Effect of dentin etching and chlorhexidine application on metalloproteinase-mediated collagen degradation

Experimental resin cements containing bioactive fillers reduce matrix metalloproteinase-mediated dentin collagen degradation

INTRODUCTION

Collagen dentin matrix may represent a suitable scaffold to be remineralized in the presence of bioactive materials. The purpose of this study was to determine if experimental resin cements containing bioactive fillers may modulate matrix metalloproteinase-mediated collagen degradation of etched dentin.

METHODS

Human dentin beams demineralized using 10% phosphoric acid or 0.5 mol/L EDTA were infiltrated with the following experimental resins: (1) unfilled resin, (2) resin with Bioglass 45S5 particles (Sylc; OSspray Ltd, London, UK), and (3) resin with β-tricalcium phosphate-modified calcium silicate cement (HCAT-β) particles. The filler/resin ratio was 40/60 wt%. The specimens were stored in artificial saliva, and the determination of C-terminal telopeptide (ICTP) was performed by radioimmunoassay after 24 hours, 1 week, and 4 weeks. Scanning electron microscopic analysis of dentin surfaces after 4 weeks of storage was also executed.

RESULTS

Collagen degradation was prominent both in phosphoric acid and EDTA-treated dentin. Resin infiltration strongly reduced the MMP activity in demineralized dentin. Resin-containing Bioglass 45S5 particles exerted higher and more stable protection of collagen at all tested dentin states and time points. HCAT-β induced collagen protection from MMPs only in EDTA-treated specimens. Dentin remineralization was achieved when dentin was infiltrated with the resin cements containing bioactive fillers.

CONCLUSIONS

MMP degradation of dentin collagen is strongly reduced in resin-infiltrated dentin. The inclusion of Bioglass 45S5 particles exerted an additional protection of collagen during dentin remineralization.

Bonding efficacy of an acetone/based etch-and-rinse adhesive after dentin deproteinization

Objectives: to evaluate the effect of sodium hypochlorite (NaOCl) treatment on dentin bonding by means of shear bond strength (SBS) measurements when using Prime&Bond NT (PB NT) adhesive. Ultrastructure of the interfaces was examined by scanning electron microscopy (SEM). Study design: Extracted human third molars were sectioned and ground to expose flat surfaces of superficial or deep dentin. Specimens were randomly assigned to two equal groups, and bonded as follows: (1) according to the manufacturers’ directions, after 35% H3PO4 etching, (2) 5% NaOCl treated for 2 minutes, after 35% H3PO4 etching. Each sample was embedded in a Watanabe shear test assembly for a single plane lap shear. After PB NT bonding, specimens were stored in water for 24 h at 37ºC and thermocycled (500x). Samples were tested in shear to failure using a universal testing machine at 0.75 mm/min. Data were analyzed with ANOVA and Newman-Keuls multiple comparison test procedures. Two samples of each group were randomly selected to investigate the morphologic aspect of the resin/dentin interface with SEM. Results: After etching and after aqueous sodium hypochlorite (NaOClaq) application, SBS values were similar on superficial than deep dentin (p>0.05). SEM findings shows for H3PO4 etching conditioned samples a detectable hybrid layer and long resin tags; for NaOCl treated specimens, it may be observed a non apparent hybrid layer, and the adhesive contact directly with the neck of the cylindrical resin tags. Conclusions: The use of 5% NaOCl for 2 min after dentin demineralization when PB NT was employed did not improve the bond strength to dentin, probably due to nanofiller content and/or oxidative changes on collagen-depleted dentin.

Key words:Sodium hypochlorite, shear bond strength, SEM, Prime&Bond NT, superficial dentin, deep dentin.

A ZnO-doped adhesive reduced collagen degradation favouring dentine remineralization

OBJECTIVES

The objective of the study was to determine the efficacy of a ZnO-doped etch and rinse adhesive in decreasing MMPs-mediated collagen degradation at the resin-dentine hybrid layer, and increasing bonding stability.

METHODS

C-terminal telopeptide concentrations (ICTP) were determined after 24h, 1wk and 4wk in human dentine beams. Dentine was treated: (1) 37% phosphoric acid for 15s (PA), (2) PA-etched dentine infiltrated with Single Bond (SB), (3) PA-etched dentine infiltrated with ZnO doped SB (ZnO particles--10wt%--were added to the bonding resin) (ZnO-SB), and (4) Clearfil SE Bond primed-dentine was infiltrated with Clearfil SE bonding resin (CSE). Microtensile bond strength (MTBS) was assessed for the different groups at 24h and after 3months. Debonded dentine surfaces were studied by scanning electron microscopy.

RESULTS

MMPs-mediated collagen degradation occurred in demineralized dentine (PA). Resin infiltration decreased collagen degradation. The lowest collagen degradation was found for Zn-doped SB, followed by CSE. When these adhesives were applied, ICTP values did not change throughout the study period. At 24h, similar MTBS was attained for all adhesives. Only SB decreased MTBS after three months.

CONCLUSIONS

Addition of ZnO particles to SB produced a reduction in dentine collagen degradation and increased resin-dentine bonds durability. In Zn-doped adhesive interfaces, a calcium phosphate layer and tubular occlusion was encountered at the debonded interface.

CLINICAL SIGNIFICANCE

ZnO particles addition into the bonding resin of SB makes a breakthrough to prevent the hybrid layer degradation and to preserve its bonding efficacy overtime.

Mechanical and micromorphological evaluation of chlorhexidine-mediated dentin remineralization

Chlorhexidine (CHX) has been reported to reduce self-degradation of collagen fibrils by inhibiting host-derived protease activity in demineralized dentin. Theoretically, if the collagen fibril scaffold of demineralized dentin maintains its original crosslinkage pattern on treatment with CHX and appropriate supplementation with necessary mineral sources, dentin remineralization may occur in demineralized lesions. In this study, we provide direct mechanical and micromorphological evidence for the ability of CHX to promote remineralization of demineralized dentin. Specifically, with respect to demineralized dentin blocks treated with different concentrations of CHX (0.02-2%) and stored in simulated body fluid, we have observed a significant increase in the elastic modulus of dentin treated with relatively high concentrations of CHX (0.2 and 2%) as storage time increased, whereas the elastic modulus of the non-CHX treated control group decreased. We have also observed a dense mineral deposition along collagen fibrils in the dentin group treated with 0.2 and 2% CHX via field emission scanning electron microscopy.

MMP activity in the hybrid layer detected with in situ zymography

Dentinal proteases are believed to play an important role in the degradation of hybrid layers (HL). This study investigated the HL gelatinolytic activity by in situ zymography and functional enzyme activity assay. The hypotheses were that HLs created by an etch-and-rinse adhesive exhibit active gelatinolytic activity, and MMP-2 and -9 activities in dentin increase during adhesive procedures. Etched-dentin specimens were bonded with Adper Scotchbond 1XT and restored with composite. Adhesive/dentin interface slices were placed on microscope slides, covered with fluorescein-conjugated gelatin, and observed with a multi-photon confocal microscope after 24 hrs. Human dentin powder aliquots were prepared and assigned to the following treatments: A, untreated; B, etched with 10% phosphoric acid; or C, etched with 10% phosphoric acid and mixed with Scotchbond 1XT. The MMP-2 and -9 activities of extracts of dentin powder were measured with functional enzyme assays. Intense and continuous enzyme activity was detected at the bottom of the HL, while that activity was more irregular in the upper HL. Both acid-etching and subsequent adhesive application significantly increased MMP-2 and -9 activities (p < 0.05). The results demonstrate, for the first time, intrinsic MMP activity in the HL, and intense activation of matrix-bound MMP activity with both etching and adhesive application.

Inhibition of endogenous dentin matrix metalloproteinases by ethylenediaminetetraacetic acid

INTRODUCTION

Endogenous dentin matrix metalloproteinases (MMPs) contribute to extracellular collagen matrix degradation in hybrid layers after adhesive dentin bonding procedures. Endodontic irrigants, including chlorhexidine and ethylenediaminetetraacetic acid (EDTA), might help protect the hybrid layer from this process. The objective of the present study was to determine the exposure time necessary for EDTA to inactivate endogenous MMP activity in human dentin.

METHODS

Dentin beams (2 × 1 × 3 mm) were prepared from mid-coronal dentin of extracted third molars. The beams were demineralized in 10 wt% phosphoric acid, which also activated endogenous MMPs, and were divided into 4 experimental groups on the basis of exposure time to 17% EDTA (0, 1, 2, or 5 minutes). A generic colorimetric MMP assay measured MMP activity via absorbance at 412 nm. Data were evaluated by Kruskal-Wallis analysis of variance, followed by Dunn pair-wise comparisons at α = 0.05.

RESULTS

All exposure times resulted in significant inhibition (P < .001) compared with unexposed controls. Specifically, percent inhibition for 1-, 2-, and 5-minute exposure times was 55.1% ± 21.5%, 72.8% ± 11.7%, and 74.7% ± 19.7%, respectively.

CONCLUSIONS

Seventeen percent EDTA significantly inhibits endogenous MMP activity of human dentin within 1-2 minutes. This might minimize hybrid layer degradation after resin bonding procedures in the root canal space.

Bleaching agents increase metalloproteinases-mediated collagen degradation in dentin

INTRODUCTION

Tooth bleaching is based on hydrogen peroxide application. The Objective of this study was to determine whether dental bleaching agents affect metalloproteinases-mediated dentin collagen degradation.

METHODS

Human dentin specimens were subjected to different treatments: (1) untreated dentin; (2) demineralization by 37% phosphoric acid (PA); (3) demineralization by 37% PA, followed by application of Single Bond (SB); (4) 2 immersions of 7 days each in a nonvital bleaching agent, followed by PA; (5) 2 immersions of 7 days each in nonvital bleaching, followed by PA and SB application; (6) 3 immersions by using in-office bleaching gel for 20 minutes; (7) 3 immersions by using in-office bleaching gel for 20 minutes plus activation with a light source; and (8) immersion in home bleaching gel for 8 hours per day during 3 weeks. Specimens were stored in artificial saliva. C-terminal telopeptide determinations (radioimmunoassay) were performed after 24 hours, 1 week, and 4 weeks.

RESULTS

Bleaching agents increased collagen degradation, but C-terminal telopeptide of type I collagen (ICTP) values were higher when dentin was PA-demineralized. Nonvital bleaching plus PA promoted the highest collagenolytic activity, which was reduced after SB infiltration. Halogen light application did not influence ICTP values. At 24 hours, home bleaching exhibited high collagenolytic activity, which decreased up to 4 weeks. After 4 weeks of storage, all bleaching procedures showed similar values of collagen degradation, which were not different from those of PA-demineralized and resin-infiltrated dentin.

CONCLUSIONS

All tested bleaching agents increase matrix metalloproteinases-mediated collagen degradation in dentin. This effect was not completely reverted after 4 weeks. Home bleaching induced the highest collagen degradation.

Zinc reduces collagen degradation in demineralized human dentin explants

OBJECTIVES

Dentin matrix metalloproteinases are implicated in the pathogenesis of caries and contribute to collagen degradation in resin-dentin interfaces. The objective was to determine if collagen degradation may be modulated by an excess of zinc or zinc chelators.

METHODS

Mineralized and phosphoric acid demineralized human dentin specimens were tested. Chlorhexidine digluconate, doxycycline or ZnCl₂ were added to the media. In half of the groups, active exogenous metalloproteinase-2 was incorporated into the solution. C-terminal telopeptide determinations (radioimmunoassay) were performed after 24 h, 1 and 3 weeks.

RESULTS

Collagen degradation was prominent in demineralized dentin. Doxycycline fully blocked dentin proteolysis. Chlorhexidine digluconate reduced the degradation at the 24-h period. Zinc in excess strongly inhibits hydrolysis of collagen and its effect was maintained for 3 weeks.

CONCLUSIONS

Zinc in excess reduces MMP-mediated collagen degradation. The hypothesis that binding of zinc to collagen results in protection of sensitive cleavage sites of metalloproteinases requires further validation.