Biodegradation of commercial dental composites by cholesterol esterase

Synthesis and challenges of fluorinated divinyl urethane monomers as a strategy for masking hydrolytic sensitive methacrylate groups in resin composites

OBJECTIVE

The biodegradation of methacrylate (MA)-based dental restoratives has been suggested to contribute to a loss of adhesion and subsequent detachment, or secondary caries, both major causes of restoration failure. Previous studies have demonstrated that intermolecular interactions between resin monomers may affect the hydrolytic-susceptibility of composites. Altering the intermolecular interactions by shielding or masking the hydrolytically-susceptible ester groups found in MA monomers could be an effective strategy to mitigate the biodegradation of resin composites. The objective of this work was to assess whether shielding/masking MAs using fluorinated groups could improve the biostability of experimental composites.

METHODS

Eight fluorinated monomers (FM) were synthesized, characterized (1H NMR), and formulated into experimental resin composites (FC, 65 wt%, microfill). FCs were assessed for interactions with water (water contact angle, water sorption, gel fraction), mechanical properties (both compressive and flexural strength and modulus), cytocompatibility, resistance to biodegradation using simulated human salivary esterase (SHSE) and compared to a control composite (CC) without FM.

RESULTS

Integration of FMs was found to generally decrease both the physical and mechanical properties under all incubation conditions when compared to the CC. Additionally, all FCs had a negative influence on composite biodegradation following immersion in SHSE when compared to the CC.

SIGNIFICANCE

Shielding/masking MA-esters inherently inserts molecular spaces between the polymer chains within the resin network, and shielding is likely not possible while also maintaining the necessary cohesive forces that regulate the physical and mechanical properties of resin composites. Novel dental resin development should seek to remove/replace vulnerable ester-containing MAs rather that adopting a shielding/masking approach.

Computational analysis of 3D printing: Selecting the better among newly released materials

Resin-based three-dimensional (3D) printing finds extensive application in the field of dentistry. Although studies of cytotoxicity, mechanical and physical properties have been conducted for newly released 3D printing resins such as Crowntec (Saremco), Temporary Crown Resin (Formlabs) and Crown & Bridge (Nextdent), the resistance of these materials to esterases in saliva has not been demonstrated at the molecular level. Therefore, in this study, the binding affinities and stability of these new 3D printing resins to the catalytic sites of esterases were investigated using molecular docking and molecular mechanics with Poisson-Bolzmann and surface area solvation (MM/PBSA) methods after active pocket screening. Toxicity predictions of the materials were also performed using ProTox-II and Toxtree servers. The materials were analyzed for mutagenicity, cytotoxicity, and carcinogenicity, and LD50 values were predicted from their molecular structures. The results indicated that out of the three novel 3D printing materials, Nexdent exhibited reduced binding affinity to esterases, indicating enhanced resistance to enzymatic degradation and possessing a superior toxicity profile.

Polymeric Denture Base Materials: A Review

An ideal denture base must have good physical and mechanical properties, biocompatibility, and esthetic properties. Various polymeric materials have been used to construct denture bases. Polymethyl methacrylate (PMMA) is the most used biomaterial for dentures fabrication due to its favorable properties, which include ease of processing and pigmenting, sufficient mechanical properties, economy, and low toxicity. This article aimed to comprehensively review the current knowledge about denture base materials (DBMs) types, properties, modifications, applications, and construction methods. We searched for articles about denture base materials in PubMed, Scopus, and Embase. Journals covering topics including dental materials, prosthodontics, and restorative dentistry were also combed through. Denture base material variations, types, qualities, applications, and fabrication research published in English were considered. Although PMMA has several benefits and gained popularity as a denture base material, it has certain limitations and cannot be classified as an ideal biomaterial for fabricating dental prostheses. Accordingly, several studies have been performed to enhance the physical and mechanical properties of PMMA by chemical modifications and mechanical reinforcement using fibers, nanofillers, and hybrid materials. This review aimed to update the current knowledge about DBMs' types, properties, applications, and recent developments. There is a need for specific research to improve their biological properties due to patient and dental staff adverse reactions to possibly harmful substances produced during their manufacturing and use.

Logistic Regression Analysis of LC-MS/MS Data of Monomers Eluted from Aged Dental Composites: A Supervised Machine-Learning Approach

Compound identification by database searching that matches experimental with library mass spectra is commonly used in mass spectrometric (MS) data analysis. Vendor software often outputs scores that represent the quality of each spectral match for the identified compounds. However, software-generated identification results can differ drastically depending on the initial search parameters. Machine learning is applied here to provide a statistical evaluation of software-generated compound identification results from experimental tandem MS data. This task was accomplished using the logistic regression algorithm to assign an identification probability value to each identified compound. Logistic regression is usually used for classification, but here it is used to generate identification probabilities without setting a threshold for classification. Liquid chromatography coupled with quadrupole-time-of-flight tandem MS was used to analyze the organic monomers leached from resin-based dental composites in a simulated oral environment. The collected tandem MS data were processed with vendor software, followed by statistical evaluation of these results using logistic regression. The assigned identification probability to each compound provides more confidence in identification beyond solely by database matching. A total of 21 distinct monomers were identified among all samples, including five intact monomers and chemical degradation products of bisphenol A glycidyl methacrylate (BisGMA), oligomers of bisphenol-A ethoxylate methacrylate (BisEMA), triethylene glycol dimethacrylate (TEGDMA), and urethane dimethacrylate (UDMA). The logistic regression model can be used to evaluate any database-matched liquid chromatography-tandem MS result by training a new model using analytical standards of compounds present in a chosen database and then generating identification probabilities for candidates from unknown data using the new model.

Methacrylate Polymers With “Flipped External” Ester Groups: A Review

Current resin composites have favorable handling and upon polymerization initial physical properties that allow for efficient material replacement of removed carious tooth structure. Dental resin composites have long term durability limitations due to the hydrolysis of ester bonds within the methacrylate based polymer matrix. This article outlines the importance of ester bonds positioned internal to the carbon-carbon double bond in current methacrylate monomers. Water and promiscuous salivary/bacterial esterase activity can initiate ester bond hydrolysis that can sever the polymer backbone throughout the material. Recent studies have custom synthesized, with the latest advances in modern organic chemical synthesis, a novel molecule named ethylene glycol bis (ethyl methacrylate) (EGEMA). EGEMA was designed to retain the reactive acrylate units. Upon intermolecular polymerization of vinyl groups, EGEMA ester groups are positioned outside the backbone of the polymer chain. This review highlights investigation into the degradation resistance of EGEMA using buffer, esterase, and microbial storage assays. Material samples of EGEMA had superior final physical and mechanical properties than traditional ethylene glycol dimethacrylate (EGDMA) in all degradation assays. Integrating bioinformatics-based biodegradation predictions to the experimental results of storage media analyzed by LC/GC-MS revealed that hydrolysis of EGEMA generated small amounts of ethanol while preserving the strength bearing polymer backbone. Prior studies support investigation into additional custom synthesized methacrylate polymers with “flipped external” ester groups. The long term goal is to improve clinical durability compared to current methacrylates while retaining inherent advantages of acrylic based chemistry, which may ease implementation of these novel methacrylates into clinical practice.

Meta-analytical analysis on components released from resin-based dental materials

OBJECTIVES

Resin-based materials are applied in every branch of dentistry. Due to their tendency to release substances in the oral environment, doubts have been raised about their actual safety. This review aims to provide a comprehensive analysis of the last decade literature regarding the concentrations of elutable substances released from dental resin-based materials in different type of solvents.

MATERIALS AND METHODS

All the literature published on dental journals between January 2010 and April 2022 was searched using international databases (PubMed, Scopus, Web of Science). Due to strict inclusion criteria, only 23 papers out of 877 were considered eligible. The concentration of eluted substances related to surface and volume of the sample was analyzed, considering data at 24 h as a reference. The total cumulative release was examined as well.

RESULTS

The most eluted substances were HEMA, TEGDMA, and BPA, while the less eluted were Bis-GMA and UDMA. Organic solvents caused significantly higher release of substances than water-based ones. A statistically significant inverse correlation between the release of molecules and their molecular mass was observed. A statistically significant positive correlation between the amount of released molecule and the specimen surface area was detected, as well as a weak positive correlation between the release and the specimen volume.

CONCLUSIONS

Type of solvent, molecular mass of eluates, and specimen surface and volume affect substances release from materials.

CLINICAL RELEVANCE

It could be advisable to rely on materials based on monomers with a reduced elution tendency for clinical procedures.

Effect of Streptococcus mutans on surface-topography, microhardness, and mechanical properties of contemporary resin composites

OBJECTIVE

Dental caries is the most prevalent disease globally, and Streptococcus mutans (S. mutans) is a common associated oral bacteria. Additionally, S. mutans possess esterase activity capable of degrading resin composites (RC). However, the effect of degradation on the physical-mechanical properties of the RC has not been extensively studied. We evaluated the flexure strength (FS), the diametral tensile strength (DTS), the modulus of elasticity (ME), and the microhardness of three contemporary RC to establish if S. mutans could affect them.

METHODS

One hundred thirty-eight bar-shaped and 276 disc-shaped specimens were fabricated with Enamel Plus HRi, IPS Empress Direct, and Clearfil AP-X, and physical-mechanical testing was done after been incubated during 30 and 60 days in culture media with or without S. mutans. Also, a scanning electron microscope was used to identify surface changes.

RESULTS

None of the tested RC were affected in their mechanical properties (FS, ME, and DTS). However, Clearfil AP-X and Enamel Plus HRI showed eroded surfaces and a decreased microhardness after 30 and 60 days S. mutans incubation. IPS Empress Direct presented the lowest values in all the tests, but its physical-mechanical features and surface were not affected by bacteria's exposure.

CONCLUSIONS

Exposure to S. mutans could affect some contemporary RC; however, the effect seems superficial since its mechanical features were not affected.

Intelligent pH-responsive dental sealants to prevent long-term microleakage

OBJECTIVES

Microleakage is a determinant factor of failures in sealant application. In this study, DMAEM (dodecylmethylaminoethyl methacrylate), a pH-responsive antibacterial agent, was incorporated into resin-based sealant for the first time. The objectives of this study were to: (1) investigate the long-term performance of DMAEM-modified sealants against oral microbial-aging; and (2) investigate the long-term preventive effect of DMAEM-modified sealants on microleakage.

METHODS

Depth-of-cure and cytotoxicity of DMAEM-modified sealants were measured. Then, an aging model using biofilm derived from the saliva of high caries experience children was conducted. After aging, microhardness and surface roughness were measured. Biofilm activity, lactic acid production and exopolysaccharide (EPS) production were measured. 16S rRNA gene sequencing were also performed. The effects of DMAEM on microleakage were tested using an in vitro microleakage assessment.

RESULTS

The addition of DMAEM with a mass fraction of 2.5-10% did not affect depth-of-cure values and cytotoxicity of sealants. Adding 2.5-10% DMAEM did not affect the surface roughness and microhardness after aging. Compared to control, adding 2.5-10% DMAEM reduced biofilm metabolic activity by more than 80%. The lactic acid production and EPS production were reduced by 50% in DMAEM groups. DMAEM-modified sealants maintained the microbial diversity of biofilm after aging, they also inhibited the growth of lactobacillus. The 5% and 10% DMAEM groups exhibited a significant reduction in microleakage compared to control.

SIGNIFICANCE

The long-term antibacterial activities against oral microbial-aging and the long-term microecosystem-regulating capabilities enabled DMAEM-modified sealant to prevent microleakage in sealant application and thus prevent dental caries.

Assessment of Streptococcus mutans biofilms on orthodontic adhesives over 7 days

INTRODUCTION

The purpose of this study was to compare the metabolism of Streptococcus mutans biofilms after 1-7 days of growth on different orthodontic adhesives.

METHODS

Specimens of 6 commercial orthodontic adhesives were fabricated in custom-made molds and polymerized using a light-emitting diode light-curing unit. Bioluminescent S mutans (UA159:JM10) biofilms were grown on ultraviolet-sterilized specimens for 1, 3, 5, and 7 days (n = 18 biofilms/d/product) in anaerobic conditions at 37°C. The metabolism of biofilms (relative luminescence unit [RLU]) was measured 0, 2, 4, and 6 minutes after exposure to D-luciferin solution using a microplate reader. A linear mixed-effects model was used to analyze the logarithm of RLU (log RLU). The model included fixed effects of products, days, and minutes. Tukey-Kramer post-hoc tests were then performed on the significant predictors of log RLU (α = 0.05).

RESULTS

Days (P <0.0001) and minutes (P <0.0001) were independent predictors of log RLU, but the products were not (P = 0.5869). After adjusting for minutes, the log RLU was analyzed with a post-hoc test, and all differences between days were significant with the exceptions of day 3 from day 5 (P = 0.0731) and day 5 from day 7 (P = 0.8802). After adjusting for day, log RLU was analyzed with a post-hoc test and all differences in minutes were significant.

CONCLUSIONS

No significant differences in the metabolism of S mutans biofilms were observed among the 6 orthodontic adhesives. Biofilms that were grown for 3 days demonstrated the highest levels of biofilm metabolism as evidenced by higher mean log RLU values relative to 1, 5, and 7-day growth durations.

Bioenergetic Impairment of Triethylene Glycol Dimethacrylate- (TEGDMA-) Treated Dental Pulp Stem Cells (DPSCs) and Isolated Brain Mitochondria are Amended by Redox Compound Methylene Blue †

BACKGROUND

Triethylene glycol dimethacrylate (TEGDMA) monomers released from resin matrix are toxic to dental pulp cells, induce apoptosis, oxidative stress and decrease viability. Recently, mitochondrial complex I (CI) was identified as a potential target of TEGDMA. In isolated mitochondria supported by CI, substrates oxidation and ATP synthesis were inhibited, reactive oxygen species production was stimulated. Contrary to that, respiratory Complex II was not impaired by TEGDMA. The beneficial effects of electron carrier compound methylene blue (MB) are proven in many disease models where mitochondrial involvement has been detected. In the present study, the bioenergetic effects of MB on TEGDMA-treated isolated mitochondria and on human dental pulp stem cells (DPSC) were analyzed.

METHODS

Isolated mitochondria and DPSC were acutely exposed to low millimolar concentrations of TEGDMA and 2 μM concentration of MB. Mitochondrial and cellular respiration and glycolytic flux were measured by high resolution respirometry and by Seahorse XF extracellular analyzer. Mitochondrial membrane potential was measured fluorimetrically.

RESULTS

MB partially restored the mitochondrial oxidation, rescued membrane potential in isolated mitochondria and significantly increased the impaired cellular O₂ consumption in the presence of TEGDMA.

CONCLUSION

MB is able to protect against TEGDMA-induced CI damage, and might provide protective effects in resin monomer exposed cells.

Ageing of Dental Composites Based on Methacrylate Resins-A Critical Review of the Causes and Method of Assessment

The paper reviews the environmental factors affecting ageing processes, and the degradation of resins, filler, and the filler-matrix interface. It discusses the current methods of testing materials in vitro. A review of literature was conducted with the main sources being PubMed. ScienceDirect, Mendeley, and Google Scholar were used as other resources. Studies were selected based on relevance, with a preference given to recent research. The ageing process is an inherent element of the use of resin composites in the oral environment, which is very complex and changes dynamically. The hydrolysis of dental resins is accelerated by some substances (enzymes, acids). Bonds formed between coupling agent and inorganic filler are prone to hydrolysis. Methods for prediction of long-term behaviour are not included in composite standards. Given the very complex chemical composition of the oral environment, ageing tests based on water can only provide a limited view of the clinical performance of biomaterial. Systems that can reproduce dynamic changes in stress (thermal cycling, fatigue tests) are better able to mimic clinical conditions and could be extremely valuable in predicting dental composite clinical performance. It is essential to identify procedure to determine the ageing process of dental materials.

Stoichiometry and Kinetics of Sequential Dimethacrylate Enzymolysis

The increasing use of methacrylate-based materials in tissue engineering and dental restorations demands detailed evaluation of enzymolysis of these materials due to toxicity, durability, and biocompatibility concerns. The objective of this study is to develop tools for assessing and ranking the enzymolysis kinetics of dimethacrylate (DMA) compounds. Triethyleneglycol DMA and diurethane DMA are employed as model DMAs for kinetic studies of 2-step enzymolysis by 2 esterases, pseudocholine esterase and cholesterol esterase. In addition, the intermediate hydrolysis products, mono-methacrylates (mono-MAs), are prepared via esterases. The kinetics of DMA enzymolysis are evaluated per the concentrations of DMA. The enzymolysis products are quantified by high-performance liquid chromatography. Additionally, stoichiometric analysis and a Berkeley Madonna model are employed to compare the efficacy of esterases in DMA enzymolysis. The chemical structure of mono-MAs is verified by proton and heteronuclear single quantum coherence (2D 1H-13C) nuclear magnetic resonance spectroscopy and mass spectrometry. In evaluating the ratio of sequential and simultaneous degradations of DMA and mono-MA, the stoichiometric analysis draws the same conclusions without using [mono-MA] as the experimental observation using [mono-MA]. The majority of the 4 esterase-DMA combinations undergo the sequential enzyme-catalyzed hydrolysis, from DMA to mono-MA to diol. However, cholesterol esterase is more effective than pseudocholine esterase in maintaining sequential degradation until >90% of DMA is decomposed. Both enzymolysis steps are first-order reactions. The mono-MAs are more hydrolysis resistant than DMAs. Moreover, esterase efficacy and selectivity on DMA enzymolysis are presented. The stoichiometric analysis provides valuable tools in assessing DMA enzymolysis when mono-MA is difficult to be obtained. The resistance of mono-MAs to enzymolysis suggests a need for thorough toxicity evaluations of these intermediate compounds. It also advocates the alternative approaches in designing and developing durable and biocompatible materials.

Effects of dental composite resin monomers on dental pulp cells

Methacrylate monomers found in many dental materials cause toxicity to dental pulp cells but the mechanism of the toxicity is poorly understood. We used cultured human dental pulp cells to test the effects of three commonly used monomers; bisphenol-A-glycidyl methacrylate (Bis-GMA), urethane dimethacrylate (UDMA), and triethyleneglycol dimethacrylate (TEGDMA). The order of toxicity was Bis-GMA>UDMA>TEGDMA. The toxicity correlated inversely with cystine uptake, with TEGDMA stimulating uptake and BisGMA and UDMA inhibiting uptake. Bis-GMA and UDMA induced oxidative stress, while TEGDMA did not. Toxicity correlated poorly with glutathione levels, as all compounds decreased cellular glutathione. TEGDMA is less toxic than Bis-GMA and UDMA likely because it stimulates cystine uptake and does not induce oxidative stress, the enhanced uptake of cystine appears to compensate for TEGDMA's direct interaction with glutathione. Bis-GMA and UDMA both deplete glutathione and inhibit cystine uptake leading to oxidative stress and cell death.

Use of (meth)acrylamides as alternative monomers in dental adhesive systems

OBJECTIVES

Methacrylamides are proposed as components for dental adhesive systems with enhanced resistance to hydrolytic and enzymatic degradation. The specific objective of this study was to evaluate the polymerization kinetics, water sorption and solubility, pH-derived degradation and microtensile bond strength of various monofunctional acrylamides and meth(acrylamides) when copolymerized with dimethacrylates.

METHODS

Base monomers were added at 60 wt%, and included either BisGMA or UDMA. Monofunctional monomers were added at 40 wt%, including one (meth)acrylate as the control, two secondary methacrylamides and two tertiary acrylamides. DMPA (0.2 wt%) and DPI-PF6 (0.4 wt%)/BHT (0.1 wt%) were added as initiators/inhibitor. Polymerization kinetics wwere followed with near-IR spectroscopy in real time. Water sorption (WS) and solubility (SL) were measured following ISO 4049. Monomer degradation at different pH levels was assessed with 1H NMR. Microtensile bond strength (MTBS) was assessed in caries-free human third molars 48 h and 3 weeks after restorations were placed using solvated BisGMA-based adhesives (40 vol% ethanol). Data were analyzed with one-way ANOVA/Tukey's test (α = 0.05).

RESULTS

As expected, rate of polymerization and final degree of conversion (DC) were higher for the acryl versions of each monomer, and decreased with increasing steric hindrance around the vinyl group for each molecule. In general, UDMA copolymerizations were more rapid and extensive than for BisGMA, but this was dependent upon the specific monofunctional monomer added. WS/SL were in general higher for the (meth)acrylamides compared to the (meth)acrylates, except for the tertiary acrylamide, which showed the lowest values. One of the secondary methacrylamides was significantly more stable than the methacrylate control, but the alpha substitutions decreased stability to degradation in acid pH. MTBS in general was higher for the (meth)acrylates. While for all materials the MTBS values at 3 weeks decreased in relation to the 24 h results, the tertiary acrylamide showed no reduction in bond strength.

SIGNIFICANCE

This study highlights the importance of considering steric and electronic factors when designing monomers for applications where rapid polymerizations are needed, especially when co-polymerizations with other base monomers are required to balance mechanical properties, as is the case with dental adhesives. The results of this investigation will be used to design fully formulated adhesives to be tested in clinically-relevant conditions.

Human neutrophils degrade methacrylate resin composites and tooth dentin

Cholesterol esterase-like (CE) activity from saliva and esterase from cariogenic bacteria hydrolyze ester linkages of dental methacrylate resins. Collagenolytic, matrix metalloproteinase-like (MMP) activities from dentin and bacteria degrade collagen in demineralized tooth dentin. Human neutrophils in the oral cavity contain factors that are hypothesized to have CE and MMP activities that could contribute to the degradation of methacrylate resins and dentinal collagen. OBJECTIVES: To measure the CE and MMP activities from human neutrophils and their ability to degrade dental methacrylate resin composite and dentinal collagen. Neutrophils' CE and MMP activities were measured using nitrophenyl-esters or fluorimetric MMP substrates, respectively. Neutrophils' degradation of resin composite and dentinal collagen was quantified by measuring release of a universal 2,2-Bis[4-(2-hydroxy-3-methacryloxypropoxy)phenyl]propane (bisGMA)-derived resin composite degradation byproduct, bishydroxy-propoxy-phenyl-propane (bisHPPP), or a collagen degradation by-product, hydroxyproline, respectively using ultra performance liquid chromatography/mass spectrometry. Neutrophils' CE activity increased the release of bisHPPP from bisGMA monomer compared to control after 24 and 48 h (p < 0.05). Neutrophils degraded polymerized resin composite and produced higher amounts of bisHPPP than buffer after 48 h of incubation (p < 0.05). Neutrophils show generic MMP, gelatinase, MMP-2 and MMP-9, and collagenase, MMP-1 and MMP-8 activities that were stable or increased over the first 24 h (p < 0.05). Neutrophils degraded demineralized dentin more than buffer-only groups, indicated by higher amounts of hydroxyproline (p < 0.05). The ability of neutrophils to degrade both dental resin composite and tooth dentin, suggest neutrophil's potential role in root caries, and in recurrent carries by accelerating the degradation of resin-dentin interfaces, and compromising the longevity of the restoration. STATEMENT OF SIGNIFICANCE: Neutrophils are part of the innate immune system and are constantly entering the oral cavity through the gingival sulcus, in direct contact with the tooth, restoration, restoration-tooth margins and pathogenic bacteria. The current study is the first to characterize and quantify degradative activities from neutrophils toward methacrylate resin and demineralized dentin, the two main components of the restoration-tooth interface, suggesting that this interface could be negatively influenced by neutrophils, potentially contributing to increase in caries formation and progression, and premature restoration failure. This study provides a significant finding to the biomaterials and oral health fields by identifying a potential weakness in current restorative procedures and materials used to manage gingival proximal and cervical gingival or sub-gingival carious lesions.

Biostable, antidegradative and antimicrobial restorative systems based on host-biomaterials and microbial interactions

OBJECTIVES

Despite decades of development and their status as the restorative material of choice for dentists, resin composite restoratives and adhesives exhibit a number of shortcomings that limit their long-term survival in the oral cavity. Herein we review past and current work to understand these challenges and approaches to improve dental materials and extend restoration service life.

METHODS

Peer-reviewed work from a number of researchers as well as our own are summarized and analyzed. We also include yet-unpublished work of our own. Challenges to dental materials, methods to assess new materials, and recent material improvements and research directions are presented.

RESULTS

Mechanical stress, host- and bacterial-biodegradation, and secondary caries formation all contribute to restoration failure. In particular, several host- and bacterial-derived enzymes degrade the resin and collagen components of the hybrid layer, expanding the marginal gap and increasing access to bacteria and saliva. Furthermore, the virulence of cariogenic bacteria is up-regulated by resin biodegradation by-products, creating a positive feedback loop that increases biodegradation. These factors work synergistically to degrade the restoration margin, leading to secondary caries and restoration failure. Significant progress has been made to produce hydrolytically stable resins to resist biodegradation, as well as antimicrobial materials to reduce bacterial load around the restoration. Ideally, these two approaches should be combined in a holistic approach to restoration preservation.

SIGNIFICANCE

The oral cavity is a complex environment that poses an array of challenges to long-term material success; materials testing conditions should be comprehensive and closely mimic pathogenic oral conditions.

Responsive antimicrobial dental adhesive based on drug-silica co-assembled particles

Most dental resin composite restorations are replacements for failing restorations. Degradation of the restoration-tooth margins by cariogenic bacteria results in recurrent caries, a leading cause for restoration failure. Incorporating antimicrobial agents in dental adhesives could reduce interfacial bacterial count and reduce recurrent caries rates, inhibit interfacial degradation, and prolong restoration service life, while minimizing systemic exposure. Direct addition of antimicrobial compounds into restorative materials have limited release periods and could affect the integrity of the material. Attempts to incorporate antimicrobial within mesoporous silica nanoparticles showed theoretical promise due to their physical robustness and large available internal volume, yet yielded short-term burst release and limited therapeutic payload. We have developed novel broad-spectrum antimicrobial drug-silica particles co-assembled for long-term release and high payload incorporated into dental adhesives. The release of the drug, octenidine dihydrochloride, is modulated by the oral degradative environment and mathematically modeled to predict effective service life. Steady-state release kills cariogenic bacteria, preventing biofilm formation over the adhesive surface, with no toxicity. This novel material could extend dental restoration service life and may be applied to other long-term medical device-tissue interfaces for responsive drug release upon bacterial infection.

STATEMENT OF SIGNIFICANCE

This study describes a novel dental adhesive that includes a broad-spectrum antimicrobial drug-silica co-assembled particles for long-term antimicrobial effect. The release of the drug, octenidine dihydrochloride, is modulated by the oral degradative environment and mathematically modeled to predict effective release throughout the service life of the restoration. Steady-state drug-release kills caries-forming bacteria, preventing biofilm formation over the adhesive surface, without toxicity. This novel material could extend dental restoration service life and may be applied to other long-term medical device-tissue interfaces for responsive drug release upon bacterial infection. Since recurrent cavities (caries) caused by bacteria are the major reason for dental filling failure, this development represents a significant contribution to the biomaterials field in methodology and material performance.

Short-time dental resin biostability and kinetics of enzymatic degradation

Resin biostability is of critical importance to the durability of methacrylate-based dental resin restorations. Current methods for evaluating biostability take considerable time, from weeks to months, and provide no short-time kinetics of resin degradation. The objective of this study is to develop a more sensitive method to assess resin biostability over short-time spans (hours to days) that will enhance our understanding of biostability and its resin chemistry. Ultra-flat resin films of equimolar urethane dimethacrylate (UDMA) and triethylene glycol dimethacrylate (TEGDMA) are produced through photo-curing between two flat surfaces. Next, metal-covered enclaves and bare-resin channels are generated using stencil lithography to create both degradable and protected (internal reference) regions simultaneously in a single specimen. Resins having three different degrees of vinyl conversion (DC) are compared, and changes of surface roughness and step height in the two regions are monitored by atomic force microscopy (AFM) before and after incubated in enzyme solutions and saline controls. Specimen biostability is ranked based on the topological profile changes when viewed in cross-section before and after enzymatic challenges. In addition, a model is proposed to quantify specimen enzymatic degradation. Based on this model, enzymatic degradation is detected as early as 4 h, and a surge of enzymatic degradation is detected between 4 h and 8 h. The correlation between the DC of resin network and the surge in degradation is discussed. In summary, this new method is effective in ranking biostability and quantifying enzymatic degradation while also reducing labor, time and cost, which lends itself well to materials development and evaluation of dental resins.

STATEMENT OF SIGNIFICANCE

We report, for the first time, the short-time kinetics of enzymatic degradation of methacrylate dental resins. A nanotechnology based method is developed to accelerate the evaluation of resin biostability. This new method reduces experimental time from weeks to one or two days, which will significantly reduce the costs of labor and enzymes. It also introduces a corresponding parameter (ΔH) and a three-cause model for ranking biostability, which confirms the correlation of chemical structure (DC) and material performance and opens new opportunities for studying the resin biostability and its impact on dental applications. Overall, this is a new tool for evaluating resin biostability and developing new materials.

In vitro aging behavior of dental composites considering the influence of filler content, storage media and incubation time

Objective

Over time dental composites age due to mechanical impacts such as chewing and chemical impacts such as saliva enzymes and food ingredients. For this research, the focus was placed on chemical degradation. The objective of this study was to simulate hydrolysis by using different food simulating liquids and to assess their impact on the mechanical parameter Vickers microhardness (MHV) and the physicochemical parameter contact angle (CA).

Methods

Specimen of three composites (d = 6 mm, h = 2 mm; n = 435) classified with respect to their filler content (wt%), namely low-filled, medium-filled and highly-filled, were stored for 0, 14, 30, 90 and 180 days in artificial saliva (pH 7), citric acid (pH 3; pH 5), lactic acid (pH 3; pH 5) and ethanol (40%vol; 60%vol) and assessed regarding to MHV and CA. Statistics: Kruskal-Wallis test, stepwise linear regression, bivariate Spearman Rank Correlation (p < 0.05).

Results

While stored in artificial saliva, acid and ethanol the CA decreased especially for the low- and medium-filled composites. It was shown that rising the filler content caused less surface changes in the CA. Storage in ethanol led to a significant decrease of MHV of all composites. Regression analysis showed that the effect of in vitro aging on MHV was mainly influenced by the composite material and therefore by filler content (R² = 0.67; p < 0.05). In contrast, the CA is more influenced by incubation time and filler content (R² = 0.2; p < 0.05) leading to a higher risk of plaque accumulation over time. Significance: In vitro aging showed significant changes on the mechanical and physicochemical properties of dental composites which may shorten their long-term functionality. In conclusion, it can be stated, that the type of composite material, especially rising filler content seems to improve the materials’ resistance against the processes of chemical degradation.

A novel Triclosan Methacrylate-based composite reduces the virulence of Streptococcus mutans biofilm

The use of antimicrobial monomers, linked to the polymer chain of resin composites, is an interesting approach to circumvent the effects of bacteria on the dental and material surfaces. In addition, it can likely reduce the incidence of recurrent caries lesions. The aim of this study was to evaluate the effects of a novel Triclosan Methacrylate (TM) monomer, which was developed and incorporated into an experimental resin composite, on Streptococcus mutans (S. mutans) biofilms, focusing on the analyses of vicR, gtfD, gtfC, covR, and gbpB gene expression, cell viability and biofilm characteristics. The contact time between TM-composite and S. mutans down-regulated the gbpB and covR and up-regulated the gtfC gene expression, reduced cell viability and significantly decreased parameters of the structure and characteristics of S. mutans biofilm virulence. The presence of Triclosan Methacrylate monomer causes harmful effects at molecular and cellular levels in S. mutans, implying a reduction in the virulence of those microorganisms.

Effects of triethylene glycol dimethacrylate (TEGDMA) on the odontoclastic differentiation ability of human dental pulp cells

OBJECTIVES

The primary purpose of this study was to examine the effects of triethylene glycol dimethacrylate (TEGDMA) on odontoclastic differentiation in the dental pulp tissue.

MATERIAL AND METHODS

The effects of different TEGDMA dosages on the odontoclastic differentiation capability of dental pulp cells were analyzed in vitro using the following methodologies: i) flow cytometry and tartrate-resistant acid phosphatase (TRAP) staining; ii) apoptotic effects using Annexin V staining; iii) mRNA expression of osteoprotegerin (OPG) and receptor activator of nuclear factor (NF)-kB ligand (RANKL) genes by quantitative Real-time PCR (qRT-PCR); and iv) OPG and RANKL protein expression by enzyme-linked immunosorbent assay (ELISA).

RESULTS

TEGDMA caused relatively less odontoclastic differentiation in comparison with the control group; however, odontoclastic differentiation augmented with increasing doses of TEGDMA (p<0.05). The mRNA and protein expression of OPG was lower in TEGDMA treated pulp cells than in the control group (p<0.05). While the mRNA expression of RANKL remained unchanged compared to the control group (p>0.05), its protein expression was higher than the control group (p<0.05). In addition, TEGDMA increased the apoptosis of dental pulp cells dose dependently.

CONCLUSIONS

TEGDMA reduced the odontoclastic differentiation ability of human dental pulp cells. However, odontoclastic differentiation ratios increased proportionally with the increasing dose of TEGDMA.

Interfacial degradation of adhesive composite restorations mediated by oral biofilms and mechanical challenge in an extracted tooth model of secondary caries

OBJECTIVE

To study the combined effect of simulated occlusal loading and plaque-derived biofilm on the interfacial integrity of dental composite restorations, and to explore whether the effects are modulated by the incorporation of sucrose.

METHODS

MOD-class-II restorations were prepared in third molars. Half of the specimens (n=27) were subjected to 200,000 cycles of mechanical loading using an artificial oral environment (ART). Then, both groups of specimens (fatigued and non-fatigued) were divided into three subgroups for testing in CDC-reactors under the following conditions: no biofilm (Control), biofilm with no sucrose (BNS) and biofilm pulsed with sucrose (BWS). BNS and BWS reactors were incubated with a multispecies inoculum from a single plaque donor whereas the control reactor was not. The BWS reactor was pulsed with sucrose five times a day. The biofilm challenges were repeated sequentially for 12 weeks. pH was recorded for each run. Specimens were examined for demineralization with micro-CT and load capacity by fast fracture test.

RESULTS

Demineralization next to the restorations was only detectable in BWS teeth. Fracture loads were significantly reduced by the concomitant presence of biofilm and sucrose, regardless of whether cyclic mechanical loading was applied. Cyclic loading reduced fracture loads under all reactor conditions, but the reduction was not statistically significant.

CONCLUSIONS

Sucrose pulsing was required to induce biofilm-mediated degradation of the adhesive interface. We have presented a comprehensive and clinically relevant model to study the effects of mechanical loading and microbial challenge on the interfacial integrity of dental restorations.

Biofilm-induced changes to the composite surface

OBJECTIVES

Composites may undergo biodegradation in the oral cavity. The objective was to investigate the effect of single- and multi-species biofilms on the surface roughness and topography of two composites.

METHODS

Disk-shaped specimens of a paste-like, Bis-GMA-free (Gradia Direct Anterior, GC), and a flowable, Bis-GMA-based composite (Tetric EvoFlow, Ivoclar-Vivadent) were prepared. After ethylene-oxide sterilization (38°C), specimens (n=3) were incubated with Streptococcus mutans or mixed bacterial culture (Streptococcus mutans, Streptococcus sanguinis, Actinomyces naeslundii and Fusobacterium nucleatum). As negative controls, unexposed specimens and specimens exposed to sterile medium (BHI) were used. Specimens exposed to acidified BHI medium (pH=5) and enzymatic solution of cholesterol esterase served as positive control. Following 6-week incubation, the attached biofilms were collected for real-time PCR assessment, after which the surface roughness and topography of the specimens were analyzed with atomic force microscopy. Surface hydrophilicity/hydrophobicity was determined by contact angle measurements. Biofilm structure was analyzed with scanning electron microscopy.

RESULTS

Even though multi-species biofilms were thicker, with more cells attached, they did not significantly affect the surface roughness of the composites. On the other hand, S. mutans alone significantly increased the roughness of Tetric by 40.3%, while its effect on Gradia was lower (12%). The total amount of attached bacteria, however, did not differ between the composites.

CONCLUSIONS

S. mutans can increase the surface roughness of composites, depending on their composition. This ability of S. mutans is, however, mitigated in co-culture with other species. In particular, bacterial esterases seem to be responsible for the increased composite surface roughness upon biofilms exposure.

CLINICAL SIGNIFICANCE

Cariogenic bacteria can degrade composites, thereby increasing the surface roughness. Increased roughness and subsequent improved bacterial accumulation may facilitate the development of secondary caries around composites, which is the most common reason for the restoration failure.

Salivary Esterase Activity and Its Association with the Biodegradation of Dental Composites

Pseudocholinesterase (PCE) and cholesterol esterase (CE) can hydrolyze bisphenylglycidyl dimethacrylate (bisGMA) and triethylene glycol dimethacrylate (TEGDMA) monomers. This study will test the hypothesis that enzyme activities showing CE and PCE character are found in human saliva at levels sufficient to hydrolyze ester-containing composites important to restorative denstistry. The study also seeks to ask if the active sites of CE and PCE with respect to composite could be inhibited. Photo-polymerized model composite resin was incubated in PCE and CE solutions, in the presence and absence of a specific esterase inhibitor, phenylmethylsulfonyl fluoride (PMSF). Incubation solutions were analyzed for resin degradation products by high-performance liquid chromatography (HPLC), UV spectroscopy, and mass spectrometry. Saliva was found to contain both hydrolase activities at levels that could degrade composite resins. PMSF inhibited the composite degradation, indicating a material hydrolysis mechanism similar to the enzymes’ common function.

Preparation of Dental Resins Resistant to Enzymatic and Hydrolytic Degradation in Oral Environments

The short average service life of traditional dental composite restorative materials and increasing occurrence of secondary caries adjacent to composite restorations and sealants are necessitating the development of new, longer lasting compositions. Novel monomers and their polymers, reinforcing fillers, and adhesive components are needed. The goal of this research is to develop resin systems for use in restorations, sealants, and other dental services that are superior in properties and endurance to currently used bisphenol A glycidyl dimethacrylate/triethylene glycol dimethacrylate (Bis-GMA/TEGDMA) and urethane-dimethacrylate products. Ether-based monomers and their polymers that were not susceptible to enzymatic or hydrolytic degradation were prepared and characterized. They showed no degradation under hydrolytic and enzymatic challenges, whereas the hydrolysis of ester links weakened contemporary resins within 16 days under these challenges. The success of the ether-based materials is promising in making durable systems that are subjected to long-term biochemical and hydrolytic challenges in oral environments.

Cytotoxicity of low-shrink composites with new monomer technology on bovine dental pulp-derived cells

Objectives:

The aim of this study was to evaluate the cytotoxicity of four low-shrink composites with new monomer technology on the bovine dental pulp-derived cells (bDPCs).

Materials and methods:

Ten samples were prepared for each group composites, and the samples were immersed in 7 mL of culture medium for 72 h at 37°C to extract residual monomer or cytotoxic substances. The culture medium containing the material extracts was sterile filtered for use on the cell cultures. Materials were incubated in medium with serum for 72 h. bDPCs were maintained in a medium with serum. A real-time cell analyzer was used to evaluate cell survival. After seeding 200 mL of the cell suspensions into the wells (10,000 cells/well) of the E-plate 96, bDPCs were treated with bioactive components released by the composite materials (1:1 and 1:2 dilutions) and monitored every 15 min for 50 h.

Results:

According to analysis of variance, there were significant differences between the cell indexes of the control and GC kalore ( p < 0.05) and Bisco Reflexions ( p < 0.001) groups for the 1:1 dilutions at 25 h. When evaluated at 50 h, 1:1 dilutions of GC Kalore ( p < 0.01) and Bisco Reflexions ( p < 0.001) reduced cell survival significantly.

Conclusions:

Although composites resins are being advanced, their cytotoxic effects have been proceeding till this time. However, two of the four materials tested significantly reduced cell viability when compared with control.

Clinical relevance:

Research should focus on the cytotoxicity of composites in addition to their mechanical properties.

The regulation of cytotoxicity and cyclooxygenase-2 expression by 2-hydroxy-ethyl methacrylate in human osteoblasts are related to intracellular glutathione levels

AIM

To investigate the effects of 2-hydroxy-ethyl methacrylate (HEMA) on cytotoxicity and cyclooxygenase-2 (COX-2) protein expression in human osteoblasts.

METHODOLOGY

Cytotoxicity was judged using an Alamar Blue reduction assay on human osteoblast cell line U2OS. Western blot was used to evaluate the expression of COX-2 protein by HEMA. To determine whether glutathione (GSH) levels were important in cytotoxicity and COX-2 expression of HEMA, cells were pre-treated with the GSH precursor, 2-oxothiazolidine-4-carboxylic acid (OTZ), to boost thiol levels, or buthionine sulfoximine (BSO) to deplete GSH. Paired Student's t-tests were applied for the statistical analysis of the results.

RESULTS

HEMA demonstrated a cytotoxic effect to U2OS cells in a dose-dependent manner (P < 0.05). The 50% inhibition concentration of HEMA was approximately 3 mmol L(-1) . HEMA was found to induce COX-2 protein expression in U2OS cells (P < 0.05). The addition of OTZ acted as a protective effect on HEMA-induced cytotoxicity and COX-2 expression (P < 0.05). In contrast, the addition of BSO enhanced HEMA-induced cytotoxicity and COX-2 expression (P < 0.05).

CONCLUSION

Taken together, the levels of HEMA that were tested inhibited cell growth on U2OS cells. HEMA has a significant potential for periapical toxicity. The activation of COX-2 protein expression may be one of the mechanisms of HEMA-induced periapical inflammation. These inhibitory effects were associated with intracellular GSH levels.

Effect of water-aging on the antimicrobial activities of an ORMOSIL-containing orthodontic acrylic resin

Quaternary ammonium methacryloxy silicate (QAMS), an organically modified silicate (ORMOSIL) functionalized with polymerizable methacrylate groups and an antimicrobial agent with a long lipophilic alkyl chain quaternary ammonium group, was synthesized through a silane-based sol-gel route. By dissolving QAMS in methyl methacrylate monomer, this ORMOSIL molecule was incorporated into an auto-polymerizing, powder/liquid orthodontic acrylic resin system, yielding QAMS-containing poly(methyl methacrylate). The QAMS-containing acrylic resin showed a predominant contact-killing effect on Streptococcus mutans (ATCC 35668) and Actinomyces naeslundii (ATCC 12104) biofilms, while inhibiting adhesion of Candida albicans (ATCC 90028) on the acrylic surface. The antimicrobial activities of QAMS-containing acrylic resin were maintained after a 3month water-aging period. Bromophenol blue assay showed minimal leaching of quaternary ammonium species when an appropriate amount of QAMS (<4wt.%) was incorporated into the acrylic resin. The results suggest that QAMS is predominantly co-polymerized with the poly(methyl methacrylate) network, and only a minuscule amount of free QAMS molecules is present within the polymer network after water-aging. Acrylic resin with persistent antimicrobial activities represents a promising method for preventing bacteria- and fungus-induced stomatitis, an infectious disease commonly associated with the wearing of removable orthodontic appliances.

The dentin organic matrix - limitations of restorative dentistry hidden on the nanometer scale

The prevention and treatment of dental caries are major challenges occurring in dentistry. The foundations for modern management of this dental disease, estimated to affect 90% of adults in Western countries, rest upon the dependence of ultrafine interactions between synthetic polymeric biomaterials and nanostructured supramolecular assemblies that compose the tooth organic substrate. Research has shown, however, that this interaction imposes less than desirable long-term prospects for current resin-based dental restorations. Here we review progress in the identification of the nanostructural organization of the organic matrix of dentin, the largest component of the tooth structure, and highlight aspects relevant to understating the interaction of restorative biomaterials with the dentin substrate. We offer novel insights into the influence of the hierarchically assembled supramolecular structure of dentin collagen fibrils and their structural dependence on water molecules. Secondly, we review recent evidence for the participation of proteoglycans in composing the dentin organic network. Finally, we discuss the relation of these complexly assembled nanostructures with the protease degradative processes driving the low durability of current resin-based dental restorations. We argue in favour of the structural limitations that these complexly organized and inherently hydrated organic structures may impose on the clinical prospects of current hydrophobic and hydrolyzable dental polymers that establish ultrafine contact with the tooth substrate.

Durability of bonds and clinical success of adhesive restorations

Resin-dentin bond strength durability testing has been extensively used to evaluate the effectiveness of adhesive systems and the applicability of new strategies to improve that property. Clinical effectiveness is determined by the survival rates of restorations placed in non-carious cervical lesions (NCCL). While there is evidence that the bond strength data generated in laboratory studies somehow correlates with the clinical outcome of NCCL restorations, it is questionable whether the knowledge of bonding mechanisms obtained from laboratory testing can be used to justify clinical performance of resin-dentin bonds. There are significant morphological and structural differences between the bonding substrate used in in vitro testing versus the substrate encountered in NCCL. These differences qualify NCCL as a hostile substrate for bonding, yielding bond strengths that are usually lower than those obtained in normal dentin. However, clinical survival time of NCCL restorations often surpass the durability of normal dentin tested in the laboratory. Likewise, clinical reports on the long-term survival rates of posterior composite restorations defy the relatively rapid rate of degradation of adhesive interfaces reported in laboratory studies. This article critically analyzes how the effectiveness of adhesive systems is currently measured, to identify gaps in knowledge where new research could be encouraged. The morphological and chemical analysis of bonded interfaces of resin composite restorations in teeth that had been in clinical service for many years, but were extracted for periodontal reasons, could be a useful tool to observe the ultrastructural characteristics of restorations that are regarded as clinically acceptable. This could help determine how much degradation is acceptable for clinical success.

Effect of salivary esterase on the integrity and fracture toughness of the dentin-resin interface

Human Salivary Derived Esterases (HSDE) are part of the salivary group of enzymes which show strong degradative activity toward the breakdown of one of the most common monomers used in dental composites and adhesives, 2,2-[4(2-hydroxy 3-methacryloxypropoxy)-phenyl] propane (Bis-GMA), to form the degradation product 2,2-bis [4 (2,3-hydroxy-propoxy)phenyl] propane (Bis-HPPP). This study was aimed to evaluate the effects of HSDE on the biodegradation and fracture toughness of the adhesive resin-dentin interface. Adhesive resin (Scotchbond Multi Purposes), resin composite (Z250) and mini short-rod specimens, were either not incubated; or incubated in phosphate-buffered saline (PBS) or HSDE media for up to 180 days (37 degrees C, pH 7.0). The amount of Bis-HPPP was analyzed by high performance liquid chromatography and mini-SR specimens were tested for fracture toughness using universal testing machine following 30, 90, or 180-day incubation periods. Significantly higher amounts of Bis-HPPP were produced in HSDE than in PBS incubated specimens (p < 0.05). Non-incubated mini-SR specimens had the higher fracture-toughness values, while specimens incubated for 180-days in HSDE had the lowest fracture toughness (p < 0.05). This study suggests that biodegradation is an on-going clinically relevant process that progressively compromises the integrity of the critical resin restoration-adhesive interface, as well as the resin-composite component with time.

New dental composites containing multimethacrylate derivatives of bile acids: a comparative study with commercial monomers

We have prepared multifunctional methacrylate derivatives of bile acids as cross-linkable monomers for use in dental composites. By modifying the chemical structure of the monomers, we were able to vary the viscosity, hydrophobicity, and reactivity and have studied the effect of these parameters on the conversion of the monomers, the shrinkage during polymerization, and the mechanical properties of the resulting polymers and composites. Materials containing these new monomers generally had physical, thermal, and mechanical properties comparable to those containing the commonly used dental monomers BisGMA or UDMA and had lower polymerization shrinkage. The multimethacrylate derivatives of cholic acid, which are known to be less cytotoxic than BisGMA and UDMA, are shown to be promising materials for dental applications.

Enzymatic biodegradation of HEMA/bisGMA adhesives formulated with different water content

Dentin adhesives may undergo phase separation when bonding to wet demineralized dentin. We hypothesized that adhesives exhibiting phase separation will experience enhanced biodegradation of methacrylate ester groups. The objective of this project was to study the effect of enzyme-exposure on the release of methacrylic acid (MAA) and 2-hydroxyethyl methacrylate (HEMA) from adhesives formulated under conditions simulating wet bonding. HEMA/bisGMA(2,2-bis[4(2-hydroxy-3-methacryloyloxy-propyloxy)-phenyl] propane), 45/55 w/w ratio, was formulated with different water content: 0 Wt % (A00), 8 wt % (A08), and 16 wt % (A16). After a three day prewash, adhesive discs were incubated with/without porcine liver esterase (PLE) in phosphate buffer (PB, pH 7.4) at 37 degrees C for 8 days. Supernatants were collected daily and analyzed for MAA and HEMA by HPLC. For all formulations, daily MAA release in the presence of PLE was increased compared to MAA release in PB. HEMA release in the presence of PLE was not detected while HEMA release was consistently measured in PB. A08 and A16 released significantly larger amounts of HEMA compared to A00. Analysis of the cumulative release of analytes showed that the leachables in PLE was significantly increased (p < 0.05) as compared with that released in PB indicating that MAA release was not only formed from unreacted monomers but from pendant groups in the polymer network. However, the levels of analytes HEMA in PB or MAA in PLE were increased in A08 and A16 as compared with A00, which suggests that there could be a greater loss of material in HEMA/bisGMA adhesives that experience phase separation under wet bonding conditions.

Towards a Biocompatible, Biodegradable Copolymer Incorporating Electroactive Oligothiophene Units

As part of an ongoing effort to develop biocompatible, biodegradable conducting polymers, we report here the synthesis and characterization of a novel copolymer, 5,5"'bishydroxymethyl-3,3"'-dimethyl-2,2':5',2":5",2"'-quaterthiophene-co-adipic acid polyester (QAPE). This system was designed so as to incorporate alternating electroactive quaterthiophene units and biodegradable ester units into one macromolecular framework, while allowing for facile preparation of the polymer via a polycondensation reaction. In agreement with the design expectations, the ester groups were found to be incorporated into the polymer between the quaterthiophene subunits, as inferred from standard chemical and spectroscopic analyses. QAPE exhibited redox activity as detected by cyclic voltammetry and a new red-shifted absorption peak upon doping, providing support for the notion that the quaterthiophene units maintain electroactivity after incorporation into the QAPE polymer framework. The degradation, likely through surface erosion, of this polymer in the presence of cholesterol esterase was confirmed by the detection of a fluorescence signal at wavelengths corresponding to the quaterthiophene subunit and comparisons to appropriate controls. In vitro cytocompatability studies, carried out over 48 h, indicate that the QAPE polymer is nontoxic to Schwann cells.

Influence of silanated filler content on the biodegradation of bisGMA/TEGDMA dental composite resins

It has been shown that an increase in the content of nonsilanated submicron colloidal silica filler particles within dental composites resulted in the release of more bis-phenol-A diglycidyl dimethacrylate (bisGMA)-derived product, bis-hydroxy-propoxyphenyl propane, following incubation with cholesterol esterase (CE). This work further investigates the enzyme-catalyzed biodegradation of fine composite resin systems, containing silanated micron-size irregular glass fillers, commonly used in clinical restorations. Model composite resin samples (10 or 60% weight fraction silanated barium glass filler, 1 mum average particle size) based on bisGMA/triethylene glycol dimethacrylate (TEGDMA) were incubated in buffer or buffer with CE (pH = 7.0, 37 degrees C) solutions for 32 days. The incubation solutions were analyzed using high-performance liquid chromatography, UV spectroscopy, and mass spectrometry. Both groups were characterized by Fourier transform infrared spectroscopy, scanning electron microscopy, and X-ray photoelectron spectroscopy. In contrast with previous findings for nonsilanated submicron filler systems, the higher filler containing composite showed an increase in its stability with time, following exposure to esterase and when compared to the lower filler content material. As well, the 60% filler composite leached less unreacted monomer TEGDMA. Since the model composite resins studied here were identical and only the filler content varied, the differences in biostability could be specifically associated with the relative amount of resin/filler distribution. The clinical use of different materials in varied dental applications (ranging from fissure sealant to tooth-colored highly filled materials) must consider the potential for different degradation profiles to occur as a function of filler content.

FDI report on adverse reactions to resin-based materials

Resin-based restorative materials are considered safe for the vast majority of dental patients. Although constituent chemicals such as monomers, accelerators and initiators can potentially leach out of cured resin-based materials after placement, adverse reactions to these chemicals are rare and reaction symptoms commonly subside after removal of the materials. Dentists should be aware of the rare possibility that patients could have adverse reactions to constituents of resin-based materials and be vigilant in observing any adverse reactions after restoration placement. Dentists should also be cognisant of patient complaints about adverse reactions that may result from components of resin-based materials. To minimise monomer leaching and any potential risk of dermatological reactions, resin-based materials should be adequately cured. Dental health care workers should avoid direct skin contact with uncured resin-based materials. Latex and vinyl gloves do not provide adequate barrier protection to the monomers in resin-based materials.

Mechanical Properties of Light-curing Composites Polymerized with Different Laboratory Photo-curing Units

This study aimed to analyze the microhardness (KHN) and diametral tensile strength (DTS) of two hybrid resin composites (TPH Spectrum and Filtek Z250). To this end, the composites were polymerized with six laboratory photo-curing units (LPUs) and the results compared with an alternative polymerization method using conventional halogen light source in conjunction with additional polymerization in an autoclave (15 minutes/100 degrees C). LPUs were used following the manufacturers' instructions. Diametral tensile strength and Knoop hardness tests were conducted for all groups (n=5). Data were statistically compared using ANOVA and Tukey's test (alpha = 0.05). Among the LPUs, the one that provided light curing in conjunction with heat and nitrogen pressure resulted in a significant increase in KHN and DTS of resin composites. Between the resin composites, Filtek Z250 showed higher hardness values than TPH Spectrum. It was concluded that the use of alternative polymerization with conventional light polymerization and autoclave was feasible with a wide implication for the general public in terms of reduced dental treatment cost.

Influence of salivary organic substances on the discoloration of esthetic dental materials-a review

The objective of this article was to review the articles on the interaction of salivary organic substances with resin-based dental materials and on the interaction of these organic substances with exogenous chemical agents, which results in discoloration. Original scientific articles or reviews on the saliva, acquired pellicle, and the interaction with pellicle and chemical agents related to dental resin-based materials were reviewed. Salivary esterases can increase or decrease the internal and external discoloration. The formation of acquired pellicle on the surface of a material varies by the properties of material, and the pellicle interacts with denaturation agents, such as tannin and chlorhexidine, to form stains and also adsorbs staining substances. Therefore, for the quality and longevity of restorations, protocols for the evaluation of the influence of organic substances on the extrinsic staining of restorative materials should be included in the evaluation of aesthetic restorative materials.

Hygroscopic and hydrolytic effects in dental polymer networks

OBJECTIVES

The objective of this manuscript is to outline the factors associated with hygroscopic and hydrolytic effects in dental polymer networks, and to review the literature generated over the past thirty years or more in this area.

METHODS

Information was gathered from nearly 90 published articles or abstracts appearing in the dental and polymer literature. Studies were predominantly identified through a search of the PubMED database.

RESULTS

Studies were included that provided direct evidence for the uptake of solvent by a polymer network and its subsequent physical or chemical effect, or the loss of molecular species into solvents. An attempt was made to select articles that spanned the timeframe from approximately 1970 to today to ensure that most of the classic literature as well as the latest information was included.

CONCLUSIONS

Dental polymer networks have been shown to be susceptible to hygroscopic and hydrolytic effects to varying extents dependent upon their chemistry and structure. The importance of these effects on the clinical performance of polymer restoratives is largely unknown, though numerous investigators have alluded to the potential for reduced service lives.

SIGNIFICANCE

While the physical and mechanical properties of these materials may be significantly altered by the effects of solvent uptake and component elution, what may constitute the greatest concern is the short-term release of unreacted components and the long-term elution of degradation products in the oral cavity, both of which should be strongly considered during restorative material development.

Discoloration of dental resin composites after immersion in a series of organic and chemical solutions

The objective of this study was to evaluate the color change of dental resin composites following a series of immersion treatments, especially in organic substances. The color of four resin composites was measured according to the CIELAB color scale relative to the standard illuminant D65. Color was measured at baseline, and after sequential immersion in the following substances: Step 1, porcine-liver esterase (a substitute for a salivary esterase); Step 2, organic substances (mucin and serum) and phosphate-buffered saline (PBS) as a control; Step 3, chemical alteration agents [chlorhexidine (CH) and carbamide peroxide (CP)]; and Step 4, 2% methylene blue. Porcine-liver esterase caused color changes (DeltaE(ab) (*)) of 0.7-1.1 from the baseline. Organic substances caused color changes of 0.4-1.8 from the baseline, and color changes in organic substances were not significantly higher than those in PBS (p > 0.05), except for one composite. Combined treatment with mucin (or serum) with CH (or CP) did not produce significantly higher color changes compared to controls (p > 0.05). Mucin-treated composites showed generally lower methylene blue staining compared to serum and PBS groups. Although combined treatment of organic substances and chemical agents resulted in various discolorations of resin composites, chemical alteration of organic substances did not produce higher color change compared to PBS controls.