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Shade match of tooth-colored restorative materials based on a commercial shade guide.

Many restorative materials are claimed by their manufacturers to match the Vita shade guide. To verify this claim, 40 dental personnel were asked to color match five different restorative materials to their respective Vita shade tabs according to a 5-point scale (1 = very poor color match; 5 = excellent color match). Three shades were chosen for each restorative material (a mid-Value shade as well as the highest Value shade and the lowest Value shade present in each system). Pooled scores indicated that the resin composite materials had significantly better overall shade match than did the other materials evaluated and that one resin-modified glass-ionomer cement had significantly better shade match than did the "compomer" and another resin-modified glass-ionomer cement. Only 11% of the scores for all material and shade combinations were given a good or excellent rating (score greater than 3). Shade match to the Vita shade guide was not material dependent but tended to differ among the different Value shades evaluated.

Analysis of Variance↗

A fluoride release-adsorption-release system applied to fluoride-releasing restorative materials.

This investigation compared the initial fluoride release and release following refluoridation of three resin-modified glass-ionomer cements (Photac-Fil Applicap, Vitremer, and Fuji II LC) and a new polyacid-modified resin composite material (Dyract). After daily flouride release was measured for 8 days, specimens were refluoridated in 1,000-ppm solutions of fluoride ion for 10 minutes and fluoride release was measured for 5 days. Two further 5-day refluoridation-release periods were carried out. All materials released fluoride initially. Photac released the most; Dyract released the least. Initial release was greatest over the first few days. All materials released significantly more fluoride for 24 to 48 hours after refluoridation. Less fluoride was released with each successive refluoridation for the three glass-ionomer cements. The release from the Dyract compomer remained at a comparatively constant and significantly lower level following each refluoridation.

Analysis of Variance↗

Marginal adaptation of resin-bonded light-cured glass ionomers in dentin cavities.

PURPOSE: To investigate the marginal adaptation of resin-modified glass ionomer cements in dentin cavities placed with or without additional application of resin bonding systems. MATERIALS AND METHODS: Three resin-modified materials (Fuji II LC, Photac-Fil, Vitremer), one compomer (Dyract) and as reference an adhesively bonded resin composite system (Gluma CPS-Pekafill) were used. Flat peripheral dentin surfaces on human molar teeth were produced by wet grinding on SiC paper. Cylindrical cavities, 3.5 mm wide, were prepared in these dentin areas and restored with the individual materials. Sixty cavities were pretreated and restored as requested by the respective manufacturers. Following water storage of the specimens for 15 minutes or 24 hours, excess was gently removed by wet grinding for microscopic inspection of the marginal area. Additionally, in 30 cavities an experimental one-component adhesive resin system, a proprietary dimethacrylate and HEMA mixture dissolved in acetone, was combined with each of the restoratives for evaluation after 15-minutes water storage. Finally, in six cavities each, Dyract was combined with Prime and Bond 2.0, and Vitremer with Scotchbond Multi-Purpose Plus for assessment after 15 minutes. Maximum marginal gap widths (MGW) were measured. One-way ANOVA by ranks (Kruskal-Wallis-Test) followed by Wilcoxon's Two-Sample test were used to study the statistical difference of MGW among the treatment groups at a rejection level P = 0.05. RESULTS: Neither the conventionally placed material systems nor the restorations in combination with adhesives showed consistently gap-free margins after 15-minute water storage. After 24-hour storage with Vitremer 4 of the 6 restorations were gap-free, whereas with all other materials only perfect margins were registered. There was, however, no significant difference between the groups. Application of the experimental and/or the specific resin bonding agents had no effect on early MGW except for the Photac-Fil group, which was significantly reduced.

Analysis of Variance↗

Microleakage of tooth-colored restorations with a beveled gingival margin.

OBJECTIVE: Microleakage of tooth-colored restorative systems was tested in preparations with and without beveled gingival margins. METHOD AND MATERIALS: A resin composite, Z-100, and two "compomer" restoratives, Dyract and Geristore, with their accompanying adhesive systems, were placed in nonretentive cervical cavity preparations (at the cementoenamel junction), with and without a beveled gingival margin (dentin or cementum) and beveled occlusal (enamel) margins in extracted bovine teeth. Microleakage was assessed as the ratio of the extent of methylene blue dye penetration at the tooth-restoration interface of the length of the wall. RESULTS: Z-100 restorations, without a gingival bevel, exhibited significantly less microleakage along the gingival wall and less microleakage overall than did the other materials. Dyract restorations without a gingival bevel and placed without a surface conditioner displayed greater microleakage overall than did the other groups. CONCLUSION: With all materials, Class V restorations with gingival bevels displayed greater microleakage than did nonbeveled margins.

Analysis of Variance↗

Clinical evaluation of Dyract in primary molars: 3-year results.

PURPOSE: To evaluate the 3-year clinical performance of Dyract in primary molars. MATERIALS AND METHODS: In 55 children (aged 4-9 years) 91 restorations were placed and 76 were available for evaluation after 2 years. After 3 years, 40 teeth were exfoliated leaving 37 restorations for evaluation. RESULTS: During the entire study, four restorations failed and had to be replaced. One restoration fractured after 6 months and another after 1 year. Two other restorations were completely lost between the second and third year's evaluation. Furthermore, three restorations showed minimal recurrent caries, which did not need additional treatment. Wear of the restorations was considerable. However, this was also true for the point of reference for the wear measurement on the primary molars. The excellent handling characteristics and the low failure rate during the 3-year study suggest that this compomer is a reliable restorative material in primary molars.

Child↗

Dyes for caries detection influence sound dentin bond strength.

This study evaluated the influence of caries-detection dyes on the in vitro tensile bond strength of adhesive materials to sound dentin. Caries-free human molars were ground to expose superficial dentin. Two dyes (a commercial 0.5% basic fuchsin in propylene glycol and Cari-D-Tect) were applied to sound dentin and rinsed. Subsequently, the dentin was etched with phosphoric acid (35%) and rinsed, leaving a moist dentin surface. The adhesive (Prime & Bond 2.0) was applied in two layers and light cured. A composite (TPH Spectrum), a compomer (Dyract), and a hybrid ionomer (Advance) were used to prepare the bond-strength specimens with a 3-mm-in-diameter bonding area. Control groups were made without use of dyes. Six specimens were prepared for each group. After 24 hours in distilled water, tensile bond strength (MPa) was measured using a testing machine. Analysis of variance was used to evaluate the data. Without dyes, bond strengths of TPH Spectrum and Dyract with Prime and Bond 2.0 were similar and both values were significantly (P < 0.05) higher than that of Advance with Prime & Bond 2.0. Dyes for caries detection reduced the bond strength of TPH Spectrum and Dyract but not Advance when used with Prime and Bond 2.0.

Coloring Agents↗

Two-year clinical performance of two primer adhesives on class V restorations.

The prime purpose of this clinical trial was to examine the clinical quality and retention rate of resin composite in connection with two recently developed acetone-based primer adhesives in Class V lesions according to ADA Clinical Protocol Guidelines for Dentin and Enamel Adhesive Materials. All cavities were nonretentive and predominantly in dentin (mixed Class V lesions). Total bonding was not limited either by sub-base or by base materials. All the trial restorations were placed under rubber dam. Group 1 (Version 16-135-1) and group 2 (Version 17-17-1) consisted of 42 patients with 46 trials and 38 patients with 43 fillings, respectively. The mean follow-up period and the recall response at the end of the study of group 1 were 22.8 months and 92.9% and of group 2 were 22.4 months and 94.7%. The trial restorations of both groups maintained their predominantly rated USPHS-Code Alpha level within the follow-up period. The cumulative failure rate of two trials in group 1 and four in group 2 determined a failure percentage of 4.4% and 9.3%, respectively, which is within the ADA-18 month limit of <10% Charlie. The Version KL 16-135-1 came into the market as Prime & Bond(R) 2.1, and the other one turned out to be Dyract Adhesive(R) PSA, which was primarily introduced as a single-component adhesive for compomer restorative Dyract(R) (Dentsply DeTrey, Germany).

Acetone↗

Dental restorative biomaterials induce glutathione depletion in cultured human gingival fibroblast: protective effect of N-acetyl cysteine.

Eight biomaterials eluted from four different types of dental restorative biomaterials, that is, from glass-ionomer cement (GIC: Ketac-fil and Fuji II), resin-modified glass ionomer cement (RM-GIC: Fuji II LC and Photac-fil), composite (Z100 MP and Tetric-flow), and compomer (Compoglass F and F-2000), were studied for their cytotoxic properties in relation to glutathione (GSH) content in cultured human gingival fibroblasts. Z100 MP, Tetric-flow, and Compoglass F were less cytotoxic than the others, with a toxic concentration of 50% (TC 50) > 24% (of eluate), as determined by the MTT test. F-2000, Tetric-flow, and the other biomaterials were relatively more cytotoxic (TC 50 = 9-16%). With the exception of Z100 MP, all the biomaterials induced a depletion of cellular glutathione (GSH) that was variable depending upon the biomaterial eluates. The strongest GSH depletion was with F-2000, Fuji II, and Photac-fil. GSH depletion, with Compoglass and F-2000, was rapid-detectable after one h of cell treatment and complete within 3 h-whereas a longer period of incubation was required for the other biomaterials. Interestingly, the drug cytotoxic effects induced by all the biomaterials were prevented by cell treatment with the antioxidant N-acetylcysteine (NAC). This study provides evidence that the cytotoxic property of dental restorative biomaterials is associated with depletion of the glutathione level in gingival fibroblasts. While the molecular mechanisms of this phenomenon require further investigations, our data suggest that NAC may be useful in preventing the cellular damage induced by dental restorative biomaterials.

Acetylcysteine↗

Adhesives for fixed orthodontic brackets.

BACKGROUND: Bonding of orthodontic brackets to teeth is important to enable effective and efficient treatment with fixed appliances. The problem is bracket failure during treatment which increases operator chairside time and lengthens treatment time. A prolonged treatment is likely to increase the oral health risks of orthodontic treatment with fixed appliances one of which is irreversible enamel decalcification. OBJECTIVES: To evaluate the effectiveness of different orthodontic adhesives for bonding. SEARCH STRATEGY: Electronic databases: the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Date of most recent searches: August 2002 (CENTRAL) (The Cochrane Library Issue 2, 2002). SELECTION CRITERIA: Trials were selected if they met the following criteria: randomised controlled trials (RCTs) and controlled clinical trials (CCTs) comparing two different adhesive groups. Participants were patients with fixed orthodontic appliances. The interventions were adhesives that bonded stainless steel brackets to all teeth except the molars. The primary outcome was debond or bracket failure. DATA COLLECTION AND ANALYSIS: Data were recorded on decalcification as a secondary outcome, if present. Information regarding methods, participants, interventions, outcome measures and results were extracted in duplicate by pairs of reviewers (Nicky Mandall (NM) and Rye Mattick (CRM); Declan Millett (DTM) and Joy Hickman (JH2)). Since the data were not presented in a form that was amenable to meta-analysis, the results of the review are presented in narrative form only. MAIN RESULTS: Three trials satisfied the inclusion criteria. A chemical cured composite was compared with a light cure composite (one trial), a conventional glass ionomer cement (one trial) and a polyacid-modified resin composite (compomer) (one trial). The quality of the trial reports was generally poor. REVIEWER'S CONCLUSIONS: It is difficult to draw any conclusions from this review, however, suggestions are made for methods of improving future research involving orthodontic adhesives.

Dental Cements↗

Adhesives for fixed orthodontic bands.

BACKGROUND: Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. It has been shown that the quality of treatment result obtained with fixed appliances is much better than with removable appliances. Fixed appliances are, therefore, favoured by most orthodontists for treatment. The success of a fixed orthodontic appliance depends on the metal attachments (brackets and bands) being attached securely to the teeth so that they do not become loose during treatment. Brackets are usually attached to the front and side teeth, whereas bands (metal rings that go round the teeth) are more commonly used on the back teeth (molars). A number of adhesives are available to attach bands to teeth and it is important to understand which group of adhesives bond most reliably, as well as reducing or preventing dental decay during the treatment period. OBJECTIVES: To evaluate the effectiveness of the adhesives used to attach bands to teeth during fixed appliance treatment, in terms of:(1) how often the bands come off during treatment; and(2) whether they protect the banded teeth against decay during fixed appliance treatment. SEARCH STRATEGY: Electronic databases were searched: the Cochrane Oral Health Group's Trials Register (July 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2005), MEDLINE (1966 to July 2005) and EMBASE (1980 to July 2005). A search of the internet was also undertaken. There was no restriction with regard to publication status or language of publication. SELECTION CRITERIA: Randomised and controlled clinical trials (RCTs and CCTs) (including split-mouth studies) of adhesives used to attach orthodontic bands to molar teeth were selected. Patients with full arch fixed orthodontic appliance(s) who had bands attached to molars were included. DATA COLLECTION AND ANALYSIS: All review authors were involved in study selection, validity assessment and data extraction without blinding to the authors, adhesives used or results obtained. All disagreements were resolved by discussion. MAIN RESULTS: Five RCTs and three CCTs were identified as meeting the review's inclusion criteria. All the included trials were of split-mouth design. Four trials compared chemically cured zinc phosphate and chemically cured glass ionomer; three trials compared chemically cured glass ionomer cement with light cured compomer; one trial compared chemically cured glass ionomer with a chemically cured glass phosphonate. Data analysis was often inappropriate within the studies meeting the inclusion criteria. AUTHORS' CONCLUSIONS: There is insufficient high quality evidence with regard to the most effective adhesive for attaching orthodontic bands to molar teeth. Further RCTs are required.

Adhesives↗

In vitro wear of resin-based materials--simultaneous corrosive and abrasive wear.

The aim of this study was to evaluate the wear of resin-based materials caused by the association of abrasive and corrosive processes. Twenty specimens were prepared for each material, cast in epoxy in acrylic rings, polished, and profiled with an MTS 3D Profiler. Antagonists were made from deciduous molars. Specimens were distributed into eight groups (n = 10), according to the material (Filtek Supreme, Point 4, Dyract AP, and Fuji II LC) and the type of slurry (neutral and acidic), and then cycled 100,000 times in the OHSU oral wear simulator. The specimens were cleaned and reprofiled. Volume loss and maximum depth were determined. ANOVA and Tukey's test were used for data analysis (p < 0.05). The area of the wear facet on the antagonist was also measured. Composites displayed less wear than the compomer and the resin-modified glass ionomer. Significant differences also were found for cusp wear, with a significant positive correlation shown between cusp and material wear. The acidic slurry significantly increased the wear of the materials compared to the neutral slurry. Exposure to acidic slurry accelerated the wear of resin-based materials.

Biocompatible Materials↗

Investigation of shear-peel bond strength of orthodontic brackets on enamel after using Pro Seal.

AIM: The aim of this investigation was to ascertain whether the use of a fluoride-releasing, light-curing sealant (Pro Seal, Reliance Orthodontic Products, Itasca, IL, USA) results in differences in shear-peel bond strength when teeth are etched via the conventional acid-etching method and with self-etching primers (SEP), respectively. We also examined whether Pro Seal functions as a substitute for the bonding agents recommended by the manufacturers. MATERIAL AND METHODS: To carry out this study, we randomly allocated 300 extracted molars (ISO 11405) into twelve groups (n=25). The brackets used (Victory Series, Twin UBi 0T/0A .022, 3M Unitek, Seefeld, Germany) were bonded using the same layer thickness of adhesive. The teeth were then stored for 24 h in de-ionized water (37 degrees C) and subsequently thermocycled. The brackets were debonded using a universal testing machine with a crosshead speed of 0.5 mm/min. For statistical evaluation we used the one-way analysis of variance (ANOVA [alpha = 0.05]) and the post hoc Tukey test and Weibull analysis. RESULTS: We could establish that the use of Pro Seal does not have a negative influence on shear-peel bond strength. When the compomer Assure was used, Pro Seal even led to an increase in shear-peel bond strength, especially when it was applied using the bonding agent recommended by the manufacturer. The highest Weibull modulus (m) was found for the self-etching primer IDEAL 1 without using Pro Seal (m=6.5) and the lowest for First Step SEP when using Pro Seal (m=2.2). There were also clear differences in characteristic shear-peel bond strength (sigma(0)) within some of the groups investigated. CONCLUSIONS: Although the statistical evaluation showed no significant negative influence on the shear-peel bond strength either when Pro Seal was used in addition, or when that fluoride-releasing, light-curing sealant was substituted for the bonding agent recommended by the manufacturer, the Weibull analysis showed that the use of Pro Seal in combination with SEP resulted in bond strength values that were less reliably reproducible.

Orthodontic Brackets↗

Comparative hardness and modulus of tooth-colored restoratives: a depth-sensing microindentation study.

The objective of this study was to compare the hardness and modulus of the continuum of direct tooth-colored restorative materials using a depth-sensing microindentation approach. The effects of thermal fatigue on mechanical properties were also evaluated. Six restorative materials representing the continuum were selected. They included an ormocer (Admira [AM], Voco), a giomer (Beautifil [BF], Shofu), a compomer (Dyract Extra [DE], Dentsply), a minifill composite (Esthet-X [EX], Dentsply), resin-modified (Fuji II LC [FL], GC) and highly viscous (Fuji IX [FN], GC) glass ionomer cements (GICs). Fourteen specimens (3 mm wide x 3 mm long x 2 mm deep) were made for each material. The specimens were randomly divided into two groups and treated as follows: Group A--stored in distilled water at 37 degrees C for 30 days; Group B--thermal cycled for 5000 cycles (35 degrees C [28s], 15 degrees C [2s], 35 degrees C [28s], 45 degrees C [2s]) and stored for 26.5 days. Hardness and modulus of the materials were determined using depth-sensing microindentation testing with the Instron MicroTester. Hardness was computed by dividing the peak load over the maximum projected contact area while modulus was calculated by analysis of the loading/unloading load-displacement (P-h) curves and the analytical model according to Oliver and Pharr (J. Mater. Res. 7 (1992) 1564). Results were analyzed using ANOVA/Scheffe's post hoc test and independent samples T-test (p<0.05). Hardness ranged 46.44-72.65 and 49.11-78.97 HV, while modulus ranged 7.86-12.78 and 8.12-13.13 GPa for Groups A and B, respectively. Although the ranking of mechanical properties were generally similar for both groups, disparities in statistical differences between materials were observed between Groups A and B for both hardness and modulus. For both groups, BF was significantly harder than DE, AM, FL and EX was significantly harder than FL. The modulus of FN was significantly greater than EX, DE, AM and FL was significantly stiffer than AM. With the exception of BF, no significant change in hardness and modulus was observed for all materials with thermocycling. The hardness and modulus of some glass ionomer-based/containing materials may be comparable or even superior to minifill and ormocer composites. Thermal fatigue should be considered when comparing mechanical properties between materials.

Acrylic Resins↗

Water absorption, dimensional change and radial pressure in resin matrix dental restorative materials.

The purpose of this work was to study the relationship between water absorption, dimensional change (swelling) under cavity constraint and radial stress generation in resin matrix dental restorative materials. Water absorption was determined on disc specimens whilst swelling was determined on samples of materials restrained within cavities cut in cast polymethylmethacrylate and pressure generated was determined using a 'push-out' test. Four commercially available resin matrix materials were used. A giomer material gave significantly greater water absorption than two compomers and a fluoride releasing composite (p<0.05). The giomer material was the only material which produced a significant degree of swelling (p<0.05) when restrained within a cavity. The giomer product produced the greatest radial pressure (over 20 MPa in 1 month) following water storage, however a significant pressure generation was also observed for other materials despite their much lower water absorption values. The mechanism of water absorption and the amount of water absorbed determine the dimensional changes and radial pressure generated by resin matrix materials in a moist environment.

Absorption↗

Evaluation of bacterial adhesion of Streptococcus mutans on dental restorative materials.

Bacterial adhesion to the surface of composite resins and other dental restorative materials is an important parameter in the aetiology of secondary caries formation. The aim of the present study was to investigate the adhesion of a Streptococcus mutans strain (ATCC 25175) on the surface of different restorative materials. The test materials examined included three flowable composites (Filtek Flow, Tetric Flow, and Arabesk Flow), three microhybrid composites (Clearfil APX, Solitaire 2, and Z250), two glass-ionomers (Fuji IX, Fuji IX fast), a compomer (F2000), an ormocer (Admira), and a control reference material (tissue culture grade, surface treated polystyrene). The adhesion tests were carried out in 24-well plates. Quantitative turbidimetric measurements were finally performed in order to indirectly evaluate the amount of bacteria retained on the material surface after in vitro exposure to the bacteria suspension. Under these conditions, with the exception of the Admira ormocer and the Fuji IX fast glass ionomer, which were found to be more adhesive, all the other material surfaces showed a similar susceptibility to bacterial adhesion, exhibiting values not significantly different than the reference polystyrene control. Furthermore, the release of fluoride from some of the test surfaces did not appear capable to reduce early bacterial adhesion.

Adhesiveness↗

Effect of bleaching on restorative materials and restorations--a systematic review.

OBJECTIVE: Internal and external bleaching procedures utilizing 3-35% hydrogen peroxide solutions or hydrogen peroxide releasing agents, such as carbamide peroxide or sodium perborate, can be used for whitening of teeth. The purpose of the review article was to summarize and discuss the available information concerning the effects of peroxide releasing bleaching agents on dental restorative materials and restorations. SOURCES: Information from all original scientific full papers or reviews listed in PubMed or ISI Web of Science (search term: bleaching AND (composite OR amalgam OR glass ionomer OR compomer OR resin OR alloy) were included in the review. DATA: Existing literature reveals that bleaching therapies may have a negative effect on physical properties, marginal integrity, enamel and dentin bond strength, and color of restorative materials as investigated in numerous in vitro studies. However, there are no reports in literature indicating that bleaching may exert a negative impact on existing restorations requiring renewal of the restorations under clinical conditions. CONCLUSION: Bleaching may exert a negative influence on restorations and restorative materials. Advice is provided based on the current literature to minimize the impact of bleaching therapies on restorative materials and restorations.

Composite Resins↗

Apoptosis induced by the monomers HEMA and TEGDMA involves formation of ROS and differential activation of the MAP-kinases p38, JNK and ERK.

OBJECTIVES: Cytotoxic methacrylate monomers have been identified in aqueous extracts of freshly cured compomers. Some of these compounds, including HEMA and TEGDMA, induce apoptosis and necrosis in vitro. The aim of the present study was to elucidate possible signaling pathways involved in apoptosis following exposure to HEMA or TEGDMA in a salivary gland cell line. METHODS: The cells were exposed to various concentrations of HEMA or TEGDMA. ROS formation was determined by dichlorofluorescein assay. Phosphorylated MAP-kinases ERK1/2, p38 and JNK, as well as specific caspases were identified by Western blotting. Apoptosis was assayed by fluorescence microscopy. RESULTS: HEMA or TEGDMA exposure resulted in ROS formation and concentration-dependent apoptosis as well as phosphorylation of ERK. Phosphorylation of JNK and p38 was induced by HEMA. Selective inhibitors of ERK and JNK modified the apoptotic response after HEMA and TEGDMA exposure, whereas p38 inhibition modified the apoptotic response only after HEMA exposure. Vitamin C reduced HEMA-induced apoptosis. SIGNIFICANCE: ROS formation and differential MAP kinase activation appear to be involved in the apoptotic response following exposure to HEMA and TEGDMA.

Animals↗

In vitro effects of ascorbate and Trolox on the biocompatibility of dental restorative materials.

Previous in vitro studies on the cytotoxicity of eight dental restorative materials including composites, compomers, resin-modified glass ionomer cements and glass ionomer cements have demonstrated a depletion of intracellular glutathione in gingival fibroblasts incubated with eluates of these materials and a protective effect of N-acetylcysteine. In the present study, we investigate the effects of two other antioxidants: ascorbate and Trolox. It was found that Trolox reduced the cytotoxicity induced by resin-based biomaterial eluates. In contrast, ascorbate increased in a dose-dependent manner the toxic effect of all eluates except for Z100 MP and Tetric flow (composites). The effect of D-mannitol was studied for GC FUJI II and was found to neutralize the additional toxic effect of ascorbate. Ascorbate increased the depletion of intracellular glutathione of these dental material eluates (between 17% and 24%, depending on the material). Quantification of metal ions in the dental material eluates showed the presence of significant amounts of aluminum and iron in GC FUJI II > photac fil > GC FUJI II LC > F2000. The mechanism of this increased cytotoxicity could be explained by the Fenton reaction resulting from the pro-oxidant effect of ascorbate in the presence of iron (transition metal ions) and/or aluminum.

Aluminum↗