The bonding property and cytotoxicity of a dental adhesive incorporating a new antibacterial monomer

Physicochemical Properties of Novel Copolymers of Quaternary Ammonium UDMA Analogues, Bis-GMA, and TEGDMA

This study aimed to elucidate the physicochemical properties of copolymers comprising 40 wt.% bisphenol A glycerolate dimethacrylate (Bis-GMA), 40 wt.% quaternary ammonium urethane-dimethacrylate analogues (QAUDMA-m, where m corresponds to the number of carbon atoms in the N-alkyl substituent), and 20 wt.% triethylene glycol dimethacrylate (TEGDMA) copolymers (BG:QAm:TEGs). The BG:QAm:TEG liquid monomer compositions and reference compositions (40 wt.% Bis-GMA, 40 wt.% urethane-dimethacrylate (UDMA), 20 wt.% TEGDMA (BG:UD:TEG) and 60 wt.% Bis-GMA, 40 wt.% TEGDMA (BG:TEG)) were characterized in terms of their refractive index (RI) and monomer glass transition temperature (Tg_m) and then photocured. The resulting copolymers were characterized in terms of the polymer glass transition temperature (Tg_p), experimental polymerization shrinkage (S_e), water contact angle (WCA), water sorption (WS), and water solubility (SL). The prepared BG:QAm:TEG liquid monomer compositions had RI in the range 1.4997-1.5129, and Tg_m in the range -52.22 to -42.12 °C. The BG:QAm:TEG copolymers had Tg_p ranging from 42.21 to 50.81 °C, S_e ranging from 5.08 to 6.40%, WCA ranging from 81.41 to 99.53°, WS ranging from 25.94 to 68.27 µg/mm³, and SL ranging from 5.15 to 5.58 µg/mm³. Almost all of the developed BG:QAm:TEGs fulfilled the requirements for dental materials (except BG:QA8:TEG and BG:QA10:TEG, whose WS values exceeded the 40 µg/mm³ limit).

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

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

Bibliometric Analysis of Literature Published on Antibacterial Dental Adhesive from 1996-2020

This study aimed to investigate the current state of research on antibacterial dental adhesives. The interest in this field can be drawn from an increasing number of scholarly works in this area. However, there is still a lack of quantitative measurement of this topic. The main aim of this study was to consolidate the research published on the antibacterial adhesive from 1996 to 2020 in Web of Science indexed journals. The bibliometric method, a quantitative study of investigating publishing trends and patterns, was used for this study. The result has shown that a gradual increase in research was found, whereby a substantial increase was observed from 2013. A total of 248 documents were published in 84 journals with total citations of 5107. The highly cited articles were published mainly in Q1 category journals. Most of the published articles were from the USA, China, and other developed countries; however, some developing countries contributed as well. The authorship pattern showed an interdisciplinary and collaborative approach among researchers. The thematic evaluation of keywords along with a three-factor analysis showed that 'antibacterial adhesives' and 'quaternary ammonium' have been used commonly. This bibliometric analysis can provide direction not only to researchers but also to funding organizations and policymakers.

Modifying Adhesive Materials to Improve the Longevity of Resinous Restorations

Dental caries is a common disease on a global scale. Resin composites are the most popular materials to restore caries by bonding to tooth tissues via adhesives. However, multiple factors, such as microleakage and recurrent caries, impair the durability of resinous restorations. Various innovative methods have been applied to develop adhesives with particular functions to tackle these problems, such as incorporating matrix metalloproteinase inhibitors, antibacterial or remineralizing agents into bonding systems, as well as improving the mechanical/chemical properties of adhesives, even combining these methods. This review will sum up the latest achievements in this field.

Flow Cytometry Analysis of Antibacterial Effects of Universal Dentin Bonding Agents on Streptococcus mutans

There is no consensus on the antibacterial activity of dentin bonding systems (DBS). Many study models have been used to evaluate the antimicrobial activity of dental materials. In this study, a novel detection method, flow cytometry, was introduced. It allows for evaluation of the antibacterial activity of DBS, based on assessment of the disruption of the bacterial physical membrane induced by DBS. The aim of the study was to evaluate the antibacterial properties of selected dentin bonding systems against Streptococcus mutans. The highest antibacterial activity against S. mutans was observed for Adhese Universal (99.68% dead cells) and was comparable to that of Prime&Bond Universal, OptiBond Universal, or Clearfil Universal Bond Quick (p > 0.05). The lowest activity of all tested systems was displayed by the multi-mode adhesive, Universal Bond (12.68% dead bacteria cells), followed by the self-etch adhesive, OptiBond FL (15.58% dead bacteria cells). The present study showed that in the case of two-component DBS, the primer exhibited higher antimicrobial activity than the adhesive (or bond) itself.

Antibacterial Activity of Commercial Dentine Bonding Systems against E. faecalis-Flow Cytometry Study

Literature presents inconsistent results on the antibacterial activity of dentine bonding systems (DBS). Antibacterial activity of adhesive systems depends on several factors, including composition and acidity. Flow cytometry is a novel detection method to measure multiple characteristics of a single cell: total cell number, structural (size, shape), and functional parameters (viability, cell cycle). The LIVE/DEAD^® BacLight™ bacterial viability assay was used to evaluate an antibacterial activity of DBS by assessing physical membrane disruption of bacteria mediated by DBS. Ten commercial DBSs: four total-etching (TE), four self-etching (SE) and two selective enamel etching (SEE) were tested. Both total-etching DBS ExciTE F and OptiBond Solo Plus showed comparatively low antibacterial activity against E. faecalis. The lowest activity of all tested TE systems showed Te-Econom Bond. Among SE DBS, G-ænial Bond (92.24% dead cells) followed by Clearfil S3 Bond Plus (88.02%) and Panavia F 2.0 ED Primer II (86.67%) showed the highest antibacterial activity against E. faecalis, which was comparable to isopropranol (positive control). In the present study, self-etching DBS exhibited higher antimicrobial activity than tested total-etching adhesives against E. faecalis.

Cytotoxicity of Light-Cured Dental Materials according to Different Sample Preparation Methods

Dental light-cured resins can undergo different degrees of polymerization when applied in vivo. When polymerization is incomplete, toxic monomers may be released into the oral cavity. The present study assessed the cytotoxicity of different materials, using sample preparation methods that mirror clinical conditions. Composite and bonding resins were used and divided into four groups according to sample preparation method: uncured; directly cured samples, which were cured after being placed on solidified agar; post-cured samples were polymerized before being placed on agar; and “removed unreacted layer” samples had their oxygen-inhibition layer removed after polymerization. Cytotoxicity was evaluated using an agar diffusion test, MTT assay, and confocal microscopy. Uncured samples were the most cytotoxic, while removed unreacted layer samples were the least cytotoxic (p < 0.05). In the MTT assay, cell viability increased significantly in every group as the concentration of the extracts decreased (p < 0.05). Extracts from post-cured and removed unreacted layer samples of bonding resin were less toxic than post-cured and removed unreacted layer samples of composite resin. Removal of the oxygen-inhibition layer resulted in the lowest cytotoxicity. Clinicians should remove unreacted monomers on the resin surface immediately after restoring teeth with light-curing resin to improve the restoration biocompatibility.

Quaternary ammonium-based biomedical materials: State-of-the-art, toxicological aspects and antimicrobial resistance

Microbial infections affect humans worldwide. Many quaternary ammonium compounds have been synthesized that are not only antibacterial, but also possess antifungal, antiviral and anti-matrix metalloproteinase capabilities. Incorporation of quaternary ammonium moieties into polymers represents one of the most promising strategies for preparation of antimicrobial biomaterials. Various polymerization techniques have been employed to prepare antimicrobial surfaces with quaternary ammonium functionalities; in particular, syntheses involving controlled radical polymerization techniques enable precise control over macromolecular structure, order and functionality. Although recent publications report exciting advances in the biomedical field, some of these technological developments have also been accompanied by potential toxicological and antimicrobial resistance challenges. Recent evidenced-based data on the biomedical applications of antimicrobial quaternary ammonium-containing biomaterials that are based on randomized human clinical trials, the golden standard in contemporary medicinal science, are included in the present review. This should help increase visibility, stimulate debates and spur conversations within a wider scientific community on the implications and plausibility for future developments of quaternary ammonium-based antimicrobial biomaterials.

Cytotoxic effects of one-step self-etching adhesives on an odontoblast cell line

The aim of this study was to evaluate the cytotoxic effects of one-step self-etching adhesives. Cells from an immortalized mouse odontoblast cell line (MDPC-23) were cultured with six different dental adhesive systems (diluted to concentrations of 0.5% for 4 h): Adper Easy Bond (EB), Xeno V (XV), iBond (IB), AdheSE One (AO), Clearfil SE primer (CS), and Adper Single Bond 2 (SB). MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and flow cytometric apoptosis assays were used to evaluate cell viability and the rate of apoptosis. The odontoblasts were also examined under a scanning electron microscope. While all of the cultures with adhesives showed reduced viability, the viabilities in the IB and SB groups were not significantly different from the control group. Although increased apoptosis rates were observed in all of the cultures with adhesives, the rate in the SB group was not significantly different from the rate in the control. The control group showed the lowest apoptosis rate followed by the SB, AO, IB, EB, XV, and CS groups. When examined under a scanning electron microscope, control odontoblasts and the SB group exhibited relatively large cytoplasmic extensions. In contrast, in the EB and CS groups, fewer fibroblasts remained adhered to the plate surface. Cytoplasmic membrane shrinkage and cell-free areas with residual membrane fragments from dead cells were observed. In conclusion, all cultures with one-step self-etching adhesives showed increased apoptotic activity. SB, an etch-and-rinse adhesive, was comparable to the control group, and CS and EB showed the lowest odontoblast viabilities according to the MTT assay.

Comparative evaluation of antibacterial activity of total-etch and self-etch adhesive systems: An ex vitro study

Aim:

The aim of this ex vivo study was to compare the antibacterial activity of total-etch and self-etch adhesive systems against Streptococcus mutans, Lactobacillus acidophilus, and Actinomyces viscosus through disk diffusion method.

Materials and Methods:

The antibacterial effects of Single Bond (SB) and Adper Prompt (AP) and aqueous solution of chlorhexidine 0.2% (positive control) were tested against standard strain of S. mutans, L. acidophilus, and A. viscosus using the disk diffusion method. The diameters of inhibition zones were measured in millimeters. Data was analyzed using Kruskal-Wallis test. Mann-Whitney U test was used for pairwise comparison.

Result:

Of all the materials tested, AP showed the maximum inhibitory action against S. mutans and L. acidophilus. Aqueous solution of chlorhexidine 0.2% showed the maximum inhibitory action against A. viscosus. Very minimal antibacterial effect was noted for SB.

Conclusion:

The antibacterial effects observed for the tested different dentin bonding systems may be related to the acidic nature of the materials.

One-pot synthesis of antibacterial monomers with dual biocidal modes

OBJECTIVES

The present study reported a method for preparing a blend of antibacterial quaternary ammonium silanes and quaternary ammonium methacryloxy silane (QAMS) based on the sol-gel reaction between dimethyldiethoxy silane and two trialkoxysilanes, one with an antibacterial quaternary ammonium functionality and the other with a methacryloxy functionality.

METHODS

Reaction products of the sol-gel reaction were characterised by direct infusion mass spectrometry, FTIR and proton, carbon and silicon NMR. This blend of monomers was incorporated into an experimental universal adhesive for evaluation of antimicrobial activity against Streptococcus mutans biofilms, microtensile bond strength and cytotoxicty. Retention of quaternary ammonium species on polymerised adhesive, leaching of these species from the adhesive and the ability of resin-dentine interfaces to inhibit S. mutans biofilms were evaluated over a 3-month water-ageing period.

RESULTS

The antibacterial adhesive version killed bacteria in S. mutans biofilms not only through the release of non-copolymerisable quaternary ammonium silane species (release-killing), but also via immobilised quaternary ammonium methacryloxy silane that are copolymerised with adhesive resin comonomers (contact-killing). Contact-killing was retained after water-ageing. The QAMS-containing universal adhesive has similar tensile bond strength as the control and two commercially available universal adhesives, when it was used for bonding to dentine in the etch-and-rinse mode and self-etching mode. Incorporation of the antimicrobial quaternary ammonium species blend did not adversely affect the cytotoxicity of the universal adhesive formulation.

CONCLUSIONS

Instead of using quaternary ammonium dimethacrylates and nanosilver, an alternative bimodal antimicrobial strategy for formulating antimicrobial universal dentine adhesives is achieved using the one-pot sol-gel synthesis scheme.

CLINICAL SIGNIFICANCE

The QAMS containing universal dentine adhesives with dual antimicrobial activity is a promising material aimed at preventing second caries and prolonging the longevity of resin composite restorations.

Influence of light-curing mode on the cytotoxicity of resin-based surface sealants

Background

Surface sealants have been successfully used in the prevention of erosive tooth wear. However, when multiple tooth surfaces should be sealed, the light-curing procedure is very time-consuming. Therefore, the aim of this study was to investigate whether reduced light-curing time (while maintaining similar energy density) has an influence on resin-based surface sealant cytotoxicity.

Methods

Bovine dentine discs were treated as follows: group 1: untreated, groups 2–5: Seal&Protect and groups 6–9: experimental sealer. Groups 2 and 6 were light-cured (VALO LED light-curing device) for 40 s (1000 mW/cm²), groups 3 and 7 for 10 s (1000 mW/cm²), groups 4 and 8 for 7 s (1400 mW/cm²) and groups 5 and 9 for 3 s (3200 mW/cm²). Later, materials were extracted in culture medium for 24 h, and released lactate dehydrogenase (LDH) activity as a measure of cytotoxicity was determined photometrically after cells (dental pulp cells and gingival fibroblasts) were exposed to the extracts for 24 h. Three independent experiments, for both sample preparation and cytotoxicity testing, were performed.

Results

Overall, lowest cytotoxicity was observed for the unsealed control group. No significant influence of light-curing settings on the cytotoxicity was observed (p = 0.537 and 0.838 for pulp cells and gingival fibroblasts, respectively). No significant difference in the cytotoxicity of the two sealants was observed after light-curing with same light-curing settings (group 2 vs. 6, 3 vs. 7, 4 vs. 8 and 5 vs. 9: p > 0.05, respectively).

Conclusions

Shortening the light-curing time, while maintaining constant energy density, resulted in no higher cytotoxicity of the investigated sealants.

Synthesis and characterization of dimethacrylates containing quaternary ammonium functionalities for dental applications

OBJECTIVES

The widespread incidence of recurrent caries highlights the need for improved dental restorative materials. The objective of this study was to synthesize low viscosity ionic dimethacrylate monomers (IDMAs) that contain quaternary ammoniums groups (antimicrobial functionalities) and are compatible with existing dental dimethacrylate-based monomers. Such monomers have the potential to copolymerize with other methacrylate monomers and produce antibacterial polymers.

METHODS

Two monomers (IDMA-1 and IDMA-2) were synthesized using the Menschutkin reaction and incorporated at 0-30% (by mass) into a 1:1 (by mass) bisphenol A glycerolate dimethacrylate (BisGMA):triethylene glycol dimethacrylate (TEGDMA) resin. Resin viscosity was quantified using rheology, and polymer degree of conversion (DC) and surface charge density were measured using Fourier transform infrared spectroscopy (FTIR) and fluorescein binding, respectively. Effects of IDMA-1 on initial attachment of Streptococcus mutans and on viability and metabolic activity (via reductase enzymes) of RAW 264.7 macrophage-like cells were quantified.

RESULTS

IDMA-1 and IDMA-2 were prepared and characterized. IDMA-1 was miscible with BisGMA:TEGDMA and slightly increased the resin viscosity and DC. As expected, polymeric surface charge density increased with increasing IDMA-1. Incorporation of 10% IDMA-1 into BisGMA:TEGDMA reduced bacterial colonization without affecting viability or metabolic activity of mammalian cells. Increasing IDMA-1 up to 30% had no additional effect on bacterial coverage, but ≥20% IDMA-1 significantly reduced macrophage density, viability, and metabolic activity. Leachables from polymers containing IDMA-1 were not cytotoxic.

SIGNIFICANCE

The Menschutkin reaction provides a facile, convenient means to synthesize new monomers with quaternary ammonium groups for dental and medical applications.