In-vitro evaluation of the antibacterial activity, physical and chemical properties of conventional glass-ionomer cements containing benzalkonium chloride, chlorhexidine, cetrimide and cetylpyridinum chloride

Atravmatic restorative treatment (ART ) is which is one of the caries control approaches, is a minimally invasive method in which hand tools are used and the rest is restorating of glass ionomer cements (GIC). In this method, since the caries are not completely removed, it is expected that the GIC, which is the filling material to be used, is strong enough to fight the bacteria in the caries. The long-term release of fluoride ion (F¯) from marginal edges between the filling material and the dental tissues, which glass ionomer cements have, reduces secondary caries risk. Despite this effect, however, the elimination of bacteria in the residual caries remains in adequate. For this purpose, various antibacterial (AB) materials are added to traditional GIC used in ART in many study and it is tried to increase the long term success of restoration by preventing the growth of bacteria in the remaining caries. Although studies on the use of Benzalkonium Chloride (BC), Chlorhexidine (CHX), Cetrimide (CT) and Cetylpyridinium Chloride (CPC), which are materials used to increase antibacterial activity, have been reported to be positive, there is still a need for further studies in which different compounds and ratios are evaluated. The aim of this study is to obtain a GIC-AB combination that has a potent AB activity and, while providing it, has minimal changes in ideal physical and chemical properties and is successful in ART and successful in long-term use. In this in-vitro study, a test group was formed by adding 1% concentration CHX, CT, CPC in Ketac Molar Easymix (3M ESPE, Germany) to the powder and 1% concentration BC in liquid form. Antibacterial-free GIC was used as the control group. After preparing the glass ionomer cement samples, the AB activity was assessed by the agar diffusion test (ADT), the surface hardness Vickers microhardness test (VHN), and the F¯ ion emission ion selective electrode (ISE) method. As a result of this study, it was found that the mixture obtained by the addition GIC's liquid form of BC water, GIC's powder form of CHX, CT, CPC powder provides strong AB effect while causing minimal damage to the physical properties and chemical structure of the cement, it is the ideal combination of GIC and AB that can be applied. In the study, 1% concentration of CHX, CT, CPC powder and also BC liquid application, which can produce a strong AB influence which could affect the various residual microorganisms and at the same time have minimal changes in the physical and chemical properties of the GIC material without statistical significance; it was cocncluded to be effective for use with GIC. Long-term investigation of different materials and different mixing ratios in ideal GIC and AB combinations that can be applied in ART can be recommended.