Evaluation of dental adhesive systems incorporating an antibacterial monomer eugenyl methacrylate (EgMA) for endodontic restorations

Novel 1,2-Bismethacrylate-3-Eugenyl Propane for Resin Composites: Synthesis, Characterization, Rheological, and Degree of Conversion

This work aimed to synthesize a novel dimethacrylated-derivative of eugenol (Eg) (termed EgGAA) as potential biomaterial for certain applications such as dental fillings and adhesives. EgGAA was synthesized through a two-step reaction: (i) a mono methacrylated-eugenol (EgGMA) was produced via a ring-opening etherification of glycidyl methacrylate (GMA) with Eg; (ii) EgGMA was condensed with methacryloyl chloride into EgGAA. EgGAA was further incorporated in matrices containing BisGMA and TEGDMA (50:50 wt%) (TBEa), in which EgGAA replaced BisGMA as 0–100 wt% to get a series of unfilled resin composites (TBEa0–TBEa100), and by addition of reinforcing silica (66 wt%), a series of filled resins were also obtained (F-TBEa0–F-TBEa100). Synthesized monomers were analyzed for their structural, spectral, and thermal properties using FTIR, 1H- and 13C-NMR, mass spectrometry, TGA, and DSC. Composites rheological and DC were analyzed. The viscosity (η, Pa·s) of EgGAA (0.379) was 1533 times lower than BisGMA (581.0) and 125 times higher than TEGDMA (0.003). Rheology of unfilled resins (TBEa) indicated Newtonian fluids, with viscosity decreased from 0.164 Pa·s (TBEa0) to 0.010 Pa·s (TBEa100) when EgGAA totally replaced BisGMA. However, composites showed non-Newtonian and shear-thinning behavior, with complex viscosity (η*) being shear-independent at high angular frequencies (10–100 rad/s). The loss factor crossover points were at 45.6, 20.3, 20.4, and 25.6 rad/s, indicating a higher elastic portion for EgGAA-free composite. The DC was insignificantly decreased from 61.22% for the control to 59.85% and 59.50% for F-TBEa25 and F-TBEa50, respectively, while the difference became significant when EgGAA totally replaced BisGMA (F-TBEa100, DC = 52.54%). Accordingly, these properties could encourage further investigation of Eg-containing resin-based composite as filling materials in terms of their physicochemical, mechanical, and biological potentiality as dental material.

Insight into the development of versatile dentin bonding agents to increase the durability of the bonding interface

Despite the huge improvements made in adhesive technology over the past 50 years, there are still some unresolved issues regarding the durability of the adhesive interface. A complete sealing of the interface between the resin and the dentin substrate remains difficult to achieve, and it is doubtful whether an optimal interdiffusion of the adhesive system within the demineralized collagen framework can be produced in a complete and homogeneous way. In fact, it is suggested that hydrolytic degradation, combined with the action of dentin matrix enzymes, destabilizes the tooth-adhesive bond and disrupts the unprotected collagen fibrils. While a sufficient resin–dentin adhesion is usually achieved immediately, bonding efficiency declines over time. Thus, here, a review will be carried out through a bibliographic survey of scientific articles published in the last few years to present strategies that have been proposed to improve and/or develop new adhesive systems that can help prevent degradation at the adhesive interface. It will specially focus on new clinical techniques or new materials with characteristics that contribute to increasing the durability of adhesive restorations and avoiding the recurrent replacement restorative cycle and the consequent increase in damage to the tooth.

Characterization of Experimental Nanoparticulated Dental Adhesive Resins with Long-Term Antibacterial Properties

Experimental adhesives with functional nitrogen-doped titanium dioxide nanoparticles (N_TiO₂) have been shown to display improved properties. However, these materials have not been characterized regarding their degree of conversion (DC), biaxial flexure strength (BFS), surface roughness (SR), elastic modulus (EM), and long-term antibacterial functionalities. Experimental adhesives were synthesized by dispersing N_TiO₂ (10%, 20%, or 30%, v/v%) into OptiBond Solo Plus (OPTB, Kerr Corp., USA). Unpolymerized adhesives (volume = 50 μL/drop, n = 3/group) were individually placed onto a heated (37 °C) attenuated total reflectance (ATR) monolithic diamond crystal (Golden Gate, Specac). The spectra of composites were obtained with a Fourier-transform infrared (FTIR) spectrometer (Nicolet IS50; 500-4500 cm^-1; resolution = 4 cm^-1, 10 internal scans/spectrum) before and after polymerization. Disk-shaped specimens (diameter = 6.0 mm, thickness = 0.5 mm) for BFS (n = 12/group), SR and EM (n = 3/group), and for antibacterial testing (n = 18/group/time-point) were fabricated and photopolymerized (1 min each; 385-515 nm, 1000 mW/cm²; VALO). DC values (%) were calculated from pre- and post-polymerization spectra using the two-frequency method and tangent-baseline technique. BFS was assessed using a universal testing machine (Instron 68TM-5, crosshead speed = 1.27 mm/min, 25 °C). SR and EM were investigated using an atomic force microscope (Multimode 8) with aluminum-coated silicon probes (8 nm pyramidal tip, spring constant 40 N/m, Bruker). Antibacterial testing was performed by growing Streptococcus mutans biofilms (UA159-ldh, 37 °C, microaerophilic) on the surfaces of specimens for 24 h and then measuring the relative luminescence units (RLU) with a Biotek Synergy HT multi-well plate reader. Results demonstrate that experimental materials containing 10%, 20%, and 30% of N_TiO₂ displayed higher levels of DC, had better mechanical properties, and were able to exert strong and durable antibacterial properties without visible light irradiation and after extended periods of simulated shelf-life and aging in PBS. The reported experimental materials are expected to increase the service lives of polymer-based bonded restorations by decreasing the incidence of secondary caries.

Development and Physicochemical Characterization of Eugenia brejoensis Essential Oil-Doped Dental Adhesives with Antimicrobial Action towards Streptococcus mutans

Dental caries is a multifactorial, biofilm-dependent infectious disease that develops when detrimental changes occur in the oral cavity microenvironment. The antimicrobial and antivirulence properties of the essential oil obtained from the leaves of Eugenia brejoensis Mazine (EBEO) have been reported against Gram-positive and Gram-negative bacteria. Herein, the antimicrobial action of EBEO towards Streptococcus mutans is reported, along with the development and characterization of dental adhesives doped with. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of EBEO were determined against S. mutans, while its toxicity was analyze using Tenebrio molitor larvae. EBEO (MIC and 10×MIC) was incorporated into the Ambar Advanced Polymerization System® (Ambar APS), a two-step total-etch adhesive system (FGM Dental Group), and the antibiofilm action was evaluated. The reflective strength, modulus of elasticity, degree of conversion, and maximum rate of polymerization of each adhesive were also determined. The MIC and MBC values of EBEO against S. mutans were 62.5 µg/mL. The tested concentrations of EBEO were non-toxic to T. molitor larvae. The formation of S. mutans biofilms was significantly inhibited by EBEO and EBEO-coated resin discs (p < 0.05). Importantly, EBEO incorporation did not affect the mechanical and physicochemical properties in relation to oil-free adhesive version. EBEO showed strong antibacterial and antibiofilm activity against S. mutans, no toxicity effect against T. molitor larvae, and did not jeopardize the physical-chemical properties tested.

Antimicrobial polymeric biomaterials based on synthetic, nanotechnology, and biotechnological approaches

Antimicrobial resistance is the main threat to biomaterial failure with a huge impact on National Health Systems and patients' quality of life. Materials engineering and biotechnology have experienced great advances and have converged in the development of new and more sophisticated biomimetic systems with antimicrobial properties. In this sense, polymeric biomaterials play and will play a key role in the development of new antimicrobial devices for biomedical applications. In this Current Opinion article, we review recent and relevant advances reported in the field of polymeric biomaterials with antimicrobial properties with the potential to be applied in the clinic, that is, antimicrobial polymers, antifouling surfaces, nanodelivery systems of antibiotics and antiseptic drugs, biocide polymer-metal hybrid systems, and engineered living materials that actively interact with the pathogen. We conclude with a discussion on the implications of the results for clinical practice and future research.

The influence of methodology on the comparison of cytotoxicity of total-etch and self-etch adhesive systems

OBJECTIVES

The present study aimed to compare the in vitro cytocompatibility of two etch-and-rinse (Adper Scothbond, Optibond) and two self-etch (Clearfill SE Bond and Single Bond Universal) dental adhesives through a dentin-barrier model with human pulp fibroblasts.

METHODS

Human fibroblasts were placed on a plastic device containing 500μm human dentin discs treated with each adhesive or without treatment (control). Other groups were directly exposed to media conditioned with adhesive samples according to ISO 10993-5:2009. After 24h exposure, cell viability was assessed by XTT, and released inflammatory mediators were detected with a multiparametric immunoassay.

RESULTS

The standardized test without barrier indicated both etch-and-rinse adhesives and self-etch as cytotoxic, promoting viabilities under 70% of the control group (p<0.05). The dentin-barrier model identified increased cell viability for self-etch adhesives, with Clearfill SE Bond identified as non-cytotoxic. The immunoassay evidenced high rates of cytokines by cells exposed to the conditioned media of Adper Scotchbond, Optibond S, and Single Bond Universal.

CONCLUSIONS

The use of a dentin-barrier in vitro model detected a better biocompatibility for self-etching adhesives and, in the case of Clearfill SE Bond, with a reversion from cytotoxic to biocompatible when compared to the indirect standardized test.

CLINICAL SIGNIFICANCE

The use of a dentin-barrier in vitro model was able to detect a better biocompatibility for self-etching adhesives when compared to the indirect standardized test and presents itself as a predictive in vitro method for assessing the cytotoxicity of dental restorative materials that may simulate the clinical condition more accurately.

A multi-functional dentine bonding system combining a phosphate monomer with eugenyl methacrylate

OBJECTIVE

The tooth-resin composite interface is frequently associated with failure because of microbial contamination, hydrolytic and collagenolytic degradation. Thus, designing a dentine bonding system (DBS) with an intrinsically antimicrobial polymerisable monomer is of significance especially if it can be used with self-etching primers enabling resistance to degradation of the interface.

METHODS

Experimental adhesives were developed incorporating eugenyl methacrylate (EgMA) at concentrations of 0,10 or 20 wt%, designated as EgMA0, EgMA10 and EgMA20, respectively, for use as a two-step self-etch DBS with the functional monomer bis[2-(methacryloyloxy) ethyl] phosphate (BMEP) in the primer. The curing, thermal and wettability properties of the adhesives were determined, and hybrid layer formation was characterised by confocal laser scanning microscopy, microtensile bond strengths (µTBS) and nanoleakage by back-scattered SEM. In situ zymography was used to assess MMP inhibitory activity of the BMEP-EgMA DBS.

RESULTS

EgMA in the adhesives lowered the polymerisation exotherm and resulted in higher Tg, without negatively affecting degree of conversion. Water sorption and solubility were significantly lower with higher concentrations of EgMA in the adhesive. The formation of a distinct hybrid layer was evident from confocal images with the different adhesives, whilst EgMA20 yielded the highest µTBS post water storage challenges and lowest nanoleakage after 6 months. The experimental DBS exhibited minimal to no MMP activity at 3 months.

SIGNIFICANCE

The hydrophobic nature of EgMA and high cross-link density exerts considerable benefits in lowering water uptake and polymerisation exotherm. The application of EgMA, adhesives in conjunction with BMEP in a multi-functional self-etching DBS can resist MMP activity, hence, enhance longevity of the dentine-resin composite interface.

Water Sorption, Water Solubility, and Rheological Properties of Resin-Based Dental Composites Incorporating Immobilizable Eugenol-Derivative Monomer

The present study aimed to evaluate the properties of new dental formulations incorporating a new polymerizable-derivative of eugenol (EgGMA). The experimental composites were prepared (by weight) with 35% resin-based matrix (1:1, bisphenol A-glycidyl methacrylate/triethylene glycol dimethacrylate) and 65% reinforcing materials (4:3, hydroxyapatite/zirconium oxide). A portion of 0.0, 2.5, and 5.0% of the resins with respect to the total composite was replaced by EgGMA monomer to obtain TBEg0, TBEg2.5, and TBEg5, respectively. The complex viscosity (at 25 and 37 °C), degree of conversion (DC), and water sorption (W_SP) and water solubility (W_SL) (3 cycles of sorption-desorption process) were investigated. Data were statistically analyzed using one-way and Tukey post-hoc tests. The results revealed a viscosity reduction with shear-thinning behavior as the EgGMA amount and temperature increased. The average complex viscosities at a lower frequency (ω = 1.0 rad/s) and at 25 °C were 234.7 ± 13.4, 86.4 ± 16.5, and 57.3 ± 17.1 (kPa·s) for TBEg0, TBEg2.5, and TBEg5, respectively. The inclusion of EgGMA led to a lower DC and W_SP but higher W_SL, compared to those of the reference (TBEg0). However, no significant differences between TBEg2.5 and control were detected (p > 0.05). Therefore, the incorporation of EgGMA in a low quantity, e.g., up to 8.45 mol% of resins, within the matrix may enhance the composite’s performance, including handling and solubility properties without any apparent effect on DC and water sorption, making it a promising monomeric biomaterial for various applications including restorative dentistry.

Eugenyl-2-Hydroxypropyl Methacrylate-Incorporated Experimental Dental Composite: Degree of Polymerization and In Vitro Cytotoxicity Evaluation

The aim of this study was to evaluate the properties of new dental formulations containing eugenyl-2-hydroxypropyl methacrylate (EgGMA) monomer, as restorative dental material, in terms of their degree of photopolymerization and cytotoxicity. The target model composites (TBEg0, TBEg2.5, and TBEg5) were prepared by mixing 35% organic matrix (TEGDMA/BisGMA (50/50 wt%) of which 0, 2.5, and 5 wt%, respectively, were replaced with EgGMA monomer) with 65% filler (silanized hydroxyapatite (HA)/zinc oxide (ZnO₂), 4:3 by weight). The vinylic double-bond conversion (DC) after light-curing was studied using Fourier transform infrared technique whereas cell viability was in vitro tested using primary human gingival fibroblasts cells over 7 days by means of AlamarBlue colorimetric assay. The obtained data were statistically analyzed using ANOVA and Tukey post-hoc tests. The results revealed no significant difference in DC between TBEg2.5 (66.49%) and control (TBEg0; 68.74%), whereas both differ significantly with TBEg5, likely due to the inhibitory effect of eugenol moiety at high concentration. The cell viability test indicated that all the composites are biocompatible. No significant difference was counted between TBEg2.5 and TBEg5, however, both differed significantly from the control (TBEg0). Thus, even though its apparent negative effect on polymerization, EgGMA is potentially safer than bisphenol-derived monomers. Such potential properties may encourage further investigations on term of EgGMA amount optimization, compatibility with other dental resins, and antimicrobial activity.

Effects of Adper™ Scotchbond™ 1 XT, Clearfil™ SE Bond 2 and Scotchbond™ Universal in Odontoblasts

This study aimed to assess the cytotoxicity of commercially available adhesive strategies-etch-and-rinse (Adper™ Scotchbond™ 1 XT, 3M ESPE, St. Paul, MN, USA, SB1), self-etch (Clearfil™ SE Bond 2, Kuraray Noritake Dental Inc., Tokyo, Japan, CSE), and universal (Scotchbond™ Universal, 3M Deutschland GmbH, Neuss, Germany, SBU). MDPC-23 cells were exposed to adhesives extracts in different concentrations and exposure times. To access cell metabolic activity, viability, types of cell death, and cell cycle, the MTT assay, SRB assay, double labeling with annexin V and propidium iodide, and labeling with propidium iodide/RNAse were performed, respectively. Cultures were stained with May-Grünwald Giemsa for qualitative cytotoxicity assessment. The SB1, CSE, and SBU extracts determined a significant reduction in cell metabolism and viability. This reduction was higher for prolonged exposures, even for less concentrated extracts. CSE extracts significantly reduced the cell's metabolic activity at higher concentrations (50% and 100%) from 2 h of exposure. After 24 and 96 h, a metabolic activity reduction was verified for all adhesives, even at lower concentrations. These changes were dependent on the adhesive, its concentration, and the incubation time. Regarding cell viability, SBU extracts were the least cytotoxic, and CSE was significantly more cytotoxic than SB1 and SBU. The adhesives determined a reduction in viable cells and an increase in apoptotic, late apoptosis/necrosis, and necrotic cells. Moreover, on cultures exposed to SB1 and CSE extracts, a decrease in the cells in S and G2/M phases and an increase in the cells in G0/G1 phase was observed. Exposure to SBU led to an increase of cells in the S phase. In general, all adhesives determined cytotoxicity. CSE extracts were the most cytotoxic and were classified as having a higher degree of reactivity, leading to more significant inhibition of cell growth and destruction of the cell's layers.

Model system parameters influence the sodium hypochlorite susceptibility of endodontic biofilms

AIM

To evaluate in a laboratory setting the influence of several model system parameters on the sodium hypochlorite (NaOCl) susceptibility of endodontic biofilms. Based on these findings, a relevant in vitro endodontic biofilm model is proposed.

METHODOLOGY

In vitro biofilms were cultured, varying the following experimental model parameters: biofilm composition (monospecies Enterococcus faecalis and a multispecies biofilm including E. faecalis, Fusobacterium nucleatum, Prevotella intermedia and Porphyromonas gingivalis), incubation time (24 h or 11 days), incubation atmosphere (aerobically or anaerobically) and biofilm substrate (polystyrene microtiter plate wells, hydroxyapatite or dentine). Biofilms were subjected to treatment with NaOCl (0.025%, 0.1%, 0.5%, 2.5%) for 1 min, control groups included treatment with purified water. Biofilms were harvested and the number of surviving cells was determined by plate counting using general (monospecies biofilms) or selective (multispecies biofilms) media. A two-way ANOVA was used to explore the effect of the model parameters on biofilm eradication. Finally, the most physiologically relevant biofilm model (11-day-old multispecies biofilm grown anaerobically on dentine discs) was characterized by selective media plate counting, NaOCl susceptibility testing, scanning and transmission electron microscopy.

RESULTS

There was no difference in NaOCl eradication between the anaerobically and aerobically grown E. faecalis biofilms. One-day-old biofilms of E. faecalis were more susceptible to most tested NaOCl concentrations than 11-day-old biofilms (p < .05). When grown in a multispecies biofilm, E. faecalis was significantly less susceptible to NaOCl treatment than in a monospecies biofilm (p < .05). E. faecalis in a multispecies biofilm grown in a MTP was more susceptible to NaOCl (0.025% and 0.1%) than when grown on hydroxyapatite or dentine. No difference in biofilm NaOCl susceptibility was seen between hydroxyapatite and dentine. The multispecies biofilm proved to be a reproducible model with high NaOCl resistance, complex structure and organization.

CONCLUSION

The parameters biofilm age, biofilm composition and substrate had a significant influence on the NaOCl susceptibility of E. faecalis biofilms. Older biofilms, multispecies biofilms and biofilms grown on dentine and hydroxyapatite had reduced NaOCl susceptibility. These findings emphasize the importance of selecting relevant parameters when designing a laboratory biofilm model system for the evaluation of antimicrobial treatments.

The Bond Strength and Antibacterial Activity of the Universal Dentin Bonding System: A Systematic Review and Meta-Analysis

Streptococcus mutans (S. mutans) is a group of viridans mostly located in oral flora among the wide and biodiverse biofilm. It plays a significant role not only in caries formation but also triggering intracerebral haemorrhage. The durable and stable bond interface, besides bacteria elimination, is one of the crucial factors influencing the resin composite restoration performance. This study aimed to evaluate universal adhesives (UAs) with regard to in vitro bond strength to dentin, and the inhibition of the S. mutans growth and compare them with UAs modified with antimicrobial agents through a systematic review and meta-analysis. Two reviewers performed a literature search up to April 2021 in 5 electronic databases: PubMed MedLine, Scielo, ISI Web of Science, Scopus, and EMBASE. Only in vitro studies reporting the effect of modifying UAs with antimicrobial agents on the bond strength to dentin and/or on the inhibition of the S. mutans were included. Analyses were carried out using Review Manager Software version 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). The methodological quality of each in vitro study was evaluated following the parameters of a previous systematic review. A total of 1716 potentially relevant publications were recognized. After reviewing the title and abstract, 16 studies remained in the systematic review. From these, a total of 3 studies were included in the meta-analysis. Since data from the studies included in the antimicrobial outcome included zero values, they could not be meta-analysed. Including 0 values in the analysis will lead to several biases in the analysis, so these data were discarded. The antibacterial effect against S. mutans of UAs modified with antimicrobial agents was higher than the non-modified adhesive systems. Within the limitations of the present study, the bond strength of UAs to dentin could be improved by using antimicrobial agents. The UAs modified with antibacterial agents showed a decrease in the viability of S. mutans biofilm, among the adhesives tested. However, there are not enough valid data on antibacterial properties of modified UAs; therefore, more well-designed research on these materials is needed.

Bibliometric Analysis of Literature Published on Antibacterial Dental Adhesive from 1996-2020

This study aimed to investigate the current state of research on antibacterial dental adhesives. The interest in this field can be drawn from an increasing number of scholarly works in this area. However, there is still a lack of quantitative measurement of this topic. The main aim of this study was to consolidate the research published on the antibacterial adhesive from 1996 to 2020 in Web of Science indexed journals. The bibliometric method, a quantitative study of investigating publishing trends and patterns, was used for this study. The result has shown that a gradual increase in research was found, whereby a substantial increase was observed from 2013. A total of 248 documents were published in 84 journals with total citations of 5107. The highly cited articles were published mainly in Q1 category journals. Most of the published articles were from the USA, China, and other developed countries; however, some developing countries contributed as well. The authorship pattern showed an interdisciplinary and collaborative approach among researchers. The thematic evaluation of keywords along with a three-factor analysis showed that 'antibacterial adhesives' and 'quaternary ammonium' have been used commonly. This bibliometric analysis can provide direction not only to researchers but also to funding organizations and policymakers.

Antibacterial Bio-Based Polymers for Cranio-Maxillofacial Regeneration Applications

Cranio-maxillofacial structure is a region of particular interest in the field of regenerative medicine due to both its anatomical complexity and the numerous abnormalities affecting this area. However, this anatomical complexity is what makes possible the coexistence of different microbial ecosystems in the oral cavity and the maxillofacial region, contributing to the increased risk of bacterial infections. In this regard, different materials have been used for their application in this field. These materials can be obtained from natural and renewable feedstocks, or by synthetic routes with desired mechanical properties, biocompatibility and antimicrobial activity. Hence, in this review, we have focused on bio-based polymers which, by their own nature, by chemical modifications of their structure, or by their combination with other elements, provide a useful antibacterial activity as well as the suitable conditions for cranio-maxillofacial tissue regeneration. This approach has not been reviewed previously, and we have specifically arranged the content of this article according to the resulting material and its corresponding application; we review guided bone regeneration membranes, bone cements and devices and scaffolds for both soft and hard maxillofacial tissue regeneration, including hybrid scaffolds, dental implants, hydrogels and composites.

Morpho-functional effects of different universal dental adhesives on human gingival fibroblasts: an in vitro study

To analyze the effects of four universal adhesives (Optibond Solo Plus—OB, Universal Bond—UB, Prime&Bond Active—PBA, FuturaBond M + —FB) on human gingival fibroblasts in terms of cytotoxicity, morphology and function. After in vitro exposure for up to 48 h, fibroblast viability was determined by the MTT assay determined, morphology by phase-contrast microscopy and migration by the scratch wound assay. Expression levels of IL1β, IL6, IL8, IL10, TNFα and VEGF genes were assessed by RT-PCR and their protein production by Western blot analysis. Apoptosis and cell cycle were analyzed by flow cytometry. OB and UB induced early morphological changes on fibroblasts (3 h) with extended cell death at 24 h/48 h. Gene expression of collagen type I and fibronectin increased fivefold compared with controls, elastin disappeared and elastase increased threefold, indicating gingival tissue tended to become fibrotic. Only UB and OB increased gene expression of inflammatory markers: IL1β at 3 and 48 h (up to about three times), IL6 and IL8 at 3 h (up to almost four times) which corresponded to the increase of the activated form NF-kB. All adhesives showed an effect on the functionality of fibroblasts with cytotoxic effect time and concentration dependent. Among all the OB and UB adhesives, they showed the greatest cell damage. The in-depth analysis of the effects of universal adhesives and possible functional effects represents an important information for the clinician towards choosing the most suitable adhesive system.

Structural stability of DHMAI antibacterial dental composite following in vitro biological aging

OBJECTIVE

To assess the impact of the quaternary ammonium antibacterial agent, Dimethyl-Hexadecyl-Methacryloxyethyl-Ammonium Iodide (DHMAI), on structural stability of an experimental resin composite after biological aging.

METHODS

Experimental resin composites containing 7.5% of DHMAI were incubated in a biological medium in the presence of a Streptococcus Mutans (SM) strain during 3 months. The physicochemical, mechanical, and thermal properties, before and after 3 months of aging, were evaluated using: Degree of Conversion (DC), Residual Functions (RF), Vitreous Transition (Tg), Thermal Expansion Coefficient (CTE) and thermal degradation using Fourier Transform Infrared Spectroscopy Analysis (FTIRATR), Differential Scanning Calorimetry (DSC), Thermo Mechanical analyses (TMA) and Thermo Gravimetric Analysis (TG).

RESULTS

Incorporation of DHAMI increased DC and decreased RF. After aging, DHMAI decreased and slowed RF release. Incorporation of 7.5% DHAMI provided significant modification of the thermal behavior (Tg and thermal degradation) but did not affect CTE. After aging, DHMAI enhanced the structural stability and improved resistance against biodegradation compared to the control composite.

SIGNIFICANCE

The development of an antibacterial dental composite based on DHMAI improved its physical, mechanical, and thermal behaviors, possibly enhancing dental composite longevity. Results suggest that DHMAI could be used in the composition of other bioactive dental materials.

The Cytotoxicity and Genotoxicity of Three Dental Universal Adhesives-An In Vitro Study

Dental universal adhesives are considered an useful tool in modern dentistry as they can be used in different etching techniques, allow for simplified protocol and provide sufficient bond strength. However, there is still no consensus as to their toxicity towards pulp. Thus, the present study aimed to evaluate the cytotoxicity and genotoxicity of three universal adhesives: OptiBond Universal, Prime&Bond Universal and Adhese in an in vitro experimental model, monocyte/macrophage cell line SC (ATCC CRL-9855). The cytotoxicity was measured by means of XTT assay, whereas the genotoxicity (comet assay) was evaluated based on the percentage of DNA present in the comet tail. Furthermore, the ability of the adhesives to induce apoptosis was analyzed using flow cytometry (FC) with the FITC annexin V/propidium iodide (PI) double staining. The analysis of the cell cycle progression was performed with FC using PI staining. OptiBond Universal presented significant, while Prime&Bond Universal and Adhese Universal had minimal cytotoxicity and genotoxicity towards human SC cells. Moreover, only OptiBond Universal increased the level of apoptosis in SC cell line. None of the adhesives showed significant cell cycle arrest, as revealed by FC analysis. Due to substantial differences in toxicity in in vitro studies of dental adhesives, there is a great need for further research in order to establish more reliable test protocols allowing for standardized methodology.

Synthesis of antibacterial dimethacrylate derived from niacin and its application in preparing antibacterial dental resin system

In this research, a bio-based monomer 1,3-bis(methacryloyloxy)propyl-carbonyl- hexylpyridinium bromide (QANMA) that derived from niacin was synthesized and incorporated into Bisphenol A glycidyl methacrylate (Bis-GMA)/triethylene glycol dimethacrylate (TEGDMA) (50 wt/50 wt) with a series of mass fraction as antibacterial agent. The double bond conversion (DC), volumetric shrinkage (VS), mechanical properties, water sorption (WS) and solubility (SL) were investigated among groups with different QANMA concentrations. Antibacterial activity against S. mutans were conducted by bacteria colony counting and bacteria LIVE/DEAD staining. The results showed that QANMA had no influence on DC of dental resin (p > 0.05), but would lead to lower volumetric shrinkage (p < 0.05). Only dental resin with 10 wt% and 20 wt% of QANMA showed obviously antibacterial activity. Mechanical properties, WS and SL of dental resin could be impaired by incorporation QANMA, flexural strength and modulus were decreased with the increasing of QANMA concentration (p < 0.05), while WS and SL were increased with the increasing of QANMA concentration (p < 0.05). Dental resin with 10 wt% of QANMA seemed to be the optimal resin system in this research, for it showed significant antibacterial activity and its flexural strength was still met the requirement of ISO standard. This work suggested that bio-based monomer QANMA could be used as antibacterial agent in dental materials, but further optimization experiment and biocompatibility evaluation should be taken in future.

Physicomechanical and thermal analysis of bulk-fill and conventional composites

The aim of this study was to evaluate the degree of conversion (DC) and the thermal stability of bulk-fill and conventional composite resins. Eleven composite resin samples were prepared to evaluate the DC, Vickers microhardness (VMH), mass and residue/particle loss, glass transition temperature (Tg), enthalpy, and linear coefficient of thermal expansion (CTE) using infrared spectroscopy (FTIR), microdurometer analyses, thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), and dilatometry (DIL). The data were subjected to statistical analysis, with a significance level of 95%. DC and VMH were not influenced by the polymerized side of the sample, and statistical differences were recorded only among the materials. Decomposition temperature, melting, and mass and residue loss were dependent on the material and on the evaluation condition (polymerized and non-polymerized). Tg values were similar between the composites, without statistically significant difference, and CTE ranged from 10.5 to 37.1 (10-6/°C), with no statistical difference between the materials. There was a moderate negative correlation between CTE and the % of load particles, by weight. Most resins had a DC above that which is reported in the literature. TGA, Tg, and CTE analyses showed the thermal behavior of the evaluated composites, providing data for future research, assisting with the choice of material for direct or semidirect restorations, and helping choose the appropriate temperature for increasing the DC of such materials.

In vitro cytotoxicity of dental adhesives: A systematic review

OBJECTIVES

The increased demand for esthetics and minimally invasive tooth restorations resulted in a rapid development of adhesive dentistry. However, much controversy remains about the safe use and cytotoxic effects of different groups of dental adhesives. The present study performed a systematic review to identify the answer to the following question: are self-etch adhesives more cytotoxic than those employing the etch-and-rinse system?

METHODS

This systematic review was performed in accordance with the PRISMA statement; a quality assessment for in vitro studies was conducted using the ToxRTool. Specific search strategies were developed and performed in the electronic databases MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, and LILACS/BBO. After removal of duplicated studies and application of the exclusion criteria, ten eligible articles were selected and submitted to a qualitative descriptive analysis comparing both groups of dental adhesives. Most in vitro test systems employed pulp cells or gingival fibroblasts.

RESULTS

The methodologies presented great variability regarding the exposure to the test materials. Only four studies assessed the role of the degree of conversion of the materials in their toxicity, with conflicting results.

SIGNIFICANCE

While the lack of methodological standardization among the studies still hinders the establishment of a relationship between type of dental adhesive and toxicity, studies employing dentin barrier systems indicate greater cytotoxicity for etch-and-rinse adhesives.

Synthesis and characterization of silica-chitosan hybrid materials as antibacterial coatings for titanium implants

To avoid dental implant-related infections and to promote the osseointegration of titanium implants, the application of silicon and chitosan containing coatings is proposed. Silicon is a well-known osteogenic element and chitosan was selected to confer the antibacterial properties. The synthesis of hybrid silica-chitosan coatings using the sol-gel process is presented and the characterization using ²⁹Si-NMR to verify the correct formation of the network is discussed. The ¹³C NMR spectroscopy was used to confirm the covalent union between chitosan and the silicon network. Hydrolytic degradation and silicon release studies showed the effective silicon release from the hybrids and, hence, the possibility to promote bone formation. The introduction of different amounts of chitosan and tetraethyl orthosilicate (TEOS) modulated the Si release. The analysis of cell cultures in vitro demonstrated that the hybrid coatings were not cytotoxic and promoted cell proliferation on their surfaces. The coatings containing 5%-10% chitosan had substantial antibacterial properties.

Piperonyl methacrylate: Copolymerizable coinitiator for adhesive compositions

OBJECTIVES

This study describes the synthesis of piperonyl methacrylate (PipM) and evaluates its effect when used as coinitiator in the photoinitiated radical polymerization of experimental adhesive resins.

METHODS

PipM was synthetized through an esterification reaction and characterized by FTIR and ¹H NMR spectroscopy. Adhesive resins containing camphorquinone as photoinitiator and PipM or ethyl-4-dimethyl amine benzoate (EDAB) as coinitiators were formulated. Scotchbond Multipurpose (SBMP) adhesive was used as commercial reference. All materials were analyzed for polymerization kinetics, flexural strength, elastic modulus, water sorption/solubility, shear bond strength to bovine enamel and dentin, characterization of hybrid layer by scanning electron microscopy (SEM), microbiological direct contact test, and cytotoxicity.

RESULTS

The adhesive with PipM presented higher degree of conversion and lower sorption/solubility when compared with other groups. Shear bond strength to enamel and dentin were similar for PipM and EDAB materials. The percentage of cellular viability was close to 100% and similar in the experimental groups and the commercial reference.

CONCLUSIONS

PipM presented similar or superior performance to the tertiary amine used as control, representing a potential alternative coinitiator for photopolymerizable dental materials.

CLINICAL SIGNIFICANCE

PipM could be potentially useful in the formulations of adhesive systems with enhanced chemical properties, which could mean improvement in the longevity of composite resin restorations.

Effect of heat treatment on cytotoxicity of self-adhesive resin cements: Cell viability analysis

Objective

The aim of the study was to assess, in vitro, the influence on cytotoxicity of heat treatment applied before photopolymerization, while mixing three self-adhesive resin cements, in an NIH/3T3 fibroblast cell culture, based on cell viability measures.

Methods

Samples were divided into three groups: (1) no heat treatment while mixing (control), (2) 37°C, and (3) 60°C heat treatment while mixing. Cements were light-cured immediately after mixing and immersed in Dulbecco's Modified Eagle Media for the extraction of possibly uncured products after 24 h and 7 days. Cultures contained 0.5 mL of NIH/3T3 fibroblasts per well at a concentration of 0.4 × 10⁵ cells/mL and specific extracts for each sample.

Statistical Analysis Used

Data were statistically analyzed with ANOVA and post hoc Student-Newman-Keuls (significance of 5%).

Results

Cement cytotoxicity increased with time, as shown by the higher values observed at 7 days. There was a slight difference in intragroup cytotoxicity levels between 24 h and 7 days. Heat treatment at 60°C was associated with a major decrease in cytotoxicity levels in all three groups, both at 24 h and at 7 days, with no differences among the cements.

Conclusions

Heat treatment at 60°C should be considered as a strategy to reduce cytotoxicity of self-adhesive resin cements, as evidenced by the results observed at 24 h and 7 days of analysis.

Design Variability of the Push-out Bond Test in Endodontic Research: A Systematic Review

INTRODUCTION

There is limited literature on the impact of testing variables on the push-out bond test (POBT). This review identified designs of the POBT used in the endodontic literature and aimed to determine which experimental variables may influence the push-out bond strength (POBS).

METHODS

A systematic review based on PRISMA guidelines was performed by searching the PubMed, SCOPUS, and Cochrane library databases using terms including push-out and dislocation resistance and descriptions of endodontic materials. Test variables assessed included method of root preparation, timing of sectioning compared with filling, thickness, diameter and taper of sections, and plunger size and velocity. The POBS of 3 common materials (gutta-percha and AH Plus, mineral trioxide aggregate, and Biodentine) were collected from investigations, and a comparison was attempted.

RESULTS

One hundred thirty-three studies assessed the POBS of root-filling materials, 68 assessed root repair cements/root-end filling materials, and 16 assessed orifice barrier materials other than mineral trioxide aggregate. There was significant variation in all of the assessed variables, resulting in a large range of reported values for the POBS of the various materials. Because of this heterogeneity in study design, no further statistical analysis of the impact of the test variables on POBS was possible.

CONCLUSIONS

There was considerable variation in the POBT design used in endodontic research. Greater standardization is required for future research as well as accurate reporting for all test variables to assess the impact of specific design variables on POBS.