首页 » 文章 » 文章详细信息
Acta Biomaterialia Odontologica Scandinavica Volume 5 ,Issue 1 ,2019-12-02
The effect of antimicrobial additives on the properties of dental glass-ionomer cements: a review
Review Articles
Tamer Tüzüner 1 Aleksandar Dimkov 2 John W. Nicholson 3 , 4
Show affiliations
Received 2018-7-9, accepted for publication 2018-10-10, Published 2018-10-10

Aim: The aim of this article is to review the literature on the use of antimicrobial additives in glass-ionomer dental cements.Method: An electronic search between 1987 and the end of 2017 was performed using PubMed, Web of Science and Google search engines with the terms glass-ionomer, glass polyalkenoate, antibacterial and antimicrobial as the key words. The search was refined by excluding the majority of references concerned with cement antimicrobial properties only. Extra papers already known to the authors were added to those considered.Results: A total of 92 relevant articles have been cited in the review of which 55 are specifically concerned with the enhancement of antibacterial properties of glass-ionomers, both conventional and resin-modified, with additives. In addition, information is included on the uses of glass-ionomers and the biological properties of the antibacterial additives employed. There are several reports that show that additives are typically released by diffusion, and that a high proportion is usually left behind, trapped in the cement. Additives generally increase setting times of cements, and reduce mechanical properties. However, smaller amounts of additive have only slight effects and the longer-term durability of cements appears unaffected.Conclusion: Modified glass-ionomer cements seem to be acceptable for clinical use, especially in the Atraumatic Restorative Treatment (ART) technique.


mechanical properties;antimicrobial;Glass-ionomer


© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.



Cetyl pyridinium chloride.

Benzalkonium chloride.


Fusidic acid.


John W. Nicholson.Bluefield Centre for Biomaterials, London, United Kingdom;Dental Physical Sciences, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdo.john.nicholson@bluefieldcentre.co.uk


Tamer Tüzüner,Aleksandar Dimkov,John W. Nicholson. The effect of antimicrobial additives on the properties of dental glass-ionomer cements: a review. Acta Biomaterialia Odontologica Scandinavica ,Vol.5, Issue 1(2019)



[1] SA Libério, ALA Pereira et al. The potential use of propolis as a cariostatic agent and its actions on muans group streptococci. J Ethnopharmacol. 2009;125:1–9.
[2] G Liu, H He. Long-term antibacterial properties and bond strength of experimental nano silver-containing orthodontic cements. J Wuhan Univ Technol Mater Sci Ed,. 2013;28:849–855.
[3] PPNS Garcia, MFB Cardia et al. Antibacterial activity of glass ionomer cement modified by zinc oxide nanoparticles. Microsc Res Tech. 2017;80:456–461.
[4] FM Korkmatz, T Tüzüner et al.. Antibacterial activity, surface roughness, flexural strength and solubility of conventional luting cements containing chlorhexidine diacetate/cetrimide mixtures. J Prosthet Dent. 2013;110:107–115.
[5] NS Kabil, AS Badran et al. Effect of addition of chorhexidine and miswak on the clinical performance and antimicrobial properties of conventional glass ionomer: an in vivo study. Int J Paediatr Dent. 2017;27:380–387.
[6] H Kitagawa, N Izutani et al. Evolution of resistance to cationic biocides in Streptococcus mutans and Enterococcus faecalis. J Dent. 2016;47:18–22.
[7] N Topcuoglu, F Ozan et al. In vitro antibacterial effects of glass-ionomer cement containing ethanolic extract of propolis on Streptococcus mutans. Eur J Dent. 2012;6:428–433.
[8] A El-Tatari, J de Soet et al. Influence of salvadora persica (miswak) extract on physical and antimicrobial properties of glass ionomer cement. Eur Arch Paediatr Dent. 2011;12:22–25.
[9] P Subramaniam, K Girish Babu et al. Does the addition of Propolis to glass ionomer cement alter its physicochemical properties? An in vitro study. J Clin Pediatr Dent. 2017;41:62–65.
[10] LC de Paz. Redefining the persistent infection in root canals; possible role of biofilm communities. J Endod. 2007;33:652–662.
[11] M Altinsoy, M Tanriver et al. In vitro evaluation of microleakage and microhardness of ethanolic extracts of Propolis in different proportions added to glass ionomer cement. J Clin Pediatr Dent. 2016;40:136–140.
[12] YH Tsang, JS Sun et al.. Studies of photo killing bacteria using titanium dioxide nanoparticles. Artif Organs. 2008;2008:167–174.
[13] A Yelamanchili, BW Darvell. Network competition in resin-modified glass-ionomer cement. Dent Mater. 2008;24:1064–1065.
[14] SB Mitra. Adhesion to dentin and physical properties of a light-cured glass-ionomer liner/base. J Dent Res. 1991;70:72–74.
[15] MG Botelho. Inhibitory effects on selected oral bacteria of antibacterial agents incorporated in a glass ionomer cement. Caries Res. 2003;37:108–114.
[16] M Braden. The absorption of water by acrylic resins and other materials. J Prosthet Dent. 1964;14:307–316.
[17] Y Liao, BW Brandt et al. Fluoride resistance in Streptococcus mutans: a mini review. J Oral Microbiol. 2017;9: article 1344509.
[18] P Vanajassun, M Nivedhitha et al. Effects of zinc oxide nanoparticles in combination with conventional glass ionomer cement: in vitro study. Adv Hum Biol. 2014;4:31.
[19] LSE Turkun, M Turkun et al. Long-term antibacterial effects and physical properties of a chlorhexidine-containing glass- ionomer cement. J Esthet Rest Dent. 2008;20:29–44.
[20] MG Botelho. Compressive strength of glass ionomer cements with dental antibacterial agents. S Afr Dent J. 2004;59:51–53.
[21] J Leistevno, H Jarvinen et al. Resistance to mercury and antimicrobial agents in Streptococcus mutans isolates from human subjects in relation to exposure to dental amalgam fillings. Antimicrob Agents Chemother. 2000;44:456–457.
[22] HM Anstice, JW Nicholson. Studies in the setting of polyelectrolyte materials, Part 2: The effect of organic compounds on a glass polyalkenoate cement. J Mater Sci Mater Med. 1994;5:299–302.
[23] BJ Sanders, RL Gregory et al. Antibacterial and physical properties of resin-modified glass-ionomers combined with chlorhexidine. J Oral Rehabil. 2002;29:553–558.
[24] MC Jennings, KPC Minbiole et al.. Quaternary ammonium compounds: an antimicrobial mainstay and platform for innovation to address bacterial resistance. ACS Infect Dis. 2015;1:288–303.
[25] ES Gjorgievska, G van Tendaloo et al. The incorporation of nano-particles into conventional glass ionomer dental restorative cements. Microsc Microanal. 2015;21:1–15.
[26] MJ Ellington, S Reuter et al. Emergent and evolving antimicrobial resistance cassettes in community-associated fusidic acid and metacillin-resistant Staphylococcus aureus. Int J Antimicrob Agents. 2015;45:477–484.
[27] NTM Klooster, F Vandertouw et al.. Solvent effects in polyelectrolyte solutions. 1. Potentiometric and viscometric titration of poly(acrylic acid) in methanol and counterion specificity Macromolecules. 1984;17:2070–2078.
[28] JDB Featherstone, C Shilds et al. Acid reactivity of carbonated apatites with strontium and fluoride substitutions. J Dent Res. 1983;62:1049–1053.
[29] D Boyd, H Li et al.. The antibacterial effects of zinc from zinc-based glass polyalkenoate cements. J Mater Sci Mater Med. 2006;17:489–494.
[30] AT Sidambe. Biocompatibility of advanced manufactured titanium implants – a review. Materials. 2014;7:8168–8188.
[31] J Hu, X Du et al.. Antibacterial and physical properties of ECGC-containing glass ionomer cements. J Dent. 2013;41:927–934.
[32] G McDonnell, AD Russell. Antiseptics and disinfectants: activity, action and resistance. Clin Microbiol Rev. 1999;12:147–179.
[33] A Guida, M Towler et al. Preliminary work on the antibacterial effect of strontium in glass ionomer cements. J Mater Sci Lett. 2003;22:1401–1403.
[34] P Collignon, J Turnidge. Fusidic acid in vitro activity. Int J Antimicrob Agents. 1999;12 (Suppl. 2):S45–S58.
[35] AS Pinto, FB Araújo et al. Clinical and microbiological effect of calcium hydroxide protection in indirect pulp capping in primary teeth. Am J Dent. 2006;19:382–387.
[36] AD Russell. Chlorhexidine: antibacterial action and bacterial resistance. Infection. 1986;14:212–215.
[37] F Dabsie, G Gregorie et al. Does strontium play a part in the cariostatic activity of glass ionomer? Strontium diffusion and antibacterial activity. J Dent. 2009;37:554–559.
[38] KL Weerheijm, CM Kreulen et al. Bacterial counts in carious dentine under restorations; 2-year in vivo effects, Caries Res. 1999;33:130–134.
[39] ARF de Castilho, C Duque et al. In vitro and in vivo investigation of the biological and mechanical behaviour of resin-modified glass-ionomer cement containing chlorhexidine. J Dent. 2013;41:155–163.
[40] L Björndal, T Larsen. Changes in the cultivable flora in deep carious lesions following stepwise excavation procedure. Caries Res. 2000;34:502–508.
[41] A Dimkov, E Gjorgievska et al.. Antibacterial effects of conventional glass ionomer cement. Bratisl Lek Listy. 2016;117:31–35.
[42] E Hartunoglu, F Öztürk et al. Antibacterial and mechanical properties of propolis added to glass ionomer cement. Angle Orthod. 2013;84:368–373.
[43] SP Yazdankhah, AA Schele et al. Triclosan and antimicrobial resistance in bacteria: an overview. Microb Drug Resist. 2006;12:83–90.
[44] JW Nicholson. Studies in the setting of polyelectrolyte materials, Part 3: effect sodium salts on the setting and properties of glass polyalkenoate and zinc polycarboxylate dental cements. J Mater Sci Mater Med. 1995;6:404–407.
[45] JV Yadiki, SR Jampanapalli et al. Comparative evaluation of the antimicrobial properties of glass ionomer cements with and without chlorhexidine gluconate. Int J Pediatr Dent. 2016;9:99–103.
[46] JW Nicholson, F Abiden. Studies in the setting of polyelectrolyte materials, Part 6: the effect halides on the strength and water balance of glass polyalkenoate and zinc polycarboxylate dental cements. J Mater Sci Mater Med. 1998;9:269–272.
[47] RJ Heath, JR Rubin et al. Mechanism of triclosan inhibition of bacterial fatty acid synthesis. J Biol Chem. 1999;274:11110–11114.
[48] JW Nicholson. The effect of trivalent metal nitrates on the properties of dental cements made from poly(acrylic acid). J Appl Polym Sci. 1998;70:2353–2359.
[49] Z Mulla, M Edwards et al.. The release of sodium fusidate from glass-ionomer dental cement. J Mater Sci Mater Med. 2010;21:1997–2000.
[50] H Forss, J Jokinen et al.. Fluoride and mutans streptococci in plaque growth on glass ionomer and composite. Caries Res. 1991;25:454–458.
[51] AW Wren, A Coughlan et al. Comparison of a SiO2-CaO-ZnO-SrO glass polyalkenoate cement to commercial dental materials: ion release, biocompatibility and antibacterial properties. J Mater Sci Mater Med. 2013;24:2255–2264.
[52] L Verbist. The antimicrobial activity of fusidic acid. J Antimicrob Chemother. 1990;25 (Supplement B):1–5.
[53] M Tandulkar, S Oh et al. Long-term exposure to benzalkonium chloride disinfectants results in charge of microbial community structure and increased antimicrobial resistance. Environ Sci Technol. 2013;47:9730–9738.
[54] M Darling, RG Hill. Novel polyalkenoate (glass-ionomer) dental cements based on zinc silicate glasses. Biomaterials. 1994;15:299–306.
[55] L Seppa, E Toppa-Saarinen et al.. Effect of different glass ionomers on the acid production and electrolyte metabolism of Streptococcus mutans Ingbritt. Caries Res. 1992;26:434–438.
[56] G Vermeersch, G Leloup et al. Antibacterial activity of glass-ionomers, compomers and resin composites: relationship between acidity and material setting phase. J Oral Rehabil. 2005;32:368–374.
[57] BA Khader, DJ Curran et al. Glass polyalkenoate cements designed for cranioplasty applications: an evaluation of their physical and mechanical properties. J Funct Biomater. 2016;7:8; doi 10.3390/jfb7020008
[58] SL Pinheiro, GR Azenha et al. Antimicrobial capacity of casein phosphopeptide/amorphous calcium phosphate and enzymes in glass ionomer cement in dentin carious lesions. Acta Stomatol Croat. 2015;49:104–111.
[59] U Tezel, SG Pavlostathis. Quaternary ammonium disinfectants: microbial adaption, degradation and ecology. Curr Opin Biotechnol. 2015;33:296–304.
[60] S Klai, M Altenburger et al. Antimicrobial effects of dental luting glass ionomer cements. The Scientific World J. 2014;2014:ID807086; doi:10.1155/2014/807086.
[61] A Kozlovsky, A Sintov et al. Inhibition of plaque formation by local application of a degradable controlled release system containing cetylpyridinium chloride. J Clin Periodontol. 1994;21:32–37.
[62] A Dimkov, N Panovski et al. Effects of cetylpyridinium chloride in overall cariogenic salivary micro flora reduction. Balk J Stom. 2006;10:115–121.
[63] C Duque, KL Aida et al. In vitro and in vivo evaluations of glass-ionomer cement containing chlorhexidine for atraumatic restorative treatment. J Appl Oral Sci. 2017;25:541–550.
[64] LM Marti, M da Mata et al.. Addition of chlorhexidine gluconate to a glass ionomer cement: a study on mechanical, physical and antibacterial properties. Braz Dent J. 2014;25:33–37.
[65] M Shalav, Z Fuss et al.. In vitro antibacterial activity of a glass ionomer endodontic sealer. J Endodod. 1997;2:616–619.
[66] CG Emilson. Potential efficacy of chlorhexidine against mutans streptococci and dental caries. J Dent Res. 1994;73:682–691.
[67] P. Gjermo Chlorhexidine and related compounds. J Dent Res. 1989;68(Special issue):1602–1608.
[68] GLS Ferreira, I Freires et al. Antibacterial activity of glass ionomer cements on cariogenic bacteria – an in vitro study. Int J Dent Clin. 2011;3:1–3.
[69] T Tüzüner, T Ulusu. Effect of antibacterial agents on the surface hardness of a conventional glass-ionomer cement. J Appl Oral Sci. 2012;20:45–49.
[70] J Ribeiro, D Ericson. In vitro antibacterial effect of chlorhexidine added to glass-ionomer cements. Scand J Dent Res. 1991;99:533–540.
[71] RC Silva, AC Zuanon et al. In vitro microhardness of glass ionomer cements. J Mater Sci Mater Med. 2007;18:139–142.
[72] SM Mathew, AM Thomas et al. Evaluation of microleakage of chlorhexidine-modified glass ionomer cement: An in vivo study. Int J Clin Pediatr Dent. 2013;6:7–11.
[73] K Hegstad, S Langsrud et al. Does the wide use of quaternary ammonium compounds enhance the selection and spread of antimicrobial resistance and thus threaten our health? Microb Drug Resist. 2010;16:91–104.
[74] O Clarkin, A Wren et al. Antibacterial analysis of a zinc-based glass polyalkenoate cement. J Biomater Appl. 2011;26:277–292.
[75] PW Osinga, RHM Grande et al. Zinc sulphate addition to glass-ionomer cements: influence on physical and antibacterial properties, zinc and fluoride release. Dent Mater. 2003;19:212–217.
[76] JDB Featherstone. Dental caries: a dynamic disease process. Aust Dent J. 2008;53:286–291.
[77] M Mabrouk, M Selim et al. Incorporation effect of silver and zinc zeolites into commercial glass ionomer cements. Interceram. 2013;62:50–54.
[78] A Coughlan, K Scanlon et al. Zinc and silver glass polyakenoate cements: an evaluation of their antibacterial nature. Biomed Mater Eng. 2010;20:99–106.
[79] G Lui, H He. Long-term antibacterial properties and bond strength of experimental nano silver-containing orthodontic cements. J Wuhan Univ Techno-Mater Sci Ed. 2013;28:849–855.
[80] W Scherer, N Lippman et al.. Antimicrobial properties of glass-ionomer cements and other restorative materials. Oper Dent. 1988;14:77–81
[81] SK Sidhu, JW Nicholson. A review of glass-ionomer cements for clinical dentistry. J Funct Biomater. 2016;7:E16. doi:10.3390/jfb7030016
[82] H Ali, S Maroli. Glass ionomer cement as an orthodontic bonding agent. J Contemp Dent Pract. 2012;13:650–654.
[83] Y Takahashi, S Imazato et al. Antibacterial effects and physical properties of glass-ionomer cements containing chlorhexidine for the ART approach. Dent Mater. 2006;22:647–652.
[84] S Buffet-Bataillon, P Tattevin et al. Efflux pump induction by quaternary ammonium compounds and fluoroquinoline resistance in bacteria. Future Microbiol. 2016;11:81–92.
[85] RA Buck. Glass ionomer endodontic sealers – a literature review. Gen Dent. 2001;50:365–368.
[86] M Herrera, A Castillo et al. Antibacterial activity of resin adhesives, glass ionomer and resin-modified glass ionomer cements and a compomer in contact with dentin caries samples. Oper Dent. 2000;25:265–269.
[87] RG Hill, AD Wilson. Some structural aspects of glasses used in ionomer cements. Glass Technol. 1988;29:150–188.
[88] A Hoszek, D Ericson. In vitro fluoride release and the antibacterial effect of glass ionomers containing chlorhexidine gluconate. Oper Dent. 2008;33:696–701.
[89] A Dimkov, JW Nicholson et al. Compressive strength and setting time determination of glass-ionomer cements incorporated with cetylypyridinium chloride and benzalkonium chloride. Contrib Sec Biol Med Sci Macedonian Acad Sci Arts. 2012;33:243–263.
[90] T Tüzüner, A Kuşgòz et al.. Antibacterial activity and physical properties of conventional glass-ionomer cements containing chlorhexidine diacetate/cetrimide mixtures. J Esthet Restor Dent. 2011;23:46–56.
[91] G Palmer, FH Jones et al. Chlorhexidine release from an experimental glass ionomer cement. Biomaterials. 2004;25:5423–5431.
[92] X Du, X Huang et al.. Inhibition of early biofilm formation by glass-ionomer incorporated with chlorhexidine in vivo: a pilot study. Aust Dent J. 2012;57:58–64.