Nanoparticles of Quaternary Ammonium Polyethylenimine Derivatives for Application in Dental Materials

Application of Nanomaterials in Endodontics

Recent advancements in nanotechnology have introduced a myriad of potential applications in dentistry, with nanomaterials playing an increasing role in endodontics. These nanomaterials exhibit distinctive mechanical and chemical properties, rendering them suitable for various dental applications in endodontics, including obturating materials, sealers, retro-filling agents, and root-repair materials. Certain nanomaterials demonstrate versatile functionalities in endodontics, such as antimicrobial properties that bolster the eradication of bacteria within root canals during endodontic procedures. Moreover, they offer promise in drug delivery, facilitating targeted and controlled release of therapeutic agents to enhance tissue regeneration and repair, which can be used for endodontic tissue repair or regeneration. This review outlines the diverse applications of nanomaterials in endodontics, encompassing endodontic medicaments, irrigants, obturating materials, sealers, retro-filling agents, root-repair materials, as well as pulpal repair and regeneration. The integration of nanomaterials into endodontics stands poised to revolutionize treatment methodologies, presenting substantial potential advancements in the field. Our review aims to provide guidance for the effective translation of nanotechnologies into endodontic practice, serving as an invaluable resource for researchers, clinicians, and professionals in the fields of materials science and dentistry.

Effects of chitosan and TiO2 nanoparticles on the antibacterial property and ability to self-healing of cracks and retrieve mechanical characteristics of dental composites

The aim of this study was to improve the self-healing properties of dental nanocomposite using nanoparticles of TiO2 and chitosan. We evaluated flexural and compressive strength, crack-healing, and self-healing lifespan after 3 months of water aging. The effect of the developed composite on cell viability and toxicity was assessed by an MTT assay on human alveolar basal epithelial cells (A549 cell line). The nanocomposite included 7.5 wt% polyurea-formaldehyde (PUF) and 0, 0.5, and 1 wt% n-TiO2 and chitosan. After the fracture, the samples were put in a mold for 1-90 days to enable healing. Then, the fracture toughness of the healed nanocomposites and the healing yield were measured. The flexural strength of the nanocomposite improved by adding 0.5 wt% n-TiO2, while the compressive strength increased after adding 0.5 wt% chitosan (p > 0.1). When these two materials were used simultaneously, the flexural strength was improved by around 2%; however, the compressive strength was unaffected. Compared to the other sample, the nanocomposite with 0.5 wt% n-TiO2 and chitosan had higher KIC-healing and self-healing efficiency. Self-healing efficacy had no significant effect of water aging over 90 days compared to one day (p > 0.1), demonstrating that the PUF nanocapsules were not damaged.

The effect of quaternary ammonium polyethylenimine nanoparticles on bacterial adherence, cytotoxicity, and physical and mechanical properties of experimental dental composites

A significant problem related to the functioning of resin-based composites for dental fillings is secondary or recurrent caries, which is the reason for the need for repeated treatment. The cross-linked quaternary ammonium polyethylenimine nanoparticles (QA-PEI-NPs) have been shown to be a promising antibacterial agent against different bacteria, including cariogenic ones. However, little is known about the properties of dental dimethacrylate polymer-based composites enriched with QA-PEI-NPs. This research was carried out on experimental composites based on bis-GMA/UDMA/TEGDMA matrix enriched with 0.5, 1, 1.5, 2 and 3 (wt%) QA-PEI-NPs and reinforced with two glass fillers. The cured composites were tested for their adherence of Streptococcus Mutans bacteria, cell viability (MTT assay) with 48 h and 10-days extracts , degree of conversion (DC), water sorption (WSO), and solubility (WSL), water contact angle (CA), flexural modulus (E), flexural strength (FS), compressive strength (CS), and Vickers microhardness (HV). The investigated materials have shown a complete reduction in bacteria adherence and satisfactory biocompatibility. The QA-PEI-NPs additive has no effect on the DC, VH, and E values. QA-PEI-NPs increased the CA (a favorable change), the WSO and WSL (unfavorable changes) and decreased flexural strength, and compressive strength (unfavorable changes). The changes mentioned were insignificant and acceptable for most composites, excluding the highest antibacterial filler content. Probably the reason for the deterioration of some properties was low compatibility between filler particles and the matrix; therefore, it is worth extending the research by surface modification of QA-PEI-NPs to achieve the optimum performance characteristics.

Advances in antimicrobial hydrogels for dental tissue engineering: regenerative strategies for endodontics and periodontics

Dental tissue infections have been affecting millions of patients globally leading to pain, severe tissue damage, or even tooth loss. Commercial sterilizers may not be adequate to prevent frequent dental infections. Antimicrobial hydrogels have been introduced as an effective therapeutic strategy for endodontics and periodontics since they have the capability of imitating the native extracellular matrix of soft tissues. Hydrogel networks are considered excellent drug delivery platforms due to their high-water retention capacity. In this regard, drugs or nanoparticles can be incorporated into the hydrogels to endow antimicrobial properties as well as to improve their regenerative potential, once biocompatibility criteria are met avoiding high dosages. Herein, novel antimicrobial hydrogel formulations were discussed for the first time in the scope of endodontics and periodontics. Such hydrogels seem outstanding candidates especially when designed not only as simple volume fillers but also as smart biomaterials with condition-specific adaptability within the dynamic microenvironment of the defect site. Multifunctional hydrogels play a pivotal role against infections, inflammation, oxidative stress, etc. along the way of dental regeneration. Modern techniques (e.g., 3D and 4D-printing) hold promise to develop the next generation of antimicrobial hydrogels together with their limitations such as infeasibility of implantation.

Developing Bioactive Dental Resins for Restorative Dentistry

Despite its reputation as the most widely used restorative dental material currently, resin-based materials have acknowledged shortcomings. As most systematic survival studies of resin composites and dental adhesives indicate, secondary caries is the foremost reason for resin-based restoration failure and life span reduction. In subjects with high caries risk, the microbial community dominated by acidogenic and acid-tolerant bacteria triggers acid-induced deterioration of the bonding interface and/or bulk material and mineral loss around the restorations. In addition, resin-based materials undergo biodegradation in the oral cavity. As a result, the past decades have seen exponential growth in developing restorative dental materials for antimicrobial applications addressing secondary caries prevention and progression. Currently, the main challenge of bioactive resin development is the identification of efficient and safe anticaries agents that are detrimental free to final material properties and show satisfactory long-term performance and favorable clinical translation. This review centers on the continuous efforts to formulate novel bioactive resins employing 1 or multiple agents to enhance the antibiofilm efficacy or achieve multiple functionalities, such as remineralization and antimicrobial activity antidegradation. We present a comprehensive synthesis of the constraints and challenges encountered in the formulation process, the clinical performance-related prerequisites, the materials' intended applicability, and the current advancements in clinical implementation. Moreover, we identify crucial vulnerabilities that arise during the development of dental materials, including particle aggregation, alterations in color, susceptibility to hydrolysis, and loss of physicomechanical core properties of the targeted materials.

Preparation of Biocidal Nanocomposites in X-ray Irradiated Interpolyelectolyte Complexes of Polyacrylic Acid and Polyethylenimine with Ag-Ions

Due to the presence of cationic units interpolyelectrolyte complexes (IPECs) can be used as a universal basis for preparation of biocidal coatings on different surfaces. Metallopolymer nanocomposites were successfully synthesized in irradiated solutions of polyacrylic acid (PAA) and polyethylenimine (PEI), and dispersions of non-stoichiometric IPECs of PAA–PEI containing silver ions. The data from turbidimetric titration and dynamic light scattering showed that pH 6 is the optimal value for obtaining IPECs. Metal polymer complexes based on IPEC with a PAA/PEI ratio equal to 3/1 and 1/3 were selected for synthesis of nanocomposites due to their aggregative stability. Studies using methods of UV–VIS spectroscopy and TEM have demonstrated that the size and spatial organization of silver nanoparticles depend on the composition of polymer systems. The average sizes of nanoparticles are 5 nm and 20 nm for complexes with a molar ratio of PAA/PEI units equal to 3/1 and 1/3, respectively. The synthesized nanocomposites were applied to the glass surface and exhibited high antibacterial activity against both gram-positive (Staphylococcus aureus) and gram-negative bacteria (Salmonella). It is shown that IPEC-Ag coatings demonstrate significantly more pronounced biocidal activity not only in comparison with macromolecular complexes of PAA–PEI, but also coatings of PEI and PEI based nanocomposites.

Bioactive Restorative Dental Materials-The New Frontier

Bioactive materials for dental resin restorations are a rising field of investigation exploring treatment strategies for reducing the recurrence of carious lesions. The current effort has been directed toward developing dental materials that can inhibit biofilms and prevent tooth mineral loss. Bioactive resin materials have shown the potential to interfere with polymicrobial consortia in vivo and help maintain the lifespan of restorations.

Biodegradation of Dental Resin-Based Composite—A Potential Factor Affecting the Bonding Effect: A Narrative Review

In recent years, although resin composite has played an important role in the restoration of tooth defects, it still has several disadvantages, including being biodegraded by saliva, bacteria and other enzymes in the oral cavity, which may result in repair failure. This factor is not conducive to the long-term survival of the prosthesis in the mouth. In this article, we review the causes, influencing factors and prevention methods of resin biodegradation. Biodegradation is mainly caused by esterase in saliva and bacteria, which breaks the ester bond in resin and causes the release of monomers. The mechanical properties of the prosthesis can then be affected. Meanwhile, cathepsin and MMPs are activated on the bonding surface, which may decompose the dentin collagen. In addition, neutrophils and residual water on the bonding surface can also aggravate biodegradation. Currently, the primary methods to prevent biodegradation involve adding antibacterial agents to resin, inhibiting the activity of MMPs and enhancing the crosslinking of collagen fibers. All of the above indicates that in the preparation and adhesion of resin materials, attention should be paid to the influence of biodegradation to improve the prosthesis’s service life in the complex environment of the oral cavity.

Characterization of the Mechanical Properties, Water Sorption, and Solubility of Antibacterial Copolymers of Quaternary Ammonium Urethane-Dimethacrylates and Triethylene Glycol Dimethacrylate

The use of dental composites based on dimethacrylates that have quaternary ammonium groups is a promising solution in the field of antibacterial restorative materials. This study aimed to investigate the mechanical properties and behaviors in aqueous environments of a series of six copolymers (QA:TEG) comprising 60 wt.% quaternary ammonium urethane-dimethacrylate (QAUDMA) and 40 wt.% triethylene glycol dimethacrylate (TEGDMA); these copolymers are analogous to a common dental copolymer (BG:TEG), which comprises 60 wt.% bisphenol A glycerolate dimethacrylate (Bis-GMA) and 40 wt.% TEGDMA. Hardness (HB), flexural strength (FS), flexural modulus (E), water sorption (WS), and water solubility (SL) were assessed for this purpose. The pilot study of these copolymers showed that they have high antibacterial activity and good physicochemical properties. This paper revealed that QA:TEGs cannot replace BG:TEG due to their insufficient mechanical properties and poor behavior in water. However, the results can help to explain how QAUDMA-based materials work, and how their composition should be manipulated to produce the best performance. It was found that the longer the N-alkyl chain, the lower the HB, WS, and SL. The FS and E increased with the lengthening of the N-alkyl chain from eight to ten carbon atoms. Its further extension, to eighteen carbon atoms, caused a decrease in those parameters.

The Current Antimicrobial and Antibiofilm Activities of Synthetic/Herbal/Biomaterials in Dental Application

Herbal and chemical products are used for oral care and biofilm treatment and also have been reported to be controversial in the massive trials conducted in this regard. The present review is aimed at evaluating the potential of relevant herbal and chemical products and comparing their outcomes to conventional oral care products and summarizing the current state of evidence of the antibiofilm properties of different products by evaluating studies from the past eleven years. Chlorhexidine gluconate (CHX), essential oils (EOs), and acetylpyridinium chloride were, respectively, the most commonly studied agents in the included studies. As confirmed by all systematic reviews, CHX and EO significantly control the plaque formation and gingival indices. Fluoride is another interesting reagent in oral care products that has shown promising results of oral health improvement, but the evidence quality needs to be refined. The synergy between natural plants and chemical products should be targeted in the future to accede to the formation of new, efficient, and healthy anticaries strategies. Moreover, to discover their biofilm-interfering or biofilm-inhibiting activities, effective clinical trials are needed. In this review article, therapeutic applications of herbal/chemical materials in oral biofilm infections are discussed in recent years (2010-2022).

Antimicrobial Polymeric Composites for High-touch Surfaces in Healthcare Applications

Antimicrobial polymer composites have long been utilized in the healthcare field as part of the first line of defense. These composites are desirable in that they pose a minimal risk of developing contagions with antibiotic resistance. For this reason, the field of antimicrobial composites has seen steady growth over recent years and is becoming increasingly important during the current COVID-19 pandemic. In this article, we first review the need of the antimicrobial polymers in high tough surfaces, the antimicrobial mechanism, and then the recent advances in the development of antimicrobial polymer composite including the utilization of intrinsic antimicrobial polymers, the addition of antimicrobial additives, and new exploration of surface patterning. While there are many established and developing methods of imbuing a material with antimicrobial activity, there currently is no standard quantification method for these properties leading to difficulty comparing the efficacy of these materials within the literature. A discussion of the common antimicrobial characterization methods is provided along with highlights on the need of a standardized quantification of antiviral and antibacterial properties in testing to allow ease of comparison between generated libraries and to facilitate proper screening. We also discuss and comment on the current trends of the development of antimicrobial polymer composites with long-lasting and specific antimicrobial activities, nontoxic properties, and environmental friendliness against a broad-spectrum of microbes.

Surface Modification to Modulate Microbial Biofilms-Applications in Dental Medicine

Recent progress in materials science and nanotechnology has led to the development of advanced materials with multifunctional properties. Dental medicine has benefited from the design of such materials and coatings in providing patients with tailored implants and improved materials for restorative and functional use. Such materials and coatings allow for better acceptance by the host body, promote successful implantation and determine a reduced inflammatory response after contact with the materials. Since numerous dental pathologies are influenced by the presence and activity of some pathogenic microorganisms, novel materials are needed to overcome this challenge as well. This paper aimed to reveal and discuss the most recent and innovative progress made in the field of materials surface modification in terms of microbial attachment inhibition and biofilm formation, with a direct impact on dental medicine.

Strategies toward development of antimicrobial biomaterials for dental healthcare applications

Several approaches for elimination of oral pathogens are being explored at the present time since oral diseases remain prevalent affecting approximately 3.5 billion people worldwide. Need for antimicrobial biomaterials in dental healthcare include but is not restricted to designing resin composites and adhesives for prevention of dental caries. Constant efforts are also being made to develop antimicrobial strategies for clearance of endodontic space prior root canal treatment and for treatment of periimplantitis and periodontitis. This article discusses various conventional and nanotechnology-based strategies to achieve antimicrobial efficacy in dental biomaterials. Recent developments in the design and synthesis of antimicrobial peptides and antifouling zwitterionic polymers to effectively lessen the risks of antimicrobial drug resistance are also outlined in this review. Further, the role of contemporary strategies such as use of smart biomaterials, ionic solvent-based biomaterials and quorum quenchers incorporated biomaterials in the elimination of dental pathogens are described in detail. Lastly, we mentioned the approach of using polymers to print custom-made three-dimensional antibacterial dental products via additive manufacturing technologies. This review provides a critical perspective on the chemical, biomimetic, and engineering strategies intended for developing antimicrobial biomaterials that have the potential to substantially improve the dental health.

Synthesis and Characterization of Novel Quaternary Ammonium Urethane-Dimethacrylate Monomers-A Pilot Study

Six novel urethane-dimethacrylate analogues (QAUDMAs) were synthesized and characterized. They consisted of the 2,4,4,-trimethylhexamethylene diisocyanate (TMDI) core and two methacrylate-terminated wings containing quaternary ammonium groups substituted with alkyl chains of 8, 10, 12, 14, 16, or 18 carbon atoms. QAUDMAs, due to the presence of quaternary ammonium groups, may have possible antibacterial effects. Since they showed satisfactory physicochemical properties, they will be subjected to further research towards the development of dental composites with a capacity to reduce secondary caries. The synthesis of QAUDMAs included three stages: (i) transesterification of methyl methacrylate (MMA) with N-methyldiethanolamine (MDEA), (ii) N-alkylation of the tertiary amino group with alkyl bromide, and (iii) addition of TMDI to the intermediate achieved in the second stage. The formation of QAUDMAs was confirmed by ¹H and ¹³C NMR. They were characterized for density (d_m), viscosity (η), refractive index (RI), glass transition temperature (T_g), polymerization shrinkage (S), and degree of conversion (DC). QAUDMAs were yellow, viscous resins (the η values ranged from 1.28 × 10³ to 1.39 × 10⁴ Pa·s, at 50 °C). Their RI ranged from 1.50 to 1.52, T_g from −31 to −15 °C, DC from 53 to 78%, and S from 1.24 to 2.99%, which is appropriate for dental applications.

Recent Progress in Antimicrobial Strategies for Resin-Based Restoratives

Repairing tooth defects with dental resin composites is currently the most commonly used method due to their tooth-colored esthetics and photocuring properties. However, the higher than desirable failure rate and moderate service life are the biggest challenges the composites currently face. Secondary caries is one of the most common reasons leading to repair failure. Therefore, many attempts have been carried out on the development of a new generation of antimicrobial and therapeutic dental polymer composite materials to inhibit dental caries and prolong the lifespan of restorations. These new antimicrobial materials can inhibit the formation of biofilms, reduce acid production from bacteria and the occurrence of secondary caries. These results are encouraging and open the doors to future clinical studies on the therapeutic value of antimicrobial dental resin-based restoratives. However, antimicrobial resins still face challenges such as biocompatibility, drug resistance and uncontrolled release of antimicrobial agents. In the future, we should focus on the development of more efficient, durable and smart antimicrobial dental resins. This article focuses on the most recent 5 years of research, reviews the current antimicrobial strategies of composite resins, and introduces representative antimicrobial agents and their antimicrobial mechanisms.

Physicochemical and Mechanical Properties of Bis-GMA/TEGDMA Dental Composite Resins Enriched with Quaternary Ammonium Polyethylenimine Nanoparticles

Modification of dental monomer compositions with antimicrobial agents must not cause deterioration of the structure, physicochemical, or mechanical properties of the resulting polymers. In this study, 0.5, 1, and 2 wt.% quaternary ammonium polyethylenimine nanoparticles (QA-PEI-NPs) were obtained and admixed with a Bis-GMA/TEGDMA (60:40) composition. Formulations were then photocured and tested for their degree of conversion (DC), polymerization shrinkage (S), glass transition temperature (T_g), water sorption (WS), solubility (SL), water contact angle (WCA), flexural modulus (E), flexural strength (σ), hardness (HB), and impact resistance (a_n). We found that the DC, S, Tg, WS, E, and HB were not negatively affected by the addition of QA-PEI-NPs. Changes in these values rarely reached statistical significance. On the other hand, the SL increased upon increasing the QA-PEI-NPs concentration, whereas σ and a_n decreased. These results were usually statistically significant. The WCA values increased slightly, but they remained within the range corresponding to hydrophilic surfaces. To conclude, the addition of 1 wt.% QA-PEI-NPs is suitable for applications in dental materials, as it ensures sufficient physicochemical and mechanical properties.

The Antibacterial and Remineralizing Effects of Biomaterials Combined with DMAHDM Nanocomposite: A Systematic Review

Researchers have developed novel nanocomposites that incorporate additional biomaterials with dimethylaminohexadecyl methacrylate (DMAHDM) in order to reduce secondary caries. The aim of this review was to summarize the current literature and assess the synergistic antibacterial and remineralizing effects that may contribute to the prevention of secondary caries. An electronic search was undertaken in MEDLINE using PubMed, Embase, Scopus, Web of Science and Cochrane databases. The initial search identified 954 papers. After the removal of duplicates and screening the titles and abstracts, 15 articles were eligible for this review. The amalgamation of 2-methacryloyloxyethyl phosphorylcholine (MPC) and silver nanoparticles (AgNPs) with DMAHDM resulted in increased antibacterial potency. The addition of nanoparticles of amorphous calcium phosphate (NACP) and polyamidoamine dendrimers (PAMAM) resulted in improved remineralization potential. Further clinical studies need to be planned to explore the antibacterial and remineralizing properties of these novel composites for clinical success.

Bibliometric Analysis of Literature Published on Antibacterial Dental Adhesive from 1996-2020

This study aimed to investigate the current state of research on antibacterial dental adhesives. The interest in this field can be drawn from an increasing number of scholarly works in this area. However, there is still a lack of quantitative measurement of this topic. The main aim of this study was to consolidate the research published on the antibacterial adhesive from 1996 to 2020 in Web of Science indexed journals. The bibliometric method, a quantitative study of investigating publishing trends and patterns, was used for this study. The result has shown that a gradual increase in research was found, whereby a substantial increase was observed from 2013. A total of 248 documents were published in 84 journals with total citations of 5107. The highly cited articles were published mainly in Q1 category journals. Most of the published articles were from the USA, China, and other developed countries; however, some developing countries contributed as well. The authorship pattern showed an interdisciplinary and collaborative approach among researchers. The thematic evaluation of keywords along with a three-factor analysis showed that 'antibacterial adhesives' and 'quaternary ammonium' have been used commonly. This bibliometric analysis can provide direction not only to researchers but also to funding organizations and policymakers.