Light-cured dimethacrylate-based resins and their composites: comparative study of mechanical strength, water sorption and ion release

Ion release mechanisms in composites containing CaP particles and hydrophilic monomers

OBJECTIVE

To investigate the effect of hydrophilic/permeable polymer matrices on water sorption/solubility (WS/SL), Ca2+ release, mechanical properties and hydrolytic degradation of composites containing dicalcium phosphate dihydrate (DCPD) particles.

METHODS

Six composites were tested, all with 10 vol% of glass particles and either 30 vol% or 40 vol% DCPD. Composites containing 1BisGMA:1TEGDMA in mols (at both inorganic levels) were considered controls. Four materials were formulated where 0.25 or 0.5 of the BisGMA/TEGDMA was replaced by pyromellitic dianhydride glycerol dimethacrylate (PMGDM)/ polyethylene glycol dimethacrylate (PEGDMA). Composites were tested for degree of conversion (FTIR spectroscopy), WS/SL (ISO 4049) and Ca2+ release (inductively coupled plasma optical emission spectroscopy). Fracture toughness (FT) and biaxial flexural strength/modulus (BFS/FM) were determined after 24 h and 60 days in water. The contributions of diffusional and relaxational mechanisms to Ca2+ release kinetics were analyzed using the semi-empirical Salim-Peppas model. Data were analysed by ANOVA/Tukey test (alpha: 0.05).

RESULTS

WS/SL was higher for composites containing PMGDM/PEGDMA compared to the controls (p < 0.001). Only at 40% DCPD the 0.5 PMGDM/PEGDMA composite showed statistically higher Ca2+ release than the control. Relaxation diffusion was the main release mechanism. Initial FT was not negatively affected by matrix composition. BFS (both DCPD fractions) and FM (30% DCPD) were lower for composites with hydrophilic/permeable networks (p < 0.01). After 60 days in water, composites with PMGDM/PEGDMA presented significant reductions in FT, while all composites had reductions in BFS/FM.

SIGNIFICANCE

Increasing matrix hydrophilicity/permeability significantly increased Ca2+ release only at a high DCPD fraction.

Polymerization shrinkage behaviour of resin composites functionalized with unsilanized bioactive glass fillers

Previous work has shown that partial replacement of reinforcing fillers with unsilanized silica particles can diminish polymerization shrinkage stress of dental resin composites. The aim of the present study was to investigate whether such an effect can be attained by using unsilanized bioactive glass (BG). Incorporating BG fillers into resin composites is interesting due to their potential for exerting caries-preventive effects. Experimental light-curable composites with a total filler load of 77 wt% were prepared. Reinforcing fillers were partially replaced with 0-60 wt% of BG 45S5 and an experimental low-sodium fluoride-containing BG. The following properties were investigated: linear shrinkage, degree of conversion, shrinkage stress, maximum shrinkage stress rate, and time to achieve maximum shrinkage stress rate. The diminishing effect of BG 45S5 on shrinkage stress was mediated by a decrease in degree of conversion caused by this BG type. In contrast, as the degree of conversion remained unaffected by the experimental BG, the resulting shrinkage behaviour was governed by the effect of varying amounts of silanized and unsilanized fillers on material's viscoelastic properties. The replacement of silanized reinforcing fillers with unsilanized BG did not reduce polymerization shrinkage stress unless the reduction was attained indirectly through a diminished degree of conversion.

Long-term water sorption and solubility of experimental bioactive composites based on amorphous calcium phosphate and bioactive glass

The aim of this study was to evaluate water sorption and solubility of two series of experimental composites containing amorphous calcium phosphate (ACP) or bioactive glass (BG). Water sorption and solubility were measured for up to 287 days. The surface precipitation of calcium phosphates was evaluated by scanning electron microscopy. The ACP-series showed higher water sorption (223-568 µg/mm³) than the BG-series (40-232 µg/mm³). In contrast, the ACP-series had generally lower solubility (37-106 µg/mm³) than the BG-series (1-506 µg/mm³). The constant specimen mass for the ACP-series was attained after 14 days of water immersion, while the mass decrease due to long-term solubility in the BG-series lasted beyond 287 days. Calcium phosphates precipitated in composites with the BG filler loading of 10 wt% or more, as well as in all of the ACP-containing composites. The experimental composite series showed water sorption and solubility considerably higher than commercial materials.

A review of bioceramics-based dental restorative materials

Currently, much has been published related to conventional resin-based composites and adhesives; however, little information is available about bioceramics-based restorative materials. The aim was to structure this topic into its component parts and to highlight the translational research that has been conducted up to the present time. A literature search was done from indexed journals up to September 2017. The main search terms used were based on dental resin-based composites, dental adhesives along with bioactive glass and the calcium phosphate family. The results showed that in 123 articles, amorphous calcium phosphate (39.83%), hydroxyapatite (23.5%), bioactive glass (16.2%), dicalcium phosphate (5.69%), monocalcium phosphate monohydrate (3.25%), and tricalcium phosphate (2.43%) have been used in restorative materials. Moreover, seven studies were found related to a newly developed commercial bioactive composite. The utilization of bioactive materials for tooth restorations can promote remineralization and a durable seal of the tooth-material interface.

Antimicrobial Monomers for Polymeric Dental Restoratives: Cytotoxicity and Physicochemical Properties

A trend for the next generation of polymeric dental restoratives is to incorporate multifunctional capabilities to regulate microbial growth and remineralize tooth surfaces. Polymerizable 2-(methacryloyloxy)-N-(2-(methacryloyloxy)ethyl)-N,N-dimethylethan-1-aminium bromide (IDMA1) and N,N′-([1,1′-biphenyl]-2,2′-diylbis(methylene))bis(2-(methacryloyloxy)-N,N-dimethylethan-1-aminium) bromide (IDMA2), intended for utilization in bi-functional antimicrobial and remineralizing composites, were synthesized, purified with an ethanol-diethyl ether-hexane solvent system, and validated by nuclear magnetic resonance (¹H and ¹³C NMR) spectroscopy, mass spectrometry, and Fourier-transform infrared spectroscopy. When incorporated into light-curable urethane dimethacrylate (UDMA)/polyethylene glycol-extended UDMA (PEG-U)/ethyl 2-(hydroxymethyl)acrylate (EHMA) (assigned UPE) resins, IDMAs did not affect the overall resins’ hydrophilicity/hydrophobicity balance (water contact angle: 60.8–65.5°). The attained degrees of vinyl conversion (DVC) were consistently higher in both IDMA-containing copolymers and their amorphous calcium phosphate (ACP) composites (up to 5% and 20%, respectively) reaching 92.5% in IDMA2 formulations. Notably, these high DVCs values were attained without an excessive increase in polymerization stress. The observed reduction in biaxial flexure strength of UPE-IDMA ACP composites should not prevent further evaluation of these materials as multifunctional Class V restoratives. In direct contact with human gingival fibroblasts, at biologically relevant concentrations, IDMAs did not adversely affect cell viability or their metabolic activity. Ion release from the composites was indicative of their strong remineralization potential. The above, early-phase biocompatibility and physicochemical tests justify further evaluation of these experimental materials to identify formulation(s) suitable for clinical testing. Successful completion is expected to yield a new class of restoratives with well-controlled bio-function, which will physicochemically, mechanically, and biologically outperform the conventional Class V restoratives.

Bioactive composites containing TEGDMA-functionalized calcium phosphate particles: Degree of conversion, fracture strength and ion release evaluation

OBJECTIVE

To evaluate the strength and ion release of experimental composites containing TEGDMA-functionalized calcium phosphate particles.

METHODS

Seven composites containing equal parts (in mols) of BisGMA and TEGDMA and 60vol% of fillers were manipulated. Filler phase was constituted by silanized barium glass and 0% (control), 10% or 20% (volume) of dicalcium phosphate dihydrate (DPCD) particles, either non-functionalized or functionalized with two different TEDGMA contents. DCPD particles were synthesized and characterized by X-ray diffraction (XRD), elemental analysis, surface area and dynamic light scattering. Composites were tested for degree of conversion (DC) by near-FTIR. Biaxial flexural strength (BFS) was determined after 24h and 28days in water. Calcium and phosphate release after 7days was assessed using inductively coupled plasma optical emission spectrometry (ICP-OES). Data were analyzed by ANOVA/Tukey test (alpha:5%).

RESULTS

XRD confirmed the crystalline structure corresponding to DCPD. Elemental analysis revealed particles with zero, 14% or 22% TEGDMA, with similar D₅₀ (around 19μm) and surface areas from 3.5 to 11.4m²/g. The presence of DCPD did not reduce DC. After 24h, functionalization (both 14% and 22% TEGDMA) improved composite strength in comparison to non-functionalized DCPD, both at 10% and 20% levels. After 28days, BFS of materials containing 10% functionalized DCPD were statistically similar to the control containing only barium glass. Among composites containing 10% DCPD, particle functionalization with 14% TEGDMA did not jeopardize ion release.

SIGNIFICANCE

At 10vol%, the use of TEGDMA-functionalized CaP particles improved composite strength in relation to non-functionalized particles, while maintaining similar ion release levels.

Conversion and temperature rise of remineralizing composites reinforced with inert fillers

OBJECTIVES

Remineralizing experimental composites based on amorphous calcium phosphate (ACP) were investigated. The impact of curing time (20 and 40s), curing depth (1, 2, 3 and 4mm) and addition of inert fillers (barium glass and silica) on the conversion and temperature rise during curing were examined.

METHODS

Five ACP-composites and two control composites were prepared based on the light-curable EBPADMA-TEGDMA-HEMA resin. For temperature measurements, a commercial composite was used as an additional control. Conversion was assessed using FT-Raman spectroscopy by comparing the relative change of the band at 1640 cm(-1) before and after polymerization. The temperature rise during curing was recorded in real-time using a T-type thermocouple.

RESULTS

At 1mm depth, the ACP-composites attained significantly higher conversion (77.8-87.3%) than the control composites based on the same resin (60.5-66.3%). The addition of inert fillers resulted in approximately 5% lower conversion at clinically relevant depths (up to 2mm) for the curing time of 40s. Conversion decline through depths depended on the added inert fillers. Conversion values higher than 80% of the maximum conversion were observed for all of the ACP-composites at depths up to 3mm, when cured for 40s. Significantly higher total temperature rise for the ACP-composites (11.5-13.1 °C) was measured compared to the control composites (8.6-10.8 °C) and the commercial control (8.7 °C).

CONCLUSIONS

The admixture of inert fillers represents a promising strategy for further development of ACP-composites, as it reduced the temperature rise while negligibly impairing the conversion.

CLINICAL SIGNIFICANCE

High conversions of ACP-composites are favorable in terms of mechanical properties and biocompatibility. However, high conversions were accompanied with high temperature rise, which might present a pulpal hazard.

Reinforcement of experimental composite materials based on amorphous calcium phosphate with inert fillers

OBJECTIVES

The aim of this study was to examine the influence of the addition of glass fillers with different sizes and degrees of silanization percentages to remineralizing composite materials based on amorphous calcium phosphate (ACP).

METHODS

Four different materials were tested in this study. Three ACP based materials: 0-ACP (40 wt% ACP, 60 wt% resin), Ba-ACP (40 wt% ACP, 50 wt% resin, 10 wt% barium-glass) and Sr-ACP (40 wt% ACP, 50 wt% resin, 10 wt% strontium-glass) were compared to the control material, resin modified glass ionomer (Fuji II LC capsule, GC, Japan). The fillers and composites were characterized using scanning electron microscopy. Flexural strength and modulus were determined using a three-point bending test. Calcium and phosphate ion release from ACP based composites was measured using inductively coupled plasma atomic emission spectroscopy.

RESULTS

The addition of barium-glass fillers (35.4 (29.1-42.1) MPa) (median (25-75%)) had improved the flexural strength in comparison to the 0-ACP (24.8 (20.8-36.9) MPa) and glass ionomer control (33.1 (29.7-36.2) MPa). The admixture of strontium-glass (20.3 (19.5-22.2) MPa) did not have any effect on flexural strength, but significantly improved its flexural modulus (6.4 (4.8-6.9) GPa) in comparison to 0-ACP (3.9 (3.4-4.1) GPa) and Ba-ACP (4.6 (4.2-6.9) GPa). Ion release kinetics was not affected by the addition of inert fillers to the ACP composites.

SIGNIFICANCE

Incorporation of barium-glass fillers to the composition of ACP composites contributed to the improvement of flexural strength and modulus, with no adverse influence on ion release profiles.

Effect of food stimulated liquids and thermocycling on the monomer elution from a nanofilled composite

The present study was aimed to evaluate the effects of food simulating liquids and thermocycling on the elution of monomers from a nanofilled resin composite in different immersion times. Five Specimen discs were made from a nano-hybrid composite (Supreme 3M) for each group (Total = 180) and immersed in distilled water (control), citric acid, lactic acid, and 75% aqueous ethanol solution. The discs were removed after 24 h, 48 h, 72 h, 1 wk, 4 wk, and 12 wk. Three groups of samples underwent thermocycling for 1000, 2000 and 3000 cycles. The solutes were analyzed with HPLC for detection of eluted monomers. The results showed that the amount of released TEGDMA was significantly higher than that of Bis-GMA; however, there were not any significant differences between the amount of released Bis-GMA and UDMA. Moreover, the highest amount of monomers was released from samples immersed in ethanol solution; samples immersed in citric acid and lactic acid significantly released more monomers than those immersed in distilled water. Furthermore, the immersion time in aqueous ethanol solution had an increasing effect on the release of monomers. In addition, the higher amounts of monomers were release from samples immersed in ethanol and citric acid which underwent a higher number of thermal cycles. In conclusion, food and drink stimulated liquids used in this study increased the amount of some of the monomers released from composite resin. Thermal shocks and storage time are other factors that increased the release of monomers from the composite resin

Effect of silanized nanosilica addition on remineralizing and mechanical properties of experimental composite materials with amorphous calcium phosphate

OBJECTIVES

Experimental composite resins with amorphous calcium phosphate (ACP) have the potential to regenerate demineralized tooth structures. The aim of the study was to investigate the effect of the addition of silanized silica nanofillers to the ACP-based composites on their mechanical properties and the kinetics of calcium and phosphate release.

MATERIALS AND METHODS

The test materials comprised 5 wt% (5-ACP) or 10 wt% (10-ACP) of silanized silica admixed to the 40 wt% ACP and 50 or 55 wt% resin. The ACP control (0-ACP) contained 40 wt% ACP and 60 wt% resin. Additionally, composite material CeramX (Dentsply, Germany) was included as control. Three-point bending test was performed to calculate flexural strength and modulus of elasticity. Inductively coupled plasma atomic emission spectroscopy was used for measurement of ion release. The micromorphology of calcium phosphate depositions on composite samples has been qualitatively evaluated using a scanning electron microscope. The results were analyzed using Mann-Whitney and Wilcoxon rank sum tests (α < 0.05).

RESULTS

Ion release was enhanced by the silica fillers, when compared to the 0-ACP. Although not statistically significant, flexural strength of 10-ACP was improved by 46 % compared to 0-ACP. Flexural modulus of 5-ACP was significantly higher than 0-ACP.

CONCLUSIONS

The admixture of silanized fillers seems to be a promising approach for the improvement of mechanical and remineralizing properties of ACP composite resins.

CLINICAL RELEVANCE

ACP-based composite resins with modified composition could serve as an effective remineralizing aid as base materials in restorative dental medicine.

Performance of the experimental resins and dental nanocomposites at varying deformation rates

AIM

The aim of the present study was to evaluate the bi-axial flexural strength of experimental unfilled resins and resin-based composites at varying deformation rates following 1-week dry, 1-week wet, and 13-week wet storage regimes.

METHODS

A total of 270 disc-shaped specimens (12 mm diameter, 1 mm thickness) of either unfilled resins or experimental resin-based composites comprising of three groups (n = 90) were fabricated. Three groups of each unfilled resin and resin-based composites (n = 90) were stored for 1 week under dry conditions, and at 1 and 13 weeks under wet conditions (37 ± 1°C) before testing. The bi-axial flexural strength of each unfilled resin and resin-based composites group was determined at a 0.1, 1, and 10 mm/min deformation rate (n = 30).

RESULTS

The unfilled resins revealed a deformation rate dependence following all storage regimes; however, the addition of fillers in the unfilled resins modified such reliance following the 1-week dry and 13-week wet storage regimes. In contrast, a lower bi-axial flexural strength of the 1-week wet resin-based composites specimens at a 0.1 mm/min deformation rate was identified.

CONCLUSION

A lower bi-axial flexural strength of the 1-week wet resin-based composites specimens at a low deformation rate suggests that premature failure of resin-based composites restorations might occur in patients with parafunctional habits, such as bruxism.

High strength re-mineralizing, antibacterial dental composites with reactive calcium phosphates

OBJECTIVE

Development of high strength dental composites with adhesive, antibacterial and re-mineralizing potential.

MATERIALS

Urethane and triethylene glycol dimethacrylates were combined with HEMA (10 or 20wt%) and 2MP (2 or 10wt%), antibacterial chlorhexidine (2.5wt%) and chemical cure initiators. Reactive mono/tri calcium phosphate (CP) mixed with silica/silicon carbide nanoparticles (S) (CP:S weight ratio 1:2 or 2:1) was added (50wt%).

RESULTS

Decreasing CP/S ratio and HEMA content reduced monomer conversion at 15min from 93 to 63%. Conversely, decreasing CP/S increased initial "dry" compressive (137-203MPa) and flexural (79-116MPa) strength. With high HEMA content, these decreased by ∼15-20MPa upon 24h water storage. With low HEMA content, average decline was <8MPa due to reduced water sorption. Early water sorption induced mass increase, volume expansion, mono calcium phosphate dissolution and chlorhexidine release, were proportional to the initial calcium phosphate content. Furthermore, they increased ∼1.5 fold upon raising HEMA wt%. These diffusion controlled processes and strength decline slowed after 24h as phosphates reaction bound water within the materials. Increasing 2MP concentration reduced calcium release but did not affect strength. Formulations with high CP/S indicated greater antibacterial activity in agar diffusion and in vitro biofilm tests.

SIGNIFICANCE

New material use beneath a conventional composite could potentially reduce high failure rates associated with residual caries and bacterial microleakage.

Ultra-small-angle X-ray scattering-X-ray photon correlation spectroscopy studies of incipient structural changes in amorphous calcium phosphate-based dental composites

The local structural changes in amorphous calcium phosphate (ACP)-based dental composites were studied under isothermal conditions using both static, bulk measurement techniques and a recently developed methodology based on combined ultra-small angle X-ray scattering-X-ray photon correlation spectroscopy (USAXS-XPCS), which permits a dynamic approach. While results from conventional bulk measurements do not show clear signs of structural change, USAXS-XPCS results reveal unambiguous evidence for local structural variations on a similar time scale to that of water loss in the ACP fillers. A thermal-expansion-based simulation indicates that thermal behavior alone does not account for the observed dynamics. Together, these results suggest that changes in the water content of ACP affect the composite morphology due to changes in ACP structure that occur without an amorphous-to-crystalline conversion. It is also noted that biomedical materials research could benefit greatly from USAXS-XPCS, a dynamic approach.

Light-curable polymer/calcium phosphate nanocomposite glue for bone defect treatment

Light-curable, methacrylate-based resins are clinically used for complex defect repair in dentistry (Heliobond). The present study investigates how such easy-to-apply polymers may be used on a much broader range of applications, particularly for gluing wet bone. We investigate the significantly improved adhesion of the polymer to wet bone surfaces in a close to in vivo setup using freshly cut cow hip bone as a model. The use of a reactive filler (20 wt.% amorphous, glassy calcium phosphate nanoparticles, a-CaP) allows for combination of the properties of the polymer (strength; light-curing) and the reactive filler (recrystallization of amorphous CaP to hydroxyapatite within minutes). This filler alone has been earlier suggested for use as an injectable bone cement since it reacts under in vivo conditions within 10-15 min. Our study transfers this reactivity into a composite, thus using the reactive CaP phase to establish an improved adhesion of the composite to wet bone surfaces. Additional in vitro bioactivity tests, compressive and tensile strength suggest use of such light-curable nanocomposites for complex-shaped load-bearing implant materials and fracture repair.

Degree of vinyl conversion, polymerization shrinkage and stress development in experimental endodontic composite

This study explores degree of vinyl conversion (DVC), polymerization shrinkage (PS) and shrinkage stress (PSS) of the experimental amorphous calcium phosphate (ACP) composites intended for use as an endodontic sealer. Light-cure (LC), chemical cure (CC) or dual-cure (DC; combined light and chemical cure) resins comprised urethane dimethacrylate (UDMA), 2-hydroxyethyl methacrylate (HEMA), methacryloyloxyethyl phthalate (MEP) and a high molecular mass oligomeric co-monomer, poly(ethyleneglycol)-extended UDMA (PEG-U) (designated UPHM resin). To fabricate composites, a mass fraction of 60 % UPHM resin was blended with a mass fraction of 40 % as-made (am-ACP) or ground ACP (g-ACP). DVC values of copolymer (unfilled UPHM resin) and composite specimens were determined by infrared spectroscopy. Glass-filled composites were used as controls. PS and PSS of composites were determined by dilatometry and tensometry, respectively. LC copolymers attained extraordinary high DVC values at 24 h post-cure (95.7 %), compared to CC (52 %) and DC (79.3 %) copolymer specimens. While the DVC values of LC and DC am-ACP composites were reduced between 5 and 10 %, DVC values of DC g-ACP composites increased almost 8 % compared to the corresponding copolymers. High DVC attained in LC composites was, expectedly, accompanied with high PS values (on average 7 vol%). However, PSS developed in LC and especially DC composites did not exceed PSS values seen in other UDMA-based composites. Based on this initial evaluation, it is concluded that, DC, g-ACP filled UPHM composite shows promise as an endodontic sealer. However, further physicochemical evaluations, including water sorption, mechanical stability and ion release as well as a leachability studies need to be performed before this experimental material is tested for cellular responses and, eventually recommended for clinical utility.

In vitro remineralization of enamel by polymeric amorphous calcium phosphate composite: quantitative microradiographic study

OBJECTIVE

This study explores the efficacy of an experimental orthodontic amorphous calcium phosphate (ACP) composite to remineralize in vitro subsurface enamel lesions microradiographically similar to those seen in early caries.

METHODS

Lesions were artificially created in extracted human molars. Single tooth sections a minimum of 120microm thick were cut and individually placed in holders exposing only the carious enamel surface. The exposed surfaces were either left untreated (control) or coated with a 1mm thick layer of the experimental ACP composite (mass fraction 40% zirconia-hybridized ACP and 60% photo-activated resin), or a commercial fluoride-releasing orthodontic cement. The composite-coated sections were then photo-cured and microradiographic images were taken of all three groups of specimens before the treatment. Specimens were then cyclically immersed in demineralizing and remineralizing solutions for 1 month at 37 degrees C to simulate the pH changes occurring in the oral environment. Microradiographs of all specimens were taken before and after treatment.

RESULTS

Quantitative digital image analysis of matched areas from the contact microradiographs taken before and after treatment indicated higher mineral recovery with ACP composites compared to the commercial orthodontic F-releasing cement (14.4% vs. 4.3%, respectively), while the control specimens showed an average of 55.4% further demineralization.

SIGNIFICANCE

Experimental ACP composite efficiently established mineral ion transfer throughout the body of the lesions and restored the mineral lost due to acid attack. It can be considered a useful adjuvant for the control of caries in orthodontic applications.