Biofilm composition and composite degradation during intra-oral wear

Comparative Evaluation of Microtensile Bond Strength in Three Different Dentin Luting Agents: An In vitro Study

Aim

Long-term clinical success on indirect restorations is largely determined by bonding efficiency of the luting agent, with adhesion to dentin being the main challenge. Therefore, aim of this study was to assess the microtensile bond strength when using flowable resin composite, preheated resin composite and dual self-adhesive resin cement as dentin luting agents.

Materials and Methods

Occlusal thirds of molar teeth were cut and randomly divided into 3 groups to be cemented: RelyX™U200, Filtek™ Z250 XT- preheated to 70° and Filtek Flow™ Z350XT. They were then thermocycled 5000 times between 5+/-2°C and 55+/-2°C. Subsequently, 10 microbars per group were prepared. The 30 samples were placed in saline solution for 24 hours at room temperature prior to microtensile test. This was performed with a digital universal testing machine at a crosshead speed of 0.5 mm/min. The bond strength values obtained were analyzed in Megapascals (MPa). Measures of central tendency such mean and measures of dispersion such standard deviation were used. In addition, the Kruskall Wallis non-parametric test with Bonferroni post hoc test was applied, considering a significance value of 5% (P < 0.05), with type I error.

Results

The dentin microtensile bond strengths of preheated resin composite, flowable resin composite and dual self-adhesive cement were 6.08 ± 0.66 Mpa, 5.25 ± 2.60Mpa and 2.82 ± 1.26Mpa, respectively. In addition, the preheated resin composite exhibited significantly higher microtensile bond strength compared to the dual self-adhesive cement (P < 0.001). While the flowable resin composite showed no significant difference with the dual self-adhesive cement (P = 0.054) and the preheated resin composite (P = 0.329).

Conclusions

The microtensile bond strength in dentin was significantly higher when using a preheated resin composite at 70°C as a luting agent compared to dual self-adhesive cement. However, the preheated resin composite showed similar microtensile bond strength compared to the flowable resin composite.

Degradation products of resin-based materials detected in saliva in vivo

OBJECTIVES

Dental composites remain under scrutiny regarding their (long-term) safety. In spite of numerous studies on the release of monomers both in vitro and in vivo, only limited quantitative data exist on the in vivo leaching of degradation products from monomers and additives. The aim of this observational study was for the first time to quantitatively and qualitatively monitor the release of parent compounds and their degradation products in saliva from patients undergoing multiple restorations.

MATERIALS AND METHODS

Five patients in need of multiple large composite restorations (minimally 5 up to 28 restorations) due to wear (attrition, abrasion, and erosion) were included in the study, and they received adhesive restorative treatment according to the standard procedures in the university clinic for Restorative Dentistry. Saliva was collected at different time points, starting before the restoration up until 24 h after the treatment with composite restorations. Saliva extracts were analyzed by liquid chromatography-mass spectrometry.

RESULTS

Leaching of monomers and degradation products was highest within 30 min after the placement of the restorations. The highest median concentrations of monomers were recorded for UDMA, BisEMA-3, and TEGDMA; yet, besides BisEMA-3 and TEGDMA, no monomers could be detected after 24 h. Mono- and demethacrylated degradation products remained present up to 24 h and concentrations were generally higher than those of monomers. In patients with multiple restorations, degradation products were still present in the sample taken before the next operation, several weeks after the previous operation.

CONCLUSIONS

Exposure to residual monomers and degradation products occurs in the first hours after restoration. Monomers are present in saliva shortly after restoration, but degradation products can be detected weeks after the restoration confirming a long-term release.

CLINICAL SIGNIFICANCE

Future research should focus more on the release of degradation products from monomers and additives from resin-based materials given their prolonged presence in saliva after restoration.

Clinical evaluation of lithium disilicate versus indirect resin composite partial posterior restorations - A 7.8-year retrospective study

OBJECTIVE

To evaluate retrospectively the longevity of lithium disilicate ceramic (LidiSi) vs. laboratory-processed resin-based composite (RBC) inlay/onlay/overlay restorations and risk factors associated with restoration deficiencies and failures.

METHODS

Patients (n = 91) receiving LidiSi (73.1%) and RBC (36.9%) inlays/onlays/overlays between 2007 and 2017 were selected. The restorations were evaluated using the modified U.S. Public Health Service criteria. The survival of the restorations was analyzed using the Kaplan-Meier method and log rank test. Factors affecting the occurrence of deficiencies were examined by logistic regression analysis. This was performed with the use of the Generalized Estimating Equation model including Repeated measurements (GEER), with the consideration that the same patient had several teeth in the sample. Risk estimation was conducted for each evaluated criterion (p < 0.05).

RESULTS

The survival of LidiSi and RBC restorations were 96.8% and 84.9%, respectively after a mean observation period of 7.8 ± 3.3 years. The annual failure rate was 0.2% for LidiSi and 1.0% for RBC. The probability of survival was above 98% for both restorations in the first 6 years, however, it dropped to 60% for RBC by the end of the 15th year. For both materials the reasons for failure included secondary caries, restoration fracture, and endodontic complication. In addition, LidiSi also failed due to tooth fracture, while RBC due to marginal gap formation and loss of retention. Among the evaluated risk factors, material of restoration (OR=6.8, CI95%:3.1-14.9), oral hygiene (OR=8.0, CI95%: 2.9-22.1], and bruxism (OR=1.9, CI95%: 1.1-3.3) showed a significant impact on the evaluated criteria.

SIGNIFICANCE

LidiSi and RBC restorations showed similarly excellent 6-year survival, however, in the long term significantly more failures should be expected for RBCs.

Effects of three orthodontic retainers on periodontal pathogens and periodontal parameters

The objective of this study was to compare and evaluate the changes in periodontal pathogens and periodontal status within 6 months of wearing three orthodontic retainers, namely, vacuum-formed retainer (VFR), Hawley retainer (HR), and lingual fixed retainer (LR). In total, 48 patients who underwent orthodontic treatment with ordinary metal brackets were divided into VFR, HR, and LR groups (n = 16 per group). Saliva samples were collected at the time of debonding (T0) and after 1 month (T1), 3 months (T2), and 6 months (T3). Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) were quantitatively analyzed using real-time PCR. Gingival index (GI), plaque index (PLI), and probing depth (PD) were measured at the four time points to evaluate changes in periodontal state. SPSS20.0 software was used to analyze the data, and P < 0.05 was considered statistically significant. The trial was registered at the Chinese Clinical Trial Registry (ChiCTR2300073704), the registration was retrospective. Compared to baseline (T0) values, Pg, Aa, GI, PLI, and PD were significantly decreased in all three groups 1 month after wearing the retainer (p < 0.05). Significant differences were observed in Aa at T3 among the three groups, whereby the HR group exhibited significantly better results compared to the VFR and LR groups (p < 0.05). Differences were found among the three groups' Porphyromonas gingivalis at T3, and the HR group was significantly better than the VFR and LR groups (P < 0.05). From T1 to T2, GI, PLI, and PD of the three groups tended to be stable, however differences were observed at T3, with the PLI and PD of the HR group being the lowest among the three groups (p < 0.05). Regardless of the type of retainer used, the periodontal condition of patients was significantly improved after removal of the metal brackets. After 6 months of retainer use, the Hawley retainer was superior to vacuum-formed retainer and lingual fixed retainer with regard to Pg, Aa, and periodontal clinical parameters.

In Vitro Evaluation of Candida albicans Adhesion on Heat-Cured Resin-Based Dental Composites

Microbial adhesion on dental restorative materials may jeopardize the restorative treatment long-term outcome. The goal of this in vitro study was to assess Candida albicans capability to adhere and form a biofilm on the surface of heat-cured dental composites having different formulations but subjected to identical surface treatments and polymerization protocols. Three commercially available composites were evaluated: GrandioSO (GR), Venus Diamond (VD) and Enamel Plus HRi Biofunction (BF). Cylindrical specimens were prepared for quantitative determination of C. albicans S5 planktonic CFU count, sessile cells CFU count and biomass optical density (OD570 nm). Qualitative Concanavalin-A assays (for extracellular polymeric substances of a biofilm matrix) and Scanning Electron Microscope (SEM) analyses (for the morphology of sessile colonies) were also performed. Focusing on planktonic CFU count, a slight but not significant reduction was observed with VD as compared to GR. Regarding sessile cells CFU count and biomass OD570 nm, a significant increase was observed for VD compared to GR and BF. Concanavalin-A assays and SEM analyses confirmed the quantitative results. Different formulations of commercially available resin composites may differently interact with C. albicans. The present results showed a relatively more pronounced antiadhesive effect for BF and GR, with a reduction in sessile cells CFU count and biomass quantification.

The Effect of Chemical Degradation and Polishing on the Gloss of Composite Dental Materials

This aim of this study was to investigate surface gloss changes of different composite dental materials after chemical degradation or polishing. Five different composites were used (Evetric, GrandioSO, Admira Fusion, Filtek Z550, Dynamic Plus). The gloss of the tested material was measured with a glossmeter before and after chemical degradation in different acidic beverages. Statistical analysis was performed using a t-test for dependent samples, ANOVA, and a post hoc test. For comparison between groups, a level of significance was set at 0.05. Initial gloss values ranged from 51 to 93 at baseline to 32 to 81 after chemical degradation. The highest values were obtained for Dynamic Plus (93.5 GU) and GrandioSO (77.8 GU), followed by Admira Fusion (82 GU) and Filtek Z550 (70.5 GU). Evetric showed the lowest initial gloss values. After acidic exposures, the gloss measurements revealed different patterns of surface degradation. The results showed that the gloss of the samples decreased with time regardless of the treatment. The interaction between chemical-erosive beverages and the composite could lead to a decrease in the surface gloss of the composite restoration. The nanohybrid composite showed less gloss changes under acidic conditions, suggesting that it is more suitable for anterior restorations.

Multifunctional dental resin composite with antibacterial and remineralization properties containing nMgO-BAG

The inherent characteristics of resin composite can lead to micro-leakage after polymerization shrinkage. The bacteria invasion through edge micro-leakage and attachment onto the material surface can cause secondary caries, reducing the service life of resin composites. In this study, magnesium oxide nanoparticles (nMgO) as an inorganic antimicrobial agent and bioactive glass (BAG) as a remineralization agent were simultaneously incorporated into the resin composite. With the addition of both nMgO and BAG, the resin composite showed an excellent antimicrobial effect compared to the resin composite with nMgO or BAG only. The remineralization capacity of demineralized dentin increased with the increasing content of BAG. Vickers hardness, compressive strength, and flexural strength of the resin composite with nMgO-BAG were not significantly affected compared to the ones with the same total filler amount but with BAG only. The depth of cure and water sorption values of the resin composite showed an increasing trend with the increasing total amount of nMgO and BAG fillers. This developed multifunctional resin composite is expected to reduce bacterial invasion and promote remineralization of early caries damage.

Effects of Streptococcus mutans and their metabolites on the wear behavior of dental restorative materials

The wear behavior of dental restorative materials is highly related to the biolubricating medium in the oral environment. Bacteria, along with their metabolic products, are essential substances in the oral cavity and have not been studied as a potential factor affecting lubrication performance during mastication. In this study, the effects of the Streptococcus mutans bacterial cells and their metabolites were investigated on the wear behavior of resin composites, polymer-infiltrated ceramic networks and zirconium-lithium silicate glass-ceramics. A reciprocating friction test and quantitative analysis of the wear morphology were utilized to determine the coefficient of friction (COF) and wear resistance of the test materials. The results showed that the bacterial metabolite medium significantly reduces the COF and wear rate of the three restorative materials and provide better protection against superficial abrasion. When tested under lactic acid medium, a key acid production in bacterial metabolites, similar wear reduction results were observed in the three materials, which confirmed that lactic acid should be accountable for the excellent lubricating property of bacterial metabolites. Furthermore, the resin composite with lower wettability exhibited a more significant wear reduction than the other two materials when lubricating with a bacterial metabolite medium. These findings provide novel insights into the biological basis of lubrication mechanisms in the oral cavity under high-loading and low-velocity conditions.

Biodegradation of Dental Resin-Based Composite—A Potential Factor Affecting the Bonding Effect: A Narrative Review

In recent years, although resin composite has played an important role in the restoration of tooth defects, it still has several disadvantages, including being biodegraded by saliva, bacteria and other enzymes in the oral cavity, which may result in repair failure. This factor is not conducive to the long-term survival of the prosthesis in the mouth. In this article, we review the causes, influencing factors and prevention methods of resin biodegradation. Biodegradation is mainly caused by esterase in saliva and bacteria, which breaks the ester bond in resin and causes the release of monomers. The mechanical properties of the prosthesis can then be affected. Meanwhile, cathepsin and MMPs are activated on the bonding surface, which may decompose the dentin collagen. In addition, neutrophils and residual water on the bonding surface can also aggravate biodegradation. Currently, the primary methods to prevent biodegradation involve adding antibacterial agents to resin, inhibiting the activity of MMPs and enhancing the crosslinking of collagen fibers. All of the above indicates that in the preparation and adhesion of resin materials, attention should be paid to the influence of biodegradation to improve the prosthesis’s service life in the complex environment of the oral cavity.

Surface roughness and oxygen inhibited layer control in bulk-fill and conventional nanohybrid resin composites with and without polishing: in vitro study

Background

It has been demonstrated that dental restorations with rough surfaces can have several disadvantages such as pigment retention or plaque accumulation, which can facilitate caries formation, color variation, loss of brightness, degradation of restoration, among others. The present study aimed to assess surface roughness in bulk fill and conventional nanohybrid resins with and without polishing, controlling the oxygen inhibited layer.

Methods

This in vitro and longitudinal experimental study consisted of 120 resin blocks of 6 mm diameter and 4 mm depth, divided into two groups: Bulk Fill (Tetric^® N-Ceram Bulk-fill, Opus Bulk Fill APS, Filtek™ Bulk Fill) and conventional nanohybrid (Tetric^® N-Ceram, Opallis EA2, Filtek™ Z250 XT). Each resin group was divided into two equal parts, placing glycerin only on one of them, in order to control the oxygen inhibited layer. Subsequently, the surface roughness was measured before and after the polishing procedure with Sof-Lex discs. The data were analyzed with the T-test for related measures, and for comparison between groups before and after polishing, the non-parametric Kruskal Wallis test with the Bonferroni post hoc was used, considering a significance level of p < 0.05.

Results

Before polishing, the resin composites with the lowest surface roughness were Opus Bulk Fill APS (0.383 ± 0.186 µm) and Opallis EA2 (0.430 ± 0. 177 µm) with and without oxygen inhibited layer control, respectively; while after polishing, those with the lowest surface roughness were Opus Bulk Fill APS (0.213 ± 0.214 µm) and Tetric N-Ceram (0.097 ± 0.099 µm), with and without oxygen inhibited layer control, respectively. Furthermore, before and after polishing, all resins significantly decreased their surface roughness (p < 0.05) except Opus Bulk Fill APS resin with oxygen inhibited layer control (p = 0.125). However, when comparing this decrease among all groups, no significant differences were observed (p < 0.05).

Conclusion

The Opus Bulk Fill APS resin with oxygen inhibited layer control presented lower surface roughness both before and after polishing, being these values similar at both times. However, after polishing the other bulk fill and conventional nanohybrid resins with and without oxygen inhibited layer control, the surface roughness decreased significantly in all groups, being this decrease similar in all of them.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02297-w.

Biocompatibility and mechanical properties of an experimental E-glass fiber-reinforced composite for dentistry

Objectives

To evaluate the biocompatibility and mechanical properties of experimental bis-phenol-A and bis-GMA free E-glass fiber-reinforced composites (FRCs) prepared with hexanediol dimethacrylate (HDDMA) based resin.

Methods

Two ratios of HDDMA/TEGDMA resin were evaluated: exp-1 (70/30 wt.%) and exp-2 (50/50 wt.%) with two bis-GMA resin control groups (bis-GMA/MMA and bis-GMA/TEGDMA resins, both 70/30 wt.%). E-glass fibers were embedded into the resins to prepare FRCs specimens. Biocompatibility was assessed for cytoviability and biofilm formation with Streptococcus mutans, Streptococcus sanguinis, Enterococcus faecalis, and Candida albicans. Mechanical properties were evaluated for flexural strength and hardness (24 h, water storage 1 and 28 days), water sorption (1, 7, 14, and 28 days), contact angle, and surface roughness. The data were analyzed statistically by one-way and two-way ANOVA (p < 0.05).

Results

Cytoviability of the experimental groups was significantly higher than the control groups (p < 0.05). The exp-1 cytoviability (98.2 ± 1.3%) met the ISO 10993-5 standard requirement for noncytotoxic materials. The adherence of bacteria to the experimental FRCs was visibly less than the controls, while Candida albicans adhered visibly more to the experimental groups than the controls (p < 0.05). Flexural strength showed slightly higher values for controls than for the experimental groups. The exp-1 hardness value was significantly higher in the control groups for all storage conditions (p < 0.05). The water sorption of the experimental groups was significantly higher than the controls. The surface roughness indicated no significant difference (p = 0.87). The exp-1 showed a higher contact angle with the control groups.

Conclusion

The experimental HDDMA/TEGDMA-based FRCs might be potential alternatives for bis-GMA-based FRCs.

Clinical significance

The HDDMA/TEGDMA E-glass FRCs might provide biocompatible restorations.

Ceragenin CSA-44 as a Means to Control the Formation of the Biofilm on the Surface of Tooth and Composite Fillings

Recurrent oral infections, as manifested by endodontic and periodontal disease, are often caused by Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans). Here, we assessed the anti-biofilm activity of ceragenin CSA-44 against these microbes growing as a biofilm in the presence of saliva on the surface of human teeth and dental composite (composite filling) subjected to mechanical stresses. Methods: Biofilm mass analysis was performed using crystal violet (CV) staining. The morphology, viscoelastic properties of the biofilm after CSA-44 treatment, and changes in the surface of the composite in response to biofilm presence were determined by AFM microscopy. Results: CSA-44 prevented biofilm formation and reduced the mass of biofilm formed by tested microorganisms on teeth and dental composite. Conclusion: The ability of CSA-44 to prevent the formation and to reduce the presence of established biofilm on tooth and composite filling suggests that it can serve as an agent in the development of new methods of combating oral pathogens and reduce the severity of oral infections.

Antibacterial and Antibiofilm Properties of Three Resin-Based Dental Composites against Streptococcus mutans

Antibacterial and antibiofilm properties of restorative dental materials may improve restorative treatment outcomes. The aim of this in vitro study was to evaluate Streptococcus mutans capability to adhere and form biofilm on the surface of three commercially available composite resins (CRs) with different chemical compositions: GrandioSO (VOCO), Venus Diamond (VD), and Clearfil Majesty (ES-2). Disk-shaped specimens were manufactured by light-curing the CRs through two glass slides to maintain a perfectly standardized surface topography. Specimens were subjected to Planktonic OD_600nm, Planktonic CFU count, Planktonic MTT, Planktonic live/dead, Adherent Bacteria CFU count, Biomass Quantification OD_570nm, Adherent Bacteria MTT, Concanavalin A, and Scanning Electron Microscope analysis. In presence of VOCO, VD, and ES2, both Planktonic CFU count and Planktonic OD_600nm were significantly reduced compared to that of control. The amount of Adherent CFUs, biofilm Biomass, metabolic activity, and extracellular polymeric substances were significantly reduced in VOCO, compared to those of ES2 and VD. Results demonstrated that in presence of the same surface properties, chemical composition might significantly influence the in vitro bacterial adhesion/proliferation on resin composites. Additional studies seem necessary to confirm the present results.

Utilizing a degradation prediction pathway system to understand how a novel methacrylate derivative polymer with flipped external ester groups retains physico-mechanical properties following esterase exposure

OBJECTIVE

The region of failure for current methacrylates (i.e. derivatives of acrylates) are ester bond linkages that hydrolyze in the presence of salivary and bacterial esterases that break the polymer network backbone. This effect decreases the mechanical properties of methacrylate-based materials.

METHODS

The ethylene glycol dimethacrylate (EGDMA) or novel ethylene glycol ethyl methacrylate (EGEMA) discs were prepared using 40 µL of the curing mixture containing photo/co-initiators for 40 s in a PTFE mold at 1000 mW/cm². The degree of conversion was used as a quality control measure for the prepared discs, followed by physical, mechanical, and chemical characterization of discs properties before and after cholesterol esterase treatment.

RESULTS

After 9 weeks of standardized cholesterol esterase (CEase) exposure, EGDMA discs showed exponential loss of material (p = 0.0296), strength (p = 0.0014) and increased water sorption (p = 0.0002) compared to EGEMA discs. We integrated a degradation prediction pathway system to LC/MS and GC/MS analyses to elucidate the degradation by-products of both EGEMA and EGDMA polymers. GC/MS analysis demonstrated that the esterase catalysis was directed to central polymer backbone breakage, producing ethylene glycol, for EGDMA, and to side chain breakage, producing ethanol, for EGEMA. The flipped external ester group linkage design is attributed to EGEMA showing higher resistance to esterase biodegradation and changes in mechanical and physical properties than EGDMA.

SIGNIFICANCE

EGEMA is a potential substitute for common macromer diluents, such as EGDMA, based on its resistance to biodegradation effects. This work inspires the flipped external group design to be applied to analogs of current larger, hydrophobic strength bearing macromers used in future dental material formulations.

A universal adhesive containing copper nanoparticles improves the stability of hybrid layer in a cariogenic oral environment: An in situ study

PURPOSE

To evaluate how incorporating copper nanoparticles (CuNp) into a universal adhesive affects the antimicrobial activity (AMA), bond strength (μTBS), nanoleakage (NL), elastic modulus (EM) and nanohardness (NH) of resin-dentin interfaces, at 24 h (24 h) and after in situ cariogenic challenge (CC).

METHODS

CuNp (0% [control] and 0.1 wt%) was added to an adhesive. After enamel removal, the adhesives were applied to dentine surfaces. Each restored tooth was sectioned longitudinally to obtain two hemi-teeth; one of them was evaluated after 24 h, and the other was included in one of the intra-oral palatal devices placed in the mouths of 10 volunteers for 14 days in CC. After that, each hemi-tooth was removed, and any oral biofilm that formed was collected. The AMA was evaluated against Streptococcus mutans. For the 24 h and CC groups, each hemi-tooth was sectioned in the "x" direction to obtain one slice for each EM/NH evaluation. The remains of each hemi-tooth were sectioned in the "x" and "y" directions to obtain resin-dentin beams for μTBS and NL evaluation (24 h and CC). ANOVA and Tukey's test were applied (α = 0.05).

RESULTS

The presence of CuNp significantly improved AMA as well as all of the evaluated properties (24 h; p < 0.05). Although the adhesive properties (μTBS/NL) for all groups decreased after CC (p < 0.05), the adhesive containing CuNp showed higher μTBS and lower NL as compared to the copper-free adhesive (p < 0.05). The incorporation of CuNp maintained NH/EM values after CC (p < 0.05).

CONCLUSIONS

Adding 0.1% CuNp to an adhesive may provide antimicrobial activity and increase its bonding and mechanical properties, even under a cariogenic challenge.

SIGNIFICANCE

This is the first in situ study proving that incorporating CuNp into an adhesive is an achievable alternative to provide antimicrobial properties and improve the integrity of the hybrid layer under in situ cariogenic challenge.

A novel methacrylate derivative polymer that resists bacterial cell-mediated biodegradation

This study tests biodegradation resistance of a custom synthesized novel ethylene glycol ethyl methacrylate (EGEMA) with ester bond linkages that are external to the central polymer backbone when polymerized. Ethylene glycol dimethacrylate (EGDMA) with internal ester bond linkages and EGEMA discs were prepared in a polytetrafluoroethylene (PTFE) mold using 40 μl macromer and photo/co-initiator mixture cured for 40 s at 1000 mW/cm² . The discs were stored in the constant presence of Streptococcus mutans (S. mutans) in Todd Hewitt Yeast + Glucose (THYE+G) media up to 9 weeks (n = 8 for each macromer type) and physical/mechanical properties were assessed. Initial measurements EGEMA versus EGDMA polymer discs showed equivalent degree of conversion (45.69% ± 2.38 vs. 46.79% ± 4.64), diametral tensile stress (DTS; 8.12± 2.92 MPa vs. 6.02 ± 1.48 MPa), and low subsurface optical defects (0.41% ± 0.254% vs. 0.11% ± 0.074%). The initial surface wettability (contact angle) was slightly higher (p ≤ .012) for EGEMA (62.02° ± 3.56) than EGDMA (53.86° ± 5.61°). EGDMA showed higher initial Vicker's hardness than EGEMA (8.03 ± 0.88 HV vs. 5.93 ± 0.69 HV; p ≤ .001). After 9 weeks of S. mutans exposure, EGEMA (ΔDTS-1.30 MPa) showed higher resistance to biodegradation effects with a superior DTS than EGDMA (ΔDTS-6.39 MPa) (p = .0039). Visible and scanning electron microscopy images of EGEMA show less surface cracking and defects than EGDMA. EGDMA had higher loss of material (18.9% vs. 8.5%, p = .0009), relative changes to fracture toughness (92.5% vs. 49.2%, p = .0022) and increased water sorption (6.1% vs. 1.9%, p = .0022) compared to EGEMA discs. The flipped external ester group linkage design is attributed to EGEMA showing higher resistance to bacterial degradation effects than an internal ester group linkage design methacrylate.

Influence of artificial aging: mechanical and physicochemical properties of dental composites under static and dynamic compression

OBJECTIVE

The aim of the study was to evaluate the influence of filler content, degradation media and time on the mechanical properties of different dental composites after in vitro aging.

MATERIALS AND METHODS

Specimens (1 mm³) of three commercially available composites (GrandioSO®, Arabesk Top®, Arabesk Flow®) with respect to their filler content were stored in artificial aging media: artificial saliva, ethanol (60%), lactic acid (pH 5) and citric acid (pH 5). Parameters (Vickers microhardness, compressive strength, elastic modulus, water sorption and solubility) were determined in their initial state (control group, n = 3 for microhardness, n = 5 for the other parameters) and after 14, 30, 90 and 180 days (n = 3 for microhardness, n = 5 for the other parameters for each composite group, time point and media). Specimens were also characterized with dynamic-mechanical-thermal analysis (compression tests, F =  ± 7 N; f = 0.5 Hz, 1 Hz and 3.3 Hz; t = 0-170 °C).

RESULTS

Incorporation of fillers with more than 80 w% leads to significantly better mechanical properties under static and dynamic compression tests and a better water sorption behavior, even after chemical degradation. The influence of degradation media and time is of subordinate importance for chemical degradation.

CONCLUSION

Although the investigated composites have a similar matrix, they showed different degradation behavior. Since dentine and enamel occur only in small layer thickness, a test specimen geometry with very small dimensions is recommended for direct comparison. Moreover, the use of compression tests to determine the mechanical parameters for the development of structure-compatible and functionally adapted composites makes sense as an additional standard. Clinical relevance Preferential use of highly filled composites for occlusal fillings is recommended.

A Review of Mechano-Biochemical Models for Testing Composite Restorations

Due to the severe mechano-biochemical conditions in the oral cavity, many dental restorations will degrade and eventually fail. For teeth restored with resin composite, the major modes of failure are secondary caries and fracture of the tooth or restoration. While clinical studies can answer some of the more practical questions, such as the rate of failure, fundamental understanding on the failure mechanism can be obtained from laboratory studies using simplified models more effectively. Reviewed in this article are the 4 main types of models used to study the degradation of resin-composite restorations, namely, animal, human in vivo or in situ, in vitro biofilm, and in vitro chemical models. The characteristics, advantages, and disadvantages of these models are discussed and compared. The tooth-restoration interface is widely considered the weakest link in a resin composite restoration. To account for the different types of degradation that can occur (i.e., demineralization, resin hydrolysis, and collagen degradation), enzymes such as esterase and collagenase found in the oral environment are used, in addition to acids, to form biochemical models to test resin-composite restorations in conjunction with mechanical loading. Furthermore, laboratory tests are usually performed in an accelerated manner to save time. It is argued that, for an accelerated multicomponent model to be representative and predictive in terms of both the mode and the speed of degradation, the individual components must be synchronized in their rates of action and be calibrated with clinical data. The process of calibrating the in vitro models against clinical data is briefly described. To achieve representative and predictive in vitro models, more comparative studies of in vivo and in vitro models are required to calibrate the laboratory studies.

Improper Light Curing of Bulkfill Composite Drives Surface Changes and Increases S. mutans Biofilm Growth as a Pathway for Higher Risk of Recurrent Caries around Restorations

How dentists cure a resin-based material has deleterious effects on the material's properties and its interaction with surrounding dental tissues. Biofilm accumulation has been implicated in the pathogenesis of carious lesions around dental restorations, with its composition manifesting expressed dysbiosis in patients suffering from dental caries. To evaluate the influence of varying radiant exposure on the degree of conversion (DC%), Streptococcus mutans biofilm growth, and surface roughness of bulk-fill composites under different light-curing conditions. Two light-curing units (LCU) at 600 and 1000 mW/cm² were used to simulate curing conditions with different angulations (∢20° and ∢35°) or 2 mm-distance displacements of the LCU tip. The radiant exposure (RE) was assessed, and the composites were analyzed for DC%. Biofilm formation was induced over the bulk-fill composites and analyzed via colony-forming units counting and scanning electron microscopy (SEM). The surface roughness was analyzed via a profilometer and SEM after biofilm formation. Curing conditions with different angulation or displacement decreased RE compared to the "optimal condition". The moderately (∢35°) angulated LCU tip and low (600 mW/cm²) radiant emittance significantly reduced the DC% (p < 0.05). The difference in DC% between the top and bottom of the composites ranged from 8 to 11% for 600 mW/cm² and 10 to 20% for 1000 mW/cm². Greater S. mutans biofilm and surface changes were found in composites with non-optimal RE delivery (e.g., tip displacement and angulation) (p < 0.05). Inadequate polymerization of bulk-fill composites was associated with more biofilm accumulation and surface topography changes. Overall, non-optimally performed curing procedures reduced the amount of delivered RE, which led to low DC%, more biofilm formation, and higher surface roughness. The improper light-curing of bulk-fill composites compromises their physicochemical and biological properties, which could lead to inferior clinical performance and reduced restorative treatments' longevity.

Assessment of the effect of vacuum-formed retainers and Hawley retainers on periodontal health: A systematic review and meta-analysis

Background

Recently, increasing attention has been paid to the periodontal health of orthodontic patients in the maintenance stage in clinical practice. The focus of this meta-analysis was to compare the effects of vacuum-formed retainers (VFR) and Hawley retainers (HR) on periodontal health, in order to provide a reference for clinical selection.

Methods

From the establishment of the database until November 2020, a large number of databases were searched to find relevant randomized control trials, including the Cochrane Library databases, Embase, PubMed, Medline via Ovi, Web of Science, Scopus, Grey Literature in Europe, Google Scholar and CNKI. Related literature was manually searched and included in the analysis. Two researchers screened the literature according to relevant criteria. The size of the effect was determined using RevMan5.3 software, and the mean difference and 95% confidence intervals (CI) were used to estimate the results using a random effects model.

Results

This meta-analysis included six randomized controlled trials involving 304 patients. The results of the meta-analysis showed that there was no statistical difference in sulcus probing depth status between the VFR group and the HR group, including at 1, 3, and 6 months. Compared with the VFR group, the HR group showed a lower gingival index at 1 month (mean difference = 0.12, 95%CI: 0.06 to 0.19) and 3 months (mean difference = 0.11, 95%CI: 0.06 to 0.17), while there was no statistically significant difference at 6 months (mean difference = 0.10, 95%CI: -0.07 to 0.27). The plaque index of the HR group also showed a good state at 1 month (mean difference = 0.06, 95%CI: 0.01 to 0.12), 3 months (mean difference = 0.12, 95%CI: 0.08 to 0.16), and 6 months (mean difference = 0.19, 95%CI: 0.09 to 0.29). Subgroup analysis of PLI showed that when all teeth were measured, PLI status was lower in the HR group at 6 months (mean difference = 0.32, 95%CI: 0.18 to 0.46). PLI status was also low for the other teeth group (mean difference = 0.15, 95%CI: 0.08 to 0.22).

Conclusion

Our meta-analysis showed that patients using the Hawley retainer had better periodontal health compared with those using vacuum-formed retainers. However, more research is needed to look at the periodontal health of patients using these two retainers.

Handling properties and surface characteristics of universal resin composites

OBJECTIVE

This study investigated the handling and surface characteristics of universal resin composites and determined the interrelations among the composites' handling, mechanical, and physical properties.

METHODS

Five recently introduced universal resin composites were tested. Twelve specimens per material were used to measure the stiffness and stickiness (handling properties) of the resin composite pastes. Additionally, surface properties (Knoop hardness number [KHN], surface roughness [Sa], surface gloss [SG], water contact angle [CA], and surface free energy [SFE]) of cured resin composites were determined in 12 specimens per material immediately after preparation (baseline) and after subjection to thermal cycles (TCs).

RESULTS

Handling and surface properties of the resin composites were material dependent. All the resin composites showed significantly lower KHN in the post-TC subgroups than that in the baseline subgroups. However, the influence of TC on the other surface properties was dependent on the material used. Some resin composites did not indicate any significant differences in Sa, SG, or CA between the baseline and post-TC groups.

SIGNIFICANCE

Although the resin composites in the baseline groups presented with different handling and surface properties, the surface properties of most of the composites were significantly affected by TC. Extremely strong positive or negative correlations were observed between stiffness and stickiness, KHN and Sa, KHN and SG, Sa and SG, and CA and SFE. Most correlations between the handling and surface properties were weak. Therefore, the selection of resin composites in clinical situations should be based on comprehensive consideration of their properties.

Assessment of Streptococcus mutans biofilms on orthodontic adhesives over 7 days

INTRODUCTION

The purpose of this study was to compare the metabolism of Streptococcus mutans biofilms after 1-7 days of growth on different orthodontic adhesives.

METHODS

Specimens of 6 commercial orthodontic adhesives were fabricated in custom-made molds and polymerized using a light-emitting diode light-curing unit. Bioluminescent S mutans (UA159:JM10) biofilms were grown on ultraviolet-sterilized specimens for 1, 3, 5, and 7 days (n = 18 biofilms/d/product) in anaerobic conditions at 37°C. The metabolism of biofilms (relative luminescence unit [RLU]) was measured 0, 2, 4, and 6 minutes after exposure to D-luciferin solution using a microplate reader. A linear mixed-effects model was used to analyze the logarithm of RLU (log RLU). The model included fixed effects of products, days, and minutes. Tukey-Kramer post-hoc tests were then performed on the significant predictors of log RLU (α = 0.05).

RESULTS

Days (P <0.0001) and minutes (P <0.0001) were independent predictors of log RLU, but the products were not (P = 0.5869). After adjusting for minutes, the log RLU was analyzed with a post-hoc test, and all differences between days were significant with the exceptions of day 3 from day 5 (P = 0.0731) and day 5 from day 7 (P = 0.8802). After adjusting for day, log RLU was analyzed with a post-hoc test and all differences in minutes were significant.

CONCLUSIONS

No significant differences in the metabolism of S mutans biofilms were observed among the 6 orthodontic adhesives. Biofilms that were grown for 3 days demonstrated the highest levels of biofilm metabolism as evidenced by higher mean log RLU values relative to 1, 5, and 7-day growth durations.

Bisphenol A as degradation product of monomers used in resin-based dental materials

OBJECTIVE

There is still much debate about the release of bisphenol-A (BPA) from dental materials. Therefore, this study aimed to quantify BPA present as an impurity in both BPA-based and non-BPA-based monomers and to evaluate whether these monomers may degrade to BPA upon salivary, bacterial, and chemical challenges.

METHODS

BPA was determined in three different amounts (1, 2, and 3 μmol) of each monomer (TEGDMA, UDMA, mUDMA, BisGMA, BisEMA-3, -6, -10, -30, BisPMA, EBPADMA urethane, BADGE, and BisDMA). Next, the monomers (3 μmol) were immersed in whole human pooled saliva collected from adults, Streptococcus mutans (2 × 10⁷ CFU/mL), and acidic (0.1 M HCl), alkaline (0.1 M NaOH), and control media. The amount of BPA was quantified using a specific and highly sensitive UPLC-MS/MS method including derivatization of BPA by pyridine-3-sulfonyl chloride.

RESULTS

The monomers BisGMA and BisEMA-3 contained trace amounts (0.0006% and 0.0025%, respectively) of BPA as impurities of their synthesis process. BPA concentrations increased when the monomers BisGMA, BisEMA-3, BisEMA-6, BisEMA-10, BisPMA and BADGE were exposed to saliva and S. mutans, indicating degradation of a small amount of monomer into BPA. In addition, BisPMA and BADGE degraded into BPA under alkaline conditions. The conversion rate of the monomers into BPA ranged between 0.0003% and 0.0025%.

SIGNIFICANCE

Impurities and degradation of BPA-based monomers may account for the release of BPA from resin-based dental materials. Even though the detected amounts of BPA due to monomer impurity were small, manufacturers of dental materials can reduce the BPA content by using only monomers of the highest purity. Considering the overall current trend towards BPA-free materials, it may be recommendable to investigate whether non-BPA based monomers can be used in dental resin-based materials.

Silane content influences physicochemical properties in nanostructured model composites

OBJECTIVE

To determine the effect of organosilane content on the physicochemical properties of model composites formulated with nano-sized fillers.

METHODS

Model composites were formulated with dimethacrylate-based monomers, a photoinitiator/co-initiator system and silicon dioxide nano-sized fillers treated with different amounts of 3-methacryloxypropyltrimethoxysilane (MPTS): 1.0 (G_1%), 2.0 (G_2%), 5.0 (G_5%), 7.5 (G_7.5%) and 10 (G_10%) wt.% relative to SiO₂. Non-silanized fillers (G_0%) were used in the control group. Degree of conversion (DC) was assessed by Fourier-transformed infrared spectroscopy (ATR-FTIR). Knoop hardness (KHN) and elastic modulus were determined before and after water storage for 4 months. Water sorption (Wsp) and solubility (Wsl) were calculated by successive mass determinations in analytical balance. Surface gloss and roughness were characterized before and after toothbrushing simulation.

RESULTS

With the exception of those fillers treated with 1% MPTS, DC was not dependent on the silane content. Within the silanized groups, G_1% showed the lowest initial and final KHN, without statistical difference from G_0%. The elastic modulus was not affected by the silane content, regardless of the storage condition, but those groups formulated with at least 5% silane presented improved values after storage. Silane content did not affect the WSl, but affected Wsp, in which those groups formulated with at least 2 wt.% of MPTS produced a more resistant material than G_0%. The use of treated particles with at least 2 wt.% of silane was able to produce materials that did not change their gloss after the brushing process. Additionally, these materials presented lower surface roughness than G_0% after the brushing process (p < 0.05).

SIGNIFICANCE

The concentration of MPTS affected the physicochemical properties of nano-filled composites. Therefore, 2 wt.% of silane was the optimized quantity to produce materials resistant to degradation, both in bulk and surface properties.

Effect of the addition of functionalized TiO2 nanotubes and nanoparticles on properties of experimental resin composites

OBJECTIVE

To evaluate the influence of the addition of functionalized and non-functionalized TiO₂ nanostructures on properties of a resin composite.

METHODS

TiO₂ nanostructures were synthesized and functionalized, using 3-(aminopropyl)triethoxysilane (APTMS) and 3-(trimethoxysilyl)propyl methacrylate (TSMPM). Characterizations were performed with XRD, EDS, TEM, and TGA. Resin composites containing Bis-GMA/TEGDMA, CQ, DABE, and barium-aluminum silicate glass were produced according to TiO₂ nanostructure (nanotube or nanoparticle), concentration (0.3 or 0.9 wt%), and functionalization (APTMS or TSMPM). The resin composite without nanostructures was used as control. The amount of fillers was kept constant at 78.3 wt% for all materials. The degree of conversion (DC - at 0 h and 24 h), maximum polymerization rate (Rp_max), and Knoop microhardness (KHN before and after ethanol softening) were evaluated. Data were analyzed with two-way ANOVA with repeated measures and Tukey's HSD (α = 0.05).

RESULTS

TGA results demonstrated that functionalizations were effective for both nanostructures. For DC, resin composites, time and interaction effect were significant (p < 0.001). Higher DC was found for 0.3-wt%-functionalized-nanotubes at 24 h. For nanoparticles, only 0.9-wt%-non-functionalized and 0.3-wt%-APTMS-functionalized showed DC similar to the control and all other groups showed higher DC (p < 0.05). Rp_max was higher for 0.3-wt%-APTMS-nanotubes, which corresponded to higher DC after 24 h. The lowest Rp_max occurred for 0.9-wt%-TSMPM-nanotubes, which showed smaller DC at 0 h. For KHN, resin composites, ethanol softening and interaction effect were significant (p < 0.001). KHN decreased after ethanol softening all groups, except for 0.3-wt%-TSMPM-nanotubes, 0.9-wt%-TSMPM-nanotubes, and 0.3-wt%-non-functionalized-nanoparticles.

CONCLUSION

The resin with 0.3-wt%-TSMPM-nanotubes showed higher DC after 24 h, while being the most stable material after the ethanol softening.

SIGNIFICANCE

The addition of functionalized TiO₂ nanostructures in resin-based materials may improve the properties of the material.

Zinc-based particle with ionic liquid as a hybrid filler for dental adhesive resin

OBJECTIVES

The aim of this study was to evaluate the effect of a zinc-based particle with ionic liquid as filler for an experimental adhesive resin.

METHODS

The ionic liquid 1-n-butyl-3-methylimidazolium chloride (BMI.Cl) and zinc chloride (ZnCl₂) were used to synthesize 1-n-butyl-3-methylimidazolium trichlorozincate (BMI.ZnCl₃), which was hydrolyzed under basic conditions to produce the simonkolleite (SKT) particles. SKT was analyzed by scanning electron microscopy and transmission electron microscopy. An experimental adhesive resin was formulated and SKT was incorporated at 1, 2.5, or 5 wt.% in the adhesive. One group without SKT was a control group. The antibacterial activity against Streptococcus mutans, cytotoxicity, degree of conversion (DC), ultimate tensile strength (UTS), softening in solvent, and microtensile bond strength (μ-TBS) were investigated.

RESULTS

SKT prepared from the ionic liquid BMI.ZnCl₃ presented a hexagonal shape in the micrometer scale. SKT addition provided antibacterial activity against biofilm formation of S.mutans and planktonic bacteria (p < 0.05). There were no differences in pulp cells' viability (p > 0.05). The DC ranged from 62.18 (±0.83)% for control group to 64.44 (±1.55)% for 2.5 wt.% (p > 0.05). There was no statistically significant difference among groups for UTS (p > 0.05), softening in solvent (p > 0.05), and 24 h or 6 months μ-TBS (p > 0.05).

CONCLUSIONS

The physicochemical properties of adhesives were not affected by SKT incorporation, and the filler provided antibacterial activity against S. mutans without changes in the pulp cells' viability. This hybrid zinc-based particle with ionic liquid coating may be a promising filler to improve dental restorations.

CLINICAL RELEVANCE

A filler based on a zinc-derived material coated with ionic liquid was synthesized and added in dental adhesives, showing antibacterial activity and maintaining the other properties analyzed. SKT may be a promising filler to decrease the biofilm formation around resin-based restorative materials.

Interaction between the Oral Microbiome and Dental Composite Biomaterials: Where We Are and Where We Should Go

Dental composites are routinely placed as part of tooth restoration procedures. The integrity of the restoration is constantly challenged by the metabolic activities of the oral microbiome. This activity directly contributes to a less-than-desirable half-life for the dental composite formulations currently in use. Therefore, many new antimicrobial dental composites are being developed to counteract the microbial challenge. To ensure that these materials will resist microbiome-derived degradation, the model systems used for testing antimicrobial activities should be relevant to the in vivo environment. Here, we summarize the key steps in oral microbial colonization that should be considered in clinically relevant model systems. Oral microbial colonization is a clearly defined developmental process that starts with the formation of the acquired salivary pellicle on the tooth surface, a conditioned film that provides the critical attachment sites for the initial colonizers. Further development includes the integration of additional species and the formation of a diverse, polymicrobial mature biofilm. Biofilm development is discussed in the context of dental composites, and recent research is highlighted regarding the effect of antimicrobial composites on the composition of the oral microbiome. Future challenges are addressed, including the potential of antimicrobial resistance development and how this could be counteracted by detailed studies of microbiome composition and gene expression on dental composites. Ultimately, progress in this area will require interdisciplinary approaches to effectively mitigate the inevitable challenges that arise as new experimental bioactive composites are evaluated for potential clinical efficacy. Success in this area could have the added benefit of inspiring other fields in medically relevant materials research, since microbial colonization of medical implants and devices is a ubiquitous problem in the field.

Fabrication and characterization of remineralizing dental composites containing hydroxyapatite nanoparticles

The aim of this study was to fabricate and characterize dental composites containing hydroxyapatite nanoparticles (HApNPs). Four dental composites were produced from the same organic matrix (70 wt% Bis-GMA and 30 wt% TEGDMA), with partial replacement of BaBSi particles (65 wt%) by HApNPs in the following concentrations (wt%): E0 (0) - control, E10 (10), E20 (20) and E30 (30). Ca²⁺ and PO₄^3- release was evaluated in solutions with different pHs (4, 5.5, and 7) using atomic emission spectroscopy with microwave-induced nitrogen plasma while the enamel remineralization potential was evaluated in caries-like enamel lesions induced by S. mutans biofilm using micro-CT. The following properties were characterized: degree of conversion (DC%), microhardness (KHN), flexural strength (FS), elastic modulus (EM) and translucency (TP). The higher the HApNPs content, the higher the Ca²⁺ and PO₄^3- release. The ions release was influenced by pH (4 > 5.5 > 7) (p < 0.05). All composites loaded with HApNPs were able to remineralize the enamel (E30 = E20 > E10) (p < 0.05). Contrarily, E0 was not able of recovering the enamel mineral loss. E0 and E10 presented highest DC%, while E20 and E30 showed similar and lowest DC%. KHN and FS were decreased with the addition of HApNPs, while EM was not influenced by the incorporation of HApNPs. E10 presented statistically similar TP to E0, while this property decreased for E20 and E30 (p < 0.05). Incorporation of HApNPs into dental composites promoted enamel remineralization, mainly at potentially cariogenic pH (= 4), while maintained their overall performance in terms of physicomechanical properties.

In silico non-linear dynamic analysis reflecting in vitro physical properties of CAD/CAM resin composite blocks

PURPOSE

The aim of this study was to assess the validity of in silico models of three-point bending tests to reflect in vitro physical properties obtained from three commercially available computer-aided design/computer-aided manufacturing (CAD/CAM) resin composite blocks and demonstrate notchless triangular prism analysis with those properties.

MATERIAL AND METHODS

Three types of commercially available CAD/CAM resin composite blocks were used: Cerasmart 300 (CS300; GC, Tokyo, Japan), Katana Avencia P Block (AP; Kuraray Noritake Dental, Tokyo, Japan), and KZR CAD HR3 Gamma Theta (GT; Yamakin, Osaka, Japan). In vitro/in silico three-point bending tests were conducted to obtain elastic modulus and fracture strain for non-linear dynamic finite element analysis (n = 10/each). Fractured surfaces of specimens after in vitro NTP tests were observed, and the fracture toughness of each CAD/CAM resin composite was obtained by in silico NTP analysis.

RESULTS

Both in vitro and in silico load-displacement curves obtained from three-point bending tests were significantly correlated (p < 0.05). The elastic moduli of CS300, AP, and GT were 8.0 GPa, 10.0 GPa, and 9.0 GPa, respectively. The fracture toughness values obtained from in silico NTP analysis of CS300, AP, and GT were 5.057 MPa m^1/2, 4.193 MPa m^1/2, and 4.880 MPa m^1/2, respectively. There was no significant difference in the length of the stable region among the three CAD/CAM resin composites (p = 0.09).

CONCLUSIONS

The in silico approach established in this study showed acceptable reflection of in vitro physical properties and will be useful for assessing fracture toughness related to the longevity of CAD/CAM resin composites without wastage of materials.

Myristyltrimethylammonium Bromide (MYTAB) as a Cationic Surface Agent to Inhibit Streptococcus mutans Grown over Dental Resins: An In Vitro Study

This in vitro study evaluated the effect of myristyltrimethylammonium bromide (MYTAB) on the physical, chemical, and biological properties of an experimental dental resin. The resin was formulated with dental dimetacrylate monomers and a photoinitiator/co-initiator system. MYTAB was added at 0.5 (G_0.5%), 1 (G_1%), and 2 (G_2%) wt %, and one group remained without MYTAB and was used as the control (G_Ctrl). The resins were analyzed for the polymerization kinetics, degree of conversion, ultimate tensile strength (UTS), antibacterial activity against Streptococcus mutans, and cytotoxicity against human keratinocytes. Changes in the polymerization kinetics profiling were observed, and the degree of conversion ranged from 57.36% (±2.50%) for G_2% to 61.88% (±1.91%) for G_0.5%, without a statistically significant difference among groups (p > 0.05). The UTS values ranged from 32.85 (±6.08) MPa for G_0.5% to 35.12 (±5.74) MPa for G_Ctrl (p > 0.05). MYTAB groups showed antibacterial activity against biofilm formation from 0.5 wt % (p < 0.05) and against planktonic bacteria from 1 wt % (p < 0.05). The higher the MYTAB concentration, the higher the cytotoxic effect, without differences between G_Ctrl e G_0.5% (p > 0.05). In conclusion, the addition of 0.5 wt % of MYTAB did not alter the physical and chemical properties of the dental resin and provided antibacterial activity without cytotoxic effect.

Synthesis, characterization, and aging resistance of the polyurethane dimethacrylate layer for dental restorations

In this study, polyurethane dimethacrylate (PUDMA) was synthetized from different components and incorporated into a direct resin composite restoration system with the aim to buffer tooth-resin interfacial stresses and maintain the marginal adaptation. The tensile strength, elongation at fracture (ε), and thermal stability of the PUDMA layer were characterized, showing a tensile strength of 22 MPa, an ε of 112%, and a thermal decomposition temperature of about 282°C. In addition, the degree of conversion, water sorption/solubility, hydrophobicity, microtensile bond strength (μTBS), marginal leakage, and cytotoxicity in vitro were evaluated for the PUDMA layer. The data were analyzed using one-way ANOVA, except for leakage depths (which were analyzed using the Wilcoxon paired-rank test). The level of significance was set at 0.05. Compared with dental adhesives, PUDMA displayed a higher degree of conversion, lower water sorption/solubility, and improved hydrophobicity and biocompatibility in vitro. After thermocycling, the μTBS of the restoration system containing PUDMA had increased compared with the μTBS at 24 h. Restorations containing PUDMA showed lower leakage depths than those which did not contain PUDMA. In conclusion, because of its hydrophobic and elastic nature, the PUDMA layer, when used as an intermediate between tooth and resin restoratives, may buffer interfacial stresses, improve the stability and durability of the bonding interface, and reduce microleakage.

Influences of Different Air-Inhibition Coatings on Monomer Release, Microhardness, and Color Stability of Two Composite Materials

The aim of this study was to evaluate the effect of light-curing protocols on two modern resin composites using different air-inhibition coating strategies. This was accomplished by assessing the amount of monomer elution, surface microhardness, and composite discoloration in different storage conditions. A total of 120 specimens were prepared using Filtek Supreme XTE (3M ESPE, Seefeld, Germany) and CeramX Universal (Dentsply DeTrey, Konstanz, Germany). Specimens were light-cured in air as per manufacturer's instructions or in the absence of oxygen. This latter condition was achieved using three different approaches: (i) transparent polyester strip; (ii) glycerin; (iii) argon gas. Specimens were assessed for release of monomers, Vickers hardness, and discoloration after storage in different solutions. The results were analyzed with ANOVA one-way test followed by Student-Newman-Keuls test. Moreover, multiple comparisons of means were performed using the Student t-test (p<0.05). The amount of monomers released from the tested specimens was very low in all conditions. The presence of oxygen induced some decrease in microhardness. The highest discoloration values, for both materials, were obtained after ageing in red wine. In case finish and polish procedures are awkward to achieve in posteriors composite restoration, light-curing in the absence of oxygen should be considered, especially when performing composite restoration in esthetic areas.