The effect of antibacterial agents on fissure sealant microleakage: a 6-month in vitro study

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

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

Effect of an Antibacterial Monomer on the Antibacterial Activity of a Pit-and-Fissure Sealant

Resin-based pit-and-fissure sealants are often used to form a barrier on the occlusal surface of molars to treat caries lesions; however, bacteria can remain in the pit and fissures without detection, increasing the risk of secondary caries. Sealants with antimicrobial properties or microbial repellent actions might be advantageous. The aim of this study was to assess the inhibitory effect of a 2-methacryloxylethyl dodecyl methyl ammonium bromide (MAE-DB)-incorporated sealant against Streptococcus mutans. MAE-DB (4% wt) was incorporated into a commercially available sealant, Eco-S resin-based pit-and-fissure sealant (Vericom Co., Ltd., Korea); a sealant without MAE-DB served as a negative control, and Clinpro™ Sealant (3M™ ESPE™), a fluoride-releasing resin, was used as a commercial control. The effects of the cured sealants and their eluents on the growth of S. mutans were determined according to colony-forming unit counts and metabolic tests. The effects of the cured sealants on the adherence and membrane integrity of S. mutans were investigated using confocal laser-scanning microscopy (CLSM) in conjunction with fluorescent indicators. Compared with the negative control and commercial control, the cured MAE-DB-incorporated pit-and-fissure sealant exhibited a significant inhibitory effect on the growth of S. mutans (P < 0.05), whereas the eluents did not show any detectable antibacterial activity. The commercial control also showed no detectable bactericidal activity. Moreover, the aged experimental material retained its property of contact inhibition of biofilm formation. The fluorescence analysis of CLSM images demonstrated that the cured MAE-DB-incorporated sealant could hamper the adherence of S. mutans and exert a detrimental effect on bacterial membrane integrity. The incorporation of MAE-DB can render a pit-and-fissure sealant with contact antibacterial activity after polymerization via influencing the growth, adherence, and membrane integrity of S. mutans. Therefore, MAE-DB-containing pit-and-fissure sealant shows promise for preventing or controlling dental caries on occlusal pit and fissures of molars.

Antibacterial activity of a modified unfilled resin containing a novel polymerizable quaternary ammonium salt MAE-HB

Resins with strong and long-lasting antibacterial properties are critical for the prevention of secondary dental caries. In this study, we evaluated the antibacterial effect and the underlying mechanism of action of an unfilled resin incorporating 2-methacryloxylethyl hexadecyl methyl ammonium bromide (MAE-HB) against Streptococcus mutans UA159 (S. mutans UA159). MAE-HB was added into unfilled resin at 10 mass%, and unfilled resin without MAE-HB served as the control. Bacterial growth was inhibited on 10%-MAE-HB unfilled resin compared with the control at 1 d, 7 d, 30 d, or 180 d (P < 0.05). The growth inhibitory effect was independent of the incubation time (P > 0.05). No significant differences in the antibacterial activities of eluents from control versus 10%-MAE-HB unfilled resins were observed at any time point (P > 0.05). The number of bacteria attached to 10%-MAE-HB unfilled resin was considerably lower than that to control. Fe-SEM and CLSM showed that 10%-MAE-HB unfilled resin disturbed the integrity of bacterial cells. Expression of the bacterial glucosyltransferases, gtfB and gtfC, was lower on 10%-MAE-HB unfilled resin compared to that on control (P < 0.05). These data indicate that incorporation of MAE-HB confers unfilled resin with strong and long-lasting antibacterial effects against S. mutans.