Influence of light-curing distance on degree of conversion and cytotoxicity of etch-and-rinse and self-etch adhesives

Influence of Battery Levels in Cordless LED Light-curing Units on Properties of Resin Cement and Glass Fiber Post Retention

PURPOSE

This study aimed to assess the impact of battery levels in single-peak and multi-peak light-curing units (LCUs) on irradiance, and their effects on glass fiber post push-out bond strength to root dentin and the degree of conversion of dual-cure universal resin cement.

METHODS AND MATERIALS

Sixty bovine roots underwent endodontic treatment and were randomly distributed into 6 groups (n=10), formed by combining two LCUs (single-peak and multipeak) and three battery levels (100%, 50%, and 10%). A spectrophotometer measured irradiance (mW/ cm2) and spectral irradiance (mW/cm2/nm). Push-out bond strength (PBS) tests occurred at three root regions (cervical, middle, and apical), with optical and scanning electron microscopy for failure mode analysis. Degree of conversion (DC) was evaluated across the root regions. Data were analyzed using two-way repeated measures ANOVA and the Tukey HSD test. The Fisher exact test verified failure modes (α=0.05).

RESULTS

As multipeak LCU battery levels decreased, emitted irradiance also diminished, with notable PBS reductions in the apical thirds. Failure modes were influenced by different conditions, primarily exhibiting mixed modes. Battery levels significantly impacted DC in the multipeak LCU, particularly in the cervical region, while the single-peak LCU exhibited DC reduction at the 10% battery level in the cervical region.

CONCLUSIONS

Emitted irradiance, resin cement DC, and glass fiber post bond strength to root dentin may be influenced by varying cordless LCUs and battery levels.

Impact of bisphenol A and analogues eluted from resin-based dental materials on cellular and molecular processes: An insight on underlying toxicity mechanisms

Dental resin systems, used for artificial replacement of teeth and their surrounding structures, have gained popularity due to the Food and Drug Administration's (FDA) recommendation to reduce dental amalgam use in high-risk populations and medical circumstances. Bisphenol A (BPA), an endocrine-disrupting chemical, is an essential monomer within dental resin in the form of various analogues and derivatives. Leaching of monomers from resins results in toxicity, affecting hormone metabolism and causing long-term health risks. Understanding cellular-level toxicity profiles of bisphenol derivatives is crucial for conducting toxicity studies in in vivo models. This review provides insights into the unique expression patterns of BPA and its analogues among different cell types and their underlying toxicity mechanisms. Lack of a consistent cell line for toxic effects necessitates exploring various cell lines. Among the individual monomers, BisGMA was found to be the most toxic; however, BisDMA and BADGE generates BPA endogenously and found to elicit severe adverse reactions. In correlating in vitro data with in vivo findings, further research is necessary to classify the elutes as human carcinogens or xenoestrogens. Though the basic mechanisms underlying toxicity were believed to be the production of intracellular reactive oxygen species and a corresponding decline in glutathione levels, several underlying mechanisms were identified to stimulate cellular responses at low concentrations. The review calls for further research to assess the synergistic interactions of co-monomers and other components in dental resins. The review emphasizes the clinical relevance of these findings, highlighting the necessity for safer dental materials and underscoring the potential health risks associated with current dental resin systems.

Double bond conversion of preheated composite resin beneath lithium disilicate standardized occlusal veneers

The purpose of the study was the investigation of the polymerization of a preheated composite resin beneath lithium disilicate. First, lithium disilicate discs in two shades (HT A2 and HT A4) and three different thicknesses (2, 4, and 6 mm) were bonded on dentine with preheated composite resin that was photo-polymerized for 20 s. The composite resin microhardness, the double bond conversion (DC) and their correlation were estimated. Second, standardized occlusal veneers of two shades and two different thicknesses (4 and 6 mm) were bonded with preheated composite resin and photopolymerized for 60 or 270 s. A microhardness line profiling was performed on the cross-section of each specimen and the correspondence DC was calculated. Shade and thickness of lithium disilicate were found to have a significant impact on micro-hardness and DC of the composite resin. Beneath standardized occlusal veneers DC can reach clinically acceptable level if photopolymerization duration is extended properly.

Fracture Strength of Composite Rest Seats: An In Vitro Comparative Study of Different Composite versus Amalgam Restorations

Occlusal rest provides support for removable partial dentures (RPD). Rest seats are ideally prepared in enamel, but the abutment teeth might be restored or need restorations. This study compared the fracture strength of abutments restored with composite to amalgam restorations after rest seat preparation. Disto-occlusal cavities were prepared in 30 extracted human maxillary premolars. The specimens were allocated in three groups (n = 10) based on the type of restoration. All the specimens were exposed to thermomechanical aging followed by cycling loading. Fracture strength was tested using a universal testing machine, and then, the fracture mode was recorded. The data were analyzed using Kruskal-Wallis test with a significance level set at 0.05. The fracture mode was recorded as catastrophic or non-catastrophic. The fracture strength between all tested groups showed no significant difference. The highest and lowest fracture strength were recorded on amalgam and Tetric N-Ceram groups, respectively. Composite Tetric N-Ceram showed equal distribution of fracture sites on the restorative materials and teeth, it also displayed the highest number of non-catastrophic fractures unlike other groups where the fracture occurred more within the restorations. The fracture strength of composite was comparable to that of amalgam restorations with prepared rest seats.

The influence of inorganic fillers on the light transmission through resin-matrix composites during the light-curing procedure: an integrative review

PURPOSE

The objective of this study was to perform an integrative review on the effect the inorganic fillers on the light transmission through the resin-matrix composites during the light-curing procedure.

METHOD

A bibliographic review was performed on PubMed using the following search terms: "fillers" OR "particle" AND "light curing" OR "polymerization" AND "light transmission" OR "light absorption" OR "light irradiance" OR "light attenuation" OR "light diffusion" AND "resin composite." The search involved articles published in English language in the last 10 years.

RESULTS

Selected studies reported a decrease in biaxial strength and hardness in traditional resin-matrix composites in function of the depth of polymerization. However, there were no significant differences in biaxial strength and hardness recorded along the polymerization depth of Bulk-Fill™ composites. Strength and hardness were enhanced by increasing the size and content of inorganic fillers although some studies revealed a progressive decrease in the degree of conversion on increasing silica particle size. The translucency of glass-ceramic spherical fillers promoted light diffusion mainly in critical situations such as in the case of deep proximal regions of resin-matrix composites.

CONCLUSIONS

The amount of light transmitted through the resin-matrix composites is influenced by the size, content, microstructure, and shape of the inorganic filler particles. The decrease of the degree of conversion affects negatively the physical and mechanical properties of the resin-matrix composites.

CLINICAL RELEVANCE

The type and content of inorganic fillers in the chemical composition of resin-matrix composites do affect their polymerization. As a consequence, the clinical performance of resin-matrix composites can be compromised leading to variable physical properties and degradation. The polymerization mode of resin-matrix composites can be improved according to the type of inorganic fillers in their chemical composition.

The influence of methodology on the comparison of cytotoxicity of total-etch and self-etch adhesive systems

OBJECTIVES

The present study aimed to compare the in vitro cytocompatibility of two etch-and-rinse (Adper Scothbond, Optibond) and two self-etch (Clearfill SE Bond and Single Bond Universal) dental adhesives through a dentin-barrier model with human pulp fibroblasts.

METHODS

Human fibroblasts were placed on a plastic device containing 500μm human dentin discs treated with each adhesive or without treatment (control). Other groups were directly exposed to media conditioned with adhesive samples according to ISO 10993-5:2009. After 24h exposure, cell viability was assessed by XTT, and released inflammatory mediators were detected with a multiparametric immunoassay.

RESULTS

The standardized test without barrier indicated both etch-and-rinse adhesives and self-etch as cytotoxic, promoting viabilities under 70% of the control group (p<0.05). The dentin-barrier model identified increased cell viability for self-etch adhesives, with Clearfill SE Bond identified as non-cytotoxic. The immunoassay evidenced high rates of cytokines by cells exposed to the conditioned media of Adper Scotchbond, Optibond S, and Single Bond Universal.

CONCLUSIONS

The use of a dentin-barrier in vitro model detected a better biocompatibility for self-etching adhesives and, in the case of Clearfill SE Bond, with a reversion from cytotoxic to biocompatible when compared to the indirect standardized test.

CLINICAL SIGNIFICANCE

The use of a dentin-barrier in vitro model was able to detect a better biocompatibility for self-etching adhesives when compared to the indirect standardized test and presents itself as a predictive in vitro method for assessing the cytotoxicity of dental restorative materials that may simulate the clinical condition more accurately.

Prosthetic Materials Used for Implant-Supported Restorations and Their Biochemical Oral Interactions: A Narrative Review

The purpose of this study is to outline relevant elements regarding the biochemical interactions between prosthetic materials used for obtaining implant-supported restorations and the oral environment. Implant-supported prostheses have seen unprecedented development in recent years, benefiting from the emergence of both new prosthetic materials (with increased biocompatibility and very good mechanical behavior), and computerized manufacturing technologies, which offer predictability, accuracy, and reproducibility. On the other hand, the quality of conventional materials for obtaining implant-supported prostheses is acknowledged, as they have already proven their clinical performance. The properties of PMMA (poly (methyl methacrylate))-which is a representative interim material frequently used in prosthodontics-and of PEEK (polyether ether ketone)-a biomaterial which is placed on the border between interim and final prosthetic use-are highlighted in order to illustrate the complex way these materials interact with the oral environment. In regard to definitive prosthetic materials used for obtaining implant-supported prostheses, emphasis is placed on zirconia-based ceramics. Zirconia exhibits several distinctive advantages (excellent aesthetics, good mechanical behavior, biocompatibility), through which its clinical applicability has become increasingly wide. Zirconia's interaction with the oral environment (fibroblasts, osteoblasts, dental pulp cells, macrophages) is presented in a relevant synthesis, thus revealing its good biocompatibility.

Effects of Adper™ Scotchbond™ 1 XT, Clearfil™ SE Bond 2 and Scotchbond™ Universal in Odontoblasts

This study aimed to assess the cytotoxicity of commercially available adhesive strategies-etch-and-rinse (Adper™ Scotchbond™ 1 XT, 3M ESPE, St. Paul, MN, USA, SB1), self-etch (Clearfil™ SE Bond 2, Kuraray Noritake Dental Inc., Tokyo, Japan, CSE), and universal (Scotchbond™ Universal, 3M Deutschland GmbH, Neuss, Germany, SBU). MDPC-23 cells were exposed to adhesives extracts in different concentrations and exposure times. To access cell metabolic activity, viability, types of cell death, and cell cycle, the MTT assay, SRB assay, double labeling with annexin V and propidium iodide, and labeling with propidium iodide/RNAse were performed, respectively. Cultures were stained with May-Grünwald Giemsa for qualitative cytotoxicity assessment. The SB1, CSE, and SBU extracts determined a significant reduction in cell metabolism and viability. This reduction was higher for prolonged exposures, even for less concentrated extracts. CSE extracts significantly reduced the cell's metabolic activity at higher concentrations (50% and 100%) from 2 h of exposure. After 24 and 96 h, a metabolic activity reduction was verified for all adhesives, even at lower concentrations. These changes were dependent on the adhesive, its concentration, and the incubation time. Regarding cell viability, SBU extracts were the least cytotoxic, and CSE was significantly more cytotoxic than SB1 and SBU. The adhesives determined a reduction in viable cells and an increase in apoptotic, late apoptosis/necrosis, and necrotic cells. Moreover, on cultures exposed to SB1 and CSE extracts, a decrease in the cells in S and G2/M phases and an increase in the cells in G0/G1 phase was observed. Exposure to SBU led to an increase of cells in the S phase. In general, all adhesives determined cytotoxicity. CSE extracts were the most cytotoxic and were classified as having a higher degree of reactivity, leading to more significant inhibition of cell growth and destruction of the cell's layers.

Direct and indirect monomer elution from an RBC product family

OBJECTIVE

To develop a model for quantitative comparison of elutable substances by direct elution from resin-bonded composite (RBC) test specimens versus indirect elutability of substances from RBC-restored teeth. Furthermore, it was to be investigated whether the different composites of the Tetric® RBC product family release different types and amounts of substances.

METHODS

Four different composite materials from the Tetric® product family were studied. For each material subgroup ten human third molar teeth were prepared with standard Class-I occlusal cavities. These 'tooth group' specimens were provided with a three-step adhesive system (incorporating TEGDMA) and the respective composite restoration. Same sized control specimens, of each RBC restorative material, were prepared ('direct RBC' groups). All specimens were placed in individual elution chambers such that the elution media (ethanol/water, 3:1) only came into contact with either the tooth root or ¾ height of the 'direct RBC' materials. They were incubated at 37 °C for up to 7 d. Samples of the eluant were taken after 1, 2, 4 and 7 d and were analysed by high-temperature gas chromatography/mass spectrometry.

RESULTS

Bisphenol A ethoxylate dimethacrylate (bisEMA), bisphenol A glycidyldimethacrylate (bisGMA), tetraethylene glycol dimethacrylate (TEEGDMA), decan-1,10-diol dimethacrylate (DDDMA) were mostly found in the eluates of the 'direct RBC' groups in statistically significantly greater amounts than in the eluates of the 'tooth groups'. Such quantitative differences were also the case with eluates containing bisphenol A (BPA), dicyclohexyl phthalate (DCHP) and drometrizole, which are common in the environment. In contrast to the behavior found with all the other monomers, up to 3 orders of magnitude more triethylene glycol dimethacrylate (TEGDMA) was found in the 'tooth groups' compared to the 'direct RBC' groups, evidently released by the adhesive system.

SIGNIFICANCE

The release of most of the substances was clearly delayed in the 'tooth groups' indicative of their chronic, rather than acute, elution to the oral environment. A barrier function of the residual dentin layer and the adhesion layer can be inferred. The different release patterns of substances from the various composites of the RBC product family is a manifestation of their different and indication-specific compositions. Consideration of an overall restorative care (RBC plus adhesive) system, when assessing the total amount of released substances, is emphasized.

The Cytotoxicity Assessment of Novel Formulation Developed to Reduce Dentin Hypersensitivity Utilizing Dehydrogenase Assay

The problem of real treatment of teeth hypersensitivity is still important and unsolved. The main goal of the experiment was to calculate the possible toxic effects on the fibroblasts cells CCL-1™ (NCTC clone 929) caused by original preparation to reduce tooth surfaces’ hypersensitivity, compared to the marketable preparation Seal & Protect (Dentsply). The assessment was made through measuring lactate dehydrogenase (LDH assay). Lactate dehydrogenase releases from the cell’s cytoplasm to the culture medium as a result of cell membrane damage and lysis of the cells. The measurement is based on an assessment of the ability of LDH to oxidize lactic acid to pyruvic acid, which is dependent on the increase of the release level. The increase of LDH activity in the supernatants of cell cultures shows a relationship with the percentage of dead cells (increased cytotoxicity correlates with the increasing content of dead cells). In the LDH assay, both formulations evaluated after 24 h obtained results which were located below the control values. After seven days, the mean values obtained in cytotoxicity assay LDH are measurable and lower for the original formulation in comparison to the commercial one at the dilution of 1:5. At the dilution with 1:10 ratio, they are comparable and within the range of accepted values. At the maximal dilution of 1:15, the results are higher for the experimental formulation in comparison to the marketable formulation. The polymerization process is beneficial for the cytotoxicity test results in case of both tested preparations. Average values of cytotoxicity of both preparations attain an acceptable level of less than 22.6 ± 8.1%, reliant on the degree of dilution and the remark time. Original formulation is characterized by a greater homogeneity of results. The marketable preparation has a larger diversity of effects, dependent on the time of observation and attenuation; however, the cytotoxicity values are lower when paralleled to the experimental formulation in the test conducted after seven days. This should not have a disastrous effect on the pulp, as the values of both as the values of both preparations are within expected ranges. The obtained results allows to assume that will be possible to introduce the original formulation to the stage of clinical trials in the future.

Resin composite adhesion to dentin using different curing lights and adhesive systems applied under electric current

OBJECTIVES

To evaluate the effect of electric current application on the resin composite-tooth bond strength and hybrid layer of three adhesive systems light-cured by two light-curing units (LCUs).

MATERIALS AND METHODS

Human molar teeth were distributed into 12 groups (n=6). Three adhesive systems were used: two-step etch-and-rinse (SB2; Adper Single Bond 2, 3M ESPE); two-step self-etch (CSE; Clearfil SE Bond, Kuraray); and one-step self-etch (SBU; Single Bond Universal, 3M ESPE) applied with (50μA) and without (control; conventional application) electric current, and light-cured with different LCUs. Resin composite blocks (Filtek Z350XT, 3M ESPE) were produced and cut into sticks (~1mm²) for microtensile bond strength (μTBS). Fracture patterns were analyzed on stereomicroscope and classified as cohesive-dentin, cohesive-resin, adhesive, or mixed. Specimens were prepared for scanning electron microscope observation. The hybrid layer analysis was carried out using a confocal laser scanning microscopy (n=2). Data were submitted to three-way ANOVA followed by Tukey's post hoc test (α=0.05).

RESULTS

The electric current increased the μTBS for all adhesive systems light-cured with single-emission peak and multiple-emission peak LCUs. Both LCUs presented similar μTBS values. CSE applied under electric current showed the highest μTBS mean values. The adhesive failure pattern was more frequently observed in all groups. The electric current formed long resin tags for all adhesive systems.

CONCLUSIONS

The adhesive systems applied under electric current increased the bond strength using single-emission peak and multiple-emission peak LCUs.

CLINICAL RELEVANCE

Electric current at 50μA applied throughout the dentin is a safe mode and results in better impregnation of the adhesive systems.

Cytotoxicity evaluation of eluates from universal adhesives by real-time cell analysis

The aim of this study was to evaluate the cytotoxicity of universal adhesives on L929 mouse fibroblast cell line by using a real-time cell analysis. In order to obtain extract, six different cured dental adhesives were immersed in Dulbecco's Modified Eagle's Medium (DMEM) at 37°C for 24 h. A real-time cell analysis system was used to assess cytotoxicity of the dental adhesives. After seeding 25,000 cells/300 μL/well cell suspensions into the wells of an e-plate, fibroblasts were exposed to extracts of tested adhesives at varying dilutions (1:1, 1:2, and 1:10) and observed at every 30 min intervals for 72 h. Three-way ANOVA one factor repeated measures were used to analyze the results (α=0.05). All tested adhesives induced cell viability loss, cell morphology alteration, and cell death depending on extract concentration and time. Cell viability of L929 cells to between 44 and 10% for 1:1 diluted extracts, at 72 h, when compared to the negative control.

A Review on the Biocompatibility of PMMA-Based Dental Materials for Interim Prosthetic Restorations with a Glimpse into their Modern Manufacturing Techniques

This paper's primary aim is to outline relevant aspects regarding the biocompatibility of PMMA (poly(methyl methacrylate))-based materials used for obtaining interim prosthetic restorations, such as the interaction with oral epithelial cells, fibroblasts or dental pulp cells, the salivary oxidative stress response, and monomer release. Additionally, the oral environment's biochemical response to modern interim dental materials containing PMMA (obtained via subtractive or additive methods) is highlighted in this review. The studies included in this paper confirmed that PMMA-based materials interact in a complex way with the oral environment, and therefore, different concerns about the possible adverse oral effects caused by these materials were analyzed. Adjacent to these aspects, the present work describes several advantages of PMMA-based dental materials. Moreover, the paper underlines that recent scientific studies ascertain that the modern techniques used for obtaining interim prosthetic materials, milled PMMA, and 3D (three-dimensional) printed resins, have distinctive advantages compared to the conventional ones. However, considering the limited number of studies focusing on the chemical composition and biocompatibility of these modern interim prosthetic materials, especially for the 3D printed ones, more aspects regarding their interaction with the oral environment need to be further investigated.

Development of Chlorhexidine Loaded Halloysite Nanotube Based Experimental Resin Composite with Enhanced Physico-Mechanical and Biological Properties for Dental Applications

Objective: The objective of this study was to explore the effect of Chlorhexidine-loaded Halloysite nanotubes (HNT/CHX) fillers (diverse mass fractions from 1 to 10 wt.%) on physicochemical, morphological and biological properties of newly developed experimental dental resin composite, in order to compare with the properties of composites composed of conventional glass fillers. Methods: The dental resin composites were prepared by incorporating various proportions of HNT/CHX. Six different groups of specimens: control group and five groups composed of varied mass fractions of HNT/CHX (e.g., 1.0, 2.5, 5.0, 7.5 and 10 wt.%) as fillers in each group were fabricated. Mechanical properties of the composites were monitored, using UTM. The degree of conversion of dental resin composites and their depth of cure were also evaluated. Antimicrobial properties of dental composites were studied in vitro by applying agar diffusion test on strain Streptococcus mutans and cytotoxicity were studied using NIH-3T3 cell line. Results: The incorporation of varied mass fractions (1.0 to 5.0 wt.%) of HNT/CHX in dental resins composites enhanced mechanical properties considerably with significant antibacterial activity. The slight decrease in curing depth and degree of conversion values of composites indicates its durability. No cytotoxicity was noticed on NIH-3T3 cell lines. Significance: Consistent distribution of HNT/CHX as a filler into dental composites could substantially improve not only mechanical properties but also biological properties of dental composites.

The Cytotoxicity and Genotoxicity of Three Dental Universal Adhesives-An In Vitro Study

Dental universal adhesives are considered an useful tool in modern dentistry as they can be used in different etching techniques, allow for simplified protocol and provide sufficient bond strength. However, there is still no consensus as to their toxicity towards pulp. Thus, the present study aimed to evaluate the cytotoxicity and genotoxicity of three universal adhesives: OptiBond Universal, Prime&Bond Universal and Adhese in an in vitro experimental model, monocyte/macrophage cell line SC (ATCC CRL-9855). The cytotoxicity was measured by means of XTT assay, whereas the genotoxicity (comet assay) was evaluated based on the percentage of DNA present in the comet tail. Furthermore, the ability of the adhesives to induce apoptosis was analyzed using flow cytometry (FC) with the FITC annexin V/propidium iodide (PI) double staining. The analysis of the cell cycle progression was performed with FC using PI staining. OptiBond Universal presented significant, while Prime&Bond Universal and Adhese Universal had minimal cytotoxicity and genotoxicity towards human SC cells. Moreover, only OptiBond Universal increased the level of apoptosis in SC cell line. None of the adhesives showed significant cell cycle arrest, as revealed by FC analysis. Due to substantial differences in toxicity in in vitro studies of dental adhesives, there is a great need for further research in order to establish more reliable test protocols allowing for standardized methodology.

Hot air stream reduces cytotoxicity of light-cured calcium hydroxide based cements

Background

The light-cured calcium hydroxide based cements have incomplete polymerization and unconverted monomers can cause pulp cell damage. The aim of this study was to evaluate the influence of a warm and hot air stream on the cytotoxicity of light-cured calcium hydroxide based cements.

Material and Methods

The materials Dycal (conventional cement), Biocal, Hidrox-Cal, and Ultra-Blend Plus (light-cured calcium hydroxide cements) were submitted to cytotoxicity analysis after polymerization, without vs. with previous heat treatment with a warm (37°C) and a hot (60°C) air stream. Following polymerization, cements were maintained in culture medium for 24 hours and 7 days, and subjected to the MTT test. Data were analyzed using analysis of variance (ANOVA) followed by post-hoc Student-Newman-Keuls (<0.05).

Results

The results indicated significant differences between the materials according to their composition, i.e., light-cured cements treated with a jet of warm air showed similar cytotoxicity levels to those observed for conventional cement, suggesting that they may be considered alternatives in cases requiring pulp-capping treatment.

Conclusions

Application of a hot air stream reduced cytotoxicity of materials tested.

Key words:Dental pulp capping, dental cements, calcium hydroxide, cell survival.

Physicochemical and biological assessment of silver nanoparticles immobilized Halloysite nanotubes-based resin composite for dental applications

OBJECTIVE

The purpose of this study was to investigate the effect of Silver nanoparticle immobilized Halloysite Nanotubes (HNT/Ag) fillers on physicochemical, mechanical, and biological properties of novel experimental dental resin composite in order to compare with the properties of corresponding composites containing conventional glass fillers.

METHODS

Dental resin (Bis-GMA/TEGDMA with ratio 70/30) composites were prepared by incorporation of varied mass fraction of HNT/Ag. Experimental composites were divided into six groups, one control group and five experimental groups containing mass fraction 1 to 10.0 wt. % of HNT/Ag. Mechanical properties of the dental composites were recorded. Degree of conversion and depth of cure of the dental resin composites were assessed. Antimicrobial properties were assessed using agar diffusion test and evaluation of cytotoxicity were performed on NIH-3T3 cell line.

RESULTS

The inclusion of mass fractions (1-5 wt. %) of the HNT/Ag in dental resins composites, significantly improved mechanical properties. While, addition of larger mass fractions (7.5 and 10 wt. %) of the HNT/Ag did not show further improvement in the mechanical properties of dental resins composites. Theses composites also demonstrated satisfactory depth of cure and degree of conversion. A significant antibacterial activity was observed on S. mutans. No significant cytotoxicity was found on NIH-3T3 cell lines.

CONCLUSION

The incorporation of HNT/Ag in Bis-GMA/TEGDMA dental resins composites resulted in enhancement in mechanical as well as biological properties for dental applications.

CLINICAL SIGNIFICANCE

HNT/Ag containing dental composite is proposed to be highly valuable in the development of restorative dental material for patients with high risk of dental caries.

An alternate methodology for studying diffusion and elution kinetics of dimethacrylate monomers through dentinal tubules

OBJECTIVE

Ethoxylated bisphenol A dimethacrylate (bisEMA) is a base monomer in several dental resin composites. It was the main aim of the present study to determine if bisEMA can reach the dental pulp by generally passive diffusion through the coronal dentinal tubules stimulated via eluent liquids surrounding the root structures only.

METHODS

In 20 human third molar teeth, standard Class-I occlusal cavities were prepared and provided either with an adhesive system alone or additionally with a composite restoration, according to the instructions of the manufacturer. The teeth were placed in an elution chamber such that the elution media only came into contact with the tooth root/tooth base where they were incubated at 37 °C for up to 7 d. Samples were taken after 1, 2, 4 and 7 d. Gas chromatography/mass spectrometry was used to identify bisEMA and other monomers in ethanol/water (3:1) and aqueous eluates.

RESULTS

bisEMA was only found in ethanol/water eluates, where the teeth had received a composite restoration. Traces of bisEMA with up to three ethylene oxide units could be detected in these eluates. Depending on the dentin thickness, different elution kinetics of bisEMA were determined. Regardless of the treatment of teeth, triethylene glycol dimethacrylate (TEGDMA) and tetraethylene glycol dimethacrylate (TEEGDMA) were found in ethanolic/aqueous eluates in equal amounts. Most TEGDMA and TEEGDMA diffused through the dentin within the first 24 h.

SIGNIFICANCE

Depending on the dentin layer thickness, bisEMA was released for varied time periods, resulting in varied concentrations and exposure times for the different cells of the dental pulp. The concentrations of TEGDMA and TEEGDMA were greatest for cells of the dental pulp within the first 24 h.

Physicochemical and biological assessment of flowable resin composites incorporated with farnesol loaded halloysite nanotubes for dental applications

The aim of this study was to fabricate flowable resin composites, by incorporating Farnesol loaded Halloysite Nanotubes (Fa-HNT) as a filler and evaluate their physicochemical as well as biological properties. Chemical and morphological characterization of antibacterial filler, Fa-HNT were performed using Fourier Transform Infrared Spectroscopy (FTIR), X-ray Diffraction (XRD), Transmission Electron Microscope (TEM), Scanning Electron Microscope (SEM). The antibacterial filler was mixed into composite material consisting of methacrylate monomers and dental glass fillers at concentrations of 1-20% (wt./wt.). It was observed that addition of mass fractions of Fa-HNT causes enhancement of compressive strength as well as flexural modulus of the composite. However, it significantly decreases flexural strength and degree of conversion. A significant antibacterial activity of dental composite was observed with increase in the area of zone of inhibition against the strains of Streptococcus mutans (S. mutans). There was no cytotoxicity observed by Fa-HNT resin composites on NIH-3T3 (mouse embryonic fibroblast cells) cell lines. A favourable integration of antibacterial filler with significant mechanical properties was achieved at concentrations from 7 to 13 wt% of Fa-HNT in dental composites, which is desirable in dentistry.

Cytotoxicity of Self-Etch Versus Etch-and-Rinse Dentin Adhesives: A Screening Study

Six dentin adhesives were tested in vitro regarding their cytotoxicity on human fibroblasts. The adhesives Hybrid Bond, One-up Bond F Plus, AdheSE, Clearfil SE Bond, Optibond Solo Plus and Syntac were eluted with culture medium as single or sequentially applied adhesive part for 24 h. 75 Petri dishes were produced per group. They were evaluated triangulated, comprising the quantitative evaluation (105 ones) to determine “viable”, “dead” and “debris” cells with the use of a cell-counter and the reactivity index was also identified based on the qualitative assessment (420 ones). One-up Bond F Plus, AdheSE and Clearfil SE Bond showed a statistical difference of viable cells to the cell control. For One-up Bond F Plus, statistically, differences compared to hybrid bond and Syntac were also found. All the adhesives except One-up Bond F Plus showed significant differences between single and sequentially applied adhesive part regarding the quantitative evaluation. The test material showed a moderate grade of cytotoxicity. As a result, a statistically significant difference of the cytotoxicity between the self-etch and etch-and-rinse adhesives cannot be demonstrated regarding the qualitative evaluation and the reactivity index, but the differences between sequentially applied and single applied components can be proved.

N-Acetyl Cysteine as a Novel Polymethyl Methacrylate Resin Component: Protection against Cell Apoptosis and Genotoxicity

The present study investigated the antiapoptotic and antigenotoxic capabilities of N-acetyl cysteine- (NAC-) containing polymethyl methacrylate (PMMA) resin. An in vitro Transwell insert model was used to mimic the clinical provisional restorations placed on vital teeth. Various parameters associated with cell apoptosis and genotoxicity were investigated to obtain a deeper insight into the underlying mechanisms. The exposure of human dental pulp cell (hDPC) cultures to the PMMA resin (Unifast Trad™) resulted in a rapid increase in reactive oxygen species (ROS) level beginning at 1 h, which was followed by time-dependent cell detachment and overt death. The formation of γ-H2AX and cell cycle G1 phase arrest indicated that oxidative DNA damage occurred as a result of the interactions between DNA bases and ROS, beyond the capacities of cellular redox regulation. Such oxidative DNA damage triggers the activation of p53 via the ataxia telangiectasia mutated (ATM) signaling pathway and the induction of intrinsic mitochondrial apoptosis. Oxidative stress, cell apoptosis, and DNA damage induced by the PMMA resin were recovered to almost the level of untreated controls by the incorporation of NAC. The results indicate that the PMMA resin induced the intrinsic mitochondrial apoptosis as a consequence of p53 activation via the ATM pathway in response to oxidative DNA damage. More importantly, the incorporation of NAC as a novel component into the Unifast Trad™ PMMA resin offers protective effects against cell apoptosis and genotoxicity. This procedure represents a beneficial strategy for developing more biocompatible PMMA-based resin materials.

In Vitro Cytotoxicity of Self-Adhesive Dual-Cured Resin Cement Polymerized Beneath Three Different Cusp Inclinations of Zirconia

The aim of the present study was to evaluate the in vitro cytotoxicity of self-adhesive dual-cured resin cement (SADRC) polymerized beneath three different cusp inclinations of zirconia with different light curing time. A commercial SADRC (Multilink Speed) was polymerized beneath zirconia (ZrO₂) with three different cusp inclinations (0°, 20°, and 30°) for 20 s or 40 s. After being stored in light-proof box for 24 h, the ZrO₂-SADRC specimens were immersed in DMEM for 72 h and then we got the extract solution, cultured the human gingival fibroblasts (HGF, 8 × 10³ per well) with 100% or 50% concentrations of the extract solution for 24 h, 72 h, and 120 h, respectively, and evaluated cytotoxicity of the polymerized SADRC with CCK-8 assay in optical density (OD) values, relative growth rates (RGR), and cytotoxicity grades. Statistical analysis was conducted using a two-way ANOVA followed by post hoc Student–Newman–Keuls test. The OD values varied from 0.8930 to 3.2920, the RGR varied from 33.93% to 98.68%, and the cytotoxicity grades varied from 0 to 2. There was significant difference in the OD values among the different cusp inclinations of zirconia (P < 0.001), and there was significant difference in the OD values between the different light curing times in some situations (P < 0.05). The cusp inclination of zirconia affects the in vitro cytotoxicity of SADRC. Prolonging the light curing time from 20 s to 40 s can reduce the in vitro cytotoxicity of SADRC when the cusp inclination of zirconia is smaller than 20°.

Cytotoxicity of universal dental adhesive systems: Assessment in vitro assays on human gingival fibroblasts

Universal adhesives are the most important innovation in restorative dentistry. They are composed of different monomers, solvents and fillers. The potential cytotoxic effect of these materials is an important scientific aspect in recent literature. The aim of this study was to determine, using different in vitro techniques, the cytotoxicity evaluation of seven universal enamel-dental adhesives on human gingival fibroblasts. For this purpose, seven universal dental enamel adhesives have been evaluated by in vitro cytotoxicity tests using direct contact tests (an unpolymerized and a polymerized method) and an indirect contact test: preparation of extracts. The polymerized method showed a cytotoxicity range from 36% (G-PremioBond, GPB) to 79% (FuturaBond M+, FB). With the unpolymerized direct methods the range was from 4% (Prime&Bond Active, PBA) to 40% (Ibond Universal, IB) for undiluted adhesives; generally passing to the major dilutions the test showed a strong inhibitory activity by all the adhesives. Whereas with the indirect method by diluting the extracts of all dental adhesives the cell viability increased. The data obtained from the work has shown a lower cytotoxic effect of Optibond Solo Plus (OB) and Adhesive Universal (AU) with more reliable results with the extracts technique. The choice of reliable in vitro cytotoxic technique could represent, in dental practice, an important aid for clinical procedures in the use of adhesive systems.

In vitro cytotoxicity of dental adhesives: A systematic review

OBJECTIVES

The increased demand for esthetics and minimally invasive tooth restorations resulted in a rapid development of adhesive dentistry. However, much controversy remains about the safe use and cytotoxic effects of different groups of dental adhesives. The present study performed a systematic review to identify the answer to the following question: are self-etch adhesives more cytotoxic than those employing the etch-and-rinse system?

METHODS

This systematic review was performed in accordance with the PRISMA statement; a quality assessment for in vitro studies was conducted using the ToxRTool. Specific search strategies were developed and performed in the electronic databases MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, and LILACS/BBO. After removal of duplicated studies and application of the exclusion criteria, ten eligible articles were selected and submitted to a qualitative descriptive analysis comparing both groups of dental adhesives. Most in vitro test systems employed pulp cells or gingival fibroblasts.

RESULTS

The methodologies presented great variability regarding the exposure to the test materials. Only four studies assessed the role of the degree of conversion of the materials in their toxicity, with conflicting results.

SIGNIFICANCE

While the lack of methodological standardization among the studies still hinders the establishment of a relationship between type of dental adhesive and toxicity, studies employing dentin barrier systems indicate greater cytotoxicity for etch-and-rinse adhesives.

Functions of transcription factors NF-κB and Nrf2 in the inhibition of LPS-stimulated cytokine release by the resin monomer HEMA

OBJECTIVE

Resin monomers like 2-hydroxyethyl methacrylate (HEMA) interfere with effects induced by stressors such as lipopolysaccharide (LPS) released from cariogenic microorganisms. In this study, mechanisms underlying monomer-induced inhibition of the LPS-stimulated secretion of inflammatory cytokines from immunocompetent cells were investigated.

METHODS

Secretion of pro-inflammatory cytokines TNF-α, IL-6 and the anti-inflammatory IL-10 from RAW264.7 mouse macrophages exposed to LPS and HEMA (0-6-8mM) was determined by ELISA. The formation of reactive oxygen (ROS) and nitrogen species (RNS) was determined by flow cytometry (FACS) after staining of cells with specific fluorescent dyes. Cell viability was analyzed by FACS, and protein expression was detected by Western blotting.

RESULTS

Secretion of TNF-α, IL-6 and IL-10 from LPS-stimulated cells increased after a 24h exposure. A HEMA-induced decrease in cytokine secretion resulted from the inhibition of LPS-stimulated NF-κB activation. Nuclear translocation of NF-κB was inhibited possibly as a result of enhanced levels of hydrogen peroxide (H₂O₂) and nitric oxide (NO) in HEMA-exposed cells. Oxidative stress caused by HEMA-induced formation of H₂O₂ and LPS-stimulated peroxynitrite (ONOO) also enhanced nuclear expression of Nrf2 as the major regulator of redox homeostasis, as well as Nrf2-controlled stress protein HO-1 to inhibit NF-κB activity. HEMA inhibited the LPS-stimulated expression of NOS (nitric oxide synthase) to produce NO but counteracted the expression of Nox2, which forms superoxide anions that combine with NO to peroxynitrite.

CONCLUSIONS

Resin monomers like HEMA inhibit LPS-stimulated NF-κB activation essential for cytokine release as a crucial response of immunocompetent cells of the dental pulp to invading cariogenic pathogens.