Proanthocyanidins' efficacy in stabilizing dentin collagen against enzymatic degradation: MALDI-TOF and FTIR analyses

Two Novel Membranes Based on Collagen and Polyphenols for Enhanced Wound Healing

Two novel membranes based on collagen and two polyphenols, taxifolin pentaglutarate (TfG5) and a conjugate of taxifolin with glyoxylic acid (DfTf), were prepared. Fourier transform infrared spectroscopy examination confirmed the preservation of the triple helical structure of collagen. A scanning electron microscopy study showed that both materials had a porous structure. The incorporation of DfTf into the freeze-dried collagen matrix increased the aggregation of collagen fibers to a higher extent than the incorporation of TfG5, resulting in a more compact structure of the material containing DfTf. It was found that NIH/3T3 mouse fibroblasts were attached to, and relatively evenly spread out on, the surface of both newly obtained membranes. In addition, it was shown that the membranes enhanced skin wound healing in rats with a chemical burn induced by acetic acid. The treatment with the materials led to a faster reepithelization and granulation tissue formation compared with the use of other agents (collagen without polyphenols and buffer saline). It was also found that, in the wound tissue, the level of thiobarbituric acid reactive substances (TBARS) was significantly higher and the level of low-molecular-weight SH-containing compounds (RSH) was significantly lower than those in healthy skin, indicating a rise in oxidative stress at the site of injury. The treatment with collagen membranes containing polyphenols significantly decreased the TBARS level and increased the RSH level, suggesting the antioxidant/anti-inflammatory effect of the materials. The membrane containing TfG5 was more effective than other ones (the collagen membrane containing DfTf and collagen without polyphenols). On the whole, the data obtained indicate that collagen materials containing DfTf and TfG5 have potential as powerful therapeutic agents for the treatment of burn wounds.

Matrix metalloproteinases in dentin: Assessing their presence, activity, and inhibitors - a review of current trends

INTRODUCTION

Dentin integrity is a critical aspect of tooth structure, with matrix metalloproteinases (MMPs) playing a crucial role in dentinogenesis, caries formation, and dental bonding. It is crucial to accurately assess MMP activity to understand dentin pathophysiology and develop effective clinical strategies.

OBJECTIVES

The study aimed to conduct a thorough review and comprehensive summary of diverse techniques employed in assessing MMPs in dentin.

DATA AND SOURCES

To conduct the research, electronic databases were systematically searched and manual citation searches were performed. A total of 621 articles were identified. After eliminating duplicates and irrelevant studies, 70 articles were included in the review. 25 articles with overlapping methodologies were also excluded.

STUDY SELECTION

The selection criteria were based on the relevance of the studies to MMPs and MMP inhibitors in dentin without regard to the study design. Only peer-reviewed articles published in English were included. The search was restricted to studies published until November 2022.

CONCLUSION

The comprehensive analysis of various studies has yielded 37 techniques for evaluating MMPs and MMP inhibitors, which hold significant promise in creating diagnostic markers and devising targeted therapeutic interventions.

Mechanistic study of the stabilization of dentin-bonded restorative interfaces via collagen reinforcement by multi-acrylamides

Hydrolytically and enzymatically-stable multi-acrylamides have been proposed to increase the long-term durability of dental adhesive interfaces as alternatives to methacrylates. The aim of this study was to investigate the mechanical and biochemical properties of experimental adhesives containing multi-functional acrylamides concerning collagen reinforcement and metalloproteinases (MMP) activity. Multi-functional acrylamides, TMAAEA (Tris[(2-methylaminoacryl) ethylamine) and DEBAAP (N,N-Diethyl-1,3-bis(acrylamido) propane), along with the commercially available DMAM (N,N-dimethylacrylamide) (monofunctional acrylamide) and HEMA (2-Hydroxyethyl methacrylate) (monofunctional methacrylate - control) were tested for stability against enzymatic hydrolysis by cholesterol esterase/pseudocholinesterase (PC/PCE) solutions for up to 30 days. Collagen-derived substrate and gelatin zymography were performed to examine the effect of the compounds on the biological activity of human recombinant and dentin-extracted gelatinases MMP-2 and MMP-9. In situ zymography was carried out by fluorescent collagen degradation combined with confocal microscopy analysis. Hydroxyproline content was measured in collagen derived from dentin extracts though reaction with Ehrlich's reagent p-dimethylaminobenzaldehyde (DMAB), generating a stable chromophore measured at 550 nm. Storage shear modulus of demineralized dentin discs treated with the tested compounds was measured by oscillatory rheometry, in order to investigate potential collagen reinforcement. FT-IR was performed to determine qualitative differences in collagen based on observed changes in amide bands. The results were analyzed by ANOVA/Tukey's test (α = 0.05). Multi-acrylamides survived 30 days of incubation in cholinesterase/pseudo-cholinesterase (PC/PCE) solutions, while HEMA showed approximately 70 % overall degradation. Incubation with multi-acrylamides reduced collagen degradation as evidenced by the reduced hydroxyproline levels and by the 30 % increase inshear storage modulus. Biochemical and zymography assays showed no noticeable inhibition of recombinant and extracted MMPs enzymatic activity. The infra-red spectroscopy results for multi-functional acrylamides treated samples demonstrated shifts of the amide II bonds and marked increase in intensity of the bands 1200 cm-1, which may indicate partial collagen denaturation and some degree of cross-linking of the compounds with collagen, respectively. The multi-acrylamides exhibited not only comparable mechanical properties but also demonstrated significantly enhanced biochemical stability when compared to the widely used methacrylate control. Clinical relevance: These findings highlight the potential of multi-acrylamides to increase the bonding stability to tissues and, ultimately, contribute to the longevity of dental restorations.

NDGA enhances the physicochemical and anti-biodegradation performance of dentin collagen

OBJECTIVES

Collagen fibrils from carious dentin matrix are prone to enzymatic degradation. This study investigates the feasibility and mechanism of nordihydroguaiaretic acid (NDGA), as a collagen crosslinker, to bio-modify the demineralized dentin matrix.

METHODS

The physicochemical properties of the crosslinked dentin matrix were characterized by swelling ratio, ninhydrin assay, Fourier Transform Infrared spectroscopy, and atomic force microscopy. The collagenase degradation resistance was evaluated by measuring loss of dry mass, hydroproline release, loss of elasticity, and micro-nano structure integrity. The cytotoxicity of NDGA-crosslinked dentin collagen was evaluated by flow cytometry.

RESULTS

NDGA crosslinked dentin matrix without destroying the integrity of collagen. Mechanistically, NDGA formed bisquinone bond between two adjacent o-quinone groups, resulting in NDGA polymeric matrix in which collagen fibrils were embedded. NDGA modification could significantly enhance the stiffness of dentin matrix at macro-nano scale. The NDGA-crosslinked dentin matrix exhibited remarkably low collagen degradation and sustained bulk elasticity after collagenase challenge, which were attributed to decreased water content, physical masking of collagenase bind sites on collagen, and improved stiffness of collagen fibrils. Notably, NDGA-crosslinked dentin matrix exhibited excellent biocompatibility.

CONCLUSION

NDGA, as a biocompatible collagen crosslinker, improves the mechanical properties and biodegradation resistance of demineralized dentin matrix.

Dual-functional etchants that simultaneously demineralize and stabilize dentin render collagen resistant to degradation for resin bonding

OBJECTIVES

To develop dual-functional etchants that could demineralize and stabilize dentin collagen simultaneously, and to assess the effects of these etchants on collagen crosslinking, biostability and resin bonding properties under clinically relevant conditions.

METHODS

Dual-functional etchants were prepared by mixing 56% glycolic acid and 17% phosphoric acid and adding 1% of theaflavins (TF) or proanthocyanidins from grape seed extract (GSE). The etchant without crosslinker was used as control. The prepared human dentin specimens were treated with the 3 etchants for 30 s and analyzed for chemical interaction using Fourier transform infrared spectroscopy and resistance of the demineralized layer to collagenase degradation using electron microscopy (EM). Resin-dentin interfacial bonding properties were evaluated after 24 h and after 10,000 thermocycling through microtensile bond strength (μTBS), nanoleakage and matrix metalloproteinases (MMPs) activity via in situ zymography. Statistical analysis was done using ANOVA and post- hoc Tuckey's test.

RESULTS

Compared to control, TF and GSE dual-functional etchants were able to demineralize dentin, induce collagen crosslinking and protect the demineralized layer from collagenase degradation within 30 s. High resolution EM images showed better protection with TF etchant compared to GSE. There was a significant reduction in μTBS and an increase in nanoleakage and MMPs activity in control after thermocycling (p < 0.05) while these changes weren't seen in dual-functional etchants.

SIGNIFICANCE

Dual-functional etchants, especially TF containing, provide collagen protection against degradation and result in stable μTBS and less nanoleakage and MMPs activity under clinically relevant conditions.

Polyphenols Can Improve Resin-Dentin Bond Durability by Promoting Amorphous Calcium Phosphate Nanoparticles to Backfill the Dentin Matrix

Objective

To investigate the effects of proanthocyanidins (PA), myricetin, resveratrol, and kaempferol on the modification of dentin collagen and the inhibition of matrix metalloproteinase (MMP) activity, and to evaluate their contributions to the biomimetic remineralization and resin-dentin bonding performance.

Methods

Attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) and in situ zymography were applied to verify the collagen modification and MMP activity inhibition induced by these four polyphenols. Scanning electron microscopy/energy dispersive spectrometer (SEM/EDS) analysis, X-ray diffraction (XRD), ATR-FTIR, Vickers hardness numbers (VHN), and micro-computed tomography (micro-CT) were performed to characterize the remineralized dentin. Microtensile bond strength (μTBS) and nanoleakage were investigated to evaluate the effects of the four polyphenols on resin-dentin bonding durability.

Results

ATR-FTIR and in situ zymography confirmed that these four polyphenols could modify dentin collagen and inhibit MMP activity, respectively. Chemoanalytic characterization exhibited the efficacies of the four polyphenols in promoting dentin biomimetic remineralization. The surface hardness of PA-pretreated dentin was the greatest. Micro-CT results demonstrated that the PAs group possessed the highest amount of dentin surface minerals and the lowest amount of deep-layer minerals. The surface and deep-layer mineral contents of the Myr group were higher than Res and Kae groups. Treatment with these four polyphenols significantly increased the initial μTBS compared with the control group without primer conditioning. μTBS decreased significantly during aging, and the decrease was more severe in the PAs and Kae groups than in the Myr and Res groups. With or without aging, the polyphenol groups exhibited relatively less fluorescence. However, the Myr and Res groups showed less serious nanoleakage after aging.

Conclusion

PA, myricetin, resveratrol, and kaempferol can modify dentin collagen, inhibit MMP activity, promote biomimetic remineralization, and improve resin-dentin bond durability. Compared with PA and kaempferol, myricetin and resveratrol are more effective in improving resin-dentin bonding.

Collagen stabilization by natural cross-linkers: A qualitative and quantitative FTIR study on ultra-thin dentin collagen model

Due to its low tolerance to external factors such as enzymes, dentin collagen often requires stabilization, which can be achieved through cross-linking. In this study, qualitative and quantitative Fourier transform infrared (FTIR) analyses were used to assess dentin collagen stabilization effects of three structurally-different flavonoids -A-type linkage proanthocyanidins (A-PA), B-type linkage proanthocyanidins (B-PA), and epigallocatechin gallate (EGCG), all from natural extracts. Particularly, transmission FTIR spectroscopy was used for the first time to quantitatively assess the biodegradation of fresh ultra-thin (10 µm) dentin collagen films caused by collagenase digestion. Two traditional analytical methods, namely the hydroxyproline assay and weight loss analysis, were also used for comparison purposes. The results from all three methods showed consistently that A-PA and B-PA provide better collagen stabilization than EGCG at concentrations of 0.65% and 1.3% (p<0.01). FTIR is demonstrated to be a valuable and reliable analytical tool for qualitative and quantitative evaluation of ultra-thin collagen films.

Dentin collagen denaturation status assessed by collagen hybridizing peptide and its effect on bio-stabilization of proanthocyanidins

OBJECTIVE

To assess dentin collagen denaturation from phosphoric acid and enzyme treatments using collagen hybridizing peptide (CHP) and to investigate the effect of collagen denaturation on bio-stabilization promoted by proanthocyanidins (PA).

METHODS

Human molars were sectioned into 7-µm-thick dentin films, demineralized, and assigned to six groups: control with/without PA modification, H₃PO₄-treated collagen with/without PA modification, enzyme-treated collagen with/without PA modification. PA modification involved immersing collagen films in 0.65% PA for 30 s. H₃PO₄ and enzyme treatments were used to experimentally induce collagen denaturation, which was quantitated by fluorescence intensity (FI) from the fluorescently-conjugated-CHP (F-CHP) staining (n = 4). FTIR was used to characterize collagen structures. All groups were subject to collagenase digestion to test the bio-stabilization effect of PA on denatured collagen using weight loss analysis and hydroxyproline assay (n = 6). Data were analyzed using two-factor ANOVA and Games-Howell post hoc tests (α = 0.05).

RESULTS

FTIR showed collagen secondary structural changes after denaturation treatments and confirmed the incorporation and cross-linking of PA in control and treated collagen. F-CHP staining indicated high-degree, medium-degree, and low-degree collagen denaturation from H₃PO₄-treatment (FI = 83.22), enzyme-treatment (FI = 36.54), and control (FI = 6.01) respectively. PA modification significantly reduced the weight loss and hydroxyproline release of all groups after digestion (p < 0.0001), with the results correlated with FI values at r = 0.96-0.98.

SIGNIFICANCE

A molecular method CHP is introduced as a sensitive technique to quantitate dentin collagen denaturation for the first time. PA modification is shown to effectively stabilize denatured collagen against collagenase digestion, with the stabilization effect negatively associated with the collagen denaturation degree.

Theaflavins as a novel cross-linker quickly stabilize demineralized dentin collagen against degradation

To investigate the ability of theaflavins (TF) from black tea to protect dentin collagen against enzymatic degradation via cross-linking effect under clinically relevant conditions. 10-µm-thick dentin films were microtomed from dentin slabs of human molars. Following demineralization, films or slabs were treated with TF at two concentrations (0.4% and 2%) for 30 s. A well-known collagen cross-linker grape seed proanthocyanidins (PA) was used as control. Collagen cross-linking interactions and stabilization against enzymatic degradation were investigated by Fourier transform infrared spectroscopy, weight loss, hydroxyproline release, and scanning/transmission electron microscopy. Data were analyzed by ANOVA, Tukey’s and Student’s T test (α = 0.05%). The results showed collagen cross-linking and stabilization efficacy was dependent on TF/PA concentrations. At 2.0%, TF and PA offered nearly full protection to collagen; at 0.4%, TF exhibited a significantly better collagen stabilization effect than PA (P < 0.05), while untreated collagen was completely digested. It’s concluded that TF cross-links dentin collagen within a clinically relevant time (30 s) and offers excellent collagen protection against enzymatic degradation, with efficacy comparable to or better than PA. The study supports the potential use of TF as a novel, promising collagen cross-linker for degradation resistant, long-lasting dentin bonding in composite restorations.

Cranberry Juice Extract Rapidly Protects Demineralized Dentin against Digestion and Inhibits Its Gelatinolytic Activity

Improving the longevity of composite restorations has proven to be difficult when they are bonded to dentin. Dentin demineralization leaves collagen fibrils susceptible to enzymatic digestion, which causes breakdown of the resin-dentin interface. Therefore, measures for counteracting the enzymatic environment by enhancing dentin collagen's resistance to degradation have the potential to improve the durability of dental composite restorations. This study aimed to evaluate the effects of polyphenol-rich extracts and a chemical cross-linker on the cross-linking interaction, resistance to digestion, and endogenous matrix metalloproteinase (MMP) activities of dentin collagen under clinically relevant conditions. Ten-µm-thick films were cut from dentin slabs of non-carious extracted human third molars. Following demineralization, polyphenol-rich extracts-including grape seed (GSE), green tea (GTE), and cranberry juice (CJE)-or chemical cross-linker carbodiimide with n-hydroxysuccinimide (EDC/NHS) were applied to the demineralized dentin surfaces for 30 s. The collagen cross-linking, bio-stabilization, and gelatinolytic activities of MMPs 2 and 9 were studied by using Fourier-transform infrared spectroscopy, weight loss, hydroxyproline release, scanning/transmission electron microscopy, and in situ zymography. All treatments significantly increased resistance to collagenase degradation and reduced the gelatinolytic MMP activity of dentin collagen compared to the untreated control. The CJE- and GSE-treated groups were more resistant to digestion than the GTE- or EDC/NHS-treated ones (p < 0.05), which was consistent with the cross-linking interaction found with FTIR and the in situ performance on the acid-etched dentin surface found with SEM/TEM. The collagen films treated with CJE showed the lowest MMP activity, followed by GSE, GTE, and, finally, EDC/NHS. The CJE-treated dentin collagen rapidly increased its resistance to digestion and MMP inhibition. An application of CJE as short as 30 s may be a clinically feasible approach to improving the longevity of dentin bonding in composite restorations.

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.

Dual-Functionality Evaluation of a Novel Collagen Crosslinking Resin

Current adhesives bond to dentin via a micro-interlocking mechanism within the hybrid layer. Besides such mechanical retention, bonding to dentin would benefit from additional chemical interaction between collagen and resin. This study aims to synthesize a novel light-curable collagen crosslinker methacrylate (MA) functionalized grapeseed extract (GSE) and to assess MAGSE's ability to crosslink dentin collagen in a clinically relevant setting as well as its role in light-cure as a resin. MA functionalization was accomplished by reacting GSE with methacryloyl chloride to obtain MAGSE, which was characterized by ¹H-NMR and Fourier transformed infrared spectroscopy (FTIR). The 6-µm-thick dentin films were microtomed from dentin slabs of third molars. Following demineralization, they were treated for 30 s by 1% MAGSE. Collagen crosslinking and resistance to digestion of MAGSE were evaluated by FTIR, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF) assay of films, and scanning electron microscopy (SEM)/transmission electron microscopy (TEM) on slabs. Meanwhile, 1% MAGSE or GSE was added to an experimental adhesive formulated with 2-hydroxyethyl methacrylate and a tricomponent photoinitiator system. Polymerization kinetics were monitored continuously in real time for 10 min using FTIR-attenuated total reflection. The results indicated that MAGSE could bind to dentin collagen and protect it from collagenase degradation as strong as GSE. Dentin collagen treated by 1% MAGSE for 30 s was scarcely digested (1.6 ± 1.6%) after 1 h in 0.1% collagenase, while untreated collagen was completely digested (100.9 ± 20.2%). SEM/TEM images indicated MAGSE efficiently crosslinked dentin collagen in 30 s and rendered it almost inert to digestion under clinically relevant settings. Unlike GSE that hindered light-curing of HEMA, MAGSE accelerated the rate of polymerization and exhibited typical traits of a resin monomer with multiple polymerizable units. In conclusion, a novel collagen crosslinking resin MAGSE is synthesized, which inherits collagen crosslinking ability from GSE and polymerization function from MA. Inclusion of this light-curable collagen crosslinker into adhesives might be a revolutionary way to improve durability of dentin bonding in composite restorations.

Bond strengths of three-step etch-and-rinse adhesives to silane contaminated dentin

This study aimed to evaluate the effect of silane coupling agent contamination on the microtensile bond strength (µTBS) of 3-step etch-and-rinse adhesives on dentin. Flat occlusal dentin surfaces were prepared and randomly divided into 8 groups (n=20) based on the tested adhesives; Scotchbond Multi-purpose or Optibond FL, with contamination of an experimental silane (2 vol% of 3-m ethacryloxypropyltrimethoxysilane at pH 4.5) before acid-etching, after-etching or after-priming; while the groups without silane contamination served as controls. µTBS data were analyzed by two-way ANOVA and Tukey's HSD tests at a significance level of 0.05. Additional specimens of contaminated dentin were used to analyze changes in the organic molecules by Fourier transform infrared spectroscopy (FTIR). Silane contamination before acid-etching did not significantly change µTBS (p>0.05), but contamination after-etching and after-priming significantly decreased µTBS of both adhesives (p<0.05). Silane contamination had an adverse effect on the dentin bond strength of 3-step etch-and-rinse adhesives especially after-priming.

Is it possible for a simultaneous biomodification during acid etching on naturally caries-affected dentin bonding?

OBJECTIVES

This study investigated the ability of modified phosphoric acids containing chlorhexidine (CHX) or grape seed extract (GSE) for promoting simultaneous biomodification during acid etching on bonding properties in caries-affected dentin (CAD).

MATERIALS AND METHODS

Thirty-two human molars (8 with sound dentin [SD] and 24 naturally CAD) were selected for the study. The SD and CAD were initially exposed, then randomized and etched according to the following groups: (1) SD (SD-CT) and CAD (CAD-CT) both with 37% phosphoric acid, (2) CAD with 2% CHX containing 37% phosphoric acid (CAD-CHX), and (3) CAD with 2% GSE containing 10% phosphoric acid (CAD-GSE). The bonding procedure and composite build-ups were performed after acid etching. Subsequently, they were sectioned in resin-dentin specimens. The specimens were submitted for chemical profiling by micro-Raman, microtensile bond strength (μTBS), failure mode with chemical characterization by FEG/SEM-EDX, and in situ zymography by CLSM. The data from μTBS and CLSM were statistically analyzed (1-way ANOVA and Tukey's test; α = 0.05).

RESULTS

The highest μTBS results were shown for SD-CT in comparison with all CAD groups (p < 0.001), and the lowest for CAD-CT and CAD-CHX (p < 0.001). The etching with CHX did not increase the μTBS for CAD when compared with CT (p = 0.52). However, the etching with GSE improved significantly the μTBS for CAD when compared with CT and CHX (p < 0.001). The chemical profile detected chemical and structural changes in collagen peaks for CAD-CT, which were not detected when the CAD was etched by modified acids. Also, the poorest hybridization ability was detected in CAD for CT, which was significantly improved with modified acids, especially the GSE, as evaluated by chemical profile and failure mode. A significant reduction of MMP activity on CAD was promoted by modified acids in comparison with CT (both p < 0.001).

CONCLUSIONS

The GSE-containing acid was able to promote biomodification during the acid etching, increasing the bonding properties and reducing the activity of the MMPs within the hybrid layer.

CLINICAL RELEVANCE

The use of GSE-containing phosphoric acid can be a promising alternative to improve the bonding performance on caries-affected dentin, since it is capable of biomodifying the dentin during the acid etching, without adding any extra step in bonding procedures.

Evaluation of the effect of collagen stabilizing agents like chitosan and proanthocyanidin on the shear bond strength to dentin and microleakage of resin composite at enamel and cemental walls: An in vitro study

Objectives:

The objective is to evaluate the effect of collagen stabilizing agents-chitosan and proanthocyanidin (PA) on the shear bond strength to dentin and microleakage of resin composite at enamel and cemental walls.

Materials and Methods:

Thirty premolars were decoronated 2 mm above cemento-enamel junction and restored with composite resin. Teeth were then randomly divided into three groups: Group I - Control, Group II - Pre-treatment with chitosan, and Group III - Pre-treatment with PA. Samples were then subjected to thermocycling for 500 cycles at 5°C and 55°C with the dwell time of 30 s and transfer time of 5–10 s. Then, the samples were subjected to shear bond strength evaluation on Universal testing machine. Shear load was applied until failure occurred. The load to failure was recorded individually and statistical analysis was done. Microleakage was determined by methylene blue dye penetration method and subjected to stereomicroscopic evaluation. Statistical analysis was carried out using Mann–Whitney test and Chi-square test.

Results:

Group II specimens produced the highest median shear bond strength and group I showed the least. In addition, Group I, Group II, and Group III showed no statistically significant difference in microleakage.

Conclusions:

Application of Chitosan and PA improved the shear bond strength to dentin as compared to the control. However, no significant difference in shear bond strength and microleakage was found between them.

Comparative evaluation of the effect of decontamination protocol on the shear bond strength of eighth generation bonding agent to contaminated dentin: an in vitro study

Introduction

This in vitro study aims to evaluate and compare the effect of decontamination protocol - based on sodium hypochlorite - NaOCl, as a decontaminating agent, followed by the application of a collagen cross-linking agent like sodium ascorbate or Proanthocyanidin on the shear bond strength of eighth generation bonding agent to contaminated dentin (saliva, blood and blood followed by hemostatic agent).

Methods

The buccal surfaces of extracted premolars were flattened to expose the dentine. The teeth were then randomly divided into 3 groups based on the contaminant used (saliva, blood and blood followed by hemostatic agent). Decontamination protocol was carried out with sodium hypochlorite followed by application of either of the two collagen cross-linking agents (sodium ascorbate/proanthocyanidin) in each group. FuturaBond DC (eighth generation) bonding agent was used to bond composite to dentin surfaces which was subjected to shear bond strength testing. Data was analyzed by one-way ANOVA and Tukey test.

Results

All the groups (contaminated with saliva, blood, or hemostatic agent) showed a decrease in shear bond strength of composite resin to dentin. The shear bond strength of composite resin to dentin was least affected by contamination with saliva followed by contamination with blood and was most affected by contamination with a hemostatic agent.

The decontamination protocol carried out showed that the combination of NaOCl and Proanthocyanidin improved the shear bond strength of composite to dentin significantly more than the combination of NaOCl and sodium ascorbate or of sodium hypochlorite used alone.

Sealing effects of different Chinese herbal medicines on dentinal tubules: a scanning electron microscopic observation

BACKGROUND AND OBJECTIVES

To evaluate the sealing effects of different Chinese herbal medicines on dentinal tubules, and to provide a reference for the clinical treatment of dentin hypersensitivity.

METHODS

Forty dentin slices prepared by freshly extracted bovine mandibular central incisors were randomly assigned to procyanidins, tannic acid, gallic acid, naringin, epigallocatechin gallate (EGCG), glycyrrhizic acid, paeonol, and blank groups. Dentin slices in each Chinese herbal medicine group were treated three times a day, each for 5 min, and then immersed in a remineralization solution for the rest of the time. Dentin slices in the blank group were directly immersed in the remineralization solution for 7 days. The dentinal tubule sealing effect was observed under the scanning electron microscope (SEM).

RESULTS

SEM results showed that the dentinal tubules were almost completely open in the blank group, which was mostly open in the gallic acid, EGCG, glycyrrhizic acid, and paeonol groups, and were sealed in procyanidins, tannic acid, and naringin groups. Significant differences were detected in mean area, mean diameter of dentinal tubules, and mean plugging rate of dentinal tubules between the remaining Chinese herbal medicine groups and blank group (P < .05). Among them, the dentinal tubule sealing effect of procyanidins, tannic acid, and naringin was obvious.

CONCLUSION

The findings suggested that procyanidins, tannic acid, and naringin can effectively seal dentinal tubules, which provided a basis for clinical treatment of dentin hypersensitivity.

Nanoscale chemical and mechanical heterogeneity of human dentin characterized by AFM-IR and bimodal AFM

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AFM-IR technique was used to detect the chemical heterogeneity of human dentin for the first time.

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The heterogeneity of mechanical properties of human dentin was explored by AFM AM-FM technique.

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A band at 1336 cm⁻¹ assigned to S Created by potrace 1.16, written by Peter Selinger 2001-2019 ]]>O stretching vibrations was found only in peritubular dentin.

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Peritubular dentin had a higher Young’s modulus (32.25 ± 4.67 GPa) than intertubular dentin.

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AFM-IR and AFM AM-FM are useful for understanding the mineral deposition mechanisms of dentin.

Human dentin, as an important calcified tissue in the body, plays significant roles in withstanding masticatory forces and has a complex hierarchical organization. Understanding the composition and ultrastructure of dentin is critical for elucidating mechanisms of biomineralization under healthy and pathological states. Here, atomic force microscope infrared spectroscopy (AFM-IR) and AFM-based amplitude modulation-frequency modulation (AM-FM) techniques were utilized to detect the heterogeneity in chemical composition and mechanical properties between peritubular and intertubular dentin at the nanoscale. AFM-IR spectra collected from peritubular and intertubular dentin contained similar vibrational bands in the amide regions (I, II and III), suggesting that collagen may exist in both structures. A distinctive band at 1336 cm⁻¹ indicative of SO stretching vibrations was detected only in peritubular dentin. AFM-IR imaging showed an uneven distribution of chemical components at different locations, confirming the heterogeneity of dentin. The Young’s modulus of peritubular dentin was higher, and was associated to a higher mineral content. This study demonstrated distinctive chemical and mechanical properties of peritubular dentin, implying the different development and mineralization processes between peritubular and intertubular dentin. AFM-IR is useful to provide compositional information on the heterogeneity of human dentin, helping to understand the mineral deposition mechanisms of dentin.

Effect of grape seed extract-containing phosphoric acid formulations on bonding to enamel and dentin

The aim was to evaluate the effect of 2% grape seed extract (GSE) containing phosphoric acid (PhA) on the bond strength to enamel and dentin. The control group was 37% PhA. The following three PhA formulations with 2% GSE and 20% ethanol were obtained: GSE5 = 5% PhA; GSE10 = 10% PhA; and GSE20 = 20% PhA. The enamel and dentin surfaces of molars were etched with the acid solutions, followed by Scotchbond Multi-Purpose adhesive and composite resin application. The tensile bond strength (TBS) test evaluated the bond to enamel after 24 h, and the microtensile bond strength (μTBS) test evaluated the bond to dentin after 24 h and 12-month water storage. Etched enamel and dentin were observed by scanning electron microscopy (SEM) and atomic force microscopy (AFM), respectively. The TBS data were submitted to one-way ANOVA, while µTBS data were submitted to two-way ANOVA and Tukey's test (α = 0.05). The TBS (MPa) to enamel did not significantly differ among the control (48.1 ± 15.7), GSE5 (46.1 ± 9.6), GSE10 (49.8 ± 13.6) and GSE20 (44.1 ± 11.9) groups (p = 0.537). The µTBS (MPa) to dentin of the control (28.4 ± 14.4) and GSE20 (24.1 ± 8.1) groups were significantly higher than those of the GSE5 (16.8 ± 7.4) and GSE10 (17.5 ± 6.6) groups at 24 h (p < 0.006). After 12-month storage, only GSE5 (21.0 ± 7.8) and GSE10 (17.6 ± 8.0) did not show significantly decreased μTBS (p > 0.145). SEM micrographs showed a shallower enamel etching pattern for GSE5. AFM images showed the formation of collagenous globular structures for GSE5 and GSE10. The different acid solutions did not influence the TBS to enamel, and the µTBS to dentin was stable over time when dentin was etched with GSE5 and GSE10.

Polyphenol uses in biomaterials engineering

Polyphenols are micronutrients obtained from diet that have been suggested to play an important role in health. The health benefits of polyphenols and their protective effects in food systems as antioxidant compounds are well known and have been extensively investigated. However, their functional roles as a "processing cofactor" in tissue engineering applications are less widely known. This review focuses on the functionality of polyphenols and their application in biomaterials. Polyphenols have been used to stabilize collagen and to improve its resistance to degradation in biological systems. Therefore, they have been proposed to improve the performance of biomedical devices used in cardiovascular systems by improving the mechanical properties of grafted heart valves, enhancing microcirculation through the relaxation of the arterial walls and improving the capillary blood flow and pressure resistance. Polyphenols have been found to stimulate bone formation, mineralization, as well as the proliferation, differentiation, and the survival of osteoblasts. These effects are brought about by the stimulatory effect of polyphenols on osteoblast cells and their protective effect against oxidative stress and inflammatory cytokines. In addition, polyphenols inhibit the differentiation of the osteoclast cells. Collectively, these actions lead to promote bone formation and to reduce bone resorption, respectively. Moreover, polyphenols can increase the cross-linking of dentine and hence its mechanical stability. Overall, polyphenols provide interesting properties that will stimulate further research in the bioengineering field.

Dual function of proanthocyanidins as both MMP inhibitor and crosslinker in dentin biomodification: A literature review

Proanthocyanidin, a natural phytochemical bioactive agent, simultaneously can silence the activity of dentinal proteases and crosslink the collagen matrix; both of these phenomena would be the fundamentals for bio-stability of resin-dentin interface which is essential for a promising adhesive dentistry. This review provides an overview of the data developed by different groups of researchers and highlighted topics are proanthocyanidin chemistry, natural resources and the unique interactions between proanthocyanidincollagen and proanthocyanidin-MMPs in dentin. Besides, clinical applications of proanthocyanidin in the form of proanthocyanidin-containing adhesives, preconditioners and etchants have been reviewed. One hundred and twelve studies have been published in peer-reviewed journals from 1981 to 2017, all were comprised in this review, some of them have been actually proven to be promising from clinical point of view and others need further assessment before their adoption as clinically practicable protocols.

Hesperidin interaction to collagen detected by physico-chemical techniques

OBJECTIVE

Dentin collagen can be modified by some plant-derived flavonoids to improve properties of dentin organic matrix. Hesperidin (HPN), a hesperetin-7-O-rutinoside flavonoid, has a potential of dentin modification for being based on evidence that a treatment with HPN may resist collagenase degradation and arrest demineralization of human dentin. In this study, biophysical and molecular-level information on the interaction of HPN and collagen was investigated.

METHODS

HPN is extracted from citrus fruits. Sample collagenous solution was prepared using atelocollagen (ATCL) as a triple-helical peptide model. We have performed circular dichroism spectroscopic analysis, sedimentation velocity measurement by ultracentrifuge and saturation transfer difference measurement (STD) by NMR on HPN-collagen in solution state.

RESULTS

The circular dichroism and sedimentation velocity measurement showed the evidence for the molecular interaction between ATCL and HPN, while HPN did not induce any conformational change of ATCL. The STD-NMR study further confirmed this interaction and suggested that HPN interacted with ATCL through its aromatic part, not through its disaccharide moiety.

SIGNIFICANCE

These findings indicated that HPN is weakly bound to ATCL not causing structural modification of collagen. This interaction may contribute to the preservation of collagen by protecting from collagenase degradation.

Collagen-collagen interactions mediated by plant-derived proanthocyanidins: A spectroscopic and atomic force microscopy study

Collagen cross-linkings are determinant of biological tissue stability and function. Plant-derived proanthocyanidins (PACs) mimic different hierarchical levels of collagen cross-links by non-enzymatic interactions resulting in the enhancement to the biomechanics and biostability of collagen-rich tissues such as dentin. This study investigated the interaction of PACs from Vitis vinifera grape seed extract with type I collagen in solubilized form and in the demineralized dentin matrix (DDM) by fluorescence spectral analysis; collagen-collagen binding forces in presence of cross-linking solutions by atomic force microscopy (AFM); and spectroscopic analysis of the DDM using attenuated total reflectance Fourier transform-infrared spectroscopy (ATR-FTIR). Glutaraldehyde (GA) and carbodiimide hydrochloride (EDC) with known cross-linking mechanisms were selected for comparative analyses. Changes in fluorescence upon interaction of solubilized type I collagen with PACs, EDC and GA reflected pronounced modifications in collagen conformation. PACs also promoted stronger collagen-collagen fibrils interaction than EDC and GA. A new feature was observed using ATR-FTIR spectroscopic analysis in PACs-treated collagen and DDM. The findings suggest covalent interactions between collagen and PACs. The mechanisms of interaction between PACs-collagen hold attractive and promising tissue-tailored biomedical applications and the binding forces that potentially drive such interaction were characterized.

STATEMENT OF SIGNIFICANCE

Connective tissues such as skin, bone and dentin are mainly composed of type I collagen, which is cross-linked to promote tissue stability, strength and function. Novel therapies using substances that mimic cross-links have been proposed to promote repair of collagen-based-tissues. In dentistry, naturally occurring proanthocyanidins (PACs) have the potential to enhance dentin mechanical properties and reduce its enzymatic degradation, but their mechanisms of cross-linking are unclear. The present study investigated the specific interactions between PACs-type I collagen in purified and dentin collagen and compared to the well described cross-linking mechanisms promoted by synthetic chemical substances. Findings reveal that covalent-like bonds are induced by plant PACs in type I collagen as well as in complex dental native tissue, promoting strong collagen-collagen interactions.

Comparison of two proanthocyanidin cross-linked recombinant human collagen-peptide (RHC) - chitosan scaffolds

Cross-linking plays an important role in tissue engineering, which involves the alternative of cross-linker and the way of components interaction. We compared two proanthocyanidin (PA) cross-linked recombinant human collagen-peptide - chitosan scaffolds: immerse cross-linking (I-CLS) and premix cross-linking (P-CLS). Both of the scaffolds presented homogeneous pore structure with mean pore size of 110-115 μm. The swelling ratio was decreased to 29.6 in I-CLS, but increased to 37.1 in P-CLS while porosity of the two scaffolds was reduced about 8% comparing to 94.3% before cross-linking. The cross-linked scaffolds exhibited enhanced resistance to enzyme degradation and improved compressive modulus (I-CLS > P-CLS). The scaffolds transformed from elastic region to plastic region until the strain reached 60%, and the stress was 40.5, 133.2 and 84.1 kPa of uncross-linking scaffold, I-CLS and P-CLS individually. Thermal stability indicated molecular bonding between PA and the scaffold components, simultaneously, Fourier transform infrared spectroscopy mainly presented hydrogen bonding between the protein amide carbonyl and the phenolic hydroxyl with a particular transform due to pyrrolidine rings of proline in P-CLS. Both of the I-CLS and P-CLS could promote human umbilical vein endothelial cells attachment and proliferation. The characterization suggested in situ biodegradable application of P-CLS, while a potential long-term utilization of I-CLS in tissue engineering.

Molecular weight and galloylation affect grape seed extract constituents' ability to cross-link dentin collagen in clinically relevant time

OBJECTIVE

To investigate the relationship between the structures of polyphenolic compounds found in grape seed extract (GSE) and their activity in cross-linking dentin collagen in clinically relevant settings.

METHODS

Representative monomeric and dimeric GSE constituents including (+)-catechin (pCT), (-)-catechin (CT), (-)-epicatechin (EC), (-)-epigallocatechin (EGC), (-)-epicatechin gallate (ECG), (-)-epigallocatechin gallate (EGCG), procyanidin B2 and a pCT-pCT dimer were purchased or synthesized. GSE was separated into low (PALM) and high molecular weight (PAHM) fractions. Human molars were processed into dentin films and beams. After demineralization, 11 groups of films (n=5) were treated for 1min with the aforementioned reagents (1wt% in 50/50 ethanol/water) and 1 group remained untreated. The films were studied by Fourier transform infrared spectroscopy (FTIR) followed by a quantitative mass spectroscopy-based digestion assay. Tensile properties of demineralized dentin beams were evaluated (n=7) after treatments (2h and 24h) with selective GSE species that were found to protect dentin collagen from collagenase.

RESULTS

Efficacy of GSE constituents in cross-linking dentin collagen was dependent on molecular size and galloylation. Non-galloylated species with degree of polymerization up to two, including pCT, CT, EC, EGC, procyanidin B2 and pCT-pCT dimer were not active. Galloylated species were active starting from monomeric form, including ECG, EGCG, PALM, GSE and PAHM. PALM induced the best overall improvement in tensile properties of dentin collagen.

SIGNIFICANCE

Identification under clinically relevant settings of structural features that contribute to GSE constituents' efficacy in stabilizing demineralized dentin matrix has immediate impact on optimizing GSE's use in dentin bonding.

Increased Durability of Resin-Dentin Bonds Following Cross-Linking Treatment

OBJECTIVES

This study evaluated the long-term effect of carbodiimide treatments of acid-etched dentin on resin-dentin bond strength of a simplified etch-and-rinse adhesive system.

METHODS

Forty-eight sound third molars were divided into three groups (n=16) according to the dentin treatment: G1: deionized water; G2: 0.5 mol/L 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) applied for 30 seconds; and G3: 0.5 mol/L EDC applied for 60 seconds. Flat dentin surfaces were produced, etched with 37% phosphoric acid for 15 seconds, and then treated with deionized water for 60 seconds or with 0.5 mol/L EDC for 30 or 60 seconds prior to the application of Single Bond 2. Crowns were restored with resin composite, and beam specimens were prepared for microtensile testing. The beams from each group were tested 24 hours or 6 or 12 months after the adhesive procedures. One slab from each tooth was prepared and analyzed for nanoleakage. Bond strength (MPa) data were submitted to analysis of variance and Tukey test (α=0.05).

RESULTS

The treatment of dentin with 0.5 mol/L EDC for 30 seconds (24.1±6.2 MPa) and 60 seconds (25.5±5.1 MPa) did not negatively affect the immediate bond strength of Single Bond 2 when compared to the control group (24.6±7.3 MPa). Additionally, EDC prevented resin-dentin bond degradation after 12 months in artificial saliva for both periods of treatment. An increased accumulation of silver ions was seen for the control group over time, while a much lower amount of silver grains was observed for the EDC-treated groups.

CONCLUSIONS

0.5 mol/L EDC was able to prevent resin-dentin bond degradation after 12 months, especially when applied for 60 seconds.

Water distribution in dentin matrices: bound vs. unbound water

OBJECTIVE

This work measured the amount of bound versus unbound water in completely-demineralized dentin.

METHODS

Dentin beams prepared from extracted human teeth were completely demineralized, rinsed and dried to constant mass. They were rehydrated in 41% relative humidity (RH), while gravimetrically measuring their mass increase until the first plateau was reached at 0.064 (vacuum) or 0.116 gH2O/g dry mass (Drierite). The specimens were then exposed to 60% RH until attaining the second plateau at 0.220 (vacuum) or 0.191 gH2O/g dry mass (Drierite), and subsequently exposed to 99% RH until attaining the third plateau at 0.493 (vacuum) or 0.401 gH2O/g dry mass (Drierite).

RESULTS

Exposure of the first layer of bound water to 0% RH for 5 min produced a -0.3% loss of bound water; in the second layer of bound water it caused a -3.3% loss of bound water; in the third layer it caused a -6% loss of bound water. Immersion in 100% ethanol or acetone for 5 min produced a 2.8 and 1.9% loss of bound water from the first layer, respectively; it caused a -4 and -7% loss of bound water in the second layer, respectively; and a -17 and -23% loss of bound water in the third layer. Bound water represented 21-25% of total dentin water. Chemical dehydration of water-saturated dentin with ethanol/acetone for 1 min only removed between 25 and 35% of unbound water, respectively.

SIGNIFICANCE

Attempts to remove bound water by evaporation were not very successful. Chemical dehydration with 100% acetone was more successful than 100% ethanol especially the third layer of bound water. Since unbound water represents between 75 and 79% of total matrix water, the more such water can be removed, the more resin can be infiltrated.

Addition of Grape Seed Extract Renders Phosphoric Acid a Collagen-stabilizing Etchant

Previous studies found that grape seed extract (GSE), which is rich in proanthocyanidins, could protect demineralized dentin collagen from collagenolytic activities following clinically relevant treatment. Because of proanthocyanidin's adverse interference to resin polymerization, it was believed that GSE should be applied and then rinsed off in a separate step, which in effect increases the complexity of the bonding procedure. The present study aimed to investigate the feasibility of combining GSE treatment with phosphoric acid etching to address the issue. It is also the first attempt to formulate collagen-cross-linking dental etchants. Based on Fourier-transformed infrared spectroscopy and digestion assay, it was established that in the presence of 20% to 5% phosphoric acid, 30 sec of GSE treatment rendered demineralized dentin collagen inert to bacterial collagenase digestion. Based on this positive result, the simultaneous dentin etching and collagen protecting of GSE-containing phosphoric acid was evaluated on the premise of a 30-second etching time. According to micro-Raman spectroscopy, the formulation containing 20% phosphoric acid was found to lead to overetching. Based on scanning and transmission electronic microscopy, this same formulation exhibited unsynchronized phosphoric acid and GSE penetration. Therefore, addition of GSE did render phosphoric acid a collagen-stabilizing etchant, but the preferable phosphoric acid concentration should be <20%.

A Fourier transform infrared spectroscopy analysis of carious dentin from transparent zone to normal zone

It is well known that caries invasion leads to the differentiation of dentin into zones with altered composition, collagen integrity and mineral identity. However, understanding of these changes from the fundamental perspective of molecular structure has been lacking so far. In light of this, the present work aims to utilize Fourier transform infrared spectroscopy (FTIR) to directly extract molecular information regarding collagen's and hydroxyapatite's structural changes as dentin transitions from the transparent zone (TZ) into the normal zone (NZ). Unembedded ultrathin dentin films were sectioned from carious teeth, and an FTIR imaging system was used to obtain spatially resolved FTIR spectra. According to the mineral-to-matrix ratio image generated from large-area low-spectral-resolution scan, the TZ, the NZ and the intermediate subtransparent zone (STZ) were identified. High-spectral-resolution spectra were taken from each zone and subsequently examined with regard to mineral content, carbonate distribution, collagen denaturation and carbonate substitution patterns. The integrity of collagen's triple helical structure was also evaluated based on spectra collected from demineralized dentin films of selected teeth. The results support the argument that STZ is the real sclerotic layer, and they corroborate the established knowledge that collagen in TZ is hardly altered and therefore should be reserved for reparative purposes. Moreover, the close resemblance between the STZ and the NZ in terms of carbonate content, and that between the STZ and the TZ in terms of being A-type carbonate-rich, suggest that the mineral that initially occludes dentin tubules is hydroxyapatite newly generated from odontoblastic activities, which is then transformed into whitlockite in the demineralization/remineralization process as caries progresses.

Dentin biomodification: strategies, renewable resources and clinical applications

OBJECTIVES

The biomodification of dentin is a biomimetic approach, mediated by bioactive agents, to enhance and reinforce the dentin by locally altering the biochemistry and biomechanical properties. This review provides an overview of key dentin matrix components, targeting effects of biomodification strategies, the chemistry of renewable natural sources, and current research on their potential clinical applications.

METHODS

The PubMed database and collected literature were used as a resource for peer-reviewed articles to highlight the topics of dentin hierarchical structure, biomodification agents, and laboratorial investigations of their clinical applications. In addition, new data is presented on laboratorial methods for the standardization of proanthocyanidin-rich preparations as a renewable source of plant-derived biomodification agents.

RESULTS

Biomodification agents can be categorized as physical methods and chemical agents. Synthetic and naturally occurring chemical strategies present distinctive mechanism of interaction with the tissue. Initially thought to be driven only by inter- or intra-molecular collagen induced non-enzymatic cross-linking, multiple interactions with other dentin components are fundamental for the long-term biomechanics and biostability of the tissue. Oligomeric proanthocyanidins show promising bioactivity, and their chemical complexity requires systematic evaluation of the active compounds to produce a fully standardized intervention material from renewable resource, prior to their detailed clinical evaluation.

SIGNIFICANCE

Understanding the hierarchical structure of dentin and the targeting effect of the bioactive compounds will establish their use in both dentin-biomaterials interface and caries management.