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

The influence of copper-doped mesoporous bioactive nanospheres on the temperature rise during polymerization, polymer cross-linking density, monomer release and embryotoxicity of dental composites

OBJECTIVES

Composites with copper-doped mesoporous bioactive nanospheres (Cu-MBGN) were developed to prevent secondary caries by imparting antimicrobial and ion-releasing/remineralizing properties.

METHODS

Seven experimental composites containing 1, 5 or 10 wt% Cu-MBGN, the corresponding inert controls (silica) and bioactive controls (bioactive glass 45S5) were prepared. The temperature rise during light curing, cross-linking density by ethanol softening test, monomer elution and their potential adverse effects on the early development of zebrafish Danio rerio was investigated.

RESULTS

Materials combining Cu-MBGN and silica showed the highest resistance to ethanol softening, as did the bioactive controls. Cu-MBGN composites showed significant temperature rise and reached maximum temperature in the shortest time. Bisphenol A was not detected, while bis-GMA was found only in the control materials and TEGDMA in the eluates of all materials. There was no increase in zebrafish mortality and abnormality rates during exposure to the eluates of any of the materials.

CONCLUSIONS

The composite with 5 wt% Cu-MBGN combined with nanosilica fillers showed the lowest ethanol softening, indicating the polymer's highest durability and cross-linking density. Despite the TEGDMA released from all tested materials, no embryotoxic effect was observed.

A Narrative Review of Bioactive Glass-Loaded Dental Resin Composites

This review aims to provide a comprehensive analysis of the characterizations of bioactive glass (BAG)-loaded dental resin-based composite materials. Online databases (Web of Science, PubMed, and Science Direct) were used to collect data published from January 2011 to January 2022. Only BAG-containing resin adhesive and resin restorative composites are discussed in this narrative review. BAG-loaded resin composites exhibit excellent mineralization ability reflecting enhanced ion release, pH elevation, and apatite formation, especially regarding high BAG loading. This aids the anti-demineralization and remineralization of teeth. Furthermore, BAG-loaded resin composites demonstrated in vitro biocompatibility and antibacterial performance. It has been suggested that BAG fillers with small particle sizes and no more than 20 wt% in terms of loading amount should be used to guarantee the appropriate mechanical properties of resin composites. However, most of these studies focused on one or some aspects using different resin systems, BAG types, and BAG amounts. As such, this makes the comparison difficult, and it is essential to find an optimal balance between different properties. BAG-loaded resin composites can be regarded as bioactive materials, which present major benefits in dentistry, especially their capability in the bacterial inhibition, cell biocompatibility, anti-demineralization, and remineralization of teeth.

Using Copper-Doped Mesoporous Bioactive Glass Nanospheres to Impart Anti-Bacterial Properties to Dental Composites

Experimental dental resin composites containing copper-doped mesoporous bioactive glass nanospheres (Cu-MBGN) were developed to impart anti-bacterial properties. Increasing amounts of Cu-MBGN (0, 1, 5 and 10 wt%) were added to the BisGMA/TEGDMA resin matrix containing micro- and nano-fillers of inert glass, keeping the resin/filler ratio constant. Surface micromorphology and elemental analysis were performed to evaluate the homogeneous distribution of filler particles. The study investigated the effects of Cu-MBGN on the degree of conversion, polymerization shrinkage, porosity, ion release and anti-bacterial activity on S. mutans and A. naeslundii. Experimental materials containing Cu-MBGN showed a dose-dependent Cu release with an initial burst and a further increase after 28 days. The composite containing 10% Cu-MBGN had the best anti-bacterial effect on S. mutans, as evidenced by the lowest adherence of free-floating bacteria and biofilm formation. In contrast, the 45S5-containing materials had the highest S. mutans adherence. Ca release was highest in the bioactive control containing 15% 45S5, which correlated with the highest number of open porosities on the surface. Polymerization shrinkage was similar for all tested materials, ranging from 3.8 to 4.2%, while the degree of conversion was lower for Cu-MBGN materials. Cu-MBGN composites showed better anti-bacterial properties than composites with 45S5 BG.

Improved Flexural Properties of Experimental Resin Composites Functionalized with a Customized Low-Sodium Bioactive Glass

This study evaluated the flexural properties of an experimental composite series functionalized with 5-40 wt% of a low-Na F-containing bioactive glass (F-series) and compared it to another experimental composite series containing the same amounts of the conventional bioactive glass 45S5 (C-series). Flexural strength and modulus were evaluated using a three-point bending test. Degree of conversion was measured using Fourier-transform infrared spectroscopy. Weibull analysis was performed to evaluate material reliability. The control material with 0 wt% of bioactive glass demonstrated flexural strength values of 105.1-126.8 MPa). In the C-series, flexural strength ranged between 17.1 and 121.5 MPa and was considerably more diminished by the increasing amounts of bioactive glass than flexural strength in the F-series (83.8-130.2 MPa). Analogously, flexural modulus in the C-series (0.56-6.66 GPa) was more reduced by the increase in bioactive glass amount than in the F-series (5.24-7.56 GPa). The ISO-recommended "minimum acceptable" flexural strength for restorative resin composites of 80 MPa was achieved for all materials in the F-series, while in the C-series, the materials with higher bioactive glass amounts (20 and 40 wt%) failed to meet the requirement of 80 MPa. The degree of conversion in the F-series was statistically similar or higher compared to that of the control composite with no bioactive glass, while the C-series showed a declining degree of conversion with increasing bioactive glass amounts. In summary, the negative effect of the addition of bioactive glass on mechanical properties was notably less pronounced for the customized bioactive glass than for the bioactive glass 45S5; additionally, mechanical properties of the composites functionalized with the customized bioactive glass were significantly less diminished by artificial aging. Hence, the customized bioactive glass investigated in the present study represents a promising candidate for functionalizing ion-releasing resin composites.

Bioactive Inorganic Materials for Dental Applications: A Narrative Review

Over time, much attention has been given to the use of bioceramics for biomedical applications; however, the recent trend has been gaining traction to apply these materials for dental restorations. The bioceramics (mainly bioactive) are exceptionally biocompatible and possess excellent bioactive and biological properties due to their similar chemical composition to human hard tissues. However, concern has been noticed related to their mechanical properties. All dental materials based on bioactive materials must be biocompatible, long-lasting, mechanically strong enough to bear the masticatory and functional load, wear-resistant, easily manipulated, and implanted. This review article presents the basic structure, properties, and dental applications of different bioactive materials i.e., amorphous calcium phosphate, hydroxyapatite, tri-calcium phosphate, mono-calcium phosphate, calcium silicate, and bioactive glass. The advantageous properties and limitations of these materials are also discussed. In the end, future directions and proposals are given to improve the physical and mechanical properties of bioactive materials-based dental materials.

Development and characterization of ion-releasing fiber-reinforced flowable composite

OBJECTIVE

This study aimed to develop and characterize an ion-releasing experimental fiber-reinforced flowable composite (Bio-SFRC) and dentin treatment solution made of poly(acrylic acid) (PAA) with a high molecular weight. In addition we also evaluated the interface structure and mineralization potential between the Bio-SFRC and dentin.

METHODS

Some mechanical properties (flexural properties and fracture toughness) of Bio-SFRC in comparison with commercial inert (G-aenial Flo X) and ion-releasing materials (ACTIVA-BioActive Base/Liner and Fuji II LC) were assessed (n = 8/group). Calcium-release at different time-points was measured during the first six weeks by using a calcium-ion selective electrode. Surface analysis of composites after being stored in simulated body fluid (SBF) was investigated by using SEM/EDS. Dentin disks (n = 50) were prepared from extracted sound teeth and demineralization was simulated by acid etching. SEM/EDS was used to evaluate the microstructure of dentin on the top surface and at interface with composites after being stored in SBF.

RESULTS

Bio-SFRC showed higher fracture toughness (1.6 MPa m^1/2) (p < 0.05) compared to Flo X (1.2 MPa m^1/2), ACTIVA (1 MPa m^1/2) and Fuji II LC (0.8 MPa m^1/2). Accumulative calcium release after six weeks from Bio-SFRC (15 mg/l) was higher than other tested ion-releasing materials (≈ 6 mg/l). Mineralization was clearly seen at the interface between treated dentin and Bio-SFRC. None of the commercial tested materials showed signs of mineralization at the interface and dentinal tubules remained open.

SIGNIFICANCE

Developing such reinforced ion-releasing flowable composite and PAA solution might offer the potential for mineralization at the interface and inside the organic matrix of demineralized dentin.

Impact of Copper-Doped Mesoporous Bioactive Glass Nanospheres on the Polymerisation Kinetics and Shrinkage Stress of Dental Resin Composites

We embedded copper-doped mesoporous bioactive glass nanospheres (Cu-MBGN) with antibacterial and ion-releasing properties into experimental dental composites and investigated the effect of Cu-MBGN on the polymerisation properties. We prepared seven composites with a BisGMA/TEGDMA (60/40) matrix and 65 wt.% total filler content, added Cu-MBGN or a combination of Cu-MBGN and silanised silica to the silanised barium glass base, and examined nine parameters: light transmittance, degree of conversion (DC), maximum polymerisation rate (R_max), time to reach R_max, linear shrinkage, shrinkage stress (PSS), maximum PSS rate, time to reach maximum PSS rate, and depth of cure. Cu-MBGN without silica accelerated polymerisation, reduced light transmission, and had the highest DC (58.8 ± 0.9%) and R_max (9.8 ± 0.2%/s), but lower shrinkage (3 ± 0.05%) and similar PSS (0.89 ± 0.07 MPa) versus the inert reference (0.83 ± 0.13 MPa). Combined Cu-MBGN and silica slowed the R_max and achieved a similar DC but resulted in higher shrinkage. However, using a combined 5 wt.% Cu-MBGN and silica, the PSS resembled that of the inert reference. The synergistic action of 5 wt.% Cu-MBGN and silanised silica in combination with silanised barium glass resulted in a material with the highest likelihood for dental applications in future.

Long-Term Assessment of Contemporary Ion-Releasing Restorative Dental Materials

The objective was to evaluate new commercially available ion-releasing restorative materials and compare them to established anti-cariogenic materials. Four materials were tested: alkasite Cention (Ivoclar Vivadent) in self-cure or light-cure mode, giomer Beautifil II (Shofu), conventional glass-ionomer Fuji IX (GC), and resin composite Tetric EvoCeram (Ivoclar Vivadent) as a control. Flexural strength, flexural modulus, and Weibull modulus were measured one day, three months, and after three months with accelerated aging in ethanol. Water sorption and solubility were evaluated for up to one year. Degree of conversion was measured during 120 min for self-cured and light-cured Cention. In this study, Beautifil II was the ion-releasing material with the highest flexural strength and modulus and with the best resistance to aging. Alkasite Cention showed superior mechanical properties to Fuji IX. Weibull analysis showed that the glass-ionomer had the least reliable distribution of mechanical properties with the highest water sorption. The solubility of self-cured alkasite exceeded the permissible values according to ISO 4049. Degree of conversion of light-cured Cention was higher than in self-cure mode. The use of alkasite Cention is recommended only in the light-cure mode.

Recent Advances in Direct Adhesive Restoration Resin-Based Dental Materials With Remineralizing Agents

Resin-based dental materials are popular restorative materials especially in direct adhesive restoration because of the excellent mechanical and esthetic properties. Toward the realization of minimally invasive dental procedures, direct composite resin adhesive restoration has become the main treatment for dental defects. In addition, for caries-affected dentin close to the pulp, conservation remineralization has been advocated to save the living pulp. However, the resin–dentin interface can be destabilized by various factors, especially the enzymatic degradation of collagen fibrils within the hybrid layer and polymer hydrolysis. Furthermore, for resin-based restorative materials, the marginal gap remains a major problem that can lead to the occurrence of secondary caries. To address these issues, research efforts have focused on the remineralization of mineral-depleted dental hard tissues using remineralizing bioactive substances. In this review, we first described various bioactive agents with remineralizing properties. Furthermore, we discussed recent advances in resin-based dental materials for enamel or dentin remineralization. Finally, we examined the current challenges and prospects of these emerging materials. This work aims to provide a theoretical foundation for the future development of resin-based dental materials in direct adhesive restoration with remineralizing agents.

Incorporation of Copper-Doped Mesoporous Bioactive Glass Nanospheres in Experimental Dental Composites: Chemical and Mechanical Characterization

Experimental dental resin composites incorporating copper-doped mesoporous bioactive glass nanospheres (Cu-MBGN) were designed to impart antibacterial and remineralizing properties. The study evaluated the influence of Cu-MBGN on the mechanical properties and photopolymerization of resin composites. Cu-MBGN were synthesized using a microemulsion-assisted sol-gel method. Increasing amounts of Cu-MBGN (0, 1, 5, and 10 wt %) were added to the organic polymer matrix with inert glass micro- and nanofillers while maintaining a constant resin/filler ratio. Six tests were performed: X-ray diffraction, scanning electron microscopy, flexural strength (FS), flexural modulus (FM), Vickers microhardness (MH), and degree of conversion (DC). FS and MH of Cu-MBGN composites with silica fillers showed no deterioration with aging, with statistically similar results at 1 and 28 days. FM was not influenced by the addition of Cu-MBGN but was reduced for all tested materials after 28 days. The specimens with 1 and 5% Cu-MBGN had the highest FS, FM, MH, and DC values at 28 days, while controls with 45S5 bioactive glass had the lowest FM, FS, and MH. DC was high for all materials (83.7-93.0%). Cu-MBGN composites with silica have a potential for clinical implementation due to high DC and good mechanical properties with adequate resistance to aging.

The incorporation of phosphorylated chitosan/amorphous calcium phosphate nanocomplex into an experimental composite resin

This study evaluated the effect of incorporating phosphorylated chitosan/amorphous calcium phosphate nanocomplex (Pchi/ACP) into an experimental light-cure composite resin on mechanical-chemical properties and human dentin remineralization. The results showed that the mechanical strength and contact angles of the resins decreased with the increase incorporation of Pchi/ACP. Release concentrations of calcium in saline solution were measured at different time points, showing the incorporation of Pchi/ACP significantly increased calcium release within 14 days, and kept steady thereafter. Finally, the demineralized dentin slabs treated with our resins for four weeks were characterized by SEM-EDS. Various amounts of apatite were formed on the dentin slabs which were treated with the resins containing Pchi/ACP, whereas no apatite was formed without Pchi/ACP. In conclusion, the Pchi/ACP-incorporating composite resin can be a promising dental material due to its favorable mechanical and remineralization properties.

Review of nano-technology applications in resin-based restorative materials

OBJECTIVE

Nanotechnology has progressed significantly and particles as small as 3 nm are being employed in resin-based restorative materials to improve clinical performance. The goal of this review is to report the progress of nanotechnology in Restorative Dentistry by reviewing the advantages, limitations, and applications of resin-based restorative materials with nanoparticles.

MATERIALS AND METHODS

A literature review was conducted using PubMed/Medline, Scopus and Embase databases. In vitro, in vivo and in situ research studies published in English between 1999 and 2020, and which focused on the analysis of resin-based restorative materials containing nanoparticles were included.

RESULTS

A total of 140 studies were included in this review. Studies reported the effect of incorporating different types of nanoparticles on adhesive systems or resin composites. Mechanical, physical, and anti-bacterial properties were described. The clinical performance of resin-based restorative materials with nanoparticles was also reported.

CONCLUSIONS

The high surface area of nanoparticles exponentially increases the bioactivity of materials using bioactive nanofillers. However, the tendency of nanoparticles to agglomerate, the chemical instability of the developed materials and the decline of rheological properties when high ratios of nanoparticles are employed are some of the obstacles to overcome in the near future.

CLINICAL SIGNIFICANCE

In spite of the recent advancements of nanotechnology in resin-based restorative materials, some challenges need to be overcome before new nano-based restorative materials are considered permanent solutions to clinical problems.

Long-term water sorption and solubility of experimental bioactive composites based on amorphous calcium phosphate and bioactive glass

The aim of this study was to evaluate water sorption and solubility of two series of experimental composites containing amorphous calcium phosphate (ACP) or bioactive glass (BG). Water sorption and solubility were measured for up to 287 days. The surface precipitation of calcium phosphates was evaluated by scanning electron microscopy. The ACP-series showed higher water sorption (223-568 µg/mm³) than the BG-series (40-232 µg/mm³). In contrast, the ACP-series had generally lower solubility (37-106 µg/mm³) than the BG-series (1-506 µg/mm³). The constant specimen mass for the ACP-series was attained after 14 days of water immersion, while the mass decrease due to long-term solubility in the BG-series lasted beyond 287 days. Calcium phosphates precipitated in composites with the BG filler loading of 10 wt% or more, as well as in all of the ACP-containing composites. The experimental composite series showed water sorption and solubility considerably higher than commercial materials.

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.

Protein-repellent nanocomposite with rechargeable calcium and phosphate for long-term ion release

OBJECTIVE

There has been no report on the effect of incorporating protein repellent 2-methacryloyloxyethyl phosphorylcholine (MPC) into a composite containing nanoparticles of amorphous calcium phosphate (NACP) on calcium (Ca) and phosphate (P) ion rechargeability. The objectives of this study were to develop a Ca and P ion-rechargeable and protein-repellent composite for the first time, and investigate the effects of MPC and NACP on mechanical properties, protein-repellency, anti-biofilm effects, and Ca and P ion recharge and re-release.

METHODS

NACP were synthesized using a spray-drying technique. The resin contained ethoxylated bisphenol A dimethacrylate (EBPADMA) and pyromellitic glycerol dimethacrylate (PMGDM). Three NACP composites were made with 0 (control), 1.5%, and 3% of MPC. NACP (20%) and glass particles (50%) were also added into the resin. Protein adsorption was measured using a micro-bicinchoninic acid (BCA) method. A human saliva microcosm biofilm model was used to determine biofilm metabolic activity, lactic acid, and colony-forming units (CFU). Ca and P ion recharge and re-release were measured using a spectrophotometric method.

RESULTS

Flexural strengths and moduli of CaP-rechargeable composites matched those of a commercial composite without CaP rechargeability (p>0.1). Adding 1.5% and 3% MPC reduced protein adsorption to 1/3 and 1/5, respectively, that of commercial composite (p<0.05). Adding 3% MPC suppressed biofilm metabolic activity and lactic acid production, and reduced biofilm CFU by nearly 2 logs. All three NACP composites had excellent ion rechargeability and higher levels of ion re-releases. One recharge yielded continuous ion release for 21 days. The release was maintained at the same level with increasing number of recharge cycles, indicating long-term ion release. Incorporation of MPC did not compromise the CaP ion rechargeability.

SIGNIFICANCE

Incorporating 3% MPC into NACP nanocomposite greatly reduced protein adsorption, biofilm growth and lactic acid, decreasing biofilm CFU by nearly 2 logs, without compromising Ca and P recharge. This protein-repellent NACP-MPC rechargeable composite with long-term remineralization is promising for tooth restorations to inhibit secondary caries.

Real-time curing characteristics of experimental resin composites containing amorphous calcium phosphate

The real-time polymerization of light-curable experimental resin composites filled with amorphous calcium phosphate (ACP) was monitored. Experimental composites were based on a 2,2-bis[4-(2-ethoxy-3-methacryloyloxy propoxy)phenyl]propane (Bis-EMA)/triethyleneglycol dimethacrylate (TEGDMA)/2-hydroxyethyl methacrylate (HEMA) resin photoactivated by a camphorquinone/tertiary amine system. Four ACP composites were prepared, containing 40 wt% ACP and 0/10 wt% reinforcing fillers (barium glass and silica). Additionally, two control composites were prepared which contained only reinforcing fillers (40-50 wt%). The degree of conversion (DC) was monitored in real time using a Fourier-transform infrared (FTIR) spectrometer with an attenuated total reflectance accessory. During the light curing (1,219 mW cm^-2 ) for either 20 or 40 s, infrared spectra were collected from the bottom of 2-mm-thick composite specimens at the rate of two spectra per second over 5 min. When cured for 40 s, the ACP composites attained a high DC (89.1%-92.4%), while the DC of control composites was significantly lower (53.5%-68.4%). All materials showed a lower DC for the shorter curing time (20 s) and various extents of 5-min postcure polymerization: 12.9%-21.5% for the ACP composites and 2.7%-5.2% for the control composites. The control composites reached the maximum reaction rate much earlier (4.1-4.3 s) and at lower DC (9.9%-10.4%) than did the ACP composites (17.4-22.0 s and 43.5%-49.3%, respectively).

Novel rechargeable calcium phosphate nanocomposite with antibacterial activity to suppress biofilm acids and dental caries

OBJECTIVE

Rechargeable calcium phosphate (CaP) composites were developed recently. However, none of the rechargeable CaP composites was antibacterial. The objectives of this study were to develop the first rechargeable CaP composite that was antibacterial, and to investigate the effects of adding dimethylaminohexadecyl methacrylate (DMAHDM) into rechargeable CaP composite on ion rechargeability and re-release as well as biofilm properties.

METHODS

DMAHDM was synthesized via a Menschutkin reaction. Nanoparticles of amorphous calcium phosphate (NACP) were synthesized using a spray-drying technique. The resin contained ethoxylated bisphenol A dimethacrylate (EBPADMA) and pyromellitic glycerol dimethacrylate (PMGDM). Two composites were fabricated: rechargeable NACP composite, and rechargeable NACP-DMAHDM composite. Mechanical properties and ion release and recharge were measured. A dental plaque microcosm biofilm model using saliva was tested.

RESULTS

Flexural strength and elastic modulus of rechargeable NACP and NACP-DMAHDM composites matched commercial control composite (p > 0.1). NACP-DMAHDM inhibited biofilm metabolic activity and lactic acid, and reduced biofilm colony-forming units (CFU) by 3-4 log. NACP and NACP-DMAHDM showed similar Ca and P ion recharge and re-release (p > 0.1). Therefore, adding DMAHDM did not compromise the ion rechargeability. One recharge yielded continuous release for 42 d. The release was maintained at the same level with increasing number of recharge cycles, indicating long-term ion release and remineralization capability.

CONCLUSIONS

The first CaP rechargeable and antibacterial composite was developed. Adding DMAHDM into the rechargeable NACP composite did not adversely affect the Ca and P ion release and recharge, and the composite had much less biofilm growth and lactic acid production, with CFU reduction by 3-4 log.

CLINICAL SIGNIFICANCE

This novel CaP rechargeable composite with long-term remineralization and antibacterial properties is promising for tooth restorations to inhibit caries.

Trends in restorative composites research: what is in the future?

Clinical trials have identified secondary caries and bulk fracture as the main causes for composite restoration failure. As a measure to avoid frequent reinterventions for restoration replacement, composites with some sort of defense mechanism against biofilm formation and demineralization, as well as materials with lower susceptibility to crack propagation are necessary. Also, the restorative procedure with composites are very time-consuming and technically demanding, particularly concerning the application of the adhesive system. Therefore, together with bulk-fill composites, self-adhesive restorative composites could reduce operator error and chairside time. This literature review describes the current stage of development of remineralizing, antibacterial and self-healing composites. Also, an overview of the research on fiber-reinforced composites and self-adhesive composites, both introduced for clinical use in recent years, is presented.

Remineralizing amorphous calcium phosphate based composite resins: the influence of inert fillers on monomer conversion, polymerization shrinkage, and microhardness

Aim

To determine if the addition of inert fillers to a bioactive dental restorative composite material affects its degree of conversion (DC), polymerization shrinkage (PS), and microhardness (HV).

Methods

Three amorphous calcium phosphate (ACP)-based composite resins: without added fillers (0-ACP), with 10% of barium-glass fillers (Ba-ACP), and with 10% of silica fillers (Si-ACP), as well as commercial control (Ceram•X, Dentsply DeTrey) were tested in laboratory conditions. The amount of ACP (40%) and the composition of the resin mixture (based on ethoxylated bisphenol A dimethacrylate) was the same for all ACP materials. Fourier transform infrared spectroscopy was used to determine the DC (n = 40), 20 min and 72 h after polymerization. Linear PS and Vickers microhardness (n = 40) were also evaluated. The results were analyzed by paired samples t test, ANOVA, and one-way repeated measures ANOVA with Student-Newman-Keuls or Tukey’s post-hoc test (P = 0.05).

Results

The addition of barium fillers significantly increased the DC (20 min) (75.84 ± 0.62%) in comparison to 0-ACP (73.92 ± 3.08%), but the addition of silica fillers lowered the DC (71.00 ± 0.57%). Ceram•X had the lowest DC (54.93 ± 1.00%) and linear PS (1.01 ± 0.24%) but the highest HV (20.73 ± 2.09). PS was significantly reduced (P < 0.010) in both Ba-ACP (1.13 ± 0.25%) and Si-ACP (1.17 ± 0.19%) compared to 0-ACP (1.43 ± 0.21%). HV was significantly higher in Si-ACP (12.82 ± 1.30) than in 0-ACP (10.54 ± 0.86) and Ba-ACP (10.75 ± 0.62) (P < 0.010).

Conclusion

Incorporation of inert fillers to bioactive remineralizing composites enhanced their physical-mechanical performance in laboratory conditions. Both added fillers reduced the PS while maintaining high levels of the DC. Silica fillers additionally moderately improved the HV of ACP composites.

Bioactive composites containing TEGDMA-functionalized calcium phosphate particles: Degree of conversion, fracture strength and ion release evaluation

OBJECTIVE

To evaluate the strength and ion release of experimental composites containing TEGDMA-functionalized calcium phosphate particles.

METHODS

Seven composites containing equal parts (in mols) of BisGMA and TEGDMA and 60vol% of fillers were manipulated. Filler phase was constituted by silanized barium glass and 0% (control), 10% or 20% (volume) of dicalcium phosphate dihydrate (DPCD) particles, either non-functionalized or functionalized with two different TEDGMA contents. DCPD particles were synthesized and characterized by X-ray diffraction (XRD), elemental analysis, surface area and dynamic light scattering. Composites were tested for degree of conversion (DC) by near-FTIR. Biaxial flexural strength (BFS) was determined after 24h and 28days in water. Calcium and phosphate release after 7days was assessed using inductively coupled plasma optical emission spectrometry (ICP-OES). Data were analyzed by ANOVA/Tukey test (alpha:5%).

RESULTS

XRD confirmed the crystalline structure corresponding to DCPD. Elemental analysis revealed particles with zero, 14% or 22% TEGDMA, with similar D₅₀ (around 19μm) and surface areas from 3.5 to 11.4m²/g. The presence of DCPD did not reduce DC. After 24h, functionalization (both 14% and 22% TEGDMA) improved composite strength in comparison to non-functionalized DCPD, both at 10% and 20% levels. After 28days, BFS of materials containing 10% functionalized DCPD were statistically similar to the control containing only barium glass. Among composites containing 10% DCPD, particle functionalization with 14% TEGDMA did not jeopardize ion release.

SIGNIFICANCE

At 10vol%, the use of TEGDMA-functionalized CaP particles improved composite strength in relation to non-functionalized particles, while maintaining similar ion release levels.

Impedance changes during setting of amorphous calcium phosphate composites

OBJECTIVES

To investigate the electrical properties of experimental light-curable composite materials based on amorphous calcium phosphate (ACP) with the admixture of silanized barium glass and silica fillers.

METHODS

Short-term setting was investigated by impedance measurements at a frequency of 1kHz, while for the long-term setting the impedance spectra were measured consecutively over a frequency range of 0.05Hz to 1MHz for 24h. The analysis of electrical resistivity changes during curing allowed the extraction of relevant kinetic parameters. The impedance results were correlated to the degree of conversion assessed by Raman spectroscopy, water content determined by gravimetry, light transmittance measured by CCD spectrometer and microstructural features observed by scanning electron microscopy.

RESULTS

ACP-based composites have shown higher immediate degree of conversion and less post-cure polymerization than the control composites, but lower polymerization rate. The polymerization rate assessed by impedance measurements correlated well with the light transmittance. The differences in the electrical conductivity values observed among the materials were correlated to the amount of water introduced into composites by the ACP filler. High correlation was found between the degree of conversion and electrical resistivity. Equivalent circuit modeling revealed two electrical contributions for the ACP-based composites and a single contribution for the control composites.

SIGNIFICANCE

The impedance spectroscopy has proven a valuable method for gaining insight into various features of ACP-based composites. Better understanding of the properties of ACP-based composites should further the development of these promising bioactive materials.

Light transmittance and polymerization kinetics of amorphous calcium phosphate composites

OBJECTIVES

This study investigated light transmittance and polymerization kinetics of experimental remineralizing composite materials based on amorphous calcium phosphate (ACP), reinforced with inert fillers.

MATERIALS AND METHODS

Light-curable composites were composed of Bis-EMA-TEGDMA-HEMA resin and ACP, barium glass, and silica fillers. Additionally, a commercial composite Tetric EvoCeram was used as a reference. Light transmittance was recorded in real-time during curing, and transmittance curves were used to assess polymerization kinetics. To obtain additional information on polymerization kinetics, temperature rise was monitored in real-time during curing and degree of conversion was measured immediately and 24 h post-cure.

RESULTS

Light transmittance values of 2-mm thick samples of uncured ACP composites (2.3-2.9 %) were significantly lower than those of the commercial composite (3.8 %). The ACP composites presented a considerable transmittance rise during curing, resulting in post-cure transmittance values similar to or higher than those of the commercial composite (5.5-7.9 vs. 5.4 %). The initial part of light transmittance curves of experimental composites showed a linear rise that lasted for 7-20 s. Linear fitting was performed to obtain a function whose slope was assessed as a measure of polymerization rate. Comparison of transmittance and temperature curves showed that the linear transmittance rise lasted throughout the most part of the pre-vitrification period.

CONCLUSIONS

The linear rise of light transmittance during curing has not been reported in previous studies and may indicate a unique kinetic behavior, characterized by a long period of nearly constant polymerization rate.

CLINICAL RELEVANCE

The observed kinetic behavior may result in slower development of polymerization shrinkage stress but also inferior mechanical properties.

Conversion and temperature rise of remineralizing composites reinforced with inert fillers

OBJECTIVES

Remineralizing experimental composites based on amorphous calcium phosphate (ACP) were investigated. The impact of curing time (20 and 40s), curing depth (1, 2, 3 and 4mm) and addition of inert fillers (barium glass and silica) on the conversion and temperature rise during curing were examined.

METHODS

Five ACP-composites and two control composites were prepared based on the light-curable EBPADMA-TEGDMA-HEMA resin. For temperature measurements, a commercial composite was used as an additional control. Conversion was assessed using FT-Raman spectroscopy by comparing the relative change of the band at 1640 cm(-1) before and after polymerization. The temperature rise during curing was recorded in real-time using a T-type thermocouple.

RESULTS

At 1mm depth, the ACP-composites attained significantly higher conversion (77.8-87.3%) than the control composites based on the same resin (60.5-66.3%). The addition of inert fillers resulted in approximately 5% lower conversion at clinically relevant depths (up to 2mm) for the curing time of 40s. Conversion decline through depths depended on the added inert fillers. Conversion values higher than 80% of the maximum conversion were observed for all of the ACP-composites at depths up to 3mm, when cured for 40s. Significantly higher total temperature rise for the ACP-composites (11.5-13.1 °C) was measured compared to the control composites (8.6-10.8 °C) and the commercial control (8.7 °C).

CONCLUSIONS

The admixture of inert fillers represents a promising strategy for further development of ACP-composites, as it reduced the temperature rise while negligibly impairing the conversion.

CLINICAL SIGNIFICANCE

High conversions of ACP-composites are favorable in terms of mechanical properties and biocompatibility. However, high conversions were accompanied with high temperature rise, which might present a pulpal hazard.

Mechanical properties and ion release from bioactive restorative composites containing glass fillers and calcium phosphate nano-structured particles

OBJECTIVE

To evaluate the effect of the replacement of barium glass by dicalcium phosphate dihydrate (DCPD) particles on the mechanical properties and degree of conversion (DC) of composites. Additionally, calcium and hydrogen phosphate (HPO4(2-)) release were followed for 28 days.

METHODS

Nine composites containing equal parts (in mols) of BisGMA and TEGDMA and 40, 50 or 60 vol% of total filler were manipulated. Filler phase was constituted by silanated barium glass and 0%, 10% or 20% of DCPD particles. DC was determined by near-FTIR. Biaxial flexural strength (BFS) and modulus (E) were tested using the "piston on three balls" method, while fracture toughness (KIc) used the "single edge notched beam" method. Specimens were tested after 24h and 28 days in water. Ion release was determined using inductively coupled plasma optical emission spectrometry (ICP-OES). Data were analyzed by ANOVA/Tukey (DC and ion release) or Kruskal-Wallis/Mann-Whitney (mechanical properties; alpha: 5%).

RESULTS

DC was not affected by DCPD. The presence of DCPD reduced BFS for both storage times, while differences in E became evident after 28 days. After 24h, KIc increased with the addition of DCPD; after 28 days, however, KIc decreased only for DCPD-containing composites. Calcium release was similar for both DCPD contents and remained fairly constant during the 28-day period. Overall, HPO4(2-) release was higher at 7 days and did not decrease after 14 days.

SIGNIFICANCE

The composite with the highest filler level and 10% DCPD represented the best compromise between mechanical properties after aging in water and ion release.

Reinforcement of experimental composite materials based on amorphous calcium phosphate with inert fillers

OBJECTIVES

The aim of this study was to examine the influence of the addition of glass fillers with different sizes and degrees of silanization percentages to remineralizing composite materials based on amorphous calcium phosphate (ACP).

METHODS

Four different materials were tested in this study. Three ACP based materials: 0-ACP (40 wt% ACP, 60 wt% resin), Ba-ACP (40 wt% ACP, 50 wt% resin, 10 wt% barium-glass) and Sr-ACP (40 wt% ACP, 50 wt% resin, 10 wt% strontium-glass) were compared to the control material, resin modified glass ionomer (Fuji II LC capsule, GC, Japan). The fillers and composites were characterized using scanning electron microscopy. Flexural strength and modulus were determined using a three-point bending test. Calcium and phosphate ion release from ACP based composites was measured using inductively coupled plasma atomic emission spectroscopy.

RESULTS

The addition of barium-glass fillers (35.4 (29.1-42.1) MPa) (median (25-75%)) had improved the flexural strength in comparison to the 0-ACP (24.8 (20.8-36.9) MPa) and glass ionomer control (33.1 (29.7-36.2) MPa). The admixture of strontium-glass (20.3 (19.5-22.2) MPa) did not have any effect on flexural strength, but significantly improved its flexural modulus (6.4 (4.8-6.9) GPa) in comparison to 0-ACP (3.9 (3.4-4.1) GPa) and Ba-ACP (4.6 (4.2-6.9) GPa). Ion release kinetics was not affected by the addition of inert fillers to the ACP composites.

SIGNIFICANCE

Incorporation of barium-glass fillers to the composition of ACP composites contributed to the improvement of flexural strength and modulus, with no adverse influence on ion release profiles.