Incorporation of antimicrobial agents can be used to enhance the antibacterial effect of endodontic sealers

Confocal Laser Scanner Evaluation of Bactericidal Effect of Chitosan Nanodroplets Loaded with Benzalkonium Chloride

The aim was to evaluate the antibacterial efficacy and penetration depth into dentinal tubules of a solution of chitosan nanodroplets (NDs) loaded with Benzalkonium Chloride (BAK). Seventy-two human single-root teeth with fully formed apex were used. Cylindrical root dentin blocks were longitudinally sectioned and enlarged to a size of a Gates Glidden drill #4. After sterilization, root canals were infected with Enterococcus faecalis ATCC 29212 and further incubated for three weeks. Specimens were assigned to three experimental groups (n = 20), plus positive (n = 6) and negative (n = 6) controls. In the first group, irrigation was achieved with 2 mL of NDs solution loaded with BAK (NDs-BAK), in the second with 2 mL of 5% sodium hypochlorite (NaOCl) and in the last with 2 mL of 2% chlorhexidine (CHX). Specimens were rinsed and vertically fractured. Confocal laser scanning microscopy (CLSM) and viability staining were used to analyze the proportions of dead and live bacteria quantitatively. The volume ratio of red fluorescence (dead) was calculated in 3D reconstructions. Data were analyzed by one-way ANOVA and post hoc Bonferroni tests (p < 0.05). The ratio of red fluorescence over the whole green/red fluorescence resulted in a significant comparison of NDs-BAK with NaOCl (p < 0.01) and NaOCl with CHX (p < 0.01). No differences were found between NDs-BAK and CHX (p > 0.05). The mean depth of efficacy was, respectively: NDs-BAK 325.25 μm, NaOCl 273.36 μm and CHX 246.78 μm with no statistical differences between groups. The NaOCl solution showed the highest antimicrobial efficacy, but nanodroplets with BAK seemed to have the same effect as CHX with a high depth of efficacy.

Physical and biological properties of a novel root canal sealer modified by polyhexamethylene guanidine

The key of the root canal therapy is to eliminate the micro-organism infection, fill the root canal tightly and reduce the stimulation to the periapical tissues. However, it is quite difficult to meet all the conditions due to the defect of the material. Here we develop a novel root canal sealer (MZOE), in which zinc oxide eugenol (ZOE) were fabricated with polyhexamethylene guanidine (PHMG), and the PHMG's concentration is 0.8, 1.0, 1.2 and 1.4%. Our investigation tested its physical properties, antibacterial effect to E. faecalis, C. albicans, E. coli, S. aureus and cytotoxicity to human periodontal ligament fibroblasts (HPDLFs). The physical properties of the MZOE conformed to the ISO 6876:2001, and its antibacterial effect was stronger than ZOE (p<0.05), the RGR of HPDLFs was tested between 1 to 24%, belonging to moderate cytotoxicity. It was suggested that MZOE had good physical properties, high antibacterial effect, and moderate cytotoxicity.

Effect of nanomaterial incorporation on the mechanical and microbiological properties of dental porcelain

STATEMENT OF PROBLEM

Dental porcelain restorations are subject to biological failures related to secondary caries and periodontal disease leading to prosthesis replacement.

PURPOSE

The purpose of this in vitro study was to explore the microbiological and mechanical properties of dental porcelain incorporated with different percentages of silver vanadate (β-AgVO₃) through microbiological analysis, roughness tests, and the Vickers microhardness test.

MATERIAL AND METHODS

IPS InLine porcelain specimens were made by using a cylindrical Teflon matrix in the dimensions of 8×2 mm. For the control group, the porcelain was manipulated according to the manufacturer's instructions. The groups incorporating the nanomaterial were prepared with 2.5%, 5%, and 10% of β-AgVO_3, which was added proportionally by mass to the porcelain powder. In vitro microbiologic analysis, roughness tests, and the Vickers microhardness test were performed.

RESULTS

Against Streptococcus mutans, the control group showed no inhibition halo (0 mm). All groups with AgVO₃ showed a zone of inhibition, the highest for the group with 10% (30 mm) and then the groups with 2.5% (9 mm) and 5% (17 mm). For Vickers microhardness, no statistically significant difference (P<.05) was observed between the evaluated groups. The group with 10% of AgVO₃ had the highest mean roughness and was statistically different (P<.001) from the other groups.

CONCLUSIONS

Adding β-AgVO₃ to dental porcelain demonstrated antimicrobial effectiveness at all concentrations (2.5%, 5%, and 10%), with no effect on Vickers microhardness. The 10% group had higher roughness than the other groups.

A novel zinc oxide eugenol modified by polyhexamethylene biguanide: Physical and antimicrobial properties

This study was to prepare and screen a novel root canal sealing agent modified by polyhexamethylene biguanide (PHMB) that was in accordance with the ISO 6876:2001 standard and to study its physical and antimicrobial properties. The modified sealers were produced by mixing a certain amount of zinc oxide with eugenol containing different concentrations of PHMB (0.05, 0.1, 0.2, 0.4, 0.6 and 0.8%) at a ratio of 1:1 (w/v). The setting time, flow, film thickness, solubility and dimensional change after solidifying were assessed to screen out the modified sealing agents that the physical properties met the mentioned standards. The modified direct contact test (DCT) was used to evaluate the antimicrobial activity against Enterococcus faecalis. The results suggested that when the concentrations of PHMB were 0.05, 0.1 and 0.2%, the modified root canal sealers showed the best performance in physical and antimicrobial properties.

Effects of Addition of Quaternary Ammonium Antimicrobial Compounds into Root Canal Sealers

Objective The aim of this study is to determine the effect of the addition of benzalkonium chloride and cetylpyridinium chloride in three commercial root canal sealers.

Materials and Methods Three different root canal sealers were used: EndoRez, N2, and Apexit Plus. The samples were prepared by mixing the components according to the manufacturers’ guidelines and adding 2% in weight of the antimicrobials to the newly mixed cement. The paste was placed in molds and stored in an incubator (37°C, 24 h). The samples were then stored in 5-mL distilled water. Samples without antimicrobials served as a control. All samples were tested at 3 time intervals: 1 day, 1 week, and 1 month following their storage in distilled water. The impact of the antimicrobials on the solubility of the sealers, the release of chloride ions (Cl ^— ), and the pH value were examined.

Statistical Analysis Analysis was done using one-way analysis of variance and the post hoc Tukey's honestly significant difference test.

Results Chloride ions are present in storage media with EndoRez, N2, and Apexit Plus samples (without antimicrobials) following all tested storage intervals. The addition of the antimicrobials increased the release of chloride ions. Endodontic cements without addition of antimicrobials show an increase in weight after 1 month. The highest pH value is measured in Apexit Plus samples. The solutions in which N2 samples (with and without addition of antimicrobials) were stored did not have a significant change in their pH, while in the EndoRez solutions, a significant decrease in the pH value after the first week was measured.

Conclusions The addition of antimicrobials might lead to improved characteristics of the root canal sealers.

Efficacy and potential use of novel sustained release fillers as intracanal medicaments against Enterococcus faecalis biofilm in vitro

Background

Enterococcus faecalis is a bacterium frequently isolated after failed root canal therapy. This study analyzed the antibacterial and antibiofilm effects in vitro of sustained-release fillers (SRF) containing cetylpyridinium chloride (CPC) against vancomycin resistant E. faecalis.

Methods

First, the solidification capability was tested by introducing liquid SRF into phosphate buffered saline, followed by 30 s of vortexing. The antimicrobial effects of SRF-CPC against static monospecies biofilms were analyzed with a metabolic assay. Inhibition of biofilm formation was tested by exposing daily refreshed E. faecalis suspensions to SRF-CPC for 9 weeks. To evaluate the effects of SRF-CPC against preformed biofilms, biofilms were grown for 1, 3 and 7 days, and then treated with SRF-CPC for 24 h. Biofilm kill time was tested by applying SRF-CPC to a 3-day-old biofilm and measuring its viability at different time points. All experiments were compared to Placebo SRFs and to untreated control biofilms. Data were analyzed with two-way ANOVA followed by Tukey’s test. Results were considered significant at P < 0.05.

Results

The liquid SRF solidified within seconds and no structural changes were observed after 30 s of vortexing at maximum speed. SRF-CPC inhibited E. faecalis biofilm formation for 7 weeks and significantly reduced its viability in weeks 8 and 9. Mature biofilms grown for 1, 3 and 7 days were destructed by SRF-CPC in less than 24 h. Fifty percent of a 3-day-old biofilm was destructed in 2 h and complete destruction occurred in less than 12 h. (P < 0.05 in all cases, compared to SRII-Placebo).

Conclusions

SRF-CPC’s physical properties and long-lasting anti-biofilm effects make it a promising coadjuvant medication for endodontic therapy.

Electronic supplementary material

The online version of this article (10.1186/s12903-019-0879-1) contains supplementary material, which is available to authorized users.

Sustained-Release Fillers for Dentin Disinfection: An Ex Vivo Study

Enterococcus faecalis is the most commonly recovered species from failed root canal treatments. In this study, we tested the capability of a novel intracanal sustained-release filler (SRF) containing cetylpyridinium chloride (CPC) to disinfect dentinal tubules of segmented human tooth specimens. Human dental root specimens were infected with E. faecalis V583 for 3 weeks in a static environment. The tested intracanal medicaments were SRF-CPC and calcium hydroxide (CH). Each medicament was introduced into the canal of the dental specimen and incubated for 7 days. The bacteriological samples were taken by shaving the dentine surrounding the root canal with dental burs ranging in size from ISO 014-020. The obtained dentine powder was collected in test tubes containing phosphate-buffered saline, sonicated, and plated on agar plates. Colony-forming units were counted after 48 h of incubation. Random specimens were also examined under confocal laser scanning microscopy and scanning electron microscopy. A statistical difference was found in the bacterial counts obtained from all layers of infected dentin between the control and the SRF-CPC groups. CH reduced bacterial viability significantly only in the first layer of the infected dentin, up to 150 μm into the dentinal tubules. CLSM images showed that SRF-CPC killed most bacteria throughout the infected dentin up to 700 μm of penetration. SEM images demonstrated the adhesion ability of SRF-CPC to the dentinal wall. In conclusion, SRF-CPC is a potential intracanal medicament for disinfecting dentinal tubules.

Antibacterial Additives in Epoxy Resin-Based Root Canal Sealers: A Focused Review

Dental materials used in root canal treatment have undergone substantial improvements over the past decade. However, one area that still remains to be addressed is the ability of root canal fillings to effectively entomb, kill bacteria, and prevent the formation of a biofilm, all of which will prevent reinfection of the root canal system. Thus far, no published review has analysed the literature on antimicrobial additives to root canal sealers and their influence on physicochemical properties. The aim of this paper was to systematically review the current literature on antimicrobial additives in root canal sealers, their anti-fouling effects, and influence on physicochemical properties. A systematic search was performed in two databases (PubMed and Scopus) to identify studies that investigated the effect of antimicrobial additives in epoxy resin-based root canal sealers. The nature of additives, their antimicrobial effects, methods of antimicrobial testing are critically discussed. The effects on sealer properties have also been reviewed. A total of 31 research papers were reviewed in this work. A variety of antimicrobial agents have been evaluated as additives to epoxy resin-based sealers, including quaternary ammonium compounds, chlorhexidine, calcium hydroxide, iodoform, natural extracts, antibiotics, antifungal drugs, and antimicrobial agent-functionalised nanoparticles. Antimicrobial additives generally improved the antimicrobial effect of epoxy resin-based sealers mainly without deteriorating the physicochemical properties, which mostly remained in accordance with ISO and ANSI/ADA specifications.

Monomer Modifications of Denture Base Acrylic Resin: A Systematic Review and Meta-analysis

BACKGROUND

Methyl methacrylate monomer of denture base resins was modified with several monomers to achieve better physico-mechanical properties without compromising the biocompatibility. However, there are no consensuses on the best strategy to achieve best modified monomer.

PURPOSE

To identify and evaluate the differences in the properties between conventional and modified monomers and to verify the influence of several variables on the properties of denture base acrylic resin.

MATERIALS AND METHODS

This study was executed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. In-vitro studies that investigated the properties of conventional and modified monomers were selected. Searches were carried out in the Ebscohost, PubMed, Semantic scholar and J-stage databases. The search commenced from the year 1995 and the last search was done till November 2018. A comparison was performed between modified and unmodified monomers. The analyses were carried out using fixed-effect models.

RESULTS

The meta-analysis results showed high heterogeneity in all aspects, and higher flexural strength for monomers modified with 20% methacrylic acid.

CONCLUSION

Although the articles included in this meta-analysis showed high heterogeneity and high risk of bias, the in-vitro literature seems to suggest that use of modified monomers could improve the properties of denture base resins. Other variants of monomer modifications and their tested parameters were discussed in this systematic review as well. Dimensional accuracy is an unexplored variable to be evaluated extensively in the future researches.

A comparison of the characteristics of polyurethane-based sealers including various antimicrobial agents

An obturation biomaterial that possess inherent antibacterial activity has been developed to create a tight seal for the root canal space in treatment. Novel castor oil-based polyurethane sealers composited with different proportions of silver phosphate or zinc oxide nanoparticles were synthesized to investigate the physicochemical properties, antibacterial effect on Enterococcus faecalis, and cytotoxicity on murine fibroblasts compared with commercially available products. The results showed that the physical properties of all of the polyurethane sealers could meet with the standards expected. The microdilatancy character of the polyurethane sealers was particularly preferable for the three dimensional obturation of root canal space. Compared with the silver-loaded polyurethane series, the zinc-loaded polyurethane series showed better antibacterial properties based on the contact mode. Analysis of the kinetics indicated that the setting process of the polyurethane sealers supported a first-order reaction and the setting process was highly effective, with more than 90% of the isocyanate groups participating in the setting reaction within 12 h. This is beneficial for the rapid consumption of monomers, efficiently avoiding inflammation. The in vitro results showed that the polyurethane sealers loaded with zinc oxide nanoparticles or 1 wt% silver phosphate were desirable for cell attachment and proliferation compared with the commercial sealers. In conclusion, the castor oil-based polyurethane-zinc sealers, especially PU-Zn5, present good physicochemical and antibacterial properties and cytocompatibility, and could be a promising candidate for application in the field of root canal treatment.

A comparative evaluation of antimicrobial efficacy and flow characteristics of two epoxy resin-based sealers-AH plus and Perma Evolution: An in vitro study

Aim of the Study

Bacteria that persist at the time of obturation increase the possibility of persistent apical periodontitis. An ideal sealer should be able to kill these remaining bacteria that are present on the dentinal walls as well as inside the dentinal tubules. This could be possible if a sealer has antimicrobial properties with optimum flow characteristics. Hence, the aim of this in vitro study was to assess the antimicrobial efficacy of epoxy resin-based sealer: AH Plus and Perma Evolution against Enterococcus faecalis on the 1^st, 3^rd, 5^th, and 7^th day and also to compare the flow characteristics of both epoxy resin-based sealers.

Materials and Methods

E. faecalis ATCC 35550 strain was used to assess the antibacterial efficacy of sealers by agar-diffusion test (ADT) and direct-contact test (DCT). Flow characteristics of sealers were measured according to the ADA specification no. 57.

Results

In ADT, Perma Evolution sealer showed larger zone of inhibition than AH plus on the 1^st, 3^rd, 5^th, and 7^th day, and in DCT, both sealers were equally effective in inhibiting E. faecalis growth on the 1^st, 3^rd, 5^th, and 7^th day. Flow test showed no significant difference between Perma Evolution and AH Plus sealer.

Conclusion

Both the tested sealers were equally effective against E. faecalis up to 7 days of incubation period. Considering flow properties, both the tested sealers showed optimum flow as per the ADA specification no. 57.

Incorporating Antimicrobial Nanomaterial and its Effect on the Antimicrobial Activity, Flow and Radiopacity of Endodontic Sealers

Objective:

This preliminary study aimed to evaluate the antimicrobial activity, flow and radiopacity of endodontic sealers with nanostructured silver vanadate decorated with silver nanoparticles (AgVO3).

Methods:

The minimum inhibitory concentration (MIC) of AgVO3 was evaluated against Enterococcus faecalis, Pseudomonas aeruginosa and Escherichia coli. Specimens were prepared from the following endodontic sealers: AH Plus (DENTSPLY DeTrey GmbH, Konstanz, Germany), Sealapex (Sybron Endo, Orange, CA, USA), Sealer 26 (DENTSPLY, Petrópolis, Brazil) and Endofill (DENTSPLY, Petrópolis, Brazil), with concentrations of 0%, 2.5%, 5% and 10% of AgVO3. Agar diffusion was used to evaluate the materials after 48 hours and 7 days (n=6). Flow (n=6) and radiopacity (n=9) were evaluated. The data were analysed by analysis of variance (ANOVA) and the Tukey honestly significant difference (HSD) (α=0.05).

Results:

The MIC of AgVO3 was 500 μg/mL for E. faecalis and 31.25 μg/mL for P. aeruginosa and E. coli. The AgVO3 did not influence the antimicrobial activity of AH Plus against E. faecalis (P>0.05) but did promote this activity for Sealapex (P<0.01). Moreover, this activity increased for Endofill from 2.5% and for Sealer 26 from 5% (P<0.05). Against P. aeruginosa, only AH Plus and Endofill 10% inhibited zone formation (P<0.01). The antimicrobial activity of Endofill increased from 2.5% against E. coli (P<0.01). Sealapex 5% and 10% (P<0.01), Sealer 26 10% and AH Plus promoted antimicrobial activity against E. coli. An increase in the zone of inhibition occurred between 48 hours and 7 days in the Sealapex 10% and Endofill 5% groups against E. coli. The flow of AH Plus and Endofill decreased with the increase of AgVO3 (P<0.05), and the flow of Sealer 26 and Sealapex was not affected (P>0.05). The radiopacity of AH Plus increased with AgVO3 (P<0.05). Endofill 5% and 10% did not differ from the control Endofill (P>0.05). The incorporation of AgVO3 did not influence the radiopacity of Sealer 26 (P>0.05). The incorporation of 2.5% and 5% AgVO3 reduced the radiopacity of Sealapex (P<0.05).

Conclusion:

Adding AgVO3 may increase the antimicrobial effect of endodontic sealers without major changes in their physicochemical properties.

Component Release and Mechanical Properties of Endodontic Sealers following Incorporation of Antimicrobial Agents

Root canal sealers with antimicrobial activity are highly beneficial; therefore, their antimicrobial properties could be improved by incorporation of antimicrobial agents. In the present study, the release of the quaternary ammonium compounds from endodontic sealers admixed with either benzalkonium chloride (BC) or cetylpyridinium chloride (CPC) at loadings of 2% wt was monitored. The effect of these additives on the compressive strengths and their release from the sealers was determined after 1 and 4 weeks. All of the materials studied were found to be capable of releasing antimicrobial additive in useful quantities. The release of CPC occurred to a statistically significant greater extent than BC for all materials. The addition of both BC and CPC generally decreased the compressive strength of all the endodontic sealers, with the exception of CPC in AH Plus, where the compressive strength was significantly increased. This suggests that, for these endodontic sealers, the antimicrobial additives alter the setting chemistry. AH Plus is an epoxy-based material cured with an amine, and in this case the increase in compressive strength with CPC is attributed to an enhanced cure reaction with this system. In all other cases, the additive inhibited the cure reaction to a greater or lesser extent.

Combating Antimicrobial Resistance in Foodborne Microorganisms

This review addresses an important public health hazard affecting food safety. Antimicrobial agents are used in foods to reduce or eliminate microorganisms that cause disease. Many traditional organic compounds, novel synthetic organic agents, natural products, peptides, and proteins have been extensively studied for their effectiveness as antimicrobial agents against foodborne Campylobacter spp., Escherichia coli, Listeria spp. and Salmonella. However, antimicrobial resistance can develop in microorganisms, enhancing their ability to withstand the inhibiting or killing action of antimicrobial agents. Knowledge gaps still exist with regard to the actual chemical and microbiological mechanisms that must be identified to facilitate the search for new antimicrobial agents. Technical implementation of antimicrobial active packing films and coatings against target microorganisms must also be improved for extended product shelf life. Recent advances in antimicrobial susceptibility testing can provide researchers with new momentum to pursue their quest for a resistance panacea.

Development of a novel resin with antimicrobial properties for dental application

The adhesion of biofilm on dental prostheses is a prerequisite for the occurrence of oral diseases.

OBJECTIVE

To assess the antimicrobial activity and the mechanical properties of an acrylic resin embedded with nanostructured silver vanadate (β-AgVO3).

MATERIAL AND METHODS

The minimum inhibitory concentration (MIC) of β-AgVO3 was studied in relation to the species Staphylococcus aureus ATCC 25923, Streptococcus mutans ATCC 25175, Pseudomonas aeruginosa ATCC 27853, and Candida albicans ATCC 10231. The halo zone of inhibition method was performed in triplicate to determine the inhibitory effect of the modified self-curing acrylic resin Dencor Lay-Clássico. The surface hardness and compressive strength were examined. The specimens were prepared according to the percentage of β-AgVO3 (0%-control, 0.5%, 1%, 2.5%, 5%, and 10%), with a sample size of 9x2 mm for surface hardness and antimicrobial activity tests, and 8x4 mm for the compression test. The values of the microbiologic analysis were compared and evaluated using the Kruskal-Wallis test (α=0.05); the mechanical analysis used the Shapiro-Wilk's tests, Levene's test, ANOVA (one-way), and Tukey's test (α=0.05).

RESULTS

The addition of 10% β-AgVO3 promoted antimicrobial activity against all strains. The antimicrobial effect was observed at a minimum concentration of 1% for P. aeruginosa, 2.5% for S. aureus, 5% for C. albicans, and 10% for S. mutans. Surface hardness and compressive strength increased significantly with the addition of 0.5% β-AgVO3 (p<0.05). Higher rates of the nanomaterial did not alter the mechanical properties of the resin in comparison with the control group (p>0.05).

CONCLUSIONS

The incorporation of β-AgVO3 has the potential to promote antimicrobial activity in the acrylic resin. At reduced rates, it improves the mechanical properties, and, at higher rates, it does not promote changes in the control.

Physicochemical and biological properties of a novel injectable polyurethane system for root canal filling

A root canal sealer with antibacterial activity can be efficacious in preventing reinfection that results from residual microorganisms and/or the leakage of microorganisms. In the present study, a series of injectable, self-curing polyurethane (PU)-based antibacterial sealers with different concentrations of silver phosphate (Ag₃PO₄) were fabricated. Subsequently, their physicochemical properties, antibacterial abilities, and preliminary cytocompatibilities were evaluated. The results indicated that the fabricated PU-based sealers can achieve a high conversion rate in a short amount of time. More than 95% of the isocyanate group of PU sealers with 3 wt% (PU3) and 5 wt% (PU5) concentrations of Ag₃PO₄ were included in the curing reaction after 7 hours. With the exception of those for film thickness for PU5, the results of setting time, film thickness, and solubility were able to meet the requirements of the International Organization for Standardization. The antibacterial tests showed that PU3 and PU5 exhibit stronger antimicrobial effects than that achieved with 1 wt% Ag₃PO₄ (PU1) and AH Plus (positive control) against Streptococcus mutans. The cytocompatibility evaluation revealed that the PU1 and PU3 sealers possess good cytocompatibility and low cytotoxicity. These results demonstrate that the PU3 sealer offers good physicochemical and antimicrobial properties along with cytocompatibility, which may hold great application potential in the field of root canal fillings.

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.

Synthesis of antibacterial and radio-opaque dimethacrylate monomers and their potential application in dental resin

OBJECTIVE

In this study, three dimethacrylate quaternary ammonium compounds N,N-bis[2-(3-(methacryloyloxy)propanamido)ethyl]-N-methyldodecyl ammonium iodide (QADMAI-12), N,N-bis[2-(3-(methacryloyloxy)propanamido)ethyl]-N-methylhexadecyl-ammonium iodide (QADMAI-16), and N,N-bis[2-(3-(methacryloyloxy)propanamido)ethyl]-N-methyloctadectyl ammonium iodide (QADMAI-18) were synthesized and proposed to be used as antibacterial and radio-opaque agents in dental resin.

METHODS

All QADMAIs were synthesized through a 2-steps reaction route, and their structures were confirmed by FT-IR and 1H NMR spectra. Antibacterial activities against Streptococcus mutans (S. mutans) of QADMAIs were measured by agar diffusion test. Each QADMAI was mixed with TEGDMA (50/50, w/w) and photoinitiation system (0.7 wt% of CQ and 0.7 wt% of DMAEMA) to form resin system. Degree of monomer conversion (DC) was determined by FT-IR analysis. The flexural strength (FS) and modulus (FM) of the polymer were measured using a three-point bending set up. Radiograph was taken to determine the radio-opacity of the polymer, and aluminum step-wedge (0.5-4 mm) was used as calibration standard. Surface charge density was measured using fluorescein binding. A single-species biofilm model with S. mutans as the tests organism was used to evaluate the antibacterial property of the polymer. Bis-GMA/TEGDMA resin system was used as control material in all of the tests.

RESULTS

FT-IR and 1H NMR spectra showed that the structures of QADMAIs were the same as designed. ANOVA analysis revealed that antibacterial activity of QADMAI decreased with the increasing of alkyl chain length (p<0.05). QADMAI containing polymers had higher DC (p<0.05) but lower FS and FM (p<0.05) than control polymer. Alkyl chain length had no influence on DC (p>0.05), but FS and FM of QADMAI-12 containing polymer were better than those of QADMAI-16 and QADMAI-18 containing polymers (p<0.05). QADMAI containing polymers had much better radio-opacity than control polymer (p<0.05), and the radio-opacity of polymer decreased with the increasing of alkyl chain length (p<0.05). All of QADMAIs containing polymers had higher surface charge density than control polymer (p<0.05), and surface charge densities of QADMAI-12 and QADMAI-16 containing polymers were nearly the same (p>0.05) which were higher than that of QADMAI-18 containing polymer (p<0.05). All of QADMAI containing polymers had good inhibitory effect on biofilm formation.

SIGNIFICANCE

QADMAIs had no miscibility problem with TEGDMA, and QADMAIs could endow dental resin with both antibacterial activity and radio-opacity. Formulation of QADMAI containing resin should be optimized in terms of mechanical stregth to satisfy the requirements of dental resin for clinical application.