Effect of Chemical Structure and Composition of the Resin Phase on Vinyl Conversion of Amorphous Calcium Phosphate-filled Composites

Advances in Preventive and Therapeutic Approaches for Dental Erosion: A Systematic Review

This review discusses both preventive measures and clinically implemented therapy procedures that have been developed recently for the prevention and treatment of tooth erosion.

METHODS

The databases PubMed, Scopus, and Web of Science were used for a thorough search. Studies on the prevention and treatment of dental erosion that were conducted in English and used in vitro were among the inclusion criteria.

RESULTS

The search turned up 391 papers in total, with 34 of those publications matching the requirements for inclusion. Varnishes, toothpastes, and solutions containing fluoride and other substances were used as preventive measures.

CONCLUSIONS

Dental erosion is a significant issue, and taking preventative steps is crucial to lessening the disease's spread and its effects. Interventions based on fluoride seem to be successful at halting erosion and encouraging remineralization. To effectively address severe tooth erosion, therapeutic methods, including composite restorations, prosthetic crowns, and veneers, are available. Dental erosion causes aesthetic and functional issues that are best addressed with less invasive treatments like direct composite restorations. To improve and broaden the range of available treatments for this common dental issue, additional research and development are required.

Novel hydrolytic resistant antibacterial monomers for dental resin adhesive

OBJECTIVES

To evaluate the properties of novel hydrolytic resistant antibacterial monomers and to determine the properties of resin adhesives containing these monomers.

METHODS

Methacrylamide-based QAC (Quaternary Ammonium Compound) monomers, 1-(11-Methacryla-midoundecyl)pyridine-1-ium bromide (MAUPB) and 1-(12-Methacryl-amidododecyl)pyridine-1-ium bromide (MADPB), and their methacrylate-derivatives, N-(1-Methacryloylundecanyl)pyridinium bromide (MUPB) and N-(1-Methacryloyldodecanyl)pyridinium bromide (MDPB), were synthesized and characterized. The minimum inhibitory (MIC) and bactericidal (MBC) concentrations were determined against S.mutans and E.faecalis. Cytotoxicity of unpolymerized monomers were evaluated using L-929 and MDPC-23. Each monomer was incorporated into experimental resins (BisGMA/TEGDMA/CQ/EDMAB or BisGMA/HEMA/CQ/EDMAB) at 10wt%. FTIR Spectra were collected for degree of conversion (DC%) measurement. Bacterial attachment on resin disks were determined by fluorescent microscope. Mechanical properties of experimental resins were evaluated by flexural strength & modulus and shear bond strength testing.

RESULTS

The antibacterial activity of MDPB≥MUPB>MADPB>MAUPB. The TC50 of MAUPB> MADPB>MUPB >MDPB. Incorporation of MAUPB in BisGMA/TEGDMA-based resin, had no significant effect on DC%, while significantly increase DC% in BisGMA/HEMA-based Resin. MUPB and MAUPB containing resins showed less viable bacterial attachment than pure resins. After 3-month storage, resins containing MAUPB illustrated higher flexural strength than their corresponding resins containing MUPB. BisGMA/HEMA-based resin containing MAUPB illustrated significantly higher resin-dentin shear bond strength than that of MUPB and pure resin.

CONCLUSIONS

Methacrylamide monomer containing QAC, MAUPB, possessed antibacterial properties and superior physical and mechanical properties when incorporated in resin adhesives as compared to their corresponding methacrylate monomer, MUPB.

CLINICAL SIGNIFICANCE

Methacrylamide-based QAC monomers are potentially used to formulate antibacterial hydrolytic resistant resin adhesives and enhance resin-dentin bond strength.

Analysis of laboratory adhesion studies in eroded enamel and dentin: a scoping review

Aim

To summarize and report laboratory studies of adhesion in eroded substrates, which used bond strength as an outcome measure. To determine the strategies available to overcome bonding difficulties, the quality and consistency of the methodology and to find evidence gaps.

Materials and Methods

The present review followed PRISMA-ScR guidelines. A search was conducted on PubMed/Medline, Scopus and EMBASE (Ovid) databases to identify published peer-reviewed papers (2010–2020). For final qualitative synthesis, 29 articles were selected which respected the inclusion criteria. Data charting was carried out, independently, by two reviewers and quality assessment of the articles was performed.

Results

The primary studies included fall into four major categories: comparison of restorative materials and application modes, enzymatic inhibitors, surface pretreatments or remineralization strategies. Most studies found evaluated dentin (76%), while 17% evaluated enamel, and 7% evaluated both substrates. The majority of the studies reported an effective intervention (83%). Bond strength to eroded dentin is significantly reduced, while in enamel erosion is beneficial. The bond strength to eroded dentin is material-dependent and favored in systems containing 10-MDP. Great disparities among the erosion models used were found, with citric acid in different concentrations being the preferred method, although standardization is lacking.

Conclusions

Adhesives containing 10-MDP show beneficial results in eroded dentin, and surface preparation methods should be considered. Studies which evaluated adhesion to eroded enamel/dentin show high heterogeneity in what concerns aims and methodology. Strategies that focus on remineralizing dentin and strategies to protect bond longevity in this substrate require further research.

Comparative Raman study on the molecular structure and IN VIVO wear of poly(methyl methacrylate)-based devices used as temporary knee prostheses: Effect of the antibiotic

The infection rate of total knee arthroplasty is still high, in spite of the high success of this surgical procedure. The use of an antibiotic-loaded temporary spacer made of poly(methyl methacrylate) (PMMA) has been proposed to treat infected knee arthroplasties. This study was aimed at comparatively investigating, on a molecular scale, two types of spacers from the same manufacturer (Spacer K and Vancogenx-space knee, Tecres, Italy), which differ for the added antibiotic (gentamicin sulphate in Spacer K and gentamicin sulphate + vancomycin hydrochloride in Vancogenx). Raman spectroscopy was used to gain more insights into the possible effects of the antibiotic on the spacer composition and polymer structure both in the new components and after in vivo use. Vancogenx was found to contain a lower residual MMA content than Spacer K (about 0.15% versus 0.4%). The former contained a higher amount of isotactic stereosequences than the latter, while the syndiotactic content (the prevailing component) was not significantly different in the two prostheses. The presence of vancomycin hydrochloride influenced not only the degree of polymerization and PMMA tacticity and crystallinity, but in turn also the wear behavior. Actually, Spacer K retrievals were found more affected by in vivo implantation than Vancogenx-space knee ones, revealing slight variations in polymer tacticity and crystallinity and relative radiopacifier content, besides release of MMA and additives of polymerization. However, these changes did not appear worrisome, due to the temporary nature of the prosthesis. In view of these results, the addition of vancomycin hydrochloride could offer an advantage, in spite of the higher costs requested and the potential risks of its unselective use.

A review of bioceramics-based dental restorative materials

Currently, much has been published related to conventional resin-based composites and adhesives; however, little information is available about bioceramics-based restorative materials. The aim was to structure this topic into its component parts and to highlight the translational research that has been conducted up to the present time. A literature search was done from indexed journals up to September 2017. The main search terms used were based on dental resin-based composites, dental adhesives along with bioactive glass and the calcium phosphate family. The results showed that in 123 articles, amorphous calcium phosphate (39.83%), hydroxyapatite (23.5%), bioactive glass (16.2%), dicalcium phosphate (5.69%), monocalcium phosphate monohydrate (3.25%), and tricalcium phosphate (2.43%) have been used in restorative materials. Moreover, seven studies were found related to a newly developed commercial bioactive composite. The utilization of bioactive materials for tooth restorations can promote remineralization and a durable seal of the tooth-material interface.

Calcium phosphates as ion-releasing fillers in restorative resin-based materials

Calcium phosphates (CaP) are the main constituents of the mineral phase in bones and teeth and, along with calcium silicates and bioactive glasses, have been extensively investigated in remineralization of enamel and dentin. When used as ion-releasing fillers in resin-based materials, they could contribute to extend the service life of adhesive restorations, remineralize caries-affected dentin or prevent caries lesions under sealants and orthodontic brackets. However, the development of resin-based bioactive materials is not straightforward because of the several compositional variables involved in ion release. Also, CaP particles do not reinforce the material; therefore, if high mechanical properties are required, the ratio between CaP particles and reinforcing fillers must be observed. Several research groups have investigated how CaP phase, particle size and content, as well as resin matrix formulation affect remineralization, ion release kinetics and mechanical properties of these materials. This review presents an overview of the main findings reported in the literature.

A poly(2-hydroxyethyl methacrylate)-based resin improves the dentin remineralizing ability of calcium silicates

Bioactive polymeric composites have received great attention for their capability to remineralize the dentin tissue. This study was aimed at evaluating if a poly(HEMA-co-TEGDMA) resin (HEMA: 2-hydroxyethyl methacrylate; TEGDMA: triethyleneglycol dimethacrylate) may increase the in vitro apatite forming ability of a calcium silicate cement (CaSi), in view of developing a hydrophilic light-curable composite bio-remineralizing restorative material (R-CaSi). To this purpose, the following experiments were carried out: (1) In vitro apatite forming ability of R-CaSi and CaSi was comparatively assessed by micro-Raman spectroscopy after immersion of the cement disks in Dulbecco's Phosphate Buffered Saline (DPBS) at 37°C for 1-28days; (2) Previously demineralized human dentin slices were soaked for 7days in close contact with the CaSi and R-CaSi cements as well as poly(HEMA), poly(TEGDMA) and poly(HEMA-co-TEGDMA), and then were comparatively analyzed by IR spectroscopy. Micro-Raman spectroscopy showed that in calcium phosphate nucleation tests, the B-type carbonated apatite deposit formed on R-CaSi was thicker than that on CaSi; therefore, the poly(HEMA-co-TEGDMA) resin proved able to increase the in vitro apatite forming ability of the calcium silicate-based cement. Both cements were found to induce dentin remineralization, R-CaSi to a higher extent, in agreement with the calcium phosphate nucleation tests. This result may be ascribed to the positive role played by the polymeric component, which was found to interact with collagen and to chelate calcium ions. Upon remineralization, collagen underwent conformational rearrangements and the formed apatite phase, rather than a simple deposit, was intimately bound to the collagen matrix, thanks to the calcium ions chelated by it.

The Effect of Bulk Depth and Irradiation Time on the Surface Hardness and Degree of Cure of Bulk-Fill Composites

STATEMENT OF PROBLEM

For many years, application of the composite restoration with a thickness less than 2 mm for achieving the minimum polymerization contraction and stress has been accepted as a principle. But through the recent development in dental material a group of resin based composites (RBCs) called Bulk Fill is introduced whose producers claim the possibility of achieving a good restoration in bulks with depths of 4 or even 5 mm.

OBJECTIVES

To evaluate the effect of irradiation times and bulk depths on the degree of cure (DC) of a bulk fill composite and compare it with the universal type.

MATERIALS AND METHODS

This study was conducted on two groups of dental RBCs including Tetric N Ceram Bulk Fill and Tetric N Ceram Universal. The composite samples were prepared in Teflon moulds with a diameter of 5 mm and height of 2, 4 and 6 mm. Then, half of the samples in each depth were cured from the upper side of the mould for 20s by LED light curing unit. The irradiation time for other specimens was 40s. After 24 hours of storage in distilled water, the microhardness of the top and bottom of the samples was measured using a Future Tech (Japan- Model FM 700) Vickers hardness testing machine. Data were analyzed statistically using the one and multi way ANOVAand Tukey's test (p = 0.050).

RESULTS

The DC of Tetric N Ceram Bulk Fill in defined irradiation time and bulk depth was significantly more than the universal type (p < 0.001). Also, the DC of both composites studied was significantly (p < 0.001) reduced by increasing the bulk depths. Increasing the curing time from 20 to 40 seconds had a marginally significant effect (p ≤ 0.040) on the DC of both bulk fill and universal studied RBC samples.

CONCLUSIONS

The DC of the investigated bulk fill composite was better than the universal type in all the irradiation times and bulk depths. The studied universal and bulk fill RBCs had an appropriate DC at the 2 and 4 mm bulk depths respectively and using the recommended curing time of 40s can led to the slightly better value of DC in both composites.

Effect of silanized nanosilica addition on remineralizing and mechanical properties of experimental composite materials with amorphous calcium phosphate

OBJECTIVES

Experimental composite resins with amorphous calcium phosphate (ACP) have the potential to regenerate demineralized tooth structures. The aim of the study was to investigate the effect of the addition of silanized silica nanofillers to the ACP-based composites on their mechanical properties and the kinetics of calcium and phosphate release.

MATERIALS AND METHODS

The test materials comprised 5 wt% (5-ACP) or 10 wt% (10-ACP) of silanized silica admixed to the 40 wt% ACP and 50 or 55 wt% resin. The ACP control (0-ACP) contained 40 wt% ACP and 60 wt% resin. Additionally, composite material CeramX (Dentsply, Germany) was included as control. Three-point bending test was performed to calculate flexural strength and modulus of elasticity. Inductively coupled plasma atomic emission spectroscopy was used for measurement of ion release. The micromorphology of calcium phosphate depositions on composite samples has been qualitatively evaluated using a scanning electron microscope. The results were analyzed using Mann-Whitney and Wilcoxon rank sum tests (α < 0.05).

RESULTS

Ion release was enhanced by the silica fillers, when compared to the 0-ACP. Although not statistically significant, flexural strength of 10-ACP was improved by 46 % compared to 0-ACP. Flexural modulus of 5-ACP was significantly higher than 0-ACP.

CONCLUSIONS

The admixture of silanized fillers seems to be a promising approach for the improvement of mechanical and remineralizing properties of ACP composite resins.

CLINICAL RELEVANCE

ACP-based composite resins with modified composition could serve as an effective remineralizing aid as base materials in restorative dental medicine.

Fine-Tuning of Polymeric Resins and Their Interfaces with Amorphous Calcium Phosphate. A Strategy for Designing Effective Remineralizing Dental Composites

For over a decade our group has been designing, preparing and evaluating bioactive, remineralizing composites based on amorphous calcium phosphate (ACP) fillers embedded in polymerized methacrylate resin matrices. In these studies a major focus has been on exploring structure-property relationships of the matrix phase of these composites on their anti-cariogenic potential. The main challenges were to gain a better understanding of polymer matrix/filler interfacial properties through controlling the surface properties of the fillers or through fine-tuning of the resin matrix. In this work, we describe the effect of chemical structure and composition of the resin matrices on some of the critical physicochemical properties of the copolymers and their ACP composites. Such structure-property studies are essential in formulating clinically effective products, and this knowledge base is likely to have strong impact on the future design of therapeutic materials, appropriate for mineral restoration in defective tooth structures.

Degree of vinyl conversion, polymerization shrinkage and stress development in experimental endodontic composite

This study explores degree of vinyl conversion (DVC), polymerization shrinkage (PS) and shrinkage stress (PSS) of the experimental amorphous calcium phosphate (ACP) composites intended for use as an endodontic sealer. Light-cure (LC), chemical cure (CC) or dual-cure (DC; combined light and chemical cure) resins comprised urethane dimethacrylate (UDMA), 2-hydroxyethyl methacrylate (HEMA), methacryloyloxyethyl phthalate (MEP) and a high molecular mass oligomeric co-monomer, poly(ethyleneglycol)-extended UDMA (PEG-U) (designated UPHM resin). To fabricate composites, a mass fraction of 60 % UPHM resin was blended with a mass fraction of 40 % as-made (am-ACP) or ground ACP (g-ACP). DVC values of copolymer (unfilled UPHM resin) and composite specimens were determined by infrared spectroscopy. Glass-filled composites were used as controls. PS and PSS of composites were determined by dilatometry and tensometry, respectively. LC copolymers attained extraordinary high DVC values at 24 h post-cure (95.7 %), compared to CC (52 %) and DC (79.3 %) copolymer specimens. While the DVC values of LC and DC am-ACP composites were reduced between 5 and 10 %, DVC values of DC g-ACP composites increased almost 8 % compared to the corresponding copolymers. High DVC attained in LC composites was, expectedly, accompanied with high PS values (on average 7 vol%). However, PSS developed in LC and especially DC composites did not exceed PSS values seen in other UDMA-based composites. Based on this initial evaluation, it is concluded that, DC, g-ACP filled UPHM composite shows promise as an endodontic sealer. However, further physicochemical evaluations, including water sorption, mechanical stability and ion release as well as a leachability studies need to be performed before this experimental material is tested for cellular responses and, eventually recommended for clinical utility.