Novel self-healing dental resin with microcapsules of polymerizable triethylene glycol dimethacrylate and N,N-dihydroxyethyl-p-toluidine

A Review on the Current State of Microcapsule-Based Self-Healing Dental Composites

Resin-based dental composites, commonly used in dentistry, offer several advantages including minimally invasive application, esthetically pleasing appearance, and good physical and mechanical properties. However, these dental composites can be susceptible to microcracks due to various factors in the complex oral environment. These microcracks can potentially lead to clinical restoration failure. Conventional materials and methods are inadequate for detecting and repairing these microcracks in situ. Consequently, incorporating self-healing properties into dental composites has become a necessity. Recent years have witnessed rapid advancements in self-healing polymer materials, drawing inspiration from biological bionics. Microcapsule-based self-healing dental composites (SHDCs) represent some of the most prevalent types of self-healing materials utilized in this domain. In this article, we undertake a comprehensive review of the most recent literature, highlighting key insights and findings related to microcapsule-based SHDCs. Our discussion centers particularly on the preparation techniques, application methods, and the promising future of self-healing microcapsules in the field of dentistry.

Tailoring Microemulsification Techniques for the Encapsulation of Diverse Cargo: A Systematic Analysis of Poly (Urea-Formaldehyde) Microcapsules

Cargo encapsulation through emulsion-based methods has been pondered over the years. Although several microemulsification techniques have been employed for the microcapsule's synthesis, there are still no clear guidelines regarding the suitability of one technique over the others or the impacts on the morphological and physicochemical stability of the final particles. Therefore, in this systematic study, we investigated the influence of synthesis parameters on the fabrication of emulsion-based microcapsules concerning morphological and physicochemical properties. Using poly(urea-formaldehyde) (PUF) microcapsules as a model system, and after determining the optimal core/shell ratio, we tested three different microemulsification techniques (magnetic stirring, ultrasonication, and mechanical stirring) and two different cargo types (100% TEGDMA (Triethylene glycol dimethacrylate) and 80% TEGDMA + 20% DMAM (N,N-Dimethylacrylamide)). The resulting microcapsules were characterized via optical and scanning electron microscopies, followed by size distribution analysis. The encapsulation efficiency was obtained through the extraction method, and the percentage reaction yield was calculated. Physicochemical properties were assessed by incubating the microcapsules under different osmotic pressures for 1 day and 1, 2, or 4 weeks. The data were analyzed statistically with one-way ANOVA and Tukey's tests (α = 0.05). Overall, the mechanical stirring resulted in the most homogeneous and stable microcapsules, with an increased reaction yield from 100% to 50% in comparison with ultrasonication and magnetic methods, respectively. The average microcapsule diameter ranged from 5 to 450 µm, with the smallest ones in the ultrasonication and the largest ones in the magnetic stirring groups. The water affinities of the encapsulated cargo influenced the microcapsule formation and stability, with the incorporation of DMAM leading to more homogeneous and stable microcapsules. Environmental osmotic pressure led to cargo loss or the selective swelling of the shells. In summary, this systematic investigation provides insights and highlights commonly overlooked factors that can influence microcapsule fabrication and guide the choice based on a diligent analysis of therapeutic niche requirements.

Effects of chitosan and TiO2 nanoparticles on the antibacterial property and ability to self-healing of cracks and retrieve mechanical characteristics of dental composites

The aim of this study was to improve the self-healing properties of dental nanocomposite using nanoparticles of TiO2 and chitosan. We evaluated flexural and compressive strength, crack-healing, and self-healing lifespan after 3 months of water aging. The effect of the developed composite on cell viability and toxicity was assessed by an MTT assay on human alveolar basal epithelial cells (A549 cell line). The nanocomposite included 7.5 wt% polyurea-formaldehyde (PUF) and 0, 0.5, and 1 wt% n-TiO2 and chitosan. After the fracture, the samples were put in a mold for 1-90 days to enable healing. Then, the fracture toughness of the healed nanocomposites and the healing yield were measured. The flexural strength of the nanocomposite improved by adding 0.5 wt% n-TiO2, while the compressive strength increased after adding 0.5 wt% chitosan (p > 0.1). When these two materials were used simultaneously, the flexural strength was improved by around 2%; however, the compressive strength was unaffected. Compared to the other sample, the nanocomposite with 0.5 wt% n-TiO2 and chitosan had higher KIC-healing and self-healing efficiency. Self-healing efficacy had no significant effect of water aging over 90 days compared to one day (p > 0.1), demonstrating that the PUF nanocapsules were not damaged.

Effect of silanization of poly (urea-formaldehyde) microcapsules on the flexural strength and self-healing efficiency of an experimental self-healing dental resin composite (An in-vitro study)

OBJECTIVES

This study investigated the impact of using γ-methacryloxypropyl trimethoxy silane (MPS) for surface silanization of poly (urea-formaldehyde) (PUF) microcapsules which enclose a healing liquid of "triethylene glycol dimethacrylate (TEGDMA) and N,N dihydroxyethyl-p-toluidine (DHEPT)" on some mechanical properties of an experimental dental composite as well as its self-healing efficiency.

METHODS

Synthesis of PUF microcapsules was done via in situ polymerization, followed by silanization with MPS silane. Silanized and non-silanized microcapsules were incorporated into a composite containing 30% polymer matrix and 70% fillers at different weight percentages (0%, 5%, 7.5% and 10%). The composite strength and elastic modulus were evaluated by Flexural testing. Fracture toughness KIc and self-healing efficiency were assessed by utilizing the "single edge notched beam" method.

RESULTS

Flexural strength of all groups containing silanized microcapsules was non-significantly different from control group without microcapsules. However, in contrast to control group, all groups containing non-silanized microcapsules displayed considerably decreased flexural strength. Adding silanized and non-silanized microcapsules didn't show a significant change in the KIc-virgin. The silanized microcapsules' groups achieved a self-healing efficiency of about 49-77% recovery in KIc-virgin compared to 38-69% for their non-silanized counterparts.

SIGNIFICANCE

In order to increase the interfacial adhesion with the polymer matrix, improve the mechanical properties, and increase the efficiency of self-healing of dental resin composite, PUF microcapsules were silanized for the first time in the dental field using MPS silane. This innovative silanized microcapsule-containing self-healing composite may hold promise for repairing the damage caused by restorative cracks and extending their service life.

Synthesis and characterisation of microcapsules for self-healing dental resin composites

AIM

The purpose of this study was to i) synthesise TEGDMA-DHEPT microcapsules in a laboratory setting; ii) characterise the resultant microcapsules for quality measures.

MATERIALS & METHODS

Microcapsules were prepared by in situ polymerization of PUF shells. Microcapsules characterisation include size analysis, optical and SEM microscopy to measure the diameter and analyse the morphology of PUF microcapsules. FT-IR spectrometer evaluated microcapsules and benzyl peroxide catalyst polymerization independently.

RESULT

Average diameter of TEGDMA-DHEPT microcapsules was 120 ± 45 μm (n: 100). SEM imaging of the capsular shell revealed a smooth outer surface with deposits of PUF nanoparticles that facilitate resin matrix retention to the microcapsules upon composite fracture. FT-IR spectra showed that microcapsules crushed with BPO catalyst had degree of conversion reached to 60.3%.

CONCLUSION

TEGDMA-DHEPT microcapsules were synthesised according to the selected parameters. The synthesised microcapsules have a self-healing potential when embedded into dental resin composite as will be demonstrated in our future work.

Novel low-shrinkage dental resin containing microcapsules with antibacterial and self-healing properties

Dental resin restorations commonly fail because of fractures and secondary caries. The aim of this research was to synthesize a novel low-shrinkage dental resin with antibacterial and self-healing properties. The low-shrinkage dental resin was obtained by incorporating a 20 wt% anti-shrinkage mixture of an expanding monomer 3,9-diethyl-3,9-dimethylol -1,5,7,11-tetraoxaspiro[5,5] undecane and an epoxy resin monomer diallyl bisphenol A diglycidyl ether (1:1, referred as "UE") and different mass fractions of self-healing antibacterial microcapsules (0%, 2.5%, 5%, 7.5%, and 10%) were incorporated into the matrix to prepare multifunctional dental resin. Polymerization shrinkage, mechanical properties, antibacterial activity, self-healing ability, and cytotoxicity of this dental resin were evaluated. The polymerization volumetric shrinkage of resin containing 20 wt% UE and 7.5 wt% microcapsules was reduced by 30.12% (4.13% ± 0.42%) compared with control. Furthermore, it exhibited high antibacterial activity and a good self-healing efficiency of 71% without adversely affecting the mechanical property and cell viability. This novel multifunctional dental resin with low polymerization shrinkage and excellent antibacterial activity and self-healing capability has potential application as a dental resin material to decrease the incidence of fractures and secondary caries.

Novel antimicrobial and self-healing dental resin to combat secondary caries and restoration fracture

OBJECTIVE

Dental resin composites have been the most popular materials for repairing tooth decay in recent years. However, secondary caries and bulk fracture are the major hurdles that affect the lifetime of dental resin composites. This current study synthesized a novel antimicrobial and self-healing dental resin containing nanoparticle-modified self-healing microcapsules to combat secondary caries and restoration fracture.

METHODS

Multifunctional dental resins containing 0-20% nanoparticle-modified self-healing microcapsules were prepared. The water contact angle, antimicrobial properties, mechanical properties, cell toxicity, and self-healing capability of the dental resins were tested.

RESULTS

A novel multifunctional dental resin was synthesized. When the microcapsule mass fraction was 10%, the resin presented a strong bacteriostasis rate (80.3%) and excellent self-healing efficiency (66.1%), while the hydrophilicity, mechanical properties, and cell toxicity were not affected.

SIGNIFICANCE

The novel antimicrobial self-healing dental resin is a promising candidate for use in clinical practice, which provides a simple and highly efficient strategy to combat secondary caries and restoration fracture. This novel dental resin also gives the inspiration to prolong the service life of dental restorations.

Fatigue behaviour of a self-healing dental composite

OBJECTIVE

Novel self-healing resin-based composites containing microcapsules have been developed to improve the mechanical performance of dental restorations. However, the long-term fatigue behaviour of these self-healing composites has still been hardly investigated. Therefore, this manuscript studied the fatigue behaviour of self-healing composites containing microcapsules by subjecting the specimens to traditional staircase tests and ageing in a custom-designed chewing simulator (Rub&Roll) to simulate oral ageing physiologically relevant conditions.

METHODS

To prepare self-healing composite, poly(urea-formaldehyde) microcapsules containing acrylic self-healing liquids were synthesized. Subsequently, these microcapsules (10 wt%) and initiator (benzoyl peroxide, BPO, 2 wt%) were incorporated into a commercial flowable resin-based composite. Microcapsule-free resin-based composites with and without BPO were also prepared as control specimens. A three-point flexural test was used to measure the initial flexural strength (Sinitial). Subsequently, half of the specimens were used for fatigue testing using a common staircase approach to measure the fatigue strengths (FS). In addition, the other specimens were aged in the Rub&Roll machine for four weeks where after the final flexural strength (Sfinal) was measured.

RESULTS

Compared to Sinitial, FS of all tested specimens significantly decreased as measured through staircase testing. After 4 weeks of ageing in the Rub&Roll machine, Sfinal was significantly reduced compared to Sinitial for microcapsule-free resin-based composites, but not for the self-healing composites (p = 0.3658). However, the self-healing composites are still in the experimental phase characterized by a low mechanical strength, which still impedes further clinical translation.

SIGNIFICANCE

Self-healing composites containing microcapsules exhibit improved fatigue resistance compared to microcapsule-free non-self-healing composites.

Development of functional fillers as a self-healing system for dental resin composite

OBJECTIVES

To evaluate the incorporation of repairing capsules containing different monomers and polymerization modulators on the self-healing efficiency of an experimental photopolymerizable resin-based composite.

METHODS

Self-healing capsules containing different monomers and polymerization modulators were prepared by emulsion polymerization: TC_DHEPT (TEGDMA and DHEPT), BTC_DHEPT (Bis-GMA, TEGDMA, and DHEPT), and BTC_BPO (Bis-GMA, TEGDMA, and BPO). The capsules were analyzed through Fourier transform infrared spectroscopy and scanning electron microscopy. The capsules were added into experimental photopolymerizable resin composites establishing the following groups: ER (Control without capsules), ER+BPO, ER+BPO+TC_DHEPT, and ER+BTC_BPO+BTC_DHEPT. Filtek Z350 resin composite (3 M ESPE) was used as a commercial reference. The materials were tested for degree of conversion (DC), flexural strength (σf), elastic modulus (Ef), fracture toughness (virgin K_IC), self-healing efficiency (healed K_IC), and roughness. For statistical analysis, the significance value was established at an a = 0.05 level.

RESULTS

When compared to the control material, the incorporation of repairing capsules did not affect DC, σf, and Ef. Fracture toughness was statistically similar between the experimental groups (p ≤ 0.05). Healed K_IC was statistically different between the groups ER+TC_DHEP and ER+BTC_BPO+BTC_DHEPT; the self-healing efficiency was higher for ER+TC_DHEPT. Surface roughness was statistically similar among all groups.

CONCLUSIONS

The use of self-healing capsules promoted repair of the material. Studies with material aging after the self-healing process are necessary to better demonstrate the effectiveness of this system.

CLINICAL SIGNIFICANCE

The self-healing system seemed to be a promising technology to be used in self-repaired restorative materials, which may prevent restoration fractures.

Update on Dental Luting Materials

A dental luting material aids in the retention and stability of indirect restorations on the prepared tooth structure. In dentistry, clinicians are using a wide range of luting materials for the cementation of indirect restorations. Zinc oxide eugenol and non-eugenol cements, zinc phosphate cement, zinc polycarboxylate cement, glass ionomer cement and resin cements are common dental cements used in dentistry. Each luting material or cement possesses unique properties and clinical implications. An ideal luting cement should be biocompatible, insoluble, resistant to thermal and chemical assaults, antibacterial, aesthetic, simple and easy to use. It should have high strength properties under tension, shear and compression to resist stress at the restoration-tooth interface, as well as adequate working and setting times. So far, no luting material possesses all of these properties of an ideal cement. Scientists have been modifying the conventional luting cements to improve the material's clinical performance and developing novel materials for clinical use. To achieve the best clinical outcome, clinicians should update their knowledge and gain a good understanding of the luting materials so that they can make a wise clinical decision on the material selection and obtain an insight into the development of luting cements. Therefore, the objective of this study is to provide a discussion on the physical, chemical, adhesive and aesthetic properties of common luting materials. The clinical indications of these luting materials are suggested based on their properties. In addition, overviews of the modification of the conventional luting materials and the newly developed luting materials are provided.

"Fatigue-Crack Propagation Behavior in Microcapsule-Containing Self-Healing Polymeric Networks"

Over the last years, research on the design of dental self-healing polymers has grown dramatically. It is related to the promising potential of maximizing the clinical lifespan of dental restorations that this strategy holds. In this manuscript, the microcapsule-based strategy is innovated by incorporating the high toughness component N,N-Dimethylacrylamide (DMAM) into the healing agent systems and analyzing in-depth the change in crack propagation behavior induced by the addition of microcapsules into the highly crosslinked polymeric network. In general, the addition of the hydrophilic and high vapor pressure DMAM into the healing agent systems imposed a challenge for the microencapsulation, which highlighted the importance of tailoring the properties of the capsules' shells according to the core composition. The addition of DMAM as cushioning agent proved to be a successful strategy since it resulted in increased G'/G" crossover time from 0.06 (control) to 0.57 s and decreased storage modulus from 8.0 (control) to 0.5GPa. In addition, the incorporation of microcapsules within the polymerized networks provided obstacles to crack propagation, which translated to an overall reinforcement of the polymeric network, as evidenced by the increase in toughness up to 50 % and energy required to propagate cracks up to 100 % in systems containing DMAM at 20 wt%.

Resin-Based Composites for Direct and Indirect Restorations: Clinical Applications, Recent Advances, and Future Trends

Continuous advancements in resin-based composites can make selection of the appropriate system a daunting task for the clinician. This review aims to simplify this process and clarify some new or controversial topics. Various types of composites for direct and indirect applications are discussed, including microfilled and microhybrid composites, nanocomposites, single shade, bulk fill, fiber-reinforced, high temperature/high pressure processed, CAD/CAM, and three-dimensional printable composites. Recent material advancements that lead to improved seal and toughness, degradation resistance, antimicrobial and self-healing capabilities are presented. Future directions are highlighted, such as the development of "smart" materials that are able to interact with the host environment.

Biocompatible Nanocapsules for Self-Healing Dental Resins and Bone Cements

Bone cements and dental resins are methacrylate-based materials that have been in use for many years, but their failure rates are quite high with essentially all dental resins failing within 10 years and 25% of all prosthetic implants will undergo aseptic loosening. There are significant healthcare costs and impacts on quality of life of patients. Self-healing bone cements and resins could improve the lifespan of these systems, reduce costs, and improve patient outcomes, but they have been limited by efficacy and toxicity of the components. To address these issues, we developed a self-healing system based on a dual nanocapsule system. Two nanocapsules were synthesized, one containing an initiator and one encapsulating a monomer, both in polyurethane shells. The monomer used was triethylene glycol dimethacrylate. The initiator capsules synthesized contained benzoyl peroxide and butylated hydroxytoluene. Resins containing the nanocapsules were tested in tension until failure, and the fractured surfaces were placed together. 33% of the samples showed self-healing behaviors to the point where they could be reloaded and tested in tension. Furthermore, the capsules and their components showed good biocompatibility with Caco-2 cells, a human epithelial cell line suggesting that they would be well tolerated in vivo.

Novel nanoparticle-modified multifunctional microcapsules with self-healing and antibacterial activities for dental applications

OBJECTIVE

Although microcapsules (MCs) have been used for dental resins to achieve self-healing capabilities, the fragile organic shell and single healing event functions during the service period limit their use. Herein, a novel nanoparticle-modified MC with a nano-antibacterial inorganic filler (NIF) containing a quaternary ammonium salt was synthesized to address these issues.

METHODS

MCs with 0 %-30 % NIFs were prepared via an in situ polymerization method and characterized their morphology, chemical composition, thermal stability, roughness, mechanical properties, and antibacterial effect. Subsequently, M-10 MCs were mixed into the resin matrix at a mass fraction of 7.5 %. The self-healing capability and cytotoxicity were evaluated.

RESULTS

The introduction of nanomaterials enhances the shell of the MCs and endows them with an antibacterial effect. With the addition of NIFs, the roughness, modulus, and hardness values of MCs all increased (p < 0.05). The presence of M-10 MCs reduced the CFU by 2-3 orders of magnitude compared to the control group. The dental resin containing 7.5 % M-10 MCs obtained almost 69 % self-healing efficiency, without significantly compromising cell viability (p < 0.05).

SIGNIFICANCE

Self-healing MCs with NIFs were prepared for the first time with strong antibacterial properties, a substantial self-healing capability, and low toxicity. This multifunctional MC is a promising candidate for use in dental resins to extend the service life and resolve the problem of bulk fracture and secondary caries.

Properties of A Model Self-Healing Microcapsule-Based Dental Composite Reinforced with Silica Nanoparticles

Aim: The purpose of this study was to evaluate the mechanical properties of an experimental self-healing dental composite model (SHDC) composed of SiO₂ nanoparticles with varying percentages of triethylene glycol dimethacrylate (TEGDMA) monomer and N,N-dihydroxyethyl-p-toluidine (DHEPT) amine microcapsules. Materials and methods: Microcapsules were prepared by in-situ polymerisation of PUF shells, as explained in our previous work. The model SHDC included bisphenol A glycidyl dimethacrylate (Bis-GMA:TEGDMA) (1:1), 1 wt% phenyl bis(2,4,6-trimethylbenzoyl) phosphine oxide (BAPO), 0.5 wt% benzoyl peroxide (BPO) catalyst, 20 wt% silanised silica dioxide (SiO₂) (15 nm) and (0, 2.5, 5, 7.5, 10 wt%) of microcapsules (120 ± 45 μm). Light transmission, hardness, degree of conversion (DC), flexural strength and elastic modulus of the SHDC model were measured. Results: The degree of conversion of the SHDC ranged from 73 to 76% 24 h after polymerisation. Hardness measurements ranged from 22 to 26 VHN (p > 0.05); however, the flexural strength was adversely affected from 80 to 55 MPa with increasing microcapsules of up to 10 wt% in the composites (p < 0.05). Conclusion: Only flexural strength decreased drastically ~30% with increasing microcapsules (>10 wt%) in the composites. All other measured properties were not significantly affected. Accordingly, we recommend a stronger composite material that could be created by increasing the filler content distribution in order to achieve a hybrid self-healing composite with enhanced mechanical properties.

Strategies to design extrinsic stimuli-responsive dental polymers capable of autorepairing

Objectives

For many years, the requirements for dental polymers were limited to inertially filling the cavity and restoring form, function, and esthetics. Inorganic filler systems were widely enhanced to maximize the mechanical properties and optimize finishing and polishing procedures. The development of alternative photoinitiator systems also improved the carbon-carbon double bond conversion, increasing biocompatibility, wear, and stain resistance. However, despite laudable progress, the clinical life span of dental restorations is still limited, and their replacement is the most common procedure in dental offices worldwide. In the last few years, the development of materials with the potential to adapt to physiological stimuli has emerged as a key step to elevating dental polymers to a higher excellence level. In this context, using polymeric networks with self-healing properties that allow for the control of the propagation of microcracks is an appealing strategy to boost the lifetime of dental restorations. This review aims to report the current state-of-the-art of extrinsic self-healing dental polymers and provide insights to open new avenues for further developments. General classification of the self-healing polymeric systems focusing on the current extrinsic strategies used to inhibit microcracks propagation in dental polymers and recover their structural integrity and toughness are presented.

Search Strategy

An electronic search was perfomed using PubMed, Google Scholar, and Scopus databases. Only studies published in English on extrinsic self-healing polymeric systems were included.

Overall Conclusions

Self-healing materials are still in their infancy in dentistry, and the future possibilities are almost limitless. Although the mouth is a unique environment and the restorative materials have to survive chemical, physical, and mechanical challenges, which limits the use of some strategies that might compromise their physicochemical performance, there are countless untapped opportunities to overcome the challenges of the current systems and advance the field.

The Development of Filler Morphology in Dental Resin Composites: A Review

Dental resin composites (DRCs) with diverse fillers added are widely-used restorative materials to repair tooth defects. The addition of fillers brings an improvement in the mechanical properties of DRCs. In the past decade, diverse fillers have emerged. However, the change of emerging fillers mainly focuses on the chemical composition, while the morphologic characteristics changes are often ignored. The fillers with new morphologies not only have the advantages of traditional fillers (particles, fibrous filler, etc.), but also endow some additional functional characteristics (stronger bonding ability to resin matrix, polymerization resistance, and wear resistance, drug release control ability, etc.). Moreover, some new morphologies are closely related to the improvement of traditional fillers, porous filler vs. glass particles, core-sheath fibrous vs. fibrous, etc. Some other new morphology fillers are combinations of traditional fillers, UHA vs. HA particles and fibrous, tetrapod-like whisker vs. whisker and fibrous filler, mesoporous silica vs. porous and silica particles. In this review, we give an overall description and a preliminary summary of the fillers, as well as our perspectives on the future direction of the development of novel fillers for next-generation DRCs.

Functional fillers for dental resin composites

Dental resin composites (DRCs) are popular materials to repair caries. Although various types of DRCs with different characteristics have been developed, restoration failures still exist. Bulk fracture and secondary caries have been considered as main causes for the failure of composites restoration. To address these problems, various fillers with specific functions have been introduced and studied. Some fillers with specific morphologies such as whisker, fiber, and nanotube, have been used to increase the mechanical properties of DRCs, and other fillers releasing ions such as Ag⁺, Ca²⁺, and F^-, have been used to inhibit the secondary caries. These functional fillers are helpful to improve the performances and lifespan of DRCs. In this article, we firstly introduce the composition and development of DRCs, then review and discuss the functional fillers classified according to their roles in the DRCs, finally give a summary on the current research and predict the trend of future development.

Influence of microcapsule parameters and initiator concentration on the self-healing capacity of resin-based dental composites

OBJECTIVE

Fracture is one of the main causes for failure of resin-based composite restorations. To overcome this drawback, self-healing resin-based composites have been designed by incorporation of microcapsules. However, the relationship between their self-healing capacity and microcapsule and resin parameters is still poorly understood. Therefore, the objective of this study was to systematically investigate the effect of initiator concentration (in the resin) and microcapsule size and concentration on the self-healing performance of commercially available flowable resin-based composites.

METHODS

Poly(urea-formaldehyde) (PUF) microcapsules containing acrylic healing liquid were synthesized in small (33±8μm), medium (68±21μm) and large sizes (198±43μm) and characterized. Subsequently, these microcapsules were incorporated into a conventional flowable resin-based composite (Majesty Flow ES2, Kuraray) at different contents (5-15wt%) and benzoyl peroxide (BPO) initiator concentrations (0.5-2.0wt%). Fracture toughness (K_IC) of test specimens was tested using a single edge V-notched beam method. Immediately after complete fracture (K_IC-initial), the two fractured parts were held together for 72h to allow for healing. Subsequently, fracture toughness of the healed resin-based composites (K_IC-healed) was tested as well.

RESULTS

The fracture toughness of healed dental composites significantly increased with increasing microcapsule size and concentration (2wt% BPO, p<0.05). The highest self-healing efficiencies (up to 76%) were obtained with microcapsules sized 198±43 um.

SIGNIFICANCE

commercially available resin-based composites can be rendered self-healing most efficiently by incorporation of large microcapsules (198±43μm). However, long-term tests on fatigue and wear behavior are needed to confirm the clinical efficacy.

Solar Freckles: Long-Term Photochromic Tattoos for Intradermal Ultraviolet Radiometry

While tattooable nanotechnology for in-skin sensing and communication has been a popular concept in science fiction since the 1990s, the first tattooable intradermal nanosensors have only emerged in the past few years, and none have been demonstrated in human skin. We developed a photochromic tattoo that serves as an intradermal ultraviolet (UV) radiometer that provides naked-eye feedback about UV exposure in real time. These small tattoos, or "solar freckles", comprise dermally implanted colorimetric UV sensors in the form of nanoencapsulated leuco dyes that become more blue in color with increasing UV irradiance. We demonstrate the tattoos' functionality for both quantitative and naked-eye UV sensing in porcine skin ex vivo, as well as in human skin in vivo. Solar freckles offer an alternative and complementary approach to self-monitoring UV exposure for the sake of skin cancer prevention. Activated solar freckles provide a visual reminder to protect the skin, and their color disappears rapidly upon removal of UV exposure or application of topical sunscreen. The sensors are implanted in a minimally invasive procedure that lasts only a few seconds, yet remain functional for months to years. These semipermanent tattoos provide an early proof-of-concept for long-term intradermal sensing nanomaterials that provide users with biomedically relevant information in the form of an observable color change.

[Development of novel self-adhesive resin cement with antibacterial and self-healing properties]

OBJECTIVE

This study aimed to develop novel self-adhesive resin cement with antibacterial and self-healing properties. Furthermore, the dentin bonding strength, mechanical properties, self-healing efficiency, and antibacterial property of the developed cement were measured.

METHODS

Novel nano-antibacterial inorganic fillers that contain quaternary ammonium salts with long-chain alkyls were synthesized. These fillers were added into self-adhesive resin cement containing self-healing microcapsules at mass fractions of 0, 2.5%, 5.0%, 7.5%, or 10.0%. The dentin shear bonding test was used to test the bonding strength, whereas the flexural test was used to measure the flexural strength and elastic modulus of the cement. The single-edge V-notched beam method was used to measure self-healing efficiency, and human dental plaque microcosm biofilms were chosen to calculate the antibacterial property.

RESULTS

The dentin shear bond strength significantly decreased when the mass fraction of the nano-antibacterial inorganic fillers in the novel cement reached 7.5% (P<0.05). The incorporation of 0, 2.5%, 5.0%, 7.5%, or 10.0% mass fraction of nano-antibacterial inorganic fillers did not adversely affect the flexural strength, elastic modulus, fracture toughness, and self-healing efficiency of the cement (P>0.1). Resin cement containing 2.5% mass fraction or more nano-antibacterial inorganic fillers significantly inhibited the metabolic activity of dental plaque microcosm biofilms, indicating strong antibacterial potency (P<0.05).

CONCLUSIONS

The novel self-adhesive resin cement exhibited promising antibacterial and self-healing properties, which enable the cement to be used for dental applications.

Self-healing biomaterials: The next generation is nano

The U.S. Agency for Healthcare Research and Quality estimates that there are over 1 million total hip and total knee replacements each year in the U.S. alone. Twenty five percent of those implants will experience aseptic loosening, and bone cement failure is an important part of this. Bone cements are based on poly(methyl methacrylate) (PMMA) systems that are strong but brittle polymers. PMMA-based materials are also essential to modern dental fillings, and likewise, the failure rates are high with lifetimes of 3-10 years. These brittle polymers are an obvious target for self-healing systems which could reduce revision surgeries and visits to dentist. Self-healing polymers have been described in the literature since 1996 and examples from Roman times are known, but their application in medicine has been challenging. This review looks at the development of self-healing biomaterials for these applications and the challenges that lie between development and the clinic. Many of the most promising formulations involve introducing nanoscale components which offer substantial potential benefits over their microscale counterparts especially in composite systems. There is substantial promise for translation, but issues with toxicity, robustness, and reproducibility of these materials in the complex environment of the body must be addressed. This article is categorized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Implantable Materials and Surgical Technologies > Nanomaterials and Implants.

[Application and potential future directions of self-healing polymers in dentistry]

Self-healing materials have rapidly developed in recent years to overcome the micro-cracks occurring in the polymer matrix. Self-healing ability offers autonomous crack repairs to prolong the service lives of polymers or polymer composites. As a main approach, extrinsic self-healing materials based on microcapsules have been applied in dentistry recently. This paper comprehensively presented and reviewed the definition and classification of self-healing materials, the synthesis of microcapsules, the calculation of self-healing efficiency, and the application of self-healing materials in dentistry. The future directions of self-healing polymers are also discussed.

Patient Perceptions of New Robotic Technologies in Clinical Restorative Dentistry

Patient perception research has failed to focus on burgeoning technology within the dental field. Specifically, researchers have yet to focus on developing robotic technologies which are being utilized by dentists to help perform certain procedures with added precision and route mapping. The current study attempts to fill the gap created by a lack of intersection between dental technology research, consumer perceptions research, and automation research. The current research takes a two-study approach, with study 1 investigating if gender or price of the procedure affects willingness to undergo a robotic dental procedure. Study 2 further investigates this phenomenon, identifying ten separate types of dental procedures (ranging from minimally invasive to extremely invasive) to further understand consumer perceptions. Results indicate that females are less willing to undergo a robotic dental procedure, and that participants in general are more willing to undergo a procedure if it is half price than if it full price. Willingness is influenced by gender and the type of procedure being performed - participants were less willing to undergo invasive procedures such as gum surgery than noninvasive procedures such as teeth whitening. These results, and their theoretical and practical significance are discussed.

Resin based restorative dental materials: characteristics and future perspectives

This review article compiles the characteristics of resin based dental composites and an effort is made to point out their future perspectives. Recent research studies along with few earlier articles were studied to compile the synthesis schemes of commonly used monomers, their characteristics in terms of their physical, mechanical and polymerization process with selectivity towards the input parameters of polymerization process. This review covers surface modification processes of various filler particles using silanes, wear behaviour, antimicrobial behaviour along with its testing procedures to develop the fundamental knowledge of various characteristics of resin based composites. In the end of this review, possible areas of further interests are pointed out on the basis of literature review on resin based dental materials.

Durability of self-healing dental composites: A comparison of performance under monotonic and cyclic loading

Durability is an important quality of dental restorative materials, and the ability to autonomously heal damage incurred during their oral function is highly desirable.

OBJECTIVE

The objective was to evaluate the improvement in durability of self-healing dental composites (SHDCs) in terms of their resistance to fracture and capacity for healing of damage under monotonic and cyclic loading.

METHODS

SHDCs were prepared by incorporating dental resin composites with microcapsules containing healing liquid. Control specimens with the same mass fraction (5% and 25%) of microcapsules filled with water were also evaluated. Two sets of SHDCs were distinguished by the silane coupling agents that functionalized and bonded the microcapsules to resin network. One set used a methacrylate silane (MA-silane) that connected resin network through covalent bonds, and the other used a H-bonding forming hydroxyl silane (OH-silane). The fatigue crack growth resistance was assessed in terms of the threshold stress intensity range and the conventional Paris Law parameters. Cyclic loading was conducted at 5 Hz with maximum cyclic load ranged between approximately 1 N and 5 N. The efficiency of the autonomous healing was determined per the recovering of the fracture toughness and the extension of fatigue life.

RESULTS

The SHDCs with 5 wt% of healing microcapsules exhibited a larger fracture toughness than those with 25 wt% microcapsules. MA-silane SHDCs had approximately five times more responsive microcapsules triggered by fracturing of the composites. Consequently, the MA-silane SHDCs with 5 wt% of microcapsules achieved the best performance in terms of fracture toughness and healing efficiency. In regards to the fatigue crack growth behavior, there was a significant increase in the resistance to fatigue crack growth and 580 ± 15% improvement in the fatigue life.

SIGNIFICANCE

Strong silanization is vital in SHDCs to simultaneously achieve clinically applicable mechanical performance and substantial healing capability. Moreover, the evaluation of self-healing under cyclic loading is a promising tool in quantifying the degree of fracture-induced healing.

[Effect of water immersion on a dental self-healing and antibacterial resin composite]

OBJECTIVE

This investigation aimed to develop a novel self-healing and antibacterial dental resin composite. The effects of water immersion on its properties were also evaluated.

METHODS

Microcapsules filled with healing agent of triethylene glycol dimethacrylate were synthesized on the basis of previous studies. Antibacterial resin composite contained nano-antibacterial inorganic fillers that were modified by quaternary ammonium salt with long-chain alkyl. Microcapsules were incorporated into antibacterial resin composite at mass fraction of 7.5%. A commercial resin composite named Tetric N-Ceram was used as control. The resin samples were immersed in 37 °C distilled water for different periods. A flexural test was used to measure the mechanical properties of the novel resin composite. A single-edge V-notched beam method was used to measure fracture toughness and self-healing efficiency. A dental plaque microcosm biofilm model with human saliva as inoculum was formed. Colony-forming units (CFU) and lactic acid production of biofilm on the novel resin composite were calculated to test the antibacterial property.

RESULTS

Mechanical properties and fracture toughness decreased significantly after the composite was immersed in water for 30 days (P<0.05), and no significant reduction was found from then on (P>0.05). Water immersion did not weaken the self-healing capability of the composite (P>0.05), and self-healing efficiency of 64% could still be obtained even after 270 days. The antibacterial resin composite showed a strong inhibition effect on the biofilm metabolic activity versus water immersion time from 1 day to 270 days. Therefore, the composite could still have a promising antibacterial property even after being immersed in water (P<0.05).

CONCLUSIONS

Water immersion could weaken the mechanical properties of the novel self-healing and antibacterial resin composite, but it insignificantly affected the self-healing and antibacterial properties of the composite.

Dental Composite Formulation Design with Bioactivity on Protein Adsorption Combined with Crack-Healing Capability

Short Title

Protein-repellent dental composite with crack-healing ability

Abstract

Fracture and secondary caries are the primary reasons for the failure of dental restorations. To face this omnipresent problem, we report the formulation design and synthesis of a protein-resistant dental composite composed of 2-methacryloyloxyethyl phosphorylcholine (MPC) that also can self-repair damage and recover the load-bearing capability via microencapsulated triethylene glycol dimethacrylate (TEGDMA) and N,N-dihydroxy ethyl-p-toluidine (DHEPT). The bioactivity of the resulting MPC-microencapsulated TEGDMA-DHEPT was evaluated on protein adsorption through early bacterial attachment. Its mechanical properties were also investigated, including self-healing assessment. Microcapsules of poly (urea-formaldehyde) (PUF) were synthesized by incorporating a TEGDMA-DHEPT healing liquid. A set of composites that contained 7.5% of MPC, 10% of microcapsules, and without MPC/microcapsules were also prepared as controls. The two distinct characteristics of strong protein repellency and load-bearing recovery were achieved by the combined strategies. The novel dual composite with a combination of protein-repellent MPC and PUF microcapsules for restoring microcracks is a promising strategy for dental restorations to address the two main challenges of fracture and secondary caries. The new dual composite formulation design has the potential to improve the longevity of dental restorations significantly.

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.

Encapsulation of grape seed extract in polylactide microcapsules for sustained bioactivity and time-dependent release in dental material applications

OBJECTIVE

To sustain the bioactivity of proanthocyanidins-rich plant-derived extracts via encapsulation within biodegradable polymer microcapsules.

METHODS

Polylactide microcapsules containing grape seed extract (GSE) were manufactured using a combination of double emulsion and solvent evaporation techniques. Microcapsule morphology, size distribution, and cross-section were examined via scanning electron microscopy. UV-vis measurements were carried out to evaluate the core loading and encapsulation efficiency of microcapsules. The bioactivity of extracts was evaluated after extraction from capsules via solvent partitioning one week or one year post-encapsulation process. Fifteen human molars were cut into 7mm×1.7mm×0.5mm thick mid-coronal dentin beams, demineralized, and treated with either encapsulated GSE, pristine GSE, or left untreated. The elastic modulus of dentin specimens was measured based on three-point bending experiments as an indirect assessment of the bioactivity of grape seed extracts. The effects of the encapsulation process and storage time on the bioactivity of extracts were analyzed.

RESULTS

Polynuclear microcapsules with average diameter of 1.38μm and core loading of up to 38wt% were successfully manufactured. There were no statistically significant differences in the mean fold increase of elastic modulus values among the samples treated with encapsulated or pristine GSE (p=0.333), or the storage time (one week versus one year storage at room temperature, p=0.967).

SIGNIFICANCE

Polynuclear microcapsules containing proanthocyanidins-rich plant-derived extracts were prepared. The bioactivity of extracts was preserved after microencapsulation.

Effects of water-aging on self-healing dental composite containing microcapsules

OBJECTIVES

The objectives of this study were to develop a self-healing dental composite containing poly(urea-formaldehyde) (PUF) shells with triethylene glycol dimethacrylate (TEGDMA) and N,N-dihydroxyethyl-p-toluidine (DHEPT) as healing liquid, and to investigate the mechanical properties of the composite and its self-healing efficacy after water-aging for 6 months.

METHODS

PUF microspheres were synthesized encapsulating a TEGDMA-DHEPT healing liquid. Composite containing 30% of a resin matrix and 70% of glass fillers by mass was incorporated with 0%, 2.5%, 5%, 7.5% and 10% of microcapsules. A flexural test was used to measure flexural strength and elastic modulus. A single edge V-notched beam method was used to measure fracture toughness (KIC) and self-healing efficacy. Specimens were water-aged at 37 °C for 1 day to 6 months and then tested for self-healing. Fractured specimens were healed while being immersed in water to examine self-healing efficacy, in comparison with that in air.

RESULTS

Incorporation of up to 7.5% of microcapsules into the resin composite achieved effective self-healing, without adverse effects on the virgin mechanical properties of the composite (p>0.1). An excellent self-healing efficacy of 64-77% recovery was obtained (mean±sd; n=6). Six months of water-aging did not decrease the self-healing efficacy compared to 1 day (p>0.1). Exposure to water did not decrease the healing efficacy, compared to that healed in air (p>0.1).

CONCLUSIONS

A composite was developed with excellent self-healing efficacy even while being immersed in water. The self-healing efficacy did not decrease with increasing water-aging time for 6 months.

CLINICAL SIGNIFICANCE

The novel self-healing composite may be promising for dental applications to heal cracks, resist fracture, and increase the durability and longevity.