Effect of denture base-resin with prereacted glass-ionomer filler on dentin demineralization

Transdentinal effects of S-PRG fillers on odontoblast-like cells

OBJECTIVES

To investigate the transdentinal effects of surface reaction-type pre-reacted glass-ionomer (S-PRG) fillers on odontoblast-like cells.

METHODS

An eluate of S-PRG fillers was obtained by dissolving the particles in distilled water (1:1 m/v). Dentin discs with similar permeability were mounted into artificial pulp chambers and MDPC-23 cells were seeded on their pulpal surface. The occlusal surface was treated with (n = 10): ultrapure water (negative control - NC), hydrogen peroxide (positive control - PC), S-PRG eluate exposure for 1 min (S-PRG 1 min), or S-PRG filler eluate exposure for 30 min (S-PRG 30 min). After 24 h, cell viability (alamarBlue) and morphology (SEM) were evaluated. The extract obtained from transdentinal diffusion was applied to MDPC-23 pre-cultured in plates for another 24 h to evaluate viability (alamarBlue, 1, 3, and 7 days), gene expression of Col1a1, Alpl, Dspp, and Dmp1 (RT-qPCR, 1 and 7 days), and mineralization (Alizarin Red, 7 days). Data were analyzed with ANOVA (α = 5 %).

RESULTS

While S-PRG 1 min did not differ from NC, S-PRG 30 min reduced 17.9 % viability of cells from discs. S-PRG treatments resulted in low cell detaching from dentin, and the remaining cells exhibited typical morphology or minor cytoplasmic contraction. S-PRG 30 min slightly increased cell viability (6 %) 1 day after contact with the extract. S-PRG treatments upregulated the expression of the investigated genes, especially after 1 day. S-PRG 30 min stimulated mineralization activity by 39.7 %.

CONCLUSIONS

S-PRG filler eluate does not cause transdentinal cytotoxicity on odontoblast-like cells, and long-term exposure can stimulate their dentinogenic-related mineralization activity.

SIGNIFICANCE

The transdentinal elution of ions from S-PRG fillers is not expected to be harmful to the dental pulp and may exert bioactive effects by inducing dentin matrix deposition through the metabolism of underlying odontoblasts.

Highlights on Drug and Ion Release and Recharge Capacity of Antimicrobial Removable Prostheses

This article aimed to review the ion and drug release, recharge abilities, and antimicrobial properties of drug/ion-releasing removable prostheses, and to assess their capability in preventing and inhibiting denture stomatitis as well preventing caries and reversing carious lesions. Data was collected from published scientific papers listed in PubMed database from January 1975 to December 2021. English full-text articles, involving clinical or in vitro studies, focusing on removable prostheses and are concerned with drug/ion release and rechargeability as a way to prevent or inhibit denture stomatitis or dental caries were included. The relevant articles reported that ion- or drug-modified polymethylmethacrylate acts as a reservoir for these ions and drugs and is capable of releasing significant amounts with sustained release effect. Recharging of modified resin resulted in greater sustainability of ion and drug release, thus improving the long-term effects of protection against demineralization and reducing the adhesion of Streptococcus mutans and Candida albicans. Modifications of removable prostheses with rechargeable ions and drugs enhance remineralization, hinder demineralization, and reduce microbial adhesion in difficult-to-access areas. Selection of denture base for clinical use will consider its ability to act as an ion/drug reservoir that is capable of release and recharge.

In vitro remineralization assessment of enamel subsurface lesions using different percentages of surface reaction-type pre-reacted glass-ionomer containing gum-based material

OBJECTIVE

To identify the remineralization activity of enamel subsurface lesions using different percentages of surface pre-reacted glass-ionomer (S-PRG) filler containing gum-base material.

METHODS

Gum extracts from gum-base materials containing 0wt%, 5wt%, and 10wt% S-PRG filler were prepared as GE0, GE5, and GE10, respectively. A total of 50 bovine enamel specimens were used, and the polished enamel surface of a 3 × 3 mm2 window area was exposed. The specimens were then subjected to a demineralization solution for seven days to create a subsurface enamel lesion. Remineralization was then conducted for seven days using a protocol whereby the specimens were immersed three times a day in prepared gum extracts (0wt%, 5wt%, and 10wt%) and artificial saliva of pH 7 (Control) for 20 min at 37 °C. Thereafter, remineralization assessment was performed by using Swept Source Optical Coherence Tomography (SS-OCT) and micro-computed tomography (μCT). Surface morphology and elemental analysis were conducted by scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDS).

RESULTS

The depths of the demineralized lesions in the GE5 and GE10 groups were significantly lower than those of the Control and the GE0 groups. SEM observations of the enamel surface morphology of the GE5 and GE10 groups indicated remineralization with S-PRG filler-related elements present.

CONCLUSION

The GE5 and GE10 S-PRG filler containing gum-base materials showed significantly improved surface remineralization and reduced demineralization of the enamel lesions. EDS analysis suggested that the released ions from the S-PRG filler might be responsible for surface remineralization.

CLINICAL SIGNIFICANCE

The S-PRG filler containing gum-base material may have a significant remineralization effect and improve the surface morphology of enamel subsurface lesions.

Multiple-Ion Releasing Bioactive Surface Pre-Reacted Glass-Ionomer (S-PRG) Filler: Innovative Technology for Dental Treatment and Care

Surface Pre-Reacted Glass-ionomer (S-PRG) filler, which releases strontium (Sr²⁺), borate (BO₃^3-), fluoride (F^-), sodium (Na⁺), silicate (SiO₃^2-), and aluminum (Al³⁺) ions at high concentrations, is a unique glass filler that are utilized in dentistry. Because of its multiple-ion releasing characteristics, S-PRG filler exhibits several bioactivities such as tooth strengthening, acid neutralization, promotion of mineralization, inhibition of bacteria and fungi, inhibition of matrix metalloproteinases, and enhancement of cell activity. Therefore, S-PRG filler per se and S-PRG filler-containing materials have the potential to be beneficial for various dental treatments and care. Those include restorative treatment, caries prevention/management, vital pulp therapy, endodontic treatment, prevention/treatment of periodontal disease, prevention of denture stomatitis, and perforation repair/root end filling. This review summarizes bioactive functions exhibited by S-PRG filler and its possible contribution to oral health.

Effect of Particle Sizes and Contents of Surface Pre-Reacted Glass Ionomer Filler on Mechanical Properties of Auto-Polymerizing Resin

Herein, the mechanical properties of an auto-polymerizing resin incorporated with a surface pre-reacted glass ionomer (S-PRG) filler were evaluated. For this, S-PRG fillers with particle sizes of 1 μm (S-PRG-1) and 3 μm (S-PRG-3) were mixed at 10, 20, 30, and 40 wt% to prepare experimental resin powders. The powders and a liquid (powder/liquid ratio = 1.0 g/0.5 mL) were kneaded and filled into a silicone mold to obtain rectangular specimens. The flexural strength and modulus (n = 12) were recorded via a three-point bending test. The flexural strengths of S-PRG-1 at 10 wt% (62.14 MPa) and S-PRG-3 at 10 and 20 wt% (68.68 and 62.70 MPa, respectively) were adequate (>60 MPa). The flexural modulus of the S-PRG-3-containing specimen was significantly higher than that of the S-PRG-1-containing specimen. Scanning electron microscopy observations of the specimen fracture surfaces after bending revealed that the S-PRG fillers were tightly embedded and scattered in the resin matrix. The Vickers hardness increased with an increasing filler content and size. The Vickers hardness of S-PRG-3 (14.86–15.48 HV) was higher than that of S-PRG-1 (13.48–14.97 HV). Thus, the particle size and content of the S-PRG filler affect the mechanical properties of the experimental auto-polymerizing resin.

Bacterial adhesion and antibacterial property of coating materials containing theobromine and S-PRG filler

Theobromine (TB) has been reported to promote tooth remineralization, strengthen tooth substance, and relieve dentin hypersensitivity. This study aimed to evaluate experimental tooth coating materials containing TB and surface pre-reacted glass-ionomer (S-PRG) fillers by examining the effects on bacterial adhesion and antibacterial properties. In addition, the amount of TB eluted from the coating material was measured. There was no significant difference in bacterial adhesion depending on the presence or absence of TB in the coating material, however, a significant decrease in the amount of bacterial adhesion was observed when S-PRG fillers were added to the coating material. The amount of eluted TB did not differ depending on the type of the filler in the coating material. It was suggested that TB could be used to develop a new dental material with the potential ability to inhibit the initiation and progression of dental caries.

Effect of surface prereacted glass ionomer nanofillers on fluoride release, flexural strength, and surface characteristics of polymethylmethacrylate resin

OBJECTIVE

Dentures should have proper fluoride release and physical properties. We evaluated how surface prereacted glass ionomer (S-PRG) nanofillers influenced fluoride release, flexural strength, and surface characteristics of polymethylmethacrylate (PMMA) resin.

MATERIALS AND METHODS

PMMA resin disc (n = 14) and rectangular (n = 5) specimens containing 0, 20 wt% microparticles, and 20 wt% nanoparticles of S-PRG were prepared. Six-disc specimens were examined for surface roughness; eight-disc specimens were immersed in 5 ml of deionized water for 24 h before analyzing the fluoride levels on days 1-3, 12, and 15. They were recharged with 1000 ppm fluoride solution for 24 h and stored in deionized water for five cycles. Fluoride release was examined. The flexural strength of the rectangular specimens was determined using a three-point bending test. Data were analyzed by two-way repeated-measures ANOVA.

RESULTS

S-PRG nanofiller had the highest fluoride exchange rate and did not significantly change the surface roughness compared with the microparticle and control groups; however, the nanofillers agglomerated and reduced the flexural strength to below 65 MPa.

CONCLUSIONS

Incorporating 20 wt% nanofillers into resin enhanced the fluoride exchange property greater than microfillers at the same content, but diminished the mechanical properties of the resin.

CLINICAL SIGNIFICANCE

Incorporating 20 wt% S-PRG nanofillers in resin denture base can improve the fluoride releasing property without affecting the surface roughness.

Efficacy of S-PRG filler varnishes on enamel caries remineralization

OBJECTIVES

To evaluate the remineralizing effect of varnishes containing different concentrations of S-PRG filler or sodium fluoride on enamel caries lesions.

METHODS

Enamel specimens were obtained from bovine incisors, flattened and polished. Half of the surface was protected, and artificial caries lesion was created in the unprotected area. They were assigned into six groups (n=20) according to the varnish applied: four containing S-PRG filler with different concentrations (10%, 20%, 30% and 40% w/w), one containing 5% sodium fluoride (5%NaF) as positive control, and one without treatment as a negative control (NC). Varnishes were applied on specimen's caries-affected surface and removed after 24h. Varnish application and pH cycling (8 days) were performed twice. Cross-sectional microhardness was measured (10-100 µm depth). Knoop microhardness percentage (KHN%) of caries affected/treated area in relation to the sound enamel area at the same depth was calculated. The area under the curve (AUC) and the Δ_AUC were also calculated. Statistical analysis was performed by two-way ANOVA for KHN% and one-way ANOVA for Δ_AUC, followed by Tukey test (α=5%).

RESULTS

Significant differences were found for the factors "treatment" (p=0.0001) and "depth" (p=0001). For the factor "treatment", the results of the Tukey test were: NC-62.2(10.3)a, 10%S-PRG-69.2(9.3)b, 20%S-PRG-71.8(9.7)bc, 30%S-PRG-74.5(9.4)c, 5%NaF-79.6(8.7)d, 40%S-PRG-85.6(8.4)e. In relation to Δ_AUC, significant differences were observed among the groups (p=0.0001) and better results for 40% S-PRG and 5%NaF.

CONCLUSIONS

The varnish containing 40% S-PRG fillers was the most effective to promote the enamel caries remineralization, followed by the one containing 5% sodium fluoride.

CLINICAL SIGNIFICANCE

The varnish containing 40% of S-PRG fillers represents an alternative for initial enamel caries remineralization, since it was more effective than the conventional 5% NaF based product.

Effects of S-PRG filler eluate on MMP-1 and MMP-3 secretion by human gingival fibroblasts

The aim of this study was to investigate the effects of surface reaction-type pre-reacted glass-ionomer (S-PRG) filler eluate on Matrix metalloproteinase (MMP)-1 and MMP-3 secretion by human gingival fibroblasts (HGF). The S-PRG filler eluate contains 6 ions (F, Na, Al, B, Sr and Si) released from the S-PRG filler. The S-PRG filler eluate stimulation induced a slight secretion of MMP-1 and MMP-3 by HGF. It also enhanced the phosphorylation of p38 and ERK. The increase in MMP-1 and MMP-3 secretion by the inflammatory cytokine TNF-α was suppressed by the S-PRG filler eluate. TNF-α-induced increases in the phosphorylation of ERK were slightly enhanced by S-PRG filler eluate. These findings may prompt the development of new therapeutic agents for oral inflammation with materials composed of S-PRG filler eluate.

Effects of multi-components released from S-PRG filler on the activities of human dental pulp-derived stem cells

Numerous studies have shown that the sustained release of ions from dental restorative materials have acid buffering capacity, prevents tooth enamel demineralization, and inhibits bacterial adhesion. Herein, the release behavior and bioresponsiveness of ions released from surface pre-reacted glass-ionomer (S-PRG) fillers were investigated in different types of media based on human dental pulp-derived stem cell (hDPSC) responses. The hDPSCs were cultured for 1-7 days in S-PRG eluates diluted with varying amounts of cell culture media. S-PRG released several types of ions, such as F^-, Sr²⁺, Na⁺, Al³⁺, BO₃^3-, and SiO₃^2-. The balance of eluted ions differed depending on the dilution and solvent, which in turn affected the cytotoxicity, cell morphology, cell proliferation, and alkane phosphatase activity of hDPSCs, among other properties. The results suggest that tailored S-PRG filler eluates could be designed and prepared for application in dental practice.

Fabrication and characterization of remineralizing dental composites containing calcium type pre-reacted glass-ionomer (PRG-Ca) fillers

OBJECTIVE

To fabricate and characterize dental composites with calcium type pre-reacted glass-ionomer (PRG-Ca) fillers.

METHODS

PRG-Ca fillers were prepared by the reaction of calcium fluoroaluminosilicate glass with polyacrylic acid. Seven dental composites were produced from the same organic matrix (70/30wt% Bis-GMA/TEGDMA), with partial replacement of barium borosilicate (BaBSi) fillers (60wt%) by PRG-Ca fillers (wt%): E0 (0) - control, E1 (10), E2 (20), E3 (30), E4 (40), E5 (50) and E6 (60). Enamel remineralization was evaluated in caries-like enamel lesions induced by S. mutans biofilm using micro-CT. The following properties were characterized: degree of conversion (DC%), roughness (Ra), Knoop hardness (KHN), flexural strength (FS), flexural modulus (FM), water sorption (W_sp), water solubility (W_sl), and translucency (TP). Data were analyzed to one-way ANOVA and Tukey's HSD test (α=0.05).

RESULTS

All composites with PRG-Ca induced enamel remineralization. E0 and E1 presented similar and highest DC% than E2=E3=E4=E5=E6. Ra and KHN were not influenced by PRG-Ca fillers (p<0.05). The higher the content of PRG-Ca, the lower FS, FM and TP (p<0.05). W_sp increased linearly with the content of PRG-Ca fillers (p<0.05). E6 presented the highest W_sl (p<0.05), while the W_sl of the other composites were not different from each other (p>0.05).

SIGNIFICANCE

Incorporation of 10-40wt.% of PRG-Ca fillers endowed remineralizing potential to dental composites without jeopardizing the overall behavior of their physicochemical properties. Dental composites with PRG-Ca fillers seems to be a good alternative for reinforcing the enamel against caries development.

Effects of desensitizer containing fluoroaluminocalciumsilicate glass nanoparticles on remineralization of root dentin subsurface lesions in vitro

We investigated the remineralization effects of Nanoseal (NS) dentin desensitizer on demineralized root dentin. Baseline lesion specimens prepared from bovine root dentin were immersed in artificial saliva (AS) or deionized water (DW) after treatment with NS or fluoride-free Nanoseal (NS(-)). Treatment and control groups comprised: 1, AS; 2, NS/AS; 3, NS(-)/AS; 4,NS/DW; 5, NS(-)/DW; and 6, baseline demineralization. Integrated mineral loss (IML) and lesion depth (LD) were determined by transverse microradiography. Fluoride concentrations in the immersion solutions were measured. AS, NS/AS and NS(-)/AS showed higher mineral volume % at the surface and lesion body than did other groups. NS/AS showed significantly lower IML than did AS. There was no significant difference in IML between NS/AS and NS(-)/AS. The highest concentration of fluoride was in the NS/AS immersion solution. The findings suggest Nanoseal facilitated remineralization of demineralized root dentin, and fluoride and other ions included may have contributed to this effect.

Release and Recharge of Fluoride Ions from Acrylic Resin Modified with Bioactive Glass

Background: Oral hygiene is essential for maintaining residual dentition of partial denture wearers. The dental material should positively affect the oral environment. Fluoride-releasing dental materials help to inhibit microbial colonization and formation of plaque as well as to initiate the remineralization process in the early cavity area. Aim: To evaluate fluoride ion release and recharge capacity, sorption, and solubility of polymethyl methacrylate (PMMA) dental resin modified with bioactive glass addition. Materials and methods: Two bioactive glass materials (5 wt% Kavitan, 10 wt% Kavitan, and 10 wt% Fritex) and pure 10 wt% NaF were added to dental acrylic resin. After polymerization of the modified resins, the release levels of fluoride anions were measured based on color complex formation by using a spectrophotometer after 7, 14, 28, and 35 days of storage in distilled water at 37 °C. Subsequently, specimens were brushed with a fluoride-containing tooth paste on each side for 30 s, and the fluoride recharge and release potential was investigated after 1, 7, and 14 days. Sorption and solubility after 7 days of storage in distilled water was also investigated. Results: The acrylic resins with addition of 10% bioactive glass materials released fluoride ions for over 4 weeks (from 0.14 to 2.27 µg/cm²). The amount of fluoride ions released from the PMMA resin with addition of 10 wt% Fritex glass was higher than that from the resin with addition of 10 wt% Kavitan. The acrylic resin containing 10 wt% NaF released a high amount of ions over a period of 1 week (1.58 µg/cm²), but the amount of released ions decreased rapidly after 14 days of storage. For specimens containing 5 wt% Kavitan glass, the ion-releasing capacity also lasted only for 14 days. Fluoride ion rechargeable properties were observed for the PMMA resin modified with addition of 10 wt% Fritex glass. The ion release levels after recharge ranged from 0.32 to 0.48 µg/cm². Sorption values ranged from 10.23 μm/mm³ for unmodified PMMA resin to 12.11 μm/mm³ for specimens modified with 10 wt% Kavitan glass. No significant differences were found regarding solubility levels after 7 days. Conclusions: The addition of 10 wt% Fritex and 10 wt% Kavitan bioactive glass materials to heat-cured acrylic resin may improve its material properties, with bioactive fluoride ion release ability lasting for over 4 weeks. The resin modified with 10 wt% Fritex glass could absorb fluoride ions from the toothpaste solution and then effectively release them. Addition of fluoride releasing fillers have a small effect on sorption and solubility increase of the modified PMMA resin. Clinical significance: The addition of bioactive glass may be promising in the development of the novel bioactive heat-cured denture base resin.

The effect of surface pre-reacted glass-ionomer filler eluate on dental pulp cells and mineral deposition on dentin: In vitro study

The effects of surface pre-reacted glass-ionomer (S-PRG) filler on pulpal cells and on the composition of dentinal deposits were investigated. Proliferation (CCK-8), cytotoxicity (LDH), and differentiation activity (ALP) tests, along with cell morphology observations, were conducted at 6 and 24 h after treatment of pulpal cells with different S-PRG filler eluate concentrations. Dentinal surfaces were immersed in deionized water or S-PRG filler eluate followed by immersion in deionized water or simulated body fluid and observed under scanning electron microscope and elemental analysis using energy dispersive x-ray spectrometer. At 24 h, there were significant differences in CCK-8 and ALP activity values between the groups in a concentration-dependent manner. LDH test data were not significantly different among the groups. Cell morphology was not altered at either exposure time. However, decreased cellular density was observed with the highest eluate concentration. Crystalline deposits and occluded dentinal tubules were observed in samples immersed in S-PRG filler with a later immersion in simulated body fluid, which also showed higher concentrations of certain ions compared to surfaces that were not initially treated with S-PRG filler. The lowest two eluate concentrations did not show significant toxicity. S-PRG enhanced the effect of simulated body fluid in the formation of mineral deposits.

Anti-demineralization characteristics of surface pre-reacted glass-ionomer (S-PRG) filler-containing varnishes

This study investigated the anti-demineralization effects of surface pre-reacted glass-ionomer (S-PRG) filler-containing varnishes. Thirty-five bovine root specimens were divided into five treatment groups, with seven specimens each coated with 1) MI varnish (MIV), 2) F varnish (FV), 3) PRG varnish I (PV), 4) PRG varnish II (with sodium fluoride added, PVF), and 5) acid-resistant nail varnish (Control). A 3×1 mm area of the dentin surface adjacent to each varnish was demineralized for one week at 37°C. Integrated mineral loss (IML) of these lesions was determined by transverse microradiography, as was the amount of fluoride released by each material. IML was significantly lower in the PV and PVF groups than in the Control group, and was significantly lower in the PVF than in the MIV and FV groups. These findings indicated that S-PRG filler-containing varnishes, especially varnish containing sodium fluoride, had superior anti-demineralization effects on root dentin.

Efficacy of S-PRG filler containing varnishes on enamel demineralization prevention

This study evaluated the efficacy of S-PRG vanishes on preventing enamel demineralization. Bovine enamel specimens were obtained, polished and the baseline Knoop microhardness was evaluated. Specimens were stratified into six groups (n = 15), according to the varnish applied: S10—experimental varnish containing 10% of S-PRG fillers, S20—20% of S-PRG fillers, S30—30% of S-PRG fillers; S40—40% of S-PRG fillers; PC (positive control)—5% of NaF; NC (negative control)—no treatment was performed. Half of enamel surfaces were protected to work as a control and varnishes were applied over the unprotected area. A demineralizing pH-cycling was performed, and surface and cross-sectional microhardness were measured. The percentage of microhardness of the treated area was calculated comparing with the untreated area. Statistical analysis was performed by one-way ANOVA and Tukey’s test (p = 5%). All experimental S-PRG varnishes protected against demineralization in relation to no treatment, but S40 was the most effective on the surface. For all depths, S30 and S40 were superior in enamel demineralization prevention than other S-PRG filler concentrations and 5% NaF. It was concluded that S-RPG filler containing varnishes were effective to prevent enamel demineralization. The higher concentrated products were more effective than 5% sodium fluoride on surface demineralization prevention.

Efficacy of S-PRG filler containing varnishes on enamel demineralization prevention

This study evaluated the efficacy of S-PRG vanishes on preventing enamel demineralization. Bovine enamel specimens were obtained, polished and the baseline Knoop microhardness was evaluated. Specimens were stratified into six groups (n = 15), according to the varnish applied: S10—experimental varnish containing 10% of S-PRG fillers, S20—20% of S-PRG fillers, S30—30% of S-PRG fillers; S40—40% of S-PRG fillers; PC (positive control)—5% of NaF; NC (negative control)—no treatment was performed. Half of enamel surfaces were protected to work as a control and varnishes were applied over the unprotected area. A demineralizing pH-cycling was performed, and surface and cross-sectional microhardness were measured. The percentage of microhardness of the treated area was calculated comparing with the untreated area. Statistical analysis was performed by one-way ANOVA and Tukey’s test (p = 5%). All experimental S-PRG varnishes protected against demineralization in relation to no treatment, but S40 was the most effective on the surface. For all depths, S30 and S40 were superior in enamel demineralization prevention than other S-PRG filler concentrations and 5% NaF. It was concluded that S-RPG filler containing varnishes were effective to prevent enamel demineralization. The higher concentrated products were more effective than 5% sodium fluoride on surface demineralization prevention.

Optimal dilutions of S-PRG filler eluate for experiments on human gingival fibroblasts in vitro

The present study attempted to identify the optimal dilution at which at which the effects of surface reaction-type pre-reacted glass-ionomer (S-PRG) filler eluate on human gingival fibroblasts (HGF) may be safely examined in vitro. S-PRG filler is a material that releases six ions and exerts strong caries-suppressing effects. We prepared S-PRG filler eluate in which S-PRG filler and α-MEM were mixed as a medium for HGF. This eluate contains six ions that are released from S-PRG filler. All cells died in proliferation experiments on HGF using S-PRG filler eluate, which demonstrated that unless S-PRG filler eluate was diluted, the ion concentration was strongly cytotoxic. S-PRG filler eluate diluted by 1/100 or more with the addition of 2% or more of FBS was safe for use. We herein successfully established the optimal dilution of S-PRG filler eluate at which HGF may be safely examined in vitro.

Cutting-edge filler technologies to release bio-active components for restorative and preventive dentistry

Advancements in materials used for restorative and preventive treatment is being directed toward "bio-active" functionality. Incorporation of filler particles that release active components is a popular method to create bio-active materials, and many approaches are available to develop fillers with the ability to release components that provide "bio-protective" or "bio-promoting" properties; e.g. metal/calcium phosphate nanoparticles, multiple ion-releasing glass fillers, and non-biodegradable polymer particles. In this review paper, recent developments in cutting-edge filler technologies to release bio-active components are addressed and summarized according to their usefulness and functions, including control of bacterial infection, tooth strengthening, and promotion of tissue regeneration.

Time dependence of multi-ion absorption into human enamel from surface prereacted glass-ionomer (S-PRG) filler eluate

Ion incorporation into the tooth is expected to be effective for caries prevention. Time-dependent ion incorporation released from surface pre-reacted glass-ionomer (S-PRG) filler eluate into tooth enamel was estimated by using inductively coupled plasma atomic emission spectroscopy (ICP-AES). Al, B, and Sr contents in enamel were increased in a time-dependent manner with immersion in S-PRG eluate. Clear ion incorporation was observed after 1 h of immersion in S-PRG filler eluate. Sr showed remarkable incorporation in enamel -up to 7,900 ppm- after 28 days of immersion. Sr and B incorporation rapidly occurred in S-PRG filler eluate, compared with their single component solutions. Simultaneous incorporation of cations and anions from S-PRG eluate occurred under balanced charge and may assist in rapid ion incorporation. Thus, various useful ions could be effectively incorporated into tooth enamel by applying S-PRG filler or its eluate; a bioactive effect can be expected.

Anti-demineralization effect of desensitizer containing copolymer and sodium fluoride on root dentin - a transverse microradiographic study

Objective: To evaluate anti-demineralization effects of dentin desensitizer containing sodium fluoride and methacrylate-co-p-styrene sulfonic acid (MS polymer) on root dentin using transverse microradiography (TMR).

Material and methods: Twenty-four dentin specimens were divided into four groups: MSO (no fluoride), MSF (3000 ppm F), FJL (9000 ppm F), and Control. In MSO and MSF, each desensitizer was rubbed into the dentin surfaces for 10 s then left for 20 s. In FJL, paste containing 9000 ppm F was applied onto the surface for 30 s. All specimens, including the Controls, were rinsed with deionized water, dried and an area of their surface exposed to pH 5.0 acidic solution, refreshed every 24 h, for 4 days. Sections 300-µm-thick were assessed by TMR. Mineral profiles and integrated mineral loss (IML) of lesions were analyzed by dedicated software. IML was analyzed with one-way ANOVA and Tukey’s test.

Results: MSF and FJL specimens showed high mineral volume % at the surface and in lesions, and significantly lower IML than the other groups (p < .05).

Conclusion: Dentin desensitizer containing 3000 ppm fluoride and MS polymer has the same anti-demineralization effect as does a fluoride paste containing 9000 ppm F.

Fluoride-Releasing Effect of a Modified Resin Denture Containing S-PRG Fillers on Salivary Fluoride Retention: A Randomized Clinical Study

This study aimed to evaluate the clinical effect of a resin denture base containing 20wt% surface prereacted glass ionomer (S-PRG) fillers on saliva fluoride concentrations as a surrogate evaluation of caries control. The study was a double-blind randomized clinical trial with a total of 110 participants aged 35-60 years who wore a removable partial resin denture for 1.5 years. Subjects were randomly assigned to receive a partial resin denture fabricated either with or without 20wt% S-PRG fillers (n = 55 per group). After 14 days of wearing the dentures, 5,000 ppm fluoride gel was applied nightly on both sides of the denture before storing it in a denture box overnight every night for 1.5 years. The salivary fluoride concentration was measured at baseline, on days 1, 14, and 15, and at 3 months and 1.5 years of wearing the denture. A significant increase in salivary fluoride concentration in the S-PRG denture group was observed from baseline to day 1, followed by a significant decrease to an approximate baseline level. After recharge with 5,000 ppm fluoride gel, salivary fluoride increased markedly on day 15 and remained elevated at month 3 through to 1.5 years. The resin denture base containing 20wt% S-PRG fillers demonstrated an initial fluoride release that increased saliva fluoride concentrations, but the fluoride release from within the material was short lived. The long-term effect of sustained fluoride release from the denture when combined with a regular fluoride recharge regimen may be beneficial for caries prevention.

Inhibitory effect of resin composite containing S-PRG filler on Streptococcus mutans glucose metabolism

OBJECTIVES

Resin composites containing surface pre-reacted glass-ionomer (S-PRG) fillers have been reported to inhibit Streptococcus mutans growth on their surfaces, and their inhibitory effects were attributed to BO₃^3- and F^- ions. The aim of this study was to evaluate S. mutans acid production through glucose metabolism on resin composite containing S-PRG fillers and assess inhibitory effects of BO₃^3- and F^- on S. mutans metabolic activities.

METHODS

The pH change through S. mutans acid production on experimental resin composite was periodically measured after the addition of glucose. Inhibitory effects of BO₃^3- or F^- solutions on S. mutans metabolism were evaluated by XTT assays and measurement of the acid production rate.

RESULTS

The pH of experimental resin containing S-PRG fillers was significantly higher than that of control resin containing silica fillers (p < 0.05). OD₄₅₀ values by XTT assays and S. mutans acid production rates significantly decreased in the presence of BO₃^3- and F^- compared with the absence of these ions (p < 0.05).

CONCLUSIONS

pH reduction by S. mutans acid production was inhibited on resin composite containing S-PRG fillers. Moreover, S. mutans glucose metabolism and acid production were inhibited in the presence of low concentrations of BO₃^3- or F^-.

CLINICAL SIGNIFICANCE

BO₃^3- or F^- released from resin composite containing S-PRG fillers exhibits inhibitory effects on S. mutans metabolism at concentrations lower than those which inhibit bacterial growth.

The pH effect of solvent in silanization on fluoride released and mechanical properties of heat-cured acrylic resin containing fluoride-releasing filler

This study aimed to evaluate the effect of an acidic-adjusted pH of solvent in silanization on the amount of fluoride released and mechanical properties of heat-cured acrylic resin containing a silanized fluoride-releasing filler. The experimental groups were divided into 4 groups; non-silanized, acidic-adjusted pH, non-adjusted pH, and no filler as control. For fluoride measurement, each specimen was placed in deionized water which was changed every day for 7 days, every week for 7 weeks and measured. The flexural strength and flexural modulus were evaluated after aging for 48 h, 1, and 2 months. Two-way ANOVA indicated significant differences among groups, storage times, and its interaction in fluoride measurement and flexural modulus. For flexural strength, there was significant difference only among groups. Acidic-adjusted pH of solvent in silanization enhanced the amount of fluoride released from acrylic resin, while non-adjusted pH of solvent exhibited better flexural strength of acrylic resin.

Antimicrobial activity of ethylene-vinyl acetate containing bioactive filler against oral bacteria

We developed an ethylene vinyl acetate (EVA) containing surface pre-reacted glass-ionomer (S-PRG) filler, as a new mouthguard material for preventing intraoral bacterial infection. We examined its physical properties, antimicrobial activity against a major cariogenic bacterium Streptococcus mutans and a periodontopathogen Porphyromonas gingivalis, and its cytotoxicity toward human gingival epithelial cells. S-PRG filler was added to EVA copolymer at 5, 10, 20, or 40 wt% and was processed into disc-shaped test specimens. Only minor differences between the Shore hardness and rebound resilience properties of EVA materials with and without the S-PRG filler were observed. The specimens with S-PRG filler showed bacteriostatic activity toward S. mutans and P. gingivalis and inhibited S. mutans biofilm formation. No cytotoxicity against the gingival epithelial cells was observed. Our findings show that EVA containing S-PRG filler has antimicrobial activity toward pathogenic oral bacteria and may be an effective material for maintaining the oral health of athletes.

Effects of resin-based temporary filling materials against dentin demineralization

This study investigated the in vitro anti-demineralization effects of resin-based temporary filling materials containing surface prereacted glass-ionomer (S-PRG) filler on dentin. Bovine root dentin specimens with a 3×3 mm experimental surface were divided into four treatment groups: DuraSeal (DU) as a control, S-PRG filler-free temporary material (S0), material containing 10% (S10) and 20% (S20) S-PRG filler. Each material was applied to 3×2 mm of the experimental surface, and the specimens were immersed in 8% methylcellulose gel demineralization system for one week at 37˚C. Mineral profiles and integrated mineral loss (IML) of lesions induced on the surface (3×1 mm) adjacent to the materials were computed by transversal microradiography. S10 and S20 yielded thick surface layers and shallow lesion bodies, with significantly lower IML than DU and S0 (p<0.05, Tukey's test). These findings indicate that temporary filling resin-based materials containing over 10% of S-PRG filler content have anti-demineralization effects on adjacent dentin.

Structural analysis of strontium in human teeth treated with surface pre-reacted glass-ionomer filler eluate by using extended X-ray absorption fine structure analysis

The bioactive effects of strontium released from surface pre-reacted glass-ionomer (S-PRG) fillers may aid in caries prevention. In this study, the local structure of strontium taken up by teeth was estimated by extended X-ray absorption fine structure analysis. Immersing teeth into S-PRG filler eluate increased the strontium content in enamel and dentin by more than 100 times. The local structure of strontium in enamel and dentin stored in distilled water was the same as that in synthetic strontium-containing hydroxyapatite (SrHAP). Moreover, the local structure of strontium in enamel and dentin after immersion in the S-PRG filler eluate was also similar to that of SrHAP. After immersion in the S-PRG filler eluate, strontium was suggested to be incorporated into the hydroxyapatite (HAP) of enamel and dentin at the calcium site in HAP.

Antibacterial activity of resin composites containing surface pre-reacted glass-ionomer (S-PRG) filler

OBJECTIVE

A surface pre-reacted glass-ionomer (S-PRG) filler is a technology of interest for providing bio-functions to restorative materials. Resin composites containing S-PRG filler have been reported to show less plaque accumulation and reduced bacterial attachment. In this study, experimental resin composites containing S-PRG filler at various concentrations were fabricated, and the inhibitory effects on bacterial growth on their surface and the association of ions released from S-PRG filler with antibacterial activity were evaluated.

METHODS

Five kinds of experimental resin composites containing S-PRG filler at 0, 13.9, 27.3, 41.8, or 55.9 (vol.%) were fabricated. Streptococcus mutans was cultured on the cured discs for 18h to examine the growth of bacteria in contact with the surface of the experimental resins. The concentrations of Al(3+), BO3(3-), F(-), Na(+), SiO3(2-), or Sr(2+) released from each experimental resin into water were measured. The standardized solutions of each ion were prepared at the concentrations determined to be released from the experimental resin, and their inhibitory effects of single ion species on S. mutans growth were evaluated by using each standardized solution.

RESULTS

Resin composites containing S-PRG filler at 13.9 (vol.%) or greater inhibited S. mutans growth on their surface. When S. mutans was incubated in the presence of six kinds of ions at the concentrations released from the resin composite containing S-PRG filler at 55.9 (vol.%), a significant reduction in bacterial number was observed for BO3(3-), F(-), Al(3+), and SiO3(2-). Among these four ions, BO3(3-) and F(-) demonstrated the strongest inhibitory effect on S. mutans growth.

SIGNIFICANCE

Our findings suggest that resin composites containing S-PRG filler inhibit the growth of S. mutans on their surface. BO3(3-), F(-), Al(3+) and SiO3(2-) released from S-PRG filler have the ability to inhibit S. mutans growth, and the inhibitory effects are mainly attributed to release of BO3(3-) and F(-).

Effects of surface reaction-type pre-reacted glass ionomer on oral biofilm formation of Streptococcus gordonii

Streptococcus gordonii, a bacterium involved in the initial colonization of tooth surfaces, contributes to dental biofilm formation and is an important cause of infective endocarditis. This study aimed to investigate the influence of surface reaction-type pre-reacted glass ionomer (S-PRG) filler on oral bacterial growth and aggregation of S. gordonii. The effect of various concentrations of S-PRG eluate on the growth and the biofilm formation of S. gordonii and other oral microorganisms (Streptococcus mutans, Streptococcus oralis, Lactobacillus acidophilus, and Candida albicans) was assessed. In addition, the effect of S-PRG eluate on coaggregation of S. gordonii with both S. oralis and Fusobacterium nucleatum was assessed. The effect of S-PRG eluate treatment on autoaggregation of S. gordonii was also evaluated. Our results indicate that S-PRG eluate treatment reduced both for the growth and for biofilm of all organisms in a dose-dependent manner. Coaggregation of S. gordonii with both S. oralis and F. nucleatum was inhibited by S-PRG eluate, whereas autoaggregation of S. gordonii increased at certain concentrations of S-PRG eluate. These results indicate that the S-PRG filler possesses antimicrobial activity that is mediated by inhibiting growth and biofilm of oral microorganisms, and by suppressing coaggregation of S. gordonii. In addition, these findings indicate that coaggregation of S. gordonii with other bacteria is inhibited by increased autoaggregation of S. gordonii.

Surface characteristics and microbial adherence ability of modified polymethylmethacrylate by fluoridated glass fillers

BACKGROUND

The current study objectives were to evaluate the influence of fluoridated glass fillers loading on the surface roughness, wettability, and adherence of candida and bacteria with and without saliva presence to a polymethylmethacrylate (PMMA) denture base material surface.

METHODS

Four concentrations of fluoridated glass fillers were added to PMMA: 1%, 2.5%, 5% and 10% by weight pre-polymerization and 0% was the control. Discs of each concentration were fabricated (n = 5 for each variable). Surface roughness (Ra ) was measured using atomic force microscopy (AFM). Wettability was assessed by measuring the contact angle of a sessile drop of water. Specimens were incubated with Candida albicans, or Streptococcus mutans with and without saliva coating. Adherence was presented as a percentage of the colonized surface area, counted using an optical microscope at x100 magnification.

RESULTS

The 10% group showed significantly greater roughness than the control and 1% groups; however, no significant differences in contact angle values were detected. The microbial adhesion was inversely proportional to the fluoridated glass fillers concentration where 10% concentration significantly decreased candidal and bacterial adhesion compared to others. Saliva coating significantly decreased microbial adhesion.

CONCLUSIONS

It was concluded that fluoridated glass fillers could decrease microbial adhesion to acrylic denture base without adversely affecting surface properties.

Effects of ion-releasing tooth-coating material on demineralization of bovine tooth enamel

We compared the effect of a novel ion-releasing tooth-coating material that contained S-PRG (surface-reaction type prereacted glass-ionomer) filler to that of non-S-PRG filler and nail varnish on the demineralization of bovine enamel subsurface lesions. The demineralization process of bovine enamel was examined using quantitative light-induced fluorescence (QLF) and electron probe microanalyzer (EPMA) measurement. Ion concentrations in demineralizing solution were measured using inductively coupled plasma atomic (ICP) emission spectrometry and an ion electrode. The nail varnish group and the non-S-PRG filler group showed linear demineralization. Although the nail varnish group and the non-S-PRG filler group showed linear demineralization, the S-PRG filler group did not. Further, plane-scanning by EPMA analysis in the S-PRG filler group showed no changes in Ca ion distribution, and F ions showed peak levels on the surface of enamel specimens. Most ions in the demineralizing solution were present at higher concentrations in the S-PRG filler group than in the other two groups. In conclusion, only the S-PRG filler-containing tooth-coating material released ions and inhibited demineralization around the coating.

Therapeutic polymers for dental adhesives: loading resins with bio-active components

OBJECTIVES

Many recent adhesives on the market exhibit reasonable clinical performance. Future innovations in adhesive materials should therefore seek out novel properties rather than simply modifying existing technologies. It is proposed that adhesive materials that are "bio-active" could contribute to better prognosis of restorative treatments.

METHODS

This review examines the recent approaches used to achieve therapeutic polymers for dental adhesives by incorporating bio-active components. A strategy to maintain adhesive restorations is the focus of this paper.

RESULTS

Major trials on therapeutic dental adhesives have looked at adding antibacterial activities or remineralization effects. Applications of antibacterial resin monomers based on quaternary ammonium compounds have received much research attention, and the loading of nano-sized bioactive particles or multiple ion-releasing glass fillers have been perceived as advantageous since they are not expected to influence the mechanical properties of the carrier polymer.

SIGNIFICANCE

The therapeutic polymer approaches described here have the potential to provide clinical benefits. However, not many technological applications in this category have been successfully commercialized. Clinical evidence as well as further advancement of these technologies can be a driving force to make these new types of materials clinically available.