Development of a new class of self-healing and therapeutic dental resins

Light-curable urushiol enhanced bisphenol A glycidyl dimethacrylate dentin bonding agent

OBJECTIVES

The low durability of composite resin restorations can be attributed to the degradation of the resin dentin bonding interface. Owing to the presence of hydrophilic components in the adhesive, the integrity of the resin dentin bonding interface is easily compromised, which, in turn, leads to a reduction in bond strength. The hydrophilic nature of the adhesive leads to water sorption, phase separation, and leaching of the resin component. Therefore, hydrophobic adhesives could effectively be used to stabilize the integrity and durability of the resin dentin bonding interface.

METHODS

We synthesized a novel hydrophobic dentin adhesive by partially replacing bisphenol A glycidyl dimethacrylate (Bis-GMA) with a light-curable urushiol monomer. The properties of the produced adhesive, including the degree of conversion, viscosity, contact angle, water sorption/solubility, and mechanical strength, were comprehensively examined and compared to those of the commercially adhesive Adper Single Bond2 as a positive control. The adhesive properties were determined using microtensile bond strength measurements, laser confocal microscopy, scanning electron microscopy observations, and nanoleakage tests. Finally, the novel adhesive was subjected to biocompatibility testing to determine its potential cytotoxicity.

RESULTS

At a light-curable urushiol content of 20 %, the synthesized adhesive exhibited high degrees of conversion and hydrophobicity, low cytotoxicity, good mechanical properties, and outstanding adhesive strength.

CONCLUSIONS

The introduction of the light-curable urushiol into dentin adhesives can significantly enhance their hydrophobic, mechanical, and bonding properties, demonstrating potential to significantly improve restoration longevity.

CLINICAL SIGNIFICANCE

The integration of light-curable urushiol has endowed the experimental adhesives with several enhanced functionalities. These notable benefits underscore the suitability of this monomer for expanded applications in clinical practice.

Effects of chitosan and TiO2 nanoparticles on the antibacterial property and ability to self-healing of cracks and retrieve mechanical characteristics of dental composites

The aim of this study was to improve the self-healing properties of dental nanocomposite using nanoparticles of TiO2 and chitosan. We evaluated flexural and compressive strength, crack-healing, and self-healing lifespan after 3 months of water aging. The effect of the developed composite on cell viability and toxicity was assessed by an MTT assay on human alveolar basal epithelial cells (A549 cell line). The nanocomposite included 7.5 wt% polyurea-formaldehyde (PUF) and 0, 0.5, and 1 wt% n-TiO2 and chitosan. After the fracture, the samples were put in a mold for 1-90 days to enable healing. Then, the fracture toughness of the healed nanocomposites and the healing yield were measured. The flexural strength of the nanocomposite improved by adding 0.5 wt% n-TiO2, while the compressive strength increased after adding 0.5 wt% chitosan (p > 0.1). When these two materials were used simultaneously, the flexural strength was improved by around 2%; however, the compressive strength was unaffected. Compared to the other sample, the nanocomposite with 0.5 wt% n-TiO2 and chitosan had higher KIC-healing and self-healing efficiency. Self-healing efficacy had no significant effect of water aging over 90 days compared to one day (p > 0.1), demonstrating that the PUF nanocapsules were not damaged.

Novel low-shrinkage dental resin containing microcapsules with antibacterial and self-healing properties

Dental resin restorations commonly fail because of fractures and secondary caries. The aim of this research was to synthesize a novel low-shrinkage dental resin with antibacterial and self-healing properties. The low-shrinkage dental resin was obtained by incorporating a 20 wt% anti-shrinkage mixture of an expanding monomer 3,9-diethyl-3,9-dimethylol -1,5,7,11-tetraoxaspiro[5,5] undecane and an epoxy resin monomer diallyl bisphenol A diglycidyl ether (1:1, referred as "UE") and different mass fractions of self-healing antibacterial microcapsules (0%, 2.5%, 5%, 7.5%, and 10%) were incorporated into the matrix to prepare multifunctional dental resin. Polymerization shrinkage, mechanical properties, antibacterial activity, self-healing ability, and cytotoxicity of this dental resin were evaluated. The polymerization volumetric shrinkage of resin containing 20 wt% UE and 7.5 wt% microcapsules was reduced by 30.12% (4.13% ± 0.42%) compared with control. Furthermore, it exhibited high antibacterial activity and a good self-healing efficiency of 71% without adversely affecting the mechanical property and cell viability. This novel multifunctional dental resin with low polymerization shrinkage and excellent antibacterial activity and self-healing capability has potential application as a dental resin material to decrease the incidence of fractures and secondary caries.

Novel antimicrobial and self-healing dental resin to combat secondary caries and restoration fracture

OBJECTIVE

Dental resin composites have been the most popular materials for repairing tooth decay in recent years. However, secondary caries and bulk fracture are the major hurdles that affect the lifetime of dental resin composites. This current study synthesized a novel antimicrobial and self-healing dental resin containing nanoparticle-modified self-healing microcapsules to combat secondary caries and restoration fracture.

METHODS

Multifunctional dental resins containing 0-20% nanoparticle-modified self-healing microcapsules were prepared. The water contact angle, antimicrobial properties, mechanical properties, cell toxicity, and self-healing capability of the dental resins were tested.

RESULTS

A novel multifunctional dental resin was synthesized. When the microcapsule mass fraction was 10%, the resin presented a strong bacteriostasis rate (80.3%) and excellent self-healing efficiency (66.1%), while the hydrophilicity, mechanical properties, and cell toxicity were not affected.

SIGNIFICANCE

The novel antimicrobial self-healing dental resin is a promising candidate for use in clinical practice, which provides a simple and highly efficient strategy to combat secondary caries and restoration fracture. This novel dental resin also gives the inspiration to prolong the service life of dental restorations.

Fatigue behaviour of a self-healing dental composite

OBJECTIVE

Novel self-healing resin-based composites containing microcapsules have been developed to improve the mechanical performance of dental restorations. However, the long-term fatigue behaviour of these self-healing composites has still been hardly investigated. Therefore, this manuscript studied the fatigue behaviour of self-healing composites containing microcapsules by subjecting the specimens to traditional staircase tests and ageing in a custom-designed chewing simulator (Rub&Roll) to simulate oral ageing physiologically relevant conditions.

METHODS

To prepare self-healing composite, poly(urea-formaldehyde) microcapsules containing acrylic self-healing liquids were synthesized. Subsequently, these microcapsules (10 wt%) and initiator (benzoyl peroxide, BPO, 2 wt%) were incorporated into a commercial flowable resin-based composite. Microcapsule-free resin-based composites with and without BPO were also prepared as control specimens. A three-point flexural test was used to measure the initial flexural strength (Sinitial). Subsequently, half of the specimens were used for fatigue testing using a common staircase approach to measure the fatigue strengths (FS). In addition, the other specimens were aged in the Rub&Roll machine for four weeks where after the final flexural strength (Sfinal) was measured.

RESULTS

Compared to Sinitial, FS of all tested specimens significantly decreased as measured through staircase testing. After 4 weeks of ageing in the Rub&Roll machine, Sfinal was significantly reduced compared to Sinitial for microcapsule-free resin-based composites, but not for the self-healing composites (p = 0.3658). However, the self-healing composites are still in the experimental phase characterized by a low mechanical strength, which still impedes further clinical translation.

SIGNIFICANCE

Self-healing composites containing microcapsules exhibit improved fatigue resistance compared to microcapsule-free non-self-healing composites.

Polymer Mixtures for Experimental Self-Limited Dental Burs Development-A Preliminary Approach (Part 1)

Alternative techniques have been investigated for effectiveness in caries removal because conventional metallic dental burs can lead to an excessive loss of sound tissue. The aim of the present study is to realize a preliminary approach in obtaining effective polymer mixtures for polymeric bur development, capable of removing primary dental caries using combinations of polymers to ensure the requirements for such instruments, but also a greater compatibility with the teeth structure. This study assessed the main mechanical properties, water sorption, solubility and microscopic structure of four new polymer mixture recipes to provide essential features in obtaining experimental self-limited dental burs. Two mixtures have in their composition polymer mixtures of Bis-phenol A diglycidyl ether dimethacrylate/Triethylene glycol dimethacrylate/Urethane dimethacrylates (R1, R2), and two other mixtures have Bis-phenol A diglycidyl ether dimethacrylate/Polymethyl methacrylate/Methyl methacrylates (R3, R4). The incorporation of nanoparticles into the polymer matrix has become essential due to the need of polymer biocompatibility increasing along with teeth surface remineralization, so that the powder charge was added to four recipes, such as 5% glass with BaF2 and 0.5% graphene with silver particles. All data sets were analyzed using the One-Way ANOVA test. R3, R4 showed higher compressive strength and diametrical compression values; these values increased when glass and graphene were added. Moreover, the addition of glass particles lead to an increase in flexural strength. Regarding the sorption, sample R3 had the most significant differences between day 69 and the rest of the investigation days, while the solubility varied at different intervals. From the mechanical evaluation, we could conclude that the Bis-GMA/PMMA/MMA mixtures fit the mechanical characteristics supported by polymer burs, following future studies regarding their use on the affected dentin.

Development of functional fillers as a self-healing system for dental resin composite

OBJECTIVES

To evaluate the incorporation of repairing capsules containing different monomers and polymerization modulators on the self-healing efficiency of an experimental photopolymerizable resin-based composite.

METHODS

Self-healing capsules containing different monomers and polymerization modulators were prepared by emulsion polymerization: TC_DHEPT (TEGDMA and DHEPT), BTC_DHEPT (Bis-GMA, TEGDMA, and DHEPT), and BTC_BPO (Bis-GMA, TEGDMA, and BPO). The capsules were analyzed through Fourier transform infrared spectroscopy and scanning electron microscopy. The capsules were added into experimental photopolymerizable resin composites establishing the following groups: ER (Control without capsules), ER+BPO, ER+BPO+TC_DHEPT, and ER+BTC_BPO+BTC_DHEPT. Filtek Z350 resin composite (3 M ESPE) was used as a commercial reference. The materials were tested for degree of conversion (DC), flexural strength (σf), elastic modulus (Ef), fracture toughness (virgin K_IC), self-healing efficiency (healed K_IC), and roughness. For statistical analysis, the significance value was established at an a = 0.05 level.

RESULTS

When compared to the control material, the incorporation of repairing capsules did not affect DC, σf, and Ef. Fracture toughness was statistically similar between the experimental groups (p ≤ 0.05). Healed K_IC was statistically different between the groups ER+TC_DHEP and ER+BTC_BPO+BTC_DHEPT; the self-healing efficiency was higher for ER+TC_DHEPT. Surface roughness was statistically similar among all groups.

CONCLUSIONS

The use of self-healing capsules promoted repair of the material. Studies with material aging after the self-healing process are necessary to better demonstrate the effectiveness of this system.

CLINICAL SIGNIFICANCE

The self-healing system seemed to be a promising technology to be used in self-repaired restorative materials, which may prevent restoration fractures.

"Fatigue-Crack Propagation Behavior in Microcapsule-Containing Self-Healing Polymeric Networks"

Over the last years, research on the design of dental self-healing polymers has grown dramatically. It is related to the promising potential of maximizing the clinical lifespan of dental restorations that this strategy holds. In this manuscript, the microcapsule-based strategy is innovated by incorporating the high toughness component N,N-Dimethylacrylamide (DMAM) into the healing agent systems and analyzing in-depth the change in crack propagation behavior induced by the addition of microcapsules into the highly crosslinked polymeric network. In general, the addition of the hydrophilic and high vapor pressure DMAM into the healing agent systems imposed a challenge for the microencapsulation, which highlighted the importance of tailoring the properties of the capsules' shells according to the core composition. The addition of DMAM as cushioning agent proved to be a successful strategy since it resulted in increased G'/G" crossover time from 0.06 (control) to 0.57 s and decreased storage modulus from 8.0 (control) to 0.5GPa. In addition, the incorporation of microcapsules within the polymerized networks provided obstacles to crack propagation, which translated to an overall reinforcement of the polymeric network, as evidenced by the increase in toughness up to 50 % and energy required to propagate cracks up to 100 % in systems containing DMAM at 20 wt%.

Novel nanoparticle-modified multifunctional microcapsules with self-healing and antibacterial activities for dental applications

OBJECTIVE

Although microcapsules (MCs) have been used for dental resins to achieve self-healing capabilities, the fragile organic shell and single healing event functions during the service period limit their use. Herein, a novel nanoparticle-modified MC with a nano-antibacterial inorganic filler (NIF) containing a quaternary ammonium salt was synthesized to address these issues.

METHODS

MCs with 0 %-30 % NIFs were prepared via an in situ polymerization method and characterized their morphology, chemical composition, thermal stability, roughness, mechanical properties, and antibacterial effect. Subsequently, M-10 MCs were mixed into the resin matrix at a mass fraction of 7.5 %. The self-healing capability and cytotoxicity were evaluated.

RESULTS

The introduction of nanomaterials enhances the shell of the MCs and endows them with an antibacterial effect. With the addition of NIFs, the roughness, modulus, and hardness values of MCs all increased (p < 0.05). The presence of M-10 MCs reduced the CFU by 2-3 orders of magnitude compared to the control group. The dental resin containing 7.5 % M-10 MCs obtained almost 69 % self-healing efficiency, without significantly compromising cell viability (p < 0.05).

SIGNIFICANCE

Self-healing MCs with NIFs were prepared for the first time with strong antibacterial properties, a substantial self-healing capability, and low toxicity. This multifunctional MC is a promising candidate for use in dental resins to extend the service life and resolve the problem of bulk fracture and secondary caries.

The Development of Filler Morphology in Dental Resin Composites: A Review

Dental resin composites (DRCs) with diverse fillers added are widely-used restorative materials to repair tooth defects. The addition of fillers brings an improvement in the mechanical properties of DRCs. In the past decade, diverse fillers have emerged. However, the change of emerging fillers mainly focuses on the chemical composition, while the morphologic characteristics changes are often ignored. The fillers with new morphologies not only have the advantages of traditional fillers (particles, fibrous filler, etc.), but also endow some additional functional characteristics (stronger bonding ability to resin matrix, polymerization resistance, and wear resistance, drug release control ability, etc.). Moreover, some new morphologies are closely related to the improvement of traditional fillers, porous filler vs. glass particles, core-sheath fibrous vs. fibrous, etc. Some other new morphology fillers are combinations of traditional fillers, UHA vs. HA particles and fibrous, tetrapod-like whisker vs. whisker and fibrous filler, mesoporous silica vs. porous and silica particles. In this review, we give an overall description and a preliminary summary of the fillers, as well as our perspectives on the future direction of the development of novel fillers for next-generation DRCs.

Shape-Memory and Self-Healing Polymers Based on Dynamic Covalent Bonds and Dynamic Noncovalent Interactions: Synthesis, Mechanism, and Application

Shape-memory and self-healing polymers have been a hotspot of research in the field of smart polymers in the past decade. Under external stimulation, shape-memory and self-healing polymers can complete programed shape transformation, and they can spontaneously repair damage, thereby extending the life of the materials. In this review, we focus on the progress in polymers with shape-memory and self-healing properties in the past decade. The physical or chemical changes in the materials during the occurrence of shape memory as well as self-healing were analyzed based on the polymer molecular structure. We classified the polymers and discussed the preparation methods for shape-memory and self-healing polymers based on the dynamic interactions which can make the polymers exhibit self-healing properties including dynamic covalent bonds (DA reaction, disulfide exchange reaction, imine exchange reaction, alkoxyamine exchange reaction, and boronic acid ester exchange reaction) and dynamic noncovalent interactions (crystallization, hydrogen bonding, ionic interaction, metal coordination interaction, host-guest interactions, and hydrophobic interactions) and their corresponding triggering conditions. In addition, we discussed the advantages and the mechanism that the shape-memory property promotes self-healing in polymers, as well as the future trends in shape-memory and self-healing polymers.

An Evaluation of the Properties of Urethane Dimethacrylate-Based Dental Resins

Most of the dental materials available on the market are still based on traditional monomers such as bisphenol A-glycidyl methacrylate (Bis-GMA), urethane dimethacrylate (UDMA), triethyleneglycol dimethacrylate (TEGDMA), and ethoxylated bisphenol-A dimethacrylate (Bis-EMA). The interactions that arise in the monomer mixture and the characteristics of the resulting polymer network are the most important factors, which define the final properties of dental materials. The use of three different monomers in proper proportions may create a strong polymer matrix. In this paper, fourteen resin materials, based on urethane dimethacrylate with different co-monomers such as Bis-GMA or Bis-EMA, were evaluated. TEGDMA was used as the diluting monomer. The flexural strength (FS), diametral tensile strength (DTS), and hardness (HV) were determined. The impacts of material composition on the water absorption and dissolution were evaluated as well. The highest FS was 89.5 MPa, while the lowest was 69.7 MPa. The median DTS for the tested materials was found to range from 20 to 30 MPa. The hardness of the tested materials ranged from 14 to 16 HV. UDMA/TEGDMA matrices were characterized by the highest adsorption values. The overall results indicated that changes in the materials' properties are not strictly proportional to the material's compositional changes. The matrices showed good properties when the composite contained an equal mixture of Bis-GMA/Bis-EMA and UDMA or the content of the UDMA monomer was higher.

Functional fillers for dental resin composites

Dental resin composites (DRCs) are popular materials to repair caries. Although various types of DRCs with different characteristics have been developed, restoration failures still exist. Bulk fracture and secondary caries have been considered as main causes for the failure of composites restoration. To address these problems, various fillers with specific functions have been introduced and studied. Some fillers with specific morphologies such as whisker, fiber, and nanotube, have been used to increase the mechanical properties of DRCs, and other fillers releasing ions such as Ag⁺, Ca²⁺, and F^-, have been used to inhibit the secondary caries. These functional fillers are helpful to improve the performances and lifespan of DRCs. In this article, we firstly introduce the composition and development of DRCs, then review and discuss the functional fillers classified according to their roles in the DRCs, finally give a summary on the current research and predict the trend of future development.

Influence of microcapsule parameters and initiator concentration on the self-healing capacity of resin-based dental composites

OBJECTIVE

Fracture is one of the main causes for failure of resin-based composite restorations. To overcome this drawback, self-healing resin-based composites have been designed by incorporation of microcapsules. However, the relationship between their self-healing capacity and microcapsule and resin parameters is still poorly understood. Therefore, the objective of this study was to systematically investigate the effect of initiator concentration (in the resin) and microcapsule size and concentration on the self-healing performance of commercially available flowable resin-based composites.

METHODS

Poly(urea-formaldehyde) (PUF) microcapsules containing acrylic healing liquid were synthesized in small (33±8μm), medium (68±21μm) and large sizes (198±43μm) and characterized. Subsequently, these microcapsules were incorporated into a conventional flowable resin-based composite (Majesty Flow ES2, Kuraray) at different contents (5-15wt%) and benzoyl peroxide (BPO) initiator concentrations (0.5-2.0wt%). Fracture toughness (K_IC) of test specimens was tested using a single edge V-notched beam method. Immediately after complete fracture (K_IC-initial), the two fractured parts were held together for 72h to allow for healing. Subsequently, fracture toughness of the healed resin-based composites (K_IC-healed) was tested as well.

RESULTS

The fracture toughness of healed dental composites significantly increased with increasing microcapsule size and concentration (2wt% BPO, p<0.05). The highest self-healing efficiencies (up to 76%) were obtained with microcapsules sized 198±43 um.

SIGNIFICANCE

commercially available resin-based composites can be rendered self-healing most efficiently by incorporation of large microcapsules (198±43μm). However, long-term tests on fatigue and wear behavior are needed to confirm the clinical efficacy.

Fabrication and application of complex microcapsules: a review

The development of new functional materials requires cutting-edge technologies for incorporating different functional materials without reducing their functionality. Microencapsulation is a method to encapsulate different functional materials at nano- and micro-scales, which can provide the necessary protection for the encapsulated materials. In this review, microencapsulation is categorized into chemical, physical, physico-chemical and microfluidic methods. The focus of this review is to describe these four categories in detail by elaborating their various microencapsulation methods and mechanisms. This review further discusses the key features and potential applications of each method. Through this review, the readers could be aware of many aspects of this field from the fabrication processes, to the main properties, and to the applications of microcapsules.