Analysis of the leaching and toxicity of new amine activators for the curing of acrylic bone cements and composites

Multifunctional monomer acts as co-initiator and crosslinker to provide autonomous strengthening with enhanced hydrolytic stability in dental adhesives

OBJECTIVE

The purpose of this study was to evaluate a new synthesized multifunctional monomer, aminosilane functionalized methacrylate (ASMA), containing polymerizable methacrylate, tertiary amine, and methoxysilane functionalities in dental adhesive formulations, and to investigate the polymerization kinetics, leachates, thermal and mechanical properties of copolymers.

METHODS

Adhesive contained HEMA/BisGMA (45/55, w/w) was used as a control, and mixtures based on HEMA/BisGMA/ASMA at the mass ratio of 45/(55-x)/x were used as experimental adhesive. Adhesives were characterized with regard to water miscibility, photo-polymerization behavior (Fourier transform infrared spectroscopy, FTIR), leached co-monomers (high performance liquid chromatography, HPLC), thermal properties (modulated differential scanning calorimeter, MDSC), and mechanical properties (dynamic mechanical analyzer, DMA). Stress relaxation times and the corresponding moduli, obtained from stress relaxation tests, are used in a simulated linear loading case.

RESULTS

As compared to the control, ASMA-containing adhesives showed higher water miscibility, lower viscosity, improved monomer-to-polymer conversion, significantly greater T_g and rubbery modulus. HPLC results indicated a substantial reduction of leached HEMA (up to 85wt%) and BisGMA (up to 55wt%) in ethanol. The simulation reveals that the ASMA-containing adhesive becomes substantially stiffer than the control.

SIGNIFICANCE

ASMA monomer plays multiple roles, i.e. it serves as both a co-initiator and crosslinker while also providing autonomous strengthening and enhanced hydrolytic stability in the adhesive formulations. This multifunctional monomer offers significant promise for improving the durability of the adhesive at the composite/tooth interface.

Sulfinates and sulfonates as high performance co-initiators in CQ based systems: Towards aromatic amine-free systems for dental restorative materials

OBJECTIVE

The aim of our study is to develop amine-free photoinitiating systems (PISs) for the polymerization of representative dental methacrylate resins under blue light irradiation. PISs based on camphorquinone (CQ)/sulfinate and CQ/sulfonate, eventually in combination with an iodonium salt, are proposed and compared to the well-established CQ/amine system. The polymerization performances of thick (1.4 mm) samples of different methacrylate blends upon exposure to a commercial blue LED centered at 477 nm under air are described. Finally, the performances of the new developed PISs are evaluated for dental composites application.

METHODS

FTIR is used to monitor the photopolymerization profiles. ESR spectroscopy and electrochemical experiments are used to identify the radicals generated. Mechanical properties measurements and color stability measurements are carried out to determine the key properties of the dental composites prepared.

RESULTS AND SIGNIFICIANCE

The performances of the new proposed PISs for the photopolymerization of thick (1.4 mm) samples of methacrylate upon exposure to a blue dental LED under air are excellent. Similar or better performances and bleaching properties are obtained with the new proposed amine-free systems compared to those reached with the CQ/amine reference system. Dental composites with excellent mechanical properties and exceptional color stability are obtained. The involved chemical mechanisms for the initiation step were also established.

Rational Design of Efficient Amine Reductant Initiators for Amine-Peroxide Redox Polymerization

Amine-peroxide redox polymerization (APRP) has been highly prevalent in industrial and medical applications since the 1950s, yet the initiation mechanism of this radical polymerization process is poorly understood so that innovations in the field are largely empirically driven and incremental. Through a combination of computational prediction and experimental analysis, we elucidate the mechanism of this important redox reaction between amines and benzoyl peroxide for the ambient production of initiating radicals. Our calculations show that APRP proceeds through S_N2 attack by the amine on the peroxide but that homolysis of the resulting intermediate is the rate-determining step. We demonstrate a correlation between the computationally predicted initiating rate and the experimentally measured polymerization rate with an R² = 0.80. The new mechanistic understanding was then applied to computationally predict amine reductant initiators with faster initiating kinetics. This led to our discovery of N-(4-methoxyphenyl)pyrrolidine (MPP) as amine reductant, which we confirmed significantly outperforms current state-of-the-art tertiary aromatic amines by ∼20-fold, making it the most efficient amine-peroxide redox initiator to date. The application of amines with superior kinetics such as MPP in APRP could greatly accelerate existing industrial processes, facilitate new industrial manufacturing methods, and improve biocompatibility in biomedical applications conducted with reduced initiator concentrations yet higher overall efficiency.

New silyl-functionalized BisGMA provides autonomous strengthening without leaching for dental adhesives

Resin-based composite has overtaken dental amalgam as the most popular material for direct restorative dentistry. In spite of this popularity the clinical lifetime of composite restorations is threatened by recurrent decay. Degradation of the adhesive leads to gaps at the composite/tooth interface-bacteria, bacterial by-products and fluids infiltrate the gaps leading to recurrent decay and composite restoration failure. The durability of resin-dentin bonds is a major problem. We address this problem by synthesizing silyl-functionalized BisGMA (e.g., silyl-BisGMA), formulating dental adhesives with the new monomer and determining the physicochemical properties and leaching characteristics of the silyl-BisGMA adhesives. Silyl-BisGMA was synthesized by stoichiometric amounts of BisGMA and 3-isocyanatopropyl trimethoxysilane (IPTMS). The control adhesive was a mixture based on HEMA/BisGMA (45/55, w/w). In the experimental formulations, BisGMA was partially or completely replaced by silyl-BisGMA. Water miscibility, polymerization behavior (Fourier transform infrared spectroscopy, FTIR), thermal property (modulated differential scanning calorimetry, MDSC), mechanical properties in dry and wet conditions (dynamic mechanical analysis, DMA), and leached species (HPLC) were investigated. Data from all tests were submitted to appropriate statistical analysis (α = 0.05). Silyl-BisGMA-containing adhesives exhibited comparable water miscibility, lower viscosities, and significantly improved degree of conversion of CC bond as compared to the control. After 4 weeks aqueous aging, the glass transition temperature and rubbery moduli of the experimental copolymers were significantly greater than the control (p < 0.05). HPLC results indicated a substantial reduction of leached HEMA (up to 99 wt%) and BisGMA (up to 90 wt%). By introducing silyl-functional group, the new BisGMA derivative exhibited potential as a monomer that can lead to dental adhesives with improved mechanical properties and reduced leaching under conditions relevant to the oral environment. STATEMENT OF SIGNIFICANCE: The low-viscosity adhesive that bonds the composite to the tooth (enamel and dentin) is intended to seal and stabilize the composite/tooth interface, but it degrades leading to a breach at the composite/tooth margin. As the most popular crosslinking monomer in adhesives, Bisphenol A-glycerolate dimethacrylate (BisGMA) has limitations, e.g. susceptible to hydrolysis and concomitant property degradation. A methoxysilyl-functionalized BisGMA derivative (silyl-BisGMA) was introduced in this work to respond to these limitations. Our results indicated that by introducing silyl-BisGMA, higher crosslinked networks were obtained without sacrificing the homogeneity, and the leached amount of HEMA was reduced up to 99%. This novel resin offers potential benefits including prolonging the functional lifetime of dental resin materials.

Physicochemical, Mechanical, and Biological Properties of Bone Cements Prepared with Functionalized Methacrylates

Bone cements prepared with methyl methacrylate (MMA) as a base monomer and either methacrylic acid (MAA) or diethyl amino ethyl methacrylate (DEAEMA) as comonomers were characterized in terms of curing behavior, mechanical properties, and their in vitro biocompatibility.

The curing time and setting temperature were found to be composition dependent while the residual monomer was not greatly affected by the presence of either acidic or alkaline comonomers in the bone cements. For samples with MAA comonomer, a faster curing time and higher setting temperature were observed when compared to the cement with DEAEMA comonomer.

In terms of mechanical properties, the highest compressive strength was exhibited by formulations containing MAA, while the highest impact strength was shown by the formulations prepared with DEAEMA. There were no differences observed between the two formulations for tensile, shear, and bending strength values. Similarly, fatigue crack propagation studies did not reveal differences with the addition of either DEAEMA or MAA.

No differences were observed in the initial number of attached primary rat femur osteoblasts on the different bone cements and positive controls. However, after 48 h there was a reduced proliferation in the cells grown on bone cements containing MAA.

Sesamin as a co-initiator for unfilled dental restorations

A natural component, sesamin (SA), was used to replace conventional amine as co-initiator for dental composite. A combination of camphorquinone (CQ) and SA was employed to initiate the photopolymerization of 2-2-bis[4-(2-hydroxy-3-methacryloxyprop-1-oxy)phenyl] propane/triethylene glycol dimethacrylate (70/30wt.%). The kinetics was recorded by real-time Fourier transform infrared spectroscopy. The mechanical properties were measured by dynamic mechanical analysis, the cell toxicity was investigated by MTT assay and a mixture of CQ and ethyl 4-N,N-dimethylaminobenzoate (EDMAB) was used as control in the same photocuring condition. The results indicated that the addition of SA as co-initiator greatly improved the rate of polymerization and final double-bond conversion (DC) when compared with the system initiated by CQ alone. Compared with EDMAB, the final DC of the CQ/SA system (71%) was slightly lower than that of CQ/EDMAB (76%); SA resulted in approximately the same storage modulus at around 37 degrees C, but a slightly higher glass transition temperature. SA produced lower yellowing effect and good in vitro biocompatibility. The water sorption and solubility for two mixtures were very close and within the range of the ISO 4049 specification. These results suggest that SA is an effective alternative co-initiator to conventional amine. The natural compound characteristics of SA make it more promising than amine in dental resin formulations.

Photopolymerization of N,N-dimethylaminobenzyl alcohol as amine co-initiator for light-cured dental resins

OBJECTIVE

The present study was carried out in order to assess the suitability of N,N-dimethylaminobenzyl alcohol (DMOH) as co-initiator of camphorquinone (CQ) and 1-phenyl-1,2-propanedione (PPD) in light-cured dental resins.

METHODS

DMOH was synthesized and used as co-initiator for the photopolymerization of a model resin based on {2,2-bis[4-(2-hydroxy-3-methacryloxyprop-1-oxy)phenyl]propane} (Bis-GMA)/triethylene glycol dimethacrylate (TEGDMA). Experimental formulations containing CQ or PPD in combination with DMOH at different concentrations were studied. The photopolymerization was carried out by means of a commercial light-emitting diode (LED) curing unit. The evolution of double bonds consumption versus irradiation time was followed by near-infrared spectroscopy (NIR). The photon absorption efficiency (PAE) of the photopolymerization process was calculated from the spectral distribution of the LED unit and the molar absorption coefficient distributions of PPD and CQ.

RESULTS

DMOH is an efficient photoreducer of CQ and PPD resulting in higher polymerization rate and higher double bond conversion compared with dimethylaminoethylmethacrylate. The PAE for PPD was higher than that for CQ. However, the polymerization initiated by PPD progressed at a lower rate and exhibited lower values of final conversion compared with the resins containing CQ. This observation indicates that the lower polymerization rate of the PPD/amine system should be explained in terms of the mechanism of generating primary radicals by PPD, which is less efficient compared with CQ.

SIGNIFICANCE

The DMOH/benzoyl peroxide redox system, has recently been proposed as a more biocompatible accelerator for the polymerization of bone cements based on poly(methyl methacrylate), because cytotoxity tests have demonstrated that DMOH possesses better biocompatibility properties compared with traditional tertiary amines. The results obtained in the present study reveal the suitability of the CQ/DMOH initiator system for the polymerization of light-cured dental composites.

Alternative acrylic bone cement formulations for cemented arthroplasties: present status, key issues, and future prospects

All the commercially available plain acrylic bone cement brands that are used in cemented arthroplasties are based on poly (methyl methacrylate) and, with a few exceptions, have the same constituents. It is well known that these brands are beset with many drawbacks, such as high maximum exotherm temperature, lack of bioactivity, and volumetric shrinkage upon curing. Furthermore, concerns have been raised about a number of the constituents, such as toxicity of the activator (N,N,dimethyl-p-toluidine) and possible involvement of the radiopacifier (BaSO(4) or ZrO(2) particles) in third-body wear. Thus, over the years, many research efforts have been expended to address these drawbacks, culminating in a large number of alternative formulations, which may be grouped into 16 categories. Although there are a number of reviews of the large literature that now exists on these formulations, each covers only some of the categories and none contains a detailed discussion of the germane issues. The objective of the present work, therefore, was to present a comprehensive and critical review of the whole field. In addition to succinct descriptions of the cements in each category, there are explicative summaries of literature reports, a detailed discussion of several key issues surrounding the potential for use of these cements in cemented arthroplasties, and a presentation of numerous ideas for future studies.

Benzodioxole derivative as coinitiator for dental resin

OBJECTIVE

The aim of this work was to examine whether it was possible to substitute benzodioxole derivatives for amine as coinitiators for dental application.

MATERIAL AND METHODS

A mixture of urethane dimethacrylate (UDMA)/triethylene glycol dimethacrylate (TEGDMA) (70/30 wt%), camphorquinone (CQ) and coinitiators was photocured. Real time Fourier Transform Infrared Spectroscopy with a horizontal sample holder was used to monitor the extent of polymerization. Dynamic mechanical analysis was performed over a temperature range from -50 degrees C to 200(o)C, with a ramping rate of 5(o)C per minute, using extension mode.

RESULTS

Benzodioxole derivatives as coinitiator improved the rate of polymerization and final double bond conversion of the dental resin. The cured samples showed similar properties, e.g. modulus, glass transition temperature, water sorption and solubility.

CONCLUSION

The results indicate that two benzodioxole derivatives, piperonyl alcohol (PAL) and benzodioxole (BDO), are viable alternatives to conventional amines as coinitiator. The biocompatibility of benzodioxole derivatives makes them more promising than amine in dental resin formulations.

A natural component as coinitiator for unfilled dental resin composites

A natural component, 1,3-benzodioxole (BDO), was used for the purpose of replacing the conventional amine for dental composite. Camphorquinone (CQ)/BDO was used to initiate the photopolymerization of urethane dimethacrylate (UDMA)/triethylene glycol dimethacrylate (TEGDMA) (70/30 wt %). The kinetics was recorded by real-time Fourier transformation infrared spectroscopy (FTIR). The mechanical properties were measured by dynamic mechanical analyzer (DMA), and CQ/ethyl 4-N,N-dimethylaminobenzoate (EDMAB) mixture was used as control in the same photocuring condition. The results indicated that, the addition of BDO as coinitiator greatly improved the rate of polymerization and final double bond conversion (DC), when compared with the system initiated by CQ alone. BDO and EDMAB were found to reach almost the same final DC (75%), though the kinetics of two systems was different. Comparing with EDMAB, BDO brought approximately the same glass transition temperature (Tg), but slightly higher storage modulus around 37 degrees C. The water sorption and solubility for two mixtures were almost the same and within the range of the ISO 4049's standards. These results suggested that BDO was an effective alternative to conventional amine for coinitiator. And the human diet characteristics of BDO made it more promising than amine in the dental resin formulations.

Influence of the activator in an acrylic bone cement on an array of cement properties

In all but one of the acrylic bone cement brands used in cemented arthroplasties, N,N-dimethyl-4-toluidine (DMPT) serves as the activator of the polymerization reaction. However, many concerns have been raised about this activator, all related to its toxicity. Thus, various workers have assessed a number of alternative activators, with two examples being N,N-dimethylamino-4-benzyl laurate (DMAL) and N,N-dimethylamino-4-benzyl oleate (DMAO). The results of limited characterization of cements that contain DMAL or DMAO have been reported in the literature. The present work is a comprehensive comparison of cements that contain one of these three activators, in which the values of a large array of their properties were determined. These properties range from the setting time and maximum exotherm temperature of the curing cement to the variation of the loss elastic modulus of the cured cement with frequency of the applied indenting force in dynamic nanoindentation tests. The present results, taken in conjunction with those presented in previous reports by the present authors and co-workers on other properties of these cements, indicate that both DMAL and DMPT are suitable alternatives to DMPT.

Analysis of the shelf life of a two-solution bone cement

Two-solution bone cement consists of methyl methacrylate monomer and poly(methyl methacrylate) polymer dissolved together to yield a viscous solution. Two solutions are used such that the initiator, benzoyl peroxide (BPO), is placed in one solution and the activator, N,N, dimethyl-para-toluidine, is placed in the other. This approach to bone cement provides for a simplified use during surgery and eliminates some of the sources of porosity formation. However, the BPO-containing solution cement will spontaneously polymerize over time and will limit the useful shelf life of this component of the system. The activator-containing component is much more stable and is not as susceptible to spontaneous polymerization. In making two-solution cements, it is envisioned that antibiotics may be incorporated and that the polymer may be sterilized using gamma(gamma)-irradiation. Therefore, this study investigated the shelf life of the initiator-containing solution bone cement and studied the effects of initiator concentration, gamma-irradiation, gentamicin addition, and the role of storage temperature. Isothermal differential scanning calorimetry (Iso-DSC) techniques were used to monitor the polymerization of BPO-containing solutions. It was found that the shelf life was highly temperature dependent and followed an Arrhenius expression where refrigeration storage (4 degrees C) yielded approximately a 12-month storage time, while 70 degrees C storage results in setting in about 5-7 min. gamma-irradiation and gentamicin addition did not significantly affect the shelf life. Initiator concentration affected storage time with higher levels resulting in shorter shelf life.

Biocompatibility and other properties of acrylic bone cements prepared with antiseptic activators

Acrylic bone cements prepared with activators of reduced toxicity have been formulated with the aim of improving the biocompatibility of the final material. The activators used were N,N-dimethylaminobenzyl alcohol (DMOH) and 4,4'-dimethylamino benzydrol (BZN). The toxicity, cytotoxicity, and antiseptic action of these activators were first studied. DMOH and BZN presented LD50 values 3-4 times higher than DMT, were less cytotoxic against polymorphonuclear leucocytes, and possessed an antimicrobial character, with a high activity against the most representative microorganisms involved in postoperative infections. The properties of the acrylic bone cements formulated with DMOH and BZN were evaluated to determine the influence of these activators on the curing process and the physicochemical characteristics of the cements. A decrease of the peak temperature was observed for the curing with DMOH or BZN with respect to that of one commercially available formulation (CMW 3). However, residual monomer content and mechanical properties in tension and compression were comparable to those of CMW 3. The biocompatibility of acrylic bone cements containing DMOH or BZN was studied and compared with CMW 3. To that end, intramuscular and intraosseous implantation procedures were carried out and the results were obtained from the histological analysis of the surrounding tissues at different periods of time. Implantation of rods of cement into the dorsal muscle of rats showed the presence of a membrane of connective tissue, which increased in collagen fibers with time of implantation, for all formulations. The intraosseous implantation of the cements in the dough state in the femur of rabbits, revealed a higher and early osseous neoformation, with the presence of osteoid material surrounding the rest of the cured material, for the cement prepared with the activator BZN in comparison with that obtained following the implantation of the cement cured with DMOH or DMT (CMW 3).

Comparative study of bone cements prepared with either HA or alpha-TCP and functionalized methacrylates

The properties of bone cements prepared with both hydroxyapatite (HA) and alpha-tricalcium phosphate (alpha-TCP) and methacrylates containing acidic or basic groups are the main interest of this article. The presence of methacrylic acid or diethyl amino ethyl methacrylate as comonomers in the bone cement and both ceramic types as filler were found not to affect the amount of residual monomer, which was generally less than 4.5 wt%. In contrast, setting times, maximum temperature, and glass transition temperature were found to be composition dependent. For samples with acidic comonomer, a faster setting time, a higher maximum temperature, and higher glass transition temperatures were observed compared to those with the basic comonomer. The presence of the fillers slightly increased the setting time but did not affect the other parameters. The mechanical properties of the filled bone cements depended mainly on composition and type of testing. Both HA or alpha-TCP filled systems fulfilled the minimum compressive strength required for bone cement application, although a significantly lower value was observed for the alkaline comonomer systems. The minimum bending strength was not satisfied by any of these formulations. The tensile and shear strength of these composites ranged from 20 to 37.9 and from 18 to 27 MPa, respectively. In all cases it was higher for bone cements containing methacrylic acid. The results of this study suggest that the properties of dry unfilled bone cements prepared with MAA are comparable to CMW 3 in mechanical terms but inferior in their setting properties.

New acrylic bone cements conjugated to vitamin E: curing parameters, properties, and biocompatibility

Acrylic bone cement formulations with antioxidant character were prepared by incorporation of a methacrylic monomer derived from vitamin E (MVE). Increasing concentrations of this monomer provided decreasing peak temperature values, ranging from 62 to 36 degrees C, and increasing setting time with values between 17 and 25 min. Mechanical properties were evaluated by compression and tension tests. Compressive strength of the new formulations were superior to 70 MPa in all cases. The cement containing 25 wt % MVE, however, showed a significant decrease in tensile properties. Biocompatibility of the new formulations was studied in vitro. The analysis of the effect of leachables from cements into the media showed continued cell proliferation and cell viability with a significant increase for the cement containing 15 wt % MVE. This formulation also showed a significant increase in cellular proliferation over a period of 7 days as indicated by the Alamar Blue test. The cells were able to differentiate and express phenotypical markers in presence of all materials. A significant increase in alkaline phosphatase activity was observed on the cements prepared in presence of 15-25 wt % MVE compared with PMMA. Morphological assessment showed that the human osteoblast (HOB) cells were able to adhere, retain their morphology, and proliferate on all the cements.

Characterization of bone cements prepared with functionalized methacrylates and hydroxyapatite

Bone cements prepared with methyl methacrylate and either methacrylic acid or diethyl amino ethyl methacrylate as comonomers were characterized by infrared spectroscopy, nuclear magnetic resonance, gel permeation chromatography, dynamic mechanical thermal analysis, and mechanical testing. Selected formulations containing these functionalized methacrylates were filled with hydroxyapatite and studied in terms of their properties in tension, compression and bending, and X-ray diffraction. It was found that residual monomer was not greatly affected by the presence of either acid or basic comonomers in the unfilled bone cements. In contrast, molecular weight, curing times, and glass transition temperature were composition dependent. For samples with acidic comonomer, a faster curing time, higher molecular weight, and higher glass transition temperatures were observed with respect to those with the basic comonomer. X-ray diffraction revealed that the crystalline structure was not affected by the nature of comonomer in the bone cement while scanning electron microscopy showed that hydroxyapatite remained as clusters in the bone cement. The mechanical properties of filled bone cements depended mainly on composition and type of testing. Hydroxyapatite-filled bone cements fullfilled the minimum compressive strength (70 MPa) required for bone cement use. However, the minimum tensile strength (30 MPa) was only fullfilled by cements prepared without comonomer and those containing methacrylic acid. The minimum bending strength requirement (50 MPa) was not satisfied by any of the formulations studied.

Application of long chain amine activator in conventional acrylic bone cement

A long chain acid derivative bearing an aromatic tertiary amine group, 4-N,N-dimethylaminobenzyl laurate (DML), which acts as an activator for the curing of acrylic cements at low temperature, has been synthesized and characterized to reduce the biological adverse effects usually associated with the classical activator N,N-dimethyl-4-toluidine (DMT). The effectiveness of the activator was tested on commercial formulations (e.g., Palacos R) and on experimental bone cements based on poly (methyl methacrylate) by using different benzoyl peroxide/amine molar ratios. The exotherms of polymerization were followed at three different temperatures: 25, 30, and 37 degrees C. The DML activator was found to be more sensitive to temperature than the corresponding DMT. DML provided exotherms of polymerization with decreasing peak temperatures and increasing setting times without impairing the mechanical properties. Residual monomer content was analyzed in a range of activator concentrations by keeping the benzoyl peroxide concentration constant. In all cases the residual monomer content was lower than 5%, indicating its good efficiency in the benzoyl peroxide initiated polymerization.

Dental materials citations: Part A, January to June 1997

OBJECTIVE

A search was conducted in biomedical journals published from January 1997 to June 1997 to identify all dental materials publications and sort them into major categories.

METHODS

Tables of contents for 79 journals for the period of January to June, 1997 were inspected and divided into 17 categories. Citations were analyzed by both frequency in journals and in categories, as well as compared to frequencies for previous years.

RESULTS

A total of 445 citations were detected in 79 journals for the period January 1997 to June 1997. Certain journals (n = 19) demonstrated a higher citation frequency (> or = 10 citations for 6 months) and represented 77.8% of all citations. The greatest number of citations continued to involve bonding (n = 97), resin-based restorative materials (composites; glass ionomers) (n = 95), prosthodontic materials (n = 51), and pulp protection/luting materials (n = 48). Frequencies by category were very similar to those for the last four years.

SIGNIFICANCE

The compiled literature citations provide a supplement for researchers and academicians seeking information in existing electronic databases.