Antimicrobial, biocompatibility, and physicochemical properties of novel adhesive methacrylate dental monomers

For the advancement of Class V restoratives, our goal was to evaluate the physicochemical and mechanical properties, antimicrobial functionality, and cytotoxic potential of novel antimicrobial copolymers. 5-Carboxy-N-(2-(methacryloyloxy)ethyl)-N,N-dimethylpentan-1-aminium bromide (AMadh1) and 10-carboxy-N-(2-(methacryloyloxy)ethyl)-N,N-dimethyldecan-1-aminium bromide (AMadh2) were incorporated into light-curable urethane dimethacrylate, polyethylene glycol–extended urethane dimethacrylate, ethyl 2-(hydroxymethyl) acrylate resin (UPE resin). In the AMadhs-UPE resin, the hydrophobic/hydrophilic balance, degree of vinyl conversion, flexural strength, elastic modulus, and shear bond strength were assessed. Antimicrobial properties were measured using Streptococcus mutans (planktonic and biofilm). Cytotoxicity was tested using human gingival fibroblasts and mouse connective tissue fibroblasts (ATCC® CCL-1™) exposed to two-fold serial dilutions (≤10.6 mmol/L AMadh1 or ≤8.8 mmol/L AMadh2). At 10% mass of AMadh, the attained degree of vinyl conversion values (AMadh1 = 90.1% and AMadh2 = 88.5%) were not statistically different from the UPE resin (88.1%). At both AMadh levels, the flexural strength was reduced in a dose-dependent manner. Elastic modulus and contact angle were not significantly affected by AMadh1. Variations in elastic modulus and contact angle were observed with AMadh2; however, this does not disqualify it in future design of Class V restoratives. Compared to UPE resin, AMadh1-UPE and AMadh2-UPE (10% mass) copolymers reduced S. mutans biofilm 4.2- and 1.6-fold, respectively (p ≤ 0.006). In direct contact with human gingival fibroblasts or ATCC CCL-1 cells, at biologically relevant concentrations, the AMadhs did not adversely affect cell viability or their metabolic activity. This effort addresses a significant oral health issue associated with elderly populations. Its successful completion is expected to yield dental restoratives with well-controlled biofunction.

Physicochemical, Mechanical, and Antimicrobial Properties of Novel Dental Polymers Containing Quaternary Ammonium and Trimethoxysilyl Functionalities

The aims of this study were to evaluate the physicochemical and mechanical properties, antimicrobial (AM) functionality, and cytotoxic potential of novel dental polymers containing quaternary ammonium and trimethoxysilyl functionalities (e.g., N-(2-(methacryloyloxy)ethyl)-N,N-dimethyl-3-(trimethoxysilyl)propan-1-aminium iodide (AMsil1) and N-(2-(methacryloyloxy)ethyl)-N,N-dimethyl-11-(trimethoxysilyl)undecan-1-aminium bromide (AMsil2)). AMsil1 or AMsil2 were incorporated into light-cured (camphorquinone + ethyl-4-N,N-dimethylamino benzoate) urethane dimethacrylate (UDMA)/polyethylene glycol-extended UDMA/ethyl 2-(hydroxymethyl)acrylate (EHMA) resins (hereafter, UPE resin) at 10 or 20 mass %. Cytotoxic potential was assessed by measuring viability and metabolic activity of immortalized mouse connective tissue and human gingival fibroblasts in direct contact with monomers. AMsil-UPE resins were evaluated for wettability by contact angle measurements and degree of vinyl conversion (DVC) by near infra-red spectroscopy analyses. Mechanical property evaluations entailed flexural strength (FS) and elastic modulus (E) testing of copolymer specimens. The AM properties were assessed using Streptococcus mutans (planktonic and biofilm forms) and Porphyromonas gingivalis biofilm. Neither AMsil exhibited significant toxicity in direct contact with cells at biologically relevant concentrations. Addition of AMsils made the UPE resin more hydrophilic. DVC values for the AMsil-UPE copolymers were 2%-31% lower than that attained in the UPE resin control. The mechanical properties (FS and E) of AMsil-UPE specimens were reduced (11%-57%) compared to the control. Compared to UPE resin, AMsil1-UPE and AMsil2-UPE (10% mass) copolymers reduced S. mutans biofilm 4.7- and 1.7-fold, respectively (p ≤ 0.005). Although not statistically different, P. gingivalis biofilm biomass on AMsil1-UPE and AM AMsil2-UPE copolymer disks were lower (71% and 85%, respectively) than that observed with a commercial AM dental material. In conclusion, the AM function of new monomers is not inundated by their toxicity towards cells. Despite the reduction in mechanical properties of the AMsil-UPE copolymers, AMsil2 is a good candidate for incorporation into multifunctional composites due to the favorable overall hydrophilicity of the resins and the satisfactory DVC values attained upon light polymerization of AMsil-containing UDMA/PEG-U/EHMA copolymers.

Ionic Dimethacrylates for Antimicrobial and Remineralizing Dental Composites

Two ionic dimethacrylates (IDMA1 and IDMA2) intended for utilization in multifunctional, antibacterial and remineralizing dental resins and composites were synthesized by nucleophilic substitution reactions. Crude IDMAs were purified by multi-step extraction from ethanol-diethyl ether-hexane solvent system. Their structures were validated by nuclear magnetic resonance and mass spectrometry. As evidenced by the water contact angle measurements ((63.2-65.5)⁰), IDMAs did not affect the wettability of urethane dimethacrylate (UDMA)- based copolymers (average contact angle ((60.8±5.1)⁰).The attained degrees of vinyl conversion increased from 88.1% (no-IDMA control) up to 93.0% (IDMA2 series). Flexural strength (FS) of copolymers was reduced from 94.8 MPa (control) to (68.9-71.8) MPa (IDMA counterparts) independent of monomer type and/or its concentration. This reduction in FS should not disqualify IDMAs from consideration as viable antibacterial agents in multifunctional restoratives. Tested at concentrations exceeding the expected leachability of unreacted monomers from cured copolymers and/or composites, IDMAs had no deleterious effect on viability and/or metabolic activity of fibroblasts. The remineralization potential of amorphous calcium phosphate IDMA/UDMA composites was confirmed by calcium and phosphate ion release kinetic experiments. Results of this study warrant in-depth biological, physicochemical, mechanical and antibacterial assessments of IDMA resins and composites to identify prototype(s) suitable for clinical testing.

Antimicrobial Monomers for Polymeric Dental Restoratives: Cytotoxicity and Physicochemical Properties

A trend for the next generation of polymeric dental restoratives is to incorporate multifunctional capabilities to regulate microbial growth and remineralize tooth surfaces. Polymerizable 2-(methacryloyloxy)-N-(2-(methacryloyloxy)ethyl)-N,N-dimethylethan-1-aminium bromide (IDMA1) and N,N′-([1,1′-biphenyl]-2,2′-diylbis(methylene))bis(2-(methacryloyloxy)-N,N-dimethylethan-1-aminium) bromide (IDMA2), intended for utilization in bi-functional antimicrobial and remineralizing composites, were synthesized, purified with an ethanol-diethyl ether-hexane solvent system, and validated by nuclear magnetic resonance (¹H and ¹³C NMR) spectroscopy, mass spectrometry, and Fourier-transform infrared spectroscopy. When incorporated into light-curable urethane dimethacrylate (UDMA)/polyethylene glycol-extended UDMA (PEG-U)/ethyl 2-(hydroxymethyl)acrylate (EHMA) (assigned UPE) resins, IDMAs did not affect the overall resins’ hydrophilicity/hydrophobicity balance (water contact angle: 60.8–65.5°). The attained degrees of vinyl conversion (DVC) were consistently higher in both IDMA-containing copolymers and their amorphous calcium phosphate (ACP) composites (up to 5% and 20%, respectively) reaching 92.5% in IDMA2 formulations. Notably, these high DVCs values were attained without an excessive increase in polymerization stress. The observed reduction in biaxial flexure strength of UPE-IDMA ACP composites should not prevent further evaluation of these materials as multifunctional Class V restoratives. In direct contact with human gingival fibroblasts, at biologically relevant concentrations, IDMAs did not adversely affect cell viability or their metabolic activity. Ion release from the composites was indicative of their strong remineralization potential. The above, early-phase biocompatibility and physicochemical tests justify further evaluation of these experimental materials to identify formulation(s) suitable for clinical testing. Successful completion is expected to yield a new class of restoratives with well-controlled bio-function, which will physicochemically, mechanically, and biologically outperform the conventional Class V restoratives.

Wear and Mechanical Properties of Nano-silica-fused Whisker Composites

Resin composites must be improved if they are to overcome the high failure rates in large stress-bearing posterior restorations. This study aimed to improve wear resistance via nano-silica-fused whiskers. It was hypothesized that nano-silica-fused whiskers would significantly improve composite mechanical properties and wear resistance. Nano-silicas were fused onto whiskers and incorporated into a resin at mass fractions of 0%-74%. Fracture toughness (mean ± SD; n = 6) was 2.92 ± 0.14 MPa•m½ for whisker composite with 74% fillers, higher than 1.13 ± 0.19 MPa•m½ for a prosthetic control, and 0.95 ± 0.11 MPa•m½ for an inlay/onlay control (Tukey’s at 0.95). A whisker composite with 74% fillers had a wear depth of 77.7 ± 6.9 μm, less than 118.0 ± 23.8 μm of an inlay/onlay control, and 172.5 ± 15.4 μm of a prosthetic control (p < 0.05). Linear correlations were established between wear and hardness, modulus, strength, and toughness, with R = 0.95–0.97. Novel nano-silica-fused whisker composites possessed high toughness and wear resistance with smooth worn surfaces, and may be useful in large stress-bearing restorations.

Sensory ability in the narwhal tooth organ system

The erupted tusk of the narwhal exhibits sensory ability. The hypothesized sensory pathway begins with ocean water entering through cementum channels to a network of patent dentinal tubules extending from the dentinocementum junction to the inner pulpal wall. Circumpulpal sensory structures then signal pulpal nerves terminating near the base of the tusk. The maxillary division of the fifth cranial nerve then transmits this sensory information to the brain. This sensory pathway was first described in published results of patent dentinal tubules, and evidence from dissection of tusk nerve connection via the maxillary division of the fifth cranial nerve to the brain. New evidence presented here indicates that the patent dentinal tubules communicate with open channels through a porous cementum from the ocean environment. The ability of pulpal tissue to react to external stimuli is supported by immunohistochemical detection of neuronal markers in the pulp and gene expression of pulpal sensory nerve tissue. Final confirmation of sensory ability is demonstrated by significant changes in heart rate when alternating solutions of high-salt and fresh water are exposed to the external tusk surface. Additional supporting information for function includes new observations of dentinal tubule networks evident in unerupted tusks, female erupted tusks, and vestigial teeth. New findings of sexual foraging divergence documented by stable isotope and fatty acid results add to the discussion of the functional significance of the narwhal tusk. The combined evidence suggests multiple tusk functions may have driven the tooth organ system's evolutionary development and persistence.

Structural and dynamical studies of acid-mediated conversion in amorphous-calcium-phosphate based dental composites

OBJECTIVE

To investigate the complex structural and dynamical conversion process of the amorphous-calcium-phosphate (ACP)-to-apatite transition in ACP based dental composite materials.

METHODS

Composite disks were prepared using zirconia hybridized ACP fillers (0.4 mass fraction) and photo-activated Bis-GMA/TEGDMA resin (0.6 mass fraction). We performed an investigation of the solution-mediated ACP-to-apatite conversion mechanism in controlled acidic aqueous environment with in situ ultra-small angle X-ray scattering based coherent X-ray photon correlation spectroscopy and ex situ X-ray diffraction, as well as other complementary techniques.

RESULTS

We established that the ACP-to-apatite conversion in ACP composites is a two-step process, owing to the sensitivity to local structural changes provided by coherent X-rays. Initially, ACP undergoes a local microstructural rearrangement without losing its amorphous character. We established the catalytic role of the acid and found the time scale of this rearrangement strongly depends on the pH of the solution, which agrees with previous findings about ACP without the polymer matrix being present. In the second step, ACP is converted to an apatitic form with the crystallinity of the formed crystallites being poor. Separately, we also confirmed that in the regular Zr-modified ACP the rate of ACP conversion to hydroxyapatite is slowed significantly compared to unmodified ACP, which is beneficial for targeted slow release of functional calcium and phosphate ions from dental composite materials.

SIGNIFICANCE

For the first time, we were able to follow the complete solution-mediated transition process from ACP to apatite in this class of dental composites in a controlled aqueous environment. A two-step process, suggested previously, was conclusively identified.

Chipping fracture resistance of denture tooth materials

OBJECTIVE

The applicability of the edge chipping method to denture tooth materials was assessed. These are softer materials than those usually tested by edge chipping. The edge chipping fracture resistances of polymethylmethacrylate (PMMA) based and two filled resin composite denture tooth materials were compared.

METHODS

An edge chipping machine was used to chip rectangular blocks and flattened anterior denture teeth. Force versus edge distance data were collected over a broad range of forces and distances. Between 20 and 65 chips were made per condition depending upon the material, the scatter, and the indenter type. Different indenter types were used including Rockwell C, sharp conical 120(o), Knoop, and Vickers. The edge toughness, Te, was evaluated for different indenter types.

RESULTS

The edge chipping data collected on the blocks matched the data collected from flattened teeth. High scatter, particularly at large distances and loads, meant that many tests (up to 64) were necessary to compare the denture tooth materials and to ascertain the appropriate data trends. A linear force-distance trend analysis was adequate for comparing these materials. A power law trend might be more appropriate, but the large scatter obscured the definitive determination of the precise trend. Different indenters produce different linear trends, with the ranking of: sharp conical 120(o), Rockwell C, and Knoop, from lowest to highest edge toughness. Vickers indenter data were extremely scattered and a sensible trend could not be obtained. Edge toughness was inversely correlated to hardness.

SIGNIFICANCE

Edge chipping data collected either from simple laboratory scale test blocks or from actual denture teeth may be used to evaluate denture materials. The edge chipping method's applicability has been extended to another class of restorative materials.

Chipping fracture resistance of dental CAD/CAM restorative materials: part 2. Phenomenological model and the effect of indenter type

The edge chipping resistances of six CAD/CAM dental restoration materials are analyzed and correlated to other mechanical properties. A new quadratic relationship that is based on a phenomenological model is presented.

OBJECTIVE

The purpose of this study was to further analyze the edge chipping resistance of the brittle materials evaluated in Part 1. One objective was to determine why some force-distance trends were linear and others were nonlinear. A second objective was to account for differences in chipping resistance with indenter type.

METHODS

Edge chipping experiments were conducted with different indenters, including some custom-made sharp conical indenters. A new force - distance quadratic expression was correlated to the data and compared to the linear and power law trends.

RESULTS

The new quadratic function was an excellent fit in every instance. It can account for why some materials can be fit by a linear trend, while others can be fit by the power law trend. The effects of indenter type are accounted for variations in crack initiation and by the wedging stresses once an indentation hole is created.

SIGNIFICANCE

The new quadratic force - edge distance function can be used with edge chipping data for all brittle materials, not just those evaluated in this study. The data trends vary from linear to nonlinear depending upon the material's hardness, fracture toughness, and elastic modulus.

Chipping fracture resistance of dental CAD/CAM restorative materials: part I--procedures and results

OBJECTIVE

The edge chipping test was used to measure the fracture resistance of CAD/CAM dental restoration ceramics and resin composites.

METHODS

An edge chipping machine was used to evaluate six materials including one feldspathic porcelain, two glass ceramics, a filled resin-composite, a yttria-stabilized zirconia, and a new ceramic-resin composite material. Force versus edge distance data were collected over a broad range of forces and distances. Data were analyzed by several approaches and several chipping resistance parameters were evaluated. The effects of using different indenter types were explored.

RESULTS

The force versus distance trends were usually nonlinear with good fits to a power law equation with exponents usually ranging from 1.2 to 1.9. The order of chipping resistance (from least to greatest) was: feldspathic porcelain and a leucite glass ceramic (which were similar), followed by the lithium disilicate glass ceramic and the two resin composites (which were similar), and finally the zirconia which had the greatest resistance to chipping. Chipping with a Vickers indenter required 28-45% more force than with the sharp conical 120° indenter. The two indenters rank materials approximately the same way. The power law exponents were very similar for the two indenters for a particular material, but the exponents varied with material. The Rockwell C indenter gives different power law trends and rankings.

SIGNIFICANCE

Despite the variations in the trends and indenters, simple comparisons between materials can be made by chipping with sharp conical 120° or Vickers indenters at 0.50mm. Broad distance ranges are recommended for trend evaluation.

Long-term mechanical durability of dental nanocomposites containing amorphous calcium phosphate nanoparticles

Half of all dental restorations fail within 10 years, with secondary caries and restoration fracture being the main reasons. Calcium phosphate (CaP) composites can release Ca and PO(4) ions and remineralize tooth lesions. However, there has been no report on their long-term mechanical durability. The objective of this study was to investigate the wear, thermal-cycling, and water-aging of composites containing amorphous calcium phosphate nanoparticles (NACP). NACP of 112-nm and glass particles were used to fabricate four composites: (1) 0% NACP+75% glass; (2) 10% NACP+65% glass; (3) 15% NACP+60% glass; and (4) 20% NACP+50% glass. Flexural strength and elastic modulus of NACP nanocomposites were not degraded by thermal-cycling. Wear depth increased with increasing NACP filler level. Wear depths of NACP nanocomposites after 4 × 10(5) cycles were within the range for commercial controls. Mechanical properties of all the tested materials decreased with water-aging time. After 2 years, the strengths of NACP nanocomposites were moderately higher than the control composite, and much higher than the resin-modified glass ionomers. The mechanism of strength loss for resin-modified glass ionomer was identified as microcracking and air-bubbles. NACP nanocomposites and control composite were generally free of microcracks and air-bubbles. In conclusion, combining NACP nanoparticles with reinforcement glass particles resulted in novel nanocomposites with long-term mechanical properties higher than those of commercial controls, and wear within the range of commercial controls. These strong long-term properties, plus the Ca-PO(4) ion release and acid-neutralization capability reported earlier, suggest that the new NACP nanocomposites may be promising for stress-bearing and caries-inhibiting restorations.

Adhesive Bonding to Dentin Improved by Polymerizable Cyclodextrin Derivatives

The objective of this work was to determine bonding characteristics of a hydrophilic monomer formulation containing polymerizable cyclodextrin derivatives. The hypothesis was that a formulation containing hydrophilic cross-linking diluent comonomers and cyclodextrins with functional groups attached by hydrolytically stable ether linkages could form strong adhesive bonds to dentin. The previously synthesized polymerizable cyclodextrin derivatives were formulated with sorbitol dimethacrylate, methacrylic acid and phenylbis(2,4,6-trimethylbenzoyl) phosphine oxide photoinitiator. The same formulation without the polymerizable cyclodextrin derivatives isolated the effects of the polymerizable cyclodextrin derivatives. A commercial self-etching bonding system was tested as a comparative control. Ground mid-coronal dentin was etched with 37 % phosphoric acid (H3PO4) for 15 s and rinsed with distilled water for 10 s. Formulations were applied to the moist dentin and light-cured 10 s. A packable composite was then applied through irises and light-cured 60 s. Teeth were stored in water for 24 h before bonds were tested in a shearing orientation. One-way ANOVA was performed on the data. The average values of shear bond strengths were defined as loads at fracture divided by the 4 mm diameter iris areas. The average value of shear bond strength for the formulation containing the polymerizable cyclodextrin derivatives was higher (p < 0.05), where p is a fraction of the probability distribution) than that of the same monomeric formulation except that the polymerizable cyclodextrin derivatives were not included. This was supporting evidence that the polymerizable cyclodextrin derivatives contributed to improved bonding. The average value of shear bond strength for the formulation containing the polymerizable cyclodextrin derivatives was also higher (p < 0.05) than that of the commercial self-etching bonding system. These preliminary results are in accordance with the hypothesis that formulations containing polymerizable cyclodextrin derivatives can form strong adhesive bonds to hydrated dentin surfaces. Further improvements in bonding to hydrated biological tissues by use of advanced formulations are anticipated.

Dentin adhesion and microleakage of a resin-based calcium phosphate pulp capping and basing cement

An experimental resin-based bioactive calcium phosphate cement, intended as a pulp capping and basing material, was evaluated for dentin shear bond strength and microleakage. The interfacial morphology was examined by scanning electron microscopy (SEM). For microleakage, dentin cavities without (Group A) or after (Group B) acid etching were restored with the calcium phosphate cement. A resin-based calcium hydroxide (VLC Dycal; Group C) was used as control material according to the manufacturer's instructions. After water storage and thermocycling, the microleakage was scored using a AgNO(3) staining procedure. For the shear bond strength, flat exposed dentin surfaces were treated as for the microleakage test. Metal irises pressed against the dentin surface were filled with the cements, which were photocured. Both tests were carried out after 1 wk. While acid etching did not result in significantly greater microleakage, it led to higher shear bond strength, and allowed, as shown by SEM, the formation of a hybrid layer and resin tags. Both groups treated with the calcium phosphate cement had significantly lower microleakage scores and higher mean shear bond strength values than the groups treated with the control material.

Three-body wear of dental resin composites reinforced with silica-fused whiskers

OBJECTIVE

Recent studies used silica-fused whiskers to increase the strength and toughness of resin composites. This study investigated the three-body wear of whisker composites. It was hypothesized that the whisker composites would be more wear resistant than composites reinforced with fine glass particles, and the whisker-to-silica filler ratio would significantly affect wear.

METHODS

Silica particles were mixed with silicon nitride whiskers at seven different whisker/(whisker + silica) mass fractions (%): 0, 16.7, 33.3, 50, 66.7, 83.3, and 100. Each mixture was heated at 800 degrees C to fuse the silica particles onto the whiskers. Each powder was then silanized and incorporated into a dental resin to make the wear specimens. A four-station wear machine was used with specimens immersed in a slurry containing polymethyl methacrylate beads, and a steel pin was loaded and rotated against the specimen at a maximum load of 76 N.

RESULTS

Whisker-to-silica ratio had significant effects (one-way ANOVA; p < 0.001) on wear. After 4 x 10(5) wear cycles, the whisker composite at whisker/(whisker + silica) of 16.7% had a wear scar diameter (mean +/- sd; n = 6) of (643 +/- 39) microm and a wear depth of (82 +/- 19) microm, significantly less than a wear scar diameter of (1184 +/- 34) microm and a wear depth of (173 +/- 15) microm of a commercial prosthetic composite reinforced with fine glass particles (Tukey's multiple comparison). SEM examination revealed that, instead of whiskers protruding from the worn surface, the whiskers were worn with the composite surface, resulting in relatively smooth wear surfaces.

SIGNIFICANCE

Silica-fused whisker reinforcement produced dental resin composites that exhibited high resistance to wear with smooth wear surfaces. These properties, together with the strength and fracture toughness being twice those of current glass particle-reinforced composites, may help extend the use of resin composite to large stress-bearing posterior restorations.

Investigations of electrospray sample deposition for polymer MALDI mass spectrometry

In the interest of a more thorough understanding of the relationship between sample deposition technique and the quality of data obtained using matrix-assisted laser desorption/ionization (MALDI) mass spectrometry, details of the electrospray (ES) process of sample deposition are investigated using a number of techniques. Sample morphology was observed with scanning electron microscopy (SEM) and atomic force microscopy (AFM), while matrix-enhanced secondary ion mass spectrometry (MESIMS) monitored surface coverage. Electrospray deposition reduces the analyte segregation that can occur during traditional dried droplet deposition for MALDI. We attribute statistically significant improvements in the reproducibility of signal intensity and MALDI average molecular mass measurements to the ES sample deposition technique.

Effects of different whiskers on the reinforcement of dental resin composites

OBJECTIVE

Whiskers were recently used to reinforce dental composites to extend their use to large stress-bearing restorations. The aim of this study was to investigate the effects of different types of whiskers on composite properties.

METHODS

Silicon nitride and silicon carbide whiskers were each mixed with silica particles at whisker/silica mass ratios of 0:1, 1:5, 1:2, 1:1, 2:1, 5:1, and 1:0, and thermally treated. The composite was heat-cured at 140 degrees C. Strength and fracture toughness were measured in flexure, while elastic modulus and hardness were measured with nano-indentation.

RESULTS

Both whisker type and whisker/silica ratio had significant effects on composite properties (two-way ANOVA; p<0.001). Silicon nitride whiskers increased the composite strength and toughness more than did silicon carbide. Silicon carbide whiskers increased the modulus and hardness more than silicon nitride did. The silicon nitride whisker composite reached a strength (mean+/-SD; n=6) of 246+/-33 MPa at whisker/silica of 1:1, while the silicon carbide whisker composite reached 210+/-14 MPa at 5:1. Both were significantly higher than 114+/-18 MPa of a prosthetic control and 109+/-23 MPa of an inlay/onlay control (Tukey's multiple comparison test; family confidence coefficient=0.95). Fracture toughness and work-of-fracture were also increased by a factor of two. Higher whisker/silica ratio reduced the composite brittleness to 1/3 that of the inlay/onlay control.

SIGNIFICANCE

Whisker type and whisker/silica ratio are key microstructural parameters that determine the composite properties. Reinforcement with silica-fused whiskers results in novel dental composites that possess substantially higher strength and fracture toughness, and lower brittleness than the non-whisker control composites.

[Studies on bonding interfaces of two dentin adhesives by scanning electron microscopy]

OBJECTIVE

To purpose of this study was to investigate the microstructure and bonding mechanism of bonding interfaces of two current one-bottle dentin bond systems(Prime & Bond NT, PBNT; Prime one Mirage, P-One).

METHODS

Fifteen extracted, caries-free human molars were prepared according to a modified method used for microtensile bond strength measurement. Each crown was divided into nearly equal halves with a 5 mm deep slot for accepting treatment of the two dentin bond systems, respectively. After 24 h storage in distilled water at 37 degrees C, the bonded teeth were subjected to two treatments: 5 teeth were observed by and tested for microtensile bond strengths without further treatment and 10 teeth were thermocycled(2400 cycles, between 5 degrees C and 55 degrees C) prior to SEM observation and bond strength testing. Hour-glass shaped microspecimens with a thickness of approximately 0.5 mm were cut from each tooth and used for SEM observation and microtensile bond strength measurement.

RESULTS

A typical resin-infiltrated zone (hybrid layer) with a thickness of 3-5 microns and well-formed cone shaped resin tags that penetrated the dentinal tubules were clearly observed at the resin-dentin interfaces in the two bond systems. There were multiple lateral branches of tubular resin tags that interconnected to form a micro-network of resin. No evident differences in SEM images between the two bond systems as well as between thermocycling and without thermocycling in each bond system were found.

CONCLUSION

PBNT and P-One provided good resin infiltration, producing a three-dimensional interlocking micro-network of resin tags in the dentin tubules with multiple lateral branches that penetrate the intertubular dentin, which positively influenced the adhesion between dentin and the two bond systems.

Effect of thermal cycling on whisker-reinforced dental resin composites

The mechanical properties of dental resin composites need to be improved in order to extend their use to high stress-bearing applications such as crown and bridge restorations. Recent studies used single crystal ceramic whiskers to reinforce dental composites. The aim of this study was to investigate the effects of thermal cycling on whisker-reinforced composites. It was hypothesized that the whisker composites would not show a reduction in mechanical properties or the breakdown of whisker-resin interface after thermal cycling. Silicon carbide whiskers were mixed with silica particles, thermally fused, then silanized and incorporated into resin to make flexural specimens. The filler mass fraction ranged from 0% to 70%. The specimens were thermal cycled in 5 degrees C and 60 degrees C water baths, and then fractured in three-point bending to measure strength. Nano-indentation was used to measure modulus and hardness. No significant loss in composite strength, modulus and hardness was found after 10(5) thermal cycles (family confidence coefficient=0.95; Tukey's multiple comparison test). The strength of whisker composite increased with filler level up to 60%, then plateaued when filler level was further increased to 70%; the modulus and hardness increased monotonically with filler level. The strength and modulus of whisker composite at 70% filler level were significantly higher than the non-whisker controls both before and after thermal cycling. SEM revealed no separation at the whisker-matrix interfaces, and observed resin remnants on the pulled-out whiskers, indicating strong whisker-resin bonding even after 10(5) thermal cycles. In conclusion, novel dental resin composites containing silica-fused whiskers possessed superior strength and modulus compared to non-whisker composites both before and after thermal cycling. The whisker-resin bonding appeared to be resistant to thermal cycling in water, so that no loss in composite strength or stiffness occurred after prolonged thermal cycling.

Microtensile bond strength of thermally stressed composite-dentin bonds mediated by one-bottle adhesives

PURPOSE

To evaluate the effects of thermally stressing composite-dentin bonds in teeth subjected to a modified microtensile bond test that allowed application of two bonding agents side-by-side to the same tooth.

MATERIALS AND METHODS

Extracted human molars with a slot dissecting the occlusal dentin surface were conditioned and primed on one side with Prime & Bond NT (PBNT) and Prime One Mirage (P-One) on the other side. The composite was light-cured onto the surface. Approximately 0.5 mm thick dumbbell-shaped tensile specimens were tested after 24-hour water storage or after thermocycling 2400 times at 5 and 55 degrees C. Interfacial morphologies were evaluated by scanning electron microscopy (SEM).

RESULTS

Mean tensile bond strengths (TBS +/- standard deviation) were (36 +/- 24 MPa and 31 +/- 16 MPa) for PBNT, and (51 +/- 25 MPa and 40 +/- 18 MPa) for P-One without and with thermocycling, respectively. 97% of all tested specimens failed adhesively. Differences between the bonding systems and the therrmal treatments were significant (two-way ANOVA, P < 0.05). Regression analysis showed regional correlation between mean TBS of each bonding agent when grouped by the teeth from which they were obtained (r = 0.66, P = 0.002). SEM revealed that both bonding agents effectively wetted the conditioned dentin producing a typical hybrid layer, surface-textured resin tags with multiple lateral branches.

[The studies on microtensile bond strength measurements of two dentin adhesives]

OBJECTIVE

The purpose of this study was to investigate the feasibility of a modified microtensile method used to test bond strengths of two current one-bottle dentin bond systems (Prime & Bond NT, PBNT; Prime one Mirage, P-One) with a parallel match design.

METHODS

15 extracted, caries-free human molars were cut to expose occlusal dentin. A 5 mm deep slot was prepared in each crown to divide the crown into nearly equal halves for accepting treatment of the two dentin bond systems, respectively. After 24 h storage in distilled water at 37 degrees C, the bonded teeth were subjected to two treatments: 5 teeth were tested without further treatment and 10 teeth were thermocycled (2400 cycles, between 5 degrees C and 55 degrees C) prior to bond strength testing. Hour-glass shaped specimens with a distance of approximately 1.0 mm at the narrowest portion were cut from each tooth and tested in tensile mode.

RESULTS

Bond strengths (mean MPa) were: for PBNT: 42 & 31, and for P-One 64 & 38 without and with thermocycling, respectively. Two-way ANOVA revealed a significant difference in bond strengths(P < 0.001) between the two systems and when thermocycled. However, a pairwise multiple comparison (Tukey test) showed that after thermocycling the difference between the two systems was not significant (P > 0.05). Regression analysis showed that a correlation existed between the two systems' tensile bond strength values grouped by tooth (correlation coefficient r = 0.575, P < 0.05).

CONCLUSION

The modified microtensile method with a parallel match design is feasible and suitable for evaluating two different bonding systems or dentin treatments.

Effects of whisker-to-silica ratio on the reinforcement of dental resin composites with silica-fused whiskers

Resin composites need to be strengthened to improve their performance in large stress-bearing restorations. This study aimed to reinforce composites with whiskers and to investigate the effects of the whisker:silica ratio. It was hypothesized that changing the whisker-silica ratio would affect the whisker-matrix bonding and the filler's distribution, and hence alter the composite properties. Silica particles and whiskers were mixed at various whisker:silica mass ratios, thermally fused, and combined with a dental resin at filler mass fractions of 0-65%. Whisker:silica ratio and filler level had significant effects on composite properties. At 60% filler level, the silica composite (whisker:silica = 0:1) had a flexural strength (mean +/- SD; n = 6) of 104 +/- 21 MPa; that at a whisker:silica ratio of 1:0 was 74 +/- 36 MPa. However, that of the silica-fused whisker composite (whisker:silica = 5:1) was 210 +/- 14 MPa, compared with 109 +/- 23 MPa and 114 +/- 18 MPa of two prosthetic controls. Mixing silica with whiskers minimized whisker entanglement, improved filler distribution in the matrix, and facilitated whisker silanization and bonding to the matrix, thus resulting in substantially stronger composites.

Reinforcement of a self-setting calcium phosphate cement with different fibers

A water-based calcium phosphate cement (CPC) has been used in a number of medical and dental procedures due to its excellent osteoconductivity and bone replacement capability. However, the low tensile strength of CPC prohibits its use in many unsupported defects and stress-bearing locations. Little investigation has been carried out on the fiber reinforcement of CPC. The aims of the present study, therefore, were to examine whether fibers would strengthen CPC, and to investigate the effects of fiber type, fiber length, and volume fraction. Four different fibers were used: aramid, carbon, E-glass, and polyglactin. Fiber length ranged from 3-200 mm, and fiber volume fraction ranged from 1.9-9.5%. The fibers were mixed with CPC paste and placed into molds of 3 x 4 x 25 mm. A flexural test was used to fracture the set specimens and to measure the ultimate strength, work-of-fracture, and elastic modulus. Scanning electron microscopy was used to examine specimen fracture surfaces. Fiber type had significant effects on composite properties. The composite ultimate strength in MPa (mean +/- SD; n = 6) was (62+/-16) for aramid, (59+/-11) for carbon, (29+/-8) for E-glass, and (24+/-4) for polyglactin, with 5.7% volume fraction and 75 mm fiber length. In comparison, the strength of unreinforced CPC was (13+/-3). Fiber length also played an important role. For composites containing 5.7% aramid fibers, the ultimate strength was (24+/-3) for 3 mm fibers, (36+/-13) for 8 mm fibers, (48 +/-14) for 25 mm fibers, and (62+/-16) for 75 mm fibers. At 25 mm fiber length, the ultimate strength of CPC composite was found to be linearly proportional to fiber strength. In conclusion, a self-setting calcium phosphate cement was substantially strengthened via fiber reinforcement. Fiber length, fiber volume fraction, and fiber strength were found to be key microstructural parameters that controlled the mechanical properties of CPC composites.

Edge-bevel fracture resistance of three direct-filling materials

Edge strength is defined in this study as the resistance to fracture of the beveled extension normally located at the cavosurface margin of a dental restoration. The edge strength of direct-filling alloy restorations plays an important role in maintaining the integrity of margins at tooth-alloy interfaces during functional loading. The purpose of this study was to determine the relative strength of an experimental consolidated silver material in comparison to other direct filling materials. The method used was designed as a simulation for relative edge-strength clinical properties. Stainless steel dies were formed from disks 5 mm thick, each with a centered hole tapered (1/48) toward the bottom side of the disk. A 41 degrees bevel, 0.5 mm wide as viewed from above, was placed on the top-side of the disk. Dispersalloy (D) or Unison (U) amalgam, Z-100 composite (C), hand-consolidated silver powder (HAg), or pneumatically consolidated silver powder (PAg) was used to fill the die opening. Excess was polished from both sides of the disk with 600-grit abrasive paper. The sample was loaded from the beveled side with a 3 mm-in-diameter flat-ended plunger at a rate of 1.0 mm/minute until failure. Failure load and total energy to failure were recorded and compared. Tukey's multiple comparison test (p < 0.05) ranked the materials (U) > (HAg) > (D) > (PAg) > (C) for fracture strength and (HAg) > (D) > (U) > (PAg) > (C) for fracture energy.

Three-body wear of a hand-consolidated silver alternative to amalgam

Recent studies have investigated a mercury-free silver alternative to amalgam, but the silver powders required a relatively high compaction pressure to consolidate. The aim of the present study was to consolidate a precipitated silver powder into a cohesive solid using an air-driven pneumatic condenser fitted with an amalgam plugger at a clinically realistic load, and to study the mechanisms and rates of three-body wear of the consolidated silver in comparison with that of an amalgam. The silver powder was annealed, rinsed with a dilute acid, and consolidated either in a prepared tooth cavity or in a specimen mold at a load of 15 N. A four-station wear machine was used where each specimen was immersed in a slurry containing polymethyl methacrylate beads, then a steel pin was loaded and rotated against the specimen at a maximum load of 76 N. The flexural strength in MPa (mean +/- SD; n = 10) was 86 +/- 20 for amalgam, 181 +/- 45 for silver with a polished surface, and 202 +/- 21 for silver with a burnished surface. After 4 x 10(5) wear cycles, the wear scar depth in microm was 134 +/- 54 for amalgam, 143 +/- 8 for polished silver, and 131 +/- 9 for burnished silver, which were not significantly different (Tukey's multiple comparison test; family confidence coefficient = 0.95). SEM examination revealed cracks and fracture pits in the worn surface of amalgam, in contrast to a smooth surface in silver. Wear and material removal in amalgam occurred by microfracture and dislodgement of cracked segments, while wear in the silver occurred by ductile deformation and flow of materials. To conclude, the consolidated silver possesses a three-body wear resistance similar to that of amalgam, and a higher resistance to wear-induced damage and cracking than amalgam. The mechanism of wear in amalgam is microfracture and material dislodgement, while that in consolidated silver is ductile deformation and flow of material.

Microleakage of a consolidated silver direct filling material

Microleakage of an experimental direct filling material comprised of a chemically precipitated silver powder that had been surface treated with a dilute acid to promote cold welding upon consolidation was evaluated. Microleakage was compared to both dispersed-phase and spherical amalgam by use of an in vitro gas-diffusion method and in class 5 restorations placed in extracted human teeth. The effect of two cavity varnishes and two dentin adhesives as cavity liners on microleakage was also evaluated using extracted teeth. Microleakage of silver powder consolidated with dental instruments was less than that found with dental amalgam. The use of copal or polyamide cavity varnish resulted in the lowest combination of microleakage on dentin and enamel margins.

Two-body sliding wear of a direct-filling silver alternative to amalgam

OBJECTIVE

This study investigated the wear resistance of a mercury-free silver direct-filling material and a dental amalgam.

METHOD AND MATERIALS

A precipitated silver powder was rinsed with dilute fluoboric acid and consolidated into a cohesive solid. For tooth cavity restoration and flexural testing, the silver was consolidated with a dental amalgam plugger at a load of 15 N. For wear testing, because of the relatively large specimen size, the silver was pressed at a pressure of 150 MPa, yielding a density similar to that obtained by hand consolidation.

RESULTS

The silver had a flexural strength twice that of amalgam. Pin-on-disk wear resulted in a smooth surface and hardening in silver, as measured by indentation inside the wear tracks, in contrast to the damage that was found in amalgam. The wear track cross-sectional area (n = 12) at 10(6) revolutions was not statistically significantly different among amalgam, polished silver, and burnished silver.

CONCLUSION

The consolidated silver exhibited work hardening and surface densification during wear and, as a result, was more resistant to wear-induced damage than amalgam.

Cyclic contact fatigue of a silver alternative to amalgam

OBJECTIVE

To purpose of this study was to compare the cyclic contact fatigue resistance of a novel mercury-free silver direct filling material to that of a dental amalgam (Dispersalloy).

METHODS

The silver specimens were made by pressing a precipitated powder at room temperature with a pressure of 150 MPa, which can be achieved in clinical hand-consolidation. To simulate clinical contact of restorations against enamel cusps, a cyclic contact fatigue methodology was employed. A spherical indenter was used to repeatedly indent the specimen, while the accumulation of deformation and damage was examined as a function of the number of cycles up to 5 x 10(5). Student's t test, analysis of variance (ANOVA) and Duncan's multiple range test were used to compare the specimen groups for significant differences in flexural strength, indentation impression diameter, and hardness. A type I error of alpha = 0.05 was considered as significant. Subsurface damage was examined by using a bonded-interface technique.

RESULTS

As a result of cyclic indentation, microcracks were produced in the amalgam, but no cracks were found in the silver filling material. At fewer numbers of cycles, indentation produced larger impressions in silver (e.g., diameter = [450 +/- 31] microns at 10(2) cycles) than in amalgam ([145 +/- 20] microns) due to a lower hardness of the former. However, with increasing number of cycles, damage accumulated more rapidly in the amalgam, while the silver beneficially work-hardened in repeated indentations. At 5 x 10(5) cycles, the difference in impression diameter between silver and amalgam ([582 +/- 20] microns vs. [568 +/- 42] microns) become insignificant (p > 0.1, Student's t test).

SIGNIFICANCE

The mercury-free silver direct filling material is more resistant to microcracking and to cyclic contact fatigue than amalgam, and the indentation impression sizes in the consolidated silver and dental amalgam are not statistically different at large numbers of cycles.

Compatibility of ceramic-ceramic systems for fixed prosthodontics

This study evaluated dilatometric data for predicting ceramic-ceramic compatibility for porcelains fired on central incisor copings (n = 72) of high expansion colored IPS-Empress porcelain. Nine body porcelains (leucite 0 wt% to 51 wt%) were each fired onto eight copings. Cracks were detected at 10 x magnification using transilluminating light. Failure was defined as the presence of at least one crack and probability of failure (Pf) as the ratio of failed to total crowns. Thermal contraction coefficients (alpha) were determined using four bars of each porcelain following the protocol of ISO 9693. Absolute differences in thermal contraction, magnitude of delta alpha, between core and test porcelains were plotted against Pf and curve fit. Significant differences in alpha were found among the porcelains tested (ANOVA, 95% Tukey); the alpha values ranged from 7.92 to 17.83 x 10(-6)/degree C; Pf ranged from 0 to 1. Compatible porcelains (no cracks during any firing of all eight crowns) had magnitude of delta alpha values less than 1 x 10(-6)/degree C. Absolute values (magnitude of delta alpha) were surprisingly predictive of Pf given the very different cooling rates (dilatometry versus dental lab) and the relatively complex crown shape. Standard dilatometry may be useful for predicting the compatibility of ceramic-ceramic systems. Three porcelains, IPS-Empress dentin, Duceram, and Will-Ceram were successfully used for veneering IPS Empress cores.

Consolidation conditions for a cold-welded mercury-free alloy

Alloys being investigated as possible direct-filling materials rely upon a cold-welded, deformable silver matrix phase for cohesion and strength. The silver matrix is formed by direct consolidation of comminuted silver under an oxide-removing acid. The object of this study was to determine the effect of conditions such as load, increment thickness, and concentration of oxide-removing acid on the properties of the silver matrix. Results indicate that the addition of higher impact loads significantly improved yield strength and specimens built up by using thinner increments were significantly stronger and denser.