Ion Releasing Materials PDF

Alkasite-Based Restorative Materials Composition: Contains three inorganic glass fillers: Alkasite filler, inert barium alumino-silicate glass, and an ionomer glass with fluoride. The liquid contains a blend of monomers, Ivocerin as a photointiator and some chemopolymerization components. It does n...

Alkasite-Based Restorative Materials Composition: Contains three inorganic glass fillers: Alkasite filler, inert barium alumino-silicate glass, and an ionomer glass with fluoride. The liquid contains a blend of monomers, Ivocerin as a photointiator and some chemopolymerization components. It does not contain any water. Reactive silanized fluoroalumino silicate glass fillers enhance reactivity, particularly in acidic environments. Advantages  Utilizes an alkaline filler that releases acid-neutralizing ions.  Superior mechanical properties (shear strength, tensile strength, fracture toughness, flexural strength) compared to glass ionomer cements (GIC).  Surface roughness and color stability characteristics comparable to resin composites and GICs. Disadvantages Limited information provided on potential drawbacks or limitations. Setting Reaction  Contains a blend of monomers including Ivocerin as a photoinitiator.  No water content in the material.  Resin polymerization reaction initiated upon mixing due to a chemical initiator.  Water sorption in FAS fillers releases calcium, aluminum, and fluoride ions in a moist environment, aiding in ion release.  No acid–base reaction occurs during the material's setting reaction.  Alkasite fillers do not participate in the setting mechanism. 1 Application of Cention Forte  Apply Cention Primer (Self-etch primer) starting in the enamel, ensuring complete coverage of the tooth surfaces.  Scrub the primer for at least 10 seconds before the application of the material. Mineral Trioxide Aggregate (MTA) Composition Mineral Trioxide Aggregate (MTA) is primarily composed of calcium oxide in the form of tricalcium silicate, dicalcium silicate, and tricalcium aluminate. Bismuth oxide is added for radiopacity. MTA is considered a silicate cement due to its reaction products. The primary reaction product of MTA with water is Calcium Hydroxide, which contributes to MTA’s biocompatibility. Advantages  Biocompatibility: MTA's ability to promote hydroxyapatite formation and dentin bridging enhances the regenerative potential of dental tissues. 2   Antibacterial Properties: MTA's alkaline PH has antibacterial properties, aiding in the prevention of microbial colonization.  Sealing Ability: MTA provides a more leakage-proof seal due to its sealing ability.  Clinical Outcomes: MTA is suggested to be superior to Calcium Hydroxide in terms of uniform and thicker dentin bridge formation, less inflammatory response, and less necrosis of pulpal tissues. Disadvantages  Long Setting Time: MTA has long setting times, which can be inconvenient for both dentists and patients.  Poor Handling: The "sandy" feeling mixture produced by MTA can be difficult to deliver to the required site and hard to condense adequately.  Tooth Discoloration: Tooth discoloration has been reported with the use of MTA, especially the gray variant.  Cost: MTA is expensive compared to alternatives like calcium hydroxide. Application Techniques Newer formulations of MTA often include other materials to reduce the setting time, making it more practical for clinical use. Direct pulp-capping with MTA typically involves application in two visits: the first for MTA application and the second for seating the permanent restoration over the sufficiently hardened MTA. Conclusion MTA offers significant advantages in terms of biocompatibility and clinical outcomes but comes with drawbacks such as long setting times, poor handling 3 characteristics, tooth discoloration risks, and high costs. Understanding these aspects is crucial for informed decision-making in dental procedures involving MTA. 4 5  Biodentine Composition: The powder contains tricalcium and dicalcium silicate, along with calcium carbonate. The liquid contains calcium chloride, which acts as a setting accelerator. Advantages  Considered as a dentin substitute.  Setting time reduced to 10 to 15 minutes  High mechanical properties, excellent biocompatibility, good sealing ability.  Promotes hydroxyapatite formation and remineralization of dentin.  Induces mineralization and alkaline pH.  Promotes differentiation and proliferation of odontoblast-like cells for regeneration and repair. Disadvantages Color changes over time may pose challenges in aesthetic considerations. Setting Reaction  Upon contact with water, undergoes hydration process forming calcium hydroxide.  The alkalinity of the material promotes mineralization and stimulates remineralization of dentin. Clinical Application  Favorable as a pulp capping material over MTA and Calcium hydroxide. 6   Low-quality evidence suggests high success rate for direct pulp capping in teeth with cariously exposed pulps, with better long-term outcomes for MTA and Biodentine compared with calcium hydroxide. Calcium Hydroxide Composition  Calcium hydroxide is a chemical compound with the formula Ca(OH)2.  It is a white, odorless powder that is sparingly water-soluble, forming a strongly alkaline solution. Advantages  Stimulates tertiary dentin formation.  Promotes odontoblast activity and reparative dentin matrix deposition. 7   Supports dentin bridge formation to protect the pulp from injury.  Displays antibacterial properties by creating an alkaline pH unfavorable for bacteria.  Calcium hydroxide liners help maintain odontoblast survival when the remaining dentin thickness (RDT) is ≤ 0.5 mm.  The influx of calcium ions triggers recruitment and proliferation of undifferentiated cells from the pulp. Disadvantages  Low elastic modulus and compressive strength restrict usage to thin layers.  Reduced antibacterial activity over time.  High solubility and water sorption, requiring careful placement to ensure proper sealing.  Should not be acid-etched to prevent softening and contamination of cavity walls. Clinical tips  In cases with an RDT between 0.5 and 1.5 mm, RMGI liners are recommended instead of calcium hydroxide liners.  Calcium hydroxide liners are unnecessary in these cases and may not provide sufficient support for restorations.  High solubility and water sorption necessitate precise placement to prevent issues with sealing and bonding. 8 Light-cured calcium hydroxide  Light-cured calcium hydroxide liners were introduced in 1988 as a single- component liner containing calcium hydroxide, polymerized by visible light. This innovation aimed to overcome the drawbacks of chemically-cured calcium hydroxide, offering advantages such as setting on command, enhanced strength, minimal solubility in acid, and reduced solubility in water.  Based on literature, self-setting calcium hydroxide material provided better dental pulp response than light-cured calcium hydroxide. 9  TheraCal LC Promoted for pulp capping and as a protective liner for restorative materials. Advantages  Immediate polymerization due to its light-curable formulation, reducing treatment time.  Releases calcium hydroxide, creating an alkaline environment that promotes dentin production and cell growth.  Lower solubility and water absorption properties Disadvantages  Incomplete hydration reported due to limited moisture diffusion, impacting its full potential.  Light-curable formulation might have limitations in certain clinical scenarios. Setting Reaction and action  Dependent on environmental moisture for hydration, hence placement on moist dentin is advised.  Induces apatite formation and new dentin production.  Promotes cell growth and proliferation. Clinical use:  Resin-modified calcium silicates are recommended for indirect pulp capping or stepwise excavation due to lower cytotoxic potential.  Caution advised when in direct contact with vital dental pulp due to potential cytotoxicity at high concentrations. 10