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Study Protocol
Revised

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]
PUBLISHED 26 Sep 2024
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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.

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,

n=Z1α/2+Z1β2p11p1+p21p2p1p22

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

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VERSION 2 PUBLISHED 01 Sep 2023
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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
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
Views
9
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Reviewer Report 30 Apr 2025
Muna Saleem Khalaf, Pedodontics and Preventive Dentistry, University of Baghdad, Baghdad, Iraq 
Approved with Reservations
VIEWS 9
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:
... Continue reading
CITE
CITE
HOW TO CITE THIS REPORT
Khalaf MS. Reviewer Report For: 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/10.5256/f1000research.172182.r379209)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
  • 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.
COMMENTS ON THIS REPORT
  • 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.
Views
6
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Reviewer Report 23 Apr 2025
Paulo J. Palma, University of Coimbra, Coimbra, Portugal 
Not Approved
VIEWS 6
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 ... Continue reading
CITE
CITE
HOW TO CITE THIS REPORT
Palma PJ. Reviewer Report For: 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/10.5256/f1000research.172182.r379207)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
  • 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.
COMMENTS ON THIS REPORT
  • 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.
Views
9
Cite
Reviewer Report 11 Apr 2025
Daniela Prócida Raggio, University of São Paulo, Sao Paulo, Brazil 
Not Approved
VIEWS 9
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 ... Continue reading
CITE
CITE
HOW TO CITE THIS REPORT
Raggio DP. Reviewer Report For: 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/10.5256/f1000research.172182.r376651)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
  • 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.
COMMENTS ON THIS REPORT
  • 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.
Version 1
VERSION 1
PUBLISHED 01 Sep 2023
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Cite
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
VIEWS 8
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 ... Continue reading
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CITE
HOW TO CITE THIS REPORT
Ivanišević Malčić A. Reviewer Report For: 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/10.5256/f1000research.146446.r318291)
NOTE: 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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8
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Reviewer Report 11 Sep 2024
Tamer M Hamdy, National Research Centre, Dokki, 12622, Cairo, Egypt 
Approved with Reservations
VIEWS 8
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 ... Continue reading
CITE
CITE
HOW TO CITE THIS REPORT
Hamdy TM. Reviewer Report For: 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/10.5256/f1000research.146446.r250686)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Views
19
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Reviewer Report 22 Dec 2023
Dr.Anushka Deoghare, Chhattisgarh Dental CollegE, Chhattisgarh, India 
Approved
VIEWS 19
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 ... Continue reading
CITE
CITE
HOW TO CITE THIS REPORT
Deoghare DA. Reviewer Report For: 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/10.5256/f1000research.146446.r229250)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.

Comments on this article Comments (0)

Version 2
VERSION 2 PUBLISHED 01 Sep 2023
Comment
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
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