Mechanical and biological characterization of resin-modified glass-ionomer cement containing doxycycline hyclate

Exploring the effectiveness of doxycycline in restorative dentistry: a systematic review of in vitro studies

This systematic review evaluated the efficacy of doxycycline in MMP inhibition, its antibacterial action, and other properties relevant to dental materials testing. The study protocol was registered at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/ZVK2T ). Reporting was based on PRISMA statement. The search was carried out in the databases: PubMed, Scopus, Web of Science, Embase, Lilacs, and Google Scholar. Articles were restricted to Portuguese, English, and Spanish, with no date limit. In vitro studies were selected based on the following outcomes: DOX antibacterial and anti-metalloproteinase activity and its influence in physico-chemical properties. Two researchers independently selected the articles and collected the data. Of 1507 documents, 82 were fully evaluated and 21 were included. Different forms of doxycycline incorporation were found, both as free form and incorporated into carrier agents. The drug was tested as primers, incorporated in adhesive or glass ionomer cement. No studies were found that evaluated its incorporation in resin composite or resin cement. The results confirmed the therapeutic properties of the medication, with more significant results when incorporated in an adhesive. However, although promising, the use of this substance requires standardization in application methods and adopted concentrations, allowing for more direct comparisons between studies. Furthermore, long-term studies are interesting to conduct, ensuring biocompatibility and complete understanding of long-term effects on dental materials.

Characterization of polymethylmethacrylate microspheres loaded with silver and doxycycline for dental materials applications

OBJECTIVES

The manufacturing of polymethylmethacrylate(PMMA) microspheres loaded with doxycycline(DOX) and/or silver sulfate(Ag₂SO₄) to be incorporated into glass ionomer cement(GIC).

METHODS

PMMA microspheres were manufactured with Ag₂SO₄(1-5%) and/or DOX(5-15%). Particle size, encapsulation efficiency and drug release were measured by light microscope, ICP, and HPLC. Microspheres were added to a dental GIC(20%w/w). Drug release and DTS were investigated. Minimum inhibitory concentration and antibacterial effects of PMMA microspheres into GIC materials were tested.

RESULTS

The median diameter of 50 µm was obtained for microspheres. DOX was encapsulated at an efficiency of 8.3% using a theoretical loading of 15%DOX + 5%Ag₂SO₄. The Ag₂SO₄ encapsulation efficiency was 0.63% using a theoretical loading of 5%AgSO₄. All groups showed burst release within the first day and continued released up to 15 days, with 60-83% of DOX and approximately 30% of silver. For GIC, approximately 15% of DOX and 0.18% of silver were released in a 7-day period. Microbiological results showed an antimicrobial effect against S. mutans when the lead formulation of microspheres was added. The DTS was reduced by the inclusion of microspheres.

SIGNIFICANCE

PMMA microspheres containing DOX and Ag₂SO₄ offer a sustained antimicrobial activity for dental applications and promising potential for the biomedical field.

Antibacterial Activity and Biofilm Inhibition of New-Generation Hybrid/Fluoride-Releasing Restorative Materials

The antibacterial activity, and the effect of the application of additional topical fluoride on the bacterial activity, biofilm formation, and surface roughness of new-generation hybrid/fluoride-releasing materials were investigated. Two hundred and forty specimens were prepared in split Teflon molds (8 × 2 mm) from a resin composite (as negative control: G-aenial A’Chord/GC), Equia Forte HT Fil(GC), Equia Forte HT Fil+Equia Forte Coat, Riva Self-Cure (SDI), Riva Self-Cure+Equia Forte Coat, Zirconomer (Shofu), Beautifil II (Shofu), and Riva Silver (Shofu). Penicillin G,1U was used as positive control. The antibacterial activity was evaluated by the agar diffusion test immediately after the materials set using Streptococcus mutans (S. mutans) and Lactobacillus casei (L. casei), and repeated after application of 0.20% w/w (900 ppm) topical fluoride. The biofilm formation of S. mutans on each material was quantified by crystal violet staining. Surface roughness of the specimens was measured by a profilometer. The data were analyzed by Kruskal–Wallis, Dunn’s, one-way ANOVA, and Tukey’s HSD tests (p < 0.05). None of the tested restorative materials showed antibacterial activity and no inhibition zones were observed after treatment of the restoratives with additional topical fluoride. There were significant differences among the groups in terms of biofilm formation (p < 0.005). Equia Forte HT Fil with and without coating showed the lowest, while Riva self-cure without coating and Zirconomer showed the highest biofilm accumulation. None of the new-generation hybrid/fluoride-releasing materials demonstrated antibacterial activity and additional topical fluoride application did not make any change. Biofilm formation of the tested materials differed. All tested materials showed different surface roughness values (p < 0.005). Characteristics and compositions of the materials seemed to be more effective than the surface roughness.

Trans,trans-farnesol, an antimicrobial natural compound, improves glass ionomer cement properties

A series of experiments were conducted to characterize a novel restorative material. We explored the effect on biological, physical and chemical properties of glass ionomer cement (GIC) adding-the naturally occurring tt-farnesol (900 mM). Two groups were accomplished for all assays: GIC+tt-farnesol and GIC (control). Biological assays: 1) agar diffusion against some cariogenic bacteria; 2) S. mutans biofilm formation and confocal laser scanning microscopy-CLSM. 3) gtfB, gtfC, gtfD, gbpB, vicR, and covR expression; 4) MTT and microscopic morphology. Physical properties assays: 1) roughness; 2) hardness; 3) compressive strength and 4) diametral tensile strength. Chemical assay: Raman spectroscopy. The adding of tt-farnesol to GIC led to larger zones of inhibition (p<0.05), biofilms with a short-term reduction in bacterial viability but similar biomass (p>0.05). Polysaccharides levels increased over time, similarly over groups (p>0.05). Viable and non-viable S. mutans were seen on the specimens’ surface by CLSM but their virulence was not modulated by tt-farnesol. The tt-farnesol increased the HaCaT cell viability without impact on compressive and diametral tensile strength and roughness although the hardness was positively affected (p<0.05). Raman confirmed the presence of tt-farnesol. The incorporation of tt-farnesol into GIC inhibited the growth of cariogenic bacteria but had a little effect on the composition, structure and physiology of the biofilm matrices. Also, the tt-farnesol increased the hardness and the biocompatibility of the GIC, not influencing negatively other physical properties of the restorative material.

Evaluation of Preventive Antibacterial Properties of a Glass-Ionomer Cement Containing Purified Powder of Salvia officinalis: An In vitro Study

Background

In this study, the anti-Streptococcus mutans and anti-Lactobacillus casei properties of a restorative glass-ionomer cement (GIC) modified with extract powder of Salvia officinalis as a safe and effective herbal extract at weight concentration levels of 0.5%, 0.75%, 1%, and 1.25% are investigated.

Methods

The S. officinalis extract powder is provided by doing a multistep laboratory procedure and is filtered to obtain particles smaller than 50 μ. The GIC powder is modified by adding extract powder in weight concentrations of 0.5% (Group II), 0.75% (Group III), 1% (Group IV), and 1.25% (Group V) to form experimental groups, each of 1 g. Five disk-shaped samples, 1 cm in diameter and 2 mm height, of each group (including control group [Group I]) are prepared for each bacterial category of S. mutans and L. casei. The twenty-five samples for each category are tested in vitro against strains of S. mutans and L. casei. Following Agar diffusion tests, the inhibition zone diameters are recorded. The data are tested for normality by means of Kolmogorov-Smirnov procedure. The Kruskal-Wallis and Mann-Whitney tests are used to perform a one-way ANOVA and to do pair-wise comparisons, respectively, at 5% significance level.

Results

The mean diameter of the inhibition zones are significantly different among the test groups and also the test groups and the control group except for the group with 0.5% in L. casei category which shows no significant difference with the control group.

Conclusions

The present study revealed direct inhibitory activities of S. officinalis-containing GIC against S. mutans and L. casei in a dose-response manner.

Glass Ionomer Cements for the Restoration of Non-Carious Cervical Lesions in the Geriatric Patient

Background: The restoration of non-carious cervical lesions in geriatric patients is a demanding process. Glass ionomer cements can be promising materials for the management of these lesions in older adults. The aim of this literature review is to present the benefits of glass ionomers and how they can be used for the restoration of non-carious cervical lesions of older adults depending on the geriatric patient’s profile. Data sources: All available in vitro and in vivo studies from Google Scholar, PubMed and Scopus search engines corresponding to glass ionomer cements, geriatric dentistry, elderly patients, and non-carious lesions as key words were reviewed. Data synthesis: The advantages of glass ionomer cements, such as good retention and fluoride release, make them suitable for the restoration of non-carious cervical lesions. However, several factors related to the geriatric patient’s profile determine the most suitable material type. Conclusion: In general, the resin modified glass ionomer cements (RMGICs) appear to be preferred, but under certain circumstances the use of the conventional product is more appropriate, despite its poorer mechanical features. Further studies are required for more reliable data analysis and clinical interpretation of the relevant results.

Doxycycline-containing glass ionomer cement for arresting residual caries: an in vitro study and a pilot trial

In a previous study, we demonstrated that the incorporation of doxycycline hyclate (DOX) into resin-modified glass ionomer cement (RMGIC) inhibited important cariogenic microorganisms, without modifying its biological and mechanical characteristics. In this study, we keep focused on the effect of that experimental material as a potential therapy for arresting residual caries by analyzing other in vitro properties and conducting a pilot clinical trial assessing the in vivo effect of DOX-containing RMGIC on residual mutans streptococci after partial carious removal in primary molars. Specimens of the groups RMGIC (control); RMGIC + 1.5% DOX; RMGIC + 3% DOX; and RMGIC + 4.5% DOX were made to evaluate the effect of DOX incorporation on surface microhardness and fluoride release of RMGIC and against biofilm of Streptococcus mutans. Clinical intervention consisted of partial caries removal comparing RMGIC and RMGIC + 4.5% DOX as lining materials. After 3 months, clinical and microbiologic evaluations were performed. Data were submitted to ANOVA/Tukey or Wilcoxon/Mann-Whitney set as α=0.05. Fluoride release and surface microhardness was not influenced by the incorporation of DOX (p>0.05). There was a significant reduction of S. mutans biofilm over the material surface with the increase of DOX concentration. After clinical trial, the remaining dentin was hard and dry. Additionally, mutans streptococci were completely eliminated after 3 months of treatment with RMGIC + 4.5% DOX. The incorporation of DOX provided better antibiofilm effect, without jeopardizing fluoride release and surface microhardness of RMGIC. This combination also improved the in vivo shortterm microbiological effect of RMGIC after partial caries removal.

Thermo-setting glass ionomer cements promote variable biological responses of human dental pulp stem cells

OBJECTIVE

To evaluate the in vitro cytotoxicity of Equia Forte (GC, Tokyo, Japan) and Ionostar Molar (Voco, Cuxhaven, Germany) on human dental pulp stem cells (hDPSCs).

METHODS

hDPSCs isolated from third molars were exposed to several dilutions of Equia Forte and Ionostar Molar eluates (1/1, 1/2 and 1/4). These eluates were obtained by storing material samples in respective cell culture medium for 24h (n=40). hDPSCs in basal growth culture medium were the control. Cell viability and cell migration assays were performed using the MTT and wound-healing assays, respectively. Also, induction of apoptosis and changes in cell phenotype were evaluated by flow cytometry. Changes in cell morphology were analysed by immunocytofluorescence staining. To evaluate cell attachment to the different materials, hDPSCs were directly seeded onto the material surfaces and analyzed by scanning electron microscopy (SEM). The chemical composition of the materials was determined by energy dispersive X-ray (EDX) and eluates were analyzed by inductively coupled plasma-mass spectrometry (ICP-MS). Statistical analysis was performed with analysis of variance (ANOVA) and Student's t-test (α<0.05).

RESULTS

Undiluted Equia Forte extracts led to a similar cell proliferation rates than the control group from 72h onwards. There were no significance differences between Equia Forte and Ionostar Molar in terms of cell apoptosis and phenotype. However, in presence of Equia extracts the migration capacity of hDPSCs was higher than in presence of Ionostar Molar (p<0.05). Also, SEM studies showed a higher degree of cell attachment when Equia Forte extracts were used. Finally, EDX analysis pointed to different weight percentages of C, O and Ca ions in glass ionomer cements, while other elements such as La, Al, Si, W, Mo and F were also detected.

SIGNIFICANCE

In summary, Equia Forte promoted better biological responses in hDPSCs than Ionostar Molar.

In vitro and in vivo evaluations of glass-ionomer cement containing chlorhexidine for Atraumatic Restorative Treatment

Objectives:

Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX.

Material and Methods:

For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05).

Results:

Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment.

Conclusions:

The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations.

Effect of monomer blend and chlorhexidine-adding on physical, mechanical and biological properties of experimental infiltrants

OBJECTIVES

The aim of the study was to evaluate antimicrobial inhibition zone, degree of conversion (DC) and Knoop hardness (KH) of experimental infiltrants. Experimental low viscosity monomer blends were prepared and chlorhexidine diacetate salt (CHX) (0.1% or 0.2%) was added comprising the groups: G1) TEGDMA; G2) TEGDMA/0.1CHX; G3) TEGDMA/0.2CHX; G4) TEGDMA/UDMA; G5) TEGDMA/UDMA/0.1CHX; G6) TEGDMA/UDMA/0.2CHX; G7) TEGDMA/BISEMA; G8) TEGDMA/BISEMA/0.1CHX; G9) TEGDMA/BISEMA/0.2CHX. Icon^® was used as control group.

METHODS

Specimens of resin blends were made (n=9) to accomplished DC and KH. Pour plate was accomplished to evaluate antimicrobial groups' activity against Streptococcus mutans (SM) and Lactobacillus acidophilus (LA). Data obtained were submitted to two-way ANOVA and Tukey tests for blends comparisons and Dunnett's test for comparisons between experimental infiltrants and Icon^® (p<0.05).

RESULTS

In relation to antimicrobial effect, uncured blends showed higher antibacterial activity than cured ones for the most of blends. After polymerization, G5 showed the highest inhibition zone against SM and, G3 and G6 against LA. Concerning KH, TEGDMA/UDMA-based blends showed the highest values of KH number and it was influenced by monomeric base, regardless CHX concentration. DC was not affected by monomer blend composition, neither for CHX concentration. The antimicrobial activity was affected by monomeric base, CHX concentration and polymerization. Experimental infiltrants presented similar or higher performance than Icon^® for the properties evaluated.

SIGNIFICANCE

White spot lesion infiltration with low viscosity monomer blends (infiltrants) is an alternative to stop initial caries lesions progression. The incorporation of an antimicrobial agent as chlorhexidine diacetate salt in infiltrants composition could enhance the performance of these materials.

Antibacterial effect of silver (I) carbohydrate complexes on oral pathogenic key species in vitro

Background

It was the aim of this study to evaluate the antibacterial impact of two silver(I) carbohydrate complexes with tripodal thioglycosides, namely tris[2-(β-D-thio-glucopyranosyl)ethyl]-amine-silver(I)-nitrate (3) and tris[2-(α-D-thio-manno-pyranosyl)ethyl]-amine-silver(I)-nitrate (4), on five oral pathogenic bacterial strains. Furthermore, cytocompatibility was tested using human gingival fibroblasts (HGF).

Methods

Minimum inhibitory concentrations (MIC) were determined on five oral pathogenic bacterial strains by using the broth microdilution method: Fusobacterium nucleatum (ATCC 10953), Aggregatibacter actinomycetemcomitans (ATCC 33384), Porphyromonas gingivalis (ATCC 33277), Streptococcus mutans (ATCC 25175) and Enterococcus faecalis (DSMZ 20376). Furthermore, antimicrobial efficiency was tested using agar diffusion assays. To evaluate cytocompatibility, human gingival fibroblasts (HGFs) were exposed to AgNO₃ and complex 3 followed by a live/dead staining.

Results

MIC of the silver(I) complexes ranged between 0.625 and 5.0 mmol/L. The silver complexes 3 and 4 showed higher antibacterial efficiency against all tested species than AgNO₃. Antibacterial efficiency of complexes 3 and 4 on F. nucleatum (≥18 mm) and A. actinomycetemcomitans (≥23 mm) was more pronounced than against P. gingivalis (≥15 mm). Complex 3 (20 mM) induced the largest inhibition zones (30 to 31 mm) on Gram-negative strains. For Gram-positive strains, the largest inhibition zones were achieved by complex 3 (20 mM/S. mutans: 28 mm, E. faecalis: 18 mm). Complex 3 had a lower cytotoxic impact on HGFs compared to AgNO₃ by the power of ten.

Conclusions

The findings suggest that silver(I) carbohydrate complexes 3 and 4 might function as novel antimicrobial agents for the treatment of periodontal, carious or endodontic diseases.

Cytotoxicity of glass ionomer cements containing silver nanoparticles

BACKGROUND

Some studies have investigated the possibility of incorporating silver nanoparticles (NAg) into dental materials to improve their antibacterial properties. However, the potential toxic effect of this material on pulp cells should be investigated in order to avoid additional damage to the pulp tissue. This study evaluated the cytotoxicity of conventional and resin-modified glass ionomer cements (GIC) with and without addition of NAg.

MATERIAL AND METHODS

NAg were added to the materials at two different concentrations by weight: 0.1% and 0.2%. Specimens with standardized dimensions were prepared, immersed in 400 µL of culture medium and incubated at 37°C and 5% CO2 for 48 h to prepare GIC liquid extracts, which were then incubated in contact with cells for 48 h. Culture medium and 0.78% NAg solution were used as negative and positive controls, respectively. Cell viability was determined by MTT and Trypan Blue assays. ANOVA and the Tukey test (α=0.05) were used for statistical analyses.

RESULTS

Both tests revealed a significant decrease in cell viability in all groups of resin modified cements (p<0.001). There were no statistically significant differences between groups with and without NAg (p>0.05). The differences in cell viability between any group of conventional GIC and the negative control were not statistically significant (p>0.05).

CONCLUSIONS

NAg did not affect the cytotoxicity of the GIC under evaluation.

KEY WORDS

Glass ionomer cements, totoxicity, cell culture techniques, nanotechnology, metal nanoparticles.

Effects of soft denture liners on L929 fibroblasts, HaCaT keratinocytes, and RAW 264.7 macrophages

The effects of six soft liners (Ufi Gel P (UG), Sofreliner S (SR), Durabase Soft (D), Trusoft (T), Coe Comfort (CC), and Softone (ST)) on L929, HaCat, and RAW 264.7 cells were investigated. Eluates (24 and 48 h) from the materials were applied on the cells and the viability, type of cell death, and morphology were evaluated. Cells were also seeded on the specimens' surfaces (direct contact) and incubated (24 or 48 h), and viability was analyzed. Controls were cells in culture medium without eluates or specimens. For cell viability, no significant differences were found among materials or between extraction periods, and the liners were noncytotoxic or slightly cytotoxic. Morphology of RAW 264.7 cells was altered by the 24 h eluates from CC and D and the 48 h eluates from SR, CC, and D. The 24 and 48 h eluates from all materials (except T) increased the percentages of L929 necrotic cells. For direct contact tests, the lowest cytotoxicity was observed for UG and SR. Although eluates did not reduce viability, morphology alterations and increase in necrosis were seen. Moreover, in the direct contact, effects on viability were more pronounced, particularly for D, T, CC and ST. Thus, the use of UG and SR might reduce the risk of adverse effects.

Antibacterial and mechanical properties of propolis added to glass ionomer cement

OBJECTIVE

To investigate whether adding ethanolic extracts of propolis (EEP) might influence the antibacterial and mechanical (shear-peel band strength [SPBS]) properties of conventional glass ionomer cement (GIC) used in orthodontic band cementation.

MATERIALS AND METHODS

The cement was divided into four groups: one using the original composition and three with 10%, 25%, and 50% EEP added to the liquid and then manipulated. An antimicrobial assay, broth-dilution method was used to determine the antibacterial capacity of the GIC containing EEP. Eighty teeth were used for the mechanical assay, and an Instron testing machine was used to evaluate the SPBS. Kolmogorov-Smirnov and Kruskal-Wallis tests were used for statistical analyses.

RESULTS

GIC with the addition of 25% and 50% EEP activated inhibition of Streptococcus mutans (ATCC 25175) growth, but this effect did not occur in the group to which 10% EEP was added or in the control GIC group. There was no significant difference between the groups in terms of SPBS (P > .05).

CONCLUSIONS

The addition of EEP may increase antibacterial properties without negatively modifying the mechanical properties of conventional GIC.