Clinical Oral Investigations

, Volume 22, Issue 2, pp 1019–1031 | Cite as

Glass ionomer cement inhibits secondary caries in an in vitro biofilm model

  • Norbert Krämer
  • Miriam Schmidt
  • Susanne Lücker
  • Eugen Domann
  • Roland FrankenbergerEmail author
Original Article



The objective of this study was to investigate the effect of different glass ionomer cements on secondary caries inhibition in a fully automated in vitro biofilm model.

Materials and methods

One hundred and twenty-four extracted third molars received class V cavities and were filled with one conventional (Ketac Molar/KM), and two resin-modified glass ionomer cements (Photac Fil/PF, Ketac N100/KN, 3M Espe). A bonded resin composite (Single Bond Plus/Filtek Supreme XTE) served as control. After 14 days water storage at 37 °C, specimens were thermocycled (10,000 × 5/55 °C). Over a period of 10 days, specimens were subjected to cariogenic challenge for 3/4/6 h/day. Demineralization was caused by Streptococcus mutans (DSM 20523) alternatingly being rinsed over specimens using artificial saliva. After biological loading, teeth were cut longitudinally and demineralization depths were evaluated at the margins and at a distance of 0.5 mm from the margins using fluorescence microscopy. Marginal quality was investigated under a SEM at ×200 magnification.


Four-hour demineralization depths were for enamel margins (EM), enamel (E), dentin margin (DM), and dentin (D) (μm ± SD): KM: EM 12 ± 8, E 33 ± 7, DM 56 ± 11, D 79 ± 6; PF: EM 19 ± 13, E 34 ± 13, DM 53 ± 10, D 77 ± 12; and KN: EM 26 ± 5, E 38 ± 6, DM 57 ± 11, D 71 ± 7. For all glass ionomer cements (GICs), demineralization depth at the margins was less compared to 0.5 mm distance, with demineralization depth having been correlated to duration of cariogenic challenge (ANOVA [mod. LSD, p < 0.05]). Compared to the bonded resin composite, all GICs exhibited caries inhibition at restoration margins in enamel and dentin.


Fluoride-releasing GIC materials exhibit a secondary caries inhibiting effect in vitro.

Clinical relevance

Glass ionomer cements have a higher secondary caries inhibiting effect than resin composites.


Artificial mouth Caries model Glass ionomer cement Resin-modified glass ionomer cement Fluoride release Secondary caries Biofilm Secondary caries Resin composites Glass ionomer cements Demineralization 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


The work was supported by the Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Giessen and the Department of Operative Dentistry and Endodontics, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Germany.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. All procedures performed in studies involving human body parts i.e., human waste were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments. Ethical approval was provided.

Informed consent

Informed consent was obtained from all patients delivering extracted teeth.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Pediatric Dentistry, Medical Center for DentistryUniversity Medical Center Giessen and MarburgGiessenGermany
  2. 2.Institute for Medical MicrobiologyUniversity Medical Center Giessen and MarburgGiessenGermany
  3. 3.Department of Operative Dentistry and Endodontics, Medical Center for DentistryUniversity Medical Center Giessen and MarburgMarburgGermany

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