Journal of Dental Sciences (2019) 14, 346e351

Available online at www.sciencedirect.com

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journal homepage: www.e-jds.com

Original Article

Solubility of dental core build-up materials

in electric fields
Venus Hassani Katehsari*, Wilhelm Niedermeier **

Department of Prosthetic Dentistry, Center and School of Oral Medicine, University of Cologne,
Cologne, Germany

Received 19 December 2018; Final revision received 29 March 2019

Available online 30 May 2019

KEYWORDS Abstract Background/purpose: Over 250 years has been researched over the consequences
Cement; of oral galvanism. Previous studies have already examined the influence on dental fixation ma-
Composite; terials. The aim of this study was to investigate the electro-chemical solubility behavior of
Dental materials; different dental core build-up materials in a pseudo-realistic galvanic experimental setup.
Oral galvanism; Materials and methods: The composite Admira (Voco, Cuxhaven, Germany) and two glass iono-
Solubility mer cements, Ketac Molar and Photac (3M-Espe, Seefeld, Germany), were examined. Test
specimens were exposed to electric field strengths of 10e27 V/m in 0.9% saline solution. After
1, 2, 3, and 24 h, 2 ml of the electrolyte was removed for analysis. Aluminum and calcium were
selected as parameters to measure the solubility of the products. Differences between the test
samples and controls were ascertained using the two sample t-test.
Results: For all of the test groups, Admira demonstrated minimal solubility compared to Ketac
and Photac. However, after 24 h in an electric field of 27 V/m, Admira demonstrated the high-
est increase in solubility compared to the controls (3.47 vs control at 0.76 mmol/l). The second
highest increase yielded the conventional glass ionomer cement Ketac (8.62 vs control at
5.28 mmol/l), and a minor increase in solubility showed the composite-based glass ionomer ma-
terial Photac (38.73 vs control at 31.78 mmol/l) compared to the controls.
Conclusion: This study demonstrated that galvanic processes increase the solubility of glass io-
nomer and composite. Therefore, the time of storage, electric field strength, and contact of
the material with the electrodes significantly influenced their solubility.
ª 2019 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier
B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.
org/licenses/by-nc-nd/4.0/).

* Corresponding author. Department of Prosthetic Dentistry, Center and School of Oral Medicine, University of Cologne, 32 Kerpener
Street, Cologne 50931, Germany.
** Corresponding author. Department of Prosthetic Dentistry, Center and School of Oral Medicine, University of Cologne, 32 Kerpener
Street, Cologne 50931, Germany.
E-mail addresses: [email protected] (V. Hassani Katehsari), [email protected] (W. Niedermeier).

https://doi.org/10.1016/j.jds.2019.04.005
1991-7902/ª 2019 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V. This is an open access article under
the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Solubility of dental core build-up materials 347

Introduction The chemical properties of these compound materials

demonstrate that galvanic elements are formed by different
Oral galvanism (OG) leads to mucosal sensitivities1,2 such as metallic materials in the oral cavity and have potentials of
battery taste in the mouth, xerostomia,3 and oral and up to 1000 mV that can dissociate and reduce the stability of
dental diseases such as pulpitis, leukoplakia, or lichen composites or glass ionomer cements used to restore dental
planus.4 Medical symptoms such as back and shoulder pain abutments.2 Therefore, the aim of this investigation was to
and mental problems such as depression, fatigue, and assess whether OG or electric fields (EF) can impair the
insomnia2 are also associated with OG. OG is triggered by quality of dental core build-up materials.
the interaction of various dental alloys used for restorations
and fillings, with saliva as an electrolyte.5e7 Replacement
of metal restorations and fillings with non-metal appliances Materials and methods
often improves or even eliminates symptoms.8,9
New dental materials were introduced to dentistry as Specimens
better alternatives to existing metallic appliances. Com-
posite resins offer an alternative to amalgams that are Each of the 60 test specimens were produced from three
commonly used for dental fillings. Composites and glass fundamentally different material types to simulate the core
ionomer cements are used as core build-up materials. build-up materials in the mouth: (1) Ketac Molar Universal
Composites consist of an organic dimethacrylate matrix, Aplicap glass ionomer filling material; (2) Photac Fil Quick
disperse inorganic fillers such as quartz, glass, ceramics, Aplicap light-curing glass ionomer filling material (both 3M-
and silicon oxide, and a coated composite phase with si- Espe, Seefeld, Germany); and (3) Admira,ormocer (Voco,
lanes and copolymers.10 Conventional glass ionomer ce- Cuxhaven, Germany). Tables 1e3 show the composition and
ments mainly consist of polyacrylic acid and inorganic ingredients of the materials. All of the specimens were
fillers that undergo an acid-base reaction and cure within processed as specified by the manufacturer and molded
5e10 min of mixing.11,12 In addition to conventional, using a silicone template. They were 1 mm thick and had an
metal-reinforced, and highly viscous glass ionomer ce- outer diameter of 10 mm and an inner diameter of 4 mm.
ments, the plastic-modified form of glass ionomer cement The total surface of the specimens was 65.97 mm2 (circle
was developed toward the end of the 1980s. The main ring formula: a Z p*(102-42)/4 Z 65,97 mm2). The test
component is methacrylic polyacrylic acid that can be specimens were ground with metal free diamond paper
photo-polymerized.12 with a roughness of 800 (Telum K 800, Paul Sommer,

Table 1 Composition and information on ingredients of Ketac Molar Universal Aplicap.13

C.A.S. Registry Number Ingredient % by Relative Weight (Wt)
7732-18-5 Water 60e65
a
Trade Secret
29132-58-9 Copolymer of Acrylic Acid-Maleic Acid 30e40
a
Trade Secret
87-69-4 Tartaric Acid 5e10
a
Trade Secret
a
The exact percentage/concentration and specific chemical identity of this composition has been withheld as a trade secret.

Table 2 Composition and information on ingredients of Photac Fil Quick Aplicap.14

C.A.S. Registry Number Ingredient % by Relative Weight (Wt)
29132-58-9 Polyethylene Polycarbonic Acid 30e50
868-77-9 2 Hydroxyethyl Methacrylate 25e50
7732-18-5 Water 20e30
72869-86-4 Diurethane Dimetharylate 3e5
Unknown Magnesium Hema Ester 5e10

Table 3 Composition and information on ingredients of Admira.15

C.A.S. Registry Number Ingredient % by Relative Weight (Wt)
Unknown Ormocer 10e25
1565-94-2 BIS-GMA 5e10
72869-86-4 Urethandimethacrylat 5e10
EINECS: 276-957-5
348 V. Hassani Katehsari, W. Niedermeier

Loebau, Germany) to achieve a uniform and even surface in an incubator. That is why the room temperature of the
quality (Fig. 1). All of the test specimens were soaked in laboratory was used as environmental temperature. All
distilled water for 1 h to remove unlinked monomers and conditions (temperature, humidity, air pressure etc.) were
impurities. equal for every experiment. The test specimens were sus-
pended in their central hole via a plastic isolated wire. 2 ml
Pre-tests samples of the electrolyte were obtained after 1, 2, 3, and
24 h. The samples were pipetted after stirring the elec-
In preliminary tests, the materials were each stored in a trolyte solution. Each test was repeated three times under
glass container with 80 ml of sodium chloride (NaCl, 0.9%) exactly the same conditions to obtain a mean value. To
solution for 24 h. Subsequently, 2 ml of sample solutions avoid dilution and falsifying the results, the glass container
were obtained to conduct a metal screening test (multi- was not refilled with saline solution after each sample. For
element analysis). Calcium and aluminum were superior as each process, the materials and tools used were exclusively
solubility parameters in the following experiments (Fig. 2). made of glass or polyethylene. The experiments were
divided into two series.
Test procedure
(1) For the first series, test specimens of the three dental
materials Ketac, Photac, and Admira were suspended
To simulate oral conditions, the tests were conducted for 24 h in saline solution without an electric field
following a pseudo-realistic setup. 160 ml of 0.9% saline was
(EF Z 0 V/m).
used as electrolyte solution with a temperature of 26  C and
(2) The second series was conducted in a similar
a pH of 6.8 ascertained at the beginning and end of each sequence. The only difference was that two elec-
test using pH indicator strips (Neutralit pH 5.0e10.0, Merck,
trodes were added to the test setup and the samples
Darmstadt, Germany). The temperature of 26 (room
were exposed to an electric field (Fig. 3). Fine gold
temperature of the lab) was chosen because for technical
sheet electrodes (99.9%, 2  3 inches) were attached
reasons, the entire experimental setup could not be placed using clamp stands and were aligned parallel to each
other in the solution. The test specimens were
angled at 90 to the electrodes connected with an
auto-controlled voltage source. The EF was varied
from 10 to 27 V/m by adjusting the sheet electrodes
and modulating the voltage. The test material was
exposed to the fields both with and without one-
sided and two-sided contact with the electrodes.
Thereby, direct contact with the electrodes should
simulate the conditions at a dental abutment, where
the metal crowns on one side and the root post on
the other side are in direct contact with the core
build-up material.

Figure 1 Photac Fil test specimen; the surface was ground

flat using diamond paper (Telum K 800).

Mul element analysis (ICP-MS)

8.19
4.10 Ketac Molar
2.05
Photac-Fil
1.02
0.51 Admira
0.26
mg/l

0.13
0.06
0.03
0.02
0.01
0.00
0.00
0.00
Al

Ca
Ti

Cr
Mg

Fe

Se

Te

Tl
Mn

Co
Si
K

Ni

As

Mo
Ag
Cu
Zn

Cd
Sn
Sb

La

Pb

Figure 2 Detail components of the test materials by a Multi Figure 3 Specimen suspended with an insulated wire via a
element analysis (ICP-MS). The elements Calcium and central hole in a glass containing 0.9% saline solution and in
aluminum are superior solubility parameters which are con- one-sided contact with one of two gold sheet electrodes (left
tained most in the test subjects. and right).
Solubility of dental core build-up materials 349

Chemical and statistical analysis controls. The values indicate an increase in the calcium
concentrations for all of the field strengths and periods. After
The concentrations of the pipetted samples were analyzed by only two hours, the calcium solubility of all of the test sam-
an accredited laboratory using mass spectroscopy with ples had significantly increased compared to the controls.
inductively coupled plasma (ICP-MS). Each sample was tested
3 times against the standard (electrolyte without sample). Admira
The two sample t-test for independent samples was
conducted to differentiate the test samples from the con- Amira demonstrated an increase in calcium solubility after
trols. The evaluations were carried out in a post hoc test 2e24 h (Table 6). The increase was significant when the
according to Bonferroni’s correction (a Z 0.05). material had contact with both electrodes or at a field
strength of 20 V/m or more.
Results
Comparison of all materials
Ketac
Fig. 4 demonstrates a comparison of the Ketac, Photac, and
Table 4 demonstrates the solubility values of aluminum for Admira materials in an EF of 27 V/m. The aluminum release
Ketac Molar under one-sided contact (EF Z 10 V/m, was determined for Ketac and the calcium release was
EF Z 20 V/m) and under two-sided contact (EF Z 10 V/m, ascertained for Photac and Admira. Admira, although
EF Z 27 V/m) of the electrodes vs the controls (EF Z 0 V/m). showing the maximum field- and time-dependent increase
After 3e24 h, all of the samples demonstrated an increase in in solubility, demonstrated a minimum overall release of
their aluminum solubility. The differences in the controls calcium. The maximum release of inorganic minerals was
were significant without exception for an EF of 20 and 27 V/m. ascertained for Photac.

Photac Discussion

Table 5 shows the release of Ca from Photac under one-sided The present study investigated the phenomenon of oral
and two-sided contact with the electrodes against the galvanism and whether electric fields can exert an influence

Table 4 Measurements of the Al concentration for Ketac Molar with one and two electrode contact. The mean values and their
standard deviations are listed. The arrows indicate an increase ([) or decrease in the concentrations vs the controls (0 V/m).
The statistical significance of the differences (two sample t-test): *p < 0.05: noticeable increase and **p < 0.01: significant
increase.
Time 1h 2h 3h 24 h
Field strength MW SD MW SD MW SD MW SD
mmol/l mmol/l mmol/l mmol/l mmol/l mmol/l mmol/l mmol/l
0 V/m 1.22 0.19 1.68 0.43 2.2 1.12 5.28 1.78
10 V/m One-sided contact 1.25 0.65 1.70 0.93 2.62 [ 0.92 6.1 [ 0.79
20 V/m One-sided contact 2.10 [* 0.54 3.78 [** 0.63 5.27 [** 1.04 8.27 [* 1.27
10 V/m Two-sided contact 1.25 0.8 2.23 [ 0.19 3.35 [ 0.76 7.65 [* 1.94
27 V/m Two-sided contact 1.57 [ 1.01 2.79 [ 0.98 4.17 [* 1.48 8.62 [** 0.69
Bold signifies the importance of the solubility of the products in statistics.

Table 5 Measurements of the Ca concentration for Photac with one and two electrode contact. The mean values and their
standard deviations are listed. The arrows indicate an increase ([) or decrease in the concentrations vs the controls (0 V/m).
The statistical significance of the differences (two sample t-test): *p < 0.05: noticeable increase and **p < 0.01: significant
increase.
Time 1h 2h 3h 24 h
Field strength MW SD MW SD MW SD MW SD
mmol/l mmol/l mmol/l mmol/l mmol/l mmol/l mmol/l mmol/l
0 V/m 1.99 1.11 3.92 0.64 5.9 1.47 31.78 8.98
10 V/m One-sided contact 3.48 [* 1.15 4.73 [* 1.29 6.08 [ 1.66 33.63 [ 0.81
20 V/m One-sided contact 4.95 [ 4.02 8.30 [* 3.46 12.00 [** 4.64 38.36 [ 6.59
10 V/m Two-sided contact 3.63 [ 0.48 5.74 [* 0.17 6.61 [ 0.4 34.37 [ 0.54
27 V/m Two-sided contact 4.4 [* 2.15 6.4 [* 0.9 10.01 [** 2.9 38.73 [* 2.32
Bold signifies the importance of the solubility of the products in statistics.
350 V. Hassani Katehsari, W. Niedermeier

Table 6 Measurements of the Ca concentration for Admira with one and two electrode contact. The mean values and their
standard deviations are listed. The arrows indicate an increase ([) or decrease in the concentrations vs the controls (0 V/m).
The statistical significance of the differences (two sample t-test): *p < 0.05: noticeable increase and **p < 0.01: significant
increase.
Time 1h 2h 3h 24 h
Field strength MW mmol/l SD MW mmol/l SD MW mmol/l SD MW mmol/l SD
mmol/l mmol/l mmol/l mmol/l
0 V/m 0.34 0.12 0.4 0.11 0.49 0.1 0.76 0.2
10 V/m One-sided contact 0.33 0.09 0.62 [ 0.21 0.78 [ 0.39 0.98 [ 0.29
20 V/m One-sided contact 1.27 [* 0.35 1.56 [* 0.5 1.76 [* 0.59 2.54 [* 0.84
10 V/m Two-sided contact 0.83 [* 0.2 0.88 [* 0.17 1.12 [* 0.24 1.42 [* 0.3
27 V/m Two-sided contact 1.59 [* 0.5 1.97 [* 0.69 2.14 [* 0.64 3.47 [* 1.29
Bold signifies the importance of the solubility of the products in statistics.

and therefore retard the electrolysis of the test materials.

Comparison of all materials in an EF of 27 V/m
The pretest showed which components have the highest
45
solubility in Ketac Molar, Photac and Amira (Fig. 2).
40
Ketac Molar is a conventional glass ionomer cement. In
35
addition to glass, oxide, and chemicals, it is mainly
30
composed of polyacrylic acid that cross-links to form a
25 Ketac
calcium polycarboxylate gel.11,12 Preliminary tests found
μmol/l

Photac
20
Admira
that aluminum that was utilized to stabilize the material12
15
demonstrated the highest solubility among all of the in-
10
gredients. Crisp, Lewis, and Wilson,21 Sidler and Strub,22
5
Mitchem and Gronas,23 and Nathanson24 studied the solu-
0
1h 2h 3h 24h
bility of cements, including glass ionomer cements, and
proved that they dissolved under certain conditions. Peez25
Figure 4 Comparison of the release of calcium and and Frank demonstrated that Ketac Molar Easymix has a
aluminum for Admira, Ketac, and Photac in an EF of 27 V/m higher solubility in a neutral medium than in acid. The
under two-sided contact with the electrodes and their stan- current study found that the solubility of aluminum in-
dard deviation. Since Ketac does contain less calcium, creases in an almost neutral medium without EF; after
aluminum was used as a marker for this material. Therefore, exposure to an EF, a strong increase in the aluminum sol-
the ordinate shows concentrations of aluminum (for Ketac) and ubility occurs. When the test specimen came into contact
calcium (for Admira and Photac) in mmol/l. with both electrodes, the aluminum solubility increased
much more compared to the other experiments. Trans-
on dental core build-up materials. Whether the distance of ferred to the oral cavity, this happens when the build-up
the electrodes to the respective restorations is relevant and material lies in between the crown and an endodontic
decisive for their solubility behavior must also be verified. In metal post or pin. Depending on the electric potential
the mouth, different metallic restorations act as electrodes generated by different metallic materials, in a crown-post
and saliva and tissue liquor serve as electrolytes.16,17 situation, the EF can increase to 100 V/m and more.
Compared to non-precious metals, gold has a high stan- Moreover, the stability of nearby dentin and lining cements
dard potential and a very low tendency to corrode.16 The will also decrease as the result of a clinical failure.18,26 In
corrosion processes was minimized using fine gold elec- the present study, however, the EF had to be limited to
trodes. A homogenous electric field was generated to a large 27 V/m for technical reasons to maintain the stability of the
extent in vitro by a low-frequency alternating voltage electrodes.18,26 Therefore, it can be assumed that electro-
(1 Hz). The function of the voltage transformer was to pre- chemical dissociation is higher in vivo.
vent a sudden voltage drop between the gold electrodes and The solubility of the glass ionomer cement Photac Fil
guarantee a constant current flow to minimize the polari- that was methacrylate polyacrylic acid was studied using
zation of the gold electrodes. It was set at a constant calcium as a marker that demonstrated the highest solu-
voltage between 0.1 V and 0.7 V to achieve electric field bility in the pre-tests.27 Zankuli28 observed the solubility of
strengths between 10 and 27 V/m, corresponding to previ- a plastic-modified Fuji II glass ionomer cement in distilled
ous measured values found in vivo studies.16e18 The elec- water. Without an EF, a rapid time-dependent increase in
trolyte was 0.9% NaCl solution. With a pH value of 6.8, it the Ca solubility was found in the 0.9% saline solution
fulfilled the ionic requirements of an electrolyte and also (pH Z 6.8) used in the present study. Under one- and two-
was very close to the pH value of saliva.19,20 The glass sided contact with the electrode, the concentration
container in our experiments was not refilled with saline increased substantially. This means that Photac as a core
solution after each sample. Otherwise the concentration of build-up material would show a strong solubility behavior in
ions in the glass container would drop through the dilution the long run both without and with crowning.
Solubility of dental core build-up materials 351

Admira is an ormocer that is characterized by very good 6. Meiners H. Electrical phenomena associated with metal fillings.
cross-linking properties and low monomer release.29 Re- ZWR 1984;93(41e4):46e7 [Article in German].
searchers such as Inoue and Hayashi investigated whether 7. Meyer RD, Meyer J, Taloumis LJ. Intraoral galvanic corrosion:
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demonstrated a very low solubility behavior in the current potentials in the oral cavity. Dtsch zahnärztl Z 1989;44:50e1
experiments. After 24 h without an EF, the calcium solubi- [In German, English abstract].
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is more important than time and it strongly influences the stoffwissenschaft und Werkstoffechnik. thesis. School of
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11. Espe 3M. Ketac molar Aplicap instructions for use,
whether the increased solubility poses a danger to the 44000768158/01. Seefeld: 3M Espe, 2014.
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such a minimal range that they are less relevant for a 13. Espe 3M. Ketac molar Aplicap material safety data sheet.
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