The Impact of Environmental and Material Factors on Fluoride Release from Metal-Modified Glass Ionomer Cements: A Systematic Review of In Vitro Studies.

OBJECTIVE

Fluoride is widely recognized for its preventive role against secondary caries. This systematic review aimed to evaluate how environmental and material factors influence fluoride ion release from metal-reinforced glass ionomer cements.

METHODS

A structured literature search was performed in March 2025 across PubMed, Scopus, and Web of Science databases. Search terms included combinations of fluoride release AND glass ionomer AND silver OR zinc OR strontium OR copper. The study selection process followed PRISMA 2020 guidelines and was organized using the PICO framework. Out of 281 initially identified records, 153 were screened based on titles and abstracts. After applying predefined eligibility criteria, 23 studies met the inclusion requirements and were included in the qualitative analysis.

RESULTS

Among the 23 included publications, 12 involved glass ionomers modified with silver, and 6 of these reported an increase in fluoride release. Seven studies focused on zinc-modified cements, and four examined materials reinforced with strontium.

CONCLUSIONS

The addition of strontium, titanium oxide, silver nanoparticles, or zirconium oxide increases the release of fluoride ions, while sintered silver reduces it. There is a great discrepancy among researchers regarding the effect of the addition of zinc oxide and its appropriate amount in the glass ionomer material.