Saturation reduces in-vitro leakage of monomers from composites

Level of BPA contamination in resin composites determines BPA release

OBJECTIVES

Resin composites may release bisphenol A (BPA) due to impurities present in the monomers. However, there is a lack of knowledge regarding the leaching characteristics of BPA from resin composites. Therefore, experimental resin composites were prepared with known amounts of BPA. The objective of this study was (1) to determine which amount of BPA initially present in the material leaches out in the short term and, (2) how this release is influenced by the resin composition.

METHODS

BPA (0, 0.001, 0.01, or 0.1 wt%) was added to experimental resin composites containing 60 mol% BisGMA, BisEMA(3), or UDMA, respectively, as base monomer and 40 mol% TEGDMA as diluent monomer. Polymerized samples (n = 5) were immersed at 37 °C for 7 days in 1 mL of water, which was collected and refreshed daily. BPA release was quantified with UPLC-MS/MS after derivatization with pyridine-3-sulfonyl chloride.

RESULTS

Between 0.47 to 0.67 mol% of the originally added BPA eluted from the resin composites after 7 days. Similar elution trends were observed irrespective of the base monomer. Two-way ANOVA showed a significant effect of the base monomer on BPA release, but the differences were small and not consistent.

SIGNIFICANCE

The released amount of BPA was directly proportional to the quantity of BPA present in the resin composite as an impurity. BPA release was mainly diffusion-based, while polymer composition seemed to play a minor role. Our results underscore the importance for manufacturers only to use monomers of the highest purity in dental resin composites to avoid unnecessary BPA exposure in patients.

Elution from direct composites for provisional restorations

Purpose To assess elution from direct composite materials for provisional restorations and compare them with elution from direct restorative composites for permanent restorations.Methods Two dual-cure (Integrity Multi-Cure and Tempsmart DC) and two self-curing composites (Protemp 4 and Structur 3) were used, with Essentia serving as a reference. Cylindrical specimens (n=20) were cured according to the manufacturer's instructions; the dual-cure materials were prepared in both self- and dual-curing modes. Elution experiments were performed using water and absolute ethanol. The samples were incubated at 37 °C for either 24 h or four weeks; the extraction solvents were refreshed weekly. The eluted BisEMA (-3 / -6 / -10), BisGMA, CQ, UDMA, and TEGDMA were quantified using UHPLC-MS/MS.Results Monomer elution was detected in all provisional composites at 24 h and four weeks, but the amounts released did not exceed those released by the reference composite. When prepared in self-curing mode, Integrity Multi-Cure exhibited significantly higher elution of BisEMA-3, -6, and -10 in ethanol both after 24 h and cumulatively after four weeks. Self-cured Tempsmart DC released significantly more CQ, TEGDMA, and UDMA in both water and ethanol after immersion for 24 h and four weeks, along with significantly more BisGMA in ethanol both after 24 h and four weeks comparison to dual-cured Tempsmart DC (two-way ANOVA, post-hoc Tukey, P < 0.05).Conclusions Provisional composite materials did not elute higher amounts of monomers than a restorative composite. Dual-cured materials, prepared in the self-curing mode, show a trend towards higher monomer elution.

Logistic Regression Analysis of LC-MS/MS Data of Monomers Eluted from Aged Dental Composites: A Supervised Machine-Learning Approach

Compound identification by database searching that matches experimental with library mass spectra is commonly used in mass spectrometric (MS) data analysis. Vendor software often outputs scores that represent the quality of each spectral match for the identified compounds. However, software-generated identification results can differ drastically depending on the initial search parameters. Machine learning is applied here to provide a statistical evaluation of software-generated compound identification results from experimental tandem MS data. This task was accomplished using the logistic regression algorithm to assign an identification probability value to each identified compound. Logistic regression is usually used for classification, but here it is used to generate identification probabilities without setting a threshold for classification. Liquid chromatography coupled with quadrupole-time-of-flight tandem MS was used to analyze the organic monomers leached from resin-based dental composites in a simulated oral environment. The collected tandem MS data were processed with vendor software, followed by statistical evaluation of these results using logistic regression. The assigned identification probability to each compound provides more confidence in identification beyond solely by database matching. A total of 21 distinct monomers were identified among all samples, including five intact monomers and chemical degradation products of bisphenol A glycidyl methacrylate (BisGMA), oligomers of bisphenol-A ethoxylate methacrylate (BisEMA), triethylene glycol dimethacrylate (TEGDMA), and urethane dimethacrylate (UDMA). The logistic regression model can be used to evaluate any database-matched liquid chromatography-tandem MS result by training a new model using analytical standards of compounds present in a chosen database and then generating identification probabilities for candidates from unknown data using the new model.

Detection of Leachable Components from Conventional and Dental Bulk-Fill Resin Composites (High and Low Viscosity) Using Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Method

The aim of this study was to investigate leachable components (monomers) in high and low viscosity dental bulk-fill resin composites and conventional resin composite materials after polymerization. Six bulk-fill and six conventional dental resin composite materials were used in this study. The samples of each material (three sets of triplicates) were cured for 20 s with irradiance of 1200 mW/cm² with a LED curing unit and immersed in a 75% ethanol solution at 37 °C. The eluates from each triplicate set were analyzed after 24 h, 7 days or 28 days using liquid chromatography coupled with triple quadrupole tandem mass spectrometry (LC-MS/MS). Detectable amounts of 2-Hydroxyethyl methacrylate (HEMA) were found in both Gradia materials and the amount observed across different time points was statistically different (p ˂ 0.05), with the amount in solution increasing for Gradia and decreasing for Gradia Direct flo. Bisphenol A diglycidildimethacrylate (BIS GMA) was found in Filtek and Tetric materials. Triethylene glycol dimethacrylate (TEGDMA) was detected in all materials. On the other hand, there were no statistically significant differences in the amounts of TEGDMA detected across different time points in either of the tested materials. Monomers HEMA, TEGDMA, 4-dimethylaminobenzoic acid ethyl ester (DMA BEE) and BIS GMA in bulk-fill and conventional composites (high and low viscosity) can be eluted after polymerization. The good selection of composite material and proper handling, the following of the manufacturer's instructions for polymerization and the use of finishing and polishing procedures may reduce the elution of the unpolymerized monomers> responsible for the possible allergic and genotoxic potential of dental resin composites.

Monomer Release from Dental Resins: The Current Status on Study Setup, Detection and Quantification for In Vitro Testing

Improvements in mechanical properties and a shift of focus towards esthetic dentistry led to the application of dental resins in various areas of dentistry. However, dental resins are not inert in the oral environment and may release monomers and other substances such as Bisphenol-A (BPA) due to incomplete polymerization and intraoral degradation. Current research shows that various monomers present cytotoxic, genotoxic, proinflammatory, and even mutagenic effects. Of these eluting substances, the elution of BPA in the oral environment is of particular interest due to its role as an endocrine disruptor. For this reason, the release of residual monomers and especially BPA from dental resins has been a cause for public concern. The assessment of patient exposure and potential health risks of dental monomers require a reliable experimental and analytical setup. However, the heterogeneous study design applied in current research hinders biocompatibility testing by impeding comparative analysis of different studies and transfer to the clinical situation. Therefore, this review aims to provide information on each step of a robust experimental and analytical in vitro setup that allows the collection of clinically relevant data and future meta-analytical evaluations.

Effect of Volume and Renewal of the Storage Media on the Release of Monomer from Dental Composites

This study evaluated the effect of the volume and renewing of storage media on monomer leachability from dental composite. Samples of two dental composites (BEAUTIFIL II Gingiva (BG) and Filtek Bulk-Fill Flowable (FBF)) were stored after polymerization in 1 and 3 milt storage media (ethanol/water 75%) for seven days. Refreshing of storage media was done in half of the samples of each group. The amounts of releasing monomers (UDMA, BisGMA, TEGDMA) in storage media were measured by high-performance liquid chromatography (HPLC). Data was analyzed using two-way ANOVA and t-test (α = 0.05). Elution of TEGDMA and UDMA from both composites was significantly higher in 3 mL storage media. In groups with refreshing of storage media, BisGMA had higher amounts of release. Saturation makes the storage media volume important factor in monomer elution. Refreshing of storage media had significant effect on monomer release before the elution of 50% of total released monomer.

Meta-analytical analysis on components released from resin-based dental materials

OBJECTIVES

Resin-based materials are applied in every branch of dentistry. Due to their tendency to release substances in the oral environment, doubts have been raised about their actual safety. This review aims to provide a comprehensive analysis of the last decade literature regarding the concentrations of elutable substances released from dental resin-based materials in different type of solvents.

MATERIALS AND METHODS

All the literature published on dental journals between January 2010 and April 2022 was searched using international databases (PubMed, Scopus, Web of Science). Due to strict inclusion criteria, only 23 papers out of 877 were considered eligible. The concentration of eluted substances related to surface and volume of the sample was analyzed, considering data at 24 h as a reference. The total cumulative release was examined as well.

RESULTS

The most eluted substances were HEMA, TEGDMA, and BPA, while the less eluted were Bis-GMA and UDMA. Organic solvents caused significantly higher release of substances than water-based ones. A statistically significant inverse correlation between the release of molecules and their molecular mass was observed. A statistically significant positive correlation between the amount of released molecule and the specimen surface area was detected, as well as a weak positive correlation between the release and the specimen volume.

CONCLUSIONS

Type of solvent, molecular mass of eluates, and specimen surface and volume affect substances release from materials.

CLINICAL RELEVANCE

It could be advisable to rely on materials based on monomers with a reduced elution tendency for clinical procedures.

Evaluation of Residual Monomers Eluted from Pediatric Dental Restorative Materials

Unreacted monomers eluted from resin-based restorative materials have been considered a reason of local and systemic adverse reactions. This study was designed to determine the effect of finishing and polishing procedures on the elution of Bis-GMA, TEGDMA, UDMA, and HEMA monomers from compomer and bulk-fill composite resins. Bulk-fill composite (3M ESPE GmbH, Seefeld, Germany) and compomer (Dentsply DeTrey GmbH, Konstanz, Germany) specimens with 3 × 4 mm diameters were prepared. The specimens were randomly divided into two groups, and finishing-polishing procedures were applied only to the experimental groups. Release of residual monomers was analyzed by using High-Performance Liquid Chromatography (HPLC) after 24, 48, and 72 hours. Repeated measures ANOVA and Tukey post hoc tests were used for comparisons. Finishing and polishing procedures had a significant effect on reducing the quantity of UDMA release in the Filtek™ Bulk Fill composite and Bis-GMA, HEMA, and TEGDMA in the Dyract XP compomer (p < 0.05). The restorative materials investigated here are not chemically stable after polymerization, and concentrations of eluted monomers may reach critical toxicity levels even after one restoration placement. Finishing and polishing procedures are mandatory to reduce residual monomers.

Long-term elution of bisphenol A from dental composites

OBJECTIVES

BPA release from composites on the short term has been reported in several in-vitro and in-vivo studies. However, it remains unclear whether these materials also leach BPA on the long term. Even though composites may release various (BPA-based) methacrylate monomers up to one year, quantitative data about BPA have not been reported due to the lack of a sensitive method to accurately quantify low levels of BPA. In this context, the aim of the study was to quantify the one-year release of BPA with an optimized analytical method.

METHODS

Composite disks (n = 6, 6 mm diameter and 2 mm height) from four commercial materials (G-ӕnial Posterior, Venus, Ceram.x mono and Filtek Supreme XTE) were immersed in 1 mL of water or ethanol as extraction solvent and stored in the dark at 37 °C. The extraction solvent was renewed weekly for a period of 52 weeks. Samples were derivatized with pyridine-3-sulfonyl chloride before analysis with ultra-pressure liquid chromatography tandem mass spectrometry (UPLC-MS/MS).

RESULTS

Derivatizing BPA increased the sensitivity of the analytical method and allowed accurate quantification of very low levels of BPA (i.e. 0.78 pmol BPA). BPA eluted continuously in ethanol from all four tested composites over a period of one year. BPA elution was clearly higher when ethanol was used as extraction solution. In water, BPA eluted could be detected up to one year, but levels could not be accurately quantified anymore after several weeks.

SIGNIFICANCE

Composites can be considered as a potential long-term source of BPA, and thus should not be neglected when assessing the overall exposure to endocrine disrupting chemicals.

An integrative review on the toxicity of Bisphenol A (BPA) released from resin composites used in dentistry

The main aim of this study was to perform an integrative review on the release of bisphenol A (BPA) from resin-matrix composites and potential toxic effects. A bibliographic search was performed on the PubMed platform using the following keywords: "Bisphenol A" OR "BPA" AND "resin composite" OR "composite resin" AND "toxicity" OR "cytotoxicity" OR "release". Inclusion criteria involved in vitro and in vivo studies on the release and toxicity of BPA. Results highlighted the release of BPA from resin-matrix composites due to insufficient polymerization and/or degradation of the polymeric matrix. BPA is part of the organic matrix of resin-matrix composites and may be hydrolysed in human saliva, although studies report that low doses might not be detected by traditional chemical analysis. Studies exposing zebrafish embryos to different concentrations of Bis-GMA, showed 55% mortality at 10 μM Bis-GMA while 30% mortality was recorded at 1 μM Bis-GMA. In patients, a BPA concentration of around 2.09 × 10^-2 μg/ml was found in the saliva after placement of lingual orthodontic retainers with resin-matrix composites. Also, the BPA molecule can be swallowed and absorbed by the oral/gastrointestinal mucosa, which might result in systemic toxicity. The degradation of resin-matrix composites and release of BPA in oral environment are dependent on the organic matrix content and on the polymerization method. A increased release of BPA can lead to the absorption into oral and gastrointestinal mucosa with high risks of local and systemic toxicity.

Do resin-based composite CAD/CAM blocks release monomers?

OBJECTIVE

The present study aimed to identify and quantify the elution of monomers of five different resin-based CAD/CAM blocks (RCBs) using HPLC.

METHODS

Five different RCBs were used in the study: GC Cerasmart (CS), Voco Grandio blocs (GR), 3M Lava Ultimate (LU), Shofu Block (SB), and Vita Enamic (VE). Fifteen samples from each material were prepared using a low-speed precision diamond saw (ISOMET Buehler, Lake Bluff, IL, USA) at 5 × 5 × 4 mm size. After the preparation of samples, an extraction solution was mixed with %75/%25 ethanol/water. The samples were stored in the amber-colored bottles during three different immersed periods as 1 h, 24 h, and 90 days (n = 5). After immersion, 0.5 ml solutions were taken from each bottle and analyzed using HPLC.

RESULTS

A total of 16.7 μg/ml of monomers from SB, 13.4 μg/ml of monomers from GR, 13.2 μg/ml of monomers from CS, and 6.7 μg/ml of monomers from LU were found after 3-m immersion. TEGDMA after 3-m of immersion was only released from the SB group, and also BisEMA was released from the CS group. Among the specimens immersed for 1 h, UDMA was released the least from the LU group and the most from the GR group (p < 0.05). Correspondingly, 24 h and 3 m after immersion, the highest release of monomers was found in the GR (p < 0.05).

CONCLUSIONS

When the monomer release from RCBs was evaluated, it was shown that these materials released methacrylate-based monomers except VE, especially if they were kept in a solvent solution for a long time such as 3 m.

CLINICAL SIGNIFICANCE

The novel resin-based CAD/CAM blocks might monomer release, which may cause cytotoxic effects. But, the detected amount of monomer release is below the estimated daily limit.