Antibacterial activity of a triclosan-containing resin composite matrix against three common oral bacteria

The germicidal effect, biosafety and mechanical properties of antibacterial resin composite in cavity filling

In recent years, dental resin materials have become increasingly popular for cavity filling. However, these materials can shrink during polymerization, leading to microleakages that enable bacteria to erode tooth tissue and cause secondary caries. As a result, there is great clinical demand for the development of antibacterial resins. The principle of antibacterial resin includes contact killing and filler-release killing of bacteria. For contact killing, quaternary ammonium salts (QACs) and antibacterial peptides (AMPs) can be added. For filler-release killing, chlorhexidine (CHX) and nanoparticles are used. These antibacterial agents are effective against gram-positive bacteria, gram-negative bacteria, fungi, and more. Among them, QACs has a lasting antibacterial effect, and silver nanoparticles even have a certain ability to kill viruses. Biocompatibility-wise, QACs, AMPs, and CHX have low cytotoxicity to cells when added into the resin. However, nanoparticles with smaller particle sizes have higher cytotoxicity. In terms of mechanical properties, QACs, AMPs, and CHX do not negatively affect the resin. However, the addition of magnesium oxide can have a negative impact. This paper reviews the types and antibacterial principles of commonly used antibacterial resins in recent years, evaluates their antibacterial effect, biological safety, and mechanical properties, and provides references for selecting clinical filling materials.

Synthesis of Submicrometric Chitosan Particles Loaded with Calcium Phosphate for Biomedical Applications

Chitosan particles loaded with dibasic calcium phosphate anhydrous (DCPA) is a promising strategy for combining antimicrobial and osteoconduction properties in regenerative medicine. However, mostly micrometer-sized particles have been reported in the literature, limiting their use and reducing their effect in the biomedical field. We have recently overcome this limitation by developing submicrometer-sized particles with electrospray technique. The objective of this study was to understand how the process parameters control the size and properties of submicrometer chitosan particles loaded with DCPA. Solutions of 10 mg/mL chitosan and 2.5 mg/mL DCPA in a 90% acetic acid were electrosprayed under three distinct flow rate conditions: 0.2, 0.5, and 1.0 mL/h. The particles were crosslinked in a glutaraldehyde atmosphere and characterized in terms of their morphology, inorganic content, zeta potential, and minimum inhibitory concentration (MIC) against S. mutans. All conditions showed particles with two similar morphologies: one small-sized with a spherical shape and another larger-sized with a bi-concave shape. All generated a broad particle size distribution, with a similar mean size of ~ 235 nm. The addition of DCPA decreased the zeta potential for all the samples, but it was above 30 mV, indicating a low aggregation potential. The lower flow rate showed the worst efficacy for DCPA incorporation. Antimicrobial activity was greater in chitosan/DCPA particles with flow rate of 0.5 mL/h. It can be concluded that the flow rate of 0.5 mL/h presents the best compromise solution in terms of morphology, zeta potential, MIC, and inorganic content.

Potential Combinatory Effect of Cannabidiol and Triclosan Incorporated into Sustained Release Delivery System against Oral Candidiasis

Candida albicans is a common fungal pathogen. Biofilm formation on various surfaces is an important determinant of C. albicans pathogenicity. Our previous results demonstrated the high potential of cannabidiol (CBD) to affect C. albicans biofilms. Based on these data, we investigated the possibility of incorporating CBD and/or triclosan (an antimicrobial agent that is widely utilized in dentistry) in a sustained-release varnish (SRV) (SRV-CBD, SRV-triclosan) to increase their pharmaceutical potential against C. albicans biofilm, as well as that of the mixture of the agents into SRV (SRV-CBD/triclosan). The study was conducted in a plastic model, on agar, and in an ex vivo tooth model. Our results demonstrated strong antibiofilm activity of SRV-CBD and SRV-triclosan against C. albicans in all tested models. Both formulations were able to inhibit biofilm formation and to remove mature fungal biofilm. In addition, SRV-CBD and SRV-triclosan altered C. albicans morphology. Finally, we observed a dramatic enhancement of antibiofilm activity when combined SRV-CBD/triclosan was applied. In conclusion, we propose that incorporation of CBD or triclosan into SRV is an effective strategy to fight fungal biofilms. Importantly, the data demonstrate that our CBD/triclosan varnish is safe, and is not cytotoxic for normal mammalian cells. Furthermore, we propose that CBD and triclosan being in mixture in SRV exhibit complementary antibiofilm activity, and thus can be explored for further development as a potential treatment against fungal infections.

Strategies toward development of antimicrobial biomaterials for dental healthcare applications

Several approaches for elimination of oral pathogens are being explored at the present time since oral diseases remain prevalent affecting approximately 3.5 billion people worldwide. Need for antimicrobial biomaterials in dental healthcare include but is not restricted to designing resin composites and adhesives for prevention of dental caries. Constant efforts are also being made to develop antimicrobial strategies for clearance of endodontic space prior root canal treatment and for treatment of periimplantitis and periodontitis. This article discusses various conventional and nanotechnology-based strategies to achieve antimicrobial efficacy in dental biomaterials. Recent developments in the design and synthesis of antimicrobial peptides and antifouling zwitterionic polymers to effectively lessen the risks of antimicrobial drug resistance are also outlined in this review. Further, the role of contemporary strategies such as use of smart biomaterials, ionic solvent-based biomaterials and quorum quenchers incorporated biomaterials in the elimination of dental pathogens are described in detail. Lastly, we mentioned the approach of using polymers to print custom-made three-dimensional antibacterial dental products via additive manufacturing technologies. This review provides a critical perspective on the chemical, biomimetic, and engineering strategies intended for developing antimicrobial biomaterials that have the potential to substantially improve the dental health.

Should local drug delivery systems be used in dentistry?

In dentistry, the use of biomaterial-based drug delivery systems (DDS) aiming the release of the active compounds directly to the site of action is slowly getting more awareness among the scientific and medical community. Emerging technologies including nanotechnological platforms are offering novel approaches, but the majority are still in the proof-of-concept stage. This study critically reviews the potential use of DDS in anesthesiology, oral diseases, cariology, restorative dentistry, periodontics, endodontics, implantology, fixed and removable prosthodontics, and orthodontics with a special focus on infections. It also stresses the gaps and challenges faced. Despite numerous clinical and pharmacological advantages, some disadvantages of DDS pose an obstacle to their widespread use. The biomaterial's biofunctionality may be affected when the drug is incorporated and may cause an additional risk of toxicity. Also, the release of sub-therapeutic levels of drugs such as antibiotics may lead to microbial resistance. Multiple available techniques for the manufacture of DDS may affect drug release profiles and their bioavailability. If the benefits outweigh the costs, DDS may be potentially used to prevent or treat oral pathologies as an alternative to conventional strategies. A case-by-case approach must be followed.

Novel antibacterial calcium phosphate nanocomposite with long-term ion recharge and re-release to inhibit caries

Short-term studies on calcium-phosphate (CaP) ion-rechargeable composites were reported. The long-term rechargeability is important but unknown. The objectives of this study were to investigate nanocomposite with strong antibacterial and ion-recharge capabilities containing dimethylaminododecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP), and evaluate long-term ion-recharge by testing for 12 cycles (taking 6 months to complete) for the first time. Three groups were tested: (1) Heliomolar control; (2) Resin+20%NACP+50%glass; (3) Resin+3%DMAHDM+20%NACP+50%glass. Biofilm acid and colony-forming units (CFU) were measured. Ion-recharge was tested for 12 cycles. NACP-DMAHDM composite reduced biofilm acid, and reduced CFU by 4 logs. High levels of ion releases were maintained throughout 12 cycles of recharge, maintaining steady-state releases without reduction in 6 months (p>0.1), representing long-term remineralization potential. Bioactive nanocomposite demonstrated long-term ion-rechargeability for the first time, showed remineralization and potent anti-biofilm functions, with promise for tooth restorations to combat caries.

Influence of the incorporation of triclosan methacrylate on the physical properties and antibacterial activity of resin composite

The incorporation of antimicrobials in the composites as an attempt to reduce bacterial adhesion without jeopardizing mechanical properties is a challenge for Dentistry. OBJECTIVE To evaluate the bacterial adhesion and physical properties of a composite containing the methacrylate triclosan- derivative monomer (TM). METHODOLOGY TM was synthesized and added to an experimental composite. Samples were divided into two groups: Control and TM (13.4 wt%). Antibacterial Activity: Three specimens of each material were prepared and placed on bacterial suspensions of Streptococcus mutans for 1, 5 and 10 days. After these periods the counting of the colonies (log10) was performed. Assays was performed in triplicate. Physical Properties: Three-body Abrasion (TBA): Ten specimens of each material were prepared and stored at 37°C/24 h. The surface roughness (Ra) and hardness (KHN) were analyzed. Next, the specimens were submitted to abrasive wear (30,000 cycles) and re-evaluated for Ra and KHN; Sorption/solubility (SS): cylindrical specimens (n=10) were prepared and weighted. The specimens were immersed in deionized water for 7 days at 37°C and then their weight was verified again. SS were calculated using accepted formulas; Diametral tensile strength (DTS): specimens (n=10) underwent test performed in an Instron universal testing machine at a crosshead speed of 1 mm/min. Data were submitted to appropriate statistical tests according to data distribution and assay (p<0.05). RESULTS Bacterial Adhesion: TM showed a significant reduction on biofilm accumulation in the evaluated periods: 1 day (1.537±0.146); 5 days (2.183±0.138) and 10 days (4.469±0.155) when compared with Control: 1 day (4.954±0.249); 5 days (5.498±0.257) and 10 days (6.306±0.287). Physical Properties: For TBA, SS and DTS no significant difference was found between groups Control and TM. The incorporation of methacrylate triclosan-based monomer in the experimental composite reduce bacterial adhesion of S. mutans and did not affect important polymer properties.

Prevention of Periodontitis by the Addition of a Bactericidal Particulate Glass/Glass-Ceramic to a Dental Resin: A Pilot Study in Dogs

The aim of the study is to evaluate, in a ligature-induced periodontitis model, the efficacy of a commercially available dental resin containing different antimicrobial glass/glass-ceramic additions (0–26 wt.%). It has been proved that a 26 wt.% glass addition to a conventional dental resin matrix does not alter neither its workability nor its adhesion to the surface of teeth; however, it does confer notable antimicrobial properties when tested in vitro. Moreover, in vivo tests in Beagle dogs demonstrated the prevention of bone loss in ligature-induced plaque accumulation around teeth. Particularly, the glass-ceramic filler resin composite has shown excellent antimicrobial control since it displays the same bone loss as that of the negative control. The results obtained in the present investigation have shown that a conventional dental resin containing a fraction of glass/glass-ceramic (≥26 wt.%) can prevent periodontitis, which is considered to be a most serious dental disease.

Physicochemical and Microbiological Assessment of an Experimental Composite Doped with Triclosan-Loaded Halloysite Nanotubes

This study is aimed at evaluating the effects of triclosan-encapsulated halloysite nanotubes (HNT/TCN) on the physicochemical and microbiological properties of an experimental dental composite. A resin composite doped with HNT/TCN (8% w/w), a control resin composite without nanotubes (HNT/TCN-0%) and a commercial nanofilled resin (CN) were assessed for degree of conversion (DC), flexural strength (FS), flexural modulus (FM), polymerization stress (PS), dynamic thermomechanical (DMA) and thermogravimetric analysis (TGA). The antibacterial properties (M) were also evaluated using a 5-day biofilm assay (CFU/mL). Data was submitted to one-way ANOVA and Tukey tests. There was no significant statistical difference in DC, FM and RU between the tested composites (p > 0.05). The FS and CN values attained with the HNT/TCN composite were higher (p < 0.05) than those obtained with the HNT/TCN-0%. The DMA analysis showed significant differences in the TAN δ (p = 0.006) and Tg (p = 0) between the groups. TGA curves showed significant differences between the groups in terms of degradation (p = 0.046) and weight loss (p = 0.317). The addition of HNT/TCN induced higher PS, although no significant antimicrobial effect was observed (p = 0.977) between the groups for CFUs and (p = 0.557) dry weight. The incorporation of HNT/TCN showed improvements in physicochemical and mechanical properties of resin composites. Such material may represent an alternative choice for therapeutic restorative treatments, although no significance was found in terms of antibacterial properties. However, it is possible that current antibacterial tests, as the one used in this laboratory study, may not be totally appropriate for the evaluation of resin composites, unless accompanied with aging protocols (e.g., thermocycling and load cycling) that allow the release of therapeutic agents incorporated in such materials.

Properties of Experimental Dental Composites Containing Antibacterial Silver-Releasing Filler

Secondary caries is one of the important issues related to using dental composite restorations. Effective prevention of cariogenic bacteria survival may reduce this problem. The aim of this study was to evaluate the antibacterial activity and physical properties of composite materials with silver sodium hydrogen zirconium phosphate (SSHZP). The antibacterial filler was introduced at concentrations of 1%, 4%, 7%, 10%, 13%, and 16% (w/w) into model composite material consisting of methacrylate monomers and silanized glass and silica fillers. The in vitro reduction in the number of viable cariogenic bacteria Streptococcus mutans ATCC 33535 colonies, Vickers microhardness, compressive strength, diametral tensile strength, flexural strength, flexural modulus, sorption, solubility, degree of conversion, and color stability were investigated. An increase in antimicrobial filler concentration resulted in a statistically significant reduction in bacteria. There were no statistically significant differences caused by the introduction of the filler in compressive strength, diametral tensile strength, flexural modulus, and solubility. Statistically significant changes in degree of conversion, flexural strength, hardness (decrease), solubility (increase), and in color were registered. A favorable combination of antibacterial properties and other properties was achieved at SSHZP concentrations from 4% to 13%. These composites exhibited properties similar to the control material and enhanced in vitro antimicrobial efficiency.

Bactericidal and Bioactive Dental Composites

Aim: Antimicrobial and bioactive restorative materials are needed to develop a bacteria free environment and tight bond with the surrounding tissue, preventing the spread of secondary caries and thus extending the lifetime of dental restorations. The characteristic properties of new dental bioactive and antibacterial composites are presented in this work. The new composites have been microstructurally characterized and both long and short term properties have been studied. Methods: The Ag-doped sol-gel derived bioactive glass (Ag-BG) was incorporated into resin composite in concentrations 5, 10, and 15 wt.%, to fabricate new Ag-doped bioactive and antibacterial dental composites (Ag-BGCOMP). The microstructural properties and elemental analysis of the developed Ag-BGCOMP was observed. The total bond strength (TBS) was measured immediately and after long term of immersion in medium using microtensile testing. The capability of Ag-BGCOMPs to form apatite layer on their surface after immersion in Simulated Body Fluid (SBF) as well as the bacteria growth inhibition in a biofilm formed by Streptococcus mutans (S. mutans) were evaluated. Results: Homogeneous distribution of Ag-BG particles into the resin composite was observed microstructurally for all Ag-BGCOMPs. The TBS measurements showed non-statistically significant difference between control samples (Ag-BG 0 wt.%) and Ag-BGCOMP specimens. Moreover, the total bond strength between the surrounding tooth tissue and the material of restoration does not present any statistically significant change for all the cases even after 3 months of immersion in the medium. The bioactivity of the Ag-BGCOMPs was also shown by the formation of a calcium-phosphate layer on the surface of the specimens after immersion in SBF. Antibacterial activity was observed for all Ag-BGCOMPs, statistically significant differences were observed between control samples and Ag-BGCOMPs. Accordingly, the number of dead bacteria in the biofilm found to increase significantly with the increase of Ag-BG concentration in the Ag-BGCOMPs. Conclusions: New resin composites with antibacterial and remineralizing properties have been manufactured. Characterization of these materials provides a rationale for future clinical trials to evaluate clinical benefits and outcomes in comparison with currently used dental materials. Significance: The new developed composites could ultimately prevent restoration failure and could advance patients' wellbeing.

Polymerisation, antibacterial and bioactivity properties of experimental orthodontic adhesives containing triclosan-loaded halloysite nanotubes

OBJECTIVE

To evaluate the immediate enamel bond strength, in situ degree of conversion and the polymerisation rate of three experimental orthodontic adhesives containing triclosan-loaded halloysite nanotubes. The antibacterial and bioactivity properties of such experimental materials were also assessed.

MATERIALS AND METHODS

Three experimental orthodontic adhesives were formulated by incorporating triclosan-loaded halloysite nanotubes (TCN-HNT) at different concentrations (5wt%, 10wt% and 20wt%) into a resin blend (Control). The maximum polymerisation rate of the tested adhesives was evaluated trough FTIR, while Raman was used to analyse the in situ degree of conversion (DC) at the bracket/enamel interface. The shear bond strength (SBS) of the enamel-bonded specimens was assessed at 24h. The antibacterial properties of the experimental materials against S. Mutans were evaluate up to 72h, while, their bioactivity was evaluated after 14days of artificial saliva (AS) storage through SEM-EDS and Raman spectromicroscopy.

RESULTS

Incorporation of TCN-HNT increased the polymerisation properties without interfering with the immediate bonding properties of the experimental adhesives. All experimental adhesives containing TCN-HNT inhibited bacterial growth at 24h, and induced mineral deposition after 14days of AS storage. At 72h, only the experimental system containing 20% TCN-HNT maintained such a capability.

CONCLUSIONS

Adhesives doped with TCN-HNT present improved polymerisation properties and suitable bonding performance. However, only the adhesives containing TCN-HNT >10% might promote long-term antibacterial activity and reliable mineral deposition.

CLINICAL SIGNIFICANCE

The use of adhesives containing triclosan-loaded halloysite represents a promising "smart" approach to bond orthodontic brackets and bands; these might prevent enamel demineralisation and induce enamel remineralisation during the treatment.

Antimicrobial and mechanical properties of dental resin composite containing bioactive glass

BACKGROUND

The aim of this study was to evaluate the antimicrobial efficacy and mechanical properties of dental resin composites containing different amounts of microparticulate bioactive glass (BAG).

METHODS

Experimental resin composites were prepared by mixing resin matrix (70% BisGMA and 30% TEGDMA) and inorganic filler with various fractions of BAG to achieve final BAG concentrations of 5, 10 and 30 wt%. Antimicrobial efficacy was assessed in aqueous suspension against Escherichia coli, Staphylococcus aureus and Streptococcus mutans and in biofilm against S. mutans. The effect of incorporation of BAG on the mechanical properties of resin composite was evaluated by measuring the surface roughness, compressive strength and flexural strength.

RESULTS

Under the dynamic contact condition, viable counts of E. coli, S. aureus and S. mutans in suspensions were reduced up to 78%, 57% and 50%, respectively, after 90 minutes of exposure to disc-shaped composite specimens, depending on the BAG contents. In 2-day-old S. mutans biofilm, incorporation of BAG into composite at ratios of 10% and 30% resulted in 0.8 and 1.4 log reductions in the viable cell counts compared with the BAG-free composite, respectively. The surface roughness values of composite specimens did not show any significant difference (p&gt;0.05) at any concentration of BAG. However, compressive and flexural strengths of composite were decreased significantly with addition of 30% BAG (p&lt;0.05).

CONCLUSIONS

The results demonstrated the successful utilization of BAG as a promising biomaterial in resin composites to provide antimicrobial function.

Restorative materials containing antimicrobial agents: is there evidence for their antimicrobial and anticaries effects? A systematic review

The aim of this systematic literature review was to investigate whether the incorporation of antimicrobial agents into dental restorative materials truly exerts an antimicrobial effect against common cariogenic bacteria (primary outcome), and whether the inclusion of antimicrobial agents is able to prevent caries around restorations (secondary outcome). MEDLINE, via PubMed, was searched for papers published between 1980 and 30 November 2014. A total of 1126 articles were retrieved. After inclusion/exclusion assessment, 147 full text articles were read and included in the review, comprising 130 in vitro, 1 in situ, and 4 in vivo studies, as well as 12 literature reviews. In about 78% of in vitro studies, and in all identified in situ and in vivo studies, a positive antimicrobial effect had been found. However, the anticaries effect had not been tested in any of the selected studies. It was concluded that there is indeed evidence that restorative dental materials containing antimicrobial agents exert an antimicrobial effect, both in laboratory and in clinical studies. However, no evidence has been found regarding the role of these agents in preventing or controlling dental caries, or in preventing caries around restorations.

Antibacterial Effect and Physical-Mechanical Properties of Temporary Restorative Material Containing Antibacterial Agents

Introduction. For the maintenance of the aseptic chain created during the treatment the coronal sealing becomes paramount. Aim. Evaluating the antibacterial effect and the physical-mechanical properties of a temporary restorative material containing different antibacterial agents. Material and Methods. Two antibacterial agents (triclosan and chloramine T) were manually added to a temporary restorative material used as base (Coltosol). The antibacterial action of the material was analyzed using the agar diffusion method, in pure cultures of Escherichia coli (ATCC BAA-2336) and Staphylococcus aureus (ATCC 11632) and mixed culture of saliva collection. The microleakage rate was analyzed using bovine teeth, previously restored with the materials, and submitted to thermocycling, in a solution of 0.5% methylene blue, for a period of 24 hours. The physical and mechanical properties of the materials analyzed were setting time, water sorption, solubility, and compression strength. Results. No marginal leakage was observed for all groups. There was no statistical significant difference in antimicrobial activity, setting time, water sorption, solubility, and compression strength among the materials. Conclusion. The addition of antibacterial agents on a temporary restorative material did not optimize the antibacterial ability of the material and also did not change its physical-mechanical properties.

Dental composite materials containing carolacton inhibit biofilm growth of Streptococcus mutans

OBJECTIVE

Caries adjacent to restorations is one of the main causes for restoration replacement. Antimicrobial substances incorporated into dental materials would potentially be able to reduce secondary caries initiation and progression. This study investigated biofilm growth of Streptococcus mutans UA159 on the surface of composite materials containing the biomolecule carolacton compared to materials containing chlorhexidine (CHX) and triclosan.

METHODS

Biofilm inhibition was investigated by counting colony forming units (CFU), viability staining (Life/Dead), and real-time quantitative PCR.

RESULTS

First, the antimicrobial substances were added to the cultivation medium at 2.5 μg/ml (0.0002%) and 0.25 μg/ml (0.00002%). CHX eliminated bacterial growth and biofilm formation completely. Triclosan was effective at 2.5 μg/ml, but at 0.25 μg/ml biofilm mass and viability were unchanged, yet the number of CFU increased due to disruption of cell chains and biofilm aggregates. Carolacton had a limited effect on biofilm growth and mass, but reduced viability significantly. When incorporated into composite materials carolacton (25 μg/ml resp. 0.002%, w/w) had no adverse effect on physical/mechanical properties and retained its biofilm inhibiting effect. Life/Dead staining revealed a reduction of biofilm viability of up to 64%. CFUs were reduced by 98% and qPCR demonstrated a mean inhibition of 87%. In contrast, materials containing CHX or triclosan showed an insignificant effect on biofilm formation, even at a 100 fold increased concentration (0.2%). The anti-biofilm activity of composite material containing carolacton was stable over a period of 42 days.

SIGNIFICANCE

Carolacton incorporated into dental filling material has a strong biofilm-inhibiting effect on S. mutans and is therefore potentially able to prevent secondary caries formation.