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Effectiveness of surface protection for glassionomer, resin-modified glass-ionomer and

polyacid-modified composite resins
ARTICLE in DENTAL MATERIALS JOURNAL FEBRUARY 2009
Impact Factor: 0.97 DOI: 10.4012/dmj.28.96 Source: PubMed

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Dental Materials Journal 2009; 28(1): 96101

Technical Report

Effectiveness of surface protection for glass-ionomer, resin-modified

glass-ionomer and polyacid-modified composite resins
Serpil KARAOLANOLU1, Nilgn AKGL1, Hatice Nur ZDABAK1 and Hayati Murat AKGL2
1

Department of Restorative Dentistry, School of Dentistry, Atatrk University, Erzurum 25240, Turkey
Department of Oral Diagnosis and Oral Radiology, School of Dentistry, Atatrk University, Erzurum 25240, Turkey
Corresponding author, Nilgn AKGL; E-mail: nakgul2000@yahoo.com

The purpose of this study was to evaluate the effectiveness of several surface protectors for a glass-ionomer, a resinmodified glass-ionomer, and a polyacid-modified resin cement by determining dye uptake spectrophotometrically.
378 samples, made up of Ionofil U, Vitremer, and Dyract, were prepared and divided into groups of seven each.
Positive and negative control specimens remained unprotected while the experimental specimens were protected with
Finishing Gloss, Protect-It, LC Varnish, Adper Single Bond, or a nail varnish. The experimental groups and positive
controls were immersed in 0.05% methylene blue solution, while the negative controls were immersed in deionized water.
Results were evaluated using variance analysis.
Of the Ionofil U group, Adper Single Bond exhibited the least effective surface coating among the materials tested,
while the best surface protection was obtained with LC Varnish in the Dyract group. However, no statistically significant
differences were observed in the Vitremer group.
Key words: Surface protection, Glass-ionomer cement, Polyacid-modified composite resin
Received May 31, 2007: Accepted Dec 18, 2007

INTRODUCTION
Conventional glass-ionomer cement, which is a
popular restorative material commonly used in
dentistry for a long time, is formed by an acid-base
reaction between aluminosilicate glass and a 40
50 aqueous solution of acrylic acid/itaconic acid
copolymer stabilized with a 5 tartaric acid1-4).
Ionomer cements are sensitive to hydration and
dehydration during their initial setting and are
frequently protected by coating materials. Initial
setting occurs in a few minutes, but precipitation,
gelation, and hydration take at least 24 hours, and
further etching continues slowly for a much longer
period5).
In recent years, developments in the field of
glass-ionomer cements have led to the introduction of
hybrid versions6). These materials were enhanced to
overcome the problems of low initial mechanical
strength and moisture sensitivity associated with
conventional cements, while preserving their clinical
advantages such as self-adhesion to dental tissues
and fluoride release. These new materials were
classified as resin-modified glass-ionomers6-8).
Resin-modified glass-ionomer cements have two
setting mechanisms: the acid-base setting reaction
and polymerization reaction9). According to McLean
et al.7), resin-modified glass-ionomers are materials
that set concurrently via a dominant acid-base
reaction and auxiliary photopolymerization. This
latter reaction can occur due to the self-cure mode of

the resin phase and/or it can occur by light

activation. Compared with conventional analogs,
resin-modified glass-ionomer cements have been
characterized as having a longer working time, a
rapid set, improved appearance and translucency,
and higher early strength8,10).
In particular, a
remarkable feature of these materials is that they
can be finished and polished on the same visit11).
To overcome the technique-sensitive mixing and
handling properties of resin-modified glass-ionomer
cements, new materials containing acid-decomposible
glass and acidic polymerizable monomers substituting
the polyalkenoic acid polymer were developed7,12).
These materials were termed as polyacid-modified
composite resins, commonly known as compomers. A
polyacid-modified resin (PMR) is a cross between a
glass-ionomer and composite in that it contains a
reactive fluoride glass and an acid as well as a
monomer.
One major and important difference
between glass-ionomers and compomers lies herein:
in the glass-ionomer the acid is present as a polymer,
while in the compomer the acid is present as a
monomer and the polymer is formed by polymerization of the monomers during curing.
Another
significant difference is that PMR contains no water,
and reaction between the glass and acidic monomer
takes place only as PMR takes up water from the
environment13).
To reduce the susceptibility of conventional
glass-ionomer cement and its hybrid versions to
hydration and dehydration problems, surface

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Dent Mater J 2009; 28(1): 96101

protectors were suggested for these materials. In
light of this suggestion, materials referred to as
covering agents or surface sealants have been
developed specifically for rebonding of restorations.
Today, several commercial products are available.
They are resin materials with low viscosity and a
high flow rate, and that they present similar
compositions. Moreover, their application technique
is relatively simple14).
The application of surface protection seems to
preserve the water balance in the system15). Another
advantage of using such surface protectors is that
they fill small surface voids and defects and may help
to preserve the original color of the restorations by
reducing the uptake of stains16).
The purpose of this study was to evaluate the
amount of dye absorbed by a conventional GIC, a
resin-modified GIC, and a polyacid-modified
composite resin and to make an analysis of the effectiveness of various surface agents for these materials
by determining dye uptake spectrophotometrically.
MATERIALS AND METHODS
Materials used
A conventional glass-ionomer cement (Ionofil U, Voco,
Cuxhaven, Germany), a resin-modified glass-ionomer
cement (Vitremer, 3M Dental Products, St Paul, MN,
USA), and a polyacid-modified resin composite
(Dyract AP, DeTrey Dentsply, Konstanz, Germany)
were selected for this study (Table 1).

Table 1

Specimen preparation for experimental groups

These materials were prepared according to manufacturers instructions and placed in teflon disks 4.00
mm in diameter and 2.0 mm in height. These disks
were first slightly overfilled with each restorative
material under evaluation. Strip bands were placed
at both sides of each disk and then sandwiched
between two glass plates with a weight of 500 g. The
specimens prepared for Vitremer and Dyract AP
were light-cured for 40 seconds, while the Iounofil U
specimens were left for 5 minutes for setting2,17).
After which, the plates and strip bands were
removed, and one of the coating materials under
evalaution was applied with a brush on both exposed
surfaces of the specimens twice, except for the
positive and negative control groups. Excess material
was trimmed off, and the protected specimens were
coated again.
A total of 126 specimens were prepared with
each material and randomly divided into seven
groups, each of which contained 18 restorations. The
specimens to be coated with Adper Single Bond (3M
Dental Products, St Paul, MN, USA) and Protect-It
(Jeneric Pentron Inc., Wallingford, CT, USA) were
etched with 37 phosphoric acid for 15 and 20
seconds respectively. Then, they were rinsed for 15
seconds, gently air-dried, and light-cured for 20
seconds. The specimens with LC Varnish (Spofa
Dental, A Kerr Company, Markova, Jicin, CZ) and
Finishing Gloss (3M Dental Products, St Paul, MN,
USA) were not etched, but these coating materials
were spread on the surface using a stream of air and

Materials used in the present study

Product

Manufacturer

Compositiona

Ionofil U

Voco, Cuxhaven, Germany

FAS, PAA, water

Vitremer

3M Dental Products, St Paul, MN, USA

FAS, PMAA, HEMA

Dyract AP

DeTrey, Dentsply, Konstanz, Germany

UDMA, TCB, TEGDMA, Trimethacrylate

resin

Adper single bond

3M Dental Products, St Paul, MN, USA

BisGMA, HEMA, copolymer of polyacrilic

acid, photoinitiator,

Protect it

Jeneric/Pentron, Inc, Wallingford, CT, USA

BisGMA, UDMA, TEGDMA, THFMA

Finishing gloss

3M Dental Products, St Paul, MN, USA

BisGMA, TEGDMA

LC varnish

Spofa Dental, A Kerr Company, Markova, Jicin, CZ

BisGMA, UDMA

Nail varnish

Colorama, CEIL-Com Exp Ltda, Sao Paulo, SP, Brazil

Camphor,
toluene

nitrocellulose,

sulfonamide,

Approximate composition as given by manufacturers.

FAS: aluminium fluorosilicate glass, PPA: polyacrilic acid, PMAA: polymethacrylic acid, HEMA: hydroxyethylmethacrylate, UDMA: urethane dimethacrylate, TCB: carboxylic acid modified dimethacrylateS, TEGDMA: Triethyleneglycoldimethacrylate, BisGMA: Bis-phenol A diglycidylmethacrylate.
a

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Dent Mater J 2009; 28(1): 96101

then irradiated for 20 seconds. The specimens coated

with a nail varnish (Colorama, CEIL Com Exp Ind
Ltda, Sao Paulo, SP, Brazil) were merely left to dry
for 2 minutes.
Dye penetration test
Following the application of the surface coatings, the
specimens were immersed in 0.05 methylene blue
solution at 37C, except for the negative control
specimens which were immersed in deionized water.
After 24 hours, the specimens were rinsed with
deionized water and the surface coatings were
removed with medium SofLex disks (3M Dental
Products, St. Paul, MN, USA) for 5 seconds. The
method used to quantify the effectiveness of surface
protection was adapted from Douglas and Zakariasen,
as described by Serra et al.18). The specimens were
removed from the teflon disks, and each one was
immersed separately in tubes containing 1 mL of
65 nitric acid for 24 hours. After which, standard
and experimental nitric acid solutions were diluted
with 2 mL of deionized water. The solutions were
filtered and centrifuged, and finally the absorbance of
methylene blue in nitric acid was determined by a
spectrophotometer (Samsung Syncmaster 750s) at
600 nm. Dye uptake was expressed in micrograms of

Table 2

dye per specimen, whereby lower values indicated

better effectiveness of the surface protector.
Statistical analysis
At the initial stage of statistical analysis,
homogeneity of variances was first tested for
normality.
Due to the lack of variances, the
KruskalWallis test was used for data analysis.
Further analyses were conducted with the Duncan
test to highlight the significant differences between
the groups.
RESULTS
Table 2 shows the comparison in dye uptake among
the positive control specimens made from Vitremer,
Ionofil U, and Dyract AP. Statistically significant
differences were seen among the three materials with
Dyract AP having the lowest dye uptake, followed by
Ionofil U and Vitremer (p<0.0001).
Table 3 shows the results of multiple
comparisons of surface protection for Ionofil U,
Vitremer, and Dyract AP. As seen in this table, the
positive control groups for all the three restorative
materials allowed the greatest dye penetration,
significantly different from the other surface

Comparison of dye uptake with the positive control specimens from Vitremer, Ionofil U, and Dyract AP

Restorative
Materials

Dye uptake (g/specimen)

meanSD

Median

Mean
Rank

Vitremer

18

18.182.59

17.67

40a

Inofil U

18

14.305.49

15.35

33b

Dyract AP

18

2.320.10

2.37

9.5c

Different letters indicate values that are significantly different at 0.0001 probability level (Duncan test)
Table 3

Results of multiple comparisons of surface protection for Ionofil U, Vitremer, and Dyract AP

Surface
Protection

Ionofil U

Vitremer

Dyract AP

Median
(g/specimen)

Mean
Rank

Median
(g/specimen)

Mean
Rank

Median
(g/specimen)

Mean
Rank

Positive control

18

15.35

117.50a

17.80

117.50a

2.37

117.50a

Adper single bond

18

1.56

95.61b

1.02

70.53b

1.34

73.44b

Protect it

18

1.04

57.97bc

1.01

67.58b

1.33

70.17bcd

Finishing gloss

18

1.03

57.67bc

1.06

75.03b

1.27

60.03cde

Nail varnish

18

1.03

57.33bc

0.91

57.31b

1.27

64.31de

LC varnish

18

0.99

49.92bc

0.885

47.06b

1.19

49.56e

Negative control

18

0.00

9.50c

0.00

9.50c

0.00

9.50f

Different letters indicate values that are significantly different at 0.0001 probability level (Duncan test)

Dent Mater J 2009; 28(1): 96101

treatments.
For Ionofil U, ranking from the highest to the
lowest dye penetration values according to the
applied surface treatment was as follows: Positive
control, Adper Single Bond, Protect-It, Finishing
Gloss, nail varnish, LC Varnish, and negative control.
As indicated earlier, the positive control group
presented a statistically higher dye uptake than the
others (x2=97.013, p<0.0001). In addition, the dye
amounts for the specimens coated with Adper Single
Bond were statistically higher than those of negative
control specimens.
For Vitremer, ranking from the highest to the
lowest dye penetration values was as follows: Positive
control, Finishing Gloss, Adper Single Bond, ProtectIt, nail varnish, LC Varnish, and negative control.
Statistically, no differences in surface protection
effectiveness were observed among the applied
surface coating materials (p>0.05). However, the dye
uptake of the coated specimens was statistically
different from the negative and positive control
specimens (x2=85.857, p<0.0001).
For Dyract AP, ranking from the highest to the
lowest dye penetration values was as follows: Positive
control, Adper Single Bond, Protect-It, nail varnish,
Finishing Gloss, LC Varnish, and negative control.
The dye amounts for the positive and negative
control specimens were statistically different from
the other groups (x2=83.870, p<0.0001).
DISCUSSION
The effect of water on the physical properties of
restorative materials is the subject of many investigations. While some studies have reported negative
effects on physical properties as a result of water
storage and subsequent sorption17,19-26), Mitra10) has
found no significant differences in properties
immediately after curing and extended storage in
water.
In our study, the hydration properties of
conventional glass-ionomer cement and its hybrid
versions were also investigated. It was found that
resin-modified GIC, polyacid-modified composite
resin, and conventional GIC specimens immersed in
methylene blue (positive control) presented a significantly higher dye uptake. Further, it was determined
that there were statistically significant differences in
dye uptake among these materials. In particular, it
was noted that the dye uptake amounts of Vitremer
and Ionofil U were much higher than that of Dyract
AP. These differences in findings could be attributed
to the properties and amounts of resin, especially of
hydrophilic resin7,28-30).
Theoretically, it was thought that activation by
light or chemical inhibitors of glass ionomers might
be effective against water sorption9). However, the

99

addition of a photocurable capability did not significantly reduce glass-ionomer cements susceptibility to
hydration. On the contrary, it has been reported
that resin-modified GIC specimens absorbed
considerable amounts of moisture when stored in
either water or physiological saline solution21,25-27).
Water sorption appeared to be dependent on the
resin (HEMA) content23-25,30-32). Materials with higher
hydrophilic resin (HEMA) content are therofore
expected to have a higher water sorption property.
This was confirmed by Li and co-workers32) who found
that increased filler level in composite resins (i.e.,
lower resin content) resulted in lower water sorption.
The amount of hydrophilic resin (HEMA) in
resin-modified GICs is approxmiately only 533).
With this content, it behaves like a hydrogel. On the
other hand, the network resulting from the copolymerization of acidic monomers and UDMA (urethane
dimethacrylate) is less hydrophilic, such that the
effect of water on Dyract AP was retarded29). These
differences in the structures of restorative materials
indicated that the hydration feature of Dyract AP
was less than that of conventional and resin-modified
GICs and this observation also constituted one of
the findings of the present study. However, when
compared with the negative control group, it was
seen that Dyract AP also absorbed dye significantly.
In a study by Cattani-Lorente et al.29), they
compared the physical qualities of a resin-modified
glass-ionomer cement kept in water against those of
a polyacid-modified composite resin material. They
found that the amount of water uptake in resinmodified glass-ionomer cement was higher and that
it extended to a larger extent by behaving like a
hydrogel.
In the same vein, van Dijken12) observed that
non-protected
Class
III
resin-modified
GIC
restorations showed the highest color change, surface
degradation, and roughness compared with polyacidmodified composite resin and composite resin
restorations. Besides, Beltrao et al.34) determined
after a two-year clinical evaluation that while
conventional Class III GIC restorations showed an
improvement in esthetics, non-protected Class III
resin-modified GIC restorations showed color change
which could be caused by contamination during the
residual acid-base reaction12).
In another study carried out to assess the water
uptake of dental materials, Meyer et al.30) made a
comparison among the conventional GIC, resinmodified GIC, and polyacid-modified composite
resins.
They determined that polyacid-modified
composite resin absorbed less water than
conventional GIC and resin-modified GIC, and that
resin-modified GIC absorbed the largest amount of
water. Likewise, they also attributed this result to
the hydrophilic HEMA chains of the material.

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Dent Mater J 2009; 28(1): 96101

Similar results found by Small et al.35) after a

six-month storage in water further confirmed that
conventional and resin-modified GICs exhibited a
greater water uptake than the polyacid-modified
composite resin, whereby water uptake was
particularly rapid and higher for resin-modified GIC.
These results were consistent with those of the
present study.
It is noteworthy that both water uptake and
water loss of restorative materials can compromise
the physical properties of restorations17,19-24). If water
is lost due to desiccation, the reactions may stop and
surface crazing may occur19). If water is absorbed,
the matrix will become chalky and erode rapidly19).
In relation to this, surface protection is necessary
and recommended for these materials12,17,36-38). The
application of surface protection seems to preserve
the water balance in the system and provide
sufficient early protection to prevent water gain or
loss from materials15,17,36-40). For this reason, much
research has been carried out to evaluate the
bonding and sealing capabilities of surface
coating agents19,30,36-43).
Based on the results of
these studies, the application of surface coating
over GIC and RMGIC restorations is strongly
recommended19,36,37,40,41).
Hotta and Hirukawa41) applied a bonding agent
and a glazing agent on three restorative glass
ionomers and investigated the water resistance of
these two materials. They observed that the water
resistance of glazing agent was better than that of
bonding agent, but the bonding agent had a small
advantage of preventing water movement over glassionomer cement. In another study by Hotta et al.40),
it was found that light-cured bonding agent and
glazing agent were more effective than Ketac varnish
in decreasing water movement.
However, they
attributed this event to separating the varnish from
the surface. In the same vein, Lutz and Phillips42)
determined that not all light-activated resin bonding
agents were successful in protecting the cement.
These differences in findings could be attributed to
variations in the physical and chemical properties of
the resins.
In our study, the effectiveness of different
surface protectors in preventing dye absorption was
evaluated. Results for surface protectors combined
with conventional GIC showed statistically significant
differences in comparison with the positive control
group. Further, Adper Single Bond absorbed significantly more dye compared to the negative control
group. The results of our study agreed with those of
previous studies19,30,36-41).
As for the results of the surface protectors
applied on Dyract AP, it was observed that LC
Varnish absorbed the least dye and Adper Single
Bond absorbed the most. When the same surface

protectors were applied on Vitremer, no statistically

significant differences in dye absorbing capacity were
observed. However, when compared with either
positive or negative control group, statistically
significant differences were found. In another study
by Cefaly et al.43), no significant differences in surface
protection effectiveness were found for the Vitremer
group when nail varnish, flexible resin, protective
glaze, and proprietary glaze were applied on three
different resin-modified glass-ionomer cements. On
the other hand, in a research conducted by Ribeiro et
al.37), Heliobond light-activated bonding resin resulted
in the least dye penetration whereas nail varnish
resulted in the highest degree of dye penetration.
Results of the current study suggested that
conventional GIC, resin-modified GIC, and polyacidmodified resin composite restorations could take up a
considerable amount of dye, and that dye uptake
decreased with the use of a protective coating for all
of them.
A comparison of protected and non-protected
restorations is indeed important to verify the real
influence of surface protection toward restoration
performance. Clinical studies are also necessary to
compare the advantages of different protective agents
over conventional GIC and its hybrid combinations.
At this juncture, it must be highlighted that tooth
brushing and dietary habits can influence the
retention of these agents. Therefore, results obtained
from clinical studies may differ from those obtained
in our laboratory study.
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