Enterococcus faecalis Hydrolyzes Dental Resin Composites and Adhesives

Intraoral ageing of aligners and attachments: Adverse effects on clinical efficiency and release of biologically-active compounds

The clinical application of aligners is accompanied by the ageing of the polymer appliances and the attachments used, which may result in inefficiency in reaching the predicted range of tooth movement, and release of compounds and microplastics in the oral cavity as a result of the friction, wear and attrition of the aligner and composite attachment. The purpose of this review is to present the mechanism and effects of in vivo ageing; describe the hydrolytic degradation of aligners and enzymatic degradation of composite attachments; examine the ageing pattern of aligners in vivo, under actual clinical scenarios; and identify a link to the discrepancy between predicted and actual clinical outcome. Lastly, strategies to deal with three potentially critical issues associated with the use of aligners, namely the necessity of weekly renewal, the dissimilar mechanical properties of aligner and attachment resulting in wear and plastic deformation of the aligner, and the development of integuments and biofilms with microbial colonization of the appliance, are discussed.

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.

In Vitro Evaluation of Candida albicans Adhesion on Heat-Cured Resin-Based Dental Composites

Microbial adhesion on dental restorative materials may jeopardize the restorative treatment long-term outcome. The goal of this in vitro study was to assess Candida albicans capability to adhere and form a biofilm on the surface of heat-cured dental composites having different formulations but subjected to identical surface treatments and polymerization protocols. Three commercially available composites were evaluated: GrandioSO (GR), Venus Diamond (VD) and Enamel Plus HRi Biofunction (BF). Cylindrical specimens were prepared for quantitative determination of C. albicans S5 planktonic CFU count, sessile cells CFU count and biomass optical density (OD570 nm). Qualitative Concanavalin-A assays (for extracellular polymeric substances of a biofilm matrix) and Scanning Electron Microscope (SEM) analyses (for the morphology of sessile colonies) were also performed. Focusing on planktonic CFU count, a slight but not significant reduction was observed with VD as compared to GR. Regarding sessile cells CFU count and biomass OD570 nm, a significant increase was observed for VD compared to GR and BF. Concanavalin-A assays and SEM analyses confirmed the quantitative results. Different formulations of commercially available resin composites may differently interact with C. albicans. The present results showed a relatively more pronounced antiadhesive effect for BF and GR, with a reduction in sessile cells CFU count and biomass quantification.

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.

Retention of Intrafibrillar Minerals Improves Resin-Dentin Bond Durability

The concept of extrafibrillar demineralization involves selective removal of apatite crystallites from the extrafibrillar spaces of mineralized dentin without disturbing the intrafibrillar minerals within collagen. This helps avoiding activation of endogenous proteases and enables air-drying of partially demineralized dentin without causing collapse of completely demineralized collagen matrix that adversely affects resin infiltration. The objective of the present study was to evaluate the potential of quaternized carboxymethyl chitosan (QCMC)-based extrafibrillar demineralization in improving resin-dentin bond durability. Isothermal titration calorimetry indicated that QCMC synthesized by quaternization of O-carboxymethyl chitosan had moderate affinity for Ca²⁺ (binding constant: 8.9 × 10⁴ M^-1). Wet and dry bonding with the QCMC-based demineralization produced tensile bond strengths equivalent to the phosphoric acid (H₃PO₄)-based etch-and-rinse technique. Those bond strengths were maintained after thermocycling. Amide I and PO₄^3- mappings of QCMC-conditioned dentin were performed with atomic force microscope-infrared spectroscopy (AFM-IR). Whereas H₃PO₄-etched dentin exhibited an extensive reduction in PO₄^3- signals corresponding to apatite depletion, QCMC-conditioned dentin showed scattered dark areas and bright PO₄^3- streak signals. The latter were consistent with areas identified as collagen fibrils in the amide I mapping and were suggestive of the presence of intrafibrillar minerals in QCMC-conditioned dentin. Young's modulus mapping of QCMC-demineralized dentin obtained by AFM-based amplitude modulation-frequency modulation recorded moduli that were the same order of magnitude as those in mineralized dentin and at least 1 order higher than H₃PO₄-etched dentin. In situ zymography of the gelatinolytic activity within hybrid layers created with QCMC conditioning revealed extremely low signals before and after thermocycling, compared with H₃PO₄-etched dentin for both wet and dry bonding. Confocal laser scanning microscopy identified the antibacterial potential of QCMC against Streptococcus mutans and Enterococcus faecalis biofilms. Taken together, the QCMC-based demineralization retains intrafibrillar minerals, preserves the elastic modulus of collagen fibrils, reduces endogenous proteolytic activity, and inhibits bacteria biofilms to extend dentin bond durability.

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.

Intelligent pH-responsive dental sealants to prevent long-term microleakage

OBJECTIVES

Microleakage is a determinant factor of failures in sealant application. In this study, DMAEM (dodecylmethylaminoethyl methacrylate), a pH-responsive antibacterial agent, was incorporated into resin-based sealant for the first time. The objectives of this study were to: (1) investigate the long-term performance of DMAEM-modified sealants against oral microbial-aging; and (2) investigate the long-term preventive effect of DMAEM-modified sealants on microleakage.

METHODS

Depth-of-cure and cytotoxicity of DMAEM-modified sealants were measured. Then, an aging model using biofilm derived from the saliva of high caries experience children was conducted. After aging, microhardness and surface roughness were measured. Biofilm activity, lactic acid production and exopolysaccharide (EPS) production were measured. 16S rRNA gene sequencing were also performed. The effects of DMAEM on microleakage were tested using an in vitro microleakage assessment.

RESULTS

The addition of DMAEM with a mass fraction of 2.5-10% did not affect depth-of-cure values and cytotoxicity of sealants. Adding 2.5-10% DMAEM did not affect the surface roughness and microhardness after aging. Compared to control, adding 2.5-10% DMAEM reduced biofilm metabolic activity by more than 80%. The lactic acid production and EPS production were reduced by 50% in DMAEM groups. DMAEM-modified sealants maintained the microbial diversity of biofilm after aging, they also inhibited the growth of lactobacillus. The 5% and 10% DMAEM groups exhibited a significant reduction in microleakage compared to control.

SIGNIFICANCE

The long-term antibacterial activities against oral microbial-aging and the long-term microecosystem-regulating capabilities enabled DMAEM-modified sealant to prevent microleakage in sealant application and thus prevent dental caries.

Synthesis of Novel Dental Nanocomposite Resins by Incorporating Polymerizable, Quaternary Ammonium Silane-Modified Silica Nanoparticles

Diverse approaches dealing with the reinforcement of dental composite resins with quaternary ammonium compounds (QAC) have been previously reported. This work aims to investigate the physicochemical and mechanical performance of dental resins containing silica nanofillers with novel QAC. Different types of quaternary ammonium silane compounds (QASiC) were initially synthesized and characterized with proton nuclear magnetic resonance (¹H-NMR) and Fourier transform infrared (FTIR) spectroscopy. Silica nanoparticles were surface modified with the above QASiC and the structure of silanized products (S.QASiC) was confirmed by means of FTIR and thermogravimetric analysis. The obtained S.QASiC were then incorporated into methacrylate based dental resins. Scanning electron microscopy images revealed a satisfactory dispersion of silica nanoclusters for most of the synthesized nanocomposites. Curing kinetics disclosed a rise in both the autoacceleration effect and degree of conversion mainly induced by shorter QASiC molecules. Polymerization shrinkage was found to be influenced by the particular type of S.QASiC. The flexural modulus and strength of composites were increased by 74% and 19%, while their compressive strength enhancement reached up to 19% by adding 22 wt% S.QASiC nanoparticles. These findings might contribute to the proper design of multifunctional dental materials able to meet the contemporary challenges in clinical practice.

Drug-Silica Coassembled Particles Improve Antimicrobial Properties of Endodontic Sealers

INTRODUCTION

The purpose of this study was to assess the antimicrobial activity and flow of root canal sealers after incorporating novel highly loaded antimicrobial drug-silica coassembled particles (DSPs).

METHODS

DSPs were synthesized through coassembly of silica and octenidine dihydrochloride (OCT) antimicrobial surfactant. DSPs were loaded (1% and 2% wt) into epoxy resin sealer (AH Plus [AH]; Dentsply DeTrey GmbH, Konstanz, Germany) or calcium silicate-based sealer (EndoSequence Bioceramic Sealer (BC); Brasseler, Savannah, GA). OCT release from DSP-modified sealers was determined using liquid chromatography. Antimicrobial activity of sealers against planktonic or biofilm form Enterococcus faecalis was assessed using direct contact and membrane restricted tests. Sealer flow was tested according to ISO6876:2012.

RESULTS

OCT release from BC + 1% or 2% DSPs was above the minimum inhibitory concentration following 2 days throughout the 30-day experiment, whereas OCT release from AH + 1% or 2% DSP was significantly below the minimum inhibitory concentration against E. faecalis (4 μg/mL) over the whole 30-day experimental period. All materials (with or without DSPs) killed planktonic bacteria initially. AH ± 1% or 2% DSPs had no antimicrobial activity after 7 days. BC + 1% or 2% DSPs maintained antibacterial activity over the 30-day period. Both modified and unmodified sealers completely inhibited the growth of E. faecalis biofilms after 24 hours of contact. DSPs decreased the flow of AH and BC sealers; for AH, the reduction was proportional to the amount of DSPs added. All modified and unmodified sealers, except for AH + 2% DSPs, were within the acceptable limits of ISO 6876 flow tests.

CONCLUSIONS

DSPs enhanced the antimicrobial performance of BC but not AH, whereas the material's flow remained compliant with ISO 6876 standards. Depending on the sealer, DSPs may enhance antimicrobial efficacy in root canal treatment and potentially improve treatment outcome.

Human neutrophils compromise the restoration-tooth interface

Neutrophils, cells of the innate immune system, enter the mouth and release factors that are hypothesized to contribute to the degradation of tooth dentin, methacrylate resin composites, and adhesives at the restoration-tooth-dentin interface. The objectives were to characterize neutrophils' degradation towards resin composite, self-etch (SE) and total-etch (TE) adhesives, SE and TE resin-dentin interfaces and to identify proteins that could contribute to the degradation process. Neutrophils' degradation of cured resin composite, and SE and TE adhesives, was quantified by measuring the specific resin degradation by-product, bishydroxy-propoxy-phenyl-propane (bisHPPP), released after 30 days incubation of the materials with the cells. Neutrophils' degradative effect on resin-dentin interfaces was examined by recording the interfacial fracture toughness (FT), and surface analysis of the fracture mode following incubation of SE and TE miniature short-rod (mini-SR) specimens with the cells. Neutrophils increased degradation of polymerized resin composite, and TE adhesive, but not SE adhesive over 30 days (p < 0.05). Incubation of SE and TE resin-dentin interfaces with neutrophils led to a reduction in FT over time (p < 0.05). The effect was more pronounced for TE interfaces. Neutrophils also affected the fracture mode of SE and TE resin-dentin interfaces. Several proteins that could contribute to the degradative activity of neutrophils, including Neutrophil collagenase (MMP-8), Matrix metalloproteinase- 9 (MMP-9), Cathepsin G, Neutrophil- gelatinase associated lipocalin (NGAL) and Myeloperoxidase, were isolated. The ability of neutrophils to degrade resin, tooth dentin, and reduce the bond strength of resin-dentin interfaces suggest neutrophils' potential role in primary and recurrent caries and dental restoration failure.

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.

Hydrolytic and Biological Degradation of Bulk-fill and Self-adhering Resin Composites

OBJECTIVES

This study aimed to evaluate the hydrolytic degradation (in vitro) and biodegradation (in situ) of different resin composites: bulk-fill (XTra Fill, XTF/VOCO; Tetric EvoCeram Bulk Fil, TBF/ Ivoclar Vivadent), self-adhering (Vertise Flow, VTF/ Kerr; Fusio Liquid Dentin, FUS/ Pentron Clinical), and a conventional resin composite (Filtek Z250, Z250/ 3M ESPE), which was used as a control.

METHODS AND MATERIALS

Seventy-five cylindrical specimens (7 × 1 mm) were desiccated and immersed into distilled water (DW), artificial saliva (AS), and 0.1 M lactic acid (LA) (n=5) for 180 days. Specimens were weighed after 180 days, after which they were desiccated again. The sorption (μg/mm³) and solubility (μg/mm³) were calculated based on ISO 4049. For the in situ phase, an intraoral palatal device containing five cylindrical specimens (5 × 1.5 mm) was used by 20 volunteers for seven days. Surface roughness was evaluated before and after this period to analyze the superficial biodegradation. Sorption and solubility data were submitted to Kruskal-Wallis and Mann-Whitney tests. The Wilcoxon signed-rank test was used to compare roughness at different observation times. The statistical significance for all tests was considered α=0.05.

RESULTS

For in vitro, self-adhering resin composites (VTF and FUS) showed, respectively, higher sorption values independent of the solution (62.55 and 50.81 μg/mm³ in DW, 67.26 and 50.46 μg/mm³ in AS, and 64.98 and 59.86 μg/mm³ in LA). Self-adhering VTF also had a greater solubility value in DW (22.18 μg/mm³) and FUS in LA (65.87 μg/mm³). In AS, the bulk-fill resin composite XTF showed higher solubility (22.13 μg/mm³). All resins were biodegraded, but the XTF specimens were more resistant (p=0.278) to chemical attack.

CONCLUSIONS

The self-adhering resin composites showed the highest hydrolytic degradation, and the bulk-fill resin composites exhibited comparable or superior results to the conventional resin composites. Not all resin composites underwent biodegradation in the in situ environment. The storage environment influenced the final characteristics of each material tested.

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.

Biofilm composition and composite degradation during intra-oral wear

OBJECTIVES

The oral environment limits the longevity of composite-restorations due to degradation caused by chewing, salivary and biofilm-produced enzymes and acids. This study investigates degradation of two resin-composites in relation with biofilm composition in vitro and in vivo.

METHODS

Surface-chemical-composition of two Bis-GMA/TEGDMA composites was compared using X-ray-Photoelectron-Spectroscopy from which the number ester-linkages was derived. Composite-degradation was assessed through water contact angles, yielding surface-exposure of filler-particles. Degradation in vitro was achieved by composite immersion in a lipase solution. In order to evaluate in vivo degradation, composite samples were worn in palatal devices by 15 volunteers for 30-days periods in absence and presence of manually-brushing with water. PCR-DGGE analysis was applied to determine biofilm composition on the samples, while in addition to water contact angles, degradation of worn composites was assessed through surface-roughness and micro-hardness measurements.

RESULTS

In vitro degradation by lipase exposure was highest for the high ester-linkage composite and virtually absent for the low ester-linkage composite. Filler-particle surface-exposure, surface-roughness and micro-hardness of both resin-composites increased during intra-oral wear, but filler-particle surface-exposure was affected most. However, based on increased filler-particle surface-exposure, the high ester-linkage composite degraded most in volunteers harvesting composite biofilms comprising Streptococcus mutans, a known esterase and lactic acid producer. This occurred especially in absence of brushing.

SIGNIFICANCE

Degradation during intra-oral wear of a low ester-linkage composite was smaller than of a high ester-linkage composite, amongst possible other differences between both composites. S. mutans herewith is not only a cariogenic, but also a composite-degradative member of the oral microbiome.

Physical properties and cytotoxicity of antimicrobial dental resin adhesives containing dimethacrylate oligomers of Ciprofloxacin and Metronidazole

OBJECTIVE

Antimicrobial oligomers synthesized from ciprofloxacin (CF) and metronidazole (MN) were investigated for their potential use in dental adhesives.

METHODS

Susceptibility of the cariogenic bacterium Streptococcus mutans UA159 to CF, MN, and CF/MN combination was evaluated. Hydrolytic stability and drug release from the oligomers was studied in buffer and simulated human salivary esterase conditions. Cytotoxicity of films with 15wt% drug oligomers co-polymerized with commercial monomers were assessed using human gingival fibroblasts (HGFs). In-house adhesives were prepared and characterized for viscosity. Polymerized films were analysed for gel content and water swelling. Interfacial fracture toughness (K_IC) of composites bonded to dentin by either a 2 or 3-step etch-and-rinse approach using the in-house formulated adhesives was measured.

RESULTS

The respective minimum inhibitory concentration for CF and MN against S. mutans was 0.7 and 2400μg/mL, with the combination having an additive effect (0.35μg/mL CF with 1200μg/mL MN). Antibiotics were released upon hydrolysis of the oligomers. Films containing the drug oligomers were not cytotoxic against HGFs. Replacing 2-hydroxyethyl methacrylate with the drug oligomers increased the viscosity of the experimental adhesives, reduced gel content, and decreased swelling of films in water. Antimicrobial adhesives demonstrated bonding to dentin with interfacial K_IC values comparable to the in-house control in the 2-step application, and with slightly lower K_IC values in the 3-step approach.

SIGNIFICANCE

The antimicrobial oligomers can be incorporated into dental adhesive systems using formulations that show comparable fracture toughness to commercial materials, and may provide a means to deliver local antimicrobial drug release at the marginal interface.

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.

Biofabricated silver nanoparticles incorporated polymethyl methacrylate as a dental adhesive material with antibacterial and antibiofilm activity against Streptococcus mutans

In this study, polymethyl methacrylate (PMMA) thin films incorporated with biofabricated silver nanoparticles were used to evaluate the in vitro antimicrobial and antibiofilm activity against the cariogenic bacterium Streptococcus mutans. For this, silver nanoparticles (AgNPs) were generated using Bacillus amyloliquefaciens SJ14 culture (MAgNPs) and extract from Curcuma aromatica rhizome (CAgNPs). The AgNPs were further characterized by UV-Vis spectroscopy and high-resolution transmission electron microscopy. The minimum inhibitory concentration, minimum bactericidal concentration and antibiofilm activity of AgNPs against S. mutans were also assessed. Here, MAgNPs were found to have superior antimicrobial activity when compared to CAgNPs. The MAgNPs and CAgNPs also demonstrated 99% and 94% inhibition of biofilm formation of S. mutans at concentrations of 3 µg/mL and 50 µg/mL, respectively. The AgNPs were further incorporated into PMMA thin films using solvent casting method. The thin films were also characterized by scanning electron microscopy and UV-Vis spectroscopy. Subsequently, both PMMA/MAgNPs and PMMA/CAgNPs nanocomposite thin films were subjected to antimicrobial and antibiofilm analysis. The microbicidal activity was found to be higher for the PMMA/MAgNPs thin film, which highlights the potency of microbially synthesized AgNPs as excellent agents to inhibit cariogenic bacteria from colonising dental restorative material.

Esterase from a cariogenic bacterium hydrolyzes dental resins

OBJECTIVES

To identify and characterize specific esterases from S. mutans with degradative activity toward methacrylate-based resin monomers.

METHODS

Out of several putative esterases, an esterase encoded in an Open Reading Frame as SMU_118c (The National Center for Biotechnology Information, NCBI), was found to have true hydrolase activities. SMU_118c was cloned, expressed, purified and further characterized for its respective hydrolytic activity towards ester-containing nitrophenyl substrates and the universal resin monomers bis-phenyl-glycidyl-dimethacrylate (bisGMA) and triethyleneglycol dimethacrylate (TEGDMA) at neutral (7.0) or cariogenic (5.5) pH. Mass spectrometry (MS) was used to verify the expression of SMU_118c protein in S. mutans UA159.

RESULTS

Similar to the whole cell activity of S. mutans, SMU_118c showed the highest affinity toward para-nitrophenyl acetate (pNPA) and para-nitrophenyl butyrate (pNPB) vs. ortho-nitrophenyl butyrate (oNPB) and butyrylthiocholine iodide (BTC) (p < 0.05). The esterase retained 60% of its activity after 21 days and hydrolyzed bisGMA at a higher rate than TEGDMA at both neutral and cariogenic pH (p < 0.001), similarly to the predominant human salivary esterase degradative activity. MS confirmed that SMU_118c is an intracellular protein in S. mutans UA159 and expressed under pathogenic (pH 5.5) growth conditions.

SIGNIFICANCE

The similarity in the activity profile to the whole S. mutans bacterial cell, the stability over time at cariogenic pH, the preference to hydrolyze bisGMA and confirmed expression profile suggest that SMU_118c could be a significant contributor to the whole bacterial degradative activity of S. mutans toward the degradation of resin composites, adhesives and the restoration-tooth interface, potentially accelerating restoration's failure.

STATEMENT OF SIGNIFICANCE

The current study builds upon our highly-cited previous study by Bourbia et al., (JDR, 2013) that reported on that the cariogenic bacterium, S. mutans has esterase-like activities that enable the bacterium to degrade dental composites and adhesives. The current submission is the first to report on the isolation and characterization of the specific esterase activity (SMU_118c) from S. mutans that is a significant contributor to the whole bacterial degradative activity toward the hydrolysis of dental resins. This activity compromises the restoration-tooth interface, increases interfacial bacterial microleakage (Kermanshahi et al., JDR 2010), potentially contributing to the pathogenesis of recurrent caries around resin composite restorations. This represent a significant contribution to the field of biomaterials and their clinical performance.