Effects of aging on surface properties and adhesion of Streptococcus mutans on various fissure sealants

AFM Analysis of a Three-Point Flexure Tested, 3D Printing Definitive Restoration Material for Dentistry

Background: Three-dimensional printing is a rapidly developing technology across all industries. In medicine recent developments include 3D bioprinting, personalized medication and custom prosthetics and implants. To ensure safety and long-term usability in a clinical setting, it is essential to understand material specific properties. This study aims to analyze possible surface changes of a commercially available and approved DLP 3D printed definitive restoration material for dentistry after three-point flexure testing. Furthermore, this study explores whether Atomic Force Microscopy (AFM) is a feasible method for examination of 3D printed dental materials in general. This is a pilot study, as there are currently no studies that analyze 3D printed dental materials using an AFM. Methods: The present study consisted of a pretest followed by the main test. The resulting break force of the preliminary test was used to determine the force used in the main test. The main test consisted of atomic force microscopy (AFM) surface analysis of the test specimen followed by a three-point flexure procedure. After bending, the same specimen was analyzed with the AFM again, to observe possible surface changes. Results: The mean root mean square (RMS) roughness of the segments with the most stress was 20.27 nm (±5.16) before bending, while it was 26.48 nm (±6.67) afterward. The corresponding mean roughness (Ra) values were 16.05 nm (±4.25) and 21.19 nm (±5.71) Conclusions: Under three-point flexure testing, the surface roughness increased significantly. The p-value for RMS roughness was p = 0.003, while it was p = 0.006 for Ra. Furthermore, this study showed that AFM surface analysis is a suitable procedure to investigate surface changes in 3D printed dental materials.

Chlorhexidine versus organoselenium for inhibition of S. mutans biofilm, an in vitro study

Background

Chemical Plaque control by antimicrobial agent application can defend the teeth against caries. S. mutans is considered the main etiologic factor for caries. This was an in vitro study to compare between the efficacy of chlorhexidine diaceteate varnish, and an organoselenium sealant, to prevent S. mutans biofilm formation on human teeth.

Methods

Fourty five premolars extracted for orthodontic purposes were randomly divided into 3 groups of 15 teeth each. One control group and two test groups, chlorhexidine diaceteate varnish and an organoselenium sealant. The teeth were autoclaved before S. mutans biofilm was induced on to each in their respective groups. The reading T1 was taken for each tooth to assess the number of S. mutans attached in order to compare for differences in surface area among the 3 groups. The respective test materials were applied onto the teeth and biofilm induced onto them in their respective groups. The reading T2 was taken for the 2 test groups. The 3 groups were then subjected to aging for a period equivalent to 5 months before the biofilm was induced to take the reading T3 for the number of S. mutans. We used vortexing of the teeth to disrupt the biofilm at time points T1, T2 and T3. S. mutans count was then done using PCR.

Results

There were significantly lower S. mutans counts in the control group as compared to the chlorhexidine diacetate group at T3.There were no other statistically significant differences found.

Conclusion

Both organoselenium and Chlorhexidine diacetate do not inhibit S. mutans biofilm attachment onto the teeth.

Alcohol and light-polymerizing glaze effect on the physical and mechanical properties of a bisacrylate composite resin before and after immersion in chlorhexidine gluconate

STATEMENT OF PROBLEM

The use of 0.12% chlorhexidine gluconate (CHX) may damage bisacrylate composite resin interim restorations, but whether they can be protected with an application of alcohol and/or the use of a glaze is unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of applying a 70% alcohol solution on the physical and mechanical properties of a bisacrylate composite resin, with and without the application of a light-polymerizing glaze subjected to 0.12% CHX twice a day for 7 days.

MATERIAL AND METHODS

Forty specimens of an autopolymerized bisacrylate composite resin were divided into 4 groups (n=10): Group C (without alcohol, without glaze), Group G (without alcohol, with glaze), Group A (with alcohol, without glaze), and Group AG (with alcohol, with glaze). All specimens were submitted to in vitro treatment with 0.12% CHX for 7 days, and tests of color alteration (ΔE₀₀), microhardness, roughness, and surface were performed initially and after treatment. Data were submitted to analysis of variance (ANOVA) and the Tukey HSD test (α=.05).

RESULTS

Group A had the lowest mean value of ΔE₀₀ with a significant statistical difference from Group C. The groups with alcohol presented higher microhardness mean values compared with groups without alcohol in both periods of analysis, except for the groups with glaze in the final period. Group C showed higher mean roughness values in comparison with Group A in both periods. Group AG presented higher mean roughness values than Group G. Surface energy values did not vary significantly among groups, except between Groups C and A in the final period.

CONCLUSIONS

The application of alcohol optimized the properties of the autopolymerized bisacrylate composite resin analyzed, with and without the application of glaze. Overall, the use of CHX changed the microhardness and roughness when the glaze was applied.

Influence of a light-activated glaze on the adhesion of Streptococcus sanguinis to the surface of polymers used in fabrication of interim prostheses

AIM

This study aimed to investigate the adhesion of Streptococcus sanguinis to the surface of interim prostheses that were treated or not treated with a light-activated glaze, and subjected or not subjected to a thermocycling procedure.

METHODS

36 specimens of each resin were divided into 4 groups: heat-activated acrylic resin; chemically-activated acrylic resin; bis-acryl composite resin (Protemp; 3M ESPE); and bis-GMA (Charisma; Heraeus Kulzer). Half of the specimens underwent application of glaze and the other half underwent mechanical polishing. Specimens were randomly distributed into groups (N = 9) with and without thermocycling (2000 cycles). Surface energy, roughness and microbiological analyses were performed.

RESULTS

Groups treated with glaze showed lower roughness when compared with the same groups without glaze treatment, before and after thermocycling, except for the bis-acryl groups after thermocycling. Surface energy values were higher in the groups treated with glaze, except the bis-acryl group before and after thermocycling. After thermocycling, the values of bacterial adhesion decreased numerically, with the exception of the chemically-activated acrylic resin group treated with glaze and the heat-activated acrylic resin group without glaze treatment.

CONCLUSION

The application of glaze and the thermocycling do not influence, in a statistically significant manner, the bacterial adhesion on polymer surfaces.

Predictability of Microbial Adhesion to Dental Materials by Roughness Parameters

Microbial adhesion to intraoral biomaterials is associated with surface roughness. For the prevention of oral pathologies, smooth surfaces with little biofilm formation are required. Ideally, appropriate roughness parameters make microbial adhesion predictable. Although a multitude of parameters are available, surface roughness is commonly described by the arithmetical mean roughness value (Ra). The present study investigates whether Ra is the most appropriate roughness parameter in terms of prediction for microbial adhesion to dental biomaterials. After four surface roughness modifications using standardized polishing protocols, zirconia, polymethylmethacrylate, polyetheretherketone, and titanium alloy specimens were characterized by Ra as well as 17 other parameters using confocal microscopy. Specimens of the tested materials were colonized by C. albicans or S. sanguinis for 2 h; the adhesion was measured via luminescence assays and correlated with the roughness parameters. The adhesion of C. albicans showed a tendency to increase with increasing the surface roughness—the adhesion of S. sanguinis showed no such tendency. Although Sa, that is, the arithmetical mean deviation of surface roughness, and Rdc, that is, the profile section height between two material ratios, showed higher correlations with the microbial adhesion than Ra, these differences were not significant. Within the limitations of this in-vitro study, we conclude that Ra is a sufficient roughness parameter in terms of prediction for initial microbial adhesion to dental biomaterials with polished surfaces.

In vitro aging behavior of dental composites considering the influence of filler content, storage media and incubation time

Objective

Over time dental composites age due to mechanical impacts such as chewing and chemical impacts such as saliva enzymes and food ingredients. For this research, the focus was placed on chemical degradation. The objective of this study was to simulate hydrolysis by using different food simulating liquids and to assess their impact on the mechanical parameter Vickers microhardness (MHV) and the physicochemical parameter contact angle (CA).

Methods

Specimen of three composites (d = 6 mm, h = 2 mm; n = 435) classified with respect to their filler content (wt%), namely low-filled, medium-filled and highly-filled, were stored for 0, 14, 30, 90 and 180 days in artificial saliva (pH 7), citric acid (pH 3; pH 5), lactic acid (pH 3; pH 5) and ethanol (40%vol; 60%vol) and assessed regarding to MHV and CA. Statistics: Kruskal-Wallis test, stepwise linear regression, bivariate Spearman Rank Correlation (p < 0.05).

Results

While stored in artificial saliva, acid and ethanol the CA decreased especially for the low- and medium-filled composites. It was shown that rising the filler content caused less surface changes in the CA. Storage in ethanol led to a significant decrease of MHV of all composites. Regression analysis showed that the effect of in vitro aging on MHV was mainly influenced by the composite material and therefore by filler content (R² = 0.67; p < 0.05). In contrast, the CA is more influenced by incubation time and filler content (R² = 0.2; p < 0.05) leading to a higher risk of plaque accumulation over time. Significance: In vitro aging showed significant changes on the mechanical and physicochemical properties of dental composites which may shorten their long-term functionality. In conclusion, it can be stated, that the type of composite material, especially rising filler content seems to improve the materials’ resistance against the processes of chemical degradation.

Clinical/Photographic/Scanning Electron Microscopy Analysis of Pit and Fissure Sealants After 22 Years: A Case Series

Pit and fissure sealant is a clinical technique adopted to prevent caries lesion development. Ionomeric and/or resin-based materials are commonly used for this purpose. This article presents a case series of sealed teeth with 22-year follow-up evaluated by clinical, photographic, and microscopic analysis. In 1992, sixteen patients (9-14 years of age) had at least three teeth sealed with one of the following materials: resin-modified glass ionomer cement (RMGIC, Vitrebond or Fuji II LC) or polyacid-modified resin composite (PMRC, VariGlass VLC), totaling 86 sealed permanent teeth. After 22 years, 10 patients were recalled, representing 41 teeth. The retention of sealants was assessed by three methods: clinical analysis by visual inspection; photography; and scanning electron microscope (SEM) images and classified as retained (pits and fissures filled by sealant material); partially retained (pits and fissures partially filled by sealant material); or totally lost (no material was found in pits and fissures). The SEM images provided a higher number of retained sealants when compared with the clinical and photographic evaluations. Also, no totally lost scores were found with SEM analysis, regardless of the sealing material. No caries lesions were found. A fully or partially retained sealant in pits and fissures was capable of preventing caries lesions after 22 years within the patient pool analyzed.

In vitro study of Streptococcus mutans adhesion on composite resin coated with three surface sealants

OBJECTIVES

Although the coating of surface sealants to dental composite resin may potentially reduce bacterial adhesion, there seems to be little information regarding this issue. This preliminary in vitro study investigated the adhesion of Streptococcus mutans (S. mutans) on the dental composite resins coated with three commercial surface sealants.

MATERIALS AND METHODS

Composite resin (Filtek Z250) discs (8 mm in diameter, 1 mm in thickness) were fabricated in a mold covered with a Mylar strip (control). In group PoGo, the surfaces were polished with PoGo. In groups PS, OG, and FP, the surfaces polished with PoGo were coated with the corresponding surface sealants (PermaSeal, PS; OptiGuard, OG; Fortify Plus, FP). The surfaces of the materials and S. mutans cells were characterized by various methods. S. mutans adhesion to the surfaces was quantitatively evaluated using flow cytometry (n = 9).

RESULTS

Group OG achieved the lowest water contact angle among all groups tested (p < 0.001). The cell surface of S. mutans tested showed hydrophobic characteristics. Group PoGo exhibited the greatest bacterial adhesion among all groups tested (p < 0.001). The sealant-coated groups showed statistically similar (groups PS and FP, p > 0.05) or significantly lower (group OG, p < 0.001) bacterial adhesion when compared with the control group.

CONCLUSIONS

The application of the surface sealants significantly reduced S. mutans adhesion to the composite resin polished with the PoGo.

Effectiveness of antibacterial copper additives in silicone implants

Staphylococcus epidermidis plays a major role in capsular contractures of silicone breast implants. This in vitro study evaluates the antibacterial effect of copper on S. epidermidis in silicone implants. Specimens of a silicone material used for breast augmentation (Cu0) and specimens coated with different copper concentrations (Cu1, Cu2) were artificially aged. Surface roughness and surface free energy were assessed. The specimens were incubated in an S. epidermidis suspension. We assessed the quantification and the viability of adhering bacteria by live/dead cell labeling with fluorescence microscopy. Additionally, inhibition of bacterial growth was evaluated by agar diffusion, broth culture, and quantitative culture of surface bacteria. No significant differences in surface roughness and surface free energy were found between Cu0, Cu1 and Cu2. Aging did not change surface characteristics and the extent of bacterial adhesion. Fluorescence microscopy showed that the quantity of bacteria on Cu0 was significantly higher than that on Cu1 and Cu2. The ratio of dead to total adhering bacteria was significantly lower on Cu0 than on Cu1 and Cu2, and tended to be higher for Cu2 than for Cu1. Quantitative culture showed equal trends. Copper additives seem to have anti-adherence and bactericidal effects on S. epidermidis in vitro.

Impact of cranberry juice on initial adhesion of the EPS producing bacterium Burkholderia cepacia

The impact of cranberry juice was investigated with respect to the initial adhesion of three isogenic strains of the bacterium Burkholderia cepacia with different extracellular polymeric substance (EPS) producing capacities, viz. a wild-type cepacian EPS producer PC184 and its mutant strains PC184rml with reduced EPS production and PC184bceK with a deficiency in EPS production. Adhesion experiments conducted in a parallel-plate flow chamber demonstrated that, in the absence of cranberry juice, strain PC184 had a significantly higher adhesive capacity compared to the mutant strains. In the presence of cranberry juice, the adhesive capacity of the EPS-producing strain PC184 was largely reduced, while cranberry juice had little impact on the adhesion behavior of either mutant strain. Thermodynamic modeling supported the results from adhesion experiments. Surface force apparatus (SFA) and scanning electron microscope (SEM) studies demonstrated a strong association between cranberry juice components and bacterial EPS. It was concluded that cranberry juice components could impact bacterial initial adhesion by adhering to the EPS and impairing the adhesive capacity of the cells, which provides an insight into the development of novel treatment strategies to block the biofilm formation associated with bacterial infection.

Influence of artificial ageing on surface properties and Streptococcus mutans adhesion to dental composite materials

The aim of this in vitro study was to investigate the influence of artificial ageing on the surface properties and early Streptococcus mutans adhesion to current dental composites for the direct restoration of class II defects. Three hundred and thirty specimens each were prepared from five dental composites, and were randomly allotted to various artificial ageing protocols (storage in distilled water/ethanol/artificial saliva for 7/90/365 days; thermal cycling, 6,000 cycles 5/55 degrees C). Prior and after each treatment, surface roughness (R(a)) and hydrophobicity were determined, and S. mutans adhesion (ATCC 25175; 2.5 h, 37 degrees C) was simulated with and without prior exposition to human whole saliva (2 h, 37 degrees C). Adherence of S. mutans was determined fluorometrically. Means and standard deviations were calculated, and analyzed using three-way ANOVA and post-hoc analysis (alpha = 0.05). For both R(a) and S. mutans adherence to uncoated and saliva-coated specimens, significant influences of the composite material, the ageing medium and the ageing duration have been observed; for surface hydrophobicity, significant influences of the composite material and the ageing duration were found. For uncoated specimens, significant increases in S. mutans adhesion were observed with prolonged artificial ageing, whereas significant decreases in S. mutans adhesion were found for the saliva-coated specimens. The data indicate influences of the artificial ageing method on surface parameters such as R(a) and hydrophobicity as well as microbial adhesion. The results underline the relevance of saliva coating on the outcome of studies simulating microbial adhesion, and highlight differences in the susceptibility of dental composites for the adhesion of oral bacteria.