Inhibitory effects of resin composite containing bactericide-immobilized filler on plaque accumulation

Exploring the Effect of Cetylpyridinium Chloride Addition on the Antibacterial Activity and Surface Hardness of Resin-Based Dental Composites

The aim of this study was to evaluate the effect of cetylpyridinium chloride (CPC) addition on the antibacterial and surface hardness characteristics of two commercial resin-based dental composites (RBDCs). A total of two hundred and seventy (n = 270) specimens from Filtek Z250 Universal and Filtek Z350 XT flowable RBDCs were fabricated with the addition of CPC at 2 %wt and 4 %wt concentrations to assess their antibacterial activity using the agar diffusion test and direct contact inhibition test, and their surface hardness using the Vickers microhardness test after 1 day, 30 days, and 90 days of aging. A surface morphology analysis of the specimens was performed using a scanning electron microscope (SEM). The RBDCs that contained 2 %wt and 4 %wt CPC demonstrated significant antibacterial activity against Streptococcus mutans up to 90 days, with the highest activity observed for the 4 %wt concentration. Nevertheless, there was a reduction in antibacterial effectiveness over time. Moreover, compared to the control (0 %wt) and 2 %wt CPC groups, the universal RBDCs containing 4 %wt CPC exhibited a notable decrease in surface hardness, while all groups showed a decline in hardness over time. In conclusion, the satisfactory combination of the antibacterial effect and surface hardness property of RBDCs was revealed with the addition of a 2 %wt CPC concentration.

Development of Antibacterial Resin Composites Incorporating Poly(METAC) Clusters

This study examined the antibacterial effects and physical properties of a novel resin composite incorporating poly[{2-(methacryloyloxy)ethyl}trimethylammonium chloride] (poly(METAC)), a methacrylate cationic polymer comprising quaternary ammonium compounds (QACs). Resin composites incorporating poly(METAC) were fabricated by adding 6 wt.% METAC aqueous solution to a commercially available resin composite. The FE-SEM/EDS and Raman spec-troscopy analyses showed that METAC was assembled and polymerized in the resin composites after curing. The antibacterial effect was evaluated by inoculating Streptococcus mutans or Strepto-coccus sobrinus suspensions on the surface of cured resin composites, and the experimental resin composites incorporating poly(METAC) clusters exhibited bactericidal effects even after 28 days of ageing. The physical properties of the experimental resin composites were within the ISO-stipulated ranges. Newly fabricated resin composites containing the QAC-based poly(METAC) cluster ex-hibited long-term bactericidal effects against oral bacteria on their surfaces and demonstrated ac-ceptable physical properties for clinical use.

Dental Restorations

Fulfilling a patient's request for a healthy, functional and esthetic smile represents a daily challenge for dental practitioners [...].

Tailoring the monomers to overcome the shortcomings of current dental resin composites - review

Dental resin composites (DRCs) have become the first choice among different restorative materials for direct anterior and posterior restorations in the clinic. Though the properties of DRCs have been improved greatly in recent years, they still have several shortcomings, such as volumetric shrinkage and shrinkage stress, biofilm development, lack of radio-opacity for some specific DRCs, and estrogenicity, which need to be overcome. The resin matrix, composed of different monomers, constitutes the continuous phase and determine the performance of DRCs. Thus, the chemical structure of the monomers plays an important role in modifying the properties of DRCs. Numerous researchers have taken to design and develop novel monomers with specific functions for the purpose of fulfilling the needs in dentistry. In this review, the development of monomers in DRCs were highlighted, especially focusing on strategies aimed at reducing volumetric shrinkage and shrinkage stress, endowing bacteriocidal and antibacterial adhesion activities as well as protein-repelling activity, increasing radio-opacity, and replacing Bis-GMA. The influences of these novel monomers on the properties of DRCs were also discussed.

Novel Dental Restorative Solutions for Natural Teeth and Implants

The long-term survival of restorations in the oral cavity has always been one of the most significant challenges in modern dental practice [...].

The Effect of Ultraviolet Treatment on TiO2 Nanotubes: A Study of Surface Characteristics, Bacterial Adhesion, and Gingival Fibroblast Response

Titanium dioxide (TiO2) nanotubes are emerging as a provocative target for oral implant research. The aim of this study was to evaluate the effect of UV on the wettability behavior, bacterial colonization, and fibroblast proliferation rate of TiO2 nanotube surfaces prepared using different anodization voltages and aimed for use as implant abutment materials. Four different experimental materials were prepared: (1) TiO2 nanotube 10 V; (2) TiO2 nanotube 15 V; (3) TiO2 nanotube 20 V; and (4) commercial pure titanium as a control group. TiO2 nanotube arrays were prepared in an aqueous electrolyte solution of hydrofluoric acid (HF, 0.5 vol.%). Different anodization voltages were used to modify the morphology of the TiO2 nanotubes. Equilibrium contact angles were measured using the sessile drop method with a contact angle meter. The investigated surfaces (n = 3) were incubated at 37 °C in a suspension of Streptococcus mutans (S. mutans) for 30 min for bacterial adhesion and 3 days for biofilm formation. Human gingival fibroblasts were plated and cultured on the experimental substrates for up to 7 days and the cell proliferation rate was assessed using the AlamarBlue assayTM (BioSource International, Camarillo, CA, USA). The data were analyzed using one-way ANOVA followed by Tukey’s post-hoc test. Water contact angle measurements on the TiO2 after UV treatment showed an overall hydrophilic behavior regardless of the anodization voltage. The ranking of the UV-treated surfaces of experimental groups from lowest to highest for bacterial adhesion was: TiO2 nanotube 20 V < Ti and TiO2 nanotube 15 V < TiO2 nanotube 10 V (p < 0.05), and for bacterial biofilm formation was: TiO2 nanotube 20 V-TiO2 nanotube 10 V < Ti-TiO2 nanotube 15 V (p < 0.05). Fibroblast cell proliferation was lower on TiO2 nanotube surfaces throughout the incubation period and UV light treatment showed no enhancement in cellular response. UV treatment enhances the wettability behavior of TiO2 nanotube surfaces and could result in lower bacterial adhesion and biofilm formation.

Evaluation of the long-term antibiofilm effect of a surface coating with dual functionality of antibacterial and protein-repellent effects

The provision of antibacterial properties to resinous restorative/reconstructive materials by incorporating polymerizable bactericides such as 12-methacryloyloxydodecylpyridinium bromide (MDPB) has been attempted. Previously, MDPB was combined with 2-methacryloyloxyethyl phosphorylcholine (MPC) to fabricate a copolymer coating to increase antibacterial effectiveness by protein repelling. In this study, we assessed the longevity of the protein-repelling, antibacterial, and antibiofilm effects of the MDPB-MPC copolymer. After 28 days of water immersion, MPC-containing copolymers exhibited lower adsorption of bovine serum albumin and salivary proteins; after 24 h of incubation, MDPB-containing copolymers demonstrated antibacterial effects against Streptococcus mutans. The copolymer containing both MDPB and MPC showed thinner biofilm formation with a higher percentage of membrane-compromised bacteria than control. The results were consistent with those before aging, indicating the long-lasting antibacterial, protein-repellent, and antibiofilm effects of this copolymer. The durable copolymer developed in this study can be applied to dental resins to control bacteria in the oral environment.

Synthesis and Characterization of Novel Quaternary Ammonium Urethane-Dimethacrylate Monomers-A Pilot Study

Six novel urethane-dimethacrylate analogues (QAUDMAs) were synthesized and characterized. They consisted of the 2,4,4,-trimethylhexamethylene diisocyanate (TMDI) core and two methacrylate-terminated wings containing quaternary ammonium groups substituted with alkyl chains of 8, 10, 12, 14, 16, or 18 carbon atoms. QAUDMAs, due to the presence of quaternary ammonium groups, may have possible antibacterial effects. Since they showed satisfactory physicochemical properties, they will be subjected to further research towards the development of dental composites with a capacity to reduce secondary caries. The synthesis of QAUDMAs included three stages: (i) transesterification of methyl methacrylate (MMA) with N-methyldiethanolamine (MDEA), (ii) N-alkylation of the tertiary amino group with alkyl bromide, and (iii) addition of TMDI to the intermediate achieved in the second stage. The formation of QAUDMAs was confirmed by ¹H and ¹³C NMR. They were characterized for density (d_m), viscosity (η), refractive index (RI), glass transition temperature (T_g), polymerization shrinkage (S), and degree of conversion (DC). QAUDMAs were yellow, viscous resins (the η values ranged from 1.28 × 10³ to 1.39 × 10⁴ Pa·s, at 50 °C). Their RI ranged from 1.50 to 1.52, T_g from −31 to −15 °C, DC from 53 to 78%, and S from 1.24 to 2.99%, which is appropriate for dental applications.

Immobilizing Bactericides on Dental Resins via Electron Beam Irradiation

Polymerizable bactericides, such as quaternary ammonium compound-based monomers, have been intensively studied as candidates for immobilizing antibacterial components on dental resin. However, they predominantly exhibit a bacteriostatic behavior, rather than bactericidal, as the immobilized components are left with insufficient molecular movement to disrupt the bacterial surface structure through contact-mediated action. In this study, we developed a novel strategy to increase the density of the immobilized bactericide and enhance its antibacterial/antibiofilm properties by combining a surface-grafting technique with electron beam irradiation. A solution of the quaternary ammonium compound-based monomer, 12-methacryloyloxydodecylpyridinium bromide (MDPB), was coated on polymethyl methacrylate (PMMA) resin specimens at the concentrations of 30, 50, and 80 wt%. The coated resins were subsequently exposed to 10 MeV of electron beam irradiation at 50 and 100 kGy, followed by thermal stabilization at 60 °C. The antibacterial effect was evaluated by inoculating a Streptococcus mutans suspension on the coated PMMA resin samples, which exhibited bactericidal effects even after 28 d of aging (P < 0.05, Tukey's honestly significant difference test). Transmission electron microscopy and bacteriolytic activity evaluation revealed that the S. mutans cells had sustained membrane depolarization. Furthermore, the antibiofilm effects against S. mutans and bacteria collected from human saliva were assessed. The thickness and the percentage of membrane-intact cells of the S. mutans and multispecies biofilms formed on the MDPB-immobilized surfaces were significantly lower than the uncoated PMMA specimens, even after 28-d aging (P < 0.05, Tukey's honestly significant difference test). Thus, the immobilization of antibacterial MDPB via electron beam irradiation induced rapid membrane depolarization, increasing membrane permeability and eventually causing cell death. Our strategy substantially enhances the antibacterial properties of the resinous materials and inhibits biofilm formation, therefore demonstrating significant potential for preventing infectious diseases in the oral environment.

Synthesis of Novel Dental Nanocomposite Resins by Incorporating Polymerizable, Quaternary Ammonium Silane-Modified Silica Nanoparticles

Diverse approaches dealing with the reinforcement of dental composite resins with quaternary ammonium compounds (QAC) have been previously reported. This work aims to investigate the physicochemical and mechanical performance of dental resins containing silica nanofillers with novel QAC. Different types of quaternary ammonium silane compounds (QASiC) were initially synthesized and characterized with proton nuclear magnetic resonance (¹H-NMR) and Fourier transform infrared (FTIR) spectroscopy. Silica nanoparticles were surface modified with the above QASiC and the structure of silanized products (S.QASiC) was confirmed by means of FTIR and thermogravimetric analysis. The obtained S.QASiC were then incorporated into methacrylate based dental resins. Scanning electron microscopy images revealed a satisfactory dispersion of silica nanoclusters for most of the synthesized nanocomposites. Curing kinetics disclosed a rise in both the autoacceleration effect and degree of conversion mainly induced by shorter QASiC molecules. Polymerization shrinkage was found to be influenced by the particular type of S.QASiC. The flexural modulus and strength of composites were increased by 74% and 19%, while their compressive strength enhancement reached up to 19% by adding 22 wt% S.QASiC nanoparticles. These findings might contribute to the proper design of multifunctional dental materials able to meet the contemporary challenges in clinical practice.

Fighting viruses with materials science: Prospects for antivirus surfaces, drug delivery systems and artificial intelligence

OBJECTIVE

Viruses on environmental surfaces, in saliva and other body fluids represent risk of contamination for general population and healthcare professionals. The development of vaccines and medicines is costly and time consuming. Thus, the development of novel materials and technologies to decrease viral availability, viability, infectivity, and to improve therapeutic outcomes can positively impact the prevention and treatment of viral diseases.

METHODS

Herein, we discuss (a) interaction mechanisms between viruses and materials, (b) novel strategies to develop materials with antiviral properties and oral antiviral delivery systems, and (c) the potential of artificial intelligence to design and optimize preventive measures and therapeutic regimen.

RESULTS

The mechanisms of viral adsorption on surfaces are well characterized but no major breakthrough has become clinically available. Materials with fine-tuned physical and chemical properties have the potential to compromise viral availability and stability. Emerging strategies using oral antiviral delivery systems and artificial intelligence can decrease infectivity and improve antiviral therapies.

SIGNIFICANCE

Emerging viral infections are concerning due to risk of mortality, as well as psychological and economic impacts. Materials science emerges for the development of novel materials and technologies to diminish viral availability, infectivity, and to enable enhanced preventive and therapeutic strategies, for the safety and well-being of humankind.

Development of novel surface coating composed of MDPB and MPC with dual functionality of antibacterial activity and protein repellency

Resin-based reconstructive/restorative materials with antibacterial effects are potentially useful for preventing dental and oral diseases. To this end, the immobilization of an antibacterial component on the surface of a resin by incorporating polymerizable bactericide such as a quaternary ammonium compound-monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) is an effective technique. However, the effectiveness of immobilized bactericide is reduced by salivary protein coverage. We address this issue by utilizing 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer, which exhibits protein repellency, with MDPB to fabricate a novel copolymer, which served as a surface coating on a methacrylate-based resin. This coating provided a more hydrophilic surface than that provided by MDPB coating and reduced the adsorption of bovine serum albumin and salivary protein. To evaluate bacterial growth on the contact surface, Streptococcus mutans suspension was placed on the coated specimen. After 24-h incubation, MDPB/MPC copolymer exhibited killing effects against S. mutans. Moreover, confocal laser scanning microscopy and scanning electron microscopy were used to evaluate biofilm formation after 48-h incubation in S. mutans suspension, which revealed sparse biofilm and dead bacteria in biofilm on the surface coated with MDPB/MPC. Overall, the proposed surface coating on dental resins exhibited protein-repellent ability and inhibitory effects against bacteria and oral biofilms.

Synthesis of an anti-cariogenic experimental dental composite containing novel drug-decorated copper particles

Secondary caries is one of the most major cause for re-placement of dental composite restorations. Targeting the survival of cariogenic bacteria residing on the restoration surface may reduce this problem. The present study aims to evaluate the antibacterial potential as well as assess the physical and chemical properties of experimental dental composites containing novel drug-decorated copper particles (DDCP) as adjunct antibacterial filler particles. These were incorporated at concentrations of 0%, 0.5%, 0.10%, 0.20%, and 0.25% (w/w) into experimental composite consisting of methacrylate monomers and silanized silica fillers. RESULTS: Direct contact test revealed that the anti-cariogenic potential of experimental composites was more than the control groups. The cell viability assay showed no toxic effect on MC3T3-E1 cell lines in the MTT assay. The microhardness of experimental composites increased as the percentage of DDCP increased, however, the degree of cure was increased only up till the concentration of 0.20%. The release kinetics of the composites reveals that even after 28 days there was a steady and slow release of copper particles signifying the sustained anti-cariogenic effect. CONCLUSION: The experimental composites have good anti-cariogenic potential, which was sustained for one month without any deleterious effect on the physical and chemical properties of resin dental composites.

Novel antibacterial calcium phosphate nanocomposite with long-term ion recharge and re-release to inhibit caries

Short-term studies on calcium-phosphate (CaP) ion-rechargeable composites were reported. The long-term rechargeability is important but unknown. The objectives of this study were to investigate nanocomposite with strong antibacterial and ion-recharge capabilities containing dimethylaminododecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP), and evaluate long-term ion-recharge by testing for 12 cycles (taking 6 months to complete) for the first time. Three groups were tested: (1) Heliomolar control; (2) Resin+20%NACP+50%glass; (3) Resin+3%DMAHDM+20%NACP+50%glass. Biofilm acid and colony-forming units (CFU) were measured. Ion-recharge was tested for 12 cycles. NACP-DMAHDM composite reduced biofilm acid, and reduced CFU by 4 logs. High levels of ion releases were maintained throughout 12 cycles of recharge, maintaining steady-state releases without reduction in 6 months (p>0.1), representing long-term remineralization potential. Bioactive nanocomposite demonstrated long-term ion-rechargeability for the first time, showed remineralization and potent anti-biofilm functions, with promise for tooth restorations to combat caries.

Study on a novel antibacterial light-cured resin composite containing nano-MgO

A new type of photocurable resin composite containing nano-MgO was synthesized in order to reduce the occurrence of secondary caries. Different mass ratios (0 %, 1 %, 2 %, 4 %, 8 %) of nano-MgO were added into resin composites. The antibacterial properties of nano-MgO powder and modified resin composites against Streptococcus mutans (S. mutans) were detected by antibacterial ring test and film contact test, respectively. Compressive strength (CS) and wear resistance were determined by a universal testing machine and an abrasion test machine. The results indicated that antibacterial activity and wear resistance of resin composites containing nano-MgO were superior to the control group (p < 0.05). The antibacterial rate reached as high as 99.4 % when the mass ratio of nano-MgO was 8 %. However, the CS values tended to decline as the content of nano-MgO increase. Hence, the addition of nano-MgO showed excellent antibacterial property to resin composites and enhanced wear resistance, but was detrimental to their mechanical properties.

Antibacterial and thermomechanical properties of experimental dental resins containing quaternary ammonium monomers with two or four methacrylate groups

Resins with strong antibacterial and thermomechanical properties are critical for application in oral cavities. In this study, we first evaluated the antibacterial effect of an unfilled resin incorporating 1, 4, and 7 mass% of quaternary ammonium salt (QAS) monomers containing two methacrylate groups (MAE-DB) and four methacrylate groups (TMH-DB) against Streptococcus mutans, and tested the cytotoxicity and thermomechanical properties of the 4 mass% MAE-DB and TMH-DB modified resin materials. A neat resin without a QAS monomer served as the control. As the concentration of both QAS monomers increases, the formation of a Streptococcus mutans biofilm on the experimental material is increasingly inhibited. The results of colony forming unit counts and the metabolic activity showed that both the MAE-DB and TMH-DB modified resins have a strong bactericidal effect on the bacteria in a biofilm, but no bactericidal effect on the bacteria in a solution. The viability-staining and morphology results also demonstrate that the bacteria deform, lyse, shrink, and die on the surface of the two QAS-modified resins. Cytotoxicity results show that the addition of TMH-DB can reduce the cytotoxicity of the resin, while the addition of MAE-DB increases the cytotoxicity of the resin. DMA results show that a TMH-DB modified resin has a higher storage modulus than a MAE-DB modified resin owing to its better crosslink density. The two groups of experimental resins showed a similar glass transition temperature. These data indicate that the two QAS monomers can impart similar antibacterial properties upon contact with a dental resin, whereas TMH-DB can endow the resin with a higher crosslink density and storage modulus than MAE-DB because it has more polymerizable groups.

Resins with strong antibacterial and thermomechanical properties are critical for application in oral cavities.

Immobilization of quaternary ammonium based antibacterial monomer onto dentin substrate by non-thermal atmospheric plasma

Use of non-thermal atmospheric plasma (NTAP) brush on immobilization of dimethylaminohexadecyl methacrylate (DMAHDM) onto dentin bonding substrate, and resulting antibacterial activity against Streptococcus mutans were investigated. A bonding substrate with several-micron-demineralized layer was created from human dentin. DMAHDM was applied onto the demineralized layer with or without plasma exposure. Scanning electron microscopy (SEM) and Fourier transformed infrared (FTIR) spectroscopy were employed to verify immobilization/grafting of DMAHDM onto the substrate. Antibacterial activity of the resulting substrate was assessed by using colony-forming unit (CFU) and confocal scanning laser microscopy. Effects of saliva pellicle treatment and aging process on the above substrate were also evaluated. The SEM/FTIR results demonstrated that NTAP could induce DMAHDM immobilization onto dentin substrate, which was further verified via quantitative FTIR analysis. Comparing with non-plasma-treated, the plasmatreated substrate, with CFU 4 log lower, exhibited much stronger inhibitory effects, which were minimally affected by saliva or aging. The DMAHDM-immobilized dentin substrate showed effective and sustained antibacterial characteristics.

Polyvinylchloride surface with enhanced cell/bacterial adhesion-resistant and antibacterial functions

This study reports synthesis and attachment of a novel antibacterial and hydrophilic polymer onto a polyvinylchloride surface via a simple and mild surface coating technique. The compound 3,4-dichloro-5-hydroxy-2(5H)-furanone was derivatized and copolymerized with N-vinylpyrrolidone. The copolymer was then covalently coated onto polyvinylchloride surface. 3T3 mouse fibroblast cells and bacterium Pseudomonas aeruginosa were used to evaluate surface adhesion and antibacterial activity. Results showed that the polymer-modified polyvinylchloride surface not only exhibited significantly decreased 3T3 fibroblast cell adhesion with a 64–84% reduction but also demonstrated significantly decreased P. aeruginosa adhesion with a 65–84% reduction, as compared to unmodified polyvinylchloride. Furthermore, the modified polyvinylchloride surfaces exhibited significant antibacterial functions by inhibiting P. aeruginosa growth with a 58–80% reduction and killing bacteria, as compared to unmodified polyvinylchloride. These results demonstrate that covalent polymer attachment conferred cell/bacterial adhesion-resistant and antibacterial properties to the polyvinylchloride surface.

Novel multifunctional nanocomposite for root caries restorations to inhibit periodontitis-related pathogens

OBJECTIVES

The objectives of this study were to: (1) develop a novel multifunctional composite with nanoparticles of silver (NAg), 2-methacryloyloxyethyl phosphorylcholine (MPC), dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP); and (2) investigate biofilm-inhibition via the multifunctional nanocomposite against three species of periodontal pathogens for the first time.

METHODS

The multifunctional nanocomposite was fabricated by incorporating NAg, MPC, DMAHDM and NACP into the resin consisting of pyromellitic glycerol dimethacrylate (PMDGDM) and ethoxylated bisphenol A dimethacrylate (EBPADMA). Three species (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum) were tested for metabolic activity (MTT), live/dead staining, polysaccharide production and colony-forming units (CFU) of biofilms grown on resins.

RESULTS

Incorporation of 0.08% to 0.12% NAg, 3% MPC, 3% DMAHDM and 30% NACP did not compromise the mechanical properties of the composite (p > 0.1). The multifunctional nanocomposite reduced protein adsorption to nearly 1/10 of that of a commercial control (p < 0.05). For all three species, the biofilm CFU was reduced by about 5 and 1 orders of magnitude via the nanocomposite containing NAg + MPC + DMAHDM, compared to commercial control and the composite with MPC + DMAHDM, respectively.

CONCLUSIONS

The novel multifunctional nanocomposite achieved the greatest reduction in metabolic activity, polysaccharide and biofilm growth of three periodontal pathogens.

CLINICAL SIGNIFICANCE

The strongly-antibacterial, multifunctional composite is promising for treating root lesions, alleviating periodontitis and protecting the periodontal tissues.

Surface modification of polyurethane with a hydrophilic, antibacterial polymer for improved antifouling and antibacterial function

Antimicrobial surface is important for the inhibition of bacteria or biofilm formation on biomaterials. The objective of this study was to immobilize a novel hydrophilic polymer containing the antibacterial moiety onto polyurethane surface via a simple surface coating technology to make the surface not only antibacterial but also antifouling. The compound 3,4-dichloro-5-hydroxy-2(5H)-furanone was derivatized, characterized and incorporated onto polyvinylpyrrolidone containing succinimidyl functional groups, followed by coating onto the polyurethane surface. Contact angle, antibacterial function and protein adsorption of the modified surface were evaluated. The result shows that the modified surface exhibited significantly enhanced hydrophilicity with a 54-65% decrease in contact angle, increased antibacterial activity to Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa with a 24-57% decrease in viability, and reduced human serum albumin adsorption with a 64-70% decrease in adsorption, as compared to the original polyurethane.

Antibacterial quaternary ammonium compounds in dental materials: A systematic review

OBJECTIVE

Quaternary ammonium compounds (QACs) represent one of the most effective classes of disinfectant agents in dental materials and resin nanocomposites. This reviews aims to give a wide overview on the research in the field of antibacterial QACs in dental materials and nanocomposites.

METHOD

An introduction to dental materials components as well as the microorganisms and methods of evaluation for the antimicrobial assays are presented. Then, the properties and synthesis route of QACs, as monomer and filler, are shown. Finally, antimicrobial monomers and fillers, specifically those contain quaternary ammonium salts (QASs), in dental materials are reviewed.

RESULTS

QACs have been used as monomer and micro/nanofiller in restorative dentistry. They possess one or more methacrylate functional groups to participate in polymerization reactions. QACs with multiple methacrylate groups can also be used as crosslinking agents. Furthermore, QACs with chain length from ∼12 to 16 have higher antimicrobial activity in cured dental resins. In general, increasing the chain length leads to a threshold value (critical point) and then it causes decrease in the antimicrobial activity.

SIGNIFICANCE

The current state of the art of dental materials and resin nanocomposites includes a wide variety of antimicrobial materials. Among them, QACs presents low cytotoxicity and excellent long-term antimicrobial activity without leaching out over time.

Antimicrobial Monomers for Polymeric Dental Restoratives: Cytotoxicity and Physicochemical Properties

A trend for the next generation of polymeric dental restoratives is to incorporate multifunctional capabilities to regulate microbial growth and remineralize tooth surfaces. Polymerizable 2-(methacryloyloxy)-N-(2-(methacryloyloxy)ethyl)-N,N-dimethylethan-1-aminium bromide (IDMA1) and N,N′-([1,1′-biphenyl]-2,2′-diylbis(methylene))bis(2-(methacryloyloxy)-N,N-dimethylethan-1-aminium) bromide (IDMA2), intended for utilization in bi-functional antimicrobial and remineralizing composites, were synthesized, purified with an ethanol-diethyl ether-hexane solvent system, and validated by nuclear magnetic resonance (¹H and ¹³C NMR) spectroscopy, mass spectrometry, and Fourier-transform infrared spectroscopy. When incorporated into light-curable urethane dimethacrylate (UDMA)/polyethylene glycol-extended UDMA (PEG-U)/ethyl 2-(hydroxymethyl)acrylate (EHMA) (assigned UPE) resins, IDMAs did not affect the overall resins’ hydrophilicity/hydrophobicity balance (water contact angle: 60.8–65.5°). The attained degrees of vinyl conversion (DVC) were consistently higher in both IDMA-containing copolymers and their amorphous calcium phosphate (ACP) composites (up to 5% and 20%, respectively) reaching 92.5% in IDMA2 formulations. Notably, these high DVCs values were attained without an excessive increase in polymerization stress. The observed reduction in biaxial flexure strength of UPE-IDMA ACP composites should not prevent further evaluation of these materials as multifunctional Class V restoratives. In direct contact with human gingival fibroblasts, at biologically relevant concentrations, IDMAs did not adversely affect cell viability or their metabolic activity. Ion release from the composites was indicative of their strong remineralization potential. The above, early-phase biocompatibility and physicochemical tests justify further evaluation of these experimental materials to identify formulation(s) suitable for clinical testing. Successful completion is expected to yield a new class of restoratives with well-controlled bio-function, which will physicochemically, mechanically, and biologically outperform the conventional Class V restoratives.

Formation of persisters in Streptococcus mutans biofilms induced by antibacterial dental monomer

Antibacterial monomers can combat oral biofilm acids and caries; however, little is known on whether quaternary ammonium monomers (QAMs) would induce drug persistence in oral bacteria. The objectives of this study were to investigate the interactions of Streptococcus mutans (S. mutans) with dimethylaminohexadecyl methacrylate (DMAHDM), and determine for the first time whether DMAHDM could induce persisters in S. mutans. DMAHDM was synthesized using a modified Menschutkin reaction. Dose-dependent killing curves and time-dependent killing curves of planktonic S. mutans and biofilms were determined to evaluate drug persistence, using chlorhexidine (CHX) as control. The inheritability assay, minimum inhibitory concentration (MIC) and live/dead biofilm assay were determined to investigate persister characteristics. DMAHDM matched the killing potency of the gold standard CHX against S. mutans biofilms. DMAHDM and CHX induced drug persistence in S. mutans biofilms but not in planktonic bacteria. S. mutans biofilm persistence was not inheritable in that the tolerance to DMAHDM or CHX of the surviving persisters in the initial population was not transferred to subsequent generations, as displayed by the inheritability assay. The MIC of S. mutans parental strain and induced persisters remained the same. The induced persisters in S. mutans biofilms could be eliminated via higher doses of 300 μg/mL of DMAHDM and CHX. In conclusion, this study showed for the first time that (1) DMAHDM induced persisters only in biofilms, but not in planktonic bacteria; and (2) both DMAHDM-induced and CHX-induced S. mutans persister biofilms could be completely eradicated by even higher concentrations of DMAHDM and CHX. More studies are needed on the induction of persisters in oral biofilms for the development and use of a new generation of antibacterial dental monomers and resins.

Evaluation of dental adhesive systems incorporating an antibacterial monomer eugenyl methacrylate (EgMA) for endodontic restorations

OBJECTIVE

The purpose of this study was to incorporate EgMA, an antibacterial monomer into two commercial dental adhesive systems for their application in endodontic restoration with the aim to disinfect the root canal space before curing and to inhibit bacterial growth on their surfaces after being cured.

METHODS

EgMA monomer was added at 20%wt. into the formulation of the single-component self-etch, Clearfil Universal Bond™ (CUB) and into the catalyst and the adhesive components of the total-etch Adper Scotchbond-multipurpose™ (SBMP) adhesive systems. The degree of conversion (DC) was calculated from FTIR spectra, glass transition temperature (Tg) determined by DSC, water sorption and solubility were measured gravimetrically, and surface free energy (SFE) via contact angle measurements. The bonding performance to coronal and middle root canal dentin was assessed through push-out bond strength after filling the canals with a composite core material and the surface integrity was observed using SEM and confocal laser scanning microscopy (CLSM). The standard agar diffusion test (ADT) was used to identify the sensitivity of three endodontically pathogenic bacteria, Enterococcus faecalis, Streptococcus mutans and Propionibacterium acnes to uncured EgMA modified adhesives. Multispecies biofilm model from these strains was grown on the disc surface of cured adhesives and investigated using quantitative microbial culture and CLSM with live/dead staining. MTT assay was also used to determine the cytotoxicity of these adhesives.

RESULTS

The incorporation of EgMA lowered polymerization exotherm and enhanced the hydrophobic character of these adhesives, without changing the DC and Tg in comparison to the controls (without EgMA). The total push-out bond strengths of the EgMA-containing adhesives were not significantly different from those of the controls (p>0.05). The modification of self-etch adhesive system enhanced the bond strength in the middle region of the roots canal. SEM of debonded specimens and CLSM examination showed the integrity of the resin-dentin interfaces. For all three bacteria tested, the sizes of the inhibition zones produced by uncured EgMA modified adhesives were significantly greater (p<0.05) than those of the controls. The results of biofilm inhibition tests showed less CFU for total bacteria on bonding agents with EgMA compared to the control materials (p<0.05). The modification at 20% monomer concentration had no adverse effects on cytocompatibility of both adhesives tested.

SIGNIFICANCE

The inclusion of EgMA endows dental adhesives with effective antibacterial effects without influencing their curing properties, bonding ability to root canal dentin, and cytotoxicity against human gingival fibroblasts, indicating the usefulness of their application in endodontic restorations.

Effect of bioactive dental adhesive on periodontal and endodontic pathogens

The objectives of this study were to: (1) develop a new bioactive dental bonding agent with nanoparticles of amorphous calcium phosphate and dimethylaminohexadecyl methacrylate for tooth root caries restorations and endodontic applications, and (2) investigate biofilm inhibition by the bioactive bonding agent against eight species of periodontal and endodontic pathogens for the first time. Bonding agent was formulated with 5 % of dimethylaminohexadecyl methacrylate. Nanoparticles of amorphous calcium phosphate at 30 wt% was mixed into adhesive. Eight species of biofilms were grown on resins: Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Parvimonas micra, Enterococcus faecalis, Enterococcus faecium. Colony-forming units, live/dead assay, biomass, metabolic activity and polysaccharide of biofilms were determined. The results showed that adding dimethylaminohexadecyl methacrylate and nanoparticles of amorphous calcium phosphate into bonding agent did not decrease dentin bond strength (P > 0.1). Adding dimethylaminohexadecyl methacrylate reduced the colony-forming units of all eight species of biofilms by nearly three orders of magnitude. The killing efficacy of dimethylaminohexadecyl methacrylate resin was: P. gingivalis > A. actinomycetemcomitans > P. intermedia > P. nigrescens > F. nucleatum > P. micra > E. faecalis > E. faecium. Dimethylaminohexadecyl methacrylate resin had much less biomass, metabolic activity and polysaccharide of biofilms than those without dimethylaminohexadecyl methacrylate (P < 0.05). In conclusion, a novel dental adhesive was developed for root caries and endodontic applications, showing potent inhibition of biofilms of eight species of periodontal and endodontic pathogens, and reducing colony-forming units by three orders of magnitude. The bioactive adhesive is promising for tooth root restorations to provide subgingival margins with anti-periodontal pathogen capabilities, and for endodontic sealer applications to combat endodontic biofilms.

One-year water-ageing of calcium phosphate composite containing nano-silver and quaternary ammonium to inhibit biofilms

Dental composites are commonly used restorative materials; however, secondary caries due to biofilm acids remains a major problem. The objectives of this study were (1) to develop a composite containing quaternary ammonium dimethacrylate (QADM), nanoparticles of silver (NAg), and nanoparticles of amorphous calcium phosphate (NACP), and (2) to conduct the first investigation of the mechanical properties, biofilm response and acid production vs water-ageing time from 1 day to 12 months. A 4 × 5 design was utilized, with four composites (NACP-QADM composite, NACP-NAg composite, NACP-QADM-NAg composite, and a commercial control composite), and five water-ageing time periods (1 day, and 3, 6, 9, and 12 months). After each water-ageing period, the mechanical properties of the resins were measured in a three-point flexure, and antibacterial properties were tested via a dental plaque biofilm model using human saliva as an inoculum. After 12 months of water-ageing, NACP-QADM-NAg had a flexural strength and elastic modulus matching those of the commercial control (P>0.1). Incorporation of QADM or NAg into the NACP composite greatly reduced biofilm viability, metabolic activity and acid production. A composite containing both QADM and NAg possessed a stronger antibacterial capability than one with QADM or NAg alone (P<0.05). The anti-biofilm activity was maintained after 12 months of water-ageing and showed no significant decrease with increasing time (P>0.1). In conclusion, the NACP-QADM-NAg composite decreased biofilm viability and lactic acid production, while matching the load-bearing capability of a commercial composite. There was no decrease in its antibacterial properties after 1 year of water-ageing. The durable antibacterial and mechanical properties indicate that NACP-QADM-NAg composites may be useful in dental restorations to combat caries.

Effect of an Antibacterial Monomer on the Antibacterial Activity of a Pit-and-Fissure Sealant

Resin-based pit-and-fissure sealants are often used to form a barrier on the occlusal surface of molars to treat caries lesions; however, bacteria can remain in the pit and fissures without detection, increasing the risk of secondary caries. Sealants with antimicrobial properties or microbial repellent actions might be advantageous. The aim of this study was to assess the inhibitory effect of a 2-methacryloxylethyl dodecyl methyl ammonium bromide (MAE-DB)-incorporated sealant against Streptococcus mutans. MAE-DB (4% wt) was incorporated into a commercially available sealant, Eco-S resin-based pit-and-fissure sealant (Vericom Co., Ltd., Korea); a sealant without MAE-DB served as a negative control, and Clinpro™ Sealant (3M™ ESPE™), a fluoride-releasing resin, was used as a commercial control. The effects of the cured sealants and their eluents on the growth of S. mutans were determined according to colony-forming unit counts and metabolic tests. The effects of the cured sealants on the adherence and membrane integrity of S. mutans were investigated using confocal laser-scanning microscopy (CLSM) in conjunction with fluorescent indicators. Compared with the negative control and commercial control, the cured MAE-DB-incorporated pit-and-fissure sealant exhibited a significant inhibitory effect on the growth of S. mutans (P < 0.05), whereas the eluents did not show any detectable antibacterial activity. The commercial control also showed no detectable bactericidal activity. Moreover, the aged experimental material retained its property of contact inhibition of biofilm formation. The fluorescence analysis of CLSM images demonstrated that the cured MAE-DB-incorporated sealant could hamper the adherence of S. mutans and exert a detrimental effect on bacterial membrane integrity. The incorporation of MAE-DB can render a pit-and-fissure sealant with contact antibacterial activity after polymerization via influencing the growth, adherence, and membrane integrity of S. mutans. Therefore, MAE-DB-containing pit-and-fissure sealant shows promise for preventing or controlling dental caries on occlusal pit and fissures of molars.

Novel bioactive nanocomposite for Class-V restorations to inhibit periodontitis-related pathogens

OBJECTIVES

The occurrence of tooth root caries is increasing as the world population ages and tooth retention in seniors increases. Class V restorations with subgingival margins are difficult to clean and often lead to periodontitis. The objectives of this study were to develop a Class V composite containing dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP), and investigate mechanical properties and the inhibition of six species of periodontitis-related biofilms for the first time.

METHODS

Ethoxylated bisphenol A dimethacrylate (EBPADMA) and pyromellitic glycerol dimethacrylate (PMGDM) were mixed at 1:1 mass ratio to form the resin matrix. DMAHDM, NACP, and glass particles were incorporated at 3%, 20% and 50% by mass, respectively. Six species were tested: Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum and Enterococcus faecalis. Colony-forming units (CFU), live/dead assay, biomass via crystal violet staining, and polysaccharide production by biofilms were determined on composites.

RESULT

Adding 3% DMAHDM to composite did not affect the flexure strength and elastic modulus (p>0.1). For all six species of periodontal pathogens, the DMAHDM composite had biofilm CFU nearly three orders of magnitude less than that without DMAHDM. The killing efficacy of DMAHDM composite against the six species was: E. faecalis<F. nucleatum<P. nigrescens=P. intermedia<A. actinomycetemcomitans<P. gingivalis. Biofilm biomass and polysaccharide were also greatly reduced via DMAHDM (p<0.05).

SIGNIFICANCE

The novel nanocomposite containing DMAHDM and NACP showed strong inhibiting effect against all six species of periodontitis-related pathogens. This composite is promising for Class V restorations to restore root caries and combat periodontitis.

Antibacterial activity of a modified unfilled resin containing a novel polymerizable quaternary ammonium salt MAE-HB

Resins with strong and long-lasting antibacterial properties are critical for the prevention of secondary dental caries. In this study, we evaluated the antibacterial effect and the underlying mechanism of action of an unfilled resin incorporating 2-methacryloxylethyl hexadecyl methyl ammonium bromide (MAE-HB) against Streptococcus mutans UA159 (S. mutans UA159). MAE-HB was added into unfilled resin at 10 mass%, and unfilled resin without MAE-HB served as the control. Bacterial growth was inhibited on 10%-MAE-HB unfilled resin compared with the control at 1 d, 7 d, 30 d, or 180 d (P < 0.05). The growth inhibitory effect was independent of the incubation time (P > 0.05). No significant differences in the antibacterial activities of eluents from control versus 10%-MAE-HB unfilled resins were observed at any time point (P > 0.05). The number of bacteria attached to 10%-MAE-HB unfilled resin was considerably lower than that to control. Fe-SEM and CLSM showed that 10%-MAE-HB unfilled resin disturbed the integrity of bacterial cells. Expression of the bacterial glucosyltransferases, gtfB and gtfC, was lower on 10%-MAE-HB unfilled resin compared to that on control (P < 0.05). These data indicate that incorporation of MAE-HB confers unfilled resin with strong and long-lasting antibacterial effects against S. mutans.

Effects of quaternary ammonium chain length on the antibacterial and remineralizing effects of a calcium phosphate nanocomposite

Composites containing nanoparticles of amorphous calcium phosphate (NACP) remineralize tooth lesions and inhibit caries. A recent study synthesized quaternary ammonium methacrylates (QAMs) with chain lengths (CLs) of 3-18 and determined their effects on a bonding agent. This study aimed to incorporate these QAMs into NACP nanocomposites for the first time to simultaneously endow the material with antibacterial and remineralizing capabilities and to investigate the effects of the CL on the mechanical and biofilm properties. Five QAMs were synthesized: DMAPM (CL3), DMAHM (CL6), DMADDM (CL12), DMAHDM (CL16), and DMAODM (CL18). Each QAM was incorporated into a composite containing 20% NACP and 50% glass fillers. A dental plaque microcosm biofilm model was used to evaluate the antibacterial activity. The flexural strength and elastic modulus of nanocomposites with QAMs matched those of a commercial control composite (n = 6; P > 0.1). Increasing the CL from 3 to 16 greatly enhanced the antibacterial activity of the NACP nanocomposite (P < 0.05); further increasing the CL to 18 decreased the antibacterial potency. The NACP nanocomposite with a CL of 16 exhibited biofilm metabolic activity and acid production that were 10-fold lesser than those of the control composite. The NACP nanocomposite with a CL of 16 produced 2-log decreases in the colony-forming units (CFU) of total microorganisms, total streptococci, and mutans streptococci. In conclusion, QAMs with CLs of 3-18 were synthesized and incorporated into an NACP nanocomposite for the first time to simultaneously endow the material with antibacterial and remineralization capabilities. Increasing the CL reduced the metabolic activity and acid production of biofilms and caused a 2-log decrease in CFU without compromising the mechanical properties. Nanocomposites exhibiting strong anti-biofilm activity, remineralization effects, and mechanical properties are promising materials for tooth restorations that inhibit caries.

Restorative materials containing antimicrobial agents: is there evidence for their antimicrobial and anticaries effects? A systematic review

The aim of this systematic literature review was to investigate whether the incorporation of antimicrobial agents into dental restorative materials truly exerts an antimicrobial effect against common cariogenic bacteria (primary outcome), and whether the inclusion of antimicrobial agents is able to prevent caries around restorations (secondary outcome). MEDLINE, via PubMed, was searched for papers published between 1980 and 30 November 2014. A total of 1126 articles were retrieved. After inclusion/exclusion assessment, 147 full text articles were read and included in the review, comprising 130 in vitro, 1 in situ, and 4 in vivo studies, as well as 12 literature reviews. In about 78% of in vitro studies, and in all identified in situ and in vivo studies, a positive antimicrobial effect had been found. However, the anticaries effect had not been tested in any of the selected studies. It was concluded that there is indeed evidence that restorative dental materials containing antimicrobial agents exert an antimicrobial effect, both in laboratory and in clinical studies. However, no evidence has been found regarding the role of these agents in preventing or controlling dental caries, or in preventing caries around restorations.

Synthesis of antibacterial methacrylate monomer derived from thiazole and its application in dental resin

A non-quaternary ammonium antibacterial methacrylate monomer MEMT derived from thiazole was synthesized and applied into UDMA/TEGDMA dental resin with a series of mass fraction (10 wt%, 20 wt%, and 30 wt%). Double bond conversion, polymerization shrinkage, water sorption, solubility, flexural strength and modulus, and antibacterial activity of MEMT containing resin formulations were investigated with UDMA/TEGDMA as control resin. The results showed that MEMT containing dental resin had higher double bond conversion than control resin. Compared with control polymer, all MEMT containing polymer had comparable or lower polymerization shrinkage, water sorption and solubility, except for the polymer with 30 wt% of MEMT which had higher water sorption and solubility than control polymer. The MEMT had no influence on flexural strength and modulus before water immersion, but all MEMT containing polymers had lower flexural strength and modulus than control polymer after water immersion. The MEMT could endow dental polymer with obvious antibacterial activity by immobilizing MEMT into the polymeric network.

Preparation of antibacterial and radio-opaque dental resin with new polymerizable quaternary ammonium monomer

OBJECTIVE

A new polymerizable quaternary ammonium monomer (IPhene) with iodine anion was synthesized and incorporated into Bis-GMA/TEGDMA (50/50, wt/wt) to prepare antibacterial and radio-opaque dental resin.

METHODS

IPhene was synthesized through a 2-steps reaction route, and its structure was confirmed by FT-IR and (1)H-NMR spectra. IPhene was incorporated into Bis-GMA/TEGDMA (50/50, wt/wt) with a series of mass fraction (from 10 wt.% to 40 wt.%). Degree of monomer conversion (DC) was determined by FT-IR analysis. Polymerization shrinkage was determined according to the variation of density before and after polymerization. The flexural strength, modulus of elasticity, and fracture energy were measured using a three-point bending set up. Radiograph was taken to evaluate the radio-opacity of the polymer. A single-species biofilm model with Streptococcus mutans (S. mutans) as the tests organism was used to evaluate the antibacterial activity of the polymer. Bis-GMA/TEGDMA resin system without IPhene was used as a control group.

RESULTS

FT-IR and (1)H-NMR spectra of IPhene revealed that IPhene was the same as the designed structure. ANOVA analysis showed that when mass fraction of IPhene was more than 10 wt.%, the obtained resin formulation had lower DC, polymerization shrinkage, FS, and FM than control resin (p<0.05). Polymers with 20 wt.% and 30 wt.% IPhene had higher fracture energies than control polymer (p<0.05). IPhene containing samples had higher radio-opacity than control group (p<0.05), and radio-opacity of IPhene containing sample increased with the increasing of IPhene mass fraction (p<0.05). Only polymers with 30 wt.% and 40 wt.% of IPhene showed antibacterial activity (p<0.05).

SIGNIFICANCE

IPhene could endow dental resin with both antibacterial and radio-opaque activity when IPhene reached 30 wt.% or more. Though sample with 30 wt.% of IPhene had lower FS and FM than control group, its lower volumetric shrinkage, higher fracture energy, higher radio-opacity, and antibacterial activity still made it having potential to be used in dentistry.

Assessments of antibacterial and physico-mechanical properties for dental materials with chemically anchored quaternary ammonium moieties: thiol-ene-methacrylate vs. conventional methacrylate system

OBJECTIVE

Fabrication of low shrinkage stress and strain dental resins containing highly available immobilized bactericidal moieties has been reported. The goal of this study is producing dental restorative materials with long-last antibacterial activity and reduced secondary caries. It is anticipated that antibacterial properties of quaternary ammonium moieties chemically immobilized in the backbone of dental resins is directly depended on accessibility of these functions. In the present study the antibacterial effect of a series of antibacterial monomers polymerized in a ternary thiol-ene-methacrylate system were compared with corresponding classical methacrylate system against Streptococcus mutans (an oral bacteria Strain). Physical and mechanical properties of dental materials obtained from these two systems were also evaluated and compared.

METHODS

The viscosities of the resin matrixes were measured on a MCR 300 rheometer. Degree of conversion (DC%) of monomers was measured using FTIR spectroscopy. The shrinkage-strain of photocured resins was measured using the bonded-disk technique. A universal testing machine combined with a stress measurement device was utilized to measure the polymerization-induced shrinkage stress. Viscoelastic properties of the samples were also determined by dynamic mechanical thermal analysis (DMTA). Assessment of antibacterial properties was performed through agar diffusion test (AD) to confirm non-release behavior of chemically anchored moieties. Quantitative assay of antibacterial activity was evaluated through direct contact test (DCT) against S. mutans. Direct contact cytotoxicity assay with fibroblast cell line L-929 was also performed to find more insight regarding cytotoxicity of the antibacterial matrixes. The data were analyzed and compared by ANOVA and Tukey HSD tests (significance level=0.05).

RESULTS

Neat methacrylate systems had significantly higher viscosity than thiol-ene-methacrylate analogous. The degree of conversion of methacrylate moieties in thiol-ene-methacrylate system was improved in comparison to conventional methacrylate system. Shrinkage stress and strain of thiol-ene-methacrylate system was lower than the neat methacrylate system. The thiol-ene-methacrylate systems show increased homogeneity and decreased glass transition temperature (Tg) and crosslink density (νc) in comparison to the neat methacrylate-based resins. The incorporated monofuctional quaternized monomer reduces degree of conversion, shrinkage stress and crosslink density of matrix. The results showed significant improvement in antibacterial activity and cytocompatibility of dental materials obtained from thiol-ene polymerization system.

SIGNIFICANCE

It was shown that with proper control of monomers molar ratio, significant improvement in antibacterial activity and cytocompatibility as well as acceptable mechanical properties can be attained for dental resins prepared through the application of thiol-ene polymerization methodology.

Synthesis of antibacterial and radio-opaque dimethacrylate monomers and their potential application in dental resin

OBJECTIVE

In this study, three dimethacrylate quaternary ammonium compounds N,N-bis[2-(3-(methacryloyloxy)propanamido)ethyl]-N-methyldodecyl ammonium iodide (QADMAI-12), N,N-bis[2-(3-(methacryloyloxy)propanamido)ethyl]-N-methylhexadecyl-ammonium iodide (QADMAI-16), and N,N-bis[2-(3-(methacryloyloxy)propanamido)ethyl]-N-methyloctadectyl ammonium iodide (QADMAI-18) were synthesized and proposed to be used as antibacterial and radio-opaque agents in dental resin.

METHODS

All QADMAIs were synthesized through a 2-steps reaction route, and their structures were confirmed by FT-IR and 1H NMR spectra. Antibacterial activities against Streptococcus mutans (S. mutans) of QADMAIs were measured by agar diffusion test. Each QADMAI was mixed with TEGDMA (50/50, w/w) and photoinitiation system (0.7 wt% of CQ and 0.7 wt% of DMAEMA) to form resin system. Degree of monomer conversion (DC) was determined by FT-IR analysis. The flexural strength (FS) and modulus (FM) of the polymer were measured using a three-point bending set up. Radiograph was taken to determine the radio-opacity of the polymer, and aluminum step-wedge (0.5-4 mm) was used as calibration standard. Surface charge density was measured using fluorescein binding. A single-species biofilm model with S. mutans as the tests organism was used to evaluate the antibacterial property of the polymer. Bis-GMA/TEGDMA resin system was used as control material in all of the tests.

RESULTS

FT-IR and 1H NMR spectra showed that the structures of QADMAIs were the same as designed. ANOVA analysis revealed that antibacterial activity of QADMAI decreased with the increasing of alkyl chain length (p<0.05). QADMAI containing polymers had higher DC (p<0.05) but lower FS and FM (p<0.05) than control polymer. Alkyl chain length had no influence on DC (p>0.05), but FS and FM of QADMAI-12 containing polymer were better than those of QADMAI-16 and QADMAI-18 containing polymers (p<0.05). QADMAI containing polymers had much better radio-opacity than control polymer (p<0.05), and the radio-opacity of polymer decreased with the increasing of alkyl chain length (p<0.05). All of QADMAIs containing polymers had higher surface charge density than control polymer (p<0.05), and surface charge densities of QADMAI-12 and QADMAI-16 containing polymers were nearly the same (p>0.05) which were higher than that of QADMAI-18 containing polymer (p<0.05). All of QADMAI containing polymers had good inhibitory effect on biofilm formation.

SIGNIFICANCE

QADMAIs had no miscibility problem with TEGDMA, and QADMAIs could endow dental resin with both antibacterial activity and radio-opacity. Formulation of QADMAI containing resin should be optimized in terms of mechanical stregth to satisfy the requirements of dental resin for clinical application.

Optimizing the concentration of quaternary ammonium dimethacrylate monomer in bis-GMA/TEGDMA dental resin system for antibacterial activity and mechanical properties

Four novel quaternary ammonium dimethacrylate monomers named IMQ (side alkyl chain length from 12 to 18) were synthesized with the aim to synthesize dental resin with antibacterial activity. All of IMQs were added into bis-GMA/TEGDMA dental resin system with a series of mass ratio (5, 10, and 20 wt%), double bond conversion (DC), flexural strength (FS), modulus of elasticity (FM) and biofilm formation inhibitory effect were studied. According to the results of DC, FS, FM, and the biofilm inhibitory effect, IMQ-16 containing polymer had the best comprehensive properties, and the optimal concentration of IMQ-16 in bis-GMA/TEGDMA dental resin would be in the range of 5-10 wt%.

Effect of salivary pellicle on antibacterial activity of novel antibacterial dental adhesives using a dental plaque microcosm biofilm model

OBJECTIVES

Antibacterial primer and adhesive are promising to inhibit biofilms and caries. Since restorations in vivo are exposed to saliva, one concern is the attenuation of antibacterial activity due to salivary pellicles. The objective of this study was to investigate the effects of salivary pellicles on bonding agents containing a new monomer dimethylaminododecyl methacrylate (DMADDM) or nanoparticles of silver (NAg) against biofilms for the first time.

METHODS

DMADDM and NAg were synthesized and incorporated into Scotchbond Multi-Purpose adhesive and primer. Specimens were either coated or not coated with salivary pellicles. A microcosm biofilm model was used with mixed saliva from ten donors. Two types of culture medium were used: an artificial saliva medium (McBain), and Brain Heart Infusion (BHI) medium without salivary proteins. Metabolic activity, colony-forming units (CFU), and lactic acid production of plaque microcosm biofilms were measured (n=6).

RESULTS

Bonding agents containing DMADDM and NAg greatly inhibited biofilm activities, even with salivary pellicles. When using BHI, the pre-coating of salivary pellicles on resin surfaces significantly decreased the antibacterial effect (p<0.05). When using artificial saliva medium, pre-coating of salivary pellicles on resin did not decrease the antibacterial effect. These results suggest that artificial saliva yielded medium-derived pellicles on resin surfaces, which provided attenuating effects on biofilms similar to salivary pellicles. Compared with the commercial control, the DMADDM-containing bonding agent reduced biofilm CFU by about two orders of magnitude.

SIGNIFICANCE

Novel DMADDM- and NAg-containing bonding agents substantially reduced biofilm growth even with salivary pellicle coating on surfaces, indicating a promising usage in saliva-rich environment. DMADDM and NAg may be useful in a wide range of primers, adhesives and other restoratives to achieve antibacterial and anti-caries capabilities.

Preparation and evaluation of dental resin with antibacterial and radio-opaque functions

In order to prepare antibacterial and radio-opaque dental resin, a methacrylate monomer named 2-Dimethyl-2-dodecyl-1-methacryloxyethyl ammonium iodine (DDMAI) with both antibacterial and radio-opaque activities was added into a 2,2-bis[4-(2-hydroxy-3-methacryloyloxypropyl)-phenyl]propane (Bis-GMA)/methyl methacrylate (MMA) dental resin system. Degree of conversion (DC), flexural strength (FS) and modulus (FM), water sorption (WS) and solubility (WSL), antibacterial activity, and radio-opacity (ROX) of the obtained dental resin system were investigated. Bis-GMA/MMA resin system without DDMAI was used as a control. The results showed that DDMAI could endow BIS-GMA/MMA resin system with good antibacterial (p < 0.05) and radio-opaque function without influencing the DC (p > 0.05). However, incorporating DDMAI into Bis-GMA/MMA resin could reduce mechanical properties (p < 0.05) and increase WS and WSL (p < 0.05), thus further work is needed in order to optimize the resin formulation.