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Early caries in proximal tooth surface is very difficult to detect. It has been recognized that the initial carious lesion should be exposed to fluoride in the aqueous phase for a prolonged period of time to achieve the cariostatic effect.
Fluoride has been incorporated in many dental materials such as silicates, glass ionomers, amalgam, liners, pit and fissure sealants and resins. Glass ionomer materials can be considered as potential caries inhibiting materials because of their high fluoride release capacity and fluoride recharging capabilities allowing for long term fluoride release.
The Origin SmartCrown is a crown & bridge restoration that is filled with fluoride releasing material in the interproximal area to inhibit interproximal caries.
1. Caries Inhibiting Capabilities of the
Introduction - The purpose of this test is to find out whether RMGI (Resin-Modified Glass Ionomer) material has the potential to inhibit interproximal caries in comparison with fluoride releasing composite and non-fluoride releasing material.
Four different restorative materials were fixed in the 3D printed tooth model directly adjacent to the enamel surface of the tooth specimens, all of which were then placed in the artificial caries solution to analyze how the interproximal enamel surface becomes demineralized following scientific methods available.
Read More...Conclusion - Based on the test measurement results from the SEM, Zygo, Micro Bio X-ray CT and Density Profiles, the resin-modified glass ionomer materials (3M Ketac Nano & GC Equia) show an effective anti-caries result on the adjacent human tooth enamel.
2. Scientific Studies: Effectiveness of Glass Ionomers on Adjacent Teeth (2005, 2006, 2008, 2010, 2012, 2013, 2014)
Introduction - Since Glass Ionomer was first introduced in dentistry in 1972, numerous scientific articles have clinically demonstrated that, based on its fluoride release capabilities, this material could be utilized as the first choice for prevention and control of interproximal caries.
The X-Ray (2005, 3M) and CT analysis (2008) of enamel density exposed to an RMGI restorative material, along with practice-based clinical studies comprising 1,341 unrestored proximal surfaces in contact with Class II restorations using different restorative materials (2010), were reviewed to assess the effect on the interproximal caries development on the adjacent teeth.
Conclusion - The fluoride releasing materials reduce the development and progression of primary caries on adjacent proximal surfaces.
3. Interproximal Wear Study for the
Introduction – The general concern is that glass ionomer is a weaker material than composite or other established restorative materials, possibly wearing down more easily from the lateral tooth movement. Since RMGI (Resin-Modified Glass Ionomer) material is applied on the interproximal, non-load-bearing area, analytical testing parameters for physical properties should be diametral tensil strength or compressive strength rather than flexural strength or fracture toughness. The applying wear/force should be from the interproximal (1kg, 9.8 Newton), not from occlusal force (5 kg, 49 Newton).
Conclusion - Contrary to potential expectation, resin-based glass ionomer material (3M, Ketac Nano) outperforms composite in wear performance, demonstrating almost the same wear as a PFM with about 40 micron wear in a 5 year accelerated chewing test with mastication simulated at 1.25 million cycles.
4. Bond Strength of the RMGI in the
Origin SmartCrown System
Introduction – Since two different materials are used (the first being the inert primary material of zirconia, porcelain, or lithium-disilicate and the second consisting of the fluoride-releasing RMGI), long-term bonding stability between the two different materials has been tested.
A total of 24 zirconia test samples were made to find the optimal bonding strength. An In vitro autoclave aging test was given (134°C, 5 hrs) which theoretically simulated 15-20 years in vivo.
Conclusion - The combination of a mechanical undercut structure in the mesial/distal pocket and the application of a ceramic primer before applying the RMGI material gave the best result and is the key to long-term stability of the SmartCrown restorative system. The RMGI material did not dislodge and remained very stable as seen under SEM pictures.