Comparative Evaluation of Mechanical Properties and Bond Strength of Glass Ionomer Cement reinforced with three different concentrations of Silver Nanoparticles as against Conventional Glass Ionomer Cement in Primary Teeth.

Harikishan Kanani; Monika Khubchandani

doi:10.12688/f1000research.133455.2

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Comparative Evaluation of Mechanical Properties and Bond Strength of Glass Ionomer Cement reinforced with three different concentrations of Silver Nanoparticles as against Conventional Glass Ionomer Cement in Primary Teeth.

[version 2; peer review: 1 approved, 2 approved with reservations, 3 not approved]

Harikishan Kanani ¹, Monika Khubchandani¹

PUBLISHED 26 Sep 2024

Author details Author details

¹ Pediatrics and Preventive Dentistry,, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, 442001, India

Harikishan Kanani
Roles: Conceptualization, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation

Monika Khubchandani
Roles: Supervision, Validation, Visualization, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

This article is included in the Nanoscience & Nanotechnology gateway.

This article is included in the Datta Meghe Institute of Higher Education and Research collection.

Abstract

Introduction:

Restorative dental materials are defined as substances that are used to repair, replace, or enhance a patient’s teeth. Various materials used in paediatric dentistry are zinc oxide eugenol, glass ionomer cement, resin composite, calcium hydroxide, silver amalgam, giomers etc. GIC is a biocompatible material having a low thermal expansion coefficient and fluoride release property. There are still a few drawbacks of GICdue of their poor mechanical properties therefore addition of Silver Nanoparticles demonstrated improved mechanical and bactericidal capabilities. There hasn’t been much study on the quality of the bond contact between silver nanoparticles and dentin, as well as the color’s durability.

Aim: To evaluate and compare the mechanical properties and bond strength of Glass ionomer cement reinforced with three different concentrations of silver nanoparticle as against conventional glass ionomer cement in primary Teeth.

Materials and Method:

Silver nanoparticles will be prepared using three chemicals namely, silver nitrate, sodium citrate and tannic acid. Traditional GIC (GC Fuji II, GC Corporation, Tokyo, Japan) will be purchased. Three different concentrations of silver nanoparticles will be prepared i.e., 0.2, 0.4, and 0.6%. The GIC specimens will then be divided into 4 groups: GIC without silver nanoparticles (AgNPs),0.2%,0.4% and 0.6% AgNPs. Mechanical properties will be checked such as compressive, tensile, and bond strength using Universal Testing Machine.

Expected Results:

GIC reinforced with silver nano particles is expected to have better mechanical strength, less microleakage and wear resistance, greater fracture resistance and adhesive bond strength.

Conclusion:

GIC reinforced with silver nano particles will be expected to have better mechanical and physical properties than conventional Type II GICs and is expected to be a promising material for restoration in primary teeth.

Keywords

Restorative material, Glass ionomer cement, silver nano particles.

Corresponding author: Harikishan Kanani

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2024 Kanani H and Khubchandani M. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Kanani H and Khubchandani M. Comparative Evaluation of Mechanical Properties and Bond Strength of Glass Ionomer Cement reinforced with three different concentrations of Silver Nanoparticles as against Conventional Glass Ionomer Cement in Primary Teeth. [version 2; peer review: 1 approved, 2 approved with reservations, 3 not approved]. F1000Research 2024, 12:1084 (https://doi.org/10.12688/f1000research.133455.2) First published: 01 Sep 2023, 12:1084 (https://doi.org/10.12688/f1000research.133455.1) Latest published: 26 Sep 2024, 12:1084 (https://doi.org/10.12688/f1000research.133455.2)

Revised Amendments from Version 1

Recent research added in Introduction.

See the authors' detailed response to the review by Daniela Prócida Raggio
See the authors' detailed response to the review by Paulo J. Palma
See the authors' detailed response to the review by Muna Saleem Khalaf

Introduction

Restorative dental materials are defined as substances that are mostly used to repair, replace, or enhance a patient’s carious teeth. Dental caries experienced a sharp drop around the turn of the 20th century, and dental enhancement and health became more popular.¹ Properties of ideal restorative materials would be: fracture resistance, compressive strength, tensile strength, no microleakage, hardness, adhesion, higher bond strength, ease of clinical use, good clinical performance, economical, bio-compatible and cost-effectiveness.² However, the appropriate restorative material that meets all the properties has yet to be formed.³

The glass ionomer cement (GIC) was invented by Wilson & Kent (1972).⁴ This material offers plenty of applications in paediatric dentistry such as restorations, core build-up, pit and fissure sealants, liners and bases, luting materials, and orthodontic bracket adhesives. GIC is a biocompatible material with a low coefficient of thermal expansion and fluoride releasing property.⁵

GIC still has significant downsides, though, because of its poor mechanical qualities, which include low resistance to fracture, poor resistance to wear, and formal disintegration on water sorption.⁶ Secondary caries and restoration failures are caused by these mechanical defects, which encourage the formation of bacterial colonies, especially Streptococcus mutans.⁷ Fluoride release underlies the majority of GIC’s antibacterial activity.⁸ To boost antibacterial and mechanical qualities without compromising their bond strength and reduce the development of secondary caries, fillers including silicates and fluorides were added to GIC.⁹

Silver nanoparticles (AgNPs) are used in endodontics, dental prosthesis, implantology, and restorative dentistry. AgNPs may improve oral health and general well-being by reducing bacterial populations in dental composites. The chemical, physical, and biological characteristics of gNPs differ from those of bulk materials because of their tiny size. Because of their tiny size and large surface area, they are efficient antibacterial fillers.¹⁰^,¹¹

Nanotechnology is the study of making high-quality structures and materials made of particle substances with sizes ranging from 1–100 nm.¹² Among all the materials used in nanotechnology silver has been employed in its ionised forms as nanoparticles. A metal reinforced GIC that is stronger and tougher was previously made with the use of silver alloy powder.¹³ How effective silver or its compounds are against bacteria, viruses and fungus is determined by the silver ions amount created and their ability to interact with microorganism cell membranes.¹⁴ In 2023 T. Hamdy et al also reinforced the GIC with silver doped carbon nanotube fillers to improve its properties.¹⁵

Silver powder is sintered to glass after being heated to a high temperature. Silver-sintered powder has the potential to increase abrasion resistance and durability.¹⁴

When contrasted, Dentin’s mechanical attributes (compressive strength of 297 MPa, tensile strength of 44.4 MPa, and hardness of 52 to 64 KHN) outweigh those of GIC (fracture toughness of 0.72 MPa m1/2, compressive strength of 196-251 MPa, tensile strength of 18 to 26 MPa, and hardness of 87 to 177 KHN).¹⁴ According to previous study, tiny silver nanoparticles may occupy the crevices between the bigger glass particles and give an additional bonding site for the polyacrylic polymer, reducing the possibility of the cement dissolution.⁵ As when silver nanopowder were incorporated into GIC it is revealed that when the concentration of silver nanopowder raised, bacterial colonies are reduced.⁵ Higher concentration of silver nanoparticles showed a significant improvement in mechanical properties in relation to dentin.

There has not been enough research on the strength of the binding contact between dentin and silver nanoparticles, as well as the colour stability. Hence, objective of this study is to assess and compare mechanical characteristics, colour stability, and bond strength of primary teeth filled with GIC reinforced with various concentration of silver nanoparticles.

Objective

In this study we aim to evaluate and compare the mechanical properties of GIC reinforced with three different concentrations of silver nanoparticles as against traditional GIC.¹⁹

Trial design: An in vitro study.

Study setting

This is an in vitro study and will be conducted at the Department of Paediatric and Preventive Dentistry, Sharad Pawar Dental College in collaboration with Research and development house, DMIHER, Sawangi (Meghe), Wardha.

Eligibility criteria

Inclusion criteria

• Silver nanoparticle liquid (AgNPs) <100 nm particle size.
• Conventional GIC (GC Fuji II, GC Corporation, Tokyo, Japan).
• Primary molars close to their shedding time, affected by gross caries or the tooth that are over-retained will be extracted and included in this study.

Exclusion criteria

• Extracted tooth with enamel cracks, fracture, malformation, erosion, restoration will be excluded in the study.
• Permanent teeth shall not be taken into consideration.
• Primary anterior teeth will be excluded from the study.

Methods

Materials used

Traditional GIC (GC Fuji II, GC Corporation, Tokyo, Japan) shall be procured and

Three chemicals:

A. silver nitrate
B. sodium citrate
C. tannic acid

Synthesis of silver nanoparticles

Silver nitrate, sodium citrate, and tannic acid will be used to prepare silver nanoparticles for this in vitro investigation. Three different concentrations of silver nanoparticles 0.2, 0.4, and 0.6% will be synthesized by chemical reduction of reducing agents i.e. sodium citrate is used for reduction of silver ions (Ag+) in aqueous or non-aqueous solutions of silver nitrate. This reducing chemical cause the reduction of Ag+ to metallic silver (Ag0), which then aggregates into oligomeric clusters. In the end, these clusters result in the emergence of metallic colloidal silver particles.

Following that, the GIC samples will be split into four groups:

GROUP 1: GIC without silver nanoparticles (AgNPs) (n=26)

GROUP 2: GIC with 0.2% silver nanoparticles (AgNPs) (n=26)

GROUP 3: GIC with 0.4% silver nanoparticles (AgNPs) (n=26)

GROUP 4: GIC with 0.6% silver nanoparticles (AgNPs) (n=26)

The extracted teeth will be collected from an operating room and dental clinic. The teeth will be carefully examined, which will be included in the criteria. For 1 month, the teeth will be stored in a 0.1% thymol solution with 0.9% isotonic sodium chloride (5°C) until the beginning of the experiment. We will use a diamond bur at a slow-speed handpiece with continuous water cooling, perpendicular to the tooth’s long axis, and cavity preparation will be done from approx 2.0 mm of the tissue along with the cusps without exposing the pulp. The 104 teeth will be categorized into four groups with an equal distribution, which will include group 1 (applying GIC on dentin as the control group), group 2 (applying GIC with silver nanoparticles (AgNPs) (0.2%) on dentin), group 3 (applying GIC with silver nanoparticles (AgNPs) (0.4%) on dentin), and group 4 (applying GIC with silver nanoparticles (AgNPs) (0.6%) on dentin). For the preparation of the control group, the ratio of powder and liquid will be taken as per the manufacturers’ instructions, and they will be mixed on a glossy paper pad.

Then, utilising a universal testing equipment (Instron universal testing machine), mechanical qualities including compressive strength, tensile strength, and bond strength will be examined. Utilising universal hardness testing equipment, the hardness will be evaluated.

Expected outcomes

In comparison to standard Type II GIC, GIC reinforced with silver nanoparticles is anticipated to have improved mechanical and physical qualities, less microleakage, and fewer risks of secondary caries due to the antibacterial ability of silver nanoparticles. A potential restorative material for primary teeth is GIC enhanced with silver nanoparticles.

Null hypothesis

There is no difference in mechanical and physical properties, microleakage, and secondary caries formation between standard Type II Glass Ionomer Cement (GIC) and GIC reinforced with silver nanoparticles.

Sample size

Sample size is determined using the following formula,

\begin{array}{c} n = (Z 1 - α / 2 + Z 1 - β) 2 p 1 (1 - p 1) + p 2 (1 - p 2) \\ (p 1 - p 2) 2 \end{array}

Proportion of outcome (p1) = 0.58

Proportion of outcome (p2) = 0.65

Level of significance (α) = 0.05

Power (1- β) = 0.80

Z alpha value = 1.96

Z beta value = 0.85

Input: Effect size f = 0.34

α error probability = 0.05

Power (1-β error probability) = 0.85

Numerator df = 10

Number of covariates = 1

Output: Noncentrality parameter λ = 25.0000000

Critical F = 1.759

Denominator df = 76

Total sample size = 104

Actual power = 0.9125

Sample size = 104

Total Sample size = 104

As per Wassefy et al.¹⁶

Statistical method

All the results will be calculated using SPSS version 27 software (IBM Corp, 2020) (RRID:SCR_002865). Data for outcome variables will be tested for normality using kalmogorov-smirlov. Comparative analysis over the outcome of functional occlusion in different malocclusion will be evaluated and measurement of depth of curve of Spee and Wilson in millimetres respectively. ANOVA will be used to find significant difference in mean in comparison of four groups. The Tukey test will be used for comparative evaluation of measurement in between two groups pairwise. P-value≤0.05 will be considered significant with a 5% level of significance and 95% confidence of interval.

Dissemination

Article will be published in indexed journal/findings will be shared in conferences.

Study status

The study is not yet started. However, we are planning to begin the research in August 2023 and complete in around six months.

Discussion

Anti-bio adhesion coatings, antibiotic coatings, and silver inclusion are some of the ways proposed to inhibit bacterial attachment to bare material surfaces; the latter has attracted the curiosity of many researchers.

Noha A. El-Wassefy et al., investigated adding silver nanoparticles to GIC. This showed that this can prevent the establishment of S. Aureus biofilms while having just a minor impact on mechanical properties.¹⁶

Faisal Mohammed Abed et al., conducted an in vitro investigation and found that GIC added with AgNPs positively affected the bond quality in dentin interaction at concentrations more than 0.4%.⁵

A broad-spectrum antibiofilm effect of silver has been found, with little to no bacterial resistance. According to literature on the antibiofilm actions of silver compounds, silver can be used in bone cement and wound dressings.¹⁷^,¹⁸ Thus, data from past studies indicate the advantages of inserting silver nanoparticles, which show increased mechanical and antibacterial properties. There is still not enough research on the strength of the bond contact between dentin and silver nanoparticles as well as durability of colour. As a result, the goal of this work is to evaluate and compare the mechanical properties, colour stability, and bond strength of primary teeth filled with glass ionomer cement at varying concentrations of silver nanoparticles.

Ethical considerations

Ethical approval received from Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha

IEC reference number - DMIHER (DU)/IEC/2023/566

Data availability

Reporting guidelines

Zenodo: Spirit _checklist Harry, https://doi.org/10.5281/zenodo.7788338.¹⁹

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

References

1. Zafar MS, Amin F, Fareed MA, et al.: Biomimetic Aspects of Restorative Dentistry Biomaterials. Biomimetics. 2020 Jul 15; 5(3): 34. Publisher Full Text
2. Rekow ED, Bayne SC, Carvalho RM, et al.: What constitutes an ideal dental restorative material? Adv. Dent. Res. 2013 Nov; 25(1): 18–23. PubMed Abstract | Publisher Full Text
3. Rekow ED, Bayne SC, Carvalho RM, et al.: What Constitutes an Ideal Dental Restorative Material? Adv. Dent. Res. 2013. [cited 2023 Apr 11]. Publisher Full Text
4. Wilson AD, Kent BE: A new translucent cement for dentistry. The glass ionomer cement. Br. Dent. J. 1972 Feb 15; 132(4): 133–135. PubMed Abstract | Publisher Full Text
5. Abed FM, Kotha SB, AlShukairi H, et al.: Effect of Different Concentrations of Silver Nanoparticles on the Quality of the Chemical Bond of Glass Ionomer Cement Dentine in Primary Teeth. Front. Bioeng. Biotechnol. 2022 [cited 2023 Apr 11]; 10. PubMed Abstract | Publisher Full Text | Free Full Text
6. McLean JW, Wilson AD: The clinical development of the glass-ionomer cement. II. Some clinical applications. Aust. Dent. J. 1977 Apr; 22(2): 120–127. Publisher Full Text
7. Hu J, Du X, Huang C, et al.: Antibacterial and physical properties of EGCG-containing glass ionomer cements. J. Dent. 2013 Oct; 41(10): 927–934. PubMed Abstract | Publisher Full Text
8. Garcia-Contreras R, Scougall-Vilchis RJ, Contreras-Bulnes R, et al.: Mechanical, antibacterial and bond strength properties of nano-titanium-enriched glass ionomer cement. J. Appl. Oral Sci. 2015; 23(3): 321–328. PubMed Abstract | Publisher Full Text | Free Full Text
9. Khan I, Saeed K, Khan I: Nanoparticles: Properties, applications and toxicities. Arab. J. Chem. 2019 Nov 1; 12(7): 908–931. Publisher Full Text
10. Fernandez CC, Sokolonski AR, Fonseca MS, et al.: Applications of Silver Nanoparticles in Dentistry: Advances and Technological Innovation.Int. J. Mol. Sci.2021 Mar 2;22(5): 2485. PubMed Abstract | Publisher Full Text | Free Full Text
11. Moraes G, Zambom C, Siqueira WL: Nanoparticles in Dentistry: A Comprehensive Review.Pharmaceuticals (Basel).2021 Jul 30; 14(8): 752. PubMed Abstract | Publisher Full Text | Free Full Text
12. Monteiro DR, Gorup LF, Takamiya AS, et al.: The growing importance of materials that prevent microbial adhesion: antimicrobial effect of medical devices containing silver. Int. J. Antimicrob. Agents. 2009 Aug; 34(2): 103–110. PubMed Abstract | Publisher Full Text
13. Lansdown ABG: Silver. I: Its antibacterial properties and mechanism of action. J. Wound Care. 2002 Apr; 11(4): 125–130. PubMed Abstract | Publisher Full Text
14. Anusavice KJ, Phillips RW, Shen C, et al.: Phillips’ science of dental materials. 12th ed.St. Louis, Mo.: Elsevier/Saunders; 2013 [cited 2023 Apr 16]; 29. Reference Source
15. Hamdy TM: Evaluation of compressive strength, surface microhardness, solubility and antimicrobial effect of glass ionomer dental cement reinforced with silver doped carbon nanotube fillers. BMC Oral Health 2023; 23: 777. PubMed Abstract | Publisher Full Text | Free Full Text
16. El-Wassefy NA, El-Mahdy RH, El-Kholany NR: The impact of silver nanoparticles integration on biofilm formation and mechanical properties of glass ionomer cement. J. Esthet. Restor. Dent. Off. Publ. Am. Acad. Esthet. Dent. Al. 2018 Mar; 30(2): 146–152. PubMed Abstract | Publisher Full Text
17. Alt V, Bechert T, Steinrücke P, et al.: An in vitro assessment of the antibacterial properties and cytotoxicity of nanoparticulate silver bone cement. Biomaterials. 2004 Aug; 25(18): 4383–4391. PubMed Abstract | Publisher Full Text
18. Bjarnsholt T, Kirketerp-Møller K, Kristiansen S, et al.: Silver against Pseudomonas aeruginosa biofilms. APMIS Acta Pathol. Microbiol. Immunol. Scand. 2007 Aug; 115(8): 921–928. Publisher Full Text
19. Kanani H, Khubchandani M: Spirit _checklist Harry (Version V1). [Guidelines]. Zenodo. 2023. Publisher Full Text

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Version 2

VERSION 2 PUBLISHED 01 Sep 2023

Author details Author details

¹ Pediatrics and Preventive Dentistry,, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, 442001, India

Harikishan Kanani
Roles: Conceptualization, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation

Monika Khubchandani
Roles: Supervision, Validation, Visualization, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

The author(s) declared that no grants were involved in supporting this work.

Article Versions (2)

version 2

Revised

Published: 26 Sep 2024, 12:1084

https://doi.org/10.12688/f1000research.133455.2

version 1

Published: 01 Sep 2023, 12:1084

https://doi.org/10.12688/f1000research.133455.1

© 2024 Kanani H and Khubchandani M. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Kanani H and Khubchandani M. Comparative Evaluation of Mechanical Properties and Bond Strength of Glass Ionomer Cement reinforced with three different concentrations of Silver Nanoparticles as against Conventional Glass Ionomer Cement in Primary Teeth. [version 2; peer review: 1 approved, 2 approved with reservations, 3 not approved]. F1000Research 2024, 12:1084 (https://doi.org/10.12688/f1000research.133455.2)

NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.

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Open Peer Review

Current Reviewer Status: ?

Key to Reviewer Statuses VIEW HIDE

ApprovedThe paper is scientifically sound in its current form and only minor, if any, improvements are suggested

Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.

Not approvedFundamental flaws in the paper seriously undermine the findings and conclusions

Version 2

VERSION 2

PUBLISHED 26 Sep 2024

Revised

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Reviewer Report 30 Apr 2025

Muna Saleem Khalaf, Pedodontics and Preventive Dentistry, University of Baghdad, Baghdad, Iraq

Approved with Reservations

https://doi.org/10.5256/f1000research.172182.r379209

Title:
The title is too detailed and long. Review changing it to “Impact of Silver Nanoparticle Inclusion to Reinforced Glass Ionomer Cement on Mechanical Properties and Bond
Strength in Primary Teeth"

Introduction:

The introduction requires a few corrections or additions. For example, defining restorative dental materials as to replace carious teeth should be corrected. Restorative dental materials replace lost dental tissue or structure that maybe due to caries in addition to many other causes such as trauma, wear…. etc. The drawbacks of GIC should concentrate on the aim of this study to enhance these downsides. Mentioning overall drawbacks or weaknesses of the material was fine but to focus on the weak bond strength of the material to dentin and enamel and other mechanical properties to be studied is more important to justify the need for this study.
Silver Nanoparticles have shown antibacterial effect and remineralization of dental tissues. Their preventive role in reducing caries progression and increasing hardness of dental tissue has not been mentioned. More reference on the effect of Silver Nanoparticles in increasing hardness and remineralization on bonding strength should be considered.
At the end of the introduction, the objectives of the study included color stability while it was not mentioned in the aims. Was this measured? If color stability was measured, the method of measurements was not mentioned. Details should be provided on the method and device or exclude it from the study.

Aim/Objective:

Be more detailing when writing the aims of the study. Mention the mechanical properties specifically to be included in the study.

Materials and Methods:

This part needs more details on the materials used and their production, method of preparation (especially Silver Nanoparticles in different concentrations) and manipulation. Fuji II is provided in the form of liquid and powder. Silver Nanoparticles at different concentrations are used but the form of addition is not clarified. Added as powder by weight to the powder of Fuji II? Or to the liquid constituent. Has their addition been taken in account to the overall volume of the GIC material. Meaning: if added to the powder or liquid it will increase the amount and will this affect the mixing property or the setting property of the material? Was the mixing of material manually or by a mixing device? This should be clarified because the method of mixing has a significant effect on the properties of the material. How was the material applied in the cavity?
Sample collection and preparation:
The collection of teeth needs to be more precise. Was a consent obtained from the child, parent or guardian? The criteria for collection, centers or clinics whether public or private. preparation of teeth also needs to be clarified such as cleaning and polishing before storage.
Criteria for cavity preparation should be mentioned. Standardization involving drilling device, type of bur, depth of cavity. 2,0 mm of the tissue along with the cusps is unclear. Provide precise dimensions. What was the severity of caries in carious teeth. How will the severity be recorded? Unify the sample; carious teeth or sound teeth at shedding time. By what criteria or index was the depth or cavity preparation decision considered enough. The reach of sound dentin? Affected dentin? Within a standard thickness of dentin? If the cavity was finished, confirmation of sound or affected dentin was obtained by which mean? A device or dye?

Discussion:

The writing of the discussion section should focus on the objectives of the study. The effect of incorporating Silver Nanoparticles in GIC on bacterial establishment and antibiofilm effect has not been included as an aim of this study. Therefore, should not be discussed. This also applies for the use of silver compounds in wound dressing and bone cement. Focus on the tests carried out. Rewrite the discussion to avoid being presented as review of literature.

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Partly

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: dentistry, pedodontics, child behavior

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

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Author Response 25 Jun 2025

Harikishan Kanani, Pediatrics and Preventive Dentistry,, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, 442001, India

25 Jun 2025

Author Response

Thank you so much
Competing Interests: No competing interests were disclosed.
Thank you so much
Thank you so much
Competing Interests: No competing interests were disclosed. Close
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Author Response 25 Jun 2025

Harikishan Kanani, Pediatrics and Preventive Dentistry,, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, 442001, India

25 Jun 2025

Author Response

Thank you so much
Competing Interests: No competing interests were disclosed.
Thank you so much
Thank you so much
Competing Interests: No competing interests were disclosed. Close
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Reviewer Report 23 Apr 2025

Paulo J. Palma, University of Coimbra, Coimbra, Portugal

Not Approved

https://doi.org/10.5256/f1000research.172182.r379207

The study aims to evaluate the effect of silver nanoparticle (AgNP) reinforcement on the mechanical properties and bond strength of glass ionomer cement (GIC) in primary teeth. This is a relevant topic, as improving the properties of GIC could lead to better clinical outcomes in pediatric dentistry. However, several areas need to be addressed to enhance the manuscript's quality and suitability for a high-impact journal.

Specific Comments:
Title:

The title is quite long. Consider shortening it for clarity and impact. For example: "Silver Nanoparticle-Reinforced Glass Ionomer Cement Improves Mechanical Properties and Bond Strength in Primary Teeth"

Abstract:

The abstract should be concise and clearly state the study's purpose, methods, key findings (if available), and conclusion.
The current abstract lacks specific details about the methodology (e.g., how the teeth were prepared, the exact mechanical tests used) and doesn't include any quantitative results.
Suggestion: Revise the abstract to include more specific information.

Introduction:

The introduction provides a good overview of the background and rationale for the study.
The literature review is generally adequate, but could benefit from more recent and high-impact publications.(e.g., Mansoor A, et al., 2025 (Ref 1); Lehmann A, et al., 2024 (Ref 2); Omer et al 2024).
A stronger connection between the identified problems of GIC and how AgNPs specifically address those problems would improve the flow. For instance, more emphasis on the specific mechanisms by which AgNPs enhance mechanical properties and reduce bacterial activity. It is suggested to add a sentence or two explaining how AgNPs improve mechanical properties (e.g., 'AgNPs fill the gaps in the GIC matrix, increasing its density and strength.') and reduce bacterial activity (e.g., 'AgNPs release silver ions, which have a broad-spectrum antibacterial effect.').
The last paragraph of the introduction mentions color stability but this is not mentioned in the aim or methods. If it is to be studied, it needs to be formally included.
Suggestions:

Include more recent references.
Elaborate on the mechanisms of AgNP action.
Ensure all aspects mentioned in the introduction (e.g., color stability) are included in the aim, methods, results, and discussion. It is suggested to add a sentence to the Aim/Objective section: 'To also evaluate the color stability of GIC reinforced with different concentrations of silver nanoparticles.' If color stability is included, add details to the Methods section on how color stability will be measured (e.g., using a spectrophotometer). If color stability will not be measured, remove the reference to it from the introduction.

Aim/Objective:

The aim is clearly stated. However, it could be more concise.
The aim mentions mechanical properties. The methods mention hardness, compressive strength, tensile strength, and bond strength. Please ensure that the aim includes all of these.
Suggestion: Ensure that the aim is in line with what is measured in the methods.

Materials and Methods:

This section needs significant improvement in terms of detail and clarity.
Study design: The study design is described as "An in vitro study." This should be more detailed.
Sample Size Justification: The sample size calculation is present, but it's unclear why two different calculations are shown. The text refers to Wassefy et al., but it is unclear if this study is the primary source for the power calculation. Provide a clear justification for the final sample size of 104.
Materials:
Provide more specific information about the GIC (GC Fuji II). Include the manufacturer's details (city, country). (GC Fuji II, GC Corporation, Tokyo, Japan)
Provide the manufacturer and grade/purity of the chemicals used: silver nitrate, sodium citrate, and tannic acid. Silver nitrate (Sigma-Aldrich, St. Louis, MO, USA, 99.99% purity), sodium citrate (Sigma-Aldrich, 99% purity), and tannic acid (Sigma-Aldrich, reagent grade) will be used.
Synthesis of Silver Nanoparticles:

This section lacks critical details. The method for synthesizing AgNPs must be described in sufficient detail to allow for replication. Include:

Exact concentrations of the starting materials (silver nitrate, sodium citrate, and tannic acid).
The order of addition of the reagents.
Reaction temperature and time.
Stirring speed.
pH of the solutions.
Any purification steps (e.g., washing, centrifugation).
Characterization methods used to confirm the size and morphology of the synthesized AgNPs (e.g., TEM, DLS). This is crucial.

It is not sufficient to say "redução química de agentes redutores". Silver nanoparticles were synthesized using a previously described method [Reference]. Briefly, 100 ml of 1 mM silver nitrate solution was heated to 90°C under constant stirring. Then, 10 ml of 1% sodium citrate solution was added rapidly, and the solution was stirred for 30 minutes until a color change occurred. The solution was then cooled to room temperature. The pH was not adjusted. The resulting AgNP solution was washed three times by centrifugation at 10,000 rpm for 15 minutes to remove excess reactants. The size and morphology of the synthesized AgNPs were characterized using Transmission Electron Microscopy (TEM) and Dynamic Light Scattering (DLS).

Specimen Preparation:

The preparation of the extracted teeth needs more detail.
Specify the number of teeth per group (it says n=26 in one section and 104 total in another).
Clarify the storage conditions (0.1% thymol solution with 0.9% isotonic sodium chloride at 5°C). Why this specific solution and temperature?
The cavity preparation method needs more detail. "2,0 mm of the tissue along with the cusps" is unclear. Provide precise dimensions and a diagram if possible. What bur size and shape was used? Was a standardized cavity preparation method used?
How was the GIC mixed? Was it done manually or mechanically? What was the mixing time?
How was the GIC inserted into the cavities? Was any bonding agent used?
What was the curing/setting time of the GIC?
Was there any finishing or polishing of the restorations?

Mechanical Testing:

More detail is needed on the mechanical testing procedures.
Specify the crosshead speed for the Universal Testing Machine for each test (compressive strength, tensile strength, and bond strength).
For bond strength, describe the specific test method (e.g., microtensile bond strength, shear bond strength). Include details about the bonding area.
Specify how hardness will be measured. Which hardness test will be used (e.g., Vickers, Knoop)? What will be the load and dwell time? Hardness was measured using a Vickers hardness tester (Model, Manufacturer, City, Country) with a load of 500 g and a dwell time of 15 seconds. Three indentations were made on each specimen, and the average value was recorded.

Statistical Analysis:

The statistical methods are generally appropriate.
Specify which post-hoc test will be used following ANOVA. The text mentions Tukey, but this should be stated clearly in this section.
Justify the choice of statistical tests.
Define what is meant by "functional occlusion" in this study. This term seems out of place in an in vitro study on extracted teeth.
Suggestion: Revise this section carefully for accuracy and clarity.

Expected Outcomes/Null Hypothesis:

The expected outcomes are clearly stated.
The null hypothesis is also clear.

Discussion:

The discussion should interpret the findings in light of the existing literature, highlight the study's limitations, and suggest future research directions. As there are no results, this is not possible.
The current discussion is more of a literature review.
Suggestions:

Rewrite the discussion after the results are obtained.
Focus on the study's findings and their implications.
Discuss the limitations of the in vitro design and the clinical relevance of the findings.

Ethical Considerations:

Ethical approval is mentioned, which is good.

Data Availability:

Data availability is stated.

References:

The reference list is generally adequate, but ensure all references are correctly formatted according to the journal's guidelines.
Include more recent references, especially for the introduction and discussion. To that end, recent publications, including "Synthesis of novel titania nanoparticles using corn silky hair fibres and their role in developing a smart restorative material in dentistry" (Mansoor et al., 2025), "Awareness of possible complications associated with direct composite restorations: A multinational survey among dentists from 13 countries with meta-analysis." (Lehmann et al., 2024), "Repair versus replacement of defective direct dental restorations: A multinational cross-sectional study with meta-analysis." (Hatipoğlu et al., 2024), and "Novel microbial synthesis of titania nanoparticles using probiotic Bacillus coagulans and its role in enhancing the microhardness of glass ionomer restorative materials" (Mansoor et al., 2024), could be of significant value. Mansoor A, Mansoor E,
- Mansoor A, et al., 2025 (Ref 1)
- Lehmann A, et al., 2024 (Ref 2)
- Hatipoğlu Ö, et al., 2024 (Ref 3)
- Mansoor A, et al., 2024 (Ref 4)
Check for consistency in reference formatting.

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Partly

References

1. Mansoor A, Mansoor E, Mansoor E, Mansoor E, et al.: Synthesis of novel titania nanoparticles using corn silky hair fibres and their role in developing a smart restorative material in dentistry.Comput Struct Biotechnol J. 2025; 29: 29-40 PubMed Abstract | Publisher Full Text
2. Lehmann A, Nijakowski K, Jankowski J, Donnermeyer D, et al.: Awareness of possible complications associated with direct composite restorations: A multinational survey among dentists from 13 countries with meta-analysis.J Dent. 2024; 145: 105009 PubMed Abstract | Publisher Full Text
3. Hatipoğlu Ö, Martins JFB, Karobari MI, Taha N, et al.: Repair versus replacement of defective direct dental restorations: A multinational cross-sectional study with meta-analysis.J Dent. 2024; 148: 105096 PubMed Abstract | Publisher Full Text
4. Mansoor A, Mansoor E, Mehmood M, Hassan SMU, et al.: Novel microbial synthesis of titania nanoparticles using probiotic Bacillus coagulans and its role in enhancing the microhardness of glass ionomer restorative materials.Odontology. 2024; 112 (4): 1123-1134 PubMed Abstract | Publisher Full Text

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Dentistry, NanoMaterials and Endodontic

I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above.

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Author Response 16 Jun 2025

Harikishan Kanani, Pediatrics and Preventive Dentistry,, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, 442001, India

16 Jun 2025

Author Response

Thank you
Competing Interests: No competing interests were disclosed.
Thank you
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Author Response 16 Jun 2025

Harikishan Kanani, Pediatrics and Preventive Dentistry,, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, 442001, India

16 Jun 2025

Author Response

Thank you
Competing Interests: No competing interests were disclosed.
Thank you
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Reviewer Report 11 Apr 2025

Daniela Prócida Raggio, University of São Paulo, Sao Paulo, Brazil

Not Approved

https://doi.org/10.5256/f1000research.172182.r376651

This manuscript presents a protocol for a study aiming to evaluate glass ionomer cement (GIC) reinforced with silver nanoparticles. However, it contains major conceptual flaws, methodological errors, and scientific misunderstandings that make it unsuitable for acceptance and raise serious concerns about the validity and ethical justification of conducting such a study. As it stands, this protocol should not be approved, funded, or implemented.

Major Concerns:

Lack of Scientific Rationale:
The central premise of using silver nanoparticles in GIC, purportedly for their antibacterial properties, is scientifically unfounded in the context of caries prevention. There is robust evidence from both clinical and laboratory studies indicating that the antibacterial effect of restorative materials does not significantly reduce caries risk in vivo. Caries is a multifactorial disease, and addressing it solely with antimicrobial materials reflects a fundamental misunderstanding of its etiology. This invalidates the rationale for the study.
Inappropriate Use of Terminology:
The authors continue to use the outdated and scientifically unsupported term "microleakage," which has been widely criticized in the literature for its lack of clinical relevance and methodological inconsistency. Moreover, the manuscript states this will not even be measured in the study, making its inclusion in the justification section entirely inappropriate and misleading.
Misuse of SPIRIT Checklist:
The SPIRIT checklist is designed strictly for clinical trial protocols. The current study is not a clinical trial, and its use here is inappropriate and misleading. This suggests a lack of understanding of research reporting standards.
Discussion Section:
The discussion is conceptually weak and disconnected from the study's aims and methodology. It fails to engage critically with existing literature, ignores key clinical implications, and lacks scientific coherence.
Sample Size Miscalculation:
The sample size calculation is severely flawed. Using the standard formula for comparing two proportions and the values provided by the authors (p1 = 0.58, p2 = 0.65, α = 0.05, power = 80%), the correct sample size would be approximately 754 participants per group (totaling over 1,500). The manuscript significantly underestimates the required sample, making the planned study underpowered and statistically invalid from the outset Correct calculation:n=(Z1−α/2+Z1−β)2⋅[p1(1−p1)+p2(1−p2)](p1−p2)2n=(p1−p2)2(Z1−α/2+Z1−β)2⋅[p1(1−p1)+p2(1−p2)] Substituting the values: n=(1.96+0.84)2⋅[0.58(0.42)+0.65(0.35)](0.58−0.65)2≈754 per groupn=(0.58−0.65)2(1.96+0.84)2⋅[0.58(0.42)+0.65(0.35)]≈754 per group
Typographical and Terminological Errors:
There are multiple language and technical errors throughout the manuscript, including the misspelling of the Kolmogorov-Smirnov test ("kalmogorov-smirlov"), further suggesting a lack of basic statistical literacy required to conduct and report a study.
Timeline Statement:
The authors state, “The study is not yet started. However, we are planning to begin the research in August 2023 and complete in around six months.” This lack of specificity, coupled with major unresolved issues in the protocol, reflects poor planning and raises ethical concerns about initiating the study without methodological integrity.

Is the rationale for, and objectives of, the study clearly described?

No
Is the study design appropriate for the research question?

No
Are sufficient details of the methods provided to allow replication by others?

No
Are the datasets clearly presented in a useable and accessible format?

No

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Paediatric Dentistry; cariology, Research integrity

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Author Response 15 Apr 2025

Harikishan Kanani, Pediatrics and Preventive Dentistry,, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, 442001, India

15 Apr 2025

Author Response

Thank you
Competing Interests: No competing interests were disclosed.
Thank you
Thank you
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Author Response 15 Apr 2025

Harikishan Kanani, Pediatrics and Preventive Dentistry,, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, 442001, India

15 Apr 2025

Author Response

Thank you
Competing Interests: No competing interests were disclosed.
Thank you
Thank you
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Version 1

VERSION 1

PUBLISHED 01 Sep 2023

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Reviewer Report 14 Sep 2024

Ana Ivanišević Malčić, Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia

Not Approved

https://doi.org/10.5256/f1000research.146446.r318291

Please consider the following:
Abstract
After you establish that much of the previous research with the addition of silver particles to GIC has dealt with the mechanical properties, you want to introduce the purpose of your study and that is determining how the addition of the silver particles affects the bond strength of the modified material to dentine and color stability of the GIC modified with silver nano particles, (rather than „the quality of the bond contact between the silver particles and, as well as the color's durability.'') However, if determining the color stability is not the aim of the study and is not mentioned in the expected results and methods, maybe this part can be omitted from this introductory section of the Abstract as well.

''Three different concentrations of silver nanoparticles will be prepared i.e., 0.2, 0.4, and 0.6%.'' Here you should be more precise. If you are talking about weight or volume percentage than it would be better to write wt%, or vol%

Introduction
Similarly as in abstract, authors state at the end of the introduction ''There has not been enough research on the strength of the binding contact between dentin and silver nanoparticles, as well as the cooler stability.'' But, the bond between particular particles is not the objective rather the bond strength of the modified material to the dentin of primary teeth. So, a sentence describing objective should be clear: instead ''… bond strength of primary teeth filled with GIC reinforced ….'' It should say ''…bond strength of GIC reinforced with various concentration of silver nanoparticles to primary teeth…''

Objective
It is not compatible with the last sentence in the Introduction. It is not clear whether the color stability will be determined or not.

Methods
It is important to carefully chose storage solutions. It is also important to properly describe concentration of storage solutions. Was it W/V % of chloramine and thymol? It was shown that storage in thymol (up to 6 months) does not affect the bond strength of dental resins to dentin, but PBS would be better choice than saline.
For testing mechanical properties, material specimens should be prepared. Please consult ISO 9917-1:2007, ISO 9917-2:2017 (CS and TS cylinders 4x6mm, and for FS rods 25 x2x2 mm). Also, The ISO 9917-1:2007 is relevant to micro tensile bond strength measurement for water-based cements.

Statistical method
The choice of statistical tests will depend on the dana distribution which you cannot predict. In case you get normal distribution, the suggested tests can be performed.

Discussion
You discuss antibacterial effect of silver, jet it is not your objective of the proposed study.

Is the rationale for, and objectives of, the study clearly described?

No
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

No
Are the datasets clearly presented in a useable and accessible format?

No

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Endodontics, endodontic surgery, restorative materials

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Reviewer Report 11 Sep 2024

Tamer M Hamdy, National Research Centre, Dokki, 12622, Cairo, Egypt

Approved with Reservations

https://doi.org/10.5256/f1000research.146446.r250686

Reviewer comments to Editor
I would like to express my deepest appreciation to the editor for the invitation to review the manuscript. The current article investigates and compares the mechanical properties and bond strength of Glass ionomer cement reinforced with three different concentrations of silver nanoparticles as against conventional glass. The following comments and minor corrections provided to the author are given below.

Reviewer comments to Author
According to this manuscript, I would like to express my thanks to the authors for their great efforts. In my opinion, the paper is found interesting.
I would like to get attention to the following simple comments.

The null hypothesis should be mentioned in the introduction
In the introduction, you should mention other studied modifications performed in G.I. as "Evaluation of compressive strength, surface microhardness, solubility and antimicrobial effect of glass ionomer dental cement reinforced with silver doped carbon nanotube fillers" as they added silver-doped carbon CNT into conventional G.I. ( Hamdy TM. et al., 2023)[Ref 1]. Also, in the discussion, you should compare it with your results.
In the introduction, you should address the advantages and benefits of adding nanosilver to dental restorations.
You should mention in the methodology the causes of using the selected percentages of nanosilver.

-Limitations of the study and recommendations should be added to the end of the manuscript.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Yes

References

1. Hamdy TM: Evaluation of compressive strength, surface microhardness, solubility and antimicrobial effect of glass ionomer dental cement reinforced with silver doped carbon nanotube fillers.BMC Oral Health. 2023; 23 (1): 777 PubMed Abstract | Publisher Full Text

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Dental materials, nanotechnology

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Reviewer Report 22 Dec 2023

Dr.Anushka Deoghare, Chhattisgarh Dental CollegE, Chhattisgarh, India

Approved

https://doi.org/10.5256/f1000research.146446.r229250

The present article evaluates the most commonly used dental material which is Glass ionomer cement in pediatric dentistry. This modification with silver nanoparticles will improve the strength of the material and improves the quality of the material. This paper will contribute in the literature. It will provide a base for the further in vivo studies which will give a new modified way to use GIC covering its drawback

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Yes

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Dental materials.. Oral habits

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

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Version 2

VERSION 2 PUBLISHED 01 Sep 2023

Open Peer Review

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Reviewer Reports

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Dr.Anushka Deoghare, Chhattisgarh Dental CollegE, Chhattisgarh, India
Tamer M Hamdy, National Research Centre, Dokki, 12622, Cairo, Egypt
Ana Ivanišević Malčić, University of Zagreb, Zagreb, Croatia
Daniela Prócida Raggio, University of São Paulo, Sao Paulo, Brazil
Paulo J. Palma, University of Coimbra, Coimbra, Portugal
Muna Saleem Khalaf, University of Baghdad, Baghdad, Iraq

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11 Views

30 Apr 2025 | for Version 2

Muna Saleem Khalaf, Pedodontics and Preventive Dentistry, University of Baghdad, Baghdad, Iraq

11 Views Cite this report Responses(1)

Approved With Reservations

The introduction requires a few corrections or additions. For example, defining restorative dental materials as to replace carious teeth should be corrected. Restorative dental materials replace lost dental tissue or structure that maybe due to caries in addition to many other causes such as trauma, wear…. etc. The drawbacks of GIC should concentrate on the aim of this study to enhance these downsides. Mentioning overall drawbacks or weaknesses of the material was fine but to focus on the weak bond strength of the material to dentin and enamel and other mechanical properties to be studied is more important to justify the need for this study.
Silver Nanoparticles have shown antibacterial effect and remineralization of dental tissues. Their preventive role in reducing caries progression and increasing hardness of dental tissue has not been mentioned. More reference on the effect of Silver Nanoparticles in increasing hardness and remineralization on bonding strength should be considered.
At the end of the introduction, the objectives of the study included color stability while it was not mentioned in the aims. Was this measured? If color stability was measured, the method of measurements was not mentioned. Details should be provided on the method and device or exclude it from the study.

Aim/Objective:

Be more detailing when writing the aims of the study. Mention the mechanical properties specifically to be included in the study.

Materials and Methods:

This part needs more details on the materials used and their production, method of preparation (especially Silver Nanoparticles in different concentrations) and manipulation. Fuji II is provided in the form of liquid and powder. Silver Nanoparticles at different concentrations are used but the form of addition is not clarified. Added as powder by weight to the powder of Fuji II? Or to the liquid constituent. Has their addition been taken in account to the overall volume of the GIC material. Meaning: if added to the powder or liquid it will increase the amount and will this affect the mixing property or the setting property of the material? Was the mixing of material manually or by a mixing device? This should be clarified because the method of mixing has a significant effect on the properties of the material. How was the material applied in the cavity?
Sample collection and preparation:
The collection of teeth needs to be more precise. Was a consent obtained from the child, parent or guardian? The criteria for collection, centers or clinics whether public or private. preparation of teeth also needs to be clarified such as cleaning and polishing before storage.
Criteria for cavity preparation should be mentioned. Standardization involving drilling device, type of bur, depth of cavity. 2,0 mm of the tissue along with the cusps is unclear. Provide precise dimensions. What was the severity of caries in carious teeth. How will the severity be recorded? Unify the sample; carious teeth or sound teeth at shedding time. By what criteria or index was the depth or cavity preparation decision considered enough. The reach of sound dentin? Affected dentin? Within a standard thickness of dentin? If the cavity was finished, confirmation of sound or affected dentin was obtained by which mean? A device or dye?

Discussion:

The writing of the discussion section should focus on the objectives of the study. The effect of incorporating Silver Nanoparticles in GIC on bacterial establishment and antibiofilm effect has not been included as an aim of this study. Therefore, should not be discussed. This also applies for the use of silver compounds in wound dressing and bone cement. Focus on the tests carried out. Rewrite the discussion to avoid being presented as review of literature.

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Partly

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

dentistry, pedodontics, child behavior

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7 Views

23 Apr 2025 | for Version 2

Paulo J. Palma, University of Coimbra, Coimbra, Portugal

7 Views Cite this report Responses(1)

Not Approved

The title is quite long. Consider shortening it for clarity and impact. For example: "Silver Nanoparticle-Reinforced Glass Ionomer Cement Improves Mechanical Properties and Bond Strength in Primary Teeth"

Abstract:

The abstract should be concise and clearly state the study's purpose, methods, key findings (if available), and conclusion.
The current abstract lacks specific details about the methodology (e.g., how the teeth were prepared, the exact mechanical tests used) and doesn't include any quantitative results.
Suggestion: Revise the abstract to include more specific information.

Introduction:

The introduction provides a good overview of the background and rationale for the study.
The literature review is generally adequate, but could benefit from more recent and high-impact publications.(e.g., Mansoor A, et al., 2025 (Ref 1); Lehmann A, et al., 2024 (Ref 2); Omer et al 2024).
A stronger connection between the identified problems of GIC and how AgNPs specifically address those problems would improve the flow. For instance, more emphasis on the specific mechanisms by which AgNPs enhance mechanical properties and reduce bacterial activity. It is suggested to add a sentence or two explaining how AgNPs improve mechanical properties (e.g., 'AgNPs fill the gaps in the GIC matrix, increasing its density and strength.') and reduce bacterial activity (e.g., 'AgNPs release silver ions, which have a broad-spectrum antibacterial effect.').
The last paragraph of the introduction mentions color stability but this is not mentioned in the aim or methods. If it is to be studied, it needs to be formally included.
Suggestions:

Include more recent references.
Elaborate on the mechanisms of AgNP action.
Ensure all aspects mentioned in the introduction (e.g., color stability) are included in the aim, methods, results, and discussion. It is suggested to add a sentence to the Aim/Objective section: 'To also evaluate the color stability of GIC reinforced with different concentrations of silver nanoparticles.' If color stability is included, add details to the Methods section on how color stability will be measured (e.g., using a spectrophotometer). If color stability will not be measured, remove the reference to it from the introduction.

Aim/Objective:

The aim is clearly stated. However, it could be more concise.
The aim mentions mechanical properties. The methods mention hardness, compressive strength, tensile strength, and bond strength. Please ensure that the aim includes all of these.
Suggestion: Ensure that the aim is in line with what is measured in the methods.

Materials and Methods:

This section needs significant improvement in terms of detail and clarity.
Study design: The study design is described as "An in vitro study." This should be more detailed.
Sample Size Justification: The sample size calculation is present, but it's unclear why two different calculations are shown. The text refers to Wassefy et al., but it is unclear if this study is the primary source for the power calculation. Provide a clear justification for the final sample size of 104.
Materials:
Provide more specific information about the GIC (GC Fuji II). Include the manufacturer's details (city, country). (GC Fuji II, GC Corporation, Tokyo, Japan)
Provide the manufacturer and grade/purity of the chemicals used: silver nitrate, sodium citrate, and tannic acid. Silver nitrate (Sigma-Aldrich, St. Louis, MO, USA, 99.99% purity), sodium citrate (Sigma-Aldrich, 99% purity), and tannic acid (Sigma-Aldrich, reagent grade) will be used.
Synthesis of Silver Nanoparticles:

This section lacks critical details. The method for synthesizing AgNPs must be described in sufficient detail to allow for replication. Include:

Exact concentrations of the starting materials (silver nitrate, sodium citrate, and tannic acid).
The order of addition of the reagents.
Reaction temperature and time.
Stirring speed.
pH of the solutions.
Any purification steps (e.g., washing, centrifugation).
Characterization methods used to confirm the size and morphology of the synthesized AgNPs (e.g., TEM, DLS). This is crucial.

It is not sufficient to say "redução química de agentes redutores". Silver nanoparticles were synthesized using a previously described method [Reference]. Briefly, 100 ml of 1 mM silver nitrate solution was heated to 90°C under constant stirring. Then, 10 ml of 1% sodium citrate solution was added rapidly, and the solution was stirred for 30 minutes until a color change occurred. The solution was then cooled to room temperature. The pH was not adjusted. The resulting AgNP solution was washed three times by centrifugation at 10,000 rpm for 15 minutes to remove excess reactants. The size and morphology of the synthesized AgNPs were characterized using Transmission Electron Microscopy (TEM) and Dynamic Light Scattering (DLS).

Specimen Preparation:

The preparation of the extracted teeth needs more detail.
Specify the number of teeth per group (it says n=26 in one section and 104 total in another).
Clarify the storage conditions (0.1% thymol solution with 0.9% isotonic sodium chloride at 5°C). Why this specific solution and temperature?
The cavity preparation method needs more detail. "2,0 mm of the tissue along with the cusps" is unclear. Provide precise dimensions and a diagram if possible. What bur size and shape was used? Was a standardized cavity preparation method used?
How was the GIC mixed? Was it done manually or mechanically? What was the mixing time?
How was the GIC inserted into the cavities? Was any bonding agent used?
What was the curing/setting time of the GIC?
Was there any finishing or polishing of the restorations?

Mechanical Testing:

More detail is needed on the mechanical testing procedures.
Specify the crosshead speed for the Universal Testing Machine for each test (compressive strength, tensile strength, and bond strength).
For bond strength, describe the specific test method (e.g., microtensile bond strength, shear bond strength). Include details about the bonding area.
Specify how hardness will be measured. Which hardness test will be used (e.g., Vickers, Knoop)? What will be the load and dwell time? Hardness was measured using a Vickers hardness tester (Model, Manufacturer, City, Country) with a load of 500 g and a dwell time of 15 seconds. Three indentations were made on each specimen, and the average value was recorded.

Statistical Analysis:

The statistical methods are generally appropriate.
Specify which post-hoc test will be used following ANOVA. The text mentions Tukey, but this should be stated clearly in this section.
Justify the choice of statistical tests.
Define what is meant by "functional occlusion" in this study. This term seems out of place in an in vitro study on extracted teeth.
Suggestion: Revise this section carefully for accuracy and clarity.

Expected Outcomes/Null Hypothesis:

The expected outcomes are clearly stated.
The null hypothesis is also clear.

Discussion:

The discussion should interpret the findings in light of the existing literature, highlight the study's limitations, and suggest future research directions. As there are no results, this is not possible.
The current discussion is more of a literature review.
Suggestions:

Rewrite the discussion after the results are obtained.
Focus on the study's findings and their implications.
Discuss the limitations of the in vitro design and the clinical relevance of the findings.

Ethical Considerations:

Ethical approval is mentioned, which is good.

Data Availability:

Data availability is stated.

References:

The reference list is generally adequate, but ensure all references are correctly formatted according to the journal's guidelines.
Include more recent references, especially for the introduction and discussion. To that end, recent publications, including "Synthesis of novel titania nanoparticles using corn silky hair fibres and their role in developing a smart restorative material in dentistry" (Mansoor et al., 2025), "Awareness of possible complications associated with direct composite restorations: A multinational survey among dentists from 13 countries with meta-analysis." (Lehmann et al., 2024), "Repair versus replacement of defective direct dental restorations: A multinational cross-sectional study with meta-analysis." (Hatipoğlu et al., 2024), and "Novel microbial synthesis of titania nanoparticles using probiotic Bacillus coagulans and its role in enhancing the microhardness of glass ionomer restorative materials" (Mansoor et al., 2024), could be of significant value. Mansoor A, Mansoor E,
- Mansoor A, et al., 2025 (Ref 1)
- Lehmann A, et al., 2024 (Ref 2)
- Hatipoğlu Ö, et al., 2024 (Ref 3)
- Mansoor A, et al., 2024 (Ref 4)
Check for consistency in reference formatting.

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Partly

References

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Dentistry, NanoMaterials and Endodontic

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11 Views

11 Apr 2025 | for Version 2

Daniela Prócida Raggio, University of São Paulo, Sao Paulo, Brazil

11 Views Cite this report Responses(1)

Not Approved

Lack of Scientific Rationale:
The central premise of using silver nanoparticles in GIC, purportedly for their antibacterial properties, is scientifically unfounded in the context of caries prevention. There is robust evidence from both clinical and laboratory studies indicating that the antibacterial effect of restorative materials does not significantly reduce caries risk in vivo. Caries is a multifactorial disease, and addressing it solely with antimicrobial materials reflects a fundamental misunderstanding of its etiology. This invalidates the rationale for the study.
Inappropriate Use of Terminology:
The authors continue to use the outdated and scientifically unsupported term "microleakage," which has been widely criticized in the literature for its lack of clinical relevance and methodological inconsistency. Moreover, the manuscript states this will not even be measured in the study, making its inclusion in the justification section entirely inappropriate and misleading.
Misuse of SPIRIT Checklist:
The SPIRIT checklist is designed strictly for clinical trial protocols. The current study is not a clinical trial, and its use here is inappropriate and misleading. This suggests a lack of understanding of research reporting standards.
Discussion Section:
The discussion is conceptually weak and disconnected from the study's aims and methodology. It fails to engage critically with existing literature, ignores key clinical implications, and lacks scientific coherence.
Sample Size Miscalculation:
The sample size calculation is severely flawed. Using the standard formula for comparing two proportions and the values provided by the authors (p1 = 0.58, p2 = 0.65, α = 0.05, power = 80%), the correct sample size would be approximately 754 participants per group (totaling over 1,500). The manuscript significantly underestimates the required sample, making the planned study underpowered and statistically invalid from the outset Correct calculation:n=(Z1−α/2+Z1−β)2⋅[p1(1−p1)+p2(1−p2)](p1−p2)2n=(p1−p2)2(Z1−α/2+Z1−β)2⋅[p1(1−p1)+p2(1−p2)] Substituting the values: n=(1.96+0.84)2⋅[0.58(0.42)+0.65(0.35)](0.58−0.65)2≈754 per groupn=(0.58−0.65)2(1.96+0.84)2⋅[0.58(0.42)+0.65(0.35)]≈754 per group
Typographical and Terminological Errors:
There are multiple language and technical errors throughout the manuscript, including the misspelling of the Kolmogorov-Smirnov test ("kalmogorov-smirlov"), further suggesting a lack of basic statistical literacy required to conduct and report a study.
Timeline Statement:
The authors state, “The study is not yet started. However, we are planning to begin the research in August 2023 and complete in around six months.” This lack of specificity, coupled with major unresolved issues in the protocol, reflects poor planning and raises ethical concerns about initiating the study without methodological integrity.

Is the rationale for, and objectives of, the study clearly described?

No
Is the study design appropriate for the research question?

No
Are sufficient details of the methods provided to allow replication by others?

No
Are the datasets clearly presented in a useable and accessible format?

No

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Paediatric Dentistry; cariology, Research integrity

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Reviewer Report

9 Views

14 Sep 2024 | for Version 1

Ana Ivanišević Malčić, Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia

9 Views Cite this report Responses(0)

Not Approved

Is the rationale for, and objectives of, the study clearly described?

No
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

No
Are the datasets clearly presented in a useable and accessible format?

No

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Endodontics, endodontic surgery, restorative materials

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9 Views

11 Sep 2024 | for Version 1

Tamer M Hamdy, National Research Centre, Dokki, 12622, Cairo, Egypt

9 Views Cite this report Responses(0)

Approved With Reservations

The null hypothesis should be mentioned in the introduction
In the introduction, you should mention other studied modifications performed in G.I. as "Evaluation of compressive strength, surface microhardness, solubility and antimicrobial effect of glass ionomer dental cement reinforced with silver doped carbon nanotube fillers" as they added silver-doped carbon CNT into conventional G.I. ( Hamdy TM. et al., 2023)[Ref 1]. Also, in the discussion, you should compare it with your results.
In the introduction, you should address the advantages and benefits of adding nanosilver to dental restorations.
You should mention in the methodology the causes of using the selected percentages of nanosilver.

-Limitations of the study and recommendations should be added to the end of the manuscript.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Yes

References

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Dental materials, nanotechnology

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20 Views

22 Dec 2023 | for Version 1

Dr.Anushka Deoghare, Chhattisgarh Dental CollegE, Chhattisgarh, India

20 Views Cite this report Responses(0)

Approved

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Yes

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Dental materials.. Oral habits

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

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Alongside their report, reviewers assign a status to the article:

Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested

Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.

Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions

[1] 1. Zafar MS, Amin F, Fareed MA, et al.: Biomimetic Aspects of Restorative Dentistry Biomaterials. Biomimetics. 2020 Jul 15; 5(3): 34. Publisher Full Text

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[3] 3. Rekow ED, Bayne SC, Carvalho RM, et al.: What Constitutes an Ideal Dental Restorative Material? Adv. Dent. Res. 2013. [cited 2023 Apr 11]. Publisher Full Text

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[5] 5. Abed FM, Kotha SB, AlShukairi H, et al.: Effect of Different Concentrations of Silver Nanoparticles on the Quality of the Chemical Bond of Glass Ionomer Cement Dentine in Primary Teeth. Front. Bioeng. Biotechnol. 2022 [cited 2023 Apr 11]; 10. PubMed Abstract | Publisher Full Text | Free Full Text

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[9] 9. Khan I, Saeed K, Khan I: Nanoparticles: Properties, applications and toxicities. Arab. J. Chem. 2019 Nov 1; 12(7): 908–931. Publisher Full Text

[10] 10. Fernandez CC, Sokolonski AR, Fonseca MS, et al.: Applications of Silver Nanoparticles in Dentistry: Advances and Technological Innovation.Int. J. Mol. Sci.2021 Mar 2;22(5): 2485. PubMed Abstract | Publisher Full Text | Free Full Text

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[12] 12. Monteiro DR, Gorup LF, Takamiya AS, et al.: The growing importance of materials that prevent microbial adhesion: antimicrobial effect of medical devices containing silver. Int. J. Antimicrob. Agents. 2009 Aug; 34(2): 103–110. PubMed Abstract | Publisher Full Text

[13] 13. Lansdown ABG: Silver. I: Its antibacterial properties and mechanism of action. J. Wound Care. 2002 Apr; 11(4): 125–130. PubMed Abstract | Publisher Full Text

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[15] 15. Hamdy TM: Evaluation of compressive strength, surface microhardness, solubility and antimicrobial effect of glass ionomer dental cement reinforced with silver doped carbon nanotube fillers. BMC Oral Health 2023; 23: 777. PubMed Abstract | Publisher Full Text | Free Full Text

[16] 16. El-Wassefy NA, El-Mahdy RH, El-Kholany NR: The impact of silver nanoparticles integration on biofilm formation and mechanical properties of glass ionomer cement. J. Esthet. Restor. Dent. Off. Publ. Am. Acad. Esthet. Dent. Al. 2018 Mar; 30(2): 146–152. PubMed Abstract | Publisher Full Text

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Comparative Evaluation of Mechanical Properties and Bond Strength of Glass Ionomer Cement reinforced with three different concentrations of Silver Nanoparticles as against Conventional Glass Ionomer Cement in Primary Teeth.

Abstract

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Revised Amendments from Version 1

Introduction

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Expected outcomes

Null hypothesis

Sample size

Statistical method

Dissemination

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