Introduction

The field of dentistry has seen significant advancements in recent years, with a particular fo-
cus on the development and improvement of dental materials. One such material, glass
ionomer cement (GIC), has been widely used due to its unique properties such as biocompat-
ibility, fluoride release, and adhesion to tooth structure. It is a versatile material that can be
used for a variety of applications, including fillings, crowns, and bridges. GIC is also known
for its cariostatic properties, meaning that it can help to prevent tooth decay. However, des-
pite these advantages, GICs are not without their limitations. One of the primary concerns is
their susceptibility to microbial attack, which can lead to secondary caries and compromise
the longevity of the restoration. The antimicrobial activity of GIC is due to the release of flu-
oride ions. Fluoride ions are able to bind to the tooth enamel, making it more resistant to acid
attacks from bacteria. In addition, fluoride ions can inhibit the growth of bacteria.

Typically, glass-ionomers consist of a fine powder of basic glass and a solution of polymeric
acid, such as poly (acrylic acid) in water. These formulations are considered to be conven-
tional glass-ionomers and they are set by an acid-base reaction that results in the formation of
a polysalt. The glass is a complex material that consists of calcium or strontium alumino-
silicates, together with added phosphate and fluoride components. Its basic character is con-
trolled by the ratio of alumina to silica in the glass formulation and is designed so that the fin-
ished glass powder can react with the polymer solution to form a hardened material in about
2–3 min.

In the early 1990s, the resin-modified glass-ionomer was introduced to the dental profession.
The essential feature of this material is that, as well as the components of the conventional
glass-ionomer, it contains a monomer and an initiator system. On irradiation by visible light
from a dental cure lamp, the initiator triggers polymerization of the monomer. This cement
therefore sets by dual mechanisms, namely polymerization and neutralization. This results in
a complex set material, and physical properties depend to an extent on the time between mix -
ing, which begins the neutralization, and polymerization. The monomer used in these ce-
ments is 2-hydroxyethyl methacrylate, HEMA. HEMA is water-miscible, but poly (HEMA)
is insoluble in water.

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Despite this, no phase-separation occurs, and the cement sets to give a uniform material
whose physical properties closely resemble those of the conventional glass-ionomer.
Glass-ionomer cements of both types are used to repair teeth damaged by caries. Caries is
known to result from metabolic activity of certain microorganisms on the surface of the teeth,
the most significant of which is Streptococcus mutans.
The fact that such bacteria may remain on the tooth surface to which a restorative material is
applied has led to the suggestion that materials with antimicrobial properties may be benefi-
cial. In the case of glass-ionomers, the materials show a degree of antibacterial character, but
this may need to be augmented by adding bactericides to increase the therapeutic benefit.
Several antibacterial substances have been studied for use as additives within glass-ionomer
cements. These substances must be carefully selected, because they must not be toxic towards
the cells of the pulp or the gingiva but must still be able to protect against the growth of cari-
ogenic bacteria.
In an effort to enhance the antimicrobial properties of GICs, researchers have turned to the in-
corporation of organic antimicrobial agents. This project focuses on the impact of six such
agents:

 Chlorhexidine diacetate
 Chlorhexidine di gluconate
 Benzalkonium chloride
 Cetylpyridinium chloride
 2-hydroxyethyl methacrylate
 Methanol
 Cetrimide

These agents have been selected due to their proven antimicrobial efficacy and their potential
compatibility with GICs. These organic antimicrobial agents have different mechanisms of
action.
Chlorhexidine diacetate and chlorhexidine digluconate are both cationic surfactants that can
bind to the cell membranes of bacteria, disrupting their structure and killing them and is a
widely used antimicrobial agent in dentistry, known for its broad-spectrum activity against a
range of oral bacteria. Benzalkonium chloride is a quaternary ammonium compound that also
binds to cell membranes, while cetylpyridinium chloride is a cationic detergent that works by
disrupting the cell walls of bacteria. 2-Hydroxyethyl methacrylate (HEMA) is a polymer that
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can form a physical barrier that prevents bacteria from adhering to the surface of the GIC.
Methanol is a solvent that can help to dissolve and disperse the organic antimicrobial agents.
The incorporation of these agents into GICs could potentially enhance their antimicrobial
activity, thereby reducing the risk of secondary caries. However, it is crucial to understand
that the addition of these agents could also impact other properties of the GICs.
This project, therefore, aims to investigate not only the antimicrobial activity of the modified
GICs but also their setting time, microhardness, and compressive strength.

The following are the specific objectives of the study:

1. To evaluate the antimicrobial activity of GIC containing organic antimicrobial agents

against Streptococcus mutants, the primary cariogenic bacterium.
2. To determine the effect of organic antimicrobial agents on the setting time of GIC.
3. To assess the impact of organic antimicrobial agents on the micro hardness of GIC.
4. To evaluate the compressive strength of GIC containing organic antimicrobial agents.
The results of this study will provide valuable information on the use of organic antimicrobial
agents in GIC. This information can be used to develop new GIC formulations with improved
antimicrobial properties.
The following are some of the limitations of this study:
 The study was conducted in vitro, so the results may not be directly applicable to clin-
ical settings.
 The study only evaluated the effects of a few different organic antimicrobial agents.
More research is needed to evaluate the effects of other organic antimicrobial agents.
 The study did not evaluate the long-term effects of using GIC containing organic anti-
microbial agents. More research is needed to determine if there are any adverse ef-
fects associated with the long-term use of these materials.

Despite these limitations, in conclusion, this project aims to provide a comprehensive under-
standing of the impact of organic antimicrobial agents on selected properties of conventional
GICs. The findings from this study could potentially pave the way for the development of im-
proved GICs with enhanced antimicrobial properties, without compromising their physical
and mechanical properties.