Experimental primers containing synthetic and natural compounds reduce enzymatic activity at the dentin-adhesive interface under cyclic loading

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.

Effects of proanthocyanidin-functionalized hydroxyapatite nanoparticles on dentin bonding

OBJECTIVES

To evaluate the effect of proanthocyanidin-functionalized hydroxyapatite nanoparticles (nHAp_PA) used as pretreatment at different concentrations on the microtensile bond strength (µTBS) and endogenous enzymatic activity (MMPs) on pH-cycled dentin after 24 h and 6 months of artificial aging.

MATERIALS AND METHODS

Fifty human sound dentin blocks were randomly assigned to 5 groups (n = 10): (i) negative control (no treatment); (ii) positive control (pH-cycling); (iii) pH-cycling + 2% nHAp_PA for 60s; (iv) pH-cycling + 6.5% nHAp_PA for 60s; (v) pH-cycling + 15% nHAp_PA for 60s. A self-etch adhesive was used for bonding procedures before resin composite build-ups. Specimens were tested with the µTBS test after 24 h and 6 months of laboratory storage. The proteolytic activity in each group was evaluated with gelatin zymography and in situ zymography. Data were statistically analyzed (p < 0.05).

RESULTS

At 24 h, the µTBS of the experimental groups were significantly higher than the controls (p ≤ 0.001), and no differences were observed between different concentrations (p > 0.05). Artificial aging significantly decreased bond strength in all groups (p ≤ 0.008); however, nHAp_PA 2% still yielded higher bonding values than controls (p ≤ 0.007). The groups pretreated with nHAp_PA exhibited lower MMP-9 and MMP-2 activities compared to the positive control group and almost the same enzymatic activity as the negative control group. In situ zymography showed that after 6 months of aging, nHAp_PA 2% and nHAp_PA 6,5% decreased enzymatic activity as well as the negative control.

CONCLUSIONS

Dentin pretreatment with nHAp_PA increased the bonding performance of a self-etch adhesive and decreased MMP-2 and MMP-9 activities after 6 months.

Effect of the use of bromelain associated with bioactive glass-ceramic on dentin/adhesive interface

OBJECTIVES

To evaluate the effect of bromelain associated with Biosilicate on the bond strength (BS) of a universal adhesive system to sound (SD) and caries-affected dentin (CAD), and on the proteolytic activity.

MATERIALS AND METHODS

Cavities were prepared in 360 molars, half submitted to cariogenic challenge. Teeth were separated into groups (n=20): Control-No treatment; CHX-0.12% chlorhexidine; NaOCl-5% sodium hypochlorite; Br5%-5% bromelain; Br10%-10% bromelain; Bio-10% Biosilicate; NaOClBio-NaOCl+Bio; Br5%Bio-Br5%+Bio; Br10%Bio-Br10%+Bio. Following treatments, the adhesive system was applied, and cavities were restored. Samples were sectioned into sticks and stored at 37 °C for 24 h, 6 months, and 1 year. Microtensile BS (2-way ANOVA, Bonferroni's test, α=0.05), fracture patterns (SEM), and adhesive interfaces (TEM) were evaluated. Bacterial collagenase assay and in situ zymography were performed.

RESULTS

In CAD, Br10% presented higher BS (p=0.0208) than Br5%Bio. Br5% presented higher BS (p=0.0033) after 6 months than after 24 h; and association of treatments, higher BS (p<0.05) after aging than after 24 h. Mixed fractures were the most prevalent. Association of treatments promoted a more uniform hybrid layer with embedded Bio particles. Experimental groups presented lower (p<0.0001) relative fluorescence units than Control. Bromelain, associated or not with Bio, showed collagenolytic degradation.

CONCLUSIONS

Bromelain associated with Biosilicate did not affect the BS to SD. In CAD, Br5%Bio decreased immediate BS but had no long-term influence. This association decreased the proteolytic activity.

CLINICAL RELEVANCE

Bromelain and Biosilicate may enhance the longevity of adhesive restorations by inhibiting endogenous proteases.

Analysis of the adhesive interface of dentine treated with carbodiimide and chitosan before cementation of fiberglass posts with different resin cements

The objective of this study is to evaluate the effect of 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (EDC) and chitosan (CHI) on the adhesive interface of resin cements to root dentine. Forty-five upper canines were sectioned, endodontically treated, prepared and divided into three groups according to dentine treatment (distilled water-DW, CHI 0.2% and EDC 0.5) and in three subgroups according to resin cement: RelyX ARC, Panavia F 2.0 or RelyX U200. Slices were obtained, with five slices of each third submitted to the analysis of the adaptation of the adhesive interface through scores and the perimeter with gaps in confocal laser scanning microscopy and one slice of each third later evaluated qualitatively in scanning electron microscopy. The results were analyzed using with Kruskal-Wallis and Spearman correlation tests. There was no difference in adaptation for the different resin cements (p = .438). EDC presented better adaptation when compared to the groups treated with DW and CHI (p < .001), while the CHI and DW presented similar adaptation values (p = .365). No difference was observed in the perimeter referring to the gap areas for the different resin cements (p = .510). EDC showed a lower percentage of perimeters with gaps when compared to CHI (p < .001), with the percentage of perimeter with gaps of teeth treated with CHI being lower than DW (p < .001). A positive correlation coefficient equal to 0.763 was obtained between the perimeter with gaps and the adaptation data of the adhesive interface (p < .001). EDC resulted in better adaptation of the adhesive interface and a lower percentage of perimeters with gaps compared to chitosan.

Development of Proanthocyanidin-Loaded Mesoporous Silica Nanoparticles for Improving Dental Adhesion

Dentin biomodification is a promising approach to enhance dental tissue biomechanics and biostability for restorative and reparative therapies. One of the most active dentin tissue biomodifiers is proanthocyanidin (PAC)-rich natural extracts, which are used in the dental bonding procedure in combination with resin-based adhesives (RBAs). This study aimed to investigate the use of mesoporous silica nanoparticles (MSNs) for the sustained delivery of PACs for dentin biomodification as a novel drug-delivery system for dental applications. The effects of the incorporation of MSN functionalized with 3-aminopropyltriethoxysilane (APTES) and loaded with PAC into an experimental RBA were assessed by characterizing the material mechanical properties. In addition, the immediate and long-term bonding performance of an experimental resin-based primer (RBP) containing MSN-APTES loaded with PAC was also evaluated. For that, different formulations of RBA and RBP were prepared containing 20% w/v MSN-APTES loaded with PAC before or after functionalization (MSN-PAC-APTES and MSN-APTES-PAC, respectively). The incorporation of MSN-APTES-PAC did not negatively impact the degree of conversion or the overall mechanical properties of the RBA. However, adding MSN-PAC-APTES resulted in inferior mechanical properties of the experimental RBA. In the adhesion studies, APTES-functionalized MSN was successfully added to an experimental RBP for drug-delivery purposes without compromising the bond strength to the dentin or the failure mode. Interestingly, the sequence of surface functionalization with APTES resulted in differences in the bonding performance, with better long-term results for RBP containing MSN loaded with PAC after functionalization.

Paradoxical effects of galloyl motifs in the interactions of proanthocyanidins with collagen-rich dentin

Plant-derived proanthocyanidins (PACs) mediate physicochemical modifications to the dentin extracellular matrix (ECM). The structure-activity relationships of PACs remain largely unknown, mostly due to the varied complex composition of crude extracts, as well as the challenges of purification and mechanistic assessment. To assess the role of galloylated PACs as significant contributors to high yet unstable biomodification activity to the dentin ECM, we removed the galloyl moieties (de-galloylation) via enzymatic hydrolysis from three galloyl-rich PAC-containing extracts (Camellia sinensis, Vitis vinifera, and Hamamelis virginiana). The biomechanical and biological properties of dentin were assessed upon treatment with these extracts vs. their de-galloylated counterparts. An increase in the complex modulus of the dentin matrix was found with all extracts, however, the crude extract was significantly higher when compared to the de-galloylated version. Exhibiting the highest content of galloylated PACs among the investigated plants, Camellia sinensis crude extract also exhibited the biggest relapse in mechanical properties after one-month incubation. De-galloylation did not modify the damping capacity of dentin ECM. Moreover, PAC-mediated protection against proteolytic degradation was unaffected by de-galloylation. The de-galloylation experiments confirmed that gallic acid in galloylated rich-PAC extracts drive stronger yet significantly less sustained mechanical effects in dentin ECM.

Synthesis and characterization of an experimental primer containing chitosan nanoparticles - Effect on the inactivation of metalloproteinases, antimicrobial activity and adhesive strength

OBJECTIVE

The aim of this study was to synthesize and characterize an experimental primer containing cationic lipid nanoparticles (NPL-chitosan) and to evaluate its properties.

DESIGN

The NPL-chitosan were synthesized by emulsion and sonication method. The experimental primers were applied in dentin surface of fifty human molars. The experimental groups were: 1) application of commercial primer; 2) Primer containing 2% of Chlorhexidine (CHX) 3); Primer with 2% NPL-chitosan 4); Primer with 0.6 % of NPL-chitosan 5); Primer with 0.4 % of NPL-chitosan. A composite resin plateau was used for the analysis, where sections were made for making the dentin beams. The effect of experimental primer with cationic nanoparticles in the inhibition of matrix metalloproteinase (MMP) activity was carrying out by in situ zymography. For the Resin-Dentin Adhesive Strength and in situ Zymography analysis, was used the One-way analysis of variance (ANOVA) with significance level of 95 %.

RESULTS

Spherical NPL-chitosan presented size below 220 nm, polydispersity index of 0.179 and zeta potential positive and was stable over 75 days. These nanoparticles showed antibacterial activity agsainst S. mutans with MIC of the 0.4 % and MBC of 0.67 %. In the Microtensile Strength, no statistical difference was observed between the experimental groups (p = 0.9054). The in situ zymography assay showed that the group with 2% of NPL-chitosan presented higher inactivation activity of MMPs compared to the other groups (p < 0.05).

CONCLUSION

The experimental primer containing NPL-chitosan has antimicrobial activity, does not alter the adhesive resistance and inactivates MMPs present in dentin.

Impact of biomineralization on resin/biomineralized dentin bond longevity in a minimally invasive approach: An "in vitro" 18-month follow-up

OBJECTIVES

To determine the impact of treating caries-affected dentin (CAD) with: 0.2% sodium fluoride (NaF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP/MI Paste™) or peptide P₁₁-4 (Curodont™ Repair) on the longevity of resin/CAD interface at storage times of 24 -h, 6- and 18-month.

METHODS

255 caries-free third molars were used, and CAD was produced by a biological method. The teeth were randomly distributed into: G1- Sound dentin (SD); G2- CAD; G3- CAD + 0.2% NaF (CAD/NaF); G4- CAD + CPP-ACP (CAD/ACP); G5- CAD + Curodont™ Repair (CAD/P₁₁-4). The Filtek Z350 composite resin block was bonded to dentin using Adper™ Single 2 (4 mm/height). Resin/dentin blocks were stored in a solution of Simulated Body Fluid at 37 °C, pressures were modified to simulate natural pulpal pressures. Specimens were investigated by microtensile bond strength (μTBS) (n = 8), Scanning Electron Microscopy (to assess the failure mode) (n = 8), nanoinfiltration (to assess the interface sealing) (n = 3), in situ zymography (to assess the gelatinolytic activity) (n = 3) and micro-computed microtomography (μ-CT) (to assess the mineralization) (n = 3). Data from μTBS, μ-CT and, nanoinfiltration and hybrid layer formation/degradation were submitted to two-way ANOVA and Tukey tests, and failure patterns and in situ zymography to Kruskal-Wallis and Dunn tests (α = 5%).

RESULTS

The highest mineral density change by μ-CT, smallest silver nitrate infiltration and proteolytic activity in the adhesive layer were obtained significantly for the groups SD, CAD/ACP and CAD/P₁₁-4, with most mixed fractures at 18-month (p < 0.001). CAD/NaF showed significantly similar values to CAD, CAD and CAD/NaF which presented a high percentage of adhesive fracture (p < 0.001) at all time periods.

SIGNIFICANCE

Treating caries-affected dentin with remineralizing agents CPP-ACP and Curodont™ Repair, has the potential to be a clinically relevant treatment protocol to increase the longevity of adhesive restorations.

Effect of natural primer associated to bioactive glass-ceramic on adhesive/dentin interface

OBJECTIVES

This study evaluated the effect of propolis associated with Biosilicate on the bond strength (BS) and gelatinolytic activity at the adhesive/dentin interface.

METHODS

Occlusal cavities were prepared in 320 human molars. Half of them were submitted to cariogenic challenge. All the teeth were separated into eight groups (n = 20): Control - Adhesive System (Single Bond Universal, 3 MESPE); CHX - 0.12 % Chlorhexidine; Bio - 10 % Biosilicate; P16 - Propolis with low levels of polyphenols; P45 - Propolis with high levels of polyphenols; CHX Bio - CHX + Bio; P16 Bio - P16+Bio; P45 Bio - P45+Bio. The adhesive was applied (self-etch mode) after treatments. Restorations (Filtek Z350, 3 MESPE) were performed and samples sectioned into sticks, separated and stored in distilled water at 37 °C for 24 h, 6 months and 1 year. Microtensile BS (0.5 mm/min) was tested and analyzed (2-way ANOVA, Bonferroni's Test, p < .05 and Weibull analysis). Fracture patterns (VH-M100, Keyence) and adhesive interfaces (SEM, EVO-MA10, ZEISS and TEM, JEM-1010, JEOL) were observed; and biodegradation and in situ zymography performed.

RESULTS

P16 presented the highest BS values on sound dentin after 6 months. In caries-affected dentin (CAD), the association of treatments promoted the highest BS after 24 h. Sound dentin obtained significantly higher Weibull modulus than CAD. SEM displayed resin tags in P16, P45 and association of treatments. TEM showed good interaction between adhesive and dentin. According to the in situ zymography and biodegradation assay all natural primers reduced the gelatinolytic activity. P45 presented the lowest biodegradation and enzymatic activity.

CONCLUSIONS

Propolis and the association of treatments promoted the highest bond strength results and preserved the dentin. All the experimental groups exhibited low gelatinolytic activity.

CLINICAL SIGNIFICANCE

Propolis and the association of treatments with Biosilicate could preserve the dentin substrate and improve the longevity of composite restorations.

Shear bond strength of the adhesive/dentin interface after different etching protocols

Background:

Aim:

Materials and Methods:

Results:

Conclusion:

Development of an antibacterial and anti-metalloproteinase dental adhesive for long-lasting resin composite restorations

Despite all the advances in adhesive dentistry, dental bonds are still fragile due to degradation events that start during application of adhesive agents and the inherent hydrolysis of resin-dentin bonds. Here, we combined two outstanding processing methods (electrospinning and cryomilling) to obtain bioactive (antimicrobial and anti-metalloproteinase) fiber-based fillers containing a potent matrix metalloproteinase (MMP) inhibitor (doxycycline, DOX). Poly(ε)caprolactone solutions containing different DOX amounts (0, 5, 25, and 50 wt%) were processed via electrospinning, resulting in non-toxic submicron fibers with antimicrobial activity against Streptococcus mutans and Lactobacillus. The fibers were embedded in a resin blend, light-cured, and cryomilled for the preparation of fiber-containing fillers, which were investigated with antibacterial and in situ gelatin zymography analyzes. The fillers containing 0, 25, and 50 wt% DOX-releasing fibers were added to aliquots of a two-step, etch-and-rinse dental adhesive system. Mechanical strength, hardness, degree of conversion (DC), water sorption and solubility, bond strength to dentin, and nanoleakage analyses were performed to characterize the physico-mechanical, biological, and bonding properties of the modified adhesives. Statistical analyses (ANOVA; Kruskal-Wallis) were used when appropriate to analyze the data (α = 0.05). DOX-releasing fibers were successfully obtained, showing proper morphological architecture, cytocompatibility, drug release ability, slow degradation profile, and antibacterial activity. Reduced metalloproteinases (MMP-2 and MMP-9) activity was observed only for the DOX-containing fillers, which have also demonstrated antibacterial properties against tested bacteria. Adhesive resins modified with DOX-containing fillers demonstrated greater DC and similar mechanical properties as compared to the fiber-free adhesive (unfilled control). Concerning bonding performance to dentin, the experimental adhesives showed similar immediate bond strengths to the control. After 12 months of water storage, the fiber-modified adhesives (except the group consisting of 50 wt% DOX-loaded fillers) demonstrated stable bonds to dentin. Nanoleakage was similar among all groups investigated. DOX-releasing fibers showed promising application in developing novel dentin adhesives with potential therapeutic properties and MMP inhibition ability; antibacterial activity against relevant oral pathogens, without jeopardizing the physico-mechanical characteristics; and bonding performance of the adhesive.

Physicochemical properties, metalloproteinases inhibition, and antibiofilm activity of doxycycline-doped dental adhesive

OBJECTIVES

To evaluate the incorporation of doxycycline (DOX) into a commercial dental adhesive regarding physicochemical properties, microtensile bond strength (μTBS), nanoleakage (NL), nanohardness (NH) and Young's modulus (YM), metalloproteinases (MMP) inhibition, and antibiofilm activity.

METHODS

DOX was incorporated into the adhesive at 0.05, 0.1, 0.5, and 1 wt%. Restored teeth were evaluated for μTBS, NL, NH, and YM after 24 -hs and 1-year of water storage. Biofilms of Streptococcus mutans were grown on top of these adhesives and determined for bacterial viability and amount of biomass. The inhibitory effect on MMP was analyzed by in situ zymography under confocal microscopy.

RESULTS

Adhesives with 0.5 and 1 wt% of DOX presented reduced pH and degree of conversion. The incorporation of DOX did not affect μTBS and hybrid layer YM. The control group (no DOX) had a decrease in μTBS and the densest silver nitrate areas after 1-year storage. Hybrid layer NH values increased with 0.1 wt% DOX compared to control and 1 wt% DOX groups, at 24 -hs. After 1-year storage, NH of 1 wt% DOX adhesive decreased compared to the control group. The 0.5 and 1 wt% concentrations of DOX decreased the bacterial viability and the biofilm biomass. Confocal images suggest an increased MMP inhibition proportional to the percentage of DOX.

CONCLUSION

At any concentration, DOX-doped dental adhesives were able to inhibit MMP activity, diminish nanoleakage, and maintain the resin-dentin bond-strength after 1 year of artificial aging.

CLINICAL SIGNIFICANCE

Doxycycline-doped dental adhesive inhibited metalloproteinases activity and preserved interface bond strength. This formulation has a potential to improve adhesive restorations clinical longevity.

Chlorhexidine-modified nanotubes and their effects on the polymerization and bonding performance of a dental adhesive

OBJECTIVES

The purpose of this study was to synthesize chlorhexidine (CHX)-encapsulated aluminosilicate clay nanotubes (Halloysite®, HNTs) and to incorporate them into the primer/adhesive components of an etch-and-rinse adhesive system (SBMP; Scotchbond Multipurpose, 3M ESPE) and to test their effects on degree of conversion, viscosity, immediate and long-term bonding to dentin.

METHODS

CHX-modified HNTs were synthesized using 10% or 20% CHX solutions. The primer and the adhesive components of SBMP were incorporated with 15wt.% of the CHX-encapsulated HNTs. Degree of conversion (DC) and viscosity analyses were performed to characterize the modified primers/adhesives. For bond strength testing, acid-etched dentin was treated with one of the following: SBMP (control); 0.2%CHX solution before SBMP; CHX-modified primers+SBMP adhesive; SBMP primer+CHX-modified adhesives; and SBMP primer+CHX-free HNT-modified adhesive. The microtensile bond strength test was performed after immediate (24h) and long-term (6 months) of water storage. Data were analyzed using ANOVA and Tukey (α=5%) and the Weibull analysis.

RESULTS

DC was greater for the CHX-free HNT-modified adhesive, whereas the other experimental adhesives showed similar DC as compared with the control. Primers were less viscous than the adhesives, without significant differences within the respective materials. At 24h, all groups showed similar bonding performance and structural reliability; whereas at the 6-month period, groups treated with the 0.2%CHX solution prior bonding or with the CHX-modified primers resulted in greater bond strength than the control and superior reliability.

SIGNIFICANCE

The modification of a primer or adhesive with CHX-encapsulated HNTs was an advantageous approach that did not impair the polymerization, viscosity and bonding performance of the materials, showing a promising long-term effect on resin-dentin bonds.

Effect of thermo-mechanical cycling and chlorhexidine on the bond strength of universal adhesive system to dentin

OBJECTIVES

This study evaluated the influence of thermo-mechanical cycling (TMC) on the bond strength (BS) of a universal adhesive system (UAS - Adper Single Bond Universal, 3M ESPE) to dentin treated or not with 0.2% chlorhexidine (CHX).

METHODS

Eighty human molars were flattened until reach the dentin and separated into 4 groups according to the bonding protocol: ENR Group: 37% phosphoric acid + 3-step etch-and-rinse adhesive system (ENR); UAS Group: UAS in self-etch mode; ENR + CHX Group: 37% phosphoric acid + CHX + ENR; UAS + CHX Group: CHX + UAS in self-etch mode. After treatments, teeth were restored (Filtek Z350, 3M ESPE). Samples (n = 10) were submitted to aging process: stored in distilled water at 37°C/30 days or TMC (ERIOS - 98N/1.6Hz + thermal cycling 5/37/55 °C - 1,200,000 cycles). Specimens were sectioned into sticks (1.0 mm2) and submitted to the microtensile test (Mechanical Test Machine - 0.5 mm/min). Fracture patterns and hybrid layer integrity were analyzed under Stereomicroscope and Scanning Electron Microscopy (SEM).

RESULTS

The BS results (3-way ANOVA, Bonferroni's test, α = 5%) showed that groups treated with CHX presented higher BS values than control groups; significant in all cases (p < .05), except for ENR submitted to TMC (p > .05). When CHX was applied and samples were cycled, UAS revealed higher BS (p < .05) than ENR. After TMC, cohesive fractures increased for UAS, regardless of CHX application. SEM analysis demonstrated different hybridization patterns for the adhesive systems tested.

CONCLUSION

The performance of the universal adhesive system used in self-etch mode was better than that of the 3-step etch-and-rinse adhesive system.

CLINICAL SIGNIFICANCE

Universal adhesive systems have been developed in order to simplify the dentin hybridization protocol. It is important to determine the longevity of the adhesive interface using these bonding materials after chewing.

Dimeric Proanthocyanidins on the Stability of Dentin and Adhesive Biointerfaces

A dentin biomodification strategy with selective proanthocyanidin (PAC)-enriched extracts reinforces dentin and dentin-resin interfaces. Enrichment of the extracts according to the degree of polymerization allows exploration of bioactive principles of PACs and structure-activity relationships. This study investigated the sustained dentin matrix biomodification and dentin-resin bioadhesion of 2 fractions consisting exclusively of B-type PAC dimers with or without a single galloyl motif (specifically, DIMER_G and DIMER_NG) and their precursor material, enriched grape seed extract (e-GSE; Vitis vinifera). The biomodification potential was determined by long-term evaluation of the apparent modulus of elasticity and collagen solubility (hydroxyproline release). Chemical characterization of the dentin matrix was performed by attenuated total reflectance-Fourier-transform infrared spectroscopy. The bioadhesive properties were assessed by a microtensile bond strength test at different time points, and macro-hybrid layers were produced to verify the degree of conversion of the adhesive resin. Fractions consisting of DIMER_G, DIMER_NG, and their precursor, e-GSE, increased the modulus of elasticity at all time points and reduced collagen degradation. Specimens treated with DIMER_NG remained stable throughout 12 mo of storage, whereas a significant drop in the modulus of elasticity was observed for the DIMER_G and e-GSE groups at 6 mo. The fractions and precursor did not affect the degree of resin conversion at the hybrid layer. Changes in infrared resonances corresponding to collagen cross-links in the dentin matrix occurred for all treatments. Higher bond strength was observed for dentin treated with e-GSE as compared with DIMER_G and DIMER_NG; all biointerfaces remained stable after 12 mo. Nongalloylated PACs mediate stable dentin biomodification, which includes protective activity against collagen degradation and reinforcement of the anchoring dentin matrix. Collectively, PACs with a higher degree of oligomerization offer a robust bioadhesion between the hydrophilic dentin matrix and the hydrophobic adhesive.

Evidence to the role of interflavan linkages and galloylation of proanthocyanidins at sustaining long-term dentin biomodification

OBJECTIVES

The interactivity of proanthocyanidins (PACs) with collagen modulates dentin matrix biomechanics and biostability. Herein, PAC extracts selected based on structural diversity were investigated to determine key PAC features driving sustained effects on dentin matrices over a period of 18months.

METHODS

The chemical profiles of PAC-rich plant sources, Pinus massoniana (PM), Cinnamomum verum (CV) and Hamamelis virginiana (HV) barks, as well as Vitis vinifera (VV) seeds, were obtained by diol HPLC analysis after partitioning of the extracts between methyl acetate and water. Dentin matrices (n=15) were prepared from human molars to determine the apparent modulus of elasticity over 18months of aging. Susceptibility of the dentin matrix to degradation by endogenous and exogenous proteases was determined by presence of solubilized collagen in supernatant, and resistance to degradation by bacterial collagenase, respectively. Data were analyzed using ANOVA and Games-Howell post hoc tests (α=0.05).

RESULTS

After 18months, dentin matrices modified by PM and CV extracts, containing only non-galloylated PACs, were highly stable mechanically (p<0.05). Dentin matrices treated with CV exhibited the lowest degradation by bacterial collagenase after 1h and 18months of aging (p<0.05), while dentin matrices treated with PM showed the least mass loss and collagen solubilization by endogenous enzymes over time (p<0.05).

SIGNIFICANCE

Resistance against long-term degradation was observed for all experimental groups; however, the most potent and long-lasting dentin biomodification resulted from non-galloylated PACs.

An Overview of Dental Adhesive Systems and the Dynamic Tooth-Adhesive Interface

From the conception of resin-enamel adhesion to today's contemporary dental adhesive systems, clinicians are no longer afraid of exploring the many advantages brought by adhesive restorative concepts. To maximize the performance of adhesive-based restorative procedures, practitioners must be familiar with the mechanism of adhesion, clinical indications, proper handling, the inherent limitations of the materials and the biological challenges. This review provides an overview of the current status of restorative dental adhesives, their mechanism of adhesion, mechanisms of degradation of dental adhesive interfaces, how to maximize performance, and future trends in adhesive dentistry.

Effects of Collagen Crosslinkers on Dentine: A Literature Review

This aim of this review is to explore the current research related to crosslinking agents used on dentine. A systematic search of publications in PubMed and Web of Science databases was performed. Further retrieval was conducted using the search terms of specific names of crosslinkers. Reviews, conference abstracts, dissertation and theses, non-English articles, studies of intrinsic crosslinking of dentine, studies of adhesives without specific crosslinker components, studies of crosslinker applications in other collagenous tissues or tooth-like structures and irrelevant studies were excluded. Manual screening was conducted on the bibliographies of remaining papers to identify other relevant articles. One hundred and one articles were included in this systematic review and full texts were retrieved. Both synthetic and naturally derived crosslinkers have been found to exhibit significant effects in biomodification of dentine via their multiple interactions with the dentine matrix. A stable matrix network or a durable hybrid layer in dentine bonding could be achieved, where the dentine collagen fibrils show improved biochemical and biomechanical properties and enzymatic biodegradation is reduced. Although no crosslinkers have been tested in clinical trials, extensive research has been conducted in laboratory studies to investigate their potential applicability for inhibition of demineralisation and/or promotion of remineralisation, caries prevention as well as improvement of bonding performance of adhesive systems. Further studies are needed to develop the feasibility for clinical use, reduce side effects as well as explore mechanisms of action and long-term effectiveness.

Sodium Trimetaphosphate as a Novel Strategy for Matrix Metalloproteinase Inhibition and Dentin Remineralization

The effect of sodium trimetaphosphate (STMP) as an antiproteolytic and remineralizing agent on demineralized dentin was evaluated in vitro. The inhibitory potential of STMP at 0.5, 1.5, 3.5, and 5% against recombinant matrix metalloproteinases (MMPs) MMPs-2 and -9 was assessed by zymography. To investigate its remineralization potential, 40 bovine root specimens were obtained and subjected to a demineralization protocol to produce caries-like dentin lesions. After that, dentin surfaces were divided into 3 areas: (1) mineralized (no treatment); (2) demineralized; and (3) demineralized/treated with STMP and submitted to a pH-cycling associated or not with STMP (1.5, 3.5, or 5% STMP, 10 min of treatment). After that, superficial hardness (SH) and cross-sectional hardness (CSH) were determined. Polarized light microscopy (PLM) was used to qualitatively evaluate mineralization within the caries-like lesions. The zymographic analysis showed that STMP solution is a potent inhibitor of the gelatinolytic activity of MMPs-2 and -9 depending on the dose, since the lowest concentration (0.5%) partially inhibited the enzyme activity, while the higher concentrations completely inhibited enzyme activity. Regarding remineralization effect, only 1.5% STMP solution enhanced both the SH and CSH. PLM showed that the area treated with 1.5% STMP presented similar birefringence as mineralized sound dentin. In conclusion, 1.5% STMP solution is effective as an antiproteolytic agent against MMPs and promotes dentin remineralization.

Recent Advances in Adhesive Bonding - The Role of Biomolecules, Nanocompounds, and Bonding Strategies in Enhancing Resin Bonding to Dental Substrates

PURPOSE OF REVIEW

To present an overview on the main agents (i.e., biomolecules and nanocompounds) and/or strategies currently available to amplify or stabilize resin-dentin bonding.

RECENT FINDINGS

According to studies retrieved for full text reading (2014-2017), there are currently six major strategies available to overcome resin-dentin bond degradation: (i) use of collagen crosslinking agents, which may form stable covalent bonds with collagen fibrils, thus strengthening the hybrid layer; (ii) use of antioxidants, which may allow further polymerization reactions over time; (iii) use of protease inhibitors, which may inhibit or inactivate metalloproteinases; (iv) modification of the bonding procedure, which may be performed by using the ethanol wet-bonding technique or by applying an additional adhesive (hydrophobic) coating, thereby strengthening the hybrid layer; (v) laser treatment of the substrate prior to bonding, which may cause specific topographic changes in the surface of dental substrates, increasing bonding efficacy; and (vi) reinforcement of the resin matrix with inorganic fillers and/or remineralizing agents, which may positively enhance physico-mechanical properties of the hybrid layer.

SUMMARY

With the present review, we contributed to the better understanding of adhesion concepts and mechanisms of resin-dentin bond degradation, showing the current prospects available to solve that problematic. Also, adhesively-bonded restorations may be benefited by the use of some biomolecules, nanocompounds or alternative bonding strategies in order to minimize bond strength degradation.