Objectives: We are introducing novel glass-ionomer cement (GIC) dually-modified with chitosan (CH) in the liquid phase and titanium-dioxide nano-powder (TiO2 /NP) in the powder phase. The aim was to investigate the effect of this dual-modification on the antibacterial properties against S. mutans biofilms and on the bulk and surface mechanical properties.
Methods: Commercially available powder/liquid restorative GIC was used in this study. The GIC specimens were modified with 3% (w/w) TiO2 /NP, 10% (v/v) CH solution, or dually-modified with TiO2 /CH. The non-modified GIC was used as a control. The biofilms formations were characterized by SEM, live/dead assay using confocal-microscopy, colony-forming unit counts, and MTS assay. The bulk and surface mechanical properties were characterized in terms of flexural and compressive strengths and surface hardness, respectively.
Results: With the dual-modification, a significant improvement in the antibacterial properties was found both qualitatively and quantitatively. The synergetic effect of the dual-modification was also reflected on the enhancement of the flexural and compressive strengths. However, no difference was found in surface hardness.
Conclusions: The modification of GIC powder with TiO2 /NP showed to be more effective in enhancing the mechanical properties. However, the enhancement in the antibacterial properties was more evident with CH incorporation in GIC liquid.
Clinical significance: This study introduced novel glass ionomer cement dually-modified with TiO2 NP and chitosan with superior mechanical and antibacterial properties for potential applications in restorative and preventive dentistry. The modification of GIC powder with TiO2 NP showed to be more effective in enhancing the mechanical properties. However, the enhancement in the antibacterial properties was more evident with CH incorporation in GIC liquid. Although of the promising synergetic effect of the dual-modification of GIC with TiO2 NP/CH, further clinically-related studies are recommended. (J Esthet Restor Dent 29:146-156, 2017).
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