Designing Multiagent Dental Materials for Enhanced Resistance to Biofilm Damage at the Bonded Interface

Multifunctional scaffolds for bone repair following age-related biological decline: Promising prospects for smart biomaterial-driven technologies

The repair of large bone defects due to trauma, disease, and infection can be exceptionally challenging in the elderly. Despite best clinical practice, bone regeneration within contemporary, surgically implanted synthetic scaffolds is often problematic, inconsistent, and insufficient where additional osteobiological support is required to restore bone. Emergent smart multifunctional biomaterials may drive important and dynamic cellular crosstalk that directly targets, signals, stimulates, and promotes an innate bone repair response following age-related biological decline and when in the presence of disease or infection. However, their role remains largely undetermined. By highlighting their mechanism/s and mode/s of action, this review spotlights smart technologies that favorably align in their conceivable ability to directly target and enhance bone repair and thus are highly promising for future discovery for use in the elderly. The four degrees of interactive scaffold smartness are presented, with a focus on bioactive, bioresponsive, and the yet-to-be-developed autonomous scaffold activity. Further, cell- and biomolecular-assisted approaches were excluded, allowing for contemporary examination of the capabilities, demands, vision, and future requisites of next-generation biomaterial-induced technologies only. Data strongly supports that smart scaffolds hold significant promise in the promotion of bone repair in patients with a reduced osteobiological response. Importantly, many techniques have yet to be tested in preclinical models of aging. Thus, greater clarity on their proficiency to counteract the many unresolved challenges within the scope of aging bone is highly warranted and is arguably the next frontier in the field. This review demonstrates that the use of multifunctional smart synthetic scaffolds with an engineered strategy to circumvent the biological insufficiencies associated with aging bone is a viable route for achieving next-generation therapeutic success in the elderly population.

Novel strategy of S. mutans gcrR gene over-expression plus antibacterial dimethylaminohexadecyl methacrylate suppresses biofilm acids and reduces dental caries in rats

OBJECTIVE

Streptococcus mutans (S. mutans) is a major contributor to dental caries, with its ability to synthesize extracellular polysaccharides (EPS) and biofilms. The gcrR gene is a regulator of EPS synthesis and biofilm formation. The objectives of this study were to investigate a novel strategy of combining gcrR gene over-expression with dimethylaminohexadecyl methacrylate (DMAHDM), and to determine their in vivo efficacy in reducing caries in rats for the first time.

METHODS

Two types of S. mutans were tested: Parent S. mutans; and gcrR gene over-expressed S. mutans (gcrR OE S. mutans). Bacterial minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were measured with DMAHDM and chlorhexidine (CHX). Biofilm biomass, polysaccharide, lactic acid production, live/dead staining, colony-forming units (CFUs), and metabolic activity (MTT) were evaluated. A Sprague-Dawley rat model was used with parent S. mutans and gcrR OE S. mutans colonization to determine caries-inhibition in vivo.

RESULTS

Drug-susceptibility of gcrR OE S. mutans to DMAHDM or CHX was 2-fold higher than that of parent S. mutans. DMAHDM reduced biofilm CFU by 3-4 logs. Importantly, the combined gcrR OE S. mutans+ DMAHDM dual strategy reduced biofilm CFU by 5 logs. In the rat model, the parent S. mutans group had a higher cariogenicity in dentinal (Dm) and extensive dentinal (Dx) regions. The DMAHDM + gcrR OE group reduced the Dm and Dx caries to only 20 % and 0 %, those of parent S. mutans + PBS control group (p < 0.05). The total caries severity of gcrR OE + DMAHDM group was decreased to 51 % that of parent S. mutans control (p < 0.05).

SIGNIFICANCE

The strategy of combining S. mutans gcrR over-expression with antibacterial monomer reducing biofilm acids by 97 %, and reduced in vivo total caries in rats by 48 %. The gcrR over-expression + DMAHDM strategy is promising for a wide range of dental applications to inhibit caries and protect tooth structures.

S. mutans Antisense vicK RNA Over-Expression Plus Antibacterial Dimethylaminohexadecyl Methacrylate Suppresses Oral Biofilms and Protects Enamel Hardness in Extracted Human Teeth

Streptococcus mutans (S. mutans) antisense vicK RNA (ASvicK) is a non-coding RNA that regulates cariogenic virulence and metabolic activity. Dimethylaminohexadecyl methacrylate (DMAHDM), a quaternary ammonium methacrylate used in dental materials, has strong antibacterial activity. This study examined the effects of S. mutans ASvicK on DMAHDM susceptibility and their combined impact on inhibiting S. mutans biofilm formation and protecting enamel hardness. The parent S. mutans UA159 and ASvicK overexpressing S. mutans (ASvicK) were tested. The minimum inhibitory concentration (MIC) and minimum bactericidal concentrations for planktonic bacteria (MBC-P) and biofilms (MBC-B) were measured. As the ASvicK MBC-B was 175 μg/mL, live/dead staining, metabolic activity (MTT), colony-forming units (CFUs), biofilm biomass, polysaccharide, and lactic acid production were investigated at 175 μg/mL and 87.5 μg/mL. The MIC, MBC-P, and MBC-B values for DMAHDM for the ASvicK strain were half those of the UA159 strain. In addition, combining S. mutans ASvicK with DMAHDM resulted in a significant 4-log CFU reduction (p < 0.05), with notable decreases in polysaccharide levels and lactic acid production. In the in vitro cariogenic model, the combination achieved the highest enamel hardness at 67.1% of sound enamel, while UA159 without DMAHDM had the lowest at 16.4% (p < 0.05). Thus, S. mutans ASvicK enhanced DMAHDM susceptibility, and their combination effectively inhibited biofilm formation and minimized enamel demineralization. The S. mutans ASvicK + DMAHDM combination shows great potential for anti-caries dental applications.

Promotion of Dentin Biomimetic Mineralization and Bonding Efficacy by Interfacial Control of an Experimental Citric Acid Dental Etching Agent

Resin-bonded restorations are the most important caries treatment method in clinical practice. Thus, improving the durability of dentin bonding remains a pressing issue. As a promising solution, guided tissue remineralization can induce the formation of apatite nanocrystals to repair defects in the dentin bonding interface. In this study, we present an experimental 20 wt % citric acid (CA) dental etching agent that removes the smear layer. After CA-etching, approximately 3.55 wt % residual CA formed a strong bond with collagen fibrils, reducing the interfacial energy between the remineralizing solution and dentin. CA helped achieve almost complete intrafibrillar and extrafibrillar mineralization after 24 h of mineralization. CA also significantly promoted poly(amidoamine)-induced dentin biomimetic mineralization. The elastic modulus and microhardness of remineralized dentin were restored to that of sound dentin. The remineralized interface reduced microleakage and provided a stronger, longer-lasting bond than conventional phosphate acid-etching. The newly developed CA dental etching agents promoted rapid dentin biomimetic mineralization and improved bonding efficacy through interfacial control, representing a new approach with clinical practice implications.

Aging processes in dental thermoplastics - Thermoanalytical investigations and effects on Vickers as well as Martens hardness

OBJECTIVE

The influence of various aging protocols, representing and accelerating influences present in the dental context, on possible changes in the microstructure and mechanical properties of thermoplastics was investigated. In order to minimize the complexity of the systems, first pure polymers and then later the equivalent dental polymeric materials were analyzed.

MATERIALS AND METHODS

Pure polymers (Poly(methyl methacrylate) - PMMA, Polyoxymethylene homopolymer - POM-H, Polyether ether ketone - PEEK, Nylon 12 - PA12, Polypropylene - PP) were analyzed before as well as after applying different aging protocols relevant to the oral environment (ethanol, thermocycling, alkaline and acidic setting) by differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). The thermoanalytical parameters used were glass transition temperature (Tg), melting peak and crystallization peak temperature (Tpm, Tpc) and decomposition behavior. In a second step selected commercially available dental products (Telio CAD - PMMAD, Zirlux Acetal - POMD, Juvora Natural Dental Disc - PEEKD) aged by the protocol that previously showed strong effects were examined and additionally tested for changes in their Vickers and Martens hardness by Mann-Whitney-U test.

RESULTS

The combinations of pure polymers and viable aging protocols analyzed within this study were identified via TGA or DSC as PA12 & thermocycling, POM-H & denture cleanser/lactic acid/ethanol, PP & lactic acid. The dental polymeric materials PMMAD and POMD due to aging in lactic acid showed slight but significantly (p < 0.01) reduced Vickers and partly Martens hardness. PEEK showed the greatest material resistance within this study.

Cytotoxicity evaluation, antibacterial effect, and degree of conversion of QAM-containing adhesives

The aim of this study was to evaluate the influence of adding quaternary ammonium methacrylates (QAMs) to experimental adhesives by assessing the degree of conversion (DC), cytotoxicity against keratinocytes and fibroblasts, and antibacterial activity against biofilm formation. Two QAMs were added to an experimental adhesive: dimethylaminododecyl methacrylate bromododecane (DMADDM) or dimethylaminododecyl methacrylate bromohexadecane (DMAHDM) at three concentrations each: 1, 2.5, and 5 wt.%. Experimental adhesive without QAMs (control group) and commercially available Transbond XT Primer (3M Unitek, Monrovia, California, USA) were used for comparisons. The adhesives were tested for DC, cytotoxicity against keratinocytes and fibroblasts, and antibacterial activity against biofilm formation. DC, cytotoxicity against fibroblasts, and antibacterial activity were analyzed using one-way ANOVA and Tukey's multiple comparisons. Cytotoxicity against keratinocytes was evaluated using the Kruskal Wallis and Dunn's post-hoc (α = 5%) tests. Transbond showed lower DC as compared to 5% DMAHDM, 1% DMADDM, and 5% DMADDM (p < 0.05). However, all groups presented proper DC when compared to commercial adhesives in the literature. In the evaluation of cytotoxicity against keratinocytes, Transbond induced higher viability than 2.5 wt.% groups (p < 0.05). Against fibroblasts, Transbond induced higher viability as compared to 5 wt.% groups (p < 0.05). DMAHDM at 5 wt.% reduced biofilm formation when compared to all the other groups (p < 0.05). Despite their cytotoxic effect against keratinocytes, gingival fibroblasts showed higher viability. DMAHDM at 5 wt.% decreased Streptococcus mutans viability. The incorporation of DMAHDM at 5 wt.% may be a strategy for reducing the development of white spot lesions.

Engineered Peptides Enable Biomimetic Route for Collagen Intrafibrillar Mineralization

Overcoming the short lifespan of current dental adhesives remains a significant clinical need. Adhesives rely on formation of the hybrid layer to adhere to dentin and penetrate within collagen fibrils. However, the ability of adhesives to achieve complete enclosure of demineralized collagen fibrils is recognized as currently unattainable. We developed a peptide-based approach enabling collagen intrafibrillar mineralization and tested our hypothesis on a type-I collagen-based platform. Peptide design incorporated collagen-binding and remineralization-mediating properties using the domain structure conservation approach. The structural changes from representative members of different peptide clusters were generated for each functional domain. Common signatures associated with secondary structure features and the related changes in the functional domain were investigated by attenuated total reflectance Fourier-transform infrared (ATR-FTIR) and circular dichroism (CD) spectroscopy, respectively. Assembly and remineralization properties of the peptides on the collagen platforms were studied using atomic force microscopy (AFM). Mechanical properties of the collagen fibrils remineralized by the peptide assemblies was studied using PeakForce-Quantitative Nanomechanics (PF-QNM)-AFM. The engineered peptide was demonstrated to offer a promising route for collagen intrafibrillar remineralization. This approach offers a collagen platform to develop multifunctional strategies that combine different bioactive peptides, polymerizable peptide monomers, and adhesive formulations as steps towards improving the long-term prospects of composite resins.

Can Differently Stabilized Silver Nanoparticles Modify Calcium Phosphate Precipitation?

Calcium phosphates (CaPs) composites with silver nanoparticles (AgNPs) attract attention as a possible alternative to conventional approaches to combating orthopedic implant-associated infections. Although precipitation of calcium phosphates at room temperatures was pointed out as an advantageous method for the preparation of various CaP-based biomaterials, to the best of our knowledge, no such study exists for the preparation of CaPs/AgNP composites. Motivated by this lack of data in this study we investigated the influence of AgNPs stabilized with citrate (cit-AgNPs), poly(vinylpyrrolidone) (PVP-AgNPs), and sodium bis(2-ethylhexyl) sulfosuccinate (AOT-AgNPs) in the concentration range 5-25 mg dm^-3 on the precipitation of CaPs. The first solid phase to precipitate in the investigated precipitation system was amorphous calcium phosphate (ACP). The effect of AgNPs on ACP stability was significant only in the presence of the highest concentration of AOT-AgNPs. However, in all precipitation systems containing AgNPs, the morphology of ACP was affected, as gel-like precipitates formed in addition to the typical chain-like aggregates of spherical particles. The exact effect depended on the type of AgNPs. After 60 min of reaction time, a mixture of calcium-deficient hydroxyapatite (CaDHA) and a smaller amount of octacalcium phosphate (OCP) formed. PXRD and EPR data point out that the amount of formed OCP decreases with increasing AgNPs concentration. The obtained results showed that AgNPs can modify the precipitation of CaPs and that CaPs properties can be fine-tuned by the choice of stabilizing agent. Furthermore, it was shown that precipitation can be used as a simple and fast method for CaP/AgNPs composites preparation which is of special interest for biomaterials preparation.

Insight into the development of versatile dentin bonding agents to increase the durability of the bonding interface

Despite the huge improvements made in adhesive technology over the past 50 years, there are still some unresolved issues regarding the durability of the adhesive interface. A complete sealing of the interface between the resin and the dentin substrate remains difficult to achieve, and it is doubtful whether an optimal interdiffusion of the adhesive system within the demineralized collagen framework can be produced in a complete and homogeneous way. In fact, it is suggested that hydrolytic degradation, combined with the action of dentin matrix enzymes, destabilizes the tooth-adhesive bond and disrupts the unprotected collagen fibrils. While a sufficient resin–dentin adhesion is usually achieved immediately, bonding efficiency declines over time. Thus, here, a review will be carried out through a bibliographic survey of scientific articles published in the last few years to present strategies that have been proposed to improve and/or develop new adhesive systems that can help prevent degradation at the adhesive interface. It will specially focus on new clinical techniques or new materials with characteristics that contribute to increasing the durability of adhesive restorations and avoiding the recurrent replacement restorative cycle and the consequent increase in damage to the tooth.

Calcium Phosphate Delivery Systems for Regeneration and Biomineralization of Mineralized Tissues of the Craniofacial Complex

Calcium phosphate (CaP)-based materials have been extensively used for mineralized tissues in the craniofacial complex. Owing to their excellent biocompatibility, biodegradability, and inherent osteoconductive nature, their use as delivery systems for drugs and bioactive factors has several advantages. Of the three mineralized tissues in the craniofacial complex (bone, dentin, and enamel), only bone and dentin have some regenerative properties that can diminish due to disease and severe injuries. Therefore, targeting these regenerative tissues with CaP delivery systems carrying relevant drugs, morphogenic factors, and ions is imperative to improve tissue health in the mineralized tissue engineering field. In this review, the use of CaP-based microparticles, nanoparticles, and polymer-induced liquid precursor (PILPs) amorphous CaP nanodroplets for delivery to craniofacial bone and dentin are discussed. The use of these various form factors to obtain either a high local concentration of cargo at the macroscale and/or to deliver cargos precisely to nanoscale structures is also described. Finally, perspectives on the field using these CaP materials and next steps for the future delivery to the craniofacial complex are presented.

Dual function of anti-biofilm and modulating biofilm equilibrium of orthodontic cement containing quaternary ammonium salt

The objectives of this study were to incorporate dimethylaminohexadecyl methacrylate (DMAHDM) into resin-modified glass ionomer cement (RMGI) to develop a novel orthodontic cement which endowed RMGI with strong antibacterial ability and investigated its modulation biofilm equilibrium from cariogenic state to non-cariogenic state for the first time. Cariogenic Streptococcus mutans (S. mutans), and non-cariogenic Streptococcus sanguinis (S. sanguinis) and Streptococcus gordonii (S. gordonii) were selected to form a tri-species biofilm model. RMGI incorporated with different mass fraction of DMAHDM was examined: biofilm colony-forming units, metabolic activity, live/dead staining, lactic acid and exopolysaccharides productions. TaqMan real-time polymerase chain reaction was used to determine changes of biofilm species compositions. The results showed RMGI containing 3% DMAHDM achieved strong antibacterial ability and suppressed the cariogenic species in biofilm, modulating biofilm equilibrium from cariogenic state to non-cariogenic state tendency. The novel bioactive cement containing DMAHDM is promising in fixed orthodontic treatments and protecting tooth enamel.

Dental Materials for Oral Microbiota Dysbiosis: An Update

The balance or dysbiosis of the microbial community is a major factor in maintaining human health or causing disease. The unique microenvironment of the oral cavity provides optimal conditions for colonization and proliferation of microbiota, regulated through complex biological signaling systems and interactions with the host. Once the oral microbiota is out of balance, microorganisms produce virulence factors and metabolites, which will cause dental caries, periodontal disease, etc. Microbial metabolism and host immune response change the local microenvironment in turn and further promote the excessive proliferation of dominant microbes in dysbiosis. As the product of interdisciplinary development of materials science, stomatology, and biomedical engineering, oral biomaterials are playing an increasingly important role in regulating the balance of the oral microbiome and treating oral diseases. In this perspective, we discuss the mechanisms underlying the pathogenesis of oral microbiota dysbiosis and introduce emerging materials focusing on oral microbiota dysbiosis in recent years, including inorganic materials, organic materials, and some biomolecules. In addition, the limitations of the current study and possible research trends are also summarized. It is hoped that this review can provide reference and enlightenment for subsequent research on effective treatment strategies for diseases related to oral microbiota dysbiosis.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

SIGNIFICANCE

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

Physicochemical and biological properties of experimental dental adhesives doped with a guanidine-based polymer: an in vitro study

OBJECTIVES

The objective of this study is to formulate experimental dental adhesives with different polyhexamethylene guanidine hydrochloride concentrations (PHMGH) and evaluate their physical, chemical, and biological properties.

MATERIALS AND METHODS

The experimental adhesives were formulated with 0 (control, G_CTRL), 0.5 (G_0.5%), 1 (G_1%), or 2 (G_2%) wt.% into the adhesive. The adhesives were analyzed for degree of conversion (DC%), softening in solvent (ΔKHN%), ultimate tensile strength (UTS), microtensile bond strength (μTBS) immediately and after 1 year of aging, antibacterial activity, and cytotoxicity.

RESULTS

There were no differences among groups for DC%, ΔKHN%, and UTS (p > 0.05%). There were no differences between each PHMGH-doped adhesive compared to G_CTRL in the immediate μ-TBS (p > 0.05). Adhesives with at least 1 wt.% of PHMGH presented better stability of μ-TBS. PHMGH-doped adhesives showed improved longitudinal μ-TBS compared to G_CTRL (p < 0.05). Lower Streptococcus mutans biofilm formation was observed for PHMGH-doped adhesives (p < 0.05). There was lower viability of planktonic S. mutans in the media in contact with the samples when at least 1 wt.% of PHGMGH was incorporated (p < 0.05). The formulated adhesives showed no cytotoxicity against pulp cells (p > 0.05).

CONCLUSIONS

The adhesive with 2 wt.% of PHMGH showed the highest antibacterial activity, without affecting the physicochemical properties and cytotoxicity, besides conferring stability for the dental adhesion.

CLINICAL RELEVANCE

PHMGH, a positively charged polymer, conveyed antibacterial activity to dental adhesives. Furthermore, it did not negatively affect the essential physicochemical and biocompatibility properties of the adhesives. More importantly, the incorporation of PHMGH provided stability for the μ-TBS compared to the control group without this additive.

Exploring the use of a Ruthenium complex incorporated into a methacrylate-based dental material for antimicrobial photodynamic therapy

OBJECTIVES

To evaluate the effects of a blue light photosensitizer (PS), Ruthenium II complex (Ru), on the chemical, physical, mechanical, and antimicrobial properties of experimental dental resin blends.

METHODS

The experimental resin (BisEMA, TEEGDMA, HPMA, ethanol, and photoinitiator) was loaded with Ru at 0.00%, 0.07%, 0.14%, 0.28%, 0.56%, 1.12%, 1.2%, 1.5%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, or 10% w/w. Samples were evaluated for the degree of conversion (DC) after 30 and 60 s curing-time (n = 6). Selected formulations (0.00%, 0.28%, 0.56%, 1.12%) were further tested for shear bond strength (SBS) (n = 15); flexural strength (FS) (n = 12); and antimicrobial properties (CFUs), in dark and light conditions. These latter tests were performed on specimens stored for 24-h or 2-month in 37°C water. Water sorption (WS) and solubility (SL) tests were also performed (n = 12). Data were analyzed either by a one- or two-factor general linear model (α = 0.05).

RESULTS

Overall, Ru concentration above 1.2% resulted in reduced DC. In SBS results, only the 1.12%Ru resin blend samples had statistically lower values compared to the 0.00%Ru resin blend at 24-h storage (p = 0.004). In addition, no differences in SBS were detected among the experimental groups after 2-month storage in water. Meanwhile, FS increased for all experimental groups under similar aging conditions (p < 0.001). Antimicrobial properties were improved upon inclusion of Ru and application of light (p < 0.001 for both) at 24-h and 2-month storage. Lastly, no detectable changes in WS or SL were observed for the Ru-added resins compared to the 0.00%Ru resin blend. However, the 0.28% Ru blend presented significantly higher WS compared to the 0.56% Ru blend (p = 0.007).

CONCLUSIONS

Stable SBS, improved FS, and sustained antimicrobial properties after aging gives significant credence to our approach of adding the Ruthenium II complex into dental adhesive resin blends intended for an aPDT approach.

Bacterial leakage assessment in root canals sealed with AH Plus sealer modified with silver nanoparticles

BACKGROUND

Successful endodontic therapy requires prevention of bacterial leakage between the root canal filing and root-canal walls. Sealing quality of a root canal filling depends strongly on the sealing ability of the sealer used. The present study aimed to evaluate the bacterial leakage resistance of AH Plus sealer modified with silver nanoparticles.

METHODS

Forty sound teeth were obturated using lateral compaction technique except for five teeth as the negative controls. After considering five teeth as the positive controls (filled without sealer), the remaining teeth were assigned to two groups (n = 15) in terms of the sealer used (AH Plus sealer and silver nanoparticle-modified AH Plus). Bacterial leakage was evaluated in saliva using the two-chamber technique in every 24 h. When all the samples in the test groups were contaminated, the study was terminated. The data were analyzed with log-rank statistical test.

RESULTS

All samples in both experimental groups were contaminated during the 3-months period of observation. There was no significant difference in contamination time between study groups (P > 0.05).

CONCLUSIONS

Silver nanoparticles used in tested concentration did not improve the bacterial leakage resistance of AH Plus sealer.

Evaluation of resveratrol-doped adhesive with advanced dentin bond durability

OBJECTIVES

This paper aimed to evaluate the influence of resveratrol-doped adhesive on the durability and antibiofilm capability of dentin bonding.

METHODS

Experimental adhesives were prepared by incorporating resveratrol into a universal adhesive at concentrations of 0 (control), 0.1, 1, and 10 mg/mL. The microtensile bond strength, fracture modes, and adhesive-dentin interface nanoleakage were assessed after 24 h of water storage, 10,000 times of thermocycling or 1-month of collagenase ageing. Relevant antibiofilm capability on Streptococcus mutans (S. mutans), in situ zymography, degree of conversion, and cytotoxicity of resveratrol-doped adhesives were also determined.

RESULTS

Irrespective of thermocycled or collagenase ageing, the resveratrol-doped adhesive (1 mg/mL) maintained the bond strength and reduced the nanoleakage expression. Meanwhile, the inhibitory ability on endogenous protease activity and S. mutans biofilm formation with acceptable biocompatibility were obtained.

CONCLUSIONS

This study suggested that the resveratrol-doped adhesive achieved effective improvement on dentin bond durability and secondary caries management.

CLINICAL SIGNIFICANCE

The application of the resveratrol-doped adhesive indicates promising benefits to increase the lifetime of composite restorations.

Multifunctional Dental Composite with Piezoelectric Nanofillers for Combined Antibacterial and Mineralization Effects

After nearly seven decades of development, dental composite restorations continue to show limited clinical service. The triggering point for restoration failure is the degradation of the bond at the tooth-biomaterial interface from chemical, biological, and mechanical sources. Oral biofilms form at the bonded interfaces, producing enzymes and acids that demineralize hard tissues and damage the composite. Removing bacteria from bonded interfaces and remineralizing marginal gaps will increase restorations' clinical service. To address this need, we propose for the first time the use of piezoelectric nanoparticles of barium titanate (BaTiO₃) as a multifunctional bioactive filler in dental resin composites, offering combined antibacterial and (re)mineralization effects. In this work, we developed and characterized the properties of dental piezoelectric resin composites, including the degree of conversion and mechanical and physical properties, for restorative applications. Moreover, we evaluated the antibacterial and mineralization responses of piezoelectric composites in vitro. We observed a significant reduction in biofilm growth (up to 90%) and the formation of thick and dense layers of calcium phosphate minerals in piezoelectric composites compared to control groups. The antibacterial mechanism was also revealed. Additionally, we developed a unique approach evaluating the bond strength of dentin-adhesive-composite interfaces subjected to simultaneous attacks from bacteria and cyclic mechanical loading operating in synergy. Our innovative bioactive multifunctional composite provides an ideal technology for restorative applications using a single filler with combined long-lasting nonrechargeable antibacterial/remineralization effects.

Synthesis and Characterization of Methacrylate-Functionalized Betulin Derivatives as Antibacterial Comonomer for Dental Restorative Resins

Secondary caries is the primary cause of composite restoration failures, resulting from marginal leakage and bacterial accumulation in the oral environment. Antibacterial dental composites, especially antibacterial monomers, have emerged as a promising strategy to inhibit secondary caries, which is pivotal to prolonging the lifespan of dental restorations. In this work, monomethacrylate- and dimethacrylate-functionalized betulin derivatives (M₁Bet and M₂Bet) were synthesized via an esterification reaction and served as antibacterial comonomers to develop novel dental resin formulations, in which M₁Bet and M₂Bet were incorporated to partially or completely replace bisphenol A glycerolate dimethacrylate (Bis-GMA). The control resin was a mixture based on Bis-GMA and tri(ethyleneglycol) dimethacrylate (TEGDMA) with a weight ratio of 50:50 (5B5T). The effect of the resin compositions and the chemical structures of M₁Bet and M₂Bet on the rheology behavior, optical property, polymerization kinetics, mechanical performance, cell viability, and antibacterial activity of dental resins were systematically investigated. Among all materials, the 1M₂Bet4B5T resin with 10 wt % substitution of Bis-GMA by M₂Bet exhibited comparable viscosity, higher light transmittance, improved degree of conversion, and mechanical properties compared with 5B5T. After incubation for 24 h, this optimal resin also possessed the best antibacterial activity against Streptococcus mutans, which had a significantly lower bacterial concentration (1.53 × 10⁹ CFU/mL) than 5B5T (9.03 × 10⁹ CFU/mL). Introducing betulin-based comonomers into dental resins is a potential strategy to develop antibacterial dental materials without sacrificing physical-mechanical properties.

Molecular Interactions between Saliva and Dental Composites Resins: A Way Forward

Dentin and enamel loss related to trauma or especially caries is one of the most common pathological issues in dentistry that requires restoration of the teeth by using materials with appropriate properties. The composite resins represent dental materials with significant importance in today’s dentistry, presenting important qualities, including their mechanical behavior and excellent aesthetics. This paper focuses on the saliva interactions with these materials and on their biocompatibility, which is continuously improved in the new generations of resin-based composites. Starting from the elements involved on the molecular landscape of the dental caries process, the paper presents certain strategies for obtaining more advanced new dental composite resins, as follows: suppression of oral biofilm acids formation, promotion of remineralization process, counteraction of the proteolytic attack, and avoidance of cytotoxic effects; the relation between dental composite resins and salivary oxidative stress biomarkers is also presented in this context.

The Antibacterial and Remineralizing Effects of Biomaterials Combined with DMAHDM Nanocomposite: A Systematic Review

Researchers have developed novel nanocomposites that incorporate additional biomaterials with dimethylaminohexadecyl methacrylate (DMAHDM) in order to reduce secondary caries. The aim of this review was to summarize the current literature and assess the synergistic antibacterial and remineralizing effects that may contribute to the prevention of secondary caries. An electronic search was undertaken in MEDLINE using PubMed, Embase, Scopus, Web of Science and Cochrane databases. The initial search identified 954 papers. After the removal of duplicates and screening the titles and abstracts, 15 articles were eligible for this review. The amalgamation of 2-methacryloyloxyethyl phosphorylcholine (MPC) and silver nanoparticles (AgNPs) with DMAHDM resulted in increased antibacterial potency. The addition of nanoparticles of amorphous calcium phosphate (NACP) and polyamidoamine dendrimers (PAMAM) resulted in improved remineralization potential. Further clinical studies need to be planned to explore the antibacterial and remineralizing properties of these novel composites for clinical success.

Remineralization of dentin induced by a compound of polyamide-amine and chlorhexidine in a resin dentin bonding microenvironment

Background

The purpose of this study was to investigate the effect of a complex of polyamide-amine dendrimer (PAMAM) and chlorhexidine gluconate (CG) on remineralization of dentin in an artificial simulated resin dentin bonding microenvironment.

Methods

The structure of this complex was characterized by FT-IR. Twelve standard dentin samples were randomly divided into four treatment fluid groups namely a PAMAM group, CG group, PAMAM + CG group, and deionized water group. A microenvironmental mineralization model was established in vitro with 50 µm gap width between resin and dentin. The dentin surface was observed by a scanning electron microscope (SEM), and the chemical structure of the surface was analyzed by X-ray energy spectrum (EDS), X-ray diffraction (XRD), and laser Raman spectroscopy.

Results

SEM showed the density of dentinal tubules exposed in the PAMAM group decreased after a 14-day immersion, with corn rod-shaped crystal structures gathered around the tubules. In addition, visible mineralization occurred in partial areas of the CG group, rod-shaped crystals and in comparison, dentinal tubules in the PAMAM + CG group were almost completely covered by flaky crystal structures. Raman spectrum analysis showed that crystals formed by PAMAM, CG, and PAMAM + CG solution all had strong phosphate characteristic peaks, indicating the presence of hydroxyapatite (HA), that of the PAMAM + CG group was the strongest. The EDS results showed that the Ca and P levels of the PAMAM group and the CG group were slightly higher than those of the deionized water group, while PAMAM + CG group significantly higher than the others, Ca/P value approaching 1.67. The results of XRD showed the characteristic peaks of hydroxyapatite detected by the PAMAM + CG group at 2θ=26.0 (002), 2θ=32.0 (211), and 2θ=33.0 (112) were high and sharp, with a few diffraction line burrs indicating it had high crystallinity and purity. The Scherrer equation results showed that the appearance and size of the grains formed by the PAMAM + CG group were basically consistent with those of healthy dentin.

Conclusions

Altogether, the compound of polyamide-amine dendrimer and chlorhexidine could induce the remineralization of human dentin in a resin dentin bonding microenvironment with a gap of 50 µm to form a crystal structure similar to dentin hydroxyapatite.

On the road to smart biomaterials for bone research: definitions, concepts, advances, and outlook

The demand for biomaterials that promote the repair, replacement, or restoration of hard and soft tissues continues to grow as the population ages. Traditionally, smart biomaterials have been thought as those that respond to stimuli. However, the continuous evolution of the field warrants a fresh look at the concept of smartness of biomaterials. This review presents a redefinition of the term "Smart Biomaterial" and discusses recent advances in and applications of smart biomaterials for hard tissue restoration and regeneration. To clarify the use of the term "smart biomaterials", we propose four degrees of smartness according to the level of interaction of the biomaterials with the bio-environment and the biological/cellular responses they elicit, defining these materials as inert, active, responsive, and autonomous. Then, we present an up-to-date survey of applications of smart biomaterials for hard tissues, based on the materials' responses (external and internal stimuli) and their use as immune-modulatory biomaterials. Finally, we discuss the limitations and obstacles to the translation from basic research (bench) to clinical utilization that is required for the development of clinically relevant applications of these technologies.

Review of nano-technology applications in resin-based restorative materials

OBJECTIVE

Nanotechnology has progressed significantly and particles as small as 3 nm are being employed in resin-based restorative materials to improve clinical performance. The goal of this review is to report the progress of nanotechnology in Restorative Dentistry by reviewing the advantages, limitations, and applications of resin-based restorative materials with nanoparticles.

MATERIALS AND METHODS

A literature review was conducted using PubMed/Medline, Scopus and Embase databases. In vitro, in vivo and in situ research studies published in English between 1999 and 2020, and which focused on the analysis of resin-based restorative materials containing nanoparticles were included.

RESULTS

A total of 140 studies were included in this review. Studies reported the effect of incorporating different types of nanoparticles on adhesive systems or resin composites. Mechanical, physical, and anti-bacterial properties were described. The clinical performance of resin-based restorative materials with nanoparticles was also reported.

CONCLUSIONS

The high surface area of nanoparticles exponentially increases the bioactivity of materials using bioactive nanofillers. However, the tendency of nanoparticles to agglomerate, the chemical instability of the developed materials and the decline of rheological properties when high ratios of nanoparticles are employed are some of the obstacles to overcome in the near future.

CLINICAL SIGNIFICANCE

In spite of the recent advancements of nanotechnology in resin-based restorative materials, some challenges need to be overcome before new nano-based restorative materials are considered permanent solutions to clinical problems.

Polymeric nanoparticles protect the resin-dentin bonded interface from cariogenic biofilm degradation

The objective was to assess doxycycline (Dox) and zinc (Zn) doped nanoparticles' (NPs) potential to protect the resin-dentin interface from cariogenic biofilm. Three groups of polymeric NPs were tested: unloaded, loaded with zinc and with doxycycline. NPs were applied after dentin etching. The disks were exposed to a cariogenic biofilm challenge in a Drip-Flow Reactor during 72 h and 7 d. Half of the specimens were not subjected to biofilm formation but stored 72 h and 7 d. LIVE/DEAD® viability assay, nano-dynamic mechanical assessment, Raman spectroscopy and field emission electron microscopy (FESEM) analysis were performed. The measured bacterial death rates, at 7 d were 46% for the control group, 51% for the undoped-NPs, 32% for Dox-NPs, and 87% for Zn-NPs; being total detected bacteria reduced five times in the Dox-NPs group. Zn-NPs treated samples reached, in general, the highest complex modulus values at the resin-dentin interface over time. Regarding the mineral content, Zn-NPs-treated dentin interfaces showed the highest mineralization degree associated to the phosphate peak and the relative mineral concentration. FESEM images after Zn-NPs application permitted to observe remineralization of the etched and non-resin infiltrated collagen layer, and bacteria were scarcely encountered. The combined antibacterial and remineralizing effects, when Zn-NPs were applied, reduced biofilm formation. Dox-NPs exerted an antibacterial role but did not remineralize the bonded interface. Undoped-NPs did not improve the properties of the interfaces. Application of Zn-doped NPs during the bonding procedure is encouraged. STATEMENT OF SIGNIFICANCE: Application of Zn-doped nanoparticles on acid etched dentin reduced biofilm formation and viability at the resin-dentin interface due to both remineralization and antibacterial properties. Doxycycline-doped nanoparticles also diminished oral biofilm viability, but did not remineralize the resin-dentin interface.

Use of Silver Nanomaterials for Caries Prevention: A Concise Review

Objective

The aim of this concise review is to summarize the use of silver nanomaterials for caries prevention.

Methods

Two researchers independently performed a literature search of publications in English using Embase, Medline, PubMed, and Scopus databases. The keywords used were (silver nanoparticles OR AgNPs OR nano silver OR nano-silver) AND (caries OR tooth decay OR remineralisation OR remineralization). They screened the title and abstract to identify potentially eligible publications. They then retrieved the full texts of the identified publications to select original research reporting silver nanomaterials for caries prevention.

Results

The search identified 376 publications, and 66 articles were included in this study. The silver nanomaterials studied were categorized as resin with silver nanoparticles (n=31), silver nanoparticles (n=21), glass ionomer cement with silver nanoparticles (n=7), and nano silver fluoride (n=7). Most (59/66, 89%) studies investigated the antibacterial properties, and they all found that silver nanomaterials inhibited the adhesion and growth of cariogenic bacteria, mainly Streptococcus mutans. Although silver nanomaterials were used as anti-caries agents, only 11 (11/66, 17%) studies reported the effects of nanomaterials on the mineral content of teeth. Eight of them are laboratory studies, and they found that silver nanomaterials prevented the demineralization of enamel and dentin under an acid or cariogenic biofilm challenge. The remaining three are clinical trials that reported that silver nanomaterials prevented and arrested caries in children.

Conclusion

Silver nanoparticles have been used alone or with resin, glass ionomer, or fluoride for caries prevention. Silver nanomaterials inhibit the adhesion and growth of cariogenic bacteria. They also impede the demineralization of enamel and dentin.

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.

Myristyltrimethylammonium Bromide (MYTAB) as a Cationic Surface Agent to Inhibit Streptococcus mutans Grown over Dental Resins: An In Vitro Study

This in vitro study evaluated the effect of myristyltrimethylammonium bromide (MYTAB) on the physical, chemical, and biological properties of an experimental dental resin. The resin was formulated with dental dimetacrylate monomers and a photoinitiator/co-initiator system. MYTAB was added at 0.5 (G_0.5%), 1 (G_1%), and 2 (G_2%) wt %, and one group remained without MYTAB and was used as the control (G_Ctrl). The resins were analyzed for the polymerization kinetics, degree of conversion, ultimate tensile strength (UTS), antibacterial activity against Streptococcus mutans, and cytotoxicity against human keratinocytes. Changes in the polymerization kinetics profiling were observed, and the degree of conversion ranged from 57.36% (±2.50%) for G_2% to 61.88% (±1.91%) for G_0.5%, without a statistically significant difference among groups (p > 0.05). The UTS values ranged from 32.85 (±6.08) MPa for G_0.5% to 35.12 (±5.74) MPa for G_Ctrl (p > 0.05). MYTAB groups showed antibacterial activity against biofilm formation from 0.5 wt % (p < 0.05) and against planktonic bacteria from 1 wt % (p < 0.05). The higher the MYTAB concentration, the higher the cytotoxic effect, without differences between G_Ctrl e G_0.5% (p > 0.05). In conclusion, the addition of 0.5 wt % of MYTAB did not alter the physical and chemical properties of the dental resin and provided antibacterial activity without cytotoxic effect.

A Novel Dental Sealant Containing Dimethylaminohexadecyl Methacrylate Suppresses the Cariogenic Pathogenicity of Streptococcus mutans Biofilms

Cariogenic oral biofilms are strongly linked to dental caries around dental sealants. Quaternary ammonium monomers copolymerized with dental resin systems have been increasingly explored for modulation of biofilm growth. Here, we investigated the effect of dimethylaminohexadecyl methacrylate (DMAHDM) on the cariogenic pathogenicity of Streptococcus mutans (S. mutans) biofilms. DMAHDM at 5 mass% was incorporated into a parental formulation containing 20 mass% nanoparticles of amorphous calcium phosphate (NACP). S. mutans biofilms were grown on the formulations, and biofilm inhibition and virulence properties were assessed. The tolerances to acid stress and hydrogen peroxide stress were also evaluated. Our findings suggest that incorporating 5% DMAHDM into 20% NACP-containing sealants (1) imparts a detrimental biological effect on S. mutans by reducing colony-forming unit counts, metabolic activity and exopolysaccharide synthesis; and (2) reduces overall acid production and tolerance to oxygen stress, two major virulence factors of this microorganism. These results provide a perspective on the value of integrating bioactive restorative materials with traditional caries management approaches in clinical practice. Contact-killing strategies via dental materials aiming to prevent or at least reduce high numbers of cariogenic bacteria may be a promising approach to decrease caries in patients at high risk.

Novel endodontic sealer with dual strategies of dimethylaminohexadecyl methacrylate and nanoparticles of silver to inhibit root canal biofilms

OBJECTIVE

Endodontic treatment failures and recontamination remain a major challenge. The objectives of this study were to: (1) develop a new root canal sealer with potent and long-lasting antibiofilm effects using dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of silver (NAg); (2) determine the effects of incorporating DMAHDM and NAg each alone versus in combination on biofilm-inhibition efficacy; and (3) determine the effects on sealer paste flow, film thickness and sealing ability, compared to a commercial control sealer.

METHODS

Dual-cure endodontic sealers were formulated using DMAHDM mass fractions of 0%, 2.5% and 5%, and NAg mass fractions of 0.05%, 0.1% and 0.15%. The sealing ability of the sealers was measured using linear dye penetration method. Colony-forming units (CFU), live/dead assay, and polysaccharide production of biofilms grown on sealers were determined.

RESULTS

The sealer with 5% DMAHDM and 0.15% NAg yielded a flow of (22.18 ± 0.58) which was within the range of ISO recommendations and not statistically different from AH Plus control (23.3 ± 0.84) (p > 0.05). Incorporating DMAHDM and NAg did not negatively affect the film thickness and sealing properties (p > 0.05). The sealer with 5% DMAHDM and 0.15% NAg greatly reduced polysaccharide production by the biofilms, and decreased the biofilm CFU by nearly 6 orders of magnitude, compared to AH Plus and experimental controls (p < 0.05).

SIGNIFICANCE

A therapeutic root canal sealer was developed using 5% DMAHDM with biofilm-inhibition through contact-mediated mechanisms, plus 0.15% of NAg to release silver ions into the complex and difficult-to-reach root canal environment. The novel root canal sealer exerted potent antibiofilm effects and reduced biofilm CFU by 6 orders of magnitude without compromising sealer flow, film thickness and sealing ability. This method provided a promising approach to inhibit endodontic biofilms and prevent recurrent endodontic infections.

Dental remineralization via poly(amido amine) and restorative materials containing calcium phosphate nanoparticles

Tooth decay is prevalent, and secondary caries causes restoration failures, both of which are related to demineralization. There is an urgent need to develop new therapeutic materials with remineralization functions. This article represents the first review on the cutting edge research of poly(amido amine) (PAMAM) in combination with nanoparticles of amorphous calcium phosphate (NACP). PAMAM was excellent nucleation template, and could absorb calcium (Ca) and phosphate (P) ions via its functional groups to activate remineralization. NACP composite and adhesive showed acid-neutralization and Ca and P ion release capabilities. PAMAM+NACP together showed synergistic effects and produced triple benefits: excellent nucleation templates, superior acid-neutralization, and ions release. Therefore, the PAMAM+NACP strategy possessed much greater remineralization capacity than using PAMAM or NACP alone. PAMAM+NACP achieved dentin remineralization even in an acidic solution without any initial Ca and P ions. Besides, the long-term remineralization capability of PAMAM+NACP was established. After prolonged fluid challenge, the immersed PAMAM with the recharged NACP still induced effective dentin mineral regeneration. Furthermore, the hardness of pre-demineralized dentin was increased back to that of healthy dentin, indicating a complete remineralization. Therefore, the novel PAMAM+NACP approach is promising to provide long-term therapeutic effects including tooth remineralization, hardness increase, and caries-inhibition capabilities.

Biodegradable silver-loaded polycation modified nanodiamonds/polyurethane scaffold with improved antibacterial and mechanical properties for cartilage tissue repairing

For cartilage tissue repairing, it remains a key challenge to design implant materials with antibacterial activity, proper degradation rate and mechanical property. In this research, antibacterial nanodiamonds (QND, QND-Ag) modified acrylate-terminated polyurethanes (APU) were prepared. By the addition of nanocomposites, the crystallinity of modified APU obviously increased, which indicates a strong interaction between NDs and APU. Tensile and compression tests were carried out to evaluate the improved mechanical properties. Compared with APU, APU(10%PEG)/QND-Ag possessed the increased modulus and strength, a nevertheless slight decrease in elongation at break. Due to the dual actions of contact-killing of cationic polymers and release-killing of the Ag NPs, QND-Ag-containing polyurethane showed excellent antibacterial activity against Staphylococcus aureus. Moreover, APU containing polyethylene glycol showed a significant increase in degradability rates. Consequently, owing to the dual effect of crystallinity and hydrophilicity, our modified APU exhibited the proper degradation rate adaptable to the healing rate of cartilage tissue. Furthermore, the CCK-8 results demonstrated that synthesized samples were low toxic. Therefore, APU(10%PEG)/QND-Ag holds great promise for the application of cartilage tissue repairing.

Synthesis and characterization of silver nanoparticle-loaded amorphous calcium phosphate microspheres for dental applications

The goals of this work were (1) to synthesize composite nanostructures comprised of amorphous calcium phosphate (ACP) loaded with silver nanoparticles using a spray pyrolysis method and (2) to demonstrate their potential for use in dental adhesives. Release of silver ions from these nanostructures could provide antibacterial activity, while release of calcium and phosphate ions could promote tooth remineralization. Precursor solutions were prepared with varying silver concentrations corresponding to 5, 10, and 15 mol% of the calcium content, then sprayed into a furnace (550 °C) as droplets with a mean diameter near 2 μm. In this process, each droplet is converted into a single solid microsphere via rapid heating. The synthesized particles were collected using a polymeric filter installed at the end of the reaction zone. Different quantities (2, 5, and 10 wt%) of the nanocomposite material were mixed with a commercially available dental adhesive (Single Bond, 3M ESPE) which was then polymerized into discs for incubation in a solution simulating cariogenic conditions. Release of silver, calcium and phosphorus ions into the solution was measured for 1 month. The nanostructures of ∼10 nm silver nanoparticles embedded into 100 nm to 2 μm ACP particles demonstrated good dispersion in the adhesive resin blend, which in application would shield surrounding tissues from direct contact with silver. The composite nanoparticles provided a quick initial release of ions after which the concentration of calcium, phosphorous, and silver in the incubation solution remained constant or increased slightly. The dispersibility and ion release of the new nanostructures may offer potential for use in dental materials to achieve anti-bacterial and remineralization effects.

A photo-crosslinked hybrid interpenetrating polymer network (IPN) for antibacterial coatings on denture base materials

An interpenetrating polymer network (IPN) structured antibacterial layer was prepared on dental base materials using a one-step photo-crosslinking method.

Novel dental composite with capability to suppress cariogenic species and promote non-cariogenic species in oral biofilms

Recurrent caries often occurs and is a primary reason for the failure of dental composite restorations. The objectives of this study were to: (1) develop a bioactive composite containing dimethylaminohexadecyl methacrylate (DMAHDM), (2) investigate its antibacterial effects and suppression on biofilm growth, and (3) investigate its ability to modulate biofilm species composition for the first time. DMAHDM was incorporated into a composite at mass% of 0%, 0.75%, 1.5%, 2.25% and 3%. A commercial composite Heliomolar served as a comparative control. A biofilm model consisting of Streptococcus mutans (S. mutans), Streptococcus sanguinis (S. sanguinis) and Streptococcus gordonii (S. gordonii) was tested by growing biofilms for 48 h and 72 h on composites. Colony-forming units (CFUs), metabolic activity and live/dead staining were evaluated. Lactic acid and polysaccharide productions were measured to assess biofilm cariogenicity. TaqMan real-time polymerase chain reaction was used to determine the proportion of each species in the biofilm. DMAHDM-containing composite had a strong anti-biofilm function, reducing biofilm CFU by 2-3 orders of magnitude, compared to control composite. Biofilm metabolic activity, lactic acid and polysaccharides were decreased substantially, compared to control (p < 0.05). At 72 h, the cariogenic S. mutans proportion in the biofilm on the composite with 3% DMAHDM was 19.9%. In contrast, an overwhelming S. mutans proportion of 92.2% and 91.2% existed in biofilms on commercial control and 0% DMAHDM, respectively. In conclusion, incorporating DMAHDM into dental composite: (1) yielded potent anti-biofilm properties; (2) modulated the biofilm species composition toward a non-cariogenic tendency. The new DMAHDM composite is promising for applications in a wide range of tooth cavity restorations to modulate oral biofilm species and combat caries.

Bonding durability, antibacterial activity and biofilm pH of novel adhesive containing antibacterial monomer and nanoparticles of amorphous calcium phosphate

OBJECTIVES

The dentin bonding often fails over time, leading to secondary caries and restoration failure. The objectives of this study were to develop an adhesive with dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP), and investigate the effects of storage in artificial saliva for six months on the bonding durability, antibacterial activity, ion release and biofilm pH properties for the first time.

METHODS

DMAHDM was added at 5% (by mass) to Scotchbond Primer and Adhesive (SBMP). NACP was added at 10%, 20%, and 30% to SBMP adhesive. Dentin bonding durability, antibacterial activity against Streptococcus mutans biofilms, and calcium (Ca) and phosphate (P) ion liberation properties were investigated after 1 day and 6months of storage in artificial saliva.

RESULTS

Dentin bond strength (n = 50) had 25% loss after 6 months of aging for SBMP control. However, SBMP + DMAHDM+10NACP and SBMP + DMAHDM+20NACP showed no loss in bond strength after storage in artificial saliva for 6 months. The DMAHDM + NACP incorporation method dramatically reduced the biofilm metabolic activity and acid production, and decreased the biofilm CFU by four orders of magnitude, compared to SBMP control, even after 6 months of aging (p < 0.05). DMAHDM + NACP had long-lasting Ca and P ion releases, and raised the biofilm pH to 6.8, while the control group had a cariogenic biofilm pH of 4.5.

CONCLUSIONS

Incorporating DMAHDM + NACP in bonding agent yielded potent and long-lasting antibacterial activity and ions liberation ability, and much higher long-term dentin bond strength after 6-month of aging. The new bonding agent is promising to inhibit caries at the restoration margins and increase the resin-dentin bonding longevity.

CLINICAL SIGNIFICANCE

The novel bioactive adhesive is promising to protect tooth structures from biofilm acids and secondary caries. NACP and DMAHDM have great potential for applications to a wide range of dental materials to reduce plaque and achieve therapeutic effects.

Novel resin-based dental material with anti-biofilm activity and improved mechanical property by incorporating hydrophilic cationic copolymer functionalized nanodiamond

There is an increasing clinical need to design dental restorative materials that combine excellent mechanical property and anti-biofilm activity. In the current study, photocurable polycation functionalized nanodiamond (QND) was synthesized and proposed as novel filler for dental resins. By reason of increased repulsive force between nanoparticles and enhanced compatibility with resin matrix, QND dispersed uniformly in reinforced resins, which would help to transfer stress and deformation from the matrix to fillers more efficiently, resulting in a significant improvement in mechanical properties. Notably, the Vickers's hardness, flexural strength and flexural modulus of resins containing 1.0 wt% QND were 44.5, 36.1 and 41.3% higher than that of control, respectively. The antibacterial activity against Streptococcus mutans (S. mutans) showed that QND-incorporated resins produced anti-adhesive property due to their hydrophilic surfaces and could suppress bacterial growth as a result of the contact-killing effect of embedded nanocomposites. As the synergistic effect of anti-adhesive and bactericidal performance, resins loading 1.0~1.5 wt% QNDs displayed excellent anti-biofilm activity. Meanwhile, the results of macrophage cytotoxicity showed that the proliferation of RAW 264.7 cells remained 84.3%, even at a concentration of 1.0 wt% QNDs after 7-day incubation. Therefore, the QND-containing dental resin with the combination of high mechanical property, bacteria-repellent capability and antibacterial performance holds great potential as a restorative material based on this scheme.

Novel magnetic nanoparticle-containing adhesive with greater dentin bond strength and antibacterial and remineralizing capabilities

OBJECTIVES

A nanoparticle-doped adhesive that can be controlled with magnetic forces was recently developed to deliver drugs to the pulp and improve adhesive penetration into dentin. However, it did not have bactericidal and remineralization abilities. The objectives of this study were to: (1) develop a magnetic nanoparticle-containing adhesive with dimethylaminohexadecyl methacrylate (DMAHDM), amorphous calcium phosphate nanoparticles (NACP) and magnetic nanoparticles (MNP); and (2) investigate the effects on dentin bond strength, calcium (Ca) and phosphate (P) ion release and anti-biofilm properties.

METHODS

MNP, DMAHDM and NACP were mixed into Scotchbond SBMP at 2%, 5% and 20% by mass, respectively. Two types of magnetic nanoparticles were used: acrylate-functionalized iron nanoparticles (AINPs); and iron oxide nanoparticles (IONPs). Each type was added into the resin at 1% by mass. Dentin bonding was performed with a magnetic force application for 3min, provided by a commercial cube-shaped magnet. Dentin shear bond strengths were measured. Streptococcus mutans biofilms were grown on resins, and metabolic activity, lactic acid and colony-forming units (CFU) were determined. Ca and P ion concentrations in, and pH of biofilm culture medium were measured.

RESULTS

Magnetic nanoparticle-containing adhesive using magnetic force increased the dentin shear bond strength by 59% over SBMP Control (p<0.05). Adding DMAHDM and NACP did not adversely affect the dentin bond strength (p>0.05). The adhesive with MNP+DMAHDM+NACP reduced the S. mutans biofilm CFU by 4 logs. For the adhesive with NACP, the biofilm medium became a Ca and P ion reservoir. The biofilm culture medium of the magnetic nanoparticle-containing adhesive with NACP had a safe pH of 6.9, while the biofilm medium of commercial adhesive had a cariogenic pH of 4.5.

SIGNIFICANCE

Magnetic nanoparticle-containing adhesive with DMAHDM and NACP under a magnetic force yielded much greater dentin bond strength than commercial control. The novel adhesive reduced biofilm CFU by 4 logs and increased the biofilm pH from a cariogenic pH 4.5-6.9, and therefore is promising to enhance the resin-tooth bond, strengthen tooth structures, and suppress secondary caries at the restoration margins.

Tuning Nano-Amorphous Calcium Phosphate Content in Novel Rechargeable Antibacterial Dental Sealant

Dental sealants with antibacterial and remineralizing properties are promising for caries prevention among children and adolescents. The application of nanotechnology and polymer development have enabled nanoparticles of amorphous calcium phosphate (NACP) and dimethylaminohexadecyl methacrylate (DMAHDM) to emerge as anti-caries strategies via resin-based dental materials. Our objectives in this study were to (1) incorporate different mass fractions of NACP into a parental rechargeable and antibacterial sealant; (2) investigate the effects on mechanical performance, and (3) assess how the variations in NACP concentration would affect the calcium (Ca) and phosphate (PO₄) ion release and re-chargeability over time. NACP were synthesized using a spray-drying technique and incorporated at mass fractions of 0, 10, 20 and 30%. Flexural strength, flexural modulus, and flowability were assessed for mechanical and physical performance. Ca and PO₄ ion release were measured over 70 days, and three ion recharging cycles were performed for re-chargeability. The impact of the loading percentage of NACP upon the sealant’s performance was evaluated, and the optimized formulation was eventually selected. The experimental sealant at 20% NACP had flexural strength and flexural modulus of 79.5 ± 8.4 MPa and 4.2 ± 0.4 GPa, respectively, while the flexural strength and flexural modulus of a commercial sealant control were 70.7 ± 5.5 MPa (p > 0.05) and 3.3 ± 0.5 GPa (p < 0.05), respectively. A significant reduction in flow was observed in the experimental sealant at 30% NACP (p < 0.05). Increasing the NACP mass fraction increased the ion release. The sealant formulation with NACP at 20% displayed desirable mechanical performance and ideal flow and handling properties, and also showed high levels of long-term Ca and PO₄ ion release and excellent recharge capabilities. The findings provide fundamental data for the development of a new generation of antibacterial and rechargeable Ca and PO₄ dental sealants to promote remineralization and inhibit caries.

Antibacterial gluey silver-calcium phosphate composites for dentine remineralization

The development of multifunctional dental-restorative biomaterials with antibacterial activity and remineralization effect for damaged tooth repair is urgent since dental caries is still one of the most common tooth diseases in human beings. Herein, we report a facile strategy for the synthesis of gluey silver-calcium phosphate (GSCP) composites using the rapid microwave-assisted solvothermal method. The as-prepared GSCP composite is an organic-inorganic hybrid, and Ag⁺ ions display a significant influence on the formation of GSCP by interacting with adenosine triphosphate biomolecules. The as-prepared GSCP composite shows good antibacterial properties, in addition, it exhibits a great effect on sheltering dentinal canaliculi and improving the remineralization of dentine in the simulated saliva. The as-prepared GSCP composite is promising for various applications such as oral healthcare, especially, remineralization of dentine, and antibacterial applications.

Bioactive Dental Composites and Bonding Agents Having Remineralizing and Antibacterial Characteristics

Current dental restorative materials are typically inert and replace missing tooth structures. This article reviews efforts in the development of a new generation of bioactive materials designed to not only replace the missing tooth volume but also possess therapeutic functions. Composites and bonding agents with remineralizing and antibacterial characteristics have shown promise in replacing lost minerals, inhibiting recurrent caries, neutralizing acids, repelling proteins, and suppressing biofilms and acid production. Furthermore, they have demonstrated a low cytotoxicity similar to current resins, with additional benefits to protect the dental pulp and promote tertiary dentin formation. This new class of bioactive materials shows promise in reversing lesions and inhibiting caries.

Properties of Experimental Dental Composites Containing Antibacterial Silver-Releasing Filler

Secondary caries is one of the important issues related to using dental composite restorations. Effective prevention of cariogenic bacteria survival may reduce this problem. The aim of this study was to evaluate the antibacterial activity and physical properties of composite materials with silver sodium hydrogen zirconium phosphate (SSHZP). The antibacterial filler was introduced at concentrations of 1%, 4%, 7%, 10%, 13%, and 16% (w/w) into model composite material consisting of methacrylate monomers and silanized glass and silica fillers. The in vitro reduction in the number of viable cariogenic bacteria Streptococcus mutans ATCC 33535 colonies, Vickers microhardness, compressive strength, diametral tensile strength, flexural strength, flexural modulus, sorption, solubility, degree of conversion, and color stability were investigated. An increase in antimicrobial filler concentration resulted in a statistically significant reduction in bacteria. There were no statistically significant differences caused by the introduction of the filler in compressive strength, diametral tensile strength, flexural modulus, and solubility. Statistically significant changes in degree of conversion, flexural strength, hardness (decrease), solubility (increase), and in color were registered. A favorable combination of antibacterial properties and other properties was achieved at SSHZP concentrations from 4% to 13%. These composites exhibited properties similar to the control material and enhanced in vitro antimicrobial efficiency.