The authors have declared that no competing interests exist.
This study was conducted to evaluate the effect of sport and energy drinks on conventional and resin-modified glass ionomer restorative materials regarding fracture toughness, surface roughness and fluoride release.
The restorative materials used were conventional and resin-modified glass ionomers. Sport drinks used were Gatorade Perform 02 and Pocari sweat, while the energy drinks were Red Bull and Power Horse. Specimens were prepared and divided into five groups according to the immersion media (distilled water, two sport drinks and two energy drinks) for 1 and 7 days. The fracture toughness was determined using three-point bending method. Surface roughness was measured using surface profilometer. Fluoride release was determined using a conventional ion chromatograph testing unit. The data were analyzed using three-way ANOVA and Least Significant Difference test. For comparison between the two materials under each condition, t-test was used.
There was no significant difference in fracture toughness between sport, energy drinks and distilled water at the different time intervals except for conventional glass ionomer after 7 days. Resin-modified glass-ionomer exhibited smoother surfaces more than conventional one in sport and energy drinks after 1 day. After 7 days, both conventional and resin-modified glass ionomers showed greater surface roughness. Both conventional and resin-modified glass ionomers release more fluoride in acidic beverages than distilled water.
The effect of sport and energy drinks on the fracture toughness may depend on the composition and acidity of drink. Fluoride release increased with the consumption of sport and energy drinks.
Fluid replacement drinks or carbohydrate-electrolyte beverages may be one of the most researched sports nutrition topics ever and accompanying this high volume of research are continually evolving recommendation.
Sport drinks are popular worldwide, but the various products differ little in their composition. They contain 6% to 8% carbohydrates, with the principal carbohydrates being glucose, fructose, sucrose, and synthetic maltodextrins. All contain small amounts of electrolytes, including sodium, potassium and chloride, to improve palatability and help maintain the fluid/electrolyte balance. The purpose of sport drinks is to prevent dehydration, to provide carbohydrates to boost energy, to supply electrolytes that can replace those lost via perspiration.
In 2006, nearly 500 new brands of energy drinks were introduced and more than 7 million adolescents reported that they have consumed an energy drink. The difference between sport and energy drinks that sport drinks tend to be caffeine free, but energy drinks are loaded with caffeine. Energy drinks also tend to have a higher carbohydrate content (9% to 10%) than do sport drinks.
Glass ionomer restorative materials have a number of unique properties, including adhesion to tooth structure, biological compatibility, and anticariogenic properties due to their fluoride release.
It was found that glass ionomer in orange and apple juice underwent severe erosion and loss of strength. This was attributed to the presence of carboxylic acids such as citric and malic acids in these fruit juices, which are capable of chelating with cement-forming ions, such as calcium, to yield soluble products.
The materials used in this study are listed in
Materials | Type and Composition | Manufacturers |
Ionogem | Conventional glass ionomer restorative material (hand mixed) | Dental Composite Ltd. England |
Ionogem LC | Resin-modified glass ionomer restorative material (hand mixed) | Dental Composite Ltd. England |
Gatorade Perform 02 | Sport drink, Water, sucrose, dextrose, citric acid, natural flavor, salt, sodium citrate. monopotassium phosphate, gum arabic, yellow 6, glycerol ester of rosin, brominated vegetable oil | Gatorade, Company, USA |
Pocari Sweat | Sport drink, Water, sugar, Citrus flavor, citric acid, sodium citrate, sodium chloride, potassium chloride, malic acid, calcium lactate, glucono delta-lactone. Monosodium L- glutamate,magnesium carbonate, vitamin C | P.TAmerta, Indah Otsuka, Jakarta, Indonsia |
Red Bull | Energy drink, Water, sucrose, gluose, sodium citrate, carbon dioxide, taurine0.4%, glucoronolactone 0.24%,caffeine 0.03%, niacin, B-group vitamins, flavors | Red Bull, GmbH, Austria |
Power Horse | Energy drink, Carbonated water, sucrose, glucose, citric acid, taurine, glucuronolactone, artificial flavor, caffeine, inositol, niacin, pantothenic acid, vitB6, B12, riboflavin. | S.Spitz GmbH, Attnang-Puchheim, Austria |
Three tests were performed; fracture toughness, surface roughness and fluoride release. Specimens prepared for each material were manipulated according to manufacturer’s instructions. They were divided into five groups according to the storage medium:
Group 1: Specimens were immersed in distilled water (control).
Group 2: Specimens were immersed in Gatorade Perform 02.
Group 3: Specimens were immersed in Pocari Sweat.
Group 4: Specimens were immersed in Red Bull.
Group 5: Specimens were immersed in Power Horse.
The pH of each storage medium was determined before immersion of the specimens.
A total number of hundred and forty notched specimens were prepared, seventy specimens for each glass ionomer. Specimens were prepared in a stainless-steel split mould (25 mm length × 2.5 mm thickness × 5 mm width). The mold was notched ( 0.5 mm width and 2.5 mm depth).
The specimens were immersed in 5 mL of the testing medium and stored at 37oC. Specimens were tested after 24 h and after one week from the start of immersion. The storage medium was changed daily. Fracture toughness was determined using three-point bending method according to the procedures outlined in ASTM E399-90.
Where: PQ is the peak load (kN), B is the specimen thickness (cm), S is the span length (cm), W is the specimen width (cm), a is the crack length (cm) and f(a/W) is a function of a/W.
A total number of fifty disc-shaped specimens, twenty five for each restorative material, were fabricated in a split Teflon mould (10 mm diameter × 2 mm thickness. The cement paste was packed into the mold that was placed on a microscope slide. A second slide was placed over the mold and light hand pressure applied to enable the excess material to flow out of the mold through the slit. Resin-modified glass ionomer specimens were light cured at each surface of the specimens. The specimens were divided into five equal groups (n = 5/group) according to the storage medium as mentioned before.
The specimens were immersed in 5 mL of the testing medium and stored at 37o C. Surface roughness was measured after 24 h and one week from the start of immersion. The storage medium was changed daily. Surface roughness was measured using surface Profilometer (Surf Test SJ 201, Japan). Five tracings at different locations on each specimen were made. Surface roughness (Ra) was determined in µm using a tracing length of 2 mm and a cutoff value of 0.25 mm to maximize filtration of surface waviness.
A total number of fifty disc‐shaped specimens, twenty five specimens for each glass ionomer, were divided into five equal groups (n = 5/group), according to the storage medium as mentioned before. The specimens were fabricated in the split Teflon mold that was used for preparing specimens for surface roughness testing. The specimens were immersed in 5 mL of the storage medium and stored at 37o C. The measurement of fluoride release from the specimens was carried out at the following time intervals: 24 h, 3 days, 5 days and 7 days from the start of immersion. At each test interval, the specimen was removed from the solution, quickly blotted dry with filter paper and immediately immersed in another 5 mL of the storage medium. An Ion Chromatograph (DX 500; Dionex, Camberley, UK) with suppressed conductivity was used for free fluoride ion determination.
The instrument was fitted with an ION PAC AS14 analytical column (Dionex) and ION PAC AG14 Guard column (Dionex). A half mL of each storage solution was injected onto the injection loop of the instrument. The loop was designed such that 250 µL was fed to the column for analysis. A flow rate of 1.2 mL/min was used. Free fluoride ions have a well-defined retention time and the peak corresponding to fluoride could readily be determined from the chromatogram. The peak area was used to determine fluoride concentrations by linear interpolation between standard solutions of concentration slightly higher and lower than the test solution. The determination of each solution was made three times and fluoride concentration determined to an accuracy of 0.001 ppm.
Means and standard deviations of fracture toughness, surface roughness and fluoride release were calculated for each group. The data were analyzed using three-way ANOVA and Least Significant Difference (LSD) tests. For comparison between the two materials under each condition, unpaired student’s t-test was used. The statistical analysis was performed by Statistical Package for Social Science (SPSS) version 15. All statistical analysis were performed at α = 0.05.
The measured pH of different immersion media were as follow: pH of distilled water was 6.3, Gatorade Perform 02 was 2.9, Pocari Sweat was 3.3, Red Bull was 3.1and Power Horse was 2.8.
Mean values and standard deviations of fracture toughness of the studied materials after immersion in different media for 1 and 7 days are shown in
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IonoGem-1day | 0.62 ± 0.086 Aa | 0.54 ± 0.06 Aa | 0.62 ± 0.09 Aa | 0.6 ± 0.1 Aa | 0.6 ± 0.06 A a |
IonoGem-7day | 0.63 ± 0.1 Aa | 0.53 ± 0.11 Aa | 0.63 ± 0.07 Aa | 0.25 ± 0.07 |
0.24 ± 0.09 |
IonoGem LC-1day | 2.33 ± 0.14 |
2.36 ± 0.15 |
2.3 ± 0.11 |
2.4 ± 0.2 C a | 2.5 ± 0.2 Ca |
IonoGem LC-7day | 2.39 ±0.12 |
2.39 ± 0.09 |
2.42 ± 0.07 Ca | 2.31 ± 0.09Ca | 2.33 ± 0.16 C a |
Means with same superscript letters are not significantly different (small letters for rows and capital letters for columns).
After 7 days, for conventional glass ionomer, the lowest mean fracture toughness value was for specimens immersed in Power Horse and the highest means were for specimens immersed in distilled water. For resin-modified glass ionomer, the lowest mean fracture toughness value was for specimens immersed in Red Bull and the highest mean was for specimens immersed in Pocari Sweat. There was a significant effect of material, storage media and immersion time (P
Mean values and standard deviations of surface roughness of the studied materials after immersion in different media for 1 and 7 days are shown in
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IonoGem-1day | 0.7 ± 0.02Ab | 1.07 ± 0.19 Aa | 1.02 ± 0.17 Aa | 1.34 ± 0.29 Aa | 1.4 ± 0.39 A a |
IonoGem-7days | 0.8± 0.11 Ac | 2.08 ± 0.5 |
1.94 ± 0.48 |
3.8 ± 0.2 |
3.7 ± 0.3 |
IonoGem LC-1day | 0.52 ± 0.02 |
0.68 ± 0.07 |
0.692 ± 0.19 |
0.84 ± 0.28 |
0.87 ± 0.18 Ca |
IonoGem LC-7days | 0.59± 0.05 |
1.02 ± 0.02 C |
1.1 ± 0.01 A a | 1.82 ± 0.5 Aa | 1.96 ± 0.12 Aa |
Means with same superscript letters are not significantly different (small letters for rows and capital letters for columns).
After 7 days, for conventional glass ionomer, the smoothest surfaces were for specimens immersed in distilled water and the roughest surfaces were for specimens immersed in Red Bull. For resin-modified glass ionomer, the smoothest surfaces were for specimens immersed in distilled water and the roughest surfaces were for specimens immersed in Power Horse. There was a significant effect of materials, media and immersion time (P
Mean values and standard deviations of fluoride release of the studied materials after 1, 3, 5 and 7 days are shown in
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IonoGem-1day | 80.42 ± 1.8Ae | 367.2 ± 7.79 Ac | 296 ± 10.5 Ad | 428.2 ± 3.24b A | 438.2 ± 3.34 Aa |
IonoGem-3days | 49.6 ± 1.01 B d | 266.52 ± 6.53 Bb | 197.8 ± 16B c | 283.02 ± 4.96 Ba | 281.8 ± 4.49 Ba |
IonoGem-5days | 25.26 ± 0.58 C d | 233.6 ± 5.5 Cb | 188.2± 12.6 B Cc | 259.78 ± 3.75 Ca | 264 ± 4.84 Ca |
IonoGem-7days | 15.82 ± 1.0 D d | 171.8 ± 4.4 Dc | 186.4 ± 4.5 Cb | 193.7 ± 4.54 D a | 194.52 ± 3.1 D a |
IonoGem LC-1day | 16.08 ±1.96 De | 94.88 ± 1.51 E c | 82.24 ± 3.4 Dd | 106.74 ± 3 Eb | 117.64 ± 3.03 E a |
IonoGem LC-3days | 6.34 ± 0.35 Ed | 70.4 ± 3.2 F b | 47.36 ± 1.9 E c | 85.94 ± 3.96 F a | 89 ± 3.3 F a |
IonoGem LC- 5days | 1.76 ± 0.16F c | 59.88 ± 2.38 G a | 45.2 ± 4.74 Eb | 58.92 ± 2.38 G a | 62.6 ± 3.3 G a |
IonoGem LC-7 days | 1.63 ± 0.13 F c | 49.12 ± 2.7 H a | 41.5 ± 3.22 Eb | 48.38 ± 3.19 H a | 51.94 ± 2.9 H a |
Means with same superscript letters are not significantly different (small letters for rows and capital letters for columns).
It is well known that glass-ionomer cements (GICs) are clinically attractive dental restorative materials. These cements possess certain unique properties that make them useful as restorative and adhesive materials, including adhesion to tooth structure and base metals, anticariogenic properties due to release of fluoride, thermal compatibility with tooth enamel because of low coefficients of thermal expansion similar to those of tooth structure, biocompatibility and low cytotoxicity
In the oral cavity, restorative materials are exposed to varying environments. These include changes in temperature and acidic-base conditions from food and drinks. Therefore, the restorative materials used in the mouth should resist or show minimal change in these situations. Therefore, a long immersion time was used as an alternative for presenting the extensive effect of acidic beverages on conventional and resin-modified glass ionomer restorative materials
Fracture toughness is a measurement of a material’s ability to resist catastrophic failure.
The results showed that there was no significant difference in fracture toughness between sport and energy drinks and distilled water after 1 day for both conventional and resin-modified glass ionomer. Whereas, after 7 days, there was a significant difference between conventional glass ionomer specimens immersed in Red Bull and Power Horse and the other storage media, they underwent severe erosion resulting in dissolution of specimens and loss of strength. This may be because both are carbonated drinks which may have more erosive effect on conventional glass ionomer cements with prolonging immersion time. For the other storage media, there was no significant difference between the first and seventh days of immersion. This may be due to the immersion time was not sufficient enough to affect the mechanical properties. Moreau and Xu
Roughness refers to the surface texture of a material. There are two types: the smoothness resulting from a finishing process, referred to as applied or acquired smoothness, and the smoothness of an unpolished material, referred toas inherent smoothness. Inherent smoothness depends on the filler particle size of the material.
The results of the current study showed that conventional glass ionomer was rougher in sport and energy drinks than resin-modified glass ionomer. After 1 day of immersion, conventional glass ionomer specimens immersed in sport and energy drinks were more rough than those immersed in distilled water. Whereas, resin-modified glass ionomer specimens immersed in sport and energy drinks were not significantly different from those immersed in distilled water. This indicates that RMGI resist acid better than conventional glass ionomer cement. Hamouda IM, 2011
Both conventional and resin-modified glass ionomer had more rough surfaces after 7 days. This was owed to these beverages contain citric acid which is carboxylic acid capable of chelating ions present in the cement, such as calcium and forming complexes of reasonable solubility in water.
For the analysis of fluoride released from materials into aqueous solutions, an ion-selective electrode (ISE) or Ion Chromatograph (IC) can be used. Ion Chromatograph was chosen in the current study because this method is suitable for the measurement of not only free fluoride ions but also low concentration of fluoride ions that may not be detected by the ISE method
The highest fluoride release among sport and energy drinks was recorded for Red Bull (pH=3.1) and powerhorse (pH=2.8) and the lowest fluoride release was recorded for Pocari Sweat (pH=3.3). These results are consistent with surface roughness results, that the specimens immersed in Red Bull and Power Horse showed more rough surfaces which indicates more degradation and hence more fluoride release.
Based on the results and within the limitation of this study, the following conclusions can be made:
1.The fracture toughness was not significantly changed after 1 day for both conventional and resin-modified glass ionomer. Whereas, after 7 days, there was a reduction in fracture toughness of conventional glass ionomer in Red Bull and Power Horse.
2.Resin-modified glass ionomer showed better resistance to acidic sport and energy drinks but with prolonged consumption of these drinks, surface smoothness could be affected and thus would affect clinical performance of the filling material.
3.Fluoride release increased with the consumption of sport and energy drinks as the degradation of the glass ionomers increased according to the results of surface roughness.
4.The acidity of sport and energy drinks is not an indicator of the erosive potential. As indicated by the results carbonated energy drinks with similar pH to sport drinks had more erosive effects on glass ionomers. Hence, the erosive potential of drinks may depend on titratable acidity of individual drink or the composition of the drinks.