Preparation and properties of nano-sized calcium fluoride for dental applications

Novel calcium phosphate nanocomposite with caries-inhibition in a human in situ model

OBJECTIVES

Secondary caries at the restoration margins remains the main reason for failure. Although calcium phosphate (CaP) composites are promising for caries inhibition, there has been no report of CaP composite to inhibit caries in situ. The objectives of this study were to investigate the caries-inhibition effect of nanocomposite containing nanoparticles of amorphous calcium phosphate (NACP) in a human in situ model for the first time, and to determine colony-forming units (CFU) and Ca and P ion concentrations of biofilms on the composite restorations.

METHODS

NACP with a mean particle size of 116 nm were synthesized via a spray-drying technique. Two composites were fabricated: NACP nanocomposite, and control composite filled with glass particles. Twenty-five volunteers wore palatal devices containing bovine enamel slabs with cavities restored with NACP or control composite. After 14 days, the adherent biofilms were collected for analyses. Transverse microradiography determined the enamel mineral profiles at the margins, and the enamel mineral loss ΔZ was measured.

RESULTS

NACP nanocomposite released Ca and P ions and the release significantly increased at cariogenic low pH (p<0.05). Biofilms on NACP nanocomposite contained higher Ca (p=0.007) and P ions (p=0.005) than those of control (n=25). There was no significant difference in biofilm CFU between the two composites (p>0.1). Microradiographs showed typical subsurface lesions in enamel next to control composite, but much less lesion around NACP nanocomposite. Enamel mineral loss ΔZ (mean±sd; n=25) around NACP nanocomposite was 13.8±9.3 μm, much less than 33.5±19.0 μm of the control (p=0.001).

SIGNIFICANCE

Novel NACP nanocomposite substantially reduced caries formation in a human in situ model for the first time. Enamel mineral loss at the margins around NACP nanocomposite was less than half of the mineral loss around control composite. Therefore, the Ca and P ion-releasing NACP nanocomposite is promising for caries-inhibiting restorations.

Toxicity of novel nanosized formulations used in medicine

Nanotechnology involves the creation and manipulation of materials at nanoscale levels (1-100 nm) to create products that exhibit novel properties. While this motivation has driven nanoscience and technology in physics and engineering, it is not the main reason that nanoparticles are useful for systemic applications in the human body. The application of nanotechnology to medicine, known as nanomedicine, concerns the use of precisely engineered materials at this length scale to develop novel therapeutic and diagnostic modalities. A number of nanotherapeutic formulations are already approved for medical use and more are in the approval pipeline currently. This chapter is intended to provide an overview of the toxicity of these therapeutic nanoparticles and to summarize the current state of the field. We begin with background on the sources of exposure to nanoparticles, followed by reviewing different forms of nanosized therapeutic tools as quantum dots, nanoshells, nanocapsules, echogenic bubble, and "nanoshuttles." Moreover, cytotoxic effects of nanoparticles on cell membrane, mitochondrial function, prooxidant/antioxidant status, enzyme leakage, DNA, and other biochemical endpoints were elucidated. We highlight the need for caution during the use and disposal of such manufactured nanomaterials to prevent unintended environmental impacts. Moreover, different strategies which could be used to minimize or eliminate nanotoxicity were also discussed in detail. Understanding of how to tune size and surface properties to provide safety will permit the creation of new, more effective nanomedicines for systemic use.

Biofunctional properties of caseinophosphopeptides in the oral cavity

Caseinophosphopeptides (CPPs), bioactive peptides released from caseins, have the ability to enhance bivalent mineral solubility. This is relevant to numerous biological functions in the oral cavity (promotion of tooth enamel remineralisation, prevention of demineralisation and buffering of plaque pH). Therefore, CPPs may play a positive role as prophylactic agents for caries, enamel erosion and regression of white spot lesions. Most in vitro and in situ studies demonstrate strong evidence for the bioactivity of CPPs in the oral cavity. Nevertheless, relatively little is known concerning their use as adjuvants for oral health and more particularly regarding their long-term effects on oral health.

Nanocomposite containing CaF(2) nanoparticles: thermal cycling, wear and long-term water-aging

OBJECTIVES

Fluoride (F) releasing dental restoratives are promising to promote remineralization and combat caries. The objectives of this study were to develop nanocomposite containing calcium fluoride nanoparticles (nCaF(2)), and to investigate the long-term mechanical durability including wear, thermal-cycling and long-term water-aging behavior.

METHODS

Two types of fillers were used: nCaF(2) with a diameter of 53 nm, and glass particles of 1.4 μm. Four composites were fabricated with fillers of: (1) 0% nCaF(2)+65% glass; (2) 10% nCaF(2)+55% glass; (3) 20% nCaF(2)+45% glass; (4) 30% nCaF(2)+35% glass. Three commercial materials were also tested. Specimens were subjected to thermal-cycling between 5°C and 60°C for 10(5) cycles, three-body wear for 4×10(5) cycles, and water-aging for 2 years.

RESULTS

After thermal-cycling, the nCaF(2) nanocomposites had flexural strengths in the range of 100-150 MPa, five times higher than the 20-30 MPa for resin-modified glass ionomer (RMGI). The wear scar depth showed an increasing trend with increasing nCaF(2) filler level. Wear of nCaF(2) nanocomposites was within the range of wear for commercial controls. Water-aging decreased the strength of all materials. At 2 years, flexural strength was 94 MPa for nanocomposite with 10% nCaF(2), 60 MPa with 20% nCaF(2), and 48 MPa with 30% nCaF(2). They are 3-6 fold higher than the 15 MPa for RMGI (p<0.05). SEM revealed air bubbles and cracks in a RMGI, while composite control and nCaF(2) nanocomposites appeared dense and solid.

SIGNIFICANCE

Combining nCaF(2) with glass particles yielded nanocomposites with long-term mechanical properties that were comparable to those of a commercial composite with little F release, and much better than those of RMGI controls. These strong long-term properties, together with their F release being comparable to RMGI as previously reported, indicate that the nCaF(2) nanocomposites are promising for load-bearing and caries-inhibiting restorations.

Antibacterial and physical properties of calcium-phosphate and calcium-fluoride nanocomposites with chlorhexidine

OBJECTIVES

Previous studies have developed calcium phosphate and fluoride releasing composites. Other studies have incorporated chlorhexidine (CHX) particles into dental composites. However, CHX has not been incorporated in calcium phosphate and fluoride composites. The objectives of this study were to develop nanocomposites containing amorphous calcium phosphate (ACP) or calcium fluoride (CaF(2)) nanoparticles and CHX particles, and investigate Streptococcus mutans biofilm formation and lactic acid production for the first time.

METHODS

Chlorhexidine was frozen via liquid nitrogen and ground to obtain a particle size of 0.62 μm. Four nanocomposites were fabricated with fillers of: nano ACP; nano ACP+10% CHX; nano CaF(2); nano CaF(2)+10% CHX. Three commercial materials were tested as controls: a resin-modified glass ionomer, and two composites. S. mutans live/dead assay, colony-forming unit (CFU) counts, biofilm metabolic activity, and lactic acid were measured.

RESULTS

Adding CHX fillers to ACP and CaF(2) nanocomposites greatly increased their antimicrobial capability. ACP and CaF(2) nanocomposites with CHX that were inoculated with S. mutans had a growth medium pH>6.5 after 3 d, while the control commercial composites had a cariogenic pH of 4.2. Nanocomposites with CHX reduced the biofilm metabolic activity by 10-20 folds and reduced the acid production, compared to the controls. CFU on nanocomposites with CHX were three orders of magnitude less than that on commercial composite. Mechanical properties of nanocomposites with CHX matched a commercial composite without fluoride.

SIGNIFICANCE

The novel calcium phosphate and fluoride nanocomposites could be rendered antibacterial with CHX to greatly reduce biofilm formation, acid production, CFU and metabolic activity. The antimicrobial and remineralizing nanocomposites with good mechanical properties may be promising for a wide range of tooth restorations with anti-caries capabilities.

Nanocomposite containing amorphous calcium phosphate nanoparticles for caries inhibition

OBJECTIVES

The main challenges facing composite restorations are secondary caries and bulk fracture. The objectives of this study were to synthesize novel nanoparticles of amorphous calcium phosphate (NACP), develop NACP nanocomposite with calcium (Ca) and phosphate (PO(4)) ion release to combat caries, and investigate the effects of NACP filler level and glass co-filler reinforcement on composite properties.

METHODS

NACP (diameter=116 nm) were synthesized via a spray-drying technique for the first time. Since the local plaque pH in the oral cavity can decrease to 5 or 4, photo-activated composites were tested with immersion in solutions of pH 7, 5.5, and 4. Composite mechanical properties as well as Ca and PO(4) ion release were measured vs. pH and filler level.

RESULTS

Increasing the NACP filler level increased the ion release. At 28 d and pH 4, the Ca release was (4.66±0.05)mmol/L at 20% NACP, much higher than (0.33±0.08) at 10% NACP (p<0.05). Decreasing the pH increased the ion release. At 20% NACP, the PO(4) release at 28 d was (1.84±0.12)mmol/L at pH 4, higher than (0.59±0.08) at pH 5.5, and (0.12±0.01) at pH 7 (p<0.05). However, pH had little effect on composite mechanical properties. Flexural strength at 15% NACP was (96±13)MPa at pH 4, similar to (89±13)MPa at pH 5.5, and (89±19)MPa at pH 7 (p>0.1). The new NACP nanocomposites had strengths that were 2-fold those of previous calcium phosphate composites and resin-modified glass ionomer control.

SIGNIFICANCE

NACP composites were developed for the first time. Their strengths matched or exceeded a commercial composite with little ion release, and were 2-fold those of previous Ca-PO(4) composites. The nanocomposite was "smart" as it greatly increased the ion release at a cariogenic pH 4, when these ions would be most needed to inhibit caries. Hence, the new NACP composite may be promising for stress-bearing and caries-inhibiting restorations.

The addition of nano-sized hydroxyapatite to a sports drink to inhibit dental erosion: in vitro study using bovine enamel

OBJECTIVES

This study examined the dental erosion and demineralization potential of a sports drink containing nano-sized hydroxyapatite (nano-HA) as an additive.

METHODS

The experimental solutions were Powerade (PA) alone and PA with 0.05%, 0.10%, and 0.25% nano-HA. The pH, titratable acidity, and calcium and phosphate content of each solution were analysed, and the degree of saturation with respect to the dental enamel (DS(En)) was obtained. Twelve sound bovine enamel specimens for each group were treated in accordance with the pH-cycling schedule which had 60min treatment with experimental solution per day for 7 days. The erosion potential was determined from the changes in surface micro hardness (SMH), the depths of erosion and demineralized layer using confocal laser scanning microscopy (CLSM), and the morphological changes to the tooth surface were examined with scanning electron microscopy (SEM) after pH-cycling.

RESULTS

pH and DS(En) increased with increasing nano-HA concentration in the drinks, whereas the titratable acidity decreased. There were significant differences in the SMH between the PA alone and >0.10% nano-HA groups (p<0.001). Although the PA alone group showed a pronounced erosion depth, CLSM showed no erosion depth in 0.25% nano-HA group. SEM showed an intact surface with increasing nano-HA concentration in the drinks. In conclusion, dental erosion was effectively prevented with increase of adding concentration of nano-HA, and a sports drink containing 0.25% nano-HA might prevent dental erosion.

A new approach to prepare well-dispersed CaF(2) nanoparticles by spray drying technique

Previously, nano-sized calcium fluoride (CaF₂) particles were prepared using a spray drying method by simultaneously feeding Ca(OH)₂ and NH₄F solutions to a two-liquid nozzle. The aim of the present study was to prepare better-dispersed nano-CaF₂ particles by co-forming a soluble salt, sodium chloride (NaCl). NaCl of various concentrations were added to the NH(4) F solution, leading to formation of (CaF₂ +NaCl) composites with CaF₂ /NaCl molar ratios of 4/1, 4/4, and 4/16. Pure nano-CaF₂ was also prepared as the control. Powder X-ray diffraction analysis showed that the products contained crystalline CaF₂ and NaCl. Scanning electron microscopy examinations showed that both the CaF₂ /NaCl composite and pure CaF₂ particles were about (50-800) nm in size and consisted of primary CaF₂ particles of < 50 nm in size. BET surface area measurements showed similar primary particle sizes for all samples. Dynamic light scattering measurements showed that the washed (CaF₂+NaCl) particles were much smaller than the pure CaF₂ as the dissolution of NaCl "freed" most of the primary CaF₂ particles, leading to a greater degree of particle dispersion. The well-dispersed nano-CaF₂ may be expected to be a more effective anticaries agent than NaF by providing longer lasting elevations of fluoride concentrations in oral fluids.

Electrospraying, spray drying and related techniques for production and formulation of drug nanoparticles

IMPORTANCE OF THE FIELD

Spray drying and electrospraying are two widely used liquid atomization-based techniques for production and formulation of drug nanoparticles. The importance of spray drying in particular has increased lately in the production of nanostructured microparticles. The value of the particles is that they maintain the properties of individual nanoparticles but they are micrometer sized.

AREAS COVERED IN THIS REVIEW

In this review the most important liquid atomization techniques, spray drying and electrospraying, are presented in detail, and a short introduction is presented for other methods, including the aerosol flow reactor method and spray congealing.

WHAT THE READER WILL GAIN

A description of the possible tailoring processes depending on the technique and process parameters. Different product properties can be achieved; for example, nanosuspensions or dry powder formulations may be produced.

TAKE HOME MESSAGE

The most important advantage of these techniques as compared with many other particle formation techniques is that the production of dried powders is possible without any extra drying step.

Preparation and Properties of Nanoparticles of Calcium Phosphates With Various Ca/P Ratios

This study aimed at preparing and studying the properties of nanoparticles of calcium phosphate (nCaP) with Ca/P ratios ranging from 1.0 to 1.67 using a spray-drying technique. Micro-structural analyses suggested that the nCaPs with Ca/P ratios of 1.67 to 1.33 were nano-sized amorphous calcium phosphate (ACP) containing varying amounts of acid phosphate and carbonate. The nCaP with Ca/P ratio of 1 contained only nano-sized low crystalline dicalcium phosphate (DCP). BET measurements of the nCaPs showed specific surface areas of (12 ± 2 to 50 ± 1) m(2)/g, corresponding to estimated equivalent spherical diameters of (38 to 172) nm. However, dynamic light scattering measurements revealed much larger particles of (380 ± 49 to 768 ± 111) nm, owing to agglomeration of the smaller primary nano particles as revealed by Scanning Electron Microscopy (SEM). Thermodynamic solubility measurements showed that the nCaPs with Ca/P ratio of 1.33 - 1.67 all have similar solubility behavior. The materials were more soluble than the crystalline hydroxyapatite (HA) at pH greater than about 4.7, and more soluble than β-tricalcium phosphate (β-TCP), octacalcium phosphate (OCP) and DCP at pH above 5.5. Their solubility approached that of α-tricalcium phosphate (α-TCP) at about pH 7. These nCaPs, which cannot be readily prepared by other currently available methods for nanoparticle preparation, have potential biomedical applications.

Novel CaF(2) nanocomposite with high strength and fluoride ion release

Secondary caries and restoration fracture remain common problems in dentistry. This study tested the hypothesis that combining nano-CaF(2) and glass fillers would yield nanocomposites with high mechanical properties and F release. Novel CaF(2) nanoparticles (56-nm) were synthesized via spray-drying and incorporated into resin. F release increased with increasing the nano-CaF(2) content, or with decreasing pH (p < 0.05). F-release rates at 70-84 days were 1.13 microg/(cm(2) x day) and 0.50 microg/(cm(2) x day) for nanocomposites containing 30% and 20% nano-CaF(2), respectively. They matched the 0.65 microg/(cm(2) x day) of resin-modified glass ionomer (p > 0.1). The nanocomposites had flexural strengths of 70-120 MPa, after 84-day immersion at pH 4, pH 5.5, and pH 7. These strengths were nearly three-fold that of resin-modified glass ionomer, and matched/exceeded a composite with little F release. In summary, novel CaF(2) nanoparticles produced high F release at low filler levels, thereby making room in resin for reinforcement glass. This yielded nanocomposites with high F-release and stress-bearing properties, which may help reduce secondary caries and restoration fracture.

Strong nanocomposites with Ca, PO(4), and F release for caries inhibition

This article reviews recent studies on: (1) the synthesis of novel calcium phosphate and calcium fluoride nanoparticles and their incorporation into dental resins to develop nanocomposites; (2) the effects of key microstructural parameters on Ca, PO(4), and F ion release from nanocomposites, including the effects of nanofiller volume fraction, particle size, and silanization; and (3) mechanical properties of nanocomposites, including water-aging effects, flexural strength, fracture toughness, and three-body wear. This article demonstrates that a major advantage of using the new nanoparticles is that high levels of Ca, PO(4), and F release can be achieved at low filler levels in the resin, because of the high surface areas of the nanoparticles. This leaves room in the resin for substantial reinforcement fillers. The combination of releasing nanofillers with stable and strong reinforcing fillers is promising to yield a nanocomposite with both stress-bearing and caries-inhibiting capabilities, a combination not yet available in current materials.

The apatite formation ability of CaF2 doping tricalcium silicates in simulated body fluid

The purpose of this study was to investigate the effects of CaF(2) on the apatite formation ability of tricalcium silicates (Ca(3)SiO(5), C(3)S) and the mechanism of apatite formation on C(3)S pastes. Different amounts of CaF(2) (0, 1, 2 and 3 wt%) were mixed in the raw materials during the synthesis process of C(3)S. The apatite formation ability of the CaF(2) doping C(3)S was examined by soaking the one-day setting pastes in simulated body fluid (SBF). The fluoride concentrations, pH values, structural and morphological variations of the pastes were examined during soaking in SBF. With the addition of CaF(2), the initial crystalline apatite formation time of the pastes was decreased from three days to one day. After soaking for seven days, the thicknesses of apatite layers depositing on the surface of C(3)S doped with 0, 1, 2 and 3 wt% CaF(2) were about 88, 102, 168 and 136 microm, respectively. C(3)S doped with 2 wt% CaF(2) showed the better ability to induce the formation of apatite. Furthermore, the mechanism of the apatite formation of the CaF(2) doping C(3)S pastes may be attributed to the formation and stability of F-substituted apatite determined by x-ray photoelectron spectroscopy (XPS) at the early age. The results indicated that CaF(2) doping C(3)S has better in vitro bioactivity, and may be used to prepare novel bone cement.

On the toxicity of therapeutically used nanoparticles: an overview

Human beings have been exposed to airborne nanosized particles throughout their evolutionary stages, and such exposures have increased dramatically over the last century. The rapidly developing field of nanotechnology will result in new sources of this exposure, through inhalation, ingestion, and injection. Although nanomaterials are currently being widely used in modern technology, there is a serious lack of information concerning the human health and environmental implications of manufactured nanomaterials. Since these are relatively new particles, it is necessary to investigate their toxicological behavior. The objective of this review was to trace the cellular response to nanosized particle exposure. Therapeutic application of selected nanoparticles together with their range of toxic doses was also reviewed. Effect of therapeutically used nanoparticles on cell membrane, mitochondrial function, prooxidant/antioxidant status, enzyme leakage, DNA, and other biochemical endpoints was elucidated. This paper highlights the need for caution during the use and disposal of such manufactured nanomaterials to prevent unintended environmental impacts.

Strength and fluoride release characteristics of a calcium fluoride based dental nanocomposite

Secondary caries and restoration fracture remain the two most common problems in restorative dentistry. Release of fluoride ions (F) could be a substantial benefit because F could enrich neighboring enamel or dentin to combat caries. The objective of this study was to incorporate novel CaF(2) nanoparticles into dental resin to develop stress-bearing, F-releasing nanocomposite. CaF(2) nanoparticles, prepared in our laboratories for the first time, were combined with reinforcing whisker fillers in a resin. Flexural strength (mean+/-sd; n=6) was 110+/-11 MPa for the composite containing 30% CaF(2) and 35% whiskers by mass. It matched the 108+/-19 MPa of a stress-bearing, non-releasing commercial composite (Tukey's at 0.05). The composite containing 20% CaF(2) had a cumulative F release of 2.34+/-0.26 mmol/L at 10 weeks. The initial F release rate was 2 microg/(hcm(2)), and the sustained release rate after 10 weeks was 0.29 microg/(hcm(2)). These values exceeded the reported releases of traditional and resin-modified glass ionomer materials. In summary, nanocomposites were developed with relatively high strength as well as sustained release of fluoride ions, a combination not available in current materials. These strong and F-releasing composites may yield restorations that can reduce the occurrence of both secondary caries and restoration fracture.