Bioactive composites containing TEGDMA-functionalized calcium phosphate particles: Degree of conversion, fracture strength and ion release evaluation

Compositional boundaries for functional dental composites containing calcium orthophosphate particles

OBJECTIVES

To investigate the interrelationships among handling, degree of conversion (DC), mechanical behavior and Ca2+ release of composites containing dicalcium phosphate dihydrate (DCPD, CaHPO4.2H2O), as a function of total inorganic content and DCPD: glass ratio.

METHODS

Twenty-one formulations (1 BisGMA: 1 TEGDMA, in mols) with inorganic fractions ranging from zero to 50 vol% and different DCPD: glass ratios were evaluated for viscosity (parallel plate rheometer, n = 3), DC (near-FTIR spectroscopy, n = 3), fracture toughness/K1C (single-edge notched beam, n = 7-11) and 14-day Ca2+ release (inductively coupled plasma optical emission spectroscopy, n = 3). Data were analyzed by ANOVA/Tukey test (except viscosity, where Kruskal-Wallis/Dunn tests were used, α: 0.05).

RESULTS

Viscosity and DC increased with DCPD: glass ratio among composites with the same inorganic content (p < 0.001). At inorganic fractions of 40 vol% and 50 vol%, keeping DCPD content at a maximum of 30 vol% did not compromise K1C. Ca2+ release showed an exponential relationship with DCPD mass fraction in the formulation (R2 = 0.986). After 14 days, a maximum of 3.8% of the Ca2+ mass in the specimen was released.

CONCLUSION

Formulations containing 30 vol% DCPD and 10-20 vol% glass represent the best compromise between viscosity, K1C and Ca2+ release. Materials with 40 vol% DCPD should not be disregarded, bearing in mind that Ca2+ release will be maximized at the expense of K1C.

Influence of the calcium orthophosphate:glass ratio and calcium orthophosphate functionalization on the degree of conversion and mechanical properties of resin-based composites

The study verified the influence of calcium orthophosphate (CaP):glass ratio on the degree of conversion and mechanical properties of resin-based composites containing either TEGDMA-functionalized dicalcium phosphate anhydrous (DCPA) or non-functionalized DCPA particles. The null hypotheses were that the evaluated variables are not affected by (1) CaP:glass ratio or (2) DCPA functionalization. DCPA particles were synthesized and half of them were functionalized with TEGDMA. Particle characterization included x-ray diffraction, elemental analysis, laser scattering, helium picnometry and scanning electron microscopy. Two series of composites were prepared containing either DCPA-NF (non-functionalized) or DCPA-F (functionalized), with total inorganic content of 50 vol % and DCPA:silanized barium glass (BG) ratios from 10:40 to 50:0. A composite containing 50 vol % BG was tested as control. DC was determined using FTIR spectroscopy. Biaxial flexural strength and modulus were tested after 24 h in water. Data were analyzed using Kruskal-Wallis/Dunn (flexural properties) or analysis of variance/Tukey tests (DC). Materials with similar actual DCPA contents were compared using Student's t test (alpha: 0.05). DC was higher for materials with DCPA-F, except for the 10:40 ratio. DCPA-F resulted in higher strength than DCPA-NF only at 40:10 ratio. Modulus was not affected by functionalization. Materials with similar actual DCPA contents showed differences in DC (F > NF), while no difference in flexural properties was observed between materials with 28%-30% DCPA. Both null hypotheses were rejected.

Assessment of Physical/Mechanical Performance of Dental Resin Sealants Containing Sr-Bioactive Glass Nanoparticles and Calcium Phosphate

The aim of this study was to assess the chemical/mechanical properties of ion-releasing dental sealants containing strontium-bioactive glass nanoparticles (Sr-BGNPs) and monocalcium phosphate monohydrate (MCPM). Two experimental sealants, TS1 (10 wt% Sr-BGNPs and 2 wt% MCPM) and TS2 (5 wt% Sr-BGNPs and 4 wt% MCPM), were prepared. Commercial controls were ClinproXT (CP) and BeautiSealant (BT). The monomer conversion (DC) was tested using ATR−FTIR (n = 5). The biaxial flexural strength (BFS) and modulus (BFM) were determined (n = 5) following 24 h and 7 days of immersion in water. The Vickers surface microhardness (SH) after 1 day in acetic acid (conc) versus water was tested (n = 5). The bulk and surface calcium phosphate precipitation in simulated body fluid was examined under SEM-EDX. The ion release at 4 weeks was analyzed using ICP-MS (n = 5). The DC after 40 s of light exposure of TS1 (43%) and TS2 (46%) was significantly lower than that of CP (58%) and BT (61%) (p < 0.05). The average BFS of TS1 (103 MPa), TS2 (123 MPa), and BT (94 MPa) were lower than that of CP (173 MPa). The average BFM and SH of TS1 (2.2 GPa, 19 VHN) and TS2 (2.0 GPa, 16 VHN) were higher than that of CP (1.6 GPa, 11 VHN) and BT (1.3 GPa, 12 VHN). TS1 showed higher Ca, P, and Sr release than TS2. Bulk calcium phosphate precipitation was detected on TS1 and TS2 suggesting some ion exchange. In conclusion, the DC of experimental sealants was lower than that of commercial materials, but their mechanical properties were within the acceptable ranges. The released ions may support remineralizing actions.

TEGDMA-Functionalized Dicalcium Phosphate Dihydrate Resin-Based Composites Prevent Secondary Caries in an In Vitro Biofilm Model

This study evaluated the efficacy of experimental TEGDMA-functionalized dicalcium phosphate dihydrate (T-DCPD) filler-based resin-based composites (RBC) in preventing caries lesions around the restoration margins (secondary caries, SC). Standardized Class-II cavities were made in sound molars with the cervical margin in dentin. Cavities were filled with a commercial resin-modified glass-ionomer cement (RMGIC) or experimental RBCs containing a bisGMA-TEGDMA resin blend and one of the following inorganic fractions: 60 wt.% Ba glass (RBC-0); 40 wt.% Ba glass and 20 wt.% T-DCPD (RBC-20); or 20 wt.% Ba glass and 40 wt.% T-DCPD (RBC-40). An open-system bioreactor produced Streptococcus mutans biofilm-driven SC. Specimens were scanned using micro-CT to evaluate demineralization depths. Scanning electron microscopy and energy-dispersive X-ray spectroscopy characterized the specimen surfaces, and antimicrobial activity, buffering effect, and ion uptake by the biofilms were also evaluated. ANOVA and Tukey’s tests were applied at p < 0.05. RBC-0 and RBC-20 showed SC development in dentin, while RBC-40 and RMGIC significantly reduced the lesion depth at the restoration margin (p < 0.0001). Initial enamel demineralization could be observed only around the RBC-0 and RBC-20 restorations. Direct antibiofilm activity can explain SC reduction by RMGIC, whereas a buffering effect on the acidogenicity of biofilm can explain the behavior of RBC-40. Experimental RBC with CaP-releasing functionalized T-DCPD filler could prevent SC with the same efficacy as F-releasing materials.

Proanthocyanidin encapsulation for sustained bioactivity in dentin bioadhesion: A two-year study

OBJECTIVES

To determine the long-term effect on the stability of dentin-resin interfaces after the addition of polylactide (PLA) capsules containing proanthocyanidin (PAC) to adhesive resin.

METHODS

Sub-micron (SM) and micron (M) size capsules containing PACs were produced using a combination of emulsification and solvent evaporation techniques and characterized. Human dentin surfaces (n = 8) were etched (35% glycolic acid) and primed (15% enriched Vitis vinifera extract solution - VV_e), followed by the application of an experimental adhesive containing 0 (control), 1.5 wt% of SM or M PAC-filled PLA capsules light cured for 40 s. A crown was built using commercial composite. After 24 h-immersion (37 °C) in simulated body fluid, specimens were serially sectioned into resin-dentin beams. Microtensile bond strength (TBS), micro-permeability and fracture pattern were assessed immediately and after 1 and 2 years. Data were statistically analyzed using two-way ANOVA and post-hoc test (α = 0.05).

RESULTS

Polydisperse capsules were manufactured with average diameter of 0.36 µm and 1.08 µm for SM and M, respectively. The addition of capsules did not affect TBS (p = 0.889). After 2 years, TBS significantly decreased in SM (p = 0.006), whereas M showed similar initial values (p = 0.291). Overall, less micro-permeability was found in M than the control and SM group (p < 0.001). After 2 years, fractured surfaces from capsule-containing groups failed within the adhesive layer while control fractured at the bottom of the hybrid layer.

SIGNIFICANCE

The addition of PAC-filled PLA microcapsules in a dental adhesive did not affect the bond strength while increased and sustained the protection against micro-permeability in the interface, likely due to release of PACs.

Bioactive glasses incorporating less-common ions to improve biological and physical properties

Bioactive glasses (BGs) have been a focus of research for over five decades for several biomedical applications. Although their use in bone substitution and bone tissue regeneration has gained important attention, recent developments have also seen the expansion of BG applications to the field of soft tissue engineering. Hard and soft tissue repair therapies can benefit from the biological activity of metallic ions released from BGs. These metallic ions are incorporated in the BG network not only for their biological therapeutic effects but also in many cases for influencing the structure and processability of the glass and to impart extra functional properties. The "classical" elements in silicate BG compositions are silicon (Si), phosphorous (P), calcium (Ca), sodium (Na), and potassium (K). In addition, other well-recognized biologically active ions have been incorporated in BGs to provide osteogenic, angiogenic, anti-inflammatory, and antibacterial effects such as zinc (Zn), magnesium (Mg), silver (Ag), strontium (Sr), gallium (Ga), fluorine (F), iron (Fe), cobalt (Co), boron (B), lithium (Li), titanium (Ti), and copper (Cu). More recently, rare earth and other elements considered less common or, some of them, even "exotic" for biomedical applications, have found room as doping elements in BGs to enhance their biological and physical properties. For example, barium (Ba), bismuth (Bi), chlorine (Cl), chromium (Cr), dysprosium (Dy), europium (Eu), gadolinium (Gd), ytterbium (Yb), thulium (Tm), germanium (Ge), gold (Au), holmium (Ho), iodine (I), lanthanum (La), manganese (Mn), molybdenum (Mo), nickel (Ni), niobium (Nb), nitrogen (N), palladium (Pd), rubidium (Rb), samarium (Sm), selenium (Se), tantalum (Ta), tellurium (Te), terbium (Tb), erbium (Er), tin (Sn), tungsten (W), vanadium (V), yttrium (Y) as well as zirconium (Zr) have been included in BGs. These ions have been found to be particularly interesting for enhancing the biological performance of doped BGs in novel compositions for tissue repair (both hard and soft tissue) and for providing, in some cases, extra functionalities to the BG, for example fluorescence, luminescence, radiation shielding, anti-inflammatory, and antibacterial properties. This review summarizes the influence of incorporating such less-common elements in BGs with focus on tissue engineering applications, usually exploiting the bioactivity of the BG in combination with other functional properties imparted by the presence of the added elements.

A Hydroxypropyl Methylcellulose Film Loaded with AFCP Nanoparticles for Inhibiting Formation of Enamel White Spot Lesions

Objective

This study investigated the effects of mineralizing film consisting of hydroxypropyl methylcellulose (HPMC) and amorphous fluorinated calcium phosphate (AFCP) nanoparticles on enamel white spot lesions (WSLs).

Material and Methods

The AFCP nanoparticles and mineralizing film were prepared via nanoprecipitation and solvent evaporation, respectively. They were characterized with Fourier transform infrared spectroscopy (FTIR), X-ray powder diffraction (XRD), transmission electron microscopy (TEM), selected area electron diffraction (SAED), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), inductively coupled plasma atomic emission spectrometry (ICP-AES), and fluoride ion selective electrode. Thirty-two human enamel slices (4 mm × 4 mm × 1.5 mm) were highly polished and randomly assigned to four groups: negative control (no treatment); pure HPMC film; mineralizing film; GC Tooth Mousse Plus^® (contains 10% CPP-ACP and 0.2% NaF). Subsequently, samples were challenged by a modified pH-cycling and characterized by color measurement, Micro-CT, SEM/EDX, and nanoindentation.

Results

The mineralizing film could sustain release of Ca, P and F ions over 24 h and maintain AFCP nanoparticles in metastable state over 8~12 h. During 4 weeks of pH cycling, the mineralizing film group exhibited least color change (∆E), mineral loss and lesion depth (120 ± 10 µm) among four groups (p < 0.05). SEM findings revealed that the porosities among enamel crystals increased in negative control and pure HPMC film groups after pH cycling, whereas in mineralizing film group, the original microstructure of enamel was well conserved and mineral deposits were detected between enamel prisms. Mineralizing film group demonstrated a least reduction of nanomechanical properties such as elastic modulus of 77.02 ± 6.84 GPa and hardness of 3.62 ± 0.57 GPa (p < 0.05).

Conclusion

The mineralizing film might be a promising strategy for prevention and management of WSLs via inhibiting enamel demineralization and promoting enamel remineralization.

Cytotoxic Evaluation and Determination of Organic and Inorganic Eluates from Restorative Materials

Over the last years, diverse commercial resin-based composites have dominated as dental filling materials. The purpose of the present study was to determine organic and inorganic eluates from five restorative materials using GC/MS and ICP–OES and to compare the effect on cell survival of human gingival fibroblasts of a conventional and a bioactive resin. Five commercially available restorative materials were employed for this study: Activa^TM Bioactive Restorative, ENA HRi, Enamel plus HRi Biofunction, Fuji II LC Capsule, and Fuji IX Capsule. Disks that were polymerized with a curing LED light or left to set were immersed in: 1 mL methanol or artificial saliva for GC/MS analysis, 5mL deionized water for ICP–OES, and 5mL of culture medium for cell viability. Cell viability was investigated with a modified staining sulforhodamine B assay.The following organic substances were detected: ACP, BHT, BPA, 1,4-BDDMA, CQ, DBP, DMABEE, HEMA, MCE, MeHQ, MOPA, MS, TMPTMA, and TPSb and the ions silicon, aluminum, calcium, sodium, and barium. Activa Bioactive Restorative was found to be biocompatible. Elution of organic substances depended on material’s composition, the nature of the solvent and the storage time. Ions’ release depended on material’s composition and storage time. The newly introduced bioactive restorative was found to be more biocompatible.

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.

Single-component orthodontic adhesives: comparison of the clinical and in vitro performance

OBJECTIVES

To investigate the clinical and in vitro performance of single-component orthodontic adhesives under metal brackets.

MATERIALS AND METHODS

Bimaxillary orthodontic treatment was required for sixty patients and 60 premolar teeth were divided into three groups (n: 20). The single-component orthodontic adhesives Biofix and GC Ortho Connect (GC) that did not require primers were compared to the control group using Transbond XT, which was applied with a primer. For each patient, total bonding time was measured. The Adhesive Remnant Index (ARI_(Bracket)) score was noted over 12 months. In vitro tests were used to evaluate specimens, shear bond strength (SBS), ARI_(Bracket), and Enamel Surface Index (ESI). After in vitro debonding, the enamel surface and bracket base were analyzed using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX).

RESULTS

Clinical failure rate with primer was 9.0%, while it was 8.0 and 10.0 for GC and Biofix, respectively. The mean in vitro SBS values of the Biofix, GC, and Transbond XT groups were 8.21, 8.07, and 7.37 MPa, respectively. There were no statistically differences in clinical failure (p = 0.160) and SBS values (p = 0.158). Mean differences in bond-up time per jaw were 9.65, 10.51, and 11.97 min, which were statistically significant (p = 0.0001).

CONCLUSION

Single-component adhesives had acceptable SBS values and enamel effects according to SEM-EDX analysis. Clinically, bonding failure was not shown statistically inferior to bonding with primer. There was also a significant difference in bond-up times.

CLINICAL RELEVANCE

Considering an intensely working clinic with bonding processes for at least two jaws per day, this means a saving of the chair time of 1 patient per week. However, better saliva contamination and moisture control with lack of the primer stage and, thereby, an acceptable bracket failure rate will bring clinically significant results with less chair time for clinicians.

Mechanical properties and surface roughness of polymer-based materials containing DCPD particles

The purpose of this study was to synthesize dicalcium phosphate dihydrate (DCPD) particles functionalized with triethylene glycol dimethacrylate (TEGDMA) through different routes by varying the receptor solution: ammonium phosphate (AP groups) or calcium nitrate (CN groups) and the moment in which TEGDMA was incorporated: ab initio (ab) or at the end of dripping the solution (ap). Two syntheses were performed without adding TEGDMA (nf). The particles were characterized by X-ray diffractometry, true density (using a helium pycnometer), surface area, and scanning electron microscopy. A 20 vol% of DCPD particles from the D, E, and F groups was added to the resin matrix to determine the degree of conversion (DC), biaxial flexural strength (BFS), the flexural modulus (FM), and surface roughness after an abrasive challenge (RA). A group with silanized barium glass particles was tested as a control. The data were submitted to ANOVA/Tukey's test (DC, BFS, and RA), and the Kruskal-Wallis test (FM) (alpha = 0.05). BFS values varied between 83 and 142 MPa, and the CN_ab group presented a similar value (123 MPa) to the control group. FM values varied between 3.6 and 8.7 GPa (CN_ab and CN_nf groups, respectively), with a significant difference found only between these groups. RA did not result in significant differences. The use of calcium nitrate solution as a receptor, together with ab initio functionalization formed particles with larger surface areas. Higher BFS values were observed for the material containing DCPD particles with a higher surface area. In general, the DC, FM, and RA values were not affected by the variables studied.

Development of brushite particles synthesized in the presence of acidic monomers for dental applications

OBJECTIVES

To synthesize and characterize brushite particles in the presence of acidic monomers (acrylic acid/AA, citric acid/CA, and methacryloyloxyethyl phosphate/MOEP) and evaluate the effect of these particles on degree of conversion (DC), flexural strength/modulus (FS/FM) and ion release of experimental composites.

METHODS

Particles were synthesized by co-precipitation with monomers added to the phosphate precursor solution and characterized for monomer content, size and morphology. Composites containing 20 vol% brushite and 40 vol% reinforcing glass were tested for DC, FS and FM (after 24 h and 60 d in water), and 60-day ion release. Data were subjected to ANOVA/Tukey tests (DC) or Kruskal-Wallis/Dunn tests (FS and FM, alpha: 5%).

RESULTS

The presence of acidic monomers affected particle morphology. Monomer content on the particles was low (0.1-1.4% by mass). Composites presented similar DC. For FS/24 h, only the composite containing DCPD_AA was statistically similar to the composite containing 60 vol% of reinforcing glass (without brushite, "control"). After 60 days, all brushite-containing materials showed similar FS, statistically lower than the control composite (p<0.01). Composites containing DCPD_AA, DCPD_MOEP or DCPD_U ("unmodified") showed statistically similar FM/24 h, higher than the control composite. After prolonged immersion, all composites were similar to the control composite, except DCPD_AA. Cumulative ion release ranged from 21 ppm to 28 ppm (calcium) and 9 ppm to 17 ppm (phosphate). Statistically significant reductions in ion release between 15 and 60 days were detected only for the composite containing DCPD_MOEP.

SIGNIFICANCE

Acidic monomers added to the synthesis affected brushite particle morphology. After 60-day storage in water, composite strength was similar among all brushite-containing composites. Ion release was sustained for 60 days and it was not affected by particle morphology.

Triethyleneglycol dimethacrylate addition improves the 3D-printability and construct properties of a GelMA-nHA composite system towards tissue engineering applications

In tissue engineering, there is a growing interest in the development of 3D printable bone tissue-inspired nanocomposites. However, most such nanocomposites have poor mechanical properties, owing to poor dispersion of the mineral phase (e.g. nano-hydroxyapatite, nHA) within the organic phase (e.g. methacrylated gelatin, GelMA) and low volume fractions of each phase. Triethyleneglycol dimethacrylate (TEGDMA) is commonly added to dental resin-based composites to improve the properties of the dental resin. Here, the effects of substituting a portion of the water phase in a GelMA-nHA composite with TEGDMA were evaluated. TEGDMA improved the dispersion of nHA within the highly-concentrated GelMA-based composite ink, as well as increased the ink's shear yield strength and reduced the critical energy for ink cure. As a result, the printability of the composite ink was greatly improved upon TEGDMA inclusion. Lastly, while the swelling of the cast composite in 37 °C water increased slightly, the mechanical properties (tensile strength, toughness, and stiffness) of the cast composite increased by at least an order of magnitude upon TEGDMA addition, and all composites demonstrated MSC cytocompatibility after 24 h. Overall, TEGDMA shows promise as an additive to tune properties of the GelMA-nHA system towards use in tissue engineering applications.

Physico-chemical and antimicrobial properties and the shelf life of experimental endodontic sealers containing metal methacrylates

The objective of this study was to evaluate the physico-chemical and antimicrobial properties of a dual polymerization experimental endodontic sealer (E) and experimental sealers containing dibutyltin methacrylate (Sn²⁺) (ETs) or calcium methacrylate (Ca²⁺) (ECs). The pH and ion release levels of the sealers were measured. The dimensional stability was evaluated in accordance with ISO 6876. Biofilm growth inhibition was evaluated using confocal laser scanning microscopy (CLSM). Biofilm viability analysis was performed using the SYTO 9 technique. The shelf life was evaluated through the degree of conversion and film thickness tests after the sealers had been stored for different periods of time. For statistical analysis, ANOVA and Tukey's post hoc test were used, with a significance level of 5%. ETs revealed better anti-biofilm potential after 15 days than that of the controls. The degree of conversion was reduced after the shelf-life period. The addition of calcium and dibutyltin methacrylate improved the anti-biofilm properties of the experimental endodontic sealer without impairing their physico-chemical properties.

Functionalized calcium orthophosphates (CaPO4) and their biomedical applications

Due to the chemical similarity to natural calcified tissues (bones and teeth) of mammals, calcium orthophosphates (abbreviated as CaPO₄) appear to be good biomaterials for creation of artificial bone grafts. However, CaPO₄ alone have some restrictions, which limit their biomedical applications. Various ways have been developed to improve the properties of CaPO₄ and their functionalization is one of them. Namely, since surfaces always form the interfaces between implanted grafts and surrounding tissues, the state of CaPO₄ surfaces plays a crucial role in the survival of bone grafts. Although the biomedically relevant CaPO₄ possess the required biocompatible properties, some of their properties could be better. For example, functionalization of CaPO₄ to enhance cell attachment and cell material interactions has been developed. In addition, to prepare stable formulations from nanodimensional CaPO₄ particles and prevent them from agglomerating, the surfaces of CaPO₄ particles are often functionalized by sorption of special chemicals. Furthermore, there are functionalizations in which CaPO₄ are exposed to various types of physical treatments. This review summarizes the available knowledge on CaPO₄ functionalizations and their biomedical applications.

Mechanical properties of experimental composites containing bioactive glass after artificial aging in water and ethanol

OBJECTIVES

To evaluate the effect of bioactive glass 45S5 (BG) in experimental composites on flexural strength (FS), flexural modulus (FM), modulus of resilience (MR), and material reliability after artificial aging in water for 1, 7, and 30 days, and an additional accelerated aging for 3 days in a 75 vol% ethanol-water solution.

MATERIALS AND METHODS

Five experimental light-curable composites were prepared with 0-40 wt% of BG and a total filler load of 70 wt%. The resinous matrix was Bis-GMA/TEGDMA in 60:40 by weight. Mechanical properties were evaluated using a three-point bending test (ISO/DIN 4049:1998) with n = 20. Weibull statistics were used to assess material reliability. Additionally, the degree of conversion (DC) was assessed 24 h post-cure using FT-Raman spectroscopy.

RESULTS

FS and FM decreased linearly as the amount of BG was increased. The ISO 4049 requirement for a minimum FS of 80 MPa was fulfilled in experimental composites with up to 20 wt% of BG. Degradation of FS and FM with artificial aging was more extensive in materials with higher BG amounts. MR decreased as a function of BG amount and artificial aging. Material reliability (Weibull modulus) was stable through aging for composites with up to 10 wt% of BG. DC was negatively influenced by the BG amount and ranged from 64 to 81%.

CONCLUSION

Increasing the amount of unsilanized BG fillers from 0 to 40 wt% resulted in a progressive decline in mechanical properties and a more extensive degradation during artificial aging.

CLINICAL RELEVANCE

Bioactive fillers diminished the mechanical properties in a dose-dependent manner.

Calcium phosphates as ion-releasing fillers in restorative resin-based materials

Calcium phosphates (CaP) are the main constituents of the mineral phase in bones and teeth and, along with calcium silicates and bioactive glasses, have been extensively investigated in remineralization of enamel and dentin. When used as ion-releasing fillers in resin-based materials, they could contribute to extend the service life of adhesive restorations, remineralize caries-affected dentin or prevent caries lesions under sealants and orthodontic brackets. However, the development of resin-based bioactive materials is not straightforward because of the several compositional variables involved in ion release. Also, CaP particles do not reinforce the material; therefore, if high mechanical properties are required, the ratio between CaP particles and reinforcing fillers must be observed. Several research groups have investigated how CaP phase, particle size and content, as well as resin matrix formulation affect remineralization, ion release kinetics and mechanical properties of these materials. This review presents an overview of the main findings reported in the literature.

Development of calcium phosphate/ethylene glycol dimethacrylate particles for dental applications

This study describes the synthesis of dicalcium phosphate dihydrate (DCPD) particles in the presence of different ethylene glycol dimethacrylates (EGDMA, ethylene glycol/EG units: 1, 2, 3 or 4) at two monomer-to-ammonium phosphate molar ratios (1:1 and 2:1), as a strategy to develop CaP-monomer particles with improved interaction with resin matrices. Particles displaying high surface areas and organic contents were added to a photocurable BisGMA-TEGDMA resin and the resulting materials were tested for degree of conversion (DC), biaxial flexural strength (BFS), flexural modulus, and ion release. Data were subjected to one-way ANOVA or Kruskal-Wallis/Dunn test (alpha: 0.05). Functionalization with EGDMA derivatives was dependent upon the length of the spacer group and monomer concentration in the synthesis. No differences in DC were observed among materials (p > 0.05). A 39% increase in BFS was obtained with the use of particles with the highest functionalization level compared to non-functionalized particles (p < 0.001). The use of functionalized DCPD reduced flexural modulus in comparison to non-functionalized particles (p < 0.001). Calcium release was similar among materials and remained constant during the experiment, while phosphate release was higher at 7 days in comparison to the remaining weeks (p < 0.001). In conclusion, diethylene glycol dimethacrylate resulted in the highest functionalization levels and the highest BFS among DCPD-containing materials. Ion release was not affected by functionalization. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 708-715, 2019.

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.

Streptococcus mutans adherence and biofilm formation on experimental composites containing dicalcium phosphate dihydrate nanoparticles

This study aimed at evaluating bacterial adhesion and biofilm formation on resin-based composites (RBC) including dicalcium phosphate dihydrate nanoparticles (nDCPD).

METHODS

Specimens were prepared from experimental RBCs with BisGMA/TEGDMA resin matrix including 20 vol% of either nDCPD (nDCPD-RBC), TEGDMA-functionalized nDPCD (F-nDCPD-RBC) or silanized silica (SiO₂-RBC). Neat resin blend (control-Resin), conventional nanohybrid RBC (control-RBC) and human enamel were used for reference. Characterization of the specimens included surface roughness (SR), surface free energy (SFE), chemical surface composition (EDS, XPS), and buffering ability of a pH = 4.00 solution. Streptococcus mutans adherence was assessed after 2 h; biofilm formation was simulated for 48 h using a bioreactor. Adherent, viable biomass was determined using tetrazolium salt assay (MTT).

RESULTS

nDCPD-RBC yielded highest roughness and showed higher polar and lower disperse component to total SFE. EDS and XPS indicated higher amounts of calcium and phosphate on the surface of nDCPD-RBC than on F-nDCPD-RBC. nDCPD buffered the acidic solution to 5.74, while functionalization almost prevented buffering (pH = 4.26). F-nDCPD-RBC reduced adherence and biofilm formation in comparison to nDCPD-RBC. Regardless of functionalization, biofilm formation on nDCPD-containing RBCs was not significantly different from SiO₂-RBC. Control-Resin, control-RBC, and enamel surfaces showed similar adherence values as F-nDCPD-RBC, but lower biofilm formation compared to both nDCPD-containing RBCs. In conclusion, the incorporation of nDCPD did not minimize S. mutans adherence and biofilm formation as a function of the materials´ surface properties. However, results observed for the buffering capacity indicated that optimized formulations of biomimetic RBCs may be useful for modulating their interaction with microorganisms.