Clinical outcomes of new multifocal intraocular lenses with hydroxyethyl methacrylate and comparative results of contrast sensitivity, objective scatter, and subjective photic phenomena

Background

We investigate the performance of new hydrophobic diffractive multifocal intraocular lenses (IOL) with hydroxyethyl methacrylate (HEMA) and compare their optical quality, contrast sensitivity, and subjective photic phenomena.

Methods

Medical records of patients who underwent routine simple cataract surgery and insertion of an existing multifocal IOL (TFNT, TF group) or a new multifocal IOL (CNWT, CN group) were retrospectively reviewed. Clinical data was collected 2 months postoperatively and included optical quality analysis system (OQAS) indices, contrast sensitivity, and subjective degrees of photic phenomena.

Results

One hundred thirty-five eyes of 135 patients were included (CN group, 71; TF group, 64). There was no significant difference between the two groups in the visual acuity and defocus curve. The indices of OQAS did not show a significant difference between groups. Contrast sensitivity was significantly better in the CN group at all degrees, including the area under the log contrast sensitivity function (p = 0.01). The subjective photic phenomena survey showed better results for the CN group, with the proportion of patients reporting no photic phenomena as 9.9% and 3.1% in the CN and TF groups, respectively. The proportion of patients who reported severe photic phenomena was 11.3% in the CN group and 25.0% in the TF group. Although the follow-up period was only 2 months, glistening, surface scattering, and posterior capsule opacity were not observed in any patient.

Conclusions

The new multifocal IOL with HEMA is safe, and provides stable visual acuity as well as superior contrast sensitivity and lower subjective photic phenomena, over the prior IOL.

Back to the multi-step adhesive system: A next-generation two-step system with hydrophobic bonding agent improves bonding effectiveness

This study evaluated the bonding effectiveness of a newly developed two-step hydrophobic bonding material. Three groups using different bonding systems were compared: BZF group, using the new bonding system (BZF-29; GC, Tokyo, Japan); GPB group, using a one-step bonding system (G-Premio Bond; GC); and SE2 group, using a two-step bonding system (CLEARFIL SE Bond 2; Kuraray Noritake Dental, Tokyo, Japan). Microtensile bond strength (µTBS) was measured after storage in water for 24 h, 3 months and 6 months (n=25/group). Fracture surfaces were observed under scanning electron microscopy. The BZF group showed significantly higher µTBS than the other groups (p<0.001). Dominant failure patterns were cohesive failure for the BZF group (48-84%), mixed failure for the SE2 group (48-60%) and interface failure between adhesive and resin composite for the GPB group (48-52%). The hydrophobicity of the BZF-29 bonding system improves the long-term bonding effectiveness between adhesive and resin composite.

Viability determination data for odontoblast-like cells exposed to resin monomers

Data in this article are associated with our research article “Dental Resin Monomers Induce Early and Potent Oxidative Damage on Human Odontoblast-like Cells.” Dental adhesives are polymeric compounds consisting of several chemical substances, including resin monomers, such as 2-hydroxyethyl methacrylate (HEMA) and triethylene glycol dimethacrylate (TEGDMA), together with other comonomers, making up the organic matrix of the adhesive and whose composition is based on the methyl methacrylate chemistry. The release of residual monomers, susceptible to biodegradation, acts as a source of bioactive compounds, which can interact with tissues and induce a cytotoxic cellular response. The most used techniques to evaluate cytotoxicity, proliferation, or metabolic activity of cells exposed to different substances, are MTT and resazurin. Each chemistry evaluates cell viability differently, so the data obtained could vary depending on the technique sensitivity to detect changes in cell metabolism. The objective of this article was to present viability data as a function of the metabolic activity in human odontoblast-like cells (hOLCs), exposed to 3, 6, 9, and 12 mM HEMA, or 0.75, 1.5, 3, and 6 mM TEGDMA evaluated by the MTT, and resazurin techniques in the first 24 hours of exposure, at different time points. The absorbance data for the MTT test and the fluorescence intensity for the resazurin test were obtained by spectrometry. SIMSTAT software 2.6.5 for Windows was used to confirm the normal data distribution (Levene's test). Subsequently, an analysis of variance (one-way ANOVA) was performed to compare the control with each HEMA and TEGDMA concentration. Where a p < 0.05 indicated a high F value, a Fisher's least significant differences post-hoc analysis was performed, using an alpha value < 0.05. Data from the different time points were compared with a Student's t-test for each concentration. These data may be useful to compare the cytotoxic response of hOLCs with other cell types or the cell response to other resin monomers.

The effects of low-dose 2-hydroxyethyl methacrylate on apoptosis and survival in human dental pulp cells

BACKGROUND/PURPOSE

2-hydroxyethyl methacrylate (HEMA) is one of the most major components in dentin bonding systems. Uncured HEMA is eluted through the dentin and harmful to pulp cells. The study aimed to investigate the death pattern, morphological change and factors of human dental pulp cells (HDPCs) cultured with low-dose HEMA.

METHODS

HDPCs were cultured with low-dose concentration of HEMA at 0 mM (control), 0.125 mM, 0.25 mM, 1 mM, 2 mM and 4 mM on Day 3 and 5. The cell morphology was observed with F-actin immunocytochemical staining. The flow cytometry was used to analyze the death pattern. NF-κB and Trx-1 were measured using ELISA kits.

RESULTS

The major death pattern was early apoptosis and late apoptosis. The morphological characteristics of apoptosis were observed clearly at 4 mM on Day 3 and Day 5. The phosphorylated NF-κB normalized to total NF-κB protein was significantly higher at 2 mM and 4 mM on Day 5. There was no difference of Trx-1 on Day 3, but significantly higher at 0.25 mM and 1 mM on Day 5. The trend line of phosphorylated NF-κB and Trx-1 showed highly positive correlations with HEMA concentration.

CONCLUSION

The significant cellular morphology characteristics of apoptosis can be observed at higher dose and longer period after exposed to uncured HEMA. The expression of NF-κB was following the ratio of late apoptosis at longer exposure period. Clinically, the remaining dentin thickness should be enough to decrease HEMA concentration and thus to protect pulp cells free from harm.

Dental resin monomers induce early and potent oxidative damage on human odontoblast-like cells

Resin-based dental materials consist of filler particles and different monomers that are light cured in situ to re-establish dental function and aesthetics. Due to the degree of conversion of adhesive polymers, the monomers triethyleneglycol dimethacrylate (TEGDMA) and 2-hydroxyethyl methacrylate (HEMA) are released in relatively high amounts and are susceptible to degradation, acting as bioactive compounds and affecting cell and tissues. This study aimed to assess the effect of HEMA and TEGDMA exposure on metabolic activity, membrane integrity, and cell survival of human odontoblast-like cell (hOLCs). Exposure to resin monomers for 24 h induced major changes in cell membrane integrity, metabolic activity, and survival, which were measured by the calcein method and lactate dehydrogenase release. Increased and early reactive oxygen species (ROS) production was observed leading to degradative oxidation of membrane lipids identified as malondialdehyde production. Severe alteration in mitochondria occurred due to transmembrane mitochondrial potential collapse, possibly inducing activation of apoptotic cell death. hOLCs exposure to resin monomers modified the cell redox potential, with consequences on membrane permeability and integrity, including mitochondrial function. Lipid peroxidation appears to be a key phenomenon for the membrane structures oxidation after HEMA and TEGDMA exposure, leading to cell death and cytotoxicity. hOLCs respond early by differential induction of adaptive mechanisms to maintain cell homeostasis. Modulation of oxidative stress-induced response involves the regulation of genes that encode for antioxidant proteins such as catalase and heme oxygenase-1; regulation that functions as a critical protection mechanism against oxidative cell damage induced by HEMA and TEGDMA. Ascorbic acid as an antioxidant substance mitigates the oxidative damage associated with exposure to monomers.

Influence of N-(2-hydroxyethyl)acrylamide addition in light- and dual-cured resin cements

OBJECTIVE

To develop experimental light-cured (L) and dual-cured (D) resin cements containing N-(2-hydroxyethyl)acrylamide and evaluate the physicochemical and optical properties.

METHODS

Experimental resin cements were formulated using bisphenol A-glycidyl dimethacrylate (70%) and 2-hydroxyethyl methacrylate (30%), in the control groups, and, bisphenol A-glycidyl dimethacrylate (70%) and N-(2-hydroxyethyl)acrylamide (30%). Polymerization kinetics were evaluated by differential scanning calorimetry (n = 3), softening in solvent (ΔKHN) evaluated by the difference of Knoop microhardness before (KHN₁) and after (KHN₂) ethanol solution immersion (n = 5), radiopacity in mmAl (n = 5), film thickness (n = 3) and color stability were evaluated. Mechanical properties as ultimate tensile strength (UTS) and micro-shear bond strength (μSBS) were analyzed immediately and after 6 months. Results were analyzed using ANOVA, Tukey's test and Student's t-test (α = 0.050).

RESULTS

The L_HEAA1 group had no statistical difference from the control group regarding polymerization kinetics, KHN₁, ΔKHN and color stability (p > 0.050). In dual-cured cements, the acrylamide groups presented a lower degree of conversion and higher ΔKHN than the D_HEMA0.6 group, which obtained a higher rate of polymerization (p < 0.050). There was no statistical difference in radiopacity and film thickness (p > 0.050). Dual-cured cements with N-(2-hydroxyethyl)acrylamide showed higher color change than methacrylates. Immediate mechanical properties were lower for acrylamide groups (p < 0.050), with higher hydrolytic stability.

CONCLUSIONS

The addition of N-(2-hydroxyethyl)acrylamide negatively affected the properties of the dual-cured resin cements. LHEAA1 did not differ in physicochemical and optical properties from the control, with higher hydrolytic stability.

CLINICAL SIGNIFICANCE

The results of the study indicate that acrylamides increased mechanical properties over time independently of the curing system mode, with more hydrolytic stability. The clinical performance of experimental resin cements should be evaluated.

Interpenetrating polymer networks in polyvinyl alcohol/cellulose nanocrystals hydrogels to develop absorbent materials

Polyvinyl alcohol/cellulose nanocrystals/poly(2-Hydroxyethyl methacrylate) (PVA/CNC/polyHEMA) and PVA/CNC/poly(N'-methylenebisacrylamide) (PVA/CNC/polyMBA) hydrogels were prepared by photo-crosslinking followed by freezing/thawing (F-T) cycle and this novel preparation method was reported. The formation of interpenetrating polymer networks (IPN) resulted from the addition of crosslinking HEMA or MBA monomers displayed improved interfacial adhesion. The produced hydrogels were measured by scanning electron microscopy (SEM), real-time fourier transform infrared (RTIR), thermogravimetric analysis (TGA), mechanical, swelling and adsorption tests. The results showed both PVA/CNC/polyHEMA with semi-IPN and PVA/CNC/polyMBA with dual network (DN) hydrogels had higher thermal stability, lower water loss rate and better swelling and reswelling and mechanical properties, comparing to PVA and PVA/CNC hydrogels. The adsorption behaviors of hydrogels using xylenol orange (XO) and methylene blue (MB) as model dyes were evaluated, indicating that PVA/CNC/polyHEMA and PVA/CNC/polyMBA hydrogels could hold some dyes. Overall, this work provided a good way for increasing mechanical, swelling, reswelling, thermal, and adsorption properties of PVA/CNC, which will be a promising water-manageable material for agriculture application and a candidate for dye carrier.