Keywords
Restorative material, Glass ionomer cement, silver nano particles.
This article is included in the Nanoscience & Nanotechnology gateway.
This article is included in the Datta Meghe Institute of Higher Education and Research collection.
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.
Restorative material, Glass ionomer cement, silver nano particles.
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
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.
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.
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
Materials used
Traditional GIC (GC Fuji II, GC Corporation, Tokyo, Japan) shall be procured and
Three chemicals:
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.
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.
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 is determined using the following formula,
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
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.
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.
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).
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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
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 TextCompeting Interests: No competing interests were disclosed.
Reviewer Expertise: Dentistry, NanoMaterials and Endodontic
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
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
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 TextCompeting Interests: No competing interests were disclosed.
Reviewer Expertise: Dental materials, nanotechnology
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
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