Efficacy of S-PRG filler varnishes on enamel caries remineralization

Dual-species biofilm of Streptococcus mutans and Candida albicans produces subsurface caries lesions on bovine enamel

OBJECTIVES

To develop a protocol for forming subsurface caries lesions on bovine enamel by dual-species biofilms of Streptococcus mutans and Candida albicans in vitro.

DESIGN

Biofilms were grown on bovine enamel specimens in artificial saliva (AS) for seven days. After 24 h of formation, the AS was supplemented or not with fluoride (F) using sodium fluoride (0.005 or 0.008 ppm F), and the biofilms were exposed or not to a 20 % sucrose solution (reproducing a cariogenic challenge) once/day. On the seventh day, the biofilms were harvested and had their extracellular polysaccharides (EPS) and inorganic components analyzed. The specimens were subjected to computed X-ray microtomography analysis to determine their mineral concentration. Data were compared using two-way analyses of variance, followed by Fisher's LSD or Student-Newman-Keuls tests (p < 0.05).

RESULTS

Biofilms exposed to the cariogenic challenge had significantly higher EPS concentrations than those not exposed, regardless of the presence of F. For biofilms grown with 0.008 ppm F, those exposed to the cariogenic challenge had lower F levels than those not exposed. For biofilms exposed to the cariogenic challenge, those grown with 0.008 ppm F had lower lesion depths and integrated mineral loss, and higher outer layers than those grown without F.

CONCLUSIONS

The dual biofilm model assessed was able to create subsurface caries lesions in bovine enamel in vitro, which was influenced by the presence of F in the culture medium and exposure to sucrose.

Impact of functional monomers, bioactive particles, and HEMA, on the adhesive performance of self-etch adhesive systems applied to simulated altered dentin: "Self-etch adhesives: impact of different formulations on simulated altered dentin"

OBJECTIVES

This study aimed to evaluate how self-etching/universal DASs with differing compositions interact with sound (S), post-radiotherapy (irradiated; I), and artificially eroded (E) dentin in terms of bonding properties.

METHODS

The DASs tested were Adper Scotchbond Multipurpose (MP; control), Clearfil SE Bond (SE), FL Bond II (FL), Adper Single Bond Universal (SU) and BeautiBond Xtreme (BX). They were analyzed for initial and 6-month microtensile bond strength (µTBS, n=12), mode of failure (40x), scanning electron microscopy (SEM), surface wettability (W, n=10), and degree of conversion (DC, n=3) via Fourier-transform infrared spectroscopy (FTIR). Normal and homogeneous distribution of the data allowed their analyses through ANOVA and Tukey tests (p<0.05).

RESULTS

All DASs except BX exhibited higher µTBS for S decreasing for I and E. BX demonstrated the greatest stability among the altered substrates. FL showed the most hydrophobic properties, likely due to its bioactive components. Universal DASs achieved higher DC, regardless of composition.

CONCLUSIONS

HEMA-free formulation combined with carboxylic and phosphoric acids in BX, achieved the most stable performance for altered substrates.

Effects of experimental in-office bleaching gels incorporated with co-doped titanium dioxide nanoparticles on dental enamel physical properties

To evaluate the physical properties of enamel submitted to hydrogen peroxide (HP) incorporated with titanium dioxide nanoparticles (NP) co-doped with nitrogen and fluorine and irradiated with violet LED light (LT). Enamel-dentin disks were randomly allocated (T0) into groups, according to HP (HP6, HP15, or HP35) and NP (no NP, 5NP, or 10NP) concentrations, and irradiated or not with LT. A negative control (NC) group was set. After three bleaching sessions (T1, T2, and T3), specimens were stored in saliva for 14 days (T4). Enamel surface microhardness number (KHN), surface roughness (Ra), cross-sectional microhardness (ΔS), energy-dispersive spectroscopy (EDS), scanning electron (SEM), and polarized light (PLM) microscopies were performed. Surface KHN was significantly influenced by NP over time, independently of LT irradiation. At T3 and T4, gels with 5NP and 10NP exhibited no KHN differences compared to NC and baseline values, which were not observed under the absence of NP. NP incorporation did not statistically interfere with the ΔS and Ra. PLM images exhibited surface/subsurface darkening areas suggestive of demineralizing regions. SEM demonstrated some intraprismatic affection in the groups without NP. EDS reported a higher enamel calcium to phosphorus ratio following 10NP gels applications. Gels with NP maintained the enamel surface microhardness levels and seemed to control surface morphology, upholding the mineral content. None of the proposed experimental protocols have negatively influenced the enamel surface roughness and the cross-sectional microhardness.

Influence of Application Modes on Increasing Bond Strength Longevity of Self-etching and Universal Adhesive Systems to Enamel

The present study aimed to evaluate the influence of application mode on the short-term microshear bond strength longevity of self-etching and universal adhesive systems to enamel, the failure mode, and the resulting enamel surface micromorphology. Ninety enamel surfaces were obtained from sound third molars, planed, and randomly assigned to nine groups, according to the application mode and the adhesive system (n=10). There were three primer application modes: according to the manufacturer's recommended application time (control), using double the application time recommended for the primer and selective enamel etching. The adhesive systems used were: Clearfil SE Bond (Kuraray), FL-Bond II (SHOFU), and Futurabond U (Voco). At least two resin-bonded composite cylinders (Grandioso Light Flow, Voco) were placed on each enamel surface, and then evaluated for microshear bond strength at 24 hours and 180 days of storage in solution body fluid (SBF) at pH 7.4. Failure modes were evaluated with a stereoscopic microscope at 20× magnification. A micromorphological analysis of the enamel surface was performed under a scanning electron microscope at 5000× magnification before and after the treatments. Mixed models for repeated measures over time showed significant interaction among application modes, adhesive systems, and time periods (p=0.0331). The bond strength of FL-Bond II adhesive to enamel observed after performing selective enamel etching was significantly higher than that observed after applying the control treatment (p=0.0010) at both 24 hours and 180 days. However, no significant difference was observed between the application of this same adhesive at double the time recommended by the manufacturer and the other two application modes (p>0.05). There was also no significant difference in the microshear bond strength for the enamel treatments applied using Clearfil SE Bond and Futurabond U (p>0.05). A significant reduction in bond strength to enamel was observed at the 180-day storage time for all the adhesive systems when selective enamel etching was performed (p<0.0001). No significant association was observed between the adhesive system failure mode and the enamel treatments (p=0.1402 and p=0.7590 for 24 hours and 180 days, respectively). The most prevalent failure was the adhesive type.

Novel Universal Bond Containing Bioactive Monomer Promotes Odontoblast Differentiation In Vitro

The development of multifunctional materials has been expected in dentistry. This study investigated the effects of a novel universal bond containing a bioactive monomer, calcium 4-methacryloxyethyl trimellitic acid (CMET), on odontoblast differentiation in vitro. Eluates from bioactive universal bond with CMET (BA (+), BA bond), bioactive universal bond without CMET (BA (-)), and Scotchbond Universal Plus adhesive (SC, 3M ESPE, USA) were added to the culture medium of the rat odontoblast-like cell line MDPC-23. Then, cell proliferation, differentiation, and mineralization were examined. Statistical analyses were performed using a one-way ANOVA and Tukey's HSDtest. The cell counting kit-8 assay and alkaline phosphatase (ALP) assay showed that cell proliferation and ALP were significantly higher in the 0.5% BA (+) group than in the other groups. In a real-time reverse-transcription polymerase chain reaction, mRNA expression of the odontogenic markers, dentin sialophosphoprotein (DSPP) and dentin matrix protein-1 (DMP-1), was significantly higher in the 0.5% BA (+) group than in the BA (-) and SC groups. Calcific nodule formation in MDPC-23 cells was accelerated in the BA (+) group in a dose-dependent manner (p < 0.01); however, no such effect was observed in the BA (-) and SC groups. Thus, the BA bond shows excellent potential for dentin regeneration.

Engineered Biomaterials Trigger Remineralization and Antimicrobial Effects for Dental Caries Restoration

Dental caries is the most prevalent chronic disease globally, significantly impacting individuals' quality of life. A key reason behind the failure of implanted restorations is their biological inactivity, meaning they are unable to form crosslinks with the surrounding tooth structures, thus making patients susceptible to implant loss and recurrent tooth decay. For the treatment of caries, antibacterial medicine and remineralization are effective means of treating the recurrence of caries. Owing to the rapid progression in the biomaterials field, several biomaterials have been reported to display antimicrobial properties and aid in dentin remineralization. Bioactive materials hold considerable potential in diminishing biofilm accumulation, inhibiting the process of demineralization, enabling dentin remineralization, and combating bacteria related to caries. Bioactive materials, such as fluoride, amorphous calcium phosphate, bioactive glass, collagen, and resin-based materials, have demonstrated their effectiveness in promoting dentin remineralization and exerting antibacterial effects on dental caries. However, the concentration of fluoride needs to be strictly controlled. Although amorphous calcium phosphate can provide the necessary calcium and phosphorus ions for remineralization, it falls short in delivering the mechanical strength required for oral mastication. Resin-based materials also offer different advantages due to the complexity of their design. In this review, we delve into the application of advanced bioactive materials for enhancing dentin remineralization and antibacterial properties. We eagerly anticipate future developments in bioactive materials for the treatment of dental caries.

The bleaching effect of office bleaching agents containing S-PRG filler evaluated by pH value and electron spin resonance

OBJECTIVES

Surface reaction-type pre-reacted glass-ionomer (S-PRG) filler releases six types of ions with a neutralizing ability. This study evaluated the effect of S-PRG filler incorporation in an H₂O₂-based bleaching material on the bleaching efficacy, pH, and reaction state.

MATERIALS AND METHODS

The experimental bleaching material was formulated by the addition of 5% or 10% S-PRG fillers to the powder part. The stained bovine teeth were treated with the prepared bleaching paste. Commission internationale de l'éclairage (CIE) L*a*b* color space values were recorded before and after bleaching, and the color difference (ΔE) and whiteness index (WI_D) were calculated. Moreover, the used bleaching formulations were assessed for their pH values and reaction state by evaluating the oxidation state of manganese (Mn⁺²) using electron spin resonance (ESR).

RESULTS

The results of ΔE and WI_D showed that the addition of S-PRG filler increased the bleaching effect, but there was no significant difference between the groups with 5% and 10% S-PRG filler. A significant increase in pH in S-PRG filler groups (5% pH 6.7, 10% pH 6.8) was found compared to the 0% group (pH 4.8). ESR measurements showed that the signal emitted from Mn⁺² decreased over time. The S-PRG filler groups showed a significantly higher reduction in Mn⁺² compared to the 0% group, with no significant difference between the 5% and 10% S-PRG groups.

CONCLUSIONS

S-PRG filler addition resulted in improved bleaching efficacy, higher reaction rate, and pH values that are close to neutral.

CLINICAL RELEVANCE

S-PRG filler addition may be effective on the bleaching outcome of H₂O₂-based materials.

Multiple-Ion Releasing Bioactive Surface Pre-Reacted Glass-Ionomer (S-PRG) Filler: Innovative Technology for Dental Treatment and Care

Surface Pre-Reacted Glass-ionomer (S-PRG) filler, which releases strontium (Sr²⁺), borate (BO₃^3-), fluoride (F^-), sodium (Na⁺), silicate (SiO₃^2-), and aluminum (Al³⁺) ions at high concentrations, is a unique glass filler that are utilized in dentistry. Because of its multiple-ion releasing characteristics, S-PRG filler exhibits several bioactivities such as tooth strengthening, acid neutralization, promotion of mineralization, inhibition of bacteria and fungi, inhibition of matrix metalloproteinases, and enhancement of cell activity. Therefore, S-PRG filler per se and S-PRG filler-containing materials have the potential to be beneficial for various dental treatments and care. Those include restorative treatment, caries prevention/management, vital pulp therapy, endodontic treatment, prevention/treatment of periodontal disease, prevention of denture stomatitis, and perforation repair/root end filling. This review summarizes bioactive functions exhibited by S-PRG filler and its possible contribution to oral health.

Effect of a Toothpaste Containing Surface Pre-Reacted Glass-Ionomer Filler on the Remineralization of Artificial Carious Enamel Lesions in situ

This study evaluated the remineralizing effect of a toothpaste containing surface pre-reacted glass-ionomer (S-PRG) filler on demineralized enamel in situ. For this, 180 bovine enamel samples were demineralized by using a microcosm biofilm model for 3 days. Thereafter, the samples were randomly signed to 15 healthy volunteers and to 3 cross-over in situ phases corresponding to the following treatments: (1) toothpaste containing 1,500 ppm F as NaMFP (positive control, Colgate®Cavity Protection), (2) toothpaste containing 5% S-PRG filler (Shofu®), and (3) placebo toothpaste (negative control prepared by Shofu®). Four demineralized enamel blocks were fixed into each palatal appliance per phase. The volunteers wore the appliances for 5 days and were trained to brush their teeth 2 times for 2 min a day, while one drop of the toothpaste's slurry (1:3) was dripped on each sample for the same period. The surface hardness and TMR analyses were done and analyzed by ANOVA/Tukey and t test (p < 0.05). S-PRG filler and Colgate® toothpastes were equally able to improve 2-2.5× enamel remineralization by the analysis of % surface hardness recovery. However, S-PRG toothpaste was the only one able to significantly improve ΔΔZ (the integrated mineral loss recovery: 1,489 ± 503 %vol.μm) compared to placebo (1,050 ± 467 %vol.μm), while Colgate® did not differ from placebo. No differences were seen between the groups with respect to ΔLD. S-PRG filler and Colgate® toothpastes show similar potential to remineralize the lesion surface. However, S-PRG toothpaste is better to recover mineral loss at the subsurface area.