In vitro performance of nano-heterogeneous dentin adhesive

Compatibility versus reaction diffusion: Factors that determine the heterogeneity of polymerized adhesive networks

OBJECTIVES

Heterogeneity and phase separation during network polymerization is a major issue contributing to the failure of dental adhesives. This study investigates how the ratio of hydrophobic crosslinkers to hydrophilic comonomer (C/H ratio), as well as cosolvent fraction (ethanol/water) influences the degree of heterogeneity and proclivity for phase separation in a series of model adhesive formulations.

METHODS

Twelve formulations were investigated, with 4 different C/H ratios (7:1, 2.2:1, 1:1, 0.5:1) and 3 different overall cosolvent fractions (0, 10 and 20 wt%). The heterogeneity and phase behavior were characterized using Fourier Transform Infrared Spectroscopy (FT-IR), dynamic mechanical analysis (DMA), small-angle x-ray scattering (SAXS) and atomic force microscopy (AFM).

RESULTS

In resins without cosolvent, all characterizations confirm reduced heterogeneity as C/H ratio decreases. However, when 10 or 20 wt% of cosolvent is included in the adhesive formulation, a higher degree of heterogeneity and even distinct phase separation with domains ranging from a few hundreds of nanometers to a few micrometers in size form. This is particularly noticeable at lower C/H ratios, which is surprising as HEMA is commonly considered a compatibilizer between hydrophobic crosslinkers and aqueous (co)solvents.

SIGNIFICANCE

Our experiments demonstrate that formulations with lower C/H ratio and thus a lower viscosity experience later onsets of diffusion limitations during polymerization, which favors thermodynamically driven phase separation. Therefore, to determine or predict the resulting phase structure of adhesive materials, it is necessary to consider the kinetics and diffusion constraints during the formation of the polymer network and not just the compatibility of resin constituents.

Bonding performance and interfacial adaptation of modern bulk-fill restorative composites after aging in artificial saliva: an in vitro study

OBJECTIVES

This study aimed at comparing the microtensile bond strength (MTBS) and interfacial adaptation of a modern self-curing and a light-curing restorative bulk-fill composite to a conventional composite applied with the layering technique.

METHODS

Forty-eight occlusal cavities were divided in three main groups (16/group) based on tested materials: (i) STELA, bulk-fill self-curing restorative (STELA, SDI Ltd.); (ii) 3 M-BULK, bulk-fill composite (Filtek One Bulk-Fill, 3 M Oral Care); and (iii) 3 M-CTR, a conventional composite (Filtek Supreme XTE, 3 M Oral Care). These were used in combination with their adhesives in self-etch (SE) or etch-and-rinse (ER) mode. Specimens stored in artificial saliva (24 h or 12 months) were evaluated for MTBS and fractography. The interfacial analysis was performed through confocal microscopy. ANOVA and Fisher's LSD post hoc tests were performed with a level of significance of 5%.

RESULTS

All the tested materials applied in ER mode presented (24 h) greater bond strength than in SE mode. Although all materials showed a significant drop in the bond strength after prolonged storage, STELA showed the highest bonding performance and interfaces with few gaps. 3 M-BULK had the lowest bond strength and an interface with several voids and gaps.

CONCLUSIONS

All materials were affected by interface degradation and bonding reduction over prolonged aging. However, their use in combination with adhesives applied in ER mode may offer greater immediate bonding performance.

CLINICAL RELEVANCE

The use of restorative light-curing bulk-fill composites may generate gaps at the bonding interface and voids. STELA may represent a suitable alternative to avoid such issues.

Effect of Collagen-Reactive Functional Monomer on Etch-and-Rinse Adhesives

In this study, we evaluated a novel functional monomer (4-formylphenyl acrylate [FA]) that can specifically and covalently bind to the dentin collagen matrix as a potential alternative hydrophobic diluent-like monomer for improving the durability of dentin bonding. Experimental adhesives with different FA contents (0%, 10%, 20%, and 30%) were evaluated as partial substituents for the hydrophilic monomer 2-hydroxyethyl methacrylate, with the commercial adhesive One-Step (Bisco, Inc.) employed as the positive control. Their degree of conversion, viscosity, hydrophobicity, mechanical properties, and water absorption/solubility were measured as the comprehensive characterization. In situ zymographic assays were performed to determine the extent to which FA inhibits the endogenous hydrolytic activity of dentin. Finally, the bonding performances of the novel adhesives were evaluated with microtensile strength tests and scanning electron microscopy. The results showed that the incorporation of FA significantly improved the mobility of experimental adhesives attributable to the dilution property of FA. In contrast to the possible compromised rate of polymerization by hydroxyethyl methacrylate, FA exhibited typical characteristics of favorable copolymerization with polymerizable monomers in adhesives and improved the degree of conversion of experimental adhesives. The rigidity and hydrophobic properties of the phenyl framework of the FA molecule conferred superior mechanical properties and hydrolysis resistance to the novel experimental adhesives. An inhibitory effect on gelatinolytic activities within the hybrid layer was also observed in the in situ zymographic assays, even at a low FA concentration (10%). In conjunction with the significantly improved infiltration found via scanning electron microscopy, the experimental adhesives containing FA possessed significantly better-maintained microtensile strength, even after aging. Thus, the incorporation of this novel monomer endowed the experimental adhesives with multiple enhanced functionalities. These remarkable advantages highlight the suitability of the monomer for further applications in clinical practice.

Degradation and Stabilization of Resin-Dentine Interfaces in Polymeric Dental Adhesives: An Updated Review

Instability of the dentine-resin interface is owed to the partial/incomplete penetration of the resin adhesives in the collagen fibrils. However, interfacial hydrolysis of the resin-matrix hybrid layer complex activates the collagenolytic and esterase enzymes that cause the degradation of the hybrid layer. Adequate hybridization is often prevented due to the water trapped between the interfibrillar spaces of the collagen network. Cyclic fatigue rupture and denaturation of the exposed collagen fibrils have been observed on repeated application of masticatory forces. To prevent interfacial microstructure, various approaches have been explored. Techniques that stabilize the resin–dentine bond have utilized endogenous proteases inhibitors, cross linking agents’ incorporation in the exposed collagen fibrils, an adhesive system free of water, and methods to increase the monomer penetration into the adhesives interface. Therefore, it is important to discover and analyze the causes of interfacial degradation and discover methods to stabilize the hybrid layer to execute new technique and materials. To achieve a predictable and durable adhesive resin, restoration is a solution to the many clinical problems arising due to microleakage, loss of integrity of the restoration, secondary caries, and postoperative sensitivity. To enhance the longevity of the resin-dentine bond strength, several experimental strategies have been carried out to improve the resistance to enzymatic degradation by inhibiting intrinsic collagenolytic activity. In addition, biomimetic remineralization research has advanced considerably to contemporary approaches of both intrafibrillar and extrafibrillar remineralization of dental hard tissues. Thus, in the presence of biomimetic analog complete remineralization of collagen, fibers are identified.

New silyl-functionalized BisGMA provides autonomous strengthening without leaching for dental adhesives

Resin-based composite has overtaken dental amalgam as the most popular material for direct restorative dentistry. In spite of this popularity the clinical lifetime of composite restorations is threatened by recurrent decay. Degradation of the adhesive leads to gaps at the composite/tooth interface-bacteria, bacterial by-products and fluids infiltrate the gaps leading to recurrent decay and composite restoration failure. The durability of resin-dentin bonds is a major problem. We address this problem by synthesizing silyl-functionalized BisGMA (e.g., silyl-BisGMA), formulating dental adhesives with the new monomer and determining the physicochemical properties and leaching characteristics of the silyl-BisGMA adhesives. Silyl-BisGMA was synthesized by stoichiometric amounts of BisGMA and 3-isocyanatopropyl trimethoxysilane (IPTMS). The control adhesive was a mixture based on HEMA/BisGMA (45/55, w/w). In the experimental formulations, BisGMA was partially or completely replaced by silyl-BisGMA. Water miscibility, polymerization behavior (Fourier transform infrared spectroscopy, FTIR), thermal property (modulated differential scanning calorimetry, MDSC), mechanical properties in dry and wet conditions (dynamic mechanical analysis, DMA), and leached species (HPLC) were investigated. Data from all tests were submitted to appropriate statistical analysis (α = 0.05). Silyl-BisGMA-containing adhesives exhibited comparable water miscibility, lower viscosities, and significantly improved degree of conversion of CC bond as compared to the control. After 4 weeks aqueous aging, the glass transition temperature and rubbery moduli of the experimental copolymers were significantly greater than the control (p < 0.05). HPLC results indicated a substantial reduction of leached HEMA (up to 99 wt%) and BisGMA (up to 90 wt%). By introducing silyl-functional group, the new BisGMA derivative exhibited potential as a monomer that can lead to dental adhesives with improved mechanical properties and reduced leaching under conditions relevant to the oral environment. STATEMENT OF SIGNIFICANCE: The low-viscosity adhesive that bonds the composite to the tooth (enamel and dentin) is intended to seal and stabilize the composite/tooth interface, but it degrades leading to a breach at the composite/tooth margin. As the most popular crosslinking monomer in adhesives, Bisphenol A-glycerolate dimethacrylate (BisGMA) has limitations, e.g. susceptible to hydrolysis and concomitant property degradation. A methoxysilyl-functionalized BisGMA derivative (silyl-BisGMA) was introduced in this work to respond to these limitations. Our results indicated that by introducing silyl-BisGMA, higher crosslinked networks were obtained without sacrificing the homogeneity, and the leached amount of HEMA was reduced up to 99%. This novel resin offers potential benefits including prolonging the functional lifetime of dental resin materials.

Modulating pH through lysine integrated dental adhesives

OBJECTIVES

The objective of this study was to explore the effect of lysine integration to dental adhesives with respect to the polymerization kinetics, neutralization capacities in the acidic microenvironment, dynamic mechanical properties, and thermal properties.

MATERIALS AND METHOD

Lysine was incorporated into liquid resin formulations at 2.5 and 5.0wt % with additional water/ethanol co-solvents. The co-monomer system contained 2-hydroxyethyl-methacrylate (HEMA) and Bisphenol A glycerolate dimethacrylate (BisGMA) with a mass ratio of 45/55. The kinetics of photopolymerization, neutralization capacities, lysine-leaching, dynamic mechanical properties and thermal properties of the control and experimental adhesives were analyzed.

RESULTS

The degree of conversion of the experimental adhesive was increased substantially at 2.5wt% lysine as compared to the control. The experimental polymers provided acute neutralization of the acidic microenvironment. Approximately half of the lysine was released from the polymer network within one month. Under dry conditions and physiologic temperatures, the incorporation of lysine did not compromise the storage modulus. Comparison of the thermal properties suggests that the more compact structure of the control adhesive inhibits movement of the polymer chains resulting in increased T_g.

SIGNIFICANCE

Incorporating lysine in the adhesive formulations led to promising results regarding modulating pH, which may serve as one aspect of a multi-spectrum approach for enhancing the durability of composite restorations. The results provide insight and lay a foundation for incorporating amino acids or peptides into adhesive formulations for pH modulation or desired bioactivity at the interfacial margin between the composite and tooth.

Extrafibrillar collagen demineralization-based chelate-and-rinse technique bridges the gap between wet and dry dentin bonding

Limitations associated with wet-bonding led to the recent development of a selective demineralization strategy in which dentin was etched with a reduced concentration of phosphoric acid to create exclusive extrafibrillar demineralization of the collagen matrix. However, the use of acidic conditioners removes calcium via diffusion of very small hydronium ions into the intrafibrillar collagen water compartments. This defeats the purpose of limiting the conditioner to the extrafibrillar space to create a collagen matrix containing only intrafibrillar minerals to prevent collapse of the collagen matrix. The present work examined the use of polymeric chelators (the sodium salt of polyacrylic acid) of different molecular weights to selectively demineralize extrafibrillar dentin. These polymeric chelators exhibit different affinities for calcium ions (isothermal titration calorimetry), penetrated intrafibrillar dentin collagen to different extents based on their molecular sizes (modified size-exclusion chromatography), and preserve the dynamic mechanical properties of mineralized dentin more favorably compared with completely demineralized phosphoric acid-etched dentin (nanoscopical dynamic mechanical analysis). Scanning and transmission electron microscopy provided evidence for retention of intrafibrillar minerals in dentin surfaces conditioned with polymeric chelators. Microtensile bond strengths to wet-bonded and dry-bonded dentin conditioned with these polymeric chelators showed that the use of sodium salts of polyacrylic acid for chelating dentin prior to bonding did not result in significant decline in resin-dentin bond strength. Taken together, the findings led to the conclusion that a chelate-and-rinse conditioning technique based on extrafibrillar collagen demineralization bridges the gap between wet and dry dentin bonding.

STATEMENT OF SIGNIFICANCE

The chelate-and-rinse dental adhesive bonding concept differentiates from previous research in that it is based on the size-exclusion characteristics of fibrillar collagen; molecules larger than 40kDa are prevented from accessing the intrafibrillar water compartments of the collagen fibrils. Using this chelate-and-rinse extrafibrillar calcium chelation concept, collagen fibrils with retained intrafibrillar minerals will not collapse upon air-drying. This enables adhesive infiltration into the mineral-depleted extrafibrillar spaces without relying on wet-bonding. By bridging the gap between wet and dry dentine bonding, the chelate-and-rinse concept introduces additional insight to the field by preventing exposure of endogenous proteases via preservation of the intrafibrillar minerals within a collagen matrix. If successfully validated, this should help prevent degradation of resin-dentine bonds by collagenolytic enzymes.

Engineered Peptide Repairs Defective Adhesive-Dentin Interface

Failure of dental composite restorations is primarily due to recurrent decay at the tooth-composite interface. At this interface, the adhesive and its bond with dentin is the barrier between the restored tooth and the oral environment. In vivo degradation of the bond formed at the adhesive/dentin (a/d) interface follows a cascade of events leading to weakening of the composite restoration. Here, a peptide-based approach is developed to mineralize deficient dentin matrices at the a/d interface. Peptides that have an inherent capacity to self-assemble on dentin and to induce calcium-phosphate remineralization are anchored at the interface. Distribution of adhesive, collagen, and mineral is analyzed using micro-Raman spectroscopy and fluorescence microscopy. The analysis demonstrates remineralization of the deficient dentin matrices achieved throughout the interface with homogeneous distribution of mineral. The peptide-based remineralization demonstrated here can be an enabling technology to design integrated biomaterial-tissue interfaces.

Degree of Conversion of Self-etch Adhesives: In Situ Micro-Raman Analysis

Purpose: Degree of conversion (DC) affects the physicochemical properties of dental adhesives. The aim of this study was to measure the DC within the hybrid layer of four one-step self-etch adhesives using Raman microspectroscopy. The hypothesis tested was that there was no difference among the tested adhesives.

Methods and Materials: The selected one-step self-etch adhesives (Clearfil S3 Bond Plus, I-BOND, G-BOND, and Adper Easy Bond) were applied on human dentin disks and polymerized in accordance with the manufacturers' instructions. Specimens were transversally cut to expose the bonded interfaces to the micro-Raman beam, and Raman spectra were collected along the dentin/adhesive interface. Measurements were performed at 1-μm intervals. The relative intensities of bands associated with the C=C bond (at 1640 cm−1) and an internal stable peak (1610 cm−1) were determined to calculate the degree of conversion within the hybrid layer. Data were statistically analyzed with Kolmogorov-Smirnov and Bartlett tests and Kruskal-Wallis and Mann-Whitney U-tests.

Results: The DC ranked as follows: G-BOND (93%±6%) ≥ Adper Easy Bond (92%±6%) ≥ I-BOND (89%±7%) &gt; Clearfil S3 Bond Plus (80%±14%) (p&lt;0.05).

Conclusions: Based on the results of this study, all of the tested self-etch adhesives showed a clinically acceptable DC that was material dependent.

Cross-linked dry bonding: A new etch-and-rinse technique

OBJECTIVE

To determine if acid-etched, cross-linked dentin can be dehydrated without lowering bond strength below that of cross-linked wet-bonded dentin in vitro.

METHODS

Using extracted human third molars, control acid-etched dentin was bonded with Single Bond Plus, using either the wet- or dry-bonding technique. Experimental acid-etched dentin was treated with 5mass% grape seed extract (GSE) in different solvents for 1min before undergoing wet vs dry resin-dentin bonding with Single Bond Plus. Completely demineralized dentin beams were treated with 5% GSE for 0, 1 or 10min, before measuring stiffness by 3-point flexure. Other completely demineralized beams were treated similarly and then incubated in buffer for 1 week to measure the collagen solubilization by endogenous dentin proteases.

RESULTS

24h microtensile bond strengths (μTBS) in wet and dry controls were 53.5±3.6 and 9.4±1.8MPa, respectively (p<0.05). 5% GSE in water gave μTBS of 53.7±3.4 and 39.1±9.7MPa (p<0.05), respectively, while 5% GSE in ethanol gave μTBS of 51.2±2.3 and 35.3±2.0MPa (p<0.05). 5% GSE in 5% EtOH/95% water gave wet and dry μTBS of 53.0±2.3 and 55.7±5.1MPa (p>0.05). Cross-linking demineralized dentin with 5% GSE increased stiffness of dentin and decreased collagen degradation (p<0.05).

SIGNIFICANCE

5% GSE pretreatment of acid-etched dentin for 1min permits the dentin to be completely air-dried without lowering bond strength.

Investigation of ethanol infiltration into demineralized dentin collagen fibrils using molecular dynamics simulations

The purpose of this study is to investigate the interaction of neat ethanol with bound and non-bound water in completely demineralized dentin that is fully hydrated, using molecular dynamics (MD) simulation method. The key to creating ideal resin-dentin bonds is the removal of residual free water layers and its replacement by ethanol solvent in which resin monomers are soluble, using the ethanol wet-bonding technique. The test null hypotheses were that ethanol cannot remove any collagen-bound water, and that ethanol cannot infiltrate into the spacing between collagen triple helix due to narrow interlayer spacing. Collagen fibrillar structures of overlap and gap regions were constructed by aligning the collagen triple helix of infinite length in hexagonal packing. Three layers of the water molecules were specified as the layers of 0.15-0.22nm, 0.22-0.43nm and 0.43-0.63nm from collagen atoms by investigating the water distribution surrounding collagen molecules. Our simulation results show that ethanol molecules infiltrated into the intermolecular spacing in the gap region, which increased due to the lateral shrinkage of the collagen structures in contact with ethanol solution, while there was no ethanol infiltration observed in the overlap region. Infiltrated ethanol molecules in the gap region removed residual water molecules via modifying mostly the third water layer (50% decrease), which would be considered as a loosely-bound water layer. The first and second hydration layers, which would be considered as tightly bound water layers, were not removed by the ethanol molecules, thus maintaining the helical structures of the collagen molecules.

Probing the dual function of a novel tertiary amine compound in dentin adhesive formulations

OBJECTIVES

A novel tertiary amine compound containing three methacrylate-urethane groups was synthesized for application in dentin adhesives. The synthesis, photopolymerization kinetics, and leaching were examined in an earlier study using this novel compound as the co-initiator (0.5 and 1.75wt% based on the total resin mass). The objective of this work was to investigate the potential of TUMA (8-(2-(((2-(methacryloyloxy)ethyl)carbamoyl)oxy)propyl)-6,10-dimethyl-4,12-dioxo-5,11-dioxa-3,8,13-triazapentadecane-1,15-diyl bis(2-methylacrylate)) to serve simultaneously as a co-initiator and co-monomer (15-45wt% based on the total resin mass) in dentin adhesive formulations. The polymerization kinetics, water sorption and dynamic mechanical properties of these novel formulations were determined.

MATERIALS AND METHOD

The monomer system contained Bisphenol A glycerolate dimethacrylate (BisGMA), 2-hydroxyethylmethacrylate (HEMA) and TUMA (synthesized in our lab) at the mass ratio of 45/(55-x)/x. Two photoinitiator (PI) systems were compared. One initiator system contains three components: camphorquinone (CQ), diphenyliodonium hexafluorophosphate (DPIHP) and ethyl-4-(dimethylamino) benzoate (EDMAB) and the second initiator system contains CQ and DPIHP. The control adhesive formulations are: C0-3: HEMA/BisGMA 45/55 (w/w) and 3-component PI and C0-2: HEMA/BisGMA 45/55 (w/w) and 2-component PI. These controls were used as a comparison to the experimental adhesive resins (Ex-3 or Ex-2), in which x represents the weight percentage of synthesized co-monomer (TUMA) to replace part of BisGMA. The control and experimental adhesive formulations were photo-polymerized and compared with regard to the degree of conversion (DC), polymerization rate (Rp), water sorption and dynamic mechanical analysis (DMA) under both dry and wet conditions.

RESULTS

C0-3 and Ex-3 formulations had similar DC, while the DC of Ex-2 formulation was higher than C0-2. The DC was similar when comparing the two- component with the three-component photoinitiator system when TUMA was used at the same concentration. DMA under dry conditions shows higher rubbery storage modulus for all experimental formulations, while storage modulus at rubbery region under wet conditions was decreased as compared with control (C0-3). There was no statistically significant difference for the DMA results under both dry and wet conditions when comparing two- and three-component initiator systems with the same TUMA concentration.

SIGNIFICANCE

The newly synthesized TUMA could serve simultaneously as a co-monomer and co-initiator in the absence of commercial co-initiator. This study provides information for the future development of new co-monomer/co-initiator for dentin adhesives and dental composites.

Effect of increased exposure times on amount of residual monomer released from single-step self-etch adhesives

BACKGROUND

The aim of this study was to evaluate the effect of increased exposure times on the amount of residual Bis-GMA, TEGDMA, HEMA and UDMA released from single-step self-etch adhesive systems.

METHODS

Two adhesive systems were used. The adhesives were applied to bovine dentin surface according to the manufacturer's instructions and were polymerized using an LED curing unit for 10, 20 and 40 seconds (n = 5). After polymerization, the specimens were stored in 75% ethanol-water solution (6 mL). Residual monomers (Bis-GMA, TEGDMA, UDMA and HEMA) that were eluted from the adhesives (after 10 minutes, 1 hour, 1 day, 7 days and 30 days) were analyzed by high-performance liquid chromatography (HPLC). The data were analyzed using 1-way analysis of variance and Tukey HSD tests.

RESULTS

Among the time periods, the highest amount of released residual monomers from adhesives was observed in the 10th minute. There were statistically significant differences regarding released Bis-GMA, UDMA, HEMA and TEGDMA between the adhesive systems (p&lt;0.05). There were no significant differences among the 10, 20 and 40 second polymerization times according to their effect on residual monomer release from adhesives (p&gt;0.05).

CONCLUSIONS

Increasing the polymerization time did not have an effect on residual monomer release from single-step self-etch adhesives.

The influence of water on visible-light initiated free-radical/cationic ring-opening hybrid polymerization of methacrylate/epoxy: Polymerization kinetics, crosslinking structure and dynamic mechanical properties

The objective of this study was to determine the influence of water on the polymerization kinetics, crosslinking structure and dynamic mechanical properties of methacrylate/epoxy polymers cured by visible-light initiated free-radical/cationic ring-opening hybrid polymerization. Water-containing formulations were prepared by adding ~4-7 wt% D2O depending on the water miscibility of monomer resins. The water-containing adhesives were compared with the adhesives photo-cured in the absence of water. The results show an improved degree of conversion for both methacrylates and epoxy by adding water. The rate of the epoxy cationic ring-opening reaction is increased while the rate of free radical polymerization is decreased in the presence of water. The decreased crosslinking density noted in the presence of water suggests that the chain transfer reaction between water and epoxy competes with the hydroxyl-based chain transfer mechanism. There is potential application of this visible-light initiated hybrid polymerization in biomaterials, e.g. dental restorations and tissue engineering scaffolds.

Impact of light intensity on the polymerization kinetics and network structure of model hydrophobic and hydrophilic methacrylate based dental adhesive resin

The impact of light intensity on the degree of conversion (DC), rate of polymerization and network structure was investigated for hydrophobic and hydrophilic dental adhesive resins. Two and three component photoinitiating (PI) systems were used in this study. Low light intensities had a negative impact on the polymerization efficiency for the hydrophilic resin with 2 component PI system. Incorporation of iodonium salt in the hydrophilic resin significantly improved the polymerization efficiency of the HEMA/BisGMA system and led to a substantial DC, even at low light intensities. The results suggested that shorter polymer chains were formed in the presence of iodonium salt. It appears that there is little or no impact of light intensity on the polymer structure of the 2 component PI system. Light intensity has subtle impact on the polymer structure of the 3 component PI system. In the case of the hydrophobic resin, the polymer is so highly cross-linked that the presence of shorter chains for the 3 component PI system does not cause a decrease in the glass transition temperature (T_g ) when compared to the 2 component PI system. For the hydrophilic resin, the presence of shorter polymer chains in the 3 component PI system reduces the T_g when compared with the corresponding 2 component PI system. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1666-1678, 2016.

Effect of crosslinking density of polymers and chemical structure of amine-containing monomers on the neutralization capacity of dentin adhesives

OBJECTIVES

Neutralization of the acidic micro-environment at the tooth/material interface is expected to provide enhanced durability for dental composite restorations. The objective of this study is to explore the effect of amine-containing monomer formulations and the crosslinking density of the resultant polymers on the neutralization capacity.

MATERIALS AND METHODS

The co-monomer system was varied systematically to obtain different proportions of Bisphenol A glycerolate dimethacrylate (BisGMA) and 2-hydroxyethyl methacrylate (HEMA), while maintaining a constant amount of amine-containing methacrylate monomer. A series of amine-containing monomers covering a range of pKa values were examined. Crosslinking density of formed copolymers was controlled by adjusting the weight content of the dimethacrylate monomer BisGMA. Lactic acid (LA) was used as a probe to analyze the effectiveness of the basic polymers to neutralize acid. The neutralization capacity of each amine-containing crosslinked copolymer was characterized by measuring pH as a function of time when the specimens were soaked in 1-mM LA solution, and the results were compared to the control formulations composed solely of BisGMA and HEMA. Polymer surfaces were examined using the methyl orange (MO) assay to quantify the amount of accessible amine groups.

RESULTS

For each amine-containing crosslinked co-polymer, the neutralization capacity is enhanced by decreasing crosslinking density (e.g., by reducing BisGMA concentration in the formulation). In addition, more amine groups were accessible when crosslinking density was decreased. For different amine-containing polymers with the same BisGMA concentration, the neutralization capacity is higher when the amino monomers with higher pKa values were used in the formulations.

SIGNIFICANCE

This is the first time that the neutralization capacity based on crosslinked dental polymers has been studied. The information is important for future development of durable dentin adhesives.

Development of methacrylate/silorane hybrid monomer system: Relationship between photopolymerization behavior and dynamic mechanical properties

Resin chemistries for dental composite are evolving as noted by the introduction of silorane-based composites in 2007. This shift in the landscape from methacrylate-based composites has fueled the quest for versatile methacrylate-silorane adhesives. The objective of this study was to evaluate the polymerization behavior and structure/property relationships of methacrylate-silorane hybrid systems. Amine compound ethyl-4-(dimethylamino) benzoate (EDMAB) or silane compound tris(trimethylsilyl) silane (TTMSS) was selected as coinitiators. The mechanical properties of the copolymer were improved significantly at low concentrations (15, 25, or 35 wt %) of silorane when EDMAB was used as coinitiator. The rubbery moduli of these experimental copolymers were increased by up to 260%, compared with that of the control (30.8 ± 1.9 MPa). Visible phase separation appeared in these formulations if the silorane concentrations in the formulations were 50-75 wt %. The use of TTMSS as coinitiator decreased the phase separation, but there was a concomitant decrease in mechanical properties. In the neat methacrylate formulations, the maximum rates of free-radical polymerization with EDMAB or TTMSS were 0.28 or 0.06 s(-1) , respectively. In the neat silorane resin, the maximum rates of cationic ring-opening polymerization with EDMAB or TTMSS were 0.056 or 0.087 s(-1) , respectively. The phase separation phenomenon may be attributed to differences in the rates of free-radical polymerization of methacrylates and cationic ring-opening polymerization of silorane. In the hybrid systems, free-radical polymerization initiated with EDMAB led to higher crosslink density and better mechanical properties under dry/wet conditions. These beneficial effects were, however, associated with an increase in heterogeneity in the network structure. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 841-852, 2016.

Synthesis and evaluation of a novel co-initiator for dentin adhesives: polymerization kinetics and leachables study

A new tertiary amine co-initiator (TUMA) containing three methacrylate-urethane groups was synthesized for application in dentin adhesives. The photopolymerization kinetics and leaching of unreacted components from methacrylate-based dental polymers formulated with this new co-initiator were determined. The newly synthesize co-initiator showed good chemical stability and decreased amine release from the initiator system. This study provides important information for the future development of biocompatible dentin adhesives/composites.

Visible-Light Initiated Free-Radical/Cationic Ring-Opening Hybrid Photopolymerization of Methacrylate/Epoxy: Polymerization Kinetics, Crosslinking Structure, and Dynamic Mechanical Properties

The effects of polymerization kinetics and chemical miscibility on the crosslinking structure and mechanical properties of polymers cured by visible-light initiated free-radical/cationic ring-opening hybrid photopolymerization are determined. A three-component initiator system is used and the monomer system contains methacrylates and epoxides. The photopolymerization kinetics is monitored in situ by Fourier transform infrared-attenuated total reflectance. The crosslinking structure is studied by modulated differential scanning calorimetry and dynamic mechanical analysis. X-ray microcomputed tomography is used to evaluate microphase separation. The mechanical properties of polymers formed by hybrid formed by free-radical polymerization. These investigations mark the first time that the benefits of the chain transfer reaction between epoxy and hydroxyl groups of methacrylate, on the crosslinking network and microphase separation during hybrid visible-light initiated photopolymerization, have been determined.

Polymerization behavior of hydrophilic-rich phase of dentin adhesive

The 2-fold objectives of this study were 1) to understand whether model hydrophobic- and hydrophilic-rich phase mimics of dentin adhesive polymerize similarly and 2) to determine which factor, the dimethacrylate component, bisphenol A glycerolate dimethacrylate (BisGMA) or photoinitiator concentration, has greater influence on the polymerization of the hydrophilic-rich phase mimic. Current dentin adhesives are sensitive to moisture, as evidenced by nanoleakage in the hybrid layer and phase separation into hydrophobic- and hydrophilic-rich phases. Phase separation leads to limited availability of the cross-linkable dimethacrylate monomer and hydrophobic photoinitiators within the hydrophilic-rich phase. Model hydrophobic-rich phase was prepared as a single-phase solution by adding maximum wt% deuterium oxide (D2O) to HEMA/BisGMA neat resins containing 45 wt% 2-hydroxyethyl methacrylate (HEMA). Mimics of the hydrophilic-rich phase were prepared similarly but using HEMA/BisGMA neat resins containing 95, 99, 99.5, and 100 wt% HEMA. The hydrophilic-rich mimics were prepared with standard or reduced photoinitiator content. The photoinitiator systems were camphorquinone (CQ)/ethyl 4-(dimethylamino)benzoate (EDMAB) with or without [3-(3, 4-dimethyl-9-oxo-9H-thioxanthen-2-yloxy)-2-hydroxypropyl]trimethylammonium chloride (QTX). The polymerization kinetics was monitored using a Fourier transform infrared spectrophotometer with a time-resolved collection mode. The hydrophobic-rich phase exhibited a significantly higher polymerization rate compared with the hydrophilic-rich phase. Postpolymerization resulting in the secondary rate maxima was observed for the hydrophilic-rich mimic. The hydrophilic-rich mimics with standard photoinitiator concentration but varying cross-linker (BisGMA) content showed postpolymerization and a substantial degree of conversion. In contrast, the corresponding formulations with reduced photoinitiator concentrations exhibited lower polymerization and inhibition/delay of postpolymerization within 2 h. Under conditions relevant to the wet, oral environment, photoinitiator content plays an important role in the polymerization of the hydrophilic-rich phase mimic. Since the hydrophilic-rich phase is primarily water and monomethacrylate monomer (e.g., HEMA as determined previously), substantial polymerization is important to limit the potential toxic response from HEMA leaching into the surrounding tissues.

Effects of quaternary ammonium-methacrylates on the mechanical properties of unfilled resins

OBJECTIVE

Adding antimicrobial/anti-MMP quaternary ammonium methacrylates (QAMs) to comonomer blends should not weaken the mechanical properties of dental resins. This work evaluated the degree conversion and mechanical properties of BisGMA/TEGDMA/HEMA (60:30:10) containing 0-15 mass% QAMs A-E (A: 2-acryloxyethyltrimethyl ammonium chloride; B: [3-(methacryloylamino)propyl]trimethylammonium chloride; C: [2-(methacryloxy)ethyl] trimethyl ammonium chloride; D: diallyldimethyl ammonium chloride; E: 2-(methacryloyloxy) ethyltrimethyl ammonium methyl sulfate.

METHODS

Unfilled resins with and without QAM were placed on ATR-FTIR and light-polymerized for 20s in a thin film at 30°C. Unfilled resin beams were casted from square hollow glass tubings. Half of the beams were tested after 3 days of drying (control); the other half were tested wet after 3 days of water storage.

RESULTS

Addition of QAMs in control resins significantly increased conversion 600 s after light termination, with the exception of 5% MAPTAC (p<0.05). Increase of QAM content within a formulation significantly increased conversion. Control beams gave dry Young's moduli of ∼700 MPa. Addition of 5, 10 or 15 mass% QAMs produced significant reductions in dry Young's moduli except for 5% B or C. 15 mass% A, B and C lowered the wet Young's moduli of the resin beams by more than 30%. The ultimate tensile stress (UTS) of control dry resin was 89±11 MPa. Addition of 5-10 mass% QAMs had no adverse effect on the dry UTS. After water storage, the UTS of all resin blends fell significantly (p<0.05), especially when 15 wt% QAMs was added. Control dry beams gave fracture toughness (KIC) values of 0.88±0.1 MPa m(1/2). Wet values were significantly higher at 1.02±0.06 (p<0.05). KIC of dry beams varied from 0.85±0.08 at 5% QAMs to 0.49±0.05 at 15% QAMs. Wet beams gave KIC values of 1.02±0.06 MPa m(1/2) that fell to 0.23±0.01 at 15% QAMs.

SIGNIFICANCE

Addition of 10% QAMs increased the degree of conversion of unfilled resins, but lowered wet toughness and UTS; addition of 15% QAMs lowered the mechanical properties of wet resins below acceptable levels.

Telechelic poly(2-oxazoline)s with a biocidal and a polymerizable terminal as collagenase inhibiting additive for long-term active antimicrobial dental materials

Dental repair materials face the problem that the dentin below the composite fillings is actively decomposed by secondary caries and extracellular proteases. To address this problem, poly(2-methyloxazoline) with a biocidal and a polymerizable terminal was explored as additive for a commercial dental adhesive. 2.5 wt% of the additive rendered the adhesive contact-active against Streptococcus mutans and washing with water for 101 d did not diminish this effect. The adhesive with 5 wt% additive kills S. mutans cells in the tubuli of bovine dentin. Further, the additive inhibits bacterial collagenase at 0.5 wt% and reduces activity of MMP-9. Human MMPs bound to dentin are inhibited by 96% in a medium with 5 wt% additive. Moreover, no adverse effect on the enamel/dentine shear bond strength was detected.

Effect of Double-layer Application on Dentin Bond Durability of One-step Self-etch Adhesives

Purpose

The aim of this in vitro study was 1) to analyze the influence of a double-layer application technique of four one-step self-etch adhesive systems on dentin and 2) to determine its effect on the stability of the adhesive interfaces stored under different conditions.

Materials and Methods

Four different one-step self-etch adhesives were selected for the study (iBondSE, Clearfil S3 Bond, XenoV+, and Scotchbond Universal). Adhesives were applied according to manufacturers' instructions or with a double-layer application technique (without light curing of the first layer). After bonding, resin-dentin specimens were sectioned for microtensile bond strength testing in accordance with the nontrimming technique and divided into 3 subgroups of storage: a) 24 hours (immediate bond strength, T0), b) six months (T6) in artificial saliva at 37°C, or c) five hours in 10 % NaOCl at room temperature. After storage, specimens were stressed to failure. Fracture mode was assessed under a light microscope.

Results

At T0, iBond SE showed a significant increase in microtensile bond strength when the double-application technique was applied. All adhesive systems showed reduced bond strengths after six months of storage in artificial saliva and after storage in 10% NaOCl for five hours; however at T6, iBond SE, Clearfil S3 Bond, and XenoV+ showed significantly higher microtensile bond strength results for the double-application technique compared with the single-application technique. Scotchbond Universal showed no difference between single- or double-application, irrespective of the storage conditions.

Conclusion

The results of this study show that improvements in bond strength of one-step self-etch adhesives by using the double-application technique are adhesive dependent.

Polymerization- and solvent-induced phase separation in hydrophilic-rich dentin adhesive mimic

Current dental resin undergoes phase separation into hydrophobic-rich and hydrophilic-rich phases during infiltration of the over-wet demineralized collagen matrix. Such phase separation undermines the integrity and durability of the bond at the composite/tooth interface. This study marks the first time that the polymerization kinetics of model hydrophilic-rich phase of dental adhesive has been determined. Samples were prepared by adding varying water content to neat resins made from 95 and 99 wt.% hydroxyethylmethacrylate and 5 and 1 wt.% (2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy)phenyl1]-propane prior to light curing. Viscosity of the formulations decreased with increased water content. The photopolymerization kinetics study was carried out with a time-resolved Fourier transform infrared spectrometer. All of the samples exhibited two-stage polymerization behavior which has not been reported previously for dental resin formulation. The lowest secondary rate maxima were observed for water contents of 10-30 wt.%. Differential scanning calorimetry (DSC) showed two glass transition temperatures for the hydrophilic-rich phase of dental adhesive. The DSC results indicate that the heterogeneity within the final polymer structure decreased with increasing water content. The results suggest a reaction mechanism involving both polymerization-induced phase separation and solvent-induced phase separation for the model hydrophilic-rich phase of dental resin.

Synthesis and evaluation of novel siloxane-methacrylate monomers used as dentin adhesives

OBJECTIVES

The objectives of this study were to synthesize two new siloxane-methacrylate (SM) monomers for application in dentin adhesives and to investigate the influence of different functionality of the siloxane-containing monomers on the adhesive photopolymerization, water sorption, and mechanical properties.

METHODS

Two siloxane-methacrylate monomers (SM1 and SM2) with four and eight methacrylate groups were synthesized. Dentin adhesives containing BisGMA, HEMA and the siloxane-methacrylate monomers were photo-polymerized. The experimental adhesives were compared with the control adhesive (HEMA/BisGMA, 45/55, w/w) and characterized with regard to degree of conversion (DC), water miscibility of the liquid resin, water sorption and dynamic mechanical analysis (DMA).

RESULTS

The experimental adhesives exhibited improved water miscibility as compared to the control. When cured in the presence of 12 wt% water to simulate the wet environment of the mouth, the SM-containing adhesives showed DC comparable to the control. The experimental adhesives showed higher rubbery modulus than the control under dry conditions. Under wet conditions, the mechanical properties of the formulations containing SM monomer with increased functionality were comparable with the control, even with more water sorption.

SIGNIFICANCE

The concentration and functionality of the newly synthesized siloxane-methacrylate monomers affected the water miscibility, water sorption and mechanical properties of the adhesives. The experimental adhesives show improved water compatibility compared with the control. The mechanical properties were enhanced with an increase of the functionality of the siloxane-containing monomers. The results provide critical structure/property relationships and important information for future development of durable, versatile siloxane-containing dentin adhesives.

Optimization of direct currents to enhance dentine bonding of simplified one-step adhesive

The aim of this study was to investigate the effects of different direct current intensities on dentine bonding effectiveness of Clearfil S(3) Bond and on cell viability of human dental pulp cells (HDPCs). Thirty-five-third molars were sectioned and ground to provide flat surfaces. Clearfil S(3) Bond was applied under different current conditions for 30 s and then resin composite was built up. Specimens were processed for microtensile bond strength (µTBS) testing and for nanoleakage investigation using scanning electron microscopy. Primary HDPCs isolated from premolars were stimulated with different intensities of electric current for 30 s. Then, cell viability was tested using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. Specimens bonded with application of electrical current intensities of 50, 60, 70, and 90 µA exhibited a significant increase in immediate µTBS compared with all other groups. Bonded interfaces prepared using electrically assisted current application showed reduced interfacial nanoleakage upon scanning electron microscopy. Electric current application, from 20 to 70 µA, had no effect on the viability of HDPCs. This study provides further evidence for its future clinical use.

Synthesis and evaluation of novel dental monomer with branched carboxyl acid group

To enhance the water miscibility and increase the mechanical properties of dentin adhesives, a new glycerol-based monomer with vinyl and carboxylic acid, 4-((1,3-bis(methacryloyloxy)propan-2-yl)oxy)-2-methylene-4-oxobutanoic acid (BMPMOB), was synthesized and characterized. Dentin adhesive formulations containing 2-hydroxyethyl methacrylate (HEMA), 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy) phenyl]propane (BisGMA), and BMPMOB were characterized with regard to real-time photopolymerization behavior, water sorption, dynamic mechanical analysis, and microscale three-dimensional internal morphologies and compared with HEMA/BisGMA controls. The experimental adhesive copolymers showed higher glass transition temperature and rubbery moduli, as well as improved water miscibility compared to the controls. The enhanced properties of the adhesive copolymers indicated that BMPMOB is a promising comonomer for dental restorative materials.

Multivariate analysis of attenuated total reflection Fourier transform infrared (ATR FT-IR) spectroscopic data to confirm phase partitioning in methacrylate-based dentin adhesive

Water is ubiquitous in the mouths of healthy individuals and is a major interfering factor in the development of a durable seal between the tooth and composite restoration. Water leads to the formation of a variety of defects in dentin adhesives; these defects undermine the tooth-composite bond. Our group recently analyzed phase partitioning of dentin adhesives using high-performance liquid chromatography (HPLC). The concentration measurements provided by HPLC offered a more thorough representation of current adhesive performance and elucidated directions to be taken for further improvement. The sample preparation and instrument analysis using HPLC are, however, time-consuming and labor-intensive. The objective of this work was to develop a methodology for rapid, reliable, and accurate quantitative analysis of near-equilibrium phase partitioning in adhesives exposed to conditions simulating the wet oral environment. Analysis by Fourier transform infrared (FT-IR) spectroscopy in combination with multivariate statistical methods, including partial least squares (PLS) regression and principal component regression (PCR), were used for multivariate calibration to quantify the compositions in separated phases. Excellent predictions were achieved when either the hydrophobic-rich phase or the hydrophilic-rich phase mixtures were analyzed. These results indicate that FT-IR spectroscopy has excellent potential as a rapid method of detection and quantification of dentin adhesives that experience phase separation under conditions that simulate the wet oral environment.

Hydrolytic stability of three-step etch-and-rinse adhesives in occlusal class-I cavities

OBJECTIVES

A dental adhesive without small and hydrophilic monomers such as 2-hydroxyethyl methacrylate (HEMA) and triethylene glycol dimethacrylate (TEGDMA) would be beneficial in order to avoid contact allergies. However, these monomers are important to increase infiltration and polymerization of the adhesive. Therefore, the purpose of this study was to evaluate the bonding effectiveness and bond durability of a more hydrophobic and biocompatible adhesive as compared to a conventional three-step etch-and-rinse adhesive.

METHODS

Sixteen non-carious human third molars were used to determine the micro-tensile bond strength testing (μTBS) and interfacial ultrastructure by transmission electron microscopy (TEM) of the more hydrophobic cmf adhesive system (Saremco) adhesive as compared to the control OptiBond FL (Kerr).

RESULTS

The more hydrophobic and biocompatible three-step etch-and-rinse adhesive was able to produce a reasonable short-time bonding effectiveness. In the long term, the collagen fibrils in the hybrid layer were not effectively protected and were prone to hydrolytic degradation. As a result, long-term bonding effectiveness of this novel adhesive was very low.

CONCLUSIONS

Application of a more hydrophobic adhesive without altering the application procedure considerably results in a reduced durability of the created bond

CLINICAL RELEVANCE

Omitting small and hydrophilic components from the adhesive formulation may impair the durability of your composite restoration.

Diffusion coefficients of water and leachables in methacrylate-based crosslinked polymers using absorption experiments

The diffusion of water into dentin adhesive polymers and leaching of unpolymerized monomer from the adhesive are linked to their mechanical softening and hydrolytic degradation. Therefore, diffusion coefficient data are critical for the mechanical design of these polymeric adhesives. In this study, diffusion coefficients of water and leachables were obtained for sixteen methacrylate-based crosslinked polymers using absorption experiments. The experimental mass change data was interpreted using numerical solution of the two-dimensional diffusion equations. The calculated diffusion coefficients varied from 1.05 × 10(-8) cm(2)/sec (co-monomer TMTMA) to 3.15 × 10(-8) cm(2)/sec (co-monomer T4EGDMA). Correlation of the diffusion coefficients with crosslink density and hydrophilicity showed an inverse trend (R(2) = 0.41). The correlation of diffusion coefficient with crosslink density and hydrophilicity are closer for molecules differing by simple repeat units (R(2) = 0.95). These differences in the trends reveal mechanisms of interaction of the diffusing water with the polymer structure.

Characterization of micro- and nanophase separation of dentin bonding agents by stereoscopy and atomic force microscopy

The aim was to study the effect of solvents on the phase separation of four commercial dental adhesives. Four materials were tested: Clearfil™ SE Bond (CSE), Clearfil Protect Bond (CPB), Clearfil S3 Bond (CS3), and One-Up Bond F Plus (OUB). Distilled water or ethanol was used as a solvent (30 vol%) for microphase separation studies, by stereoscopy. For nanophase images, the mixtures were formulated with two different solvent concentrations (2.5 versus 5 vol%) and observed by atomic force microscopy. Images were analyzed by using MacBiophotonics ImageJ to measure the area of bright domains. Macrophase separations, identified as a loss of clarity, were only observed after mixing the adhesives with water. Nanophase separations were detected with all adhesive combinations. The area of bright domains ranged from 132 to 1,145 nm² for CSE, from 15 to 285 nm² for CPB, from 149 to 380 nm² for CS3, and from 26 to 157 nm² for OUB. In water-resins mixtures, CPB was the most homogeneous and OUB showed the most heterogeneous phase formation. In ethanol-resin mixtures, CSE attained the most homogeneous structure and OUB showed the most heterogeneous phase. Addition of 5 vol% ethanol to resins decreased the nanophase separation when compared with the control materials.

Quantitative analysis of aqueous phase composition of model dentin adhesives experiencing phase separation

There have been reports of the sensitivity of our current dentin adhesives to excess moisture, for example, water-blisters in adhesives placed on over-wet surfaces, and phase separation with concomitant limited infiltration of the critical dimethacrylate component into the demineralized dentin matrix. To determine quantitatively the hydrophobic/hydrophilic components in the aqueous phase when exposed to over-wet environments, model adhesives were mixed with 16, 33, and 50 wt % water to yield well-separated phases. Based upon high-performance liquid chromatography coupled with photodiode array detection, it was found that the amounts of hydrophobic BisGMA and hydrophobic initiators are less than 0.1 wt % in the aqueous phase. The amount of these compounds decreased with an increase in the initial water content. The major components of the aqueous phase were hydroxyethyl methacrylate (HEMA) and water, and the HEMA content ranged from 18.3 to 14.7 wt %. Different BisGMA homologues and the relative content of these homologues in the aqueous phase have been identified; however, the amount of crosslinkable BisGMA was minimal and, thus, could not help in the formation of a crosslinked polymer network in the aqueous phase. Without the protection afforded by a strong crosslinked network, the poorly photoreactive compounds of this aqueous phase could be leached easily. These results suggest that adhesive formulations should be designed to include hydrophilic multimethacrylate monomers and water compatible initiators.

Durable bonds at the adhesive/dentin interface: an impossible mission or simply a moving target?

Composite restorations have higher failure rates, more recurrent caries and increased frequency of replacement as compared to dental amalgam. Penetration of bacterial enzymes, oral fluids, and bacteria into the crevices between the tooth and composite undermines the restoration and leads to recurrent decay and failure. The gingival margin of composite restora tions is particularly vulnerable to decay and at this margin, the adhesive and its seal to dentin provides the primary barrier between the prepared tooth and the environment. The intent of this article is to examine physico-chemical factors that affect the integrity and durability of the adhesive/dentin interfacial bond; and to explore how these factors act synergistically with mechanical forces to undermine the composite restoration. The article will examine the various avenues that have been pursued to address these problems and it will explore how alterations in material chemistry could address the detrimental impact of physico-chemical stresses on the bond formed at the adhesive/dentin interface.

Synthesis and evaluation of novel dental monomer with branched aromatic carboxylic acid group

A new glycerol-based dimethacrylate monomer with an aromatic carboxylic acid, 2-((1,3-bis(methacryloyloxy)propan-2-yloxy)carbonyl)benzoic acid (BMPB), was synthesized, characterized, and proposed as a possible dental co-monomer for dentin adhesives. Dentin adhesives containing 2-hydroxyethyl methacrylate (HEMA) and 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy) phenyl]propane (BisGMA) in addition to BMPB were formulated with water at 0, 5, 10, and 15 wt % to simulate wet, oral conditions, and photo-polymerized. Adhesives were characterized with regard to viscosity, real-time photopolymerization behavior, dynamic mechanical analysis, and microscale 3D internal morphologies and compared with HEMA/BisGMA controls. When formulated under wet conditions, the experimental adhesives showed lower viscosities (0.04-0.07 Pa s) as compared to the control (0.09-0.12 Pa s). The experimental adhesives showed higher glass transition temperature (146-157°C), degree of conversion (78-89%), and rubbery moduli (33-36 MPa), and improved water miscibility (no voids) as compared to the controls (123-135°C, 67-71%, 15-26 MPa, and voids, respectively). The enhanced properties of these adhesives suggest that BMPB with simple, straightforward synthesis is a promising photocurable co-monomer for dental restorative materials.

Improved dental adhesive formulations based on reactive nanogel additives

Current challenges in adhesive dentistry include over-hydrophilic bonding formulations, which facilitate water percolation through the hybrid layer and result in unreliable bonded interfaces. This study introduces nanogel-modified adhesives as a way to control the material's hydrophobic character without changing the basic monomer formulation (keeping water-chasing capacity and operatory techniques unaltered). Nanogel additives of varied hydrophobicity were synthesized in solution, rendering 10- to 100-nm-sized particles. A model BisGMA/HEMA solvated adhesive was prepared (control), to which reactive nanogels were added. The increase in adhesive viscosity did not impair solvent removal by air-thinning. The degree of conversion in the adhesive was similar between control and nanogel-modified materials, while the bulk dry and, particularly, the wet mechanical properties were significantly improved through nanogel-based network reinforcement and reduced water solubility. As preliminary validation of this approach, short-term micro-tensile bond strengths to acid-etched and primed dentin were significantly enhanced by nanogel inclusion in the adhesive resins.

Ternary phase diagram of model dentin adhesive exposed to over-wet environments

When adhesives and/or composites are bonded to the tooth, water in the environment can interfere with proper interface formation. Formation of water blisters and phase separation at the adhesive/dentin interface have appeared as new types of bond defects. To better understand this problem, we determined the near-equilibrium partition of the hydrophobic/hydrophilic components when exposed to over-wet environments. Model methacrylate-based adhesives were mixed with different amounts of water to yield well-separated aqueous and resin phases. It was found that less than 0.1% BisGMA but nearly one-third of the HEMA diffused into the aqueous phase, leaving the remaining resin phase relatively hydrophobic. A partial phase diagram was created for the ternary BisGMA/HEMA/water system. All the experimental phase partitioning data were plotted, and the points lay on a binodal curve that separated the single-phase region from the two-phase region. We obtained the 3 tie lines by connecting the 2 points of each conjugate pair of the phase partitioning data from the 3 sets of tripartite mixtures. Information about solubility, water miscibility, distribution ratio, and phase partitioning behavior could be obtained quantitatively. This type of phase diagram will provide a more thorough understanding of current adhesive performance and elucidate directions for further improvement.

Limitations in bonding to dentin and experimental strategies to prevent bond degradation

The limited durability of resin-dentin bonds severely compromises the lifetime of tooth-colored restorations. Bond degradation occurs via hydrolysis of suboptimally polymerized hydrophilic resin components and degradation of water-rich, resin-sparse collagen matrices by matrix metalloproteinases (MMPs) and cysteine cathepsins. This review examined data generated over the past three years on five experimental strategies developed by different research groups for extending the longevity of resin-dentin bonds. They include: (1) increasing the degree of conversion and esterase resistance of hydrophilic adhesives; (2) the use of broad-spectrum inhibitors of collagenolytic enzymes, including novel inhibitor functional groups grafted to methacrylate resins monomers to produce anti-MMP adhesives; (3) the use of cross-linking agents for silencing the activities of MMP and cathepsins that irreversibly alter the 3-D structures of their catalytic/allosteric domains; (4) ethanol wet-bonding with hydrophobic resins to completely replace water from the extrafibrillar and intrafibrillar collagen compartments and immobilize the collagenolytic enzymes; and (5) biomimetic remineralization of the water-filled collagen matrix using analogs of matrix proteins to progressively replace water with intrafibrillar and extrafibrillar apatites to exclude exogenous collagenolytic enzymes and fossilize endogenous collagenolytic enzymes. A combination of several of these strategies should result in overcoming the critical barriers to progress currently encountered in dentin bonding.

The inhibitory effects of quaternary ammonium methacrylates on soluble and matrix-bound MMPs

Matrix metalloproteinases (MMPs) bound to dentin contribute to the progressive degradation of collagen fibrils in hybrid layers created by dentin adhesives. This study evaluated the MMP-inhibiting potential of quaternary ammonium methacrylates (QAMs), with soluble rhMMP-9 and a matrix-bound endogenous MMP model. Six different QAMs were initially screened by a rhMMP-9 colorimetric assay. For the matrix-bound endogenous MMPs, we aged demineralized dentin beams for 30 days in calcium- and zinc-containing media (CM; control), chlorhexidine, or QAMs in CM to determine the changes in dry mass loss and solubilization of collagen peptides against baseline levels. The inhibitory effects of QAMs on soluble rhMMP-9 varied between 34 and 100%. Beams incubated in CM showed a 29% decrease in dry mass (p < 0.05), whereas beams incubated with QAMs showed only 0.2%-6% loss of dry mass. Significantly more solubilized collagen was detected from beams incubated in CM (p < 0.05). It is concluded that QAMs exhibited dentin MMP inhibition comparable with that of chlorhexidine, but required higher concentrations.

Imperfect hybrid layers created by an aggressive one-step self-etch adhesive in primary dentin are amendable to biomimetic remineralization in vitro

Degradation of hybrid layers created in primary dentin occurs as early as 6 months in vivo. Biomimetic remineralization utilizes "bottom-up" nanotechnology principles for interfibrillar and intrafibrillar remineralization of collagen matrices. This study examined whether imperfect hybrid layers created in primary dentin can be remineralized. Coronal dentin surfaces were prepared from extracted primary molars and bonded using Adper Prompt L-Pop and a composite. One-millimeter-thick specimen slabs of the resin-dentin interface were immersed in a Portland cement-based remineralization medium that contained two biomimetic analogs to mimic the sequestration and templating functions of dentin noncollagenous proteins. Specimens were retrieved after 1-6 months. Confocal laser scanning microscopy was used for evaluating the permeability of hybrid layers to Rhodamine B. Transmission electron microscopy was used to examine the status of remineralization within hybrid layers. Remineralization at different locations of the hybrid layers corresponded with quenching of fluorescence within similar locations of those hybrid layers. Remineralization was predominantly intrafibrillar in nature as interfibrillar spaces were filled with adhesive resin. Biomimetic remineralization of imperfect hybrid layers in primary human dentin is a potential means for preserving bond integrity. The success of the current proof-of-concept, laterally diffusing remineralization protocol warrants development of a clinically applicable biomimetic remineralization delivery system.

Effect of Oxalate Desensitizer on the Durability of Resin-Bonded Interfaces

Despite oxalate desensitizer showing a decrease in the rate of resin-dentin bond degradation over time, it compromised the baseline bond strength of etch-and-rinse adhesives to dentin. Further investigation regarding reliability of the combination of oxalate desensitizers and etch-and-rinse adhesives is required prior to implementation of this approach in the clinical routine.

Ethanol wet-bonding challenges current anti-degradation strategy

The long-term effectiveness of chlorhexidine as a matrix metalloproteinase (MMP) inhibitor may be compromised when water is incompletely removed during dentin bonding. This study challenged this anti-bond degradation strategy by testing the null hypothesis that wet-bonding with water or ethanol has no effect on the effectiveness of chlorhexidine in preventing hybrid layer degradation over an 18-month period. Acid-etched dentin was bonded under pulpal pressure simulation with Scotchbond MP and Single Bond 2, with water wet-bonding or with a hydrophobic adhesive with ethanol wet-bonding, with or without pre-treatment with chlorhexidine diacetate (CHD). Resin-dentin beams were prepared for bond strength and TEM evaluation after 24 hrs and after aging in artificial saliva for 9 and 18 mos. Bonds made to ethanol-saturated dentin did not change over time with preservation of hybrid layer integrity. Bonds made to CHD pre-treated acid-etched dentin with commercial adhesives with water wet-bonding were preserved after 9 mos but not after 18 mos, with severe hybrid layer degradation. The results led to rejection of the null hypothesis and highlight the concept of biomimetic water replacement from the collagen intrafibrillar compartments as the ultimate goal in extending the longevity of resin-dentin bonds.

The effect of ageing on the elastic modulus and degree of conversion of two multistep adhesive systems

During the curing reaction, the monomers of dentine bonding systems should cross-link sufficiently to strengthen an adhesive so that it is clinically reliable. This study evaluated how different storage conditions (air vs. water storage) affect the elastic modulus (E-modulus) and degree of conversion (DC) of a three-step etch-and-rinse adhesive and a two-step self-etch adhesive. The biaxial flexural test and Raman microscopy were performed on resin disks made from the bonding agents Adper Scotchbond Multi-Purpose (SBMP; 3M ESPE) and Clearfil Protect Bond (CPB; Kuraray). The measurements were repeated after storage in either air or water for 15 and 30 min and for 1, 24, and 72 h. At time 0, the E-modulus was not affected by the adhesive system, whilst the degree of cure of CPB was higher than that of SBMP. Air storage increased the E-modulus at each ageing interval. Storage in water increased the E-modulus until it reached a maximum at 24 h, after which it decreased significantly at 72 h. No linear correlation between the percentage DC and E-modulus of the two adhesives was found when stored in water. The results of this study indicate that the mechanical properties and polymerization kinetics of SBMP and CPB are affected by storage time and medium.

Chlorhexidine binding to mineralized versus demineralized dentin powder

OBJECTIVES

The purposes of this work were to quantitate the affinity and binding capacity of chlorhexidine (CHX) digluconate to mineralized versus demineralized dentin powder and to determine how much debinding would result from rinsing with water, ethanol, hydroxyethylmethacrylate (HEMA) or 0.5M NaCl in water.

METHODS

Dentin powder was made from coronal dentin of extracted human third molars. Standard amounts of dentin powder were tumbled with increasing concentrations of CHX (0-30 mM) for 30 min at 37 degrees C. After centrifuging the tubes, the supernatant was removed and the decrease in CHX concentration quantitated by UV-spectroscopy. CHX-treated dentin powder was resuspended in one of the four debinding solutions for 3 min. The amount of debound CHX in the solvents was also quantitated by UV-spectroscopy.

RESULTS

As the CHX concentration in the medium increased, the CHX binding to mineralized dentin powder also increased up to 6.8 micromol/g of dry dentin powder. Demineralized dentin powder took up significantly (p<0.01) more CHX, reaching 30.1 micromol CHX/g of dry dentin powder. Debinding of CHX was in the order: HEMA

SIGNIFICANCE

As CHX is not debound by HEMA, it may remain bound to demineralized dentin during resin-dentin bonding. This may be responsible for the long-term efficacy of CHX as an MMP inhibitor in resin-dentin bonds.

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Key Words

• chlorhexidine
• binding
• debinding
• dentin bonding

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MESH Headings

• Anti-Infective Agents, Local/pharmacokinetics
• Anti-Infective Agents, Local/pharmacology
• Chlorhexidine/analogs & derivatives
• Chlorhexidine/pharmacokinetics
• Chlorhexidine/pharmacology
• Collagen/metabolism
• Dental Bonding
• Dentin/metabolism
• Durapatite
• Ethanol
• Humans
• Hydrogen Bonding
• Linear Models
• Matrix Metalloproteinase Inhibitors
• Methacrylates
• Protease Inhibitors/pharmacology
• Protein Binding
• Resin Cements/chemistry
• Sodium Chloride
• Solubility
• Spectroscopy, Fourier Transform Infrared
• Tooth Demineralization/metabolism
• Water

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Grants

• R01 DE015306 NIDCR NIH HHS
• R01 DE015306-06A1 NIDCR NIH HHS
• R01 DE015306-06 NIDCR NIH HHS

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Affiliation(s)

Jongryul Kim Department of Conservative Dentistry, School of Dentistry, Kyung Hee National University, Seoul, Republic of Korea
Toshikazu Uchiyama Department of Regenerative Dentistry, Nihon University School of Dentistry at Matsuso, Chiba, Japan
Marcela Carrilho GEO/UNIBAN, Health Institute, Bandeirante University of São Paulo, Brazil and Department of Dental Materials and Oral Biochemistry, University of São Paulo, School of Dentistry, São Paulo/SP, Brazil
Kelli A. Agee Medical College of Georgia, School of Dentistry, Medical College of Georgia, Augusta, Georgia, USA
Annalisa Mazzoni Department of SAU & FAL, University of Bologna, Bologna, Italy
Lorenzo Breschi Department of Biomedicine, University of Trieste + IGM-CNR, Unit of Bologna, c/o IOR, Bologna, Italy
Ricardo M. Carvalho Department of Operative Dentistry, College of Dentistry, University of Florida, Gainesville, Florida, USA
Leo Tjäderhane Institute of Dentistry, University of Oulu and Oulu University Hospital, Oulu, Finland
Stephen Looney Department of Biostatistics, Medical College of Georgia, Augusta, Georgia, USA
Courtney Wimmer Department of Biostatistics, Medical College of Georgia, Augusta, Georgia, USA
Arzu Tezvergil-Mutluay Department of Prosthodontics, School of Dentistry, University of Turku, Turku, Finland
Franklin R. Tay Department of Endodontics, School of Dentistry, Medical College of Georgia, Augusta, Georgia, USA
David H. Pashley Medical College of Georgia, School of Dentistry, Medical College of Georgia, Augusta, Georgia, USA

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