A Review on the Current State of Microcapsule-Based Self-Healing Dental Composites

Resin-based dental composites, commonly used in dentistry, offer several advantages including minimally invasive application, esthetically pleasing appearance, and good physical and mechanical properties. However, these dental composites can be susceptible to microcracks due to various factors in the complex oral environment. These microcracks can potentially lead to clinical restoration failure. Conventional materials and methods are inadequate for detecting and repairing these microcracks in situ. Consequently, incorporating self-healing properties into dental composites has become a necessity. Recent years have witnessed rapid advancements in self-healing polymer materials, drawing inspiration from biological bionics. Microcapsule-based self-healing dental composites (SHDCs) represent some of the most prevalent types of self-healing materials utilized in this domain. In this article, we undertake a comprehensive review of the most recent literature, highlighting key insights and findings related to microcapsule-based SHDCs. Our discussion centers particularly on the preparation techniques, application methods, and the promising future of self-healing microcapsules in the field of dentistry.

Effect of silanization of poly (urea-formaldehyde) microcapsules on the flexural strength and self-healing efficiency of an experimental self-healing dental resin composite (An in-vitro study)

OBJECTIVES

This study investigated the impact of using γ-methacryloxypropyl trimethoxy silane (MPS) for surface silanization of poly (urea-formaldehyde) (PUF) microcapsules which enclose a healing liquid of "triethylene glycol dimethacrylate (TEGDMA) and N,N dihydroxyethyl-p-toluidine (DHEPT)" on some mechanical properties of an experimental dental composite as well as its self-healing efficiency.

METHODS

Synthesis of PUF microcapsules was done via in situ polymerization, followed by silanization with MPS silane. Silanized and non-silanized microcapsules were incorporated into a composite containing 30% polymer matrix and 70% fillers at different weight percentages (0%, 5%, 7.5% and 10%). The composite strength and elastic modulus were evaluated by Flexural testing. Fracture toughness KIc and self-healing efficiency were assessed by utilizing the "single edge notched beam" method.

RESULTS

Flexural strength of all groups containing silanized microcapsules was non-significantly different from control group without microcapsules. However, in contrast to control group, all groups containing non-silanized microcapsules displayed considerably decreased flexural strength. Adding silanized and non-silanized microcapsules didn't show a significant change in the KIc-virgin. The silanized microcapsules' groups achieved a self-healing efficiency of about 49-77% recovery in KIc-virgin compared to 38-69% for their non-silanized counterparts.

SIGNIFICANCE

In order to increase the interfacial adhesion with the polymer matrix, improve the mechanical properties, and increase the efficiency of self-healing of dental resin composite, PUF microcapsules were silanized for the first time in the dental field using MPS silane. This innovative silanized microcapsule-containing self-healing composite may hold promise for repairing the damage caused by restorative cracks and extending their service life.

The short-term toxicity and metabolome of dicyclopentadiene

Dicyclopentadiene (DCPD) was investigated in a 14-day oral rat toxicity study based on the OECD 407 guideline in combination with plasma metabolomics. Wistar rats received the compound daily via gavage at dose levels of 0, 50 and 150 mg/kg bw. The high dose induced transient clinical signs of toxicity and in males only reduced body weight gain. High dose liver changes were characterized by altered clinical chemistry parameters in both sexes and pathological changes in females. In high dose males an accumulation of alpha-2 u-globulin in the kidney was noted. Comparing the DCPD metabolome with previously established specific metabolome patterns in the MetaMap® Tox data base suggested that the high dose would result in liver enzyme induction leading to increased breakdown of thyroid hormones for males and females. An indication for liver toxicity in males was also noted. Metabolomics also suggested an effect on the functionality of the adrenals in high dose males, which together with published data, is suggestive of a stress related effect in this organ. The results of the present 14-day combined toxicity and metabolome investigations were qualitatively in line with literature data from subchronic oral studies in rats with DCPD. Importantly no other types of organ toxicity, or hormone dysregulation beyond the ones associated with liver enzyme induction and stress were indicated, again in line with results of published 90-day studies. It is therefore suggested that short term "smart" studies, combining classical toxicity with 'omics technologies, could be a 2 R (refine and reduce) new approach method allowing for the reduction of in vivo toxicity testing.

Strategies to design extrinsic stimuli-responsive dental polymers capable of autorepairing

Objectives

For many years, the requirements for dental polymers were limited to inertially filling the cavity and restoring form, function, and esthetics. Inorganic filler systems were widely enhanced to maximize the mechanical properties and optimize finishing and polishing procedures. The development of alternative photoinitiator systems also improved the carbon-carbon double bond conversion, increasing biocompatibility, wear, and stain resistance. However, despite laudable progress, the clinical life span of dental restorations is still limited, and their replacement is the most common procedure in dental offices worldwide. In the last few years, the development of materials with the potential to adapt to physiological stimuli has emerged as a key step to elevating dental polymers to a higher excellence level. In this context, using polymeric networks with self-healing properties that allow for the control of the propagation of microcracks is an appealing strategy to boost the lifetime of dental restorations. This review aims to report the current state-of-the-art of extrinsic self-healing dental polymers and provide insights to open new avenues for further developments. General classification of the self-healing polymeric systems focusing on the current extrinsic strategies used to inhibit microcracks propagation in dental polymers and recover their structural integrity and toughness are presented.

Search Strategy

An electronic search was perfomed using PubMed, Google Scholar, and Scopus databases. Only studies published in English on extrinsic self-healing polymeric systems were included.

Overall Conclusions

Self-healing materials are still in their infancy in dentistry, and the future possibilities are almost limitless. Although the mouth is a unique environment and the restorative materials have to survive chemical, physical, and mechanical challenges, which limits the use of some strategies that might compromise their physicochemical performance, there are countless untapped opportunities to overcome the challenges of the current systems and advance the field.

Appraisal of the human health related toxicological information available on dicyclopentadiene (DCPD) in view of assessing the substance's potential to cause endocrine disruption

Dicyclopentadiene (DCPD) is an olefinic hydrocarbon which is manufactured and imported into the European Union (EU) at greater than 1000 tons per year. Concerns related to fetotoxic effects observed in reproductive toxicity studies at high doses led the REACH registrants to self-classify DCPD as a Category 2 reproductive toxicant under the EU CLP Regulation. DCPD was also reviewed in the European Union in the frame of an ongoing European Chemical Agency (ECHA) Community Rolling Action Plan (CoRAP) procedure and under the French National Strategy on Endocrine Disruptors (SNPE). To elucidate whether the developmental effects may be triggered by an endocrine mode of action, the Lower Olefins Sector Group (LOSG) of the European Chemical Industry Council (CEFIC) formed an ad hoc expert team to review the available scientific information pertaining to the potential endocrine activity and adversity of DCPD. Existing experimental data was complemented with structure activity modelling using ECHA-recommended (Q)SAR tools. Overall, considering the available information from (Q)SAR, mechanistic in vitro and in vivo studies, no indication of endocrine-mediated adversity was found. Hence, the available evidence supports the conclusion that DCPD does not cause developmental toxicity via an endocrine mode of action. Further work is ongoing to support this conclusion.

Resin based restorative dental materials: characteristics and future perspectives

This review article compiles the characteristics of resin based dental composites and an effort is made to point out their future perspectives. Recent research studies along with few earlier articles were studied to compile the synthesis schemes of commonly used monomers, their characteristics in terms of their physical, mechanical and polymerization process with selectivity towards the input parameters of polymerization process. This review covers surface modification processes of various filler particles using silanes, wear behaviour, antimicrobial behaviour along with its testing procedures to develop the fundamental knowledge of various characteristics of resin based composites. In the end of this review, possible areas of further interests are pointed out on the basis of literature review on resin based dental materials.

Effects of water-aging on self-healing dental composite containing microcapsules

OBJECTIVES

The objectives of this study were to develop a self-healing dental composite containing poly(urea-formaldehyde) (PUF) shells with triethylene glycol dimethacrylate (TEGDMA) and N,N-dihydroxyethyl-p-toluidine (DHEPT) as healing liquid, and to investigate the mechanical properties of the composite and its self-healing efficacy after water-aging for 6 months.

METHODS

PUF microspheres were synthesized encapsulating a TEGDMA-DHEPT healing liquid. Composite containing 30% of a resin matrix and 70% of glass fillers by mass was incorporated with 0%, 2.5%, 5%, 7.5% and 10% of microcapsules. A flexural test was used to measure flexural strength and elastic modulus. A single edge V-notched beam method was used to measure fracture toughness (KIC) and self-healing efficacy. Specimens were water-aged at 37 °C for 1 day to 6 months and then tested for self-healing. Fractured specimens were healed while being immersed in water to examine self-healing efficacy, in comparison with that in air.

RESULTS

Incorporation of up to 7.5% of microcapsules into the resin composite achieved effective self-healing, without adverse effects on the virgin mechanical properties of the composite (p>0.1). An excellent self-healing efficacy of 64-77% recovery was obtained (mean±sd; n=6). Six months of water-aging did not decrease the self-healing efficacy compared to 1 day (p>0.1). Exposure to water did not decrease the healing efficacy, compared to that healed in air (p>0.1).

CONCLUSIONS

A composite was developed with excellent self-healing efficacy even while being immersed in water. The self-healing efficacy did not decrease with increasing water-aging time for 6 months.

CLINICAL SIGNIFICANCE

The novel self-healing composite may be promising for dental applications to heal cracks, resist fracture, and increase the durability and longevity.

Novel self-healing dental resin with microcapsules of polymerizable triethylene glycol dimethacrylate and N,N-dihydroxyethyl-p-toluidine

OBJECTIVE

Bulk fracture is one of the primary reasons for resin-based dental restoration failures. To date, there has been no report on the use of polymerizable dental monomers with acceptable biocompatibility to develop a resin with substantial self-healing capability. The objectives of this study were to: (1) develop a self-healing resin containing microcapsules with triethylene glycol dimethacrylate (TEGDMA)-N,N-dihydroxyethyl-p-toluidine (DHEPT) healing liquid in poly(urea-formaldehyde) (PUF) shells for the first time, and (2) determine the physical and mechanical properties, self-healing efficiency, and fibroblast cytotoxicity.

METHODS

Microcapsules of polymerizable TEGDMA-DHEPT in PUF were prepared via an in situ polymerization method. Microcapsules were added into a BisGMA-TEGDMA resin at microcapsule mass fractions of 0%, 5%, 10%, 15% and 20%. A flexural test was used to measure composite strength and elastic modulus. A single edge V-notched beam method was used to measure fracture toughness KIC and self-healing efficiency.

RESULTS

Flexural strength and elastic modulus (mean±sd; n=6) of resin containing 5-15% microcapsules were similar to control without microcapsules (p>0.1). Adding microcapsules into the resin increased the virgin KIC, which was about 40% higher at 15% microcapsules than that with 0% microcapsules (p<0.05). Specimens were fractured and healed, then fractured again to measure the healed KIC. A self-healing efficiency of about 65% in KIC recovery was obtained with 10-20% microcapsules. All specimens with 0-20% microcapsules had fibroblast viability similar to control without resin eluents (p>0.1).

SIGNIFICANCE

Self-healing dental resin containing microcapsules with polymerizable TEGDMA-DHEPT healing liquid in PUF shells were prepared for the first time with excellent self-healing capability. These microcapsules and self-healing resins containing them may be promising for dental restorations to heal cracks/damage and increase durability.

Development of novel self-healing and antibacterial dental composite containing calcium phosphate nanoparticles

OBJECTIVES

Fracture and secondary caries are the primary reasons for dental restoration failure. The objective of this study was to develop a self-healing composite to heal cracks, while containing dimethylaminohexadecyl methacrylate (DMAHDM) for antibacterial function and nanoparticles of amorphous calcium phosphate (NACP) for remineralization.

METHODS

Microcapsules were synthesized with poly(urea-formaldehyde) (PUF) shells containing triethylene glycol dimethacrylate (TEGDMA) and N,N-dihydroxyethyl-p-toluidine (DHEPT) as healing liquid. Composite contained 20 mass% of NACP and 35% glass fillers. In addition, composite contained 0%, 2.5%, 5%, 7.5%, or 10% of microcapsules. A single edge V-notched beam method measured fracture toughness (KIC) and self-healing efficiency. A dental plaque microcosm biofilm model was used to test the antibacterial properties.

RESULTS

Incorporation of microcapsules up to 7.5% into the composite did not adversely affect the mechanical properties (p > 0.1). Successful self-healing was achieved, with KIC recovery of 65-81% (mean ± sd; n = 6) to regain the load-bearing capability after composite fracture. The self-healing DMAHDM-NACP composite displayed a strong antibacterial potency, inhibiting biofilm viability and lactic acid production, and reducing colony-forming units by 3-4 orders of magnitude, compared to control composite without DMAHDM.

CONCLUSIONS

A dental composite was developed with triple benefits of self-healing after fracture, antibacterial activity, and remineralization capability for the first time.

CLINICAL SIGNIFICANCE

The self-healing, antibacterial and remineralizing composite may be promising for tooth cavity restorations to combat bulk fracture and secondary caries. The method of using triple agents (self-healing microcapsules, DMAHDM, and NACP) may have wide applicability to other dental composites, adhesives, sealants and cements.

Results of a 90-day inhalation study of dicyclopentadiene in B6C3F1 mice

The objective of this inhalation study was to determine and evaluate the potential toxic effects of dicyclopentadiene vapor in mice exposed for 13-weeks of repeated inhalation. Four groups, each consisting of 45 male and 45 female B6C3F1 mice, were exposed to dicyclopentadiene vapor by inhalation 6 h/day, 5 days/week, for 13 weeks (64 exposures) at targeted concentrations of 0, 1.0, 5.0, or 50 ppm. An assessment of toxicity is carried out after 2, 6, and 13 weeks of inhalation exposures. Additionally, animals were evaluated during the recovery period of 4 or 13 weeks after the last exposure. Observations and measurements to assess toxicity include clinical observations, body weight, organ weights, serum chemistry, and hematologic, ophthalmologic, gross pathologic, and histologic evaluations. The only systemic effects observed were a few statistically significant changes in organ weights; but these were considered spurious in nature. Ten male and nine female mice in the highest exposure group died during the study, while no more than two mice died in any other group. However, the excess mortality was without an apparent etiology or association to exposure and was attributed to pulmonary congestion as a consequence of pulmonary irritation. Under the conditions of this study, these data demonstrated that in the absence of overt systemic toxicity, respiratory congestion has the predominant effect at the exposure levels of 50 ppm. This observation contributes to the Globally Harmonized System harmonized hazard classification of Single Target Organ Toxicity – Single Exposure (H335, may cause respiratory irritation) for this substance.