Gene expression and protein synthesis of esterase from Streptococcus mutans are affected by biodegradation by-product from methacrylate resin composites and adhesives

Antibacterial, cytotoxic and mechanical properties of a orthodontic cement with phosphate nano-sized and phosphorylated chitosan: An in vitro study

OBJECTIVES

Evaluate, in vitro, the effect of incorporating nano-sized sodium trimetaphosphate (TMPnano) and phosphorylated chitosan (Chi-Ph) into resin-modified glass ionomer cement (RMGIC) used for orthodontic bracket cementation, on mechanical, fluoride release, antimicrobial and cytotoxic properties.

METHODS

RMGIC was combined with Chi-Ph (0.25%/0.5%) and/or TMPnano (14%). The diametral compressive/tensile strength (DCS/TS), surface hardness (SH) and degree of conversion (%DC) were determined. For fluoride (F) release, samples were immersed in des/remineralizing solutions. Antimicrobial/antibiofilm activity was evaluated by the agar diffusion test and biofilm metabolism (XTT). Cytotoxicity in fibroblasts was assessed with the resazurin method.

RESULTS

After 24 h, the RMGIC-14%TMPnano group showed a lower TS value (p < 0.001); after 7 days the RMGIC-14%TMPnano-0.25%Chi-Ph group showed the highest value (p < 0.001). For DCS, the RMGIC group (24 h) showed the highest value (p < 0.001); after 7 days, the highest value was observed for the RMGIC-14%TMPnano-0.25%Chi-Ph (p < 0.001). RMGIC-14%TMPnano, RMGIC-14%TMPnano-0.25%Chi-Ph, RMGIC-14%TMPnano-0.5%Chi-Ph showed higher and similar release of F (p > 0.001). In the SH, the RMGIC-0.25%Chi-Ph; RMGIC-0.5%Chi-Ph; RMGIC-14%TMPnano-0.5%Chi-Ph groups showed similar results after 7 days (p > 0.001). The RMGIC-14%TMPnano-0.25%Chi-Ph group showed a better effect on microbial/antibiofilm growth, and the highest efficacy on cell viability (p < 0.001). After 72 h, only the RMGIC-14%TMPnano-0.25%Chi-Ph group showed cell viability (p < 0.001).

CONCLUSION

The RMGIC-14%TMPnano-0.25%Chi-Ph did not alter the physical-mechanical properties, was not toxic to fibroblasts and reduced the viability and metabolism of S. mutans.

CLINICAL RELEVANCE

The addition of phosphorylated chitosan and organic phosphate to RMGIC could provide an antibiofilm and remineralizing effect on the tooth enamel of orthodontic patients, who are prone to a high cariogenic challenge due to fluctuations in oral pH and progression of carious lesions.

A low-shrinkage-stress and anti-bacterial adherent dental resin composite: physicochemical properties and biocompatibility

Polymerisation shrinkage and biofilm accumulation are the two main problems associated with dental resin composites (DRCs) that induce secondary caries, which can cause restoration failure. Polymerisation shrinkage can lead to microleakage gaps between the tooth and the DRCs, causing the aggregation of bacteria and development of secondary caries. Reducing the shrinkage stress (SS) and improving the resistance to bacterial adhesion have always been the focus of this field in modifying DRCs. A thiol-ene resin system can effectively reduce the polymerisation SS via its step-growth mechanism for delaying the gel point. Fluorinated compounds can reduce the surface free energies, thereby reducing bacterial adhesion. Thus, in this study, a range of mass fractions (0, 10, 20, 30, and 40 wt%) of a fluorinated thiol-ene resin system were added to a fluorinated dimethacrylate resin system/tricyclo decanedimethanol diacrylate to create a fluorinated methacrylate-thiol-ene ternary resin matrix. DRCs were prepared using the obtained ternary resin matrix, and their physical and chemical properties, effect on bacterial adhesion, and biocompatibility were investigated. The results demonstrated that the volumetric shrinkage and SS of the DRCs were reduced with no reduction in conversion degree even after the thiol-ene resin system was added. All DRC-based fluorinated resin systems exhibited an excellent anti-bacterial adhesion effect, as evidenced by the colony-forming unit counts, live/dead bacterial staining, and crystal violet staining tests against Streptococcus mutans (S. mutans). The genetic expressions associated with the bacterial adhesion of S. mutans were substantially affected after being cultured with fluorinated DRCs. All fluorinated DRCs demonstrated good biocompatibility through the in vitro cytotoxicity test and live/dead staining images of the L-929 cells. The above results illustrate that the DRCs based on the fluorinated methacrylate-thiol-ene resin matrix can be potentially applied in clinical practice due to their low SS and anti-bacterial adhesion effect.

Multifunctional Dental Adhesives Formulated with Silane-Coated Magnetic Fe3O4@m-SiO2 Core-Shell Particles to Counteract Adhesive Interfacial Breakdown

The process of bonding to dentin is complex and dynamic, greatly impacting the longevity of dental restorations. The tooth/dental material interface is degraded by bacterial acids, matrix metalloproteinases (MMPs), and hydrolysis. As a result, bonded dental restorations face reduced longevity due to adhesive interfacial breakdown, leading to leakage, tooth pain, recurrent caries, and costly restoration replacements. To address this issue, we synthesized and characterized a multifunctional magnetic platform, CHX@SiQuac@Fe3O4@m-SiO2, to provide several beneficial functions. The platform comprises Fe3O4 microparticles and chlorhexidine (CHX) encapsulated within mesoporous silica, which was silanized by an antibacterial quaternary ammonium silane (SiQuac). This platform simultaneously targets bacterial inhibition, stability of the hybrid layer, and enhanced filler infiltration by magnetic motion. Comprehensive experiments include X-ray diffraction, FT-IR, VSM, EDS, N2 adsorption-desorption (BET), transmission electron microscopy, scanning electron microscopy, thermogravimetric analysis, and UV-vis spectroscopy. Then, CHX@SiQuac@Fe3O4@m-SiO2 was incorporated into an experimental adhesive resin for dental bonding restorations, followed by immediate and long-term antibacterial assessment, cytotoxicity evaluation, and mechanical and bonding performance. The results confirmed the multifunctional nature of CHX@SiQuac@Fe3O4@m-SiO2. This work outlined a roadmap for (1) designing and tuning an adhesive formulation containing the new platform CHX@SiQuac@Fe3O4@m-SiO2; (2) assessing microtensile bond strength to dentin using a clinically relevant model of simulated hydrostatic pulpal pressure; and (3) investigating the antibacterial outcome performance of the particles when embedded into the formulated adhesives over time. The results showed that at 4 wt % of CHX@SiQuac@Fe3O4@m-SiO2-doped adhesive under the guided magnetic field, the bond strength increased by 28%. CHX@SiQuac@Fe3O4@m-SiO2 enhanced dentin adhesion in the magnetic guide bonding process without altering adhesive properties or causing cytotoxicity. This finding presents a promising method for strengthening the tooth/dental material interface's stability and extending the bonded restorations' lifespan.

Biocompatibility of bulk-fill resins in vitro

OBJECTIVES

This study aims to evaluate the cytotoxicity and genotoxicity of three different extracts obtained from Filtek™ One Bulk Fill, Tetric Evoceram® Bulk Fill and Coltene Fill-Up! resins.

MATERIALS AND METHODS

The cytotoxicity was determined on 3T3 fibroblast cells using the MTT and crystal violet assays. The genotoxicity was determined using a cytokinesis-block micronucleus assay.

RESULTS

The cytotoxicity of the resin extracts on 3T3 mouse fibroblasts was found to be dose-dependent with both the MTT and crystal violet assays. Extracts concentrated above 1% were cytotoxic according to the MTT assay. The Filtek™ One Bulk Fill, Tetric Evoceram® Bulk Fill, and Coltene Fill-Up! resins reached the LD50 at concentrations of 60%, 50%, and 20%, respectively, and showed genotoxicity rates that were 2-5 times, 3-8 times, and 4-15 times higher than the negative control, respectively.

CONCLUSIONS

Coltene Fill-Up! resin extracts were the most cytotoxic and genotoxic, followed by Tetric Evoceram® Bulk Fill and Filtek™ One Bulk Fill.

CLINICAL RELEVANCE

The analyzed bulk-fill resins showed differences in in vitro biocompatibility, and the Filtek™ One Bulk Fill was found to be the safest for clinical use.

Developing Bioactive Dental Resins for Restorative Dentistry

Despite its reputation as the most widely used restorative dental material currently, resin-based materials have acknowledged shortcomings. As most systematic survival studies of resin composites and dental adhesives indicate, secondary caries is the foremost reason for resin-based restoration failure and life span reduction. In subjects with high caries risk, the microbial community dominated by acidogenic and acid-tolerant bacteria triggers acid-induced deterioration of the bonding interface and/or bulk material and mineral loss around the restorations. In addition, resin-based materials undergo biodegradation in the oral cavity. As a result, the past decades have seen exponential growth in developing restorative dental materials for antimicrobial applications addressing secondary caries prevention and progression. Currently, the main challenge of bioactive resin development is the identification of efficient and safe anticaries agents that are detrimental free to final material properties and show satisfactory long-term performance and favorable clinical translation. This review centers on the continuous efforts to formulate novel bioactive resins employing 1 or multiple agents to enhance the antibiofilm efficacy or achieve multiple functionalities, such as remineralization and antimicrobial activity antidegradation. We present a comprehensive synthesis of the constraints and challenges encountered in the formulation process, the clinical performance-related prerequisites, the materials' intended applicability, and the current advancements in clinical implementation. Moreover, we identify crucial vulnerabilities that arise during the development of dental materials, including particle aggregation, alterations in color, susceptibility to hydrolysis, and loss of physicomechanical core properties of the targeted materials.

The Role of Bacterial, Dentinal, Salivary, and Neutrophil Degradative Activity in Caries Pathogenesis

Until recently, it was widely accepted that bacteria participate in caries pathogenesis mainly through carbohydrate fermentation and acid production, which promote the dissolution of tooth components. Neutrophils, on the other hand, were considered white blood cells with no role in caries pathogenesis. Nevertheless, current literature suggests that both bacteria and neutrophils, among other factors, possess direct degradative activity towards both dentinal collagen type-1 and/or methacrylate resin-based restoratives and adhesives, the most common dental restoratives. Neutrophils are abundant leukocytes in the gingival sulcus, where they can readily reach adjacent tooth roots or gingival and cervical restorations and execute their degradative activity. In this review, we present the latest literature evidence for bacterial, dentinal, salivary, and neutrophil degradative action that may induce primary caries, secondary caries, and restoration failure.

48-month clinical evaluation of a copper-containing universal adhesive in non-carious cervical lesions: A double-blind randomised clinical trial

OBJECTIVES

This study aimed to evaluate the effect of copper nanoparticles (CuNp) on the clinical performance of a universal adhesive system used as an etch-and-rinse or self-etch strategy.

METHODS

A total of 216 class V (non-carious lesions) restorations were randomly placed in 36 subjects according to the following groups: ERcu, adhesive in etch-and-rinse with 0.1% CuNp; ERct, adhesive in etch-and-rinse without CuNp; SEcu, adhesive in self-etch with 0.1% CuNp; and Sect, adhesive in self-etch without CuNp. Restorations were evaluated at baseline and at 6, 12, 18, 36, and 48 months, using the FDI and USPHS criteria. Appropriate statistical analyses were performed (α = 0.05).

RESULTS

After 48 months, 14 restorations were lost (two for ERcu, five for SEcu, and seven for SEct) and the retention rates (95% confidence interval [CI]) were 74.1% for ERcu (95% CI 61.1-83.8); 81.5% for ERct (95% CI 69.2-89.6); 64.8% (95% CI 51.5-76.2) for SEcu; and 64.8% (95% CI 51.5-76.2) for SEct, with statistical differences between SEct vs. ERct and SEcu vs. ERct (p < 0.05). No significant differences between the groups were observed when the secondary parameters were evaluated (p > 0.05). Nineteen restorations (two for ERcu, two for ERct, six for SEcu, and nine for SEct) showed minor marginal staining, and 44 restorations (7 for ERcu, 8 for ERct, 14 for SEcu, and 15 for SEct) presented minimal marginal adaptation defects.

SIGNIFICANCE

This is the first long-term clinical trial to show that the addition of CuNp to a universal adhesive system does not affect clinical performance.

The germicidal effect, biosafety and mechanical properties of antibacterial resin composite in cavity filling

In recent years, dental resin materials have become increasingly popular for cavity filling. However, these materials can shrink during polymerization, leading to microleakages that enable bacteria to erode tooth tissue and cause secondary caries. As a result, there is great clinical demand for the development of antibacterial resins. The principle of antibacterial resin includes contact killing and filler-release killing of bacteria. For contact killing, quaternary ammonium salts (QACs) and antibacterial peptides (AMPs) can be added. For filler-release killing, chlorhexidine (CHX) and nanoparticles are used. These antibacterial agents are effective against gram-positive bacteria, gram-negative bacteria, fungi, and more. Among them, QACs has a lasting antibacterial effect, and silver nanoparticles even have a certain ability to kill viruses. Biocompatibility-wise, QACs, AMPs, and CHX have low cytotoxicity to cells when added into the resin. However, nanoparticles with smaller particle sizes have higher cytotoxicity. In terms of mechanical properties, QACs, AMPs, and CHX do not negatively affect the resin. However, the addition of magnesium oxide can have a negative impact. This paper reviews the types and antibacterial principles of commonly used antibacterial resins in recent years, evaluates their antibacterial effect, biological safety, and mechanical properties, and provides references for selecting clinical filling materials.

Bioactive Dental Resin Composites with MgO Nanoparticles

Photoactivating dental resin composites have been the most prevailing material for repairing dental defects in various clinical scenarios due to their multiple advantages. However, compared to other restorative materials, the surface of resin-based composites is more susceptible to plaque biofilm accumulation, which can lead to secondary caries and restoration failure. This study introduced different weight fractions (1, 2, 5, 10, and 15%) of magnesium oxide nanoparticles (MgONPs) as antibacterial fillers into dental resin composites. Multifarious properties of the material were investigated, including antibacterial activity against a human salivary plaque-derived biofilm, cytotoxicity on human gingival fibroblasts, mechanical and physicochemical properties as well as the performance when subjected to thermocycling aging treatment. Results showed that the incorporation of MgONPs significantly improved the composites' anti-biofilm capability even at a low amount of 2 wt % without compromising the mechanical, physicochemical, and biocompatibility performances. The results of the thermocycling test suggested certain of aging resistance. Moreover, a small amount of MgONPs possibly made a difference in enhancing photoactivated polymerization and increasing the curing depth of experimental resin composites. Overall, this study highlights the potential of MgONPs as an effective strategy for developing antibacterial resin composites, which may help mitigating cariogenic biofilm-associated secondary caries.

Antibacterial and physical properties of resin cements containing MgO nanoparticles

Cariogenic bacteria and dental plaque biofilm at prosthesis margins are considered a primary risk factor for failed restorations. Resin cement containing antibacterial agents can be beneficial in controlling bacteria and biofilm. This work aimed to evaluate the impact of incorporating magnesium oxide nanoparticles (MgONPs) as an antibacterial filler into dual-cure resin cement on bacteriostatic activity and physical properties, including mechanical, bonding, and physicochemical properties, as well as performance when subjected to a 5000-times thermocycling regimen. Experimental resin cements containing MgONPs of different mass fractions (0, 2.5%, 5%, 7.5% and 10%) were developed. Results suggested that the inclusion of MgONPs markedly improved the materials' bacteriostatic effect against Streptococcus mutans without compromising the physical properties when its addition reached 7.5 wt%. The mechanical properties of the specimens did not significantly decline after undergoing aging treatment, except for the flexural properties. In addition, the cements displayed good bonding performance and the material itself was not prone to cohesive fracture in the failure mode analysis. Furthermore, MgONPs possibly have played a role in decelerating material aging during thermocycling and enhancing bonding fastness in the early stage of cementation, which requires further investigation. Overall, developing MgONPs-doped resin cements can be a promising strategy to improve the material's performance in inhibiting cariogenic bacteria at restoration margins, in order to achieve a reduction in biofilm-associated secondary caries and a prolonged restoration lifespan.

Detection of Bacteria-Induced Early-Stage Dental Caries Using Three-Dimensional Mid-Infrared Thermophotonic Imaging

Tooth decay, or dental caries, is a widespread and costly disease that is reversible when detected early in its formation. Current dental caries diagnostic methods including X-ray imaging and intraoral examination lack the sensitivity and specificity required to routinely detect caries early in its formation. Thermophotonic imaging presents itself as a highly sensitive and non-ionizing solution, making it suitable for the frequent monitoring of caries progression. Here, we utilized a treatment protocol to produce bacteria-induced caries lesions. The lesions were imaged using two related three-dimensional photothermal imaging modalities: truncated correlation photothermal coherence tomography (TC-PCT) and its enhanced modification eTC-PCT. In addition, micro-computed tomography (μ-CT) and visual inspection by a clinical dentist were used to validate and quantify the severities of the lesions. The observational findings demonstrate the high sensitivity and depth profiling capabilities of the thermophotonic modalities, showcasing their potential use as a non-ionizing clinical tool for the early detection of dental caries.

Effects of Streptococcus mutans and its fluoride resistant strains on the adhesion of CAD/CAM ceramics to teeth and resin

BACKGROUND

The similar elastic modulus of resin-matrix ceramics to dentin has resulted in their recent widespread application clinically. Nevertheless, the bacterial environment of oral cavity can degrade the resin composite.

OBJECTIVE

The objective was to analyse the effect of S. mutans and its fluoride-resistant strains on the adhesion of three CAD/CAM ceramics.

METHODS

S. mutans UA159 (UA) was identified, and its fluoride-resistant strain (FR) was induced. For crack observation, three kinds of CAD/CAM ceramics (IPS Empress, Lava Ultimate and Vita Enamic) were bonded with tooth complex (enamel, dentin and flowable resin) through adhesive. For micro-tensile test, ceramics were bonded with flowable resin, and cut into strip test pieces. Then specimens were immersed into the UA, FR and the control solution (BHI) separately for 14 d. Ceramic-adhesive interface and adhesive-tooth complex interface were observed and analyzed through electron microscope and stereomicroscope. Micro-tensile test was conducted.

RESULTS

Specimens in bacterial solutions had more cracks and comparatively weaker micro-tensile strength than those in BHI. In ceramic-adhesive interface, Lava Ultimate produced the most cracks. In adhesive-tooth complex interface, adhesive-dentin produced the most cracks. Meanwhile, IPS Empress had the strongest micro-tensile strength when bonded with resin.

CONCLUSIONS

S. mutans and its fluoride resistant strain can cause cracks in the bonding of ceramics and dental tissue, especially resin-matrix ceramic and dentin, and weaken the bonding strength between ceramics and resin.

Proline-rich protein from S. mutans can perform a competitive mineralization function to enhance bacterial adhesion to teeth

A proline-rich region was found in Streptococcus mutans (S. mutans) surface antigen I/II (Ag I/II). The functions of this region were explored to determine its role in the cariogenic abilities of S. mutans; specifically, the proline-rich region was compared with human amelogenin. The full-length amelogenin genes were cloned from human (AmH) and surface antigen I/II genes from S. mutans. Then, the genes expressed and purified. We analyzed the structure and self-assembly ability of AmH and Ag I/II, compared their capacities to induce mineralization, and assessed the adhesion ability of S. mutans to AmH- and Ag I/II-coated tooth slices. AmH formed ordered chains and net frames in the early stage of protein self-assembly, while Ag I/II formed irregular and overlapping structures. AmH induced mineralization possessed a parallel rosary structure, while Ag I/II-induced mineralization is rougher and more irregular. The S. mutans adhesion assay indicated that the adhesion ability S. mutans on the Ag I/II-induced crystal layer was significantly higher than that on the AmH-induced crystal layer. S. mutans' Ag I/II may have evolved to resemble human amelogenin and form a rougher crystal layer on teeth, which play a competitive mineralization role and promotes better bacterial adhesion and colonization. Thus, the cariogenic ability of S. mutans Ag I/II is increased.

L-arginine-containing mesoporous silica nanoparticles embedded in dental adhesive (Arg@MSN@DAdh) for targeting cariogenic bacteria

Dental caries is the major biofilm-mediated oral disease in the world. The main treatment to restore caries lesions consists of the use of adhesive resin composites due to their good properties. However, the progressive degradation of the adhesive in the medium term makes possible the proliferation of cariogenic bacteria allowing secondary caries to emerge. In this study, a dental adhesive incorporating a drug delivery system based on L-arginine-containing mesoporous silica nanoparticles (MSNs) was used to release this essential amino acid as a source of basicity to neutralize the harmful acidic conditions that mediate the development of dental secondary caries. The in vitro and bacterial culture experiments proved that L-arginine was released in a sustained way from MSNs and diffused out from the dental adhesive, effectively contributing to the reduction of the bacterial strains Streptococcus mutans and Lactobacillus casei. Furthermore, the mechanical and bonding properties of the dental adhesive did not change significantly after the incorporation of L-arginine-containing MSNs. These results are yielding glimmers of promise for the cost-effective prevention of secondary caries.

Biodegradation of Dental Resin-Based Composite—A Potential Factor Affecting the Bonding Effect: A Narrative Review

In recent years, although resin composite has played an important role in the restoration of tooth defects, it still has several disadvantages, including being biodegraded by saliva, bacteria and other enzymes in the oral cavity, which may result in repair failure. This factor is not conducive to the long-term survival of the prosthesis in the mouth. In this article, we review the causes, influencing factors and prevention methods of resin biodegradation. Biodegradation is mainly caused by esterase in saliva and bacteria, which breaks the ester bond in resin and causes the release of monomers. The mechanical properties of the prosthesis can then be affected. Meanwhile, cathepsin and MMPs are activated on the bonding surface, which may decompose the dentin collagen. In addition, neutrophils and residual water on the bonding surface can also aggravate biodegradation. Currently, the primary methods to prevent biodegradation involve adding antibacterial agents to resin, inhibiting the activity of MMPs and enhancing the crosslinking of collagen fibers. All of the above indicates that in the preparation and adhesion of resin materials, attention should be paid to the influence of biodegradation to improve the prosthesis’s service life in the complex environment of the oral cavity.

Methacrylate Polymers With “Flipped External” Ester Groups: A Review

Current resin composites have favorable handling and upon polymerization initial physical properties that allow for efficient material replacement of removed carious tooth structure. Dental resin composites have long term durability limitations due to the hydrolysis of ester bonds within the methacrylate based polymer matrix. This article outlines the importance of ester bonds positioned internal to the carbon-carbon double bond in current methacrylate monomers. Water and promiscuous salivary/bacterial esterase activity can initiate ester bond hydrolysis that can sever the polymer backbone throughout the material. Recent studies have custom synthesized, with the latest advances in modern organic chemical synthesis, a novel molecule named ethylene glycol bis (ethyl methacrylate) (EGEMA). EGEMA was designed to retain the reactive acrylate units. Upon intermolecular polymerization of vinyl groups, EGEMA ester groups are positioned outside the backbone of the polymer chain. This review highlights investigation into the degradation resistance of EGEMA using buffer, esterase, and microbial storage assays. Material samples of EGEMA had superior final physical and mechanical properties than traditional ethylene glycol dimethacrylate (EGDMA) in all degradation assays. Integrating bioinformatics-based biodegradation predictions to the experimental results of storage media analyzed by LC/GC-MS revealed that hydrolysis of EGEMA generated small amounts of ethanol while preserving the strength bearing polymer backbone. Prior studies support investigation into additional custom synthesized methacrylate polymers with “flipped external” ester groups. The long term goal is to improve clinical durability compared to current methacrylates while retaining inherent advantages of acrylic based chemistry, which may ease implementation of these novel methacrylates into clinical practice.

Interfacial Biomaterial-Dentin Bacterial Biofilm Proliferation and Viability Is Affected by the Material, Aging Media and Period

Biomaterial−dentin interfaces undergo degradation over time, allowing salivary, tissue fluid, and bacterial movement between the root filling or restoration and dentin. This study aims to investigate the effect of aging in simulated human salivary/bacterial/blood esterases (SHSE) on proliferation and viability of Enterococcus faecalis biofilm within the dentin interface with four materials used to fill/restore the endodontic space. Root canals of human anterior teeth were prepared and filled with gutta-percha and one of the following: self-cured resin composite (BisfilTM 2B, Bisco, Schaumburg, IL, USA) with either self-etch (SE) (EasyBond) or total-etch (TE) (ScotchbondTM, 3M, Saint Paul, MN, USA) methacrylate-based adhesives, epoxy-resin sealer (AH Plus®, Dentsply Sirona, York, PA, USA), or bioceramic sealer (EndoSequence® BC Sealer™, Brasseler USA, Savannah, GA, USA). Specimens were aged in SHSE or phosphate-buffered saline (PBS) for up to 360 days, followed by cultivation of steady-state E. faecalis biofilm. Depth and viability of interfacial bacterial biofilm proliferation were assessed by confocal laser scanning microscopy and live/dead staining. Data were analyzed using three-way ANOVA and Scheffe’s post hoc analyses. Initial depths of biofilm proliferation were similar among material groups (p > 0.05). All groups showed significantly deeper biofilm proliferation with increased aging period (p < 0.05). SHSE aging increased interfacial biofilm depth for TE, SE and BC (p < 0.05) but not AH. For unaged interfaces, BC exhibited the lowest ratio of live bacteria, followed by AH, TE, and SE (p < 0.05). Interfacial bacterial biofilm proliferation and viability were dependent on the biomaterial, aging media, and period.

Simulating the Intraoral Aging of Dental Bonding Agents: A Narrative Review

Despite their popularity, resin composite restorations fail earlier and at higher rates than comparable amalgam restorations. One of the reasons for these rates of failure are the properties of current dental bonding agents. Modern bonding agents are vulnerable to gradual chemical and mechanical degradation from a number of avenues such as daily use in chewing, catalytic hydrolysis facilitated by salivary or bacterial enzymes, and thermal fluctuations. These stressors have been found to work synergistically, all contributing to the deterioration and eventual failure of the hybrid layer. Due to the expense and difficulty in conducting in vivo experiments, in vitro protocols meant to accurately simulate the oral environment’s stressors are important in the development of bonding agents and materials that are more resistant to these processes of degradation. This narrative review serves to summarize the currently employed methods of aging dental materials and critically appraise them in the context of our knowledge of the oral environment’s parameters.

Exploring the use of a Ruthenium complex incorporated into a methacrylate-based dental material for antimicrobial photodynamic therapy

OBJECTIVES

To evaluate the effects of a blue light photosensitizer (PS), Ruthenium II complex (Ru), on the chemical, physical, mechanical, and antimicrobial properties of experimental dental resin blends.

METHODS

The experimental resin (BisEMA, TEEGDMA, HPMA, ethanol, and photoinitiator) was loaded with Ru at 0.00%, 0.07%, 0.14%, 0.28%, 0.56%, 1.12%, 1.2%, 1.5%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, or 10% w/w. Samples were evaluated for the degree of conversion (DC) after 30 and 60 s curing-time (n = 6). Selected formulations (0.00%, 0.28%, 0.56%, 1.12%) were further tested for shear bond strength (SBS) (n = 15); flexural strength (FS) (n = 12); and antimicrobial properties (CFUs), in dark and light conditions. These latter tests were performed on specimens stored for 24-h or 2-month in 37°C water. Water sorption (WS) and solubility (SL) tests were also performed (n = 12). Data were analyzed either by a one- or two-factor general linear model (α = 0.05).

RESULTS

Overall, Ru concentration above 1.2% resulted in reduced DC. In SBS results, only the 1.12%Ru resin blend samples had statistically lower values compared to the 0.00%Ru resin blend at 24-h storage (p = 0.004). In addition, no differences in SBS were detected among the experimental groups after 2-month storage in water. Meanwhile, FS increased for all experimental groups under similar aging conditions (p < 0.001). Antimicrobial properties were improved upon inclusion of Ru and application of light (p < 0.001 for both) at 24-h and 2-month storage. Lastly, no detectable changes in WS or SL were observed for the Ru-added resins compared to the 0.00%Ru resin blend. However, the 0.28% Ru blend presented significantly higher WS compared to the 0.56% Ru blend (p = 0.007).

CONCLUSIONS

Stable SBS, improved FS, and sustained antimicrobial properties after aging gives significant credence to our approach of adding the Ruthenium II complex into dental adhesive resin blends intended for an aPDT approach.

Minimally Invasive Therapies for the Management of Dental Caries—A Literature Review

In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.

A novel methacrylate derivative polymer that resists bacterial cell-mediated biodegradation

This study tests biodegradation resistance of a custom synthesized novel ethylene glycol ethyl methacrylate (EGEMA) with ester bond linkages that are external to the central polymer backbone when polymerized. Ethylene glycol dimethacrylate (EGDMA) with internal ester bond linkages and EGEMA discs were prepared in a polytetrafluoroethylene (PTFE) mold using 40 μl macromer and photo/co-initiator mixture cured for 40 s at 1000 mW/cm² . The discs were stored in the constant presence of Streptococcus mutans (S. mutans) in Todd Hewitt Yeast + Glucose (THYE+G) media up to 9 weeks (n = 8 for each macromer type) and physical/mechanical properties were assessed. Initial measurements EGEMA versus EGDMA polymer discs showed equivalent degree of conversion (45.69% ± 2.38 vs. 46.79% ± 4.64), diametral tensile stress (DTS; 8.12± 2.92 MPa vs. 6.02 ± 1.48 MPa), and low subsurface optical defects (0.41% ± 0.254% vs. 0.11% ± 0.074%). The initial surface wettability (contact angle) was slightly higher (p ≤ .012) for EGEMA (62.02° ± 3.56) than EGDMA (53.86° ± 5.61°). EGDMA showed higher initial Vicker's hardness than EGEMA (8.03 ± 0.88 HV vs. 5.93 ± 0.69 HV; p ≤ .001). After 9 weeks of S. mutans exposure, EGEMA (ΔDTS-1.30 MPa) showed higher resistance to biodegradation effects with a superior DTS than EGDMA (ΔDTS-6.39 MPa) (p = .0039). Visible and scanning electron microscopy images of EGEMA show less surface cracking and defects than EGDMA. EGDMA had higher loss of material (18.9% vs. 8.5%, p = .0009), relative changes to fracture toughness (92.5% vs. 49.2%, p = .0022) and increased water sorption (6.1% vs. 1.9%, p = .0022) compared to EGEMA discs. The flipped external ester group linkage design is attributed to EGEMA showing higher resistance to bacterial degradation effects than an internal ester group linkage design methacrylate.

Improper Light Curing of Bulkfill Composite Drives Surface Changes and Increases S. mutans Biofilm Growth as a Pathway for Higher Risk of Recurrent Caries around Restorations

How dentists cure a resin-based material has deleterious effects on the material's properties and its interaction with surrounding dental tissues. Biofilm accumulation has been implicated in the pathogenesis of carious lesions around dental restorations, with its composition manifesting expressed dysbiosis in patients suffering from dental caries. To evaluate the influence of varying radiant exposure on the degree of conversion (DC%), Streptococcus mutans biofilm growth, and surface roughness of bulk-fill composites under different light-curing conditions. Two light-curing units (LCU) at 600 and 1000 mW/cm² were used to simulate curing conditions with different angulations (∢20° and ∢35°) or 2 mm-distance displacements of the LCU tip. The radiant exposure (RE) was assessed, and the composites were analyzed for DC%. Biofilm formation was induced over the bulk-fill composites and analyzed via colony-forming units counting and scanning electron microscopy (SEM). The surface roughness was analyzed via a profilometer and SEM after biofilm formation. Curing conditions with different angulation or displacement decreased RE compared to the "optimal condition". The moderately (∢35°) angulated LCU tip and low (600 mW/cm²) radiant emittance significantly reduced the DC% (p < 0.05). The difference in DC% between the top and bottom of the composites ranged from 8 to 11% for 600 mW/cm² and 10 to 20% for 1000 mW/cm². Greater S. mutans biofilm and surface changes were found in composites with non-optimal RE delivery (e.g., tip displacement and angulation) (p < 0.05). Inadequate polymerization of bulk-fill composites was associated with more biofilm accumulation and surface topography changes. Overall, non-optimally performed curing procedures reduced the amount of delivered RE, which led to low DC%, more biofilm formation, and higher surface roughness. The improper light-curing of bulk-fill composites compromises their physicochemical and biological properties, which could lead to inferior clinical performance and reduced restorative treatments' longevity.

Current status on the biodegradability of acrylic polymers: microorganisms, enzymes and metabolic pathways involved

Abstract

Acrylic polymers (AP) are a diverse group of materials with broad applications, frequent use, and increasing demand. Some of the most used AP are polyacrylamide, polyacrylic acid, polymethyl methacrylates, and polyacrylonitrile. Although no information for the production of all AP types is published, data for the most used AP is around 9 MT/year, which gives an idea of the amount of waste that can be generated after products’ lifecycles. After its lifecycle ends, the fate of an AP product will depend on its chemical structure, the environmental setting where it was used, and the regulations for plastic waste management existing in the different countries. Even though recycling is the best fate for plastic polymer wastes, few AP can be recycled, and most of them end up in landfills. Because of the pollution crisis the planet is immersed, setting regulations and developing technological strategies for plastic waste management are urgent. In this regard, biotechnological approaches, where microbial activity is involved, could be attractive eco-friendly strategies. This mini-review describes the broad AP diversity, their properties and uses, and the factors affecting their biodegradability, underlining the importance of standardizing biodegradation quantification techniques. We also describe the enzymes and metabolic pathways that microorganisms display to attack AP chemical structure and predict some biochemical reactions that could account for quaternary carbon-containing AP biodegradation. Finally, we analyze strategies to increase AP biodegradability and stress the need for more studies on AP biodegradation and developing stricter legislation for AP use and waste control.

Key points

• Acrylic polymers (AP) are a diverse and extensively used group of compounds.

• The environmental fates and health effects of AP waste are not completely known.

• Microorganisms and enzymes involved in AP degradation have been identified.

• More biodegradation studies are needed to develop AP biotechnological treatments.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00253-020-11073-1.

In vitro performance of 2-step, total etch adhesives modified by thiourethane additives

OBJECTIVES

Thio-urethane oligomeric additives have been shown to improve the mechanical properties of dental composites and resin cements. To try to harness those same properties in dental adhesives, in this study, these oligomers (TU) were added to the matrix and/or as filler functionalization of experimental adhesives, and the effects on conversion and mechanical properties were analyzed.

METHODS

BisGMA and HEMA (60/40 wt%) were used as the monomer matrix, made polymerizable by the addition of 0.2 wt% 2,2-dimethoxy-2- phenylacetophenone. 2,6-di-tert-butyl-4-methylphenol was added at 0.5 wt% as the inhibitor. This material was used as the unfilled control (BH). TU oligomers were added at 20 wt % to the matrix (BH+20%TU, unfilled) and/or used as filler functionalization (TF, 10 wt%). Fillers functionalized with methacrylate (MF, 10 wt%) served as the control. The experimental adhesives groups containing fillers were: BH+10%MF; BH+10%TF; BH+20%TU+10%MF; BH+20%TU+10%TF. Flexural properties were tested in three-point bending (wet and dry). Polymerization kinetics was followed in real-time in near-IR. Water Sorption/Solubility (WS/SL, ISO 4049) and Viscosity (rotational rheometry) were also evaluated. For Microtensile bond strength 40 vol% ethanol was added to adhesives, which was applied onto sound dentin from third human molars. The data were analyzed with one-way ANOVA and Tukey post-hoc test, and test t for the comparison between storage time of the microtensile bond strength test (alpha = 0.05).

RESULTS

There was no significant difference between groups when yield strength (YS) and flexural modulus (FM) were evaluated in dry conditions. After water storage, all the groups containing TU in the matrix showed statistically lower YS/FM values. This was true in spite of the statistically higher conversion for those same groups. The maximum rate of polymerization (Rpmax) was higher for BH+10%TF and no significant difference was found for the groups BH and BH+10% MF. The lowest Rpmax values were found for BH+20%TU+10%TF and BH+20%TU. BH+20%TU+10%TF showed the highest viscosity values followed by BH+20%TU+10%MF and BH+20%TU, with statistically significant difference between them. For the microtensile bond strength test at 24h (p = 0.13) and 6 months (p = 0.11) and WS/SL (p > 0.05), no significant difference was found among groups. The storage time (24 h and 6 months) did not affect the microtensile bond strength results.

CONCLUSION

In spite of improving the conversion, the addition of TU in the matrix reduced the mechanical properties of the adhesives tested after water storage. This did not affect the bond strength at 24 h or 6 months.

Antimicrobial antidegradative dental adhesive preserves restoration-tooth bond

OBJECTIVE

Assess the ability of an antimicrobial drug-releasing resin adhesive, containing octenidine dihydrochloride (OCT)-silica co-assembled particles (DSPs), to enhance the biostability and preserve the interfacial fracture toughness (FT) of composite restorations bonded to dentin. Enzyme-catalyzed degradation compromises the dental restoration-tooth interface, increasing cariogenic bacterial infiltration. In addition to bacterial ingress inhibition, antimicrobial-releasing adhesives may exhibit direct interfacial biodegradation inhibition as an additional benefit.

METHODS

Mini short-rod restoration bonding specimens with total-etch adhesive with/without 10% wt. DSPs were made. Interfacial fracture toughness (FT) was measured as-manufactured or post-incubation in simulated human salivary esterase (SHSE) for up to 6-months. Effect of OCT on SHSE and whole saliva/bacterial enzyme activity was assessed. Release of OCT outside the restoration interface was assessed.

RESULTS

No deleterious effect of DSPs on initial bonding capacity was observed. Aging specimens in SHSE reduced FT of control but not DSP-adhesive-bonded specimens. OCT inhibited SHSE degradation of adhesive monomer and may inhibit endogenous proteases. OCT inhibited bacterial esterase and collagenase. No endogenous collagen breakdown was detected in the present study. OCT increased human saliva degradative esterase activity below its minimum inhibitory concentration towards S. mutans (MIC), but inhibited degradation above MIC. OCT release outside restoration margins was below detection.

SIGNIFICANCE

DSP-adhesive preserves the restoration bond through a secondary enzyme-inhibitory effect of released OCT, which is virtually confined to the restoration interface microgap. Enzyme activity modulation may produce a positive-to-negative feedback switch, by increasing OCT concentration via biodegradation-triggered release to an effective dose, then subsequently slowing degradation and degradation-triggered release.

Bioactive low-shrinkage-stress nanocomposite suppresses S. mutans biofilm and preserves tooth dentin hardness

Recurrent dental caries is one of the main reasons for resin composite restoration failures. This study aimed to: (1) develop a bioactive, low-shrinkage-stress, antibacterial and remineralizing composite and evaluate the sustainability of its antibacterial effect against Streptococcus mutans (S. mutans) biofilms; and (2) evaluate the remineralization and cariostatic potential of the composite containing nanoparticles of amorphous calcium phosphate (NACP) and dimethylaminohexadecyl methacrylate (DMAHDM), using dentin hardness measurement and a biofilm-induced recurrent caries model. The antibacterial and remineralizing low-shrinkage-stress composite consisted of urethane dimethacrylate (UDMA) and triethylene glycol divinylbenzyl ether (TEG-DVBE), 3% DMAHDM and 20% NACP. S. mutans biofilm was used to evaluate antibiofilm activity, before and after 3 months of composite aging in acidic solution. Human dentin was used to develop a recurrent caries biofilm-model. Adding DMAHDM and NACP into low shrinkage-stress composite did not compromise the flexural strength. The low-shrinkage-stress composite with DMAHDM achieved substantial reductions in biofilm colony-forming units (CFU), lactic acid production, and biofilm biomass (p < 0.05). The low-shrinkage-stress DMAHDM+NACP composite exhibited no significant difference in antibacterial performance before and after 3 months of aging, demonstrating long-term antibacterial activity. Under S. mutans biofilm acidic attack, dentin hardness (GPa) was 0.24 ± 0.04 for commercial control, and 0.23 ± 0.03 for experimental control, but significantly higher at 0.34 ± 0.03 for DMAHDM+NACP group (p < 0.05). At an instrumental compliance of 0.33 μm/N, the polymerization shrinkage stress of the new composite was 36% lower than that of a traditional composite (p < 0.05). The triple strategy of antibacterial, remineralization and lower shrinkage-stress has great potential to inhibit recurrent caries and increase restoration longevity. Statement of Significance Polymerization shrinkage stress, masticatory load over time as well as biochemical degradation can lead to marginal failure and secondary caries. The present study developed a new low-shrinkage-stress, antibacterial and remineralizing dental nanocomposite. Polymerization shrinkage stress was greatly reduced, biofilm acid production was inhibited, and tooth dentin mineral and hardness were preserved. The antibacterial composite possessed a long-lasting antibiofilm effect against cariogenic bacteria S. mutans. The new bioactive nanocomposite has the potential to suppress recurrent caries at the restoration margins, protects tooth structures, and increases restoration longevity.

Interaction between the Oral Microbiome and Dental Composite Biomaterials: Where We Are and Where We Should Go

Dental composites are routinely placed as part of tooth restoration procedures. The integrity of the restoration is constantly challenged by the metabolic activities of the oral microbiome. This activity directly contributes to a less-than-desirable half-life for the dental composite formulations currently in use. Therefore, many new antimicrobial dental composites are being developed to counteract the microbial challenge. To ensure that these materials will resist microbiome-derived degradation, the model systems used for testing antimicrobial activities should be relevant to the in vivo environment. Here, we summarize the key steps in oral microbial colonization that should be considered in clinically relevant model systems. Oral microbial colonization is a clearly defined developmental process that starts with the formation of the acquired salivary pellicle on the tooth surface, a conditioned film that provides the critical attachment sites for the initial colonizers. Further development includes the integration of additional species and the formation of a diverse, polymicrobial mature biofilm. Biofilm development is discussed in the context of dental composites, and recent research is highlighted regarding the effect of antimicrobial composites on the composition of the oral microbiome. Future challenges are addressed, including the potential of antimicrobial resistance development and how this could be counteracted by detailed studies of microbiome composition and gene expression on dental composites. Ultimately, progress in this area will require interdisciplinary approaches to effectively mitigate the inevitable challenges that arise as new experimental bioactive composites are evaluated for potential clinical efficacy. Success in this area could have the added benefit of inspiring other fields in medically relevant materials research, since microbial colonization of medical implants and devices is a ubiquitous problem in the field.

Bulk Fill Composites Have Similar Performance to Conventional Dental Composites

The aim of the study was to perform comprehensive characterization of two commonly used bulk fill composite materials (SDR Flow (SDR) and Filtek™ Bulk Fill Flowable Restorative (FBF) and one conventional composite material (Tetric EvoCeram; TEC). Eleven parameters were examined: flexural strength (FS), flexural modulus (FM), degree of conversion, depth of cure, polymerisation shrinkage (PS), filler particle morphology, filler mass fraction, Vickers hardness, surface roughness following simulated toothbrush abrasion, monomer elution, and cytotoxic reaction of human gingival fibroblasts, osteoblasts, and cancer cells. The degree of conversion and depth of cure were the highest for SDR, followed by FBF and TEC, but there was no difference in PS between them. FS was higher for bulk fill materials, while their FM and hardness were lower than those of TEC. Surface roughness decreased in the order TEC→SDR→FBF. Bisphenol A-glycidyl methacrylate (BisGMA) and urethane dimethacrylate were found in TEC and FBF eluates, while SDR released BisGMA and triethylene glycol dimethacrylate. Conditioned media accumulated for 24 h from FBF and TEC were cytotoxic to primary human osteoblasts. Compared to the conventional composite, the tested bulk fill materials performed equally or better in most of the tests, except for their hardness, elastic modulus, and biocompatibility with osteoblasts.

Alternative monomer for BisGMA-free resin composites formulations

OBJECTIVE

Water sorption, high volumetric shrinkage, polymerization stress, and potential estrogenic effects triggered by leached compounds are some of the major concerns related to BisGMA-TEGDMA co-monomer systems used in dental composites. These deficiencies call for the development of alternative organic matrices in order to maximize the clinical lifespan of resin composite dental restorations. This study proposes BisGMA-free systems based on the combination of UDMA and a newly synthesized diurethane dimethacrylate, and evaluates key mechanical and physical properties of the resulting materials.

METHODS

2EMATE-BDI (2-hydroxy-1-ethyl methacrylate) was synthesized by the reaction between 2-hydroxy-1-ethyl methacrylate with a difunctional isocyanate (1.3-bis (1- isocyanato-1-methylethylbenzene) - BDI). The compound was copolymerized with UDMA (urethane dimethacrylate) at 40 and 60wt%. UDMA copolymerizations with 40 and 60wt% TEGDMA (triethylene glycol dimethacrylate) were tested as controls, as well as a formulation based in BisGMA (bisphenol A-glycidyl methacrylate)-TEGDMA 60:40% (BT). The organic matrices were made polymerizable by the addition of DMPA (2.2-dimethoxyphenoxy acetophenone) and DPI-PF6 (diphenyliodonium hexafluorophosphate) at 0.2 and 0.4wt%, respectively. Formulations were tested as composite with the addition of 70wt% inorganic content consisting of barium borosilicate glass (0.7μm) and fumed silica mixed in 95 and 5wt%, respectively. All photocuring procedures were carried out by a mercury arc lamp filtered to 320-500nm at 800mW/cm2. The experimental resin composites were tested for kinetics of polymerization and polymerization stress in real time. Flexural strength, elastic modulus, water sorption, and solubility were assessed according to ISO 4049. Biofilm formation was analyzed after 24h by luciferase assay. Data were statistically analyzed by one-way ANOVA and Tukey's test (α≤0.05).

RESULTS

In general, the addition of 2EMATE-BDI into the formulations decreased the maximum rate of polymerization (RPMAX), the degree of conversion at RPMAX (DC at RPMAX), and the final degree of conversion (final DC). However, these reductions did not compromise mechanical properties, which were comparable to the BT controls, especially after 7-day water incubation. The incorporation of 60wt% 2EMATE-BDI reduced water sorption of the composite. 2EMATE-BDI containing formulations showed reduction in polymerization stress of 30% and 50% in comparison to BT control and TEGDMA copolymerizations, respectively. Biofilm formation was similar among the tested groups.

SIGNIFICANCE

The use of the newly synthesized diurethane dimethacrylate as co-monomer in dental resin composite formulations seems to be a promising option to develop polymers with low-shrinkage and potentially decreased water degradation.

Ageing of Dental Composites Based on Methacrylate Resins-A Critical Review of the Causes and Method of Assessment

The paper reviews the environmental factors affecting ageing processes, and the degradation of resins, filler, and the filler-matrix interface. It discusses the current methods of testing materials in vitro. A review of literature was conducted with the main sources being PubMed. ScienceDirect, Mendeley, and Google Scholar were used as other resources. Studies were selected based on relevance, with a preference given to recent research. The ageing process is an inherent element of the use of resin composites in the oral environment, which is very complex and changes dynamically. The hydrolysis of dental resins is accelerated by some substances (enzymes, acids). Bonds formed between coupling agent and inorganic filler are prone to hydrolysis. Methods for prediction of long-term behaviour are not included in composite standards. Given the very complex chemical composition of the oral environment, ageing tests based on water can only provide a limited view of the clinical performance of biomaterial. Systems that can reproduce dynamic changes in stress (thermal cycling, fatigue tests) are better able to mimic clinical conditions and could be extremely valuable in predicting dental composite clinical performance. It is essential to identify procedure to determine the ageing process of dental materials.

Performance of Adhesives and Restorative Materials After Selective Removal of Carious Lesions: Restorative Materials with Anticaries Properties

Selective carious tissue-removal strategies require specific considerations in selection of restorative materials. A tight marginal seal placed over hard dentin and sound enamel is essential. For selective removal of carious tissue with permanent restoration, bioactive materials, such as high-viscosity glass-ionomer cement (HV-GIC) or calcium silicates, may be preferred over caries-affected firm or leathery dentin to improve remineralization. HV-GICs have the best clinical evidence of caries-arresting effect and demonstrate sufficient longevity as long-term provisional restorations that can later be used in open or closed sandwich restorations. As with any material, oral health maintenance remains important for long-term survival of restorations.

Esterases affect the physical properties of materials used to seal the endodontic space

Materials used to seal the endodontic space are subjected to enzymatic degradative activities of body fluids and bacteria.

OBJECTIVES

To assess effects of simulated human salivary, blood and bacterial esterases (SHSE) on physical properties of typical restorative material and root canal sealers.

METHODS

Specimens of set methacrylate-based resin composite (BisfilTM2B; RC), calcium-silicate sealer (EndoSequence®; BC) or epoxy-resin sealer (AH-Plus®; ER) were tested after up to 28Days exposure to phosphate buffered saline (PBS) or SHSE, using ANSI/ADA-57:2000 and ISO-6876:2012.

RESULTS

Regardless of media, microhardness increased with time for BC remained unchanged for ER and decreased for RC (p < 0.05). SHSE moderated the increase for BC compared to PBS (28.0 ± 4.8 vs. 38.1 ± 7.9 KHN) at 7Days, and enhanced the decrease for RC at 7Days (55.6 ± 7.1 vs. 66.3 ± 6.5 KHN) and 28Days (52.3 ± 9.2 vs. 62.6 ± 8.5 KHN). Compressive strength was enhanced only for BC by either media. BC expanded with time for both incubation conditions; SHSE moderated the expansion compared to PBS at 7Days (0.026 ± 0.01% vs. 0.049 ± 0.007%). Shrinkage of ER was similar for both incubation media and was lower than that for RC (p < 0.05). Shrinkage of RC was enhanced by SHSE compared to PBS at 7Days (0.5 ± 0.07% vs. 0.38 ± 0.08%). Weight loss was lowest for ER and highest for BC (p < 0.05). It was enhanced by SHSE compared to PBS for BC at 28Days (2.40 ± 0.2 vs. 2.96 ± 0.19 W L%), and for RC at 7Days (0.54 ± 0.09 vs. 0.80 ± 0.1 W L%).

SIGNIFICANCE

Simulated body fluids and bacterial esterases affected the physical properties of test materials, suggesting potential impacts on sealing ability and resistance to bacterial ingress, and tooth strength ultimately affecting their clinical performance.

Human neutrophils degrade methacrylate resin composites and tooth dentin

Cholesterol esterase-like (CE) activity from saliva and esterase from cariogenic bacteria hydrolyze ester linkages of dental methacrylate resins. Collagenolytic, matrix metalloproteinase-like (MMP) activities from dentin and bacteria degrade collagen in demineralized tooth dentin. Human neutrophils in the oral cavity contain factors that are hypothesized to have CE and MMP activities that could contribute to the degradation of methacrylate resins and dentinal collagen. OBJECTIVES: To measure the CE and MMP activities from human neutrophils and their ability to degrade dental methacrylate resin composite and dentinal collagen. Neutrophils' CE and MMP activities were measured using nitrophenyl-esters or fluorimetric MMP substrates, respectively. Neutrophils' degradation of resin composite and dentinal collagen was quantified by measuring release of a universal 2,2-Bis[4-(2-hydroxy-3-methacryloxypropoxy)phenyl]propane (bisGMA)-derived resin composite degradation byproduct, bishydroxy-propoxy-phenyl-propane (bisHPPP), or a collagen degradation by-product, hydroxyproline, respectively using ultra performance liquid chromatography/mass spectrometry. Neutrophils' CE activity increased the release of bisHPPP from bisGMA monomer compared to control after 24 and 48 h (p < 0.05). Neutrophils degraded polymerized resin composite and produced higher amounts of bisHPPP than buffer after 48 h of incubation (p < 0.05). Neutrophils show generic MMP, gelatinase, MMP-2 and MMP-9, and collagenase, MMP-1 and MMP-8 activities that were stable or increased over the first 24 h (p < 0.05). Neutrophils degraded demineralized dentin more than buffer-only groups, indicated by higher amounts of hydroxyproline (p < 0.05). The ability of neutrophils to degrade both dental resin composite and tooth dentin, suggest neutrophil's potential role in root caries, and in recurrent carries by accelerating the degradation of resin-dentin interfaces, and compromising the longevity of the restoration. STATEMENT OF SIGNIFICANCE: Neutrophils are part of the innate immune system and are constantly entering the oral cavity through the gingival sulcus, in direct contact with the tooth, restoration, restoration-tooth margins and pathogenic bacteria. The current study is the first to characterize and quantify degradative activities from neutrophils toward methacrylate resin and demineralized dentin, the two main components of the restoration-tooth interface, suggesting that this interface could be negatively influenced by neutrophils, potentially contributing to increase in caries formation and progression, and premature restoration failure. This study provides a significant finding to the biomaterials and oral health fields by identifying a potential weakness in current restorative procedures and materials used to manage gingival proximal and cervical gingival or sub-gingival carious lesions.

Biostable, antidegradative and antimicrobial restorative systems based on host-biomaterials and microbial interactions

OBJECTIVES

Despite decades of development and their status as the restorative material of choice for dentists, resin composite restoratives and adhesives exhibit a number of shortcomings that limit their long-term survival in the oral cavity. Herein we review past and current work to understand these challenges and approaches to improve dental materials and extend restoration service life.

METHODS

Peer-reviewed work from a number of researchers as well as our own are summarized and analyzed. We also include yet-unpublished work of our own. Challenges to dental materials, methods to assess new materials, and recent material improvements and research directions are presented.

RESULTS

Mechanical stress, host- and bacterial-biodegradation, and secondary caries formation all contribute to restoration failure. In particular, several host- and bacterial-derived enzymes degrade the resin and collagen components of the hybrid layer, expanding the marginal gap and increasing access to bacteria and saliva. Furthermore, the virulence of cariogenic bacteria is up-regulated by resin biodegradation by-products, creating a positive feedback loop that increases biodegradation. These factors work synergistically to degrade the restoration margin, leading to secondary caries and restoration failure. Significant progress has been made to produce hydrolytically stable resins to resist biodegradation, as well as antimicrobial materials to reduce bacterial load around the restoration. Ideally, these two approaches should be combined in a holistic approach to restoration preservation.

SIGNIFICANCE

The oral cavity is a complex environment that poses an array of challenges to long-term material success; materials testing conditions should be comprehensive and closely mimic pathogenic oral conditions.