Do collagen cross-linkers improve dentin’s bonding receptiveness?

Chemical analysis of n-propyl gallate used as pre-treatment for resin-dentin bond strength: In vitro study

This study aimed to evaluate the effect of n-propyl gallate as pre-treatment for resin-dentin bond strength. The dentin pre-treatments evaluated included propyl gallate of concentrations 0.1% (w/v), 1.0% (w/v), and 10.0% (w/v), as well as glutaraldehyde 5.0% (v/v), and distilled water as a control treatment. Dentin specimens were prepared for Fourier Transformed Infrared Spectroscopy (FT-IR) (n = 3/pre-treatment). Pre-treatments were actively applied to dentin blocks before performing the adhesive procedure to composite resin. Microtensile bond strength to dentin (μTBS) (n = 8/pre-treatment) was determined after 24 h and 6 months of storage. Data were submitted to a two-way ANOVA, followed by Tukey's post hoc test. As for FT-IR, propyl gallate 1%-treated specimens presented higher water, carbonate, collagen, and amide absorbance rates compared to other tested groups, while specimens pre-treated with glutaraldehyde and distilled water presented similar absorbance curves. Regarding μTBS, all concentrations of propyl gallate resulted in statistically significant higher bond strength values than distilled water at 24 h. After 6 months of storage, propyl gallate 0.1% was the only group that maintained μTBS over time. Propyl gallate 0.1% might be a suitable dentinal pre-treatment due to being able to present chemical bonds with demineralized dentin and providing resin-dentin bond stability after 6 months of storage.

Formulating an altered dentin substrate to improve dentin bonding

STATEMENT OF PROBLEM

Secondary caries is a major factor in the failure of dental restorations. However, studies on the fabrication of acid-resistant and antibacterial dentin to improve dentin bonding are sparse.

PURPOSE

The purpose of this in vitro study was to compare the effects of 2 types of fluoride-containing etchants on dentin bonding and explore the feasibility of formulating an altered dentin substrate to improve dentin bonding.

MATERIAL AND METHODS

NaF-containing and SnF2-containing etchants were developed by adding sodium fluoride and stannous fluoride to a 35% phosphoric acid aqueous solution. Two groups (N1 and N2) containing NaF, 10 and 30 mg/mL respectively, and 2 groups (S1 and S2) containing SnF2, 18.6 and 55.8 mg/mL respectively, were formulated. The etchant of the control group (C) was 35% phosphoric acid gel. Scanning electron microscopy (SEM), energy dispersive spectrometry (EDS), Fourier transform infrared spectroscopy (FTIR), microhardness, antierosion, and antibacterial tests were performed on the treated dentin. Moreover, the microtensile bond strength (µTBS) of each group was tested, and the fracture mode was determined after testing. Statistical analysis was performed with the 2-way ANOVA test (α=.05).

RESULTS

The exposed collagen fiber was observed in group C, and minerals were formed on the dentin in the experimental groups. SEM, FTIR, and the microhardness test indicated more remineralization in the SnF2-containing etchant groups. The µTBS of S1 (77.5 ±10.36 MPa) was the highest in all groups, and group C (38.5 ±9.01 MPa) was the lowest. Moreover, the antierosion and antibacterial properties of the S2 group were the best among all groups (P<.05).

CONCLUSIONS

Compared with NaF-containing etchant, SnF2-containing etchant could improve the dentin substrate, increase remineralization, improve bonding strength, and enhance antibacterial ability, especially by increasing resistance to acid erosion.

Effect of polyhydroxy-terminated PAMAM dendrimer on dentin matrix metalloproteinases within the hybrid layers

BACKGROUND

Intrafibrillar remineralization within the hybrid layers (HLs) has recently attracted extensive attention in achieving durable resin-dentin bonds. The polyhydroxy-terminated poly(amidoamine) dendrimer (PAMAM-OH) at fourth generation becomes a desirable candidate to induce intrafibrillar remineralization to protect exposed collagen fibrils within HLs based on the size exclusion effect of fibrillar collagen. However, the remineralization process in vivo is time-consuming, during which the exposed collagen fibrils are vulnerable to enzymatic degradation, resulting in unsatisfactory remineralization. Thereby, if PAMAM-OH itself possesses concomitant anti-proteolytic activity during the induction of remineralization, it would be very beneficial to obtain satisfactory remineralization.

METHODS

Binding capacity tests using adsorption isotherm and confocal laser scanning microscopy (CLSM) were performed to assess if the PAMAM-OH had adsorption capacity on dentin. Anti-proteolytic testings were detected by MMPs assay kit, in-situ zymography and ICTP assay. Adhesive infiltration of resin-dentin interface and tensile bond strength before and after thermomechanical cycling were implemented to assess if the PAMAM-OH adversely affected resin-dentin bonds.

RESULTS

Anti-proteolytic testings performed using MMPs assay kit, in-situ zymography and ICTP assay indicated that PAMAM-OH inhibited exogenous soluble MMP-9 as well as had inhibitory effect on the endogenous proteases. Adhesive infiltration of resin-dentin interface and tensile bond strength before and after thermomechanical cycling were implemented to indicate that the PAMAM-OH pretreatment had no adverse effects on immediate dentin bonding and prolonged the durability of resin-dentin bonds.

CONCLUSIONS

PAMAM-OH possesses anti-proteolytic activity and prevents exposed collagen fibrils within HLs from degradation, which lays the foundation for the satisfactory intrafibrillar remineralization induced by PAMAM-OH within HLs to achieve durable resin-dentin bonds in the next work.

Effect of dentin biomodification using natural collagen cross-linkers on the durability of the resin-dentin bond and demineralized dentin stiffness

OBJECTIVE

The purpose of this study was to evaluate the effect of using natural cross-linkers as sumac and curcumin on the durability of the resin-dentin bond and stiffness of demineralized dentin matrix.

METHODS

Thirty sound molars were divided into 5 groups: Control (CO), Grape Seed extract (GSE), Cacao seed extract (CSE), Sumac extract (SE) and Curcumin extract (CE). The teeth had their coronal dentin exposed, etched, and pre-treated for 1 min with the extracts. Teeth were then bonded using Single-Bond II adhesive and 4 mm composite was built up on dentin surface. Teeth were sectioned into 1 × 1 × 8mm beams and their micro-tensile bond strength (μTBS) was tested after 24 h and 6 months of water storage. For stiffness testing, 15 teeth were sectioned to obtain dentin beams (1 × 1 × 6.5 mm), the beams were demineralized in 10% phosphoric acid then rinsed and divided into 5 groups. Beams were then immersed in their respective extract solution for 1 min after which they were subjected to a 3- point loading test using a universal testing machine to calculate their modulus of elasticity.

RESULTS

After 24 h, no significant difference in μTBS was shown between all groups. After 6 Months, GSE, CE, and SE showed significantly higher μTBS compared to CO (p ≥ 0.05). For the modulus of elasticity; only GSE showed a significantly higher modulus compared to other groups.

CLINICAL RELEVANCE

The application of grape seed extract, curcumin and sumac extract as dentin pre-treatments appear to be a promising approach to enhance the durability of the resin-dentin bond in a clinically relevant application time.

Effect of collagen cross-linkers on dentin bond strength: A systematic review and network meta-analysis

Objective: This study aimed to evaluate the role of collagen cross-linkers in the bonding performance of the resin-dentin interface through a systematic review and a network meta-analysis. Sources: The literature search was conducted in several databases like PubMed, EMBASE, Cochrane, Scopus and Web of Science from their inception till 30 April 2022. Study selection: The inclusion criteria consisted of in vitro studies evaluating the micro-tensile and micro-shear bond strengths of different cross-linkers acting on dentin. Bayesian network meta-analysis was conducted using RStudio. Data: Out of the 294 studies evaluated in the full-text analysis, 40 were included in the systematic review and meta-analysis. Most studies have used cross-linkers as primer (65.1%), followed by incorporating them into in adhesives and acid etching agents. The application methods of the adhesive system were classified as "etch-and-rinse (ER) adhesives" (77%) and "self-etching (SE) adhesives". Moreover, there were six types of cross-linkers in this presented review, of which the most numerous were polyphenols. Conclusion: Different application methods of cross-linkers, the long-term results showed that were only effective when used for longer durations, the immediate results were not statistically different. According to immediate and long-term results, etch-and-rinse (ER) adhesives showed a greater bonding performance than the control groups (p ≤ 0.05), whereas self-etching (SE) adhesives showed similar bond strength values (p ≥ 0.05). The result of network meta-analysis (NMA) showed that Dope like compound showed higher long-term bonding performance than other cross-linkers. Clinical significance: Long-term clinical studies may be needed to determine the effect of the cross-linkers on the bonding properties.

Effect of chitosan-oleuropein nanoparticles on dentin collagen cross-linking

BACKGROUND

The integrity and stability of collagen are crucial for the dentin structure and bonding strength at dentin-resin interface. Natural plant-derived polypehenols have been used as collagen crosslinkers.

OBJECTIVE

The aims of the study were to develop novel chitosan oleuropein nanoparticles (CS-OL-NPs), and to investigate the CS-OL-NPs treated dentin's the resistance to enzymatic degradation and mechanic property.

METHODS

CS-OL-NPs were developed using the ionotropic gelation method. Release and biocompatibility of the CS-OL-NPs were tested. Twenty demineralized dentin collage specimens were randomized into four interventions groups: A, Deionized Water (DW); B, 5% glutaraldehyde solution (GA); C, 1 mg/ml chitosan (CS); and D, 100 mg/L CS-OL-NPs. After 1-min interventions, dentin matrix were evaluated by the micro-Raman spectroscopy for the modulus of elasticity test. Collagen degradation was assessed using hydroxyproline (HYP) assay.

RESULTS

CS-OL-NPs were spherical core-shape with a size of 161.29 ± 8.19 nm and Zeta potential of 19.53 ± 0.26 mV. After a burst release of oleuropein in the initial 6 h, there was a long-lasting steady slow release. CS-OL-NPs showed a good biocompatibility for the hPDLSCs. The modulus of elasticity in the crosslinked groups were significantly higher than that in the control group (P< 0.05 for all). The specimens treated with CS-OL-NP showed a greater modulus of elasticity than those treated with GA and CS (P< 0.05 for both). The release of HYP in the crosslinked group was significantly lower than that in the non-crosslinked groups (P< 0.05 for all).

CONCLUSION

CS-OL-NPs enhanced the dentin mechanical property and resistance to biodegradation, with biocompatibility and potential for clinical application.

Dental Adhesives-Surface Modifications of Dentin Structure for Stable Bonding

The latest advancements in dentin bonding have focused on strategies to impair degradation mechanisms in order to extend the longevity of bonded interfaces. Protease inhibitors can reduce collagen degradation within the hybrid layer (HL). Collagen cross-linkers allow better adhesive infiltration and also inhibit proteases activity. Particles added to adhesive can promote mineral precipitation within the HL, reducing nanoleakage and micropermeability, besides possible antimicrobial and enzymatic inhibition effects. Most of these approaches are still experimental, and aspects of the adhesive under the clinician's control are still determinant for the long-term stability of adhesive restorations.

Etch-mineralizing treatment to improve dentin bonding

OBJECTIVES

This study aimed to investigate the effect of etch-mineralizing solution as a dentin treatment agent on dentin bonding.

METHODS

This study designed four kinds of etch-mineralizing solutions (EMs) by adding sodium fluoride in 35% phosphoric acid aqueous solution with four different concentrations (5, 10, 20, and 30 mg/ml), and named F1, F2, F3 and F4, respectively. 35% phosphoric acid gel treatment was the control group. SEM, EDS, FTIR and microhardness tests were performed on the treated dentin. Shear bond strength was measured before and after aging. Nanoleakage was also evaluated. Fracture mode was researched after SBS testing. The antibacterial properties of treated dentin were also investigated through live/dead staining of biofilms.

RESULTS

The smear layer was removed and mineralization substances were observed on the dentin surface and tubule, and no obvious collagen fibers were observed compared with the control group. FTIR spectrums showed that the ratios of phosphate/collagen on EMs treated dentin surfaces were significantly increased (P<0.05). F2 group had the highest bonding strength (32.14±7.33 MPa) and microhardness (66.08±10.58), while the control group had the lowest bonding strength (21.81±4.03 MPa) and microhardness (42.34±7.08) (p<0.05), and excellent bonding strength caused the more cohesive fracture. Experimental groups showed less nanoleakage than group C (P<0.05). Moreover, experimental groups had better antiaging performance and antibacterial properties than the control group (p<0.05).

CONCLUSION

EMs treatment not only improved dentin bonding and antibacterial ability, but also remineralized dentin with autologous mineral elements.

CLINICAL SIGNIFICANCE

The treatment provides a novel therapeutic strategy for obtaining ideal dentin bonding strength and prolonging the longevity of the restoration.

Polyphenol-Enriched Extract of Lacquer Sap Used as a Dentine Primer with Benefits of Improving Collagen Cross-Linking and Antibacterial Functions

Commercial dentin adhesive systems are applied to restorations due to their resistant bonding properties, but they suffer from the lack of bioactivity and are prone to hydrolysis. Therefore, to overcome these limitations, an eco-friendly natural monomer, urushiol, was adopted to be a primer in dentin bonding due to its interaction with collagen and antibacterial activity, preventing further hydrolysis development. First, urushiol was determined to be capable of improving the biological stability of dentin collagen through cross-linking. Using high-fidelity analytical chemistry techniques, such as Fourier transform infrared spectroscopy, we quantified the effects of urushiol on collagen molecules. It could also effectively decrease weight loss after collagenase ingestion by improving the stability of dentin. Moreover, urushiol inhibited Streptococcus mutans growth as well as its biofilm formation. Finally, we demonstrated that the urushiol primer could improve the bonding strength, particularly after aging. The cross-linking and antibacterial functions of urushiol have provided promising developmental prospects for biomaterials in dentin adhesion.

Effect of Collagen Crosslinkers on Dentin Bond Strength of Adhesive Systems: A Systematic Review and Meta-Analysis

This study aimed to identify the role of crosslinking agents in the resin–dentin bond strength (BS) when used as modifiers in adhesives or pretreatments to the dentin surface through a systematic review and meta-analysis. This paper was conducted according to the directions of the PRISMA 2020 statement. The research question of this review was: “Would the use of crosslinkers agents improve the BS of resin-based materials to dentin?” The literature search was conducted in the following databases: Embase, PubMed, Scielo, Scopus, and Web of Science. Manuscripts that reported the effect on the BS after the use of crosslinking agents were included. The meta-analyses were performed using Review Manager v5.4.1. The comparisons were performed by comparing the standardized mean difference between the BS values obtained using the crosslinker agent or the control group. The subgroup comparisons were performed based on the adhesive strategy used (total-etch or self-etch). The immediate and long-term data were analyzed separately. A total of 50 articles were included in the qualitative analysis, while 45 articles were considered for the quantitative analysis. The meta-analysis suggested that pretreatment with epigallocatechin-3-gallate (EGCG), carbodiimide, ethylenediaminetetraacetic acid (EDTA), glutaraldehyde, and riboflavin crosslinking agents improved the long-term BS of resin composites to dentin (p ≤ 0.02). On the other hand, the use of proanthocyanidins as a pretreatment improved both the immediate and long-term BS values (p ≤ 0.02). When incorporated within the adhesive formulation, only glutaraldehyde, riboflavin, and EGCG improved the long-term BS to dentin. It could be concluded that the application of different crosslinking agents such as carbodiimide, EDTA, glutaraldehyde, riboflavin, and EGCG improved the long-term BS of adhesive systems to dentin. This effect was observed when these crosslinkers were used as a separate step and when incorporated within the formulation of the adhesive system.

Mussel-inspired monomer - A new selective protease inhibitor against dentine collagen degradation

OBJECTIVES

To evaluate the inhibitory effect of a novel mussel-inspired monomer (N-(3,4-dihydroxyphenethyl)methacrylamide (DMA) on the soluble and matrix-bound proteases.

METHODS

The inhibitory effect of DMA (0, 1, 5, and 10 mM) and 1 mM chlorhexidine (CHX) dissolved in 50% ethanol/water on soluble recombinant human matrix metalloproteinases (rhMMP-2, -8, and -9), as well as cysteine cathepsins (B and K) were evaluated using both fluorometric assay kits and molecular docking. The effect of CHX and DMA on matrix-bound proteases was examined by in situ zymography, and the fluorescence intensity and relative area were calculated by Image J software. All data obtained were analyzed by one-way ANOVA followed by Tukey test (α = 0.05).

RESULTS

The anti-proteolytic ability of DMA increased in a dose-dependent manner except that of rhMMP-9. Inhibitory effect of 1 mM DMA against rhMMP-2, - 8, - 9, as well as cathepsin B and K was all significantly lower than 1 mM CHX (p < 0.05). The molecular docking analysis was in good agreement with the experimental results, that the binding energy of DMA was lower than CHX for all proteases. In situ zymography revealed that all DMA- and CHX-treated groups significantly inactivated the matrix-bound proteases, with a dramatic reduction of the fluorescence intensity and relative area compared with the control group (p < 0.05).

SIGNIFICANCE

Under the prerequisite condition that the overall inhibitory performance on matrix-bound proteases was comparable by DMA and CHX, the more selective property of DMA could avoid inducing potential negative effects by suppressing MMP-9 when applied in dental treatment compared with CHX.

A Novel Chemical Binding Primer to Improve Dentin Bonding Durability

The dentin collagen matrix that is not completely enveloped by resin adhesive is vulnerable to degradation by intrinsic collagenases during the etch-and-rinse process, which contributes to the deterioration of the bonding interface. Current commercial adhesives have no functional components that can form covalent bonds to the dentin collagen matrix. In this study, a photocurable aldehyde, 4-formylphenyl acrylate (FA), was synthesized and for the first time applied as a primer in adhesive dentistry to covalently bind to collagen. Experimental groups with different concentrations of FA (1%, 3%, 5%, 7%, 9%) were prepared as primers. The cytotoxicity was evaluated by live/dead-cell staining and thiazolyl blue tetrazolium bromide assay. The interaction of FA with collagen was examined by attenuated total reflection Fourier transform infrared spectroscopy, hydroxyproline release under the degradation of type I collagenase, and thermogravimetric analysis. An optimal group was selected based on the degree of conversion of 2 universal adhesives and further divided depending on the treatment time (20 s, 30 s, 1 min, 2 min). The bonding performances were evaluated by microtensile strength before and after aging. Finally, the bonding interface was observed under confocal laser scanning microscopy and scanning electron microscope. The results indicated that FA demonstrated good biocompatibility, dentin modification capability, and infiltration. It not only effectively cross-linked dentin collagen to improve its stability against enzymatic hydrolysis and modify the adhesive interface but also potentially acted as a diluting monomer to induce deep penetration of adhesive resin monomers into the dentin. The bonding strength after aging was improved without jeopardizing the degree of conversion of 2 commercial adhesives. Such prominent advantages of using FA to improve the bonding performance promotes its further application in adhesive dentistry.

Enhancing resin-dentin bond durability using a novel mussel-inspired monomer

Numerous approaches have been developed to improve the resin-dentin bond performance, among which the bio-application of mussel-derived compounds have drawn great attention recently. To assess the performance of N-(3,4-dihydroxyphenethyl)methacrylamide (DMA), a mussel-derived compound, as a functional monomer in dental adhesive, its potential property to cross-link with dentin collagen and polymerize with adhesive will first be evaluated by transmission electron microscopy (TEM), attenuated total reflectance technique of Fourier transform infrared (ATR-FTIR), and atomic force microscopy (AFM) via Peakforce QNM mode. After validating the influence of DMA on collagen and adhesive separately, the overall performance of DMA/ethanol solution as a primer in dentin bonding was examined using micro-tensile bond strength (μTBS) testing, fracture pattern observation, and nanoleakage evaluation both immediately and after 10,000 times thermocycling aging. The inhibitory effect of DMA on endogenous metalloproteinases (MMPs) was evaluated by in situ zymography using confocal laser scanning microscopy (CLSM) and the cytotoxicity of DMA was evaluated using cell counting kit-8. Results demonstrated that DMA successfully cross-linked with dentin collagen via non-covalent bonds and had no influence on the polymerization and mechanical properties of the adhesive. Furthermore, even after 10,000 times thermocycling aging, the μTBS and nanoleakage expression of the DMA-treated groups showed no significant change compared with their immediate values. In situ zymography revealed reduced endogenous proteolytic activities after the application of DMA, and no cytotoxicity effect was observed for DMA concentration up to 25 ​μmol/L. Thus, DMA could be used as a novel, biocompatible functional monomer in dentin bonding.

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DMA acts as a functional monomer in dentin bonding system with high biocompatibility.

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DMA connects the adhesive and collagen network to resist various external attacks.

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DMA/ethanol inhibits the activity of MMPs and improve resin-dentin bond durability.

Proanthocyanidin-functionalized hydroxyapatite nanoparticles as dentin biomodifier

OBJECTIVE

This study evaluated the potential combined effects of nanohydroxyapatite and proanthocyanidin on the remineralization and collagen stabilization of demineralized dentin.

METHODS

Seventy-five coronal dentin beams (6 × 1 × 1 mm³) were randomly allocated into five experimental groups (n = 15): Sound (no treatment), Control (pH-cycling), nHAp (nanohydroxyapatite), nHAp_PA (Proanthocyanidin-functionalized nanohydroxyapatite), and PA (proanthocyanidin) treatments. The sound group (negative control) were immersed in distilled water over the experimental period. The remaining groups were submitted to a pH-cycling process for 14 days. Following the de-re mineralization process, specimens corresponding to the control group (positive control) were immersed in distilled water whereas the test groups were immersed in 1 mL of respective solution treatment (nHAp, nHAp_PA, or PA) for 1 min. The dentin samples were analyzed to determine their chemical composition (ATR-FTIR and Thermogravimetric) and mineralogical (XRD) characteristics as well as their mechanical response, obtained by three-point bending test.

RESULTS

Higher phosphate content (v₄ PO₄: ATR-FTIR) and amount of mineral (XRD) was observed in the nHAp_PA group. Furthermore, a larger induction of collagen cross-links (ATR-FTIR) and %Organic Matter (TGA) would indicate the PA incorporation and the achievement of dentin matrix stability. These effects on dentin properties were related to increasing flexural strength (MPa), demonstrating that 15% w/v nHAp_PA treatment improved the mechanical properties of the samples.

SIGNIFICANCE

nHAp_PA shows significant potential for promoting remineralization while improving collagen stability into demineralized dentin in a clinically feasible period of 1 min.

Influence of two carbodiimides on the bond strength of universal adhesives to dentin

The pretreatment of dentin with cross-linking agents during bonding procedures has been proposed to improve the mechanical properties of the collagen in the hybrid layer and reduce the biodegradation of the adhesive interface. The aim of this study was to evaluate the influence of pretreatment with two carbodiimides on the dentin bond strength of universal adhesives, after thermocycling. Three universal adhesives in the self-etching mode were used (Single Bond Universal-SBU, Clearfil Universal-CLU and Ambar Universal-ABU). A self-etching adhesive system (Clearfil SE Bond-CSB) was used as control. Two carbodiimides, 1-ethyl-3-(3'-dimethylaminopropyl)-carbodiimide (EDC) and N,N'-dicyclohexylcarbodiimide (DCC), were applied for 1 min. The excess solution was removed with absorbent paper and the universal adhesives were applied. The specimens were stored for 24 h in distilled water at 37 °C or 10,000 thermal cycles (5-55 °C, 30 s) and then were prepared for microtensile bond strength test (n  =  4 teeth, average of 21 sticks per group). Data were analyzed using three-way ANOVA and Tukey's (α  =  5%). After 24 h, SBU and CSB had statistically similar bond strength values for the control groups (22.07  ±  9.03 and 19.82  ±  7.28 MPa), with EDC (30.21  ±  11.30 and 19.67  ±  5.36 MPa) and DCC (30.12  ±  13.43 and 19.82  ±  7.28 MPa) pretreatments (p  >  0.05). The use of EDC (32.57  ±  9.60 MPa) and DCC (24.71  ±  9.87 MPa) showed statistically higher bond strength for CLU than for the control group (14.62  ±  6.16 MPa; p  <  0.05). After thermocycling, the SBU, CLU, and CSB groups showed statistically similar bond strengths with the use of EDC (27.08  ±  8.44; 18.74  ±  5.41; and 24.55  ±  10.43 MPa) and without the use of cross linkers (20.06  ±  7.99; 22.55  ±  9.04; and 26.54  ±  10.13 MPa; p  >  0.05). Groups tested after 24 h in distilled water presented higher bond strength than those submitted to thermocycling. It can be concluded that the use of cross linkers influenced the immediate bond strength of the universal adhesives, and this was dependent on the combination of the adhesive system and type of carbodiimide. The use of EDC increased the immediate bond strength of CLU. DCC increased the bond strength of ABU at 24 h, but the values were lower than those of the control group after aging for three out of the four adhesives.

Influence of Dentin Priming with Tannin-Rich Plant Extracts on the Longevity of Bonded Composite Restorations

Objective

This in vitro study evaluated the influence of bioactive plant extracts as dentin biomodifying agents to improve the longevity of bonded restorations. For that, plant extracts were applied to the dentin surface prior to the adhesive system.

Materials and Methods

Bovine incisors were ground flat to obtain 2 mm thick slices in which conical preparations were made (N = 10). Tannin-containing plant extracts were applied to dentin before the application of the restorative system, as follows: control group (untreated, CTL), chlorhexidine 0.12% (CHX), mastruz (Dysphania ambrosioides, MTZ), cat's claw (Uncaria tomentosa, CTC), guarana (Paullinia cupana, GUA), galla chinensis (Rhus chinensis, GCH), and tannic acid (extracted from Acacia decurrens, TNA). The push-out bond strength test was conducted (0.5 mm/min). Dentin biomodification was assessed by the modulus of elasticity and mass change in bovine tooth sections (0.5 × 1.7 × 7.0 mm). The dentin staining after extract treatments of dentin slices was compared. The dentin surface wettability was also evaluated by means of the contact angles of the adhesive system with the dentin surface and compared with the untreated control group. Data were subjected to ANOVA/Tukey's test (α = 0.05).

Results

The bond strength of the restoratives to dentin was not significantly improved by the plant extracts, irrespective of the evaluation time (p > 0.05). Except for TNA, the elastic modulus of demineralized dentin significantly reduced after treatment with the plant extracts (p < 0.05). The dentin staining correlated with the tannin content of the extracts. The contact angle was significantly reduced when treated with CTC, GCH, and TNA.

Conclusions

The tannin-containing extracts had a questionable effect on the longevity of bonded restorations. The dentin modulus was negatively affected by the extract treatments. Although some of the extracts changed the contact angle, which seems to improve the adhesive monomer permeation, the tannin-rich plant extract application prior to adhesive application was proven to be clinically unfeasible due to dentin staining.

In vitro evaluation of the anti-proteolytic and cross-linking effect of mussel-inspired monomer on the demineralized dentin matrix

OBJECTIVES

To evaluate the anti-proteolytic and cross-linking effect of N-(3,4-dihydroxyphenethyl)methacrylamide (DMA) on the demineralized dentin matrix in vitro.

METHODS

Four experimental solutions were selected: 50% ethanol/water solution (Control); 1, 5, and 10 mmol/L DMA dissolved in 50% ethanol/water solution. Sound human molars were sectioned to produce dentin beams with dimension of 1×1×6 mm. The dentin beams were demineralized with 10% phosphoric acid for 8 h to remove the apatite. The demineralized specimens were randomly separated into four groups and immersed in the four experimental solutions for 1 h. After the treatment, the ultimate tensile strength (UTS), loss of dry mass and the release of hydroxyproline by storing the treated specimens in 0.1 mg/mL collagenase solution for 24 h were assessed. The swelling ratio of another ten specimens from each group were evaluated. The interaction between DMA with dentin matrix was observed under Field Emission Scanning Electron Microscopy (FESEM). UTS data was analyzed by two-way ANOVA followed by Tukey test, and the other data was analyzed by one-way ANOVA followed by Tukey test (α = 0.05).

RESULTS

The two-way ANOVA factors, different solutions (p < 0.001), collagenase degradation (p < 0.001) and their interactions (p < 0.001) all significantly affected the UTS. The 10 mM DMA treatment significantly decreased the percentage of loss of dry mass, release of hydroxyproline and swelling ratio of demineralized dentin matrix compared to other treatment groups (p < 0.05). The FESEM observation depicted that with increasing concentration of DMA, the structure of dentin matrix was protected and the porosity within dentin collagen network was decreased.

CONCLUSIONS

The treatment by 10 mM DMA/ethanol solution for 1 hour is capable of enhancing the mechanical properties of demineralized dentin matrix against collagenase degradation and may be clinically useful to improve the durability of hybrid layer.

CLINICAL SIGNIFICANCE

The 10 mM DMA/ethanol primer may offer an alternative choice for dentists to strengthen the mechanical properties of demineralized dentin matrix and resist its degradation by collagenase.

Effect of chlorhexidine-loaded poly(amido amine) dendrimer on matrix metalloproteinase activities and remineralization in etched human dentin in vitro

To investigate the effect of chlorhexidine (CHX)-loaded carboxyl-terminated poly (amido amine) dendrimer (CHX-PAMAM-COOH) on matrix metalloproteinase (MMP) activities and remineralization in human dentin, CHX-PAMAM-COOH was prepared and characterized by Fourier-transform infrared spectroscopy. The inhibitory effects of CHX, PAMAM-COOH, and CHX-PAMAM-COOH on soluble recombinant human matrix metalloproteinase (rhMMP-2) and dentin-bound endogenous MMP activity were measured using an MMP Activity Assay Kit. In situ zymography was performed to evaluate the gelatinase activity in dentin pretreated with CHX, PAMAM-COOH, and CHX-PAMAM-COOH. The remineralization of etched dentin pretreated with CHX, PAMAM-COOH, and CHX-PAMAM-COOH was evaluated by field emission-scanning electron microscopy (SEM) and energy disperse spectroscopy (EDS) after incubation in artificial saliva for 14 days. The results of the rhMMP-2 activity assay showed that the MMP-2 activity in the CHX-PAMAM-COOH group and the CHX group decreased significantly to 5.58 ± 0.85% (P < 0.05) and 4.86 ± 1.12% (P < 0.05), respectively, but that in the PAMAM-COOH group increased significantly to 213.38 ± 0.11% (P < 0.05). The results of total MMP activity and in situ zymography showed a significant reduction in endogenous gelatinase activity in dentin in the CHX-PAMAM-COOH group and the CHX group. The SEM and EDS results showed that rod-like crystals were formed on the etched dentin surface in the PAMAM-COOH group and the CHX-PAMAM-COOH group, and their Ca/P ratios were 1.73 and 1.71, respectively. In conclusion, CHX-PAMAM-COOH can inhibit dentin-bound endogenous MMPs and induce remineralization in etched dentin simultaneously. However, it is important to note that the catalytic role of PAMAM dendrimers may have an undesired excitatory effect on MMP activity, which cannot be ignored if PAMAM dendrimers were used alone in the oral environment.

Bond strength of demineralized dentin after synthesized collagen/hydroxyapatite nanocomposite application

Treatment the deeper and remineralizable carious zone (DRCZ) in dentin with various remineralizing methods, either with classic top-down or biomimetic bottom-up remineralization approaches, has remained a constant main issue to enhance dentin substrate bonding quality. The concern of remineralizing the remaining, partially demineralized and physiologically re-mineralizable collagen fibrils was the optimum target. However, applying already mineralized type I collage fibrils which have the ability to chemically cross-link with remaining collagen and minerals did not gain much interest. Synthesis of collagen/hydroxyapatite (Col/Hap) nanocomposite was done with self-assembling Hap in situ onto Col fibrils with different % (70/30, 50/50, 30/70% of Col/Hap, respectively). Micro-tensile bond strength (μTBS) was evaluated after pre-treatment of artificially demineralized dentin with these suggested protocols [nanocomposite together with grape seed extract (GSE; 6.5%) cross-linker for two periods, 10min and 1 h] then applying self-adhesive bonding system. Applied Col/Hap (30/70%) together with GSE (6.5%) gave the significantly highest μTBS (25.04 ± 5.47 and 25.53 ± 7.64 MPa, for 10min and 1 h application times, respectively). After thermocycling for 10,000 cycles at 5 and 55 °C, μTBS for all protocols and both application times substantially decreased especially for the two control groups. Using the suggested dentin pre-treatment protocols, in chair-side, may possibly enhance the bond strength to DRCZ and its durability.