以往之文獻報告大多指出，添加1% chlorhexidine (CHX)於玻璃離子體填補材料中，已具有抑菌效果。但考量到CHX本身之生物毒性以及其對於玻璃離子體填補材料可能的負面影響，何種濃度方為適當有必要進一步加以探究。本研究利用高黏稠型玻璃離子體，做為乘載CHX diacetate的釋放媒介。研究中，將CHX diacetate加入高黏稠型玻璃離子體粉末中，分別得到相對重量百分比為0.5%、1%以及2%的濃度為實驗組，未添加CHX diacetate者為對照組。經抑菌測試、細胞毒性試驗、徑向拉伸試驗、表面微硬度試驗、氟離子釋放試驗、顏色穩定試驗、抗磨耗試驗以及掃瞄式電子顯微鏡的觀察，以探討添加CHX diacetate於高黏稠性玻璃離子體填補材料的適當濃度。結果顯示，隨著CHX diacetate的濃度上升，其細胞毒性、抑菌效果以及顏色變化會隨之上升，而徑向拉伸強度、表面微硬度、抗磨耗度以及氟離子釋放能力卻隨之下降。由統計分析之結果顯示，雖然加入CHX diacetate的玻璃離子體填補材料對於S. mutans以及A. actinomycetemcomitans菌皆具有抑制效果，但對於周圍纖維母細胞也會產生顯著的細胞毒性。本研究建議加入CHX diacetate的玻璃離子體填補材料較適用在三明治填補技術中當成基底填補材，或是在輕微牙周炎患者的Class V窩洞採用有添加0.5% CHX diacetate的玻璃離子體當填補材料。

Adding Chlorhexidine (CHX) into glass ionomer cement (GI) has been proved to possess antibacterial benefit. Most of related researches have postulated that 1% CHX added in GI could be applied optimally for clinical use. Regarding to the cell toxicity of CHX itself and other effects that may negatively influence GI, it is worthy to reappraise the optimal concentration of CHX in GI. This study investigated the use of an experimental GIC as a carrier for the release of CHX diacetate at concentrations of 0.5%, 1%, 2%, respectively, of CHX diacetate by w/w as experimental groups. GI without CHX diacetate was used as control. The optimal concentration of CHX in GI was verified by means of antibacterial test, cell toxicity test, diametral tensile strength, surface microhardness tests, fluoride ion release test, the color stability test, wear resistance tests and scanning electron microscopy observation. The results showed that with the increasing concentration of CHX diacetate the cell toxicity, antibacterial ability and color difference were increased. While, diametral tensile strength, microhardness, wear resistance and fluoride release ability were decreased. Although adding CHX diacetate in GI had antibacterial effect to both S. mutans and A. actinomycetemcomitans, but it also demonstrated significant adverse effects on cytotoxicity and wear resistant. We suggested that GI containing CHX should be used as the base material in sandwich technique, and only 0.5% CHX modified GI could be used to restore the class V cavity in patient with mild periodontitis.

中文摘要.....................................................................................................i
英文摘要...................................................................................................iii
目錄...........................................................................................................iv
圖目錄......................................................................................................vii
表目錄.......................................................................................................ix
一、 緒論....................................................................................................1
二、 文獻回顧............................................................................................3
(一)、 齲齒與無傷性填補治療..........................................................3
1. 齲齒成因..................................................................................3
2. 無傷性填補治療......................................................................5
(二)、 玻璃離子體的發展.. ...............................................................6
(三)、 玻璃離子體的硬化機轉..........................................................9
(四)、 玻璃離子體的釋氟機轉........................................................10
(五)、 玻璃離子體的抑菌機制........................................................12
(六)、 玻璃離子體的生物相容性....................................................14
(七)、 玻璃離子體的應用及缺點....................................................16
(八)、 玻璃離子體的改良................................................................17
三、 研究動機、假說及目的...................................................................22
四、 實驗材料與方法..............................................................................24
(一)、 實驗設計流程圖....................................................................25
(二)、 實驗材料與測試....................................................................26
1. 複合式玻璃離子體樣本製作...............................................26
2. 複合式玻璃離子體生物毒性試驗...................................... 26
3. 掃瞄式電子顯微鏡 (SEM) 觀察........................................28
4. 複合式玻璃離子體抑菌試驗...............................................28
5. 複合式玻璃離子體氟離子釋放測試...................................29
6. 複合式玻璃離子體表面微硬度測試....................................31
7. 複合式玻璃離子體表面顏色測試........................................33
8. 複合式玻璃離子體徑向拉伸試驗........................................34
9. 複合式玻璃離子體耐磨耗試驗............................................35
10. 統計分析................................................................................37
五、 結果..................................................................................................39
(一)、 複合式玻璃離子體生物毒性試驗........................................39
(二)、 掃瞄式電子顯微鏡觀察........................................................39
(三)、 複合式玻璃離子體抑菌試驗................................................40
(四)、 複合式玻璃離子體氟離子釋放測試....................................41
(五)、 複合式玻璃離子體表面微硬度測試....................................41
(六)、 複合式玻璃離子體表面顏色測試........................................42
(七)、 複合式玻璃離子體徑向拉伸試驗........................................43
(八)、 複合式玻璃離子體抗磨耗試驗............................................43
六、 討論.................................................................................................45
(一)、 複合式玻璃離子體生物毒性試驗........................................45
(二)、 電子顯微鏡觀察....................................................................47
(三)、 複合式玻璃離子體抑菌試驗...............................................48
(四)、 複合式玻璃離子體之氟離子釋放測試................................50
(五)、 複合式玻璃離子體表面微硬度測試………………………52
(六)、 複合式玻璃離子體表面顏色測試…………………………55
(七)、 複合式玻璃離子體徑向拉伸試驗…………………………56
(八)、 抗磨耗試驗…………………………………………………59
(九)、 臨床考量……………………………………………………61
(十)、 實驗限制……………………………………………………62
七、 結論………………………………………………………………..64
八、 參考文獻…………………………………………………………106

1. Kidd EA, Toffenetti F and Mjor IA: Secondary caries. Int Dent J 42:127-138, 1992.
2. Featherstone JD: Modeling the caries-inhibitory effects of dental materials. Dent Mater 12:194-197, 1996.
3. Wilson AD MJ: Glass ionomer cement. Chicago:Quintessence Publishing 1988.
4. Weerheijm KL, de Soet JJ, van Amerongen WE and de Graaff J: The effect of glass-ionomer cement on carious dentine: an in vivo study. Caries Res 27:417-423, 1993.
5. Weerheijm KL, Kreulen CM, de Soet JJ, Groen HJ and van Amerongen WE: Bacterial counts in carious dentine under restorations: 2-year in vivo effects. Caries Res 33:130-134, 1999.
6. Murdoch-Kinch CA and McLean ME: Minimally invasive dentistry. J Am Dent Assoc 134:87-95, 2003.
7. Yesilyurt C, Er K, Tasdemir T, Buruk K and Celik D: Antibacterial activity and physical properties of glass-ionomer cements containing antibiotics. Oper Dent 34:18-23, 2009.
8. Imazato S: Bio-active restorative materials with antibacterial effects: new dimension of innovation in restorative dentistry. Dent Mater J 28:11-19, 2009.
9. Zhang H: Chlorhexidine-containing cavity disinfectant may not benefit the clinical performance of high-viscosity glass-ionomer cement following ART after 24 months. J Evid Based Dent Pract 9:34-35, 2009.
10. Turkun LS, Turkun M, Ertugrul F, Ates M and Brugger S: Long-term antibacterial effects and physical properties of a chlorhexidine-containing glass ionomer cement. J Esthet Restor Dent 20:29-44; discussion 45, 2008.
11. Hoszek A and Ericson D: In vitro fluoride release and the antibacterial effect of glass ionomers containing chlorhexidine gluconate. Oper Dent 33:696-701, 2008.
12. Frencken JE, Imazato S, Toi C, Mulder J, Mickenautsch S, Takahashi Y and Ebisu S: Antibacterial effect of chlorhexidine- containing glass ionomer cement in vivo: a pilot study. Caries Res 41:102-107, 2007.
13. de Souza LB, de Aquino SG, de Souza PP, Hebling J and Costa CA: Cytotoxic effects of different concentrations of chlorhexidine. Am J Dent 20:400-404, 2007.
14. Takahashi Y, Imazato S, Kaneshiro AV, Ebisu S, Frencken JE and Tay FR: Antibacterial effects and physical properties of glass-ionomer cements containing chlorhexidine for the ART approach. Dent Mater 22:647-652, 2006.
15. Mc Donald RE and DR. A: Dentistry for the child and adolescent. 6thed. St. Louis. C.V. Mosby co 216-255., 1994.
16. Krasse B: The Effect of Caries-Inducing Streptococci in Hamsters Fed Diets with Sucrose or Glucose. Arch Oral Biol 10:223-226, 1965.
17. Gustafsson BE, Quensel CE, Lanke LS, Lundqvist C, Grahnen H, Bonow BE and Krasse B: The Vipeholm dental caries study; the effect of different levels of carbohydrate intake on caries activity in 436 individuals observed for five years. Acta Odontol Scand 11:232-264, 1954.
18. Roberson TM, Heymann H and Edward J. Swift J: Student's art & science of operative dentistry, Forth Edition. Mosby 67-68, 2002.
19. Loesche WJ: Nutrition and dental decay in infants. Am J Clin Nutr 41:423-435, 1985.
20. Akdeniz BG, Koparal E, Sen BH, Ates M and Denizci AA: Prevalence of Candida albicans in oral cavities and root canals of children. ASDC J Dent Child 69:289-292, 235, 2002.
21. de Carvalho FG, Silva DS, Hebling J, Spolidorio LC and Spolidorio DM: Presence of mutans streptococci and Candida spp. in dental plaque/dentine of carious teeth and early childhood caries. Arch Oral Biol 51:1024-1028, 2006.
22. Zaremba ML, Stokowska W, Klimiuk A, Daniluk T, Rozkiewicz D, Cylwik-Rokicka D, Waszkiel D, Tokajuk G, Kierklo A and Abdelrazek S: Microorganisms in root carious lesions in adults. Adv Med Sci 51 Suppl 1:237-240, 2006.
23. Krasse B: Can microbiological knowledge be applied in dental practice for the treatment and prevention of dental caries. J Can Dent Assoc 50:221-223, 1984.
24. Seow WK, Amaratunge A, Sim R and Wan A: Prevalence of caries in Streptococcus mutants in the mouth of infants. Arch Oral Biol 20:171-174, 1999.
25. chen L: Atraumatic restorayive treatment. Taiwan J Pediatr Dent 4:186-191, 2004.
26. Frencken JE and Holmgren CJ: ART: a minimal intervention approach to manage dental caries. Dent Update 31:295-298, 301, 2004.
27. Steenbock P: Improvements in and relating to the manufacture of a material designed for the production of cement. UK Patent Nos. 1576-1581:1954.
28. Lind V, Wennerholm G and Nystroem S: Contact Caries in Connection with Silver Amalgam, Copper Amalgam and Silicate Fillings. Acta Odontol Scand 22:333-341, 1964.
29. Wilson AD and Kent BE: A new translucent cement for dentistry. The glass ionomer cement. Br Dent J 132:133-135, 1972.
30. Smith DC: Composition and characteristics of glass ionomer cements. J Am Dent Assoc 120:20-22, 1990.
31. Takigawa T: Study on glass ionomer cement, influence of powder. J Conserv Dent 25:812-813, 1982.
32. Katsuyama S: Glass ionomer dental cement-the materials and their clinical use. Eng ed. St. Louis: Ishiyaku EuroAmerica 10-66, 1993.
33. Nasu T: Polyacrylic acid-metal adhesive bond joint characterization by x-ray photoelectron spectroscopy. J Biomed Mater Res 20:347-362, 1986.
34. McLean JW: Dentinal bonding agents versus glass-ionomer cements. Quintessence Int 27:659-667, 1996.
35. Bapna MS and Mueller HJ: Leaching from glass ionomer cements. J Oral Rehabil 21:577-583, 1994.
36. Geurtsen W: Substances released from dental resin composites and glass ionomer cements. Eur J Oral Sci 106:687-695, 1998.
37. Stamboulis A, Law RV and Hill RG: Characterisation of commercial ionomer glasses using magic angle nuclear magnetic resonance (MAS-NMR). Biomaterials 25:3907-3913, 2004.
38. Royse MC, Ott NW and Mathieu GP: Dentin adhesive superior to copal varnish in preventing microleakage in primary teeth. Pediatr Dent 18:440-443, 1996.
39. Watson TF, Pagliari D, Sidhu SK and Naasan MA: Confocal microscopic observation of structural changes in glass-ionomer cements and tooth interfaces. Biomaterials 19:581-588, 1998.
40. Wilson AD and Paddon JM: Dimensional changes occurring in a glass-ionomer cement. Am J Dent 6:280-282, 1993.
41. Wilson AD NJ: Polyalkenoate cements. Their Biomedical and Industrial Applications. Chemistry of Solid State Materials vol 3:1993.
42. Lee SY, Dong DR, Huang HM and Shih YH: Fluoride ion diffusion from a glass-ionomer cement. J Oral Rehabil 27:576-586, 2000.
43. Dhondt CL, De Maeyer EA and Verbeeck RM: Fluoride release from glass ionomer activated with fluoride solutions. J Dent Res 80:1402-1406, 2001.
44. Kuhn AT and Wilson AD: The dissolution mechanisms of silicate and glass-ionomer dental cements. Biomaterials 6:378-382, 1985.
45. Diaz-Arnold AM, Holmes DC, Wistrom DW and Swift EJ, Jr.: Short-term fluoride release/uptake of glass ionomer restoratives. Dent Mater 11:96-101, 1995.
46. Forsten L: Fluoride release and uptake by glass-ionomers and related materials and its clinical effect. Biomaterials 19:503-508, 1998.
47. Yip HK, Guo J and Wong WH: Protection offered by root-surface restorative materials against biofilm challenge. J Dent Res 86:431-435, 2007.
48. Davidovich E, Weiss E, Fuks AB and Beyth N: Surface antibacterial properties of glass ionomer cements used in atraumatic restorative treatment. J Am Dent Assoc 138:1347-1352, 2007.
49. Tyas MJ: Milestones in adhesion: glass-ionomer cements. J Adhes Dent 5:259-266, 2003.
50. Oppermann RV and Rolla G: Effect of some polyvalent cations on the acidogenicity of dental plaque in vivo. Caries Res 14:422-427, 1980.
51. Hamilton IR: Biochemical effects of fluoride on oral bacteria. J Dent Res 69 Spec No:660-667; discussion 682-663, 1990.
52. Seppa L, Forss H and Ogaard B: The effect of fluoride application on fluoride release and the antibacterial action of glass ionomers. J Dent Res 72:1310-1314, 1993.
53. Kan KC, Messer LB and Messer HH: Variability in cytotoxicity and fluoride release of resin-modified glass-ionomer cements. J Dent Res 76:1502-1507, 1997.
54. Van Loveren C: Antimicrobial activity of fluoride and its in vivo importance: identification of research questions. Caries Res 35 Suppl 1:65-70, 2001.
55. Wiegand A, Buchalla W and Attin T: Review on fluoride-releasing restorative materials--fluoride release and uptake characteristics, antibacterial activity and influence on caries formation. Dent Mater 23:343-362, 2007.
56. Maltz M and Emilson CG: Susceptibility of oral bacteria to various fluoride salts. J Dent Res 61:786-790, 1982.
57. Moura JS, Lima EM, Paes Leme AF, Del Bel Cury AA, Tabchoury CP and Cury JA: Effect of luting cement on dental biofilm composition and secondary caries around metallic restorations in situ. Oper Dent 29:509-514, 2004.
58. Forss H, Nase L and Seppa L: Fluoride concentration, mutans streptococci and lactobacilli in plaque from old glass ionomer fillings. Caries Res 29:50-53, 1995.
59. van Dijken JW, Kalfas S, Litra V and Oliveby A: Fluoride and mutans streptococci levels in plaque on aged restorations of resin-modified glass ionomer cement, compomer and resin composite. Caries Res 31:379-383, 1997.
60. Mount GJ: Adhesion of glass-ionomer cement in the clinical environment. Oper Dent 16:141-148, 1991.
61. Mount GJ: Buonocore Memorial Lecture. Glass-ionomer cements: past, present and future. Oper Dent 19:82-90, 1994.
62. Renard JL, Felten D and Bequet D: Post-otoneurosurgery aluminium encephalopathy. Lancet 344:63-64, 1994.
63. Nicholson JW, Braybrook JH and Wasson EA: The biocompatibility of glass-poly(alkenoate) (Glass-Ionomer) cements: a review. J Biomater Sci Polym Ed 2:277-285, 1991.
64. Caughman WF, Caughman GB, Dominy WT and Schuster GS: Glass ionomer and composite resin cements: effects on oral cells. J Prosthet Dent 63:513-521, 1990.
65. Sasanaluckit P, Albustany KR, Doherty PJ and Williams DF: Biocompatibility of glass ionomer cements. Biomaterials 14:906-916, 1993.
66. Franz A, Konradsson K, Konig F, Van Dijken JW and Schedle A: Cytotoxicity of a calcium aluminate cement in comparison with other dental cements and resin-based materials. Acta Odontol Scand 64:1-8, 2006.
67. Muller J, Bruckner G, Kraft E and Horz W: Reaction of cultured pulp cells to eight different cements based on glass ionomers. Dent Mater 6:172-177, 1990.
68. Lewis J, Nix L, Schuster G, Lefebvre C, Knoernschild K and Caughman G: Response of oral mucosal cells to glass ionomer cements. Biomaterials 17:1115-1120, 1996.
69. Buric N, Jovanovic G, Krasic D and Kesic L: Investigation of the bone tissue response to glass-ionomer microimplants in the canine maxillary alveolar ridge. J Oral Sci 45:207-212, 2003.
70. Cole I, Dan N and Anker A: Bone replacement in head and neck surgery: a biocompatible alternative. Aust N Z J Surg 66:469-472, 1996.
71. de Souza Costa CA, Hebling J, Garcia-Godoy F and Hanks CT: In vitro cytotoxicity of five glass-ionomer cements. Biomaterials 24:3853-3858, 2003.
72. Lan WH, Lan WC, Wang TM, Lee YL, Tseng WY, Lin CP, Jeng JH and Chang MC: Cytotoxicity of conventional and modified glass ionomer cements. Oper Dent 28:251-259, 2003.
73. Nicholson JW and Croll TP: Glass-ionomer cements in restorative dentistry. Quintessence Int 28:705-714, 1997.
74. Holmgren CJ, Lo EC, Hu D and Wan H: ART restorations and sealants placed in Chinese school children--results after three years. Community Dent Oral Epidemiol 28:314-320, 2000.
75. Mandari GJ, Frencken JE and van't Hof MA: Six-year success rates of occlusal amalgam and glass-ionomer restorations placed using three minimal intervention approaches. Caries Res 37:246-253, 2003.
76. Prentice LH, Tyas MJ and Burrow MF: The effect of particle size distribution on an experimental glass-ionomer cement. Dent Mater 21:505-510, 2005.
77. Moshaverinia A, Ansari S, Movasaghi Z, Billington RW, Darr JA and Rehman IU: Modification of conventional glass-ionomer cements with N-vinylpyrrolidone containing polyacids, nano-hydroxy and fluoroapatite to improve mechanical properties. Dent Mater 24:1381-1390, 2008.
78. Moshaverinia A, Ansari S, Moshaverinia M, Roohpour N, Darr JA and Rehman I: Effects of incorporation of hydroxyapatite and fluoroapatite nanobioceramics into conventional glass ionomer cements (GIC). Acta Biomater 4:432-440, 2008.
79. Smith DC: Polyacrylic acid-based cements: adhesion to enamel and dentin. Oper Dent Suppl 5:177-183, 1992.
80. Moshaverinia A, Roohpour N, Darr JA and Rehman IU: Synthesis and characterization of a novel N-vinylcaprolactam-containing acrylic acid terpolymer for applications in glass-ionomer dental cements. Acta Biomater 5:2101-2108, 2009.
81. Culbertson BM: New polymeric materials for use in glass-ionomer cements. Journal of Dentistry 34:556-565, 2006.
82. Moshaverinia A, Roohpour N, Darr JA and Rehman IU: Synthesis of a proline-modified acrylic acid copolymer in supercritical CO(2) for glass-ionomer dental cement applications. Acta Biomater 2009.
83. Chang HJ, Wu CM, Chang YC, Fanchiang JC, Shieh DB and Wong TY: Collagen enhances compatibility and strength of glass ionomers. J Dent Res 88:449-454, 2009.
84. Ma JK and Lehner T: Prevention of colonization of Streptococcus mutans by topical application of monoclonal antibodies in human subjects. Arch Oral Biol 35 Suppl:115S-122S, 1990.
85. Rolla G and Melsen B: On the mechanism of the plaque inhibition by chlorhexidine. J Dent Res 54 Spec No B:B57-62, 1975.
86. Hennessey TD: Antibacterial properties of Hibitane. J Clin Periodontol 4:36-48, 1977.
87. Roberts WR and Addy M: Comparison of the bisbiguanide antiseptics alexidine and chlorhexidine. I. Effect on plaque accumulation and salivary bacteria. J Clin Periodontol 8:213-219, 1981.
88. Addy M and Roberts WR: Comparison of the bisbiguanide antiseptics alexidine and chlorhexidine. II. Clinical and in vitro staining properties. J Clin Periodontol 8:220-230, 1981.
89. Briner WW, Kayrouz GA and Chanak MX: Comparative antimicrobial effectiveness of a substantive (0.12% chlorhexidine) and a nonsubstantive (phenolic) mouthrinse in vivo and in vitro. Compendium 15:1158, 1160, 1162 passim; quiz 1170, 1994.
90. Faria G, Cardoso CR, Larson RE, Silva JS and Rossi MA: Chlorhexidine-induced apoptosis or necrosis in L929 fibroblasts: A role for endoplasmic reticulum stress. Toxicol Appl Pharmacol 234:256-265, 2009.
91. Ahn SJ, Lee SJ, Kook JK and Lim BS: Experimental antimicrobial orthodontic adhesives using nanofillers and silver nanoparticles. Dent Mater 25:206-213, 2009.
92. Spencer CG, Campbell PM, Buschang PH, Cai J and Honeyman AL: Antimicrobial effects of zinc oxide in an orthodontic bonding agent. Angle Orthod 79:317-322, 2009.
93. Hung SL, Lin YW, Wang YH, Chen YT, Su CY and Ling LJ: Permeability of Streptococcus mutans and Actinobacillus actinomycetemcomitans Through guided tissue regeneration membranes and their effects on attachment of periodontal ligament cells. J Periodontol 73:843-851, 2002.
94. Can-Karabulut DC, Batmaz I, Solak H and Tastekin M: Linear regression modeling to compare fluoride release profiles of various restorative materials. Dent Mater 23:1057-1065, 2007.
95. Xu X and Burgess JO: Compressive strength, fluoride release and recharge of fluoride-releasing materials. Biomaterials 24:2451-2461, 2003.
96. Yap AU, Cheang PH and Chay PL: Mechanical properties of two restorative reinforced glass-ionomer cements. J Oral Rehabil 29:682-688, 2002.
97. Bagheri R, Burrow MF and Tyas MJ: Surface characteristics of aesthetic restorative materials - an SEM study. J Oral Rehabil 34:68-76, 2007.
98. Bresciami E, Barata TdJE and Fagundes TC: Compressive and diametral tensil strength of glass ionomer cement. J Appl Oral Sci 12:344-348, 2004.
99. Wegehaupt F, Gries D, Wiegand A and Attin T: Is bovine dentine an appropriate substitute for human dentine in erosion/abrasion tests? J Oral Rehabil 35:390-394, 2008.
100. Dzakovich JJ and Oslak RR: In vitro reproduction of noncarious cervical lesions. J Prosthet Dent 100:1-10, 2008.
101. Lambrechts P, Debels E, Van Landuyt K, Peumans M and Van Meerbeek B: How to simulate wear? Overview of existing methods. Dent Mater 22:693-701, 2006.
102. Okada K, Tosaki S, Hirota K and Hume WR: Surface hardness change of restorative filling materials stored in saliva. Dent Mater 17:34-39, 2001.
103. Palmer G, Jones FH, Billington RW and Pearson GJ: Chlorhexidine release from an experimental glass ionomer cement. Biomaterials 25:5423-5431, 2004.
104. DeSchepper EJ, White RR and von der Lehr W: Antibacterial effects of glass ionomers. Am J Dent 2:51-56, 1989.
105. ten Cate JM and van Loveren C: Fluoride mechanisms. Dent Clin North Am 43:713-742, vii, 1999.
106. Mazzaoui SA, Burrow MF and Tyas MJ: Fluoride release from glass ionomer cements and resin composites coated with a dentin adhesive. Dent Mater 16:166-171, 2000.
107. van Strijp AJ, van Steenbergen TJ and ten Cate JM: Effects of chlorhexidine on the bacterial colonization and degradation of dentin and completely demineralized dentin in situ. Eur J Oral Sci 105:27-35, 1997.
108. Emilson CG: Potential efficacy of chlorhexidine against mutans streptococci and human dental caries. J Dent Res 73:682-691, 1994.
109. Botelho MG: Inhibitory effects on selected oral bacteria of antibacterial agents incorporated in a glass ionomer cement. Caries Res 37:108-114, 2003.
110. Sanders BJ, Gregory RL, Moore K and Avery DR: Antibacterial and physical properties of resin modified glass-ionomers combined with chlorhexidine. J Oral Rehabil 29:553-558, 2002.
111. Jedrychowski JR, Caputo AA and Kerper S: Antibacterial and mechanical properties of restorative materials combined with chlorhexidines. J Oral Rehabil 10:373-381, 1983.
112. Barkvoll P, Rolla G and Bellagamba S: Interaction between chlorhexidine digluconate and sodium monofluorophosphate in vitro. Scand J Dent Res 96:30-33, 1988.
113. Dolles OK, Bonesvoll P, Gamst ON and Gjermo P: Determination of fluoride and chlorhexidine from chlorhexidine/fluoride-containing dentifrices. Scand J Dent Res 87:115-122, 1979.
114. Silva RC, Zuanon AC, Esberard RR, Candido MS and Machado JS: In vitro microhardness of glass ionomer cements. J Mater Sci Mater Med 18:139-142, 2007.
115. Burke FM, Hamlin PD and Lynch EJ: Depth of cure of light-cured glass-ionomer cements. Quintessence Int 21:977-981, 1990.
116. Swift EJ, Jr., Pawlus MA, Vargas MA and Fortin D: Depth of cure of resin-modified glass ionomers. Dent Mater 11:196-200, 1995.
117. Abate PF, Polack MA and Macchi RL: Barcoll hardness of resin-modified glass-ionomer cements and a compomer. Quintessence Int 28:345-348, 1997.
118. Bourke AM, Walls AW and McCabe JF: Light-activated glass polyalkenoate (ionomer) cements: the setting reaction. J Dent 20:115-120, 1992.
119. Nicholson JW: Chemistry of glass-ionomer cements: a review. Biomaterials 19:485-494, 1998.
120. Matsuya S, Maeda T and Ohta M: IR and NMR analyses of hardening and maturation of glass-ionomer cement. J Dent Res 75:1920-1927, 1996.
121. Czarnecka B, Limanowska Shaw H and Nicholson JW: Microscopic evaluation of the interface between glass-ionomer cements and tooth structures prepared using conventional instruments and the atraumatic restorative treatment (ART) technique. Quintessence Int 37:557-564, 2006.
122. Imparato JC, Garcia A, Bonifacio CC, Scheidt L, Raggio DP, Mendes FM and Vedovello Filho M: Color stability of esthetic ion-releasing restorative materials subjected to pH variations. J Dent Child (Chic) 74:189-193, 2007.
123. Abu-Bakr N, Han L, Okamoto A and Iwaku M: Color stability of compomer after immersion in various media. J Esthet Dent 12:258-263, 2000.
124. Hayacibara MF, Ambrozano GM and Cury JA: Simultaneous release of fluoride and aluminum from dental materials in various immersion media. Oper Dent 29:16-22, 2004.
125. Williams JA, Billington RW and Pearson GJ: A long term study of fluoride release from metal-containing conventional and resin-modified glass-ionomer cements. J Oral Rehabil 28:41-47, 2001.
126. Iazzetti G, Burgess JO, Gardiner D and Ripps A: Color stability of fluoride-containing restorative materials. Oper Dent 25:520-525, 2000.
127. McKinney JE, Antonucci JM and Rupp NW: Wear and microhardness of glass-ionomer cements. J Dent Res 66:1134-1139, 1987.
128. Prosser HJ, Powis DR and Wilson AD: Glass-ionomer cements of improved flexural strength. J Dent Res 65:146-148, 1986.
129. Institution BS: British Standards Specification for Dental Glass Ionomer Cement. BS 6039 4, 1981.
130. Guggenberger R, May R and Stefan KP: New trends in glass-ionomer chemistry. Biomaterials 19:479-483, 1998.
131. Ribeiro J and Ericson D: In vitro antibacterial effect of chlorhexidine added to glass-ionomer cements. Scand J Dent Res 99:533-540, 1991.
132. Heintze SD: How to qualify and validate wear simulation devices and methods. Dent Mater 22:712-734, 2006.