self-Etch Adhesive is also a univer-
     sal glass ionomer-based bonding that utilizes the meth-
     acryloxyhexyl phosphate (MHP) functional monomer.               References
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