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B. Kuter*, E. Eden*, H.

Yıldız** Keywords Command set; Glass-ionomer cement;


Heat; Mechanical strength.
* Ege University, Faculty of Dentistry, Department of Pediatric
Dentistry, IZMIR, TURKEY
** Ege University, Engineering Faculty, Department of
Mechanical Engineering, IZMIR / TURKEY Introduction
e-mail: bernakuter@yahoo.com Glass ionomer cements (GICs ) were developed in the
early 1970s by McLean and Wilson [Wilson and Mclean,
1998]. The material was based on the hardening
reaction among aluminosilicate glass powders and
The effect of heat aqueous solutions of polymers and copolymers of acrylic
acid [Wilson and Kent, 1972]. GICs have been usually
on the mechanical preferred as restorative materials in paediatric dentistry
due to their low sensitivity to moisture, good adhesion
properties of glass ability [Kilpatrick, 1996], and high fluoride content [Croll,
1990]. However, insufficient mechanical properties limit
ionomer cements the use of the material and numerous researches have
been carried out in attempts to improve the longevity
and the success of the restorations [Woolford, 1994;
Towler et al., 2001; Kleverlaan et al., 2004; Algera et al.,
abstract 2005; Skrinjaric et al., 2008; Yan et al., 2007].
Besides the new additives, Woolford [1994]
Aim The objective of this study was to assess the effect investigated the effect of heat activation on the GICs
of heat application on the mechanical properties of glass and found that rising the temperature of the surface
ionomer cements. of the cements to a maximum of 60 °C significantly
Materials and methods Study design: experimental improved the early surface hardness of the cement after
design. The effect of heat on glass ionomer cements during 24 h compared to cements which had not been heat
their setting was evaluated by measuring compressive treated. Towler et al. [2001] showed that the application
strength, flexural strength and microhardness. Moroever, of ultrasound to GICs improved the short-term surface
temperature changes from one surface of the glass mechanical properties. The initial setting obtained
ionomer cement specimens 2, 4, and 6 mm thick to by the application of ultrasound provides improved
the other surface were measured. A condensable glass surface hardness, particularly within the first 24 hours
ionomer cement (Fuji IX) and a ceramic-reinforced glass after setting. Kleverlaan et al. [2004] investigated
ionomer cement (Amalgomer CR) were used as test the influence of externally applied command
materials. Heat was applied with soldering iron for 2 setting applications on the mechanical properties
minutes at 80±2oC. All mechanical tests were carried out of conventional GICs. Significant temperature rise
24 hours after the setting of glass ionomer cements. in the GICs was observed with ultrasonic excitation,
Results No significant differences in compressive so it was hypothesized that its effect on the setting
strength were found between the control groups and of GICs may partially be explained by the increase in
the heated groups. There were no statistically significant temperature. Algera et al. [2005] investigated the
differences in the flexural strength value for both groups influence of heat and ultrasound application on the
of Fuji IX. On the contrary, when heat was applied to setting reaction of GICs and determined that the heat
Amalgomer, its mean flexural strength reached a curing (70±2) and ultrasound accelerated the setting
value that was higher than that of Amalgomer control. reaction. Furthermore, in that study ıt was shown
Significant differences in microhardness were found that mechanical properties could be improved with
between the control groups and the heated groups ultrasound and heat. Ultrasound especially affected
and between Fuji IX and Amalgomer CR. Temperature glass ionomer cements properties by producing
rising in both glass ionomer cements was also noted. heat. Skrinjaric et al. [2008] showed that the heating
Statistics: two-way ANOVA was used where appropriate procedure during setting of GICs sealants can not be
and independent samples t-test was used in case of recommended as routine treatments in clinical practice.
interaction. Yan et al. [2007] investigated the dimensional changes
Conclusion It is established that heat application caused by thermal stimuli of GICs with different
improved the surface mechanical properties of glass matrix ratios and showed that water loss from
conventional glass ionomer cements. conventional GICs with different power/liquid (P/L)
ratios compensated for thermal expansion and resulted

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Heat application on glass ionomer cements

in a minimal dimensional change. It was shown the incubator during initial setting time of the cement.
that under wet conditions glass ionomer cements Heat was applied with a soldering iron (Lötstation MLS-
maintained their original dimensions upon heating. 48, McVoice, Verzeuge, Germany). The active tip of
Rafeek [2008] showed that heat treatment of the soldering iron was 5 mm in diameter. The soldering
conventional GICs seemed to have no significant effect iron was set to 80±2°C and applied on one surface of
on the compressive strength, fluoride release and the specimens in the study group for 2 minutes. The
modulus on stress relaxation characteristics. samples were kept in distilled water at 37°C and all
O’Brıen et al. [2010] investigated the effects of tests were carried out 24 hours after the setting of glass
various energy sources on the upper and lower surface ionomer cements. Eighty specimens were prepared
hardness of a setting GIC and showed that preheating and then divided into 4 groups. The effect of heat on
GIC capsules prior to mixing resulted in superior the mechanical properties of conventional GICs was
hardness values. evaluated by measuring compressive strength, flexural
Thermal response of glass ionomer cements when strength, microhardness and temperature rising in the
heated is a very important clinical implication for the test materials was also measured and noted.
longevity of the restored tooth [Yan et al., 2007].
The objective of this study was to assess the effect Compressive strength
of heat application on the mechanical properties and Cylindrical specimens were prepared in stainless steel
microstructure of conventional GICs. It was also the molds [ISO] of 4 mm in diameter and 6 mm in height.
subject of this study to analyse the heat transfer degree Heat was applied only on the circular surface of the
through the specimens. cylinder, and a universal testing machine (Shımadzu
AG-IS 100kN Autograph, Japan) was used on the
heated surface for compressive strength test at a
Materials and methods loading rate of 0.5 mm/min.

Fuji IX (GC, Japan), a condensable glass ionomer Flexural strength


cement, and Amalgomer CR (AHL, England), a ceramic- For testing flexural strength, the prepared specimens
reinforced glass ionomer cement, were used as test dimensions were 25x2x2 mm. Heat was applied on
materials. The information about some characteristics the square surface of 2x2 mm. The flexural strength
of the test materials are summarized in Tables 1 and 2. of these materials was determined using a three-
The materials were mixed according to the point bending machine with Autograph (the distance
manufacturers’ instructions and Fuji varnish was between supports was set to 20 mm) (Shımadzu AG-IS
applied after the initial setting time (Table 1) for both 100kN Autograph, Japan).
glass ionomer cements. The study was carried out at
room temperature (23±1°C) and relative humidity of Microhardness
50%±10 as stated in the ISO Standard 9917-1:2003 Vickers Hardness Testing Machine (HMV-2 Shımadzu
(E) for glass polyalkeonate cements. The stainless steel Kyoto, Japan) was used to test microhardness of these
molds were preheated to 37°C and the cement surface materials. Disc-shaped specimens of 5 mm diameter
was covered with a single cellulose acetate sheet in and 2 mm height were prepared in a plastic mold. A
order to obtain a smooth surface. The other molds load of 300 g was applied to the heated surface of
were placed on top of the cellulose sheet to give the the specimens. The load was applied for 10 s and the
specimen a flat surface and GICs samples were kept in application was repeated 5 times.

Product Manufacturer Lot Component Initial Setting Time


Amalgomer CR AHL, ENGLAND Powder 020615-1 Powder: Glass, Polyacrylic acid, 3 min, 30 s
Liquid 040522-7 tartaric acid, zirconium oxide
Liquid: polyacrylicacid, water
Fuji IX GC, JAPAN Powder 0411051 Powder: Glass, polyacrylic acid, 2 min, 20 s
Liquid 0411051 tartaric acid
Liquid: polyacrylic acid

tabLE 1 Materials tested.

Element Al Si Ca Na P F Sr La tabLE 2 Weight percentage


Amalomer CR 15.8 18.7 7.1 5.5 1.6 12.9 0 0 composition of GICs.
Fuji IX 17.9 13.7 0 1.0 2.2 10.2 19.9 0

European Journal of Paediatric Dentistry vol. 14/2-2013 91


Kuter B., Eden E. and Yıldız H.

70
275
250 60
Compressive strength (Mpa)

225

Flexural strength (Mpa)


200 50
175
40
150
125
30
100
75 20
50
25 10
0
0
Fuji Cntr. Fuji healed Arrig. Cntr. Arrig. healed
Fuji Cntr. Fuji healed Arrig. Cntr. Arrig. healed

Fig. 1 Compressive strength of Fuji IX and Amalgomer CR. Fig. 2 Flexural strength of Fuji IX and Amalgomer CR.

Thickness 2 mm 4 mm 6 mm
105 Fuji IX 33.3 ±2.6ºC 32.5 ± 2.0ºC 31.5 ± 1.0ºC
Amalgomer CR 37.3 ± 1.0ºC 34.5 ± 1.6ºC 31.9 ± 0.9ºC
90

75 tabLE 3 Temperatures measured at the bottom of the


Microhardness (VHN)

specimens after heat application from the top (ºC).


60

45 Results

30 The results of the compressive strengths and the


statistical analysis between groups are shown in Figure
1. No significant (ANOVA) differences in compressive
15
strength were reported between Fuji IX and Amalgomer
CR. Moreover, no significant differences in compressive
0 strength were found between control group and heated
Fuji Cntr. Fuji healed Arrig. Cntr. Arrig. healed group, as well.
The flexural strengths of the materials with and
without heat application are shown in Figure 2. No
Fig. 3 Microhardness of Fuji IX and Amalgomer CR. significant differences in flexural strength among Fuji
IX and Amalgomer CR were found in the study. When
heat was applied to the Fuji IX, no significant differences
Heat Application on GICs (independent samples t-test) in flexural strengths were
In this case were used 20 disc-shaped specimens of 5 mm found between control and heated groups. When
diameter and thickness of 2, 4 and 6 mm. Temperature the heat source was applied to the Amalgomer, the
increase due to heat application from the top surface of mean flexural strengths were higher than that of the
the specimens to bottom was measured by thermocouple corresponding control group and significant differences
(Thermometer HD 8605, Delta OHM, Italy). were found (p<0.05).
The mean surface hardness of Fuji IX was 66.5
Statistical analysis (±11.4) VHN. When heat was applied to the surface
Statistical analysis was done using two-way ANOVA of the Fuji IX, the mean surface hardness was found
where appropriate and independent samples t-test was to be 84.8(±7.5) VHN. The mean surface hardness of
used when there was interaction. Amalgomer was 60.1(±16.4) VHN. When heat source

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Heat application on glass ionomer cements

was applied to the surface of the Amalgomer, the mean cement matrix was increased in the SEM evaluation
surface hardness was measured as 65.4(±8.5) VHN. [Kuter et al., 2010] this was particularly evident at SEM
Significant differences in micro-hardness were found on the heated specimens.
between control and heated groups (p<0.05) (Fig 3). Algera et al. [2005] showed that heat may contribute
Temperatures measured at the bottom of the to acceleration of the reaction by de-clustering
specimens after heat application on the top surface are glass particles and enhancing the diffusion of the
shown in Table 3 and it can be seen that temperature reaction components. SEM evaluation did not show
rising in both materials was inconsiderable. de-clustering of the glass particles or a reduction of
porosity in that study [Algera et al., 2005]. Kuter et
al. [2010] showed that the portion of GICs specimens
Discussion closer to the heat were affected to a greater extent.
In that study the top part where heat was applied had
The effect of heat on the setting reaction is likely a better and more meaningful differentiation. The
to make the polyalkenoic acid more active [Woolford, bottom part had a lesser differentiation after the heat
1994]. When the acid gets in contact with the surface treatment. Voids decreased, texture became denser
of the glass, it is able to break down the surface of and there were particles with larger sizes with the heat
the glass more readily. It increases the rate at which applied. These results showed that application of heat
the ions are leached and released from the glass. The affected the top portion where heat was applied more
total effect of all these accelerated reactions produces than the lower portion and for this reason, mechanical
a more rapid formation of the calcium polyalkeonate strength of heated GICs specimens highly increased
matrix. Gu and Fu [2004] showed thar particle size only microhardness.
of GICs increases after heat application. This is due Kleverlaan et al. [2004] showed that an increase in
to particle agglomeration, coalescence and growth at compressive strength of the Fuji IX was found with
high temperatures. Particle size distribution influenced the heat and ultrasonic application. No significant
the mechanical properties of glass ionomer cements differences in compressive strengths of the Fuji IX heat
significantly [Gu et al., 2004]. and control groups were found 24 hours later, in this
The thermal behaviour of GICs is different because of study. However, Kleverlaan et al. [2004] stored the
interaction with water from the environment [Carrick samples in lubricants, in order to prevent dehydration,
and McCabe, 2007]. Thermal behaviour may be and the glass ionomer cement was placed between
affected by the original P/L ratio and the structure of two heated metal elements for 5 minutes. Algera et
the set cement [Yan et al., 2007]. The matrix of GICs al. [2005] showed that materials cured in oil reached
contains loosely bound water as well as tightly bound a significantly higher compressive strength compared
water [Wilson and McLean, 1998]. Depending on to storage in water. Jones et al. [2007] showed that
the environment, loosely bound water is easily lost or the temperature rise on the samples lubricated with
gained, depending on the level of moisture/humidity in oil were greater than samples lubricated with water.
the wet or dry environment. Wilson et al. [1998] showed For this reason, the results of our study did not show a
that the water content and especially the loosely bound similarity with that study, since all of the samples in our
water in GICs depends on the P/L ratio and the storage study were stored in water according to ISO [ISO] and
method. A great amount of mass loss was observed heat was applied for 2 minutes from one surface of the
in GICs after heating in a dry environment [Yan et glass ionomer cement.
al., 2007]. The mass loss of GICs in wet conditions is When Rafeek [2008] carried out his study with
significantly lower. samples stored in water, like in our study, he showed
Yan et al. [2007] showed that all the GICs tested that compressive strength values between the control
in their study lost weight during the heating process and the heat-treated conventional GICs specimens were
and the greatest P/L ratios produced the lowest not statistically different.
final weight loss. The lowest P/L ratio produced the There were no statistically significant differences
greatest contraction after heating. The water content in flexural strengths of Fuji IX in both groups. On the
and ıts relative mobility in the GICs matrix have been contrary, when the heat was applied to the Amalgomer,
considered as major factors in determining the thermal its mean flexural strength reached a value that was
response behaviour of GICs. The ratio of reinforcing higher than that of Amalgomer control, and this time
glass-core and matrix affects the diffusion of water in significant differences were noted. When temperature
the glass ionomer matrix [Davies et al., 1993]. When is high, the P/L ratio can increase due to evaporation
GICs are mixed at a high initial P/L ratio, the ratio of of the liquid, which results in high strength of materials
reinforcing glass core in the matured cement matrix is [Kleverlaan et al., 2004]. Increasing the P/L ratio can
increased. Decreasing the P/L ratio reduces the amount improve the mechanical properties of the glass ionomer
of the reinforcing fillers in the matrix [Fleming et al., cements. Fuji IX is a condensable glass ionomer cement,
2003]. The ratio of reinforcing glass core in the matured but Amalgomer CR is a ceramic-reinforced glass ionomer

European Journal of Paediatric Dentistry vol. 14/2-2013 93


Kuter B., Eden E. and Yıldız H.

cement and Fuji IX has higher P/L ratio. Thus, Fuji IX that and less retention areas on the glass ionomer cements.
further increasing P/L ratio, due to the heat application, However, further research is necessary to establish the
did not lead to higher flexural strength values. potential effect of heat and long-term results of the
When a temperature of 700C was applied on the restorations.
glass ionomer cement (Fuji IX Fast) with soldering
iron, the temperature in the pulp chamber showed a
maximum rise of 2.50C after 60 seconds [Algera et al., References
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