In Vitro Cytotoxicity Evaluation of Novel Nano-Hydroxyapatite-Silica Incorporated Glass Ionomer Cement

Nanohydroxyapatite in dentistry: A comprehensive review

Enamel, being the hardest and the highest mineralized tissue of the human body, contains nearly 96% inorganic components and 4% organic compounds and water. Dentin contains 65% inorganic components and 35% organic and water content. The translucency and white appearance of enamel are attributed to Hydroxyapatite (HA), which constitutes the major part of the inorganic component of dental hard tissue. With the advent of nanotechnology, the application of Nanohydroxyapatite (nHA) has piqued interest in dentistry due to its excellent mechanical, physical, and chemical properties. Compared to HA, nHA is found to have superior properties such as increased solubility, high surface energy and better biocompatibility. This is due to the morphological and structural similarity of nanosized hydroxyapatite particles to tooth hydroxyapatite crystals. These nanoparticles have been incorporated into various dental formulations for different applications to ensure comprehensive oral healthcare. To prevent dental caries, several nHA based dentifrices, mouth rinsing solutions and remineralizing pastes have been developed. nHA-based materials, such as nanocomposites, nano impression materials, and nanoceramics, have proven to be very effective in restoring tooth deformities (decay, fracture, and tooth loss). The nHA coating on the surface of the dental implant helps it bind to the bone by forming a biomimetic coating. A recent innovative strategy involves using nHA to reduce dentinal hypersensitivity and to reconstruct periodontal bone defects. The purpose of the present review is to discuss the different applications of nHA in dentistry, especially in preventive and restorative dentistry, dental implantology, bleaching and dentine hypersensitivity management.

Incorporation of Nanomaterials in Glass Ionomer Cements-Recent Developments and Future Perspectives: A Narrative Review

Glass ionomer cements (GICs), restorative materials with commercial availability spanning over five decades, are widely applied due to their advantages (including bio-compatibility, fluoride release, or excellent bonding properties). However, GICs have shortcomings. Among the disadvantages limiting the application of GICs, the poor mechanical properties are the most significant. In order to enhance the mechanical or antimicrobial properties of these materials, the addition of nanomaterials represents a viable approach. The present paper aims to review the literature on the application of different types of nanomaterials for the enhancement of GICs' mechanical and antimicrobial properties, which could lead to several clinical benefits, including better physical properties and the prevention of tooth decay. After applying the described methodology, representative articles published in the time period 2011-present were selected and included in the final review, covering the modification of GICs with metallic nanoparticles (Cu, Ag), metallic and metalloid oxide nanoparticles (TiO₂, ZnO, MgO, Al₂O₃, ZrO₂, SiO₂), apatitic nanomaterials, and other nanomaterials or multi-component nanocomposites.

Influence of Concentration Levels of β-Tricalcium Phosphate on the Physical Properties of a Dental Adhesive

Our study assessed the influence of integrating 5% and 10% tricalcium phosphate (β-TCP-Ca₃(PO₄)₂.) nanoparticles into a dental adhesive on the adhesive’s bonding. To evaluate the filler nanoparticles, scanning electron microscopy (SEM), Energy Dispersive X-Ray (EDX) spectroscopy, Fourier-transform infrared (FTIR) spectroscopy, and micro-Raman spectroscopy techniques were used. Shear Bond strength (SBS) testing, degree of conversion (DC) analysis, investigation of the adhesive–dentin interface, and biofilm experiments were conducted. The SEM micrographs revealed non-uniform agglomerates, while the EDX demonstrated the existence of oxygen ‘O’ (24.2%), phosphorus ‘P’ (17.4%) and calcium ‘Ca’ (60.1%) in the β-TCP nanoparticles. The FTIR and micro-Raman spectra indicated characteristic bands for β-TCP containing materials. The 10 wt.% β-TCP adhesive presented the highest SBS values (NTC-10 wt.% β-TCP: 33.55 ± 3.73 MPa, TC-10 wt.% β-TCP: 30.50 ± 3.25 MPa), followed by the 5 wt.% β-TCP adhesive (NTC-5 wt.% β-TCP: 32.37 ± 3.10 MPa, TC-5 wt.% β-TCP: 27.75 ± 3.15 MPa). Most of the detected failures after bond strength testing were adhesive in nature. The β-TCP adhesives demonstrated suitable dentin interaction by forming a hybrid layer (with few or no gaps) and resin tags. The β-TCP adhesives (10 wt.%) revealed lower DC values compared to control. The incorporation of 5 and 10 wt.% concentrations of β-TCP particles resulted in an increase in SBS values. A linear decline in DC values was witnessed when the nanoparticle concentration was increased. Further research focusing on exploring the influence of higher filler concentrations on adhesive’s properties is recommended.

Effects of Nanohydroxyapatite Incorporation into Glass Ionomer Cement (GIC)

Glass ionomer cement (GIC) or polyalkenoate cement is a water-based cement that is commonly used in clinical dentistry procedures as a restorative material. It exhibits great properties such as fluoride-ion release, good biocompatibility, ease of use and great osteoconductive properties. However, GIC’s low mechanical properties have become a major drawback, limiting the cement’s usage, especially in high stress-bearing areas. Nanohydroxyapatite, which is a biologically active phosphate ceramic, is added as a specific filler into glass ionomer cement to improve its properties. In this review, it is shown that incorporating hydroxyapatite nanoparticles (nHA) into GIC has been proven to exhibit better physical properties, such as increasing the compressive strength and fracture toughness. It has also been shown that the addition of nanohydroxyapatite into GIC reduces cytotoxicity and microleakage, whilst heightening its fluoride ion release and antibacterial properties. This review aims to provide a brief overview of the recent studies elucidating their recommendations which are linked to the benefits of incorporating hydroxyapatite nanoparticles into glass ionomer cement.

Effect of Nanostructures on the Properties of Glass Ionomer Dental Restoratives/Cements: A Comprehensive Narrative Review

Overall perspective of nanotechnology and reinforcement of dental biomaterials by nanoparticles has been reported in the literature. However, the literature regarding the reinforcement of dental biomaterials after incorporating various nanostructures is sparse. The present review addresses current developments of glass ionomer cements (GICs) after incorporating various metallic, polymeric, inorganic and carbon-based nanostructures. In addition, types, applications, and implications of various nanostructures incorporated in GICs are discussed. Most of the attempts by researchers are based on the laboratory-based studies; hence, it warrants long-term clinical trials to aid the development of suitable materials for the load bearing posterior dentition. Nevertheless, a few meaningful conclusions are drawn from this substantial piece of work; they are as follows: (1) most of the nanostructures are likely to enhance the mechanical strength of GICs; (2) certain nanostructures improve the antibacterial activity of GICs against the cariogenic bacteria; (3) clinical translation of these promising outcomes are completely missing, and (4) the nanostructured modified GICs could perform better than their conventional counterparts in the load bearing posterior dentition.

Application of β-Tricalcium Phosphate in Adhesive Dentin Bonding

The study aimed at synthesizing β-tricalcium phosphate (β-TCP) nanoparticles and comparing the mechanical properties and dentin interaction of two adhesives: experimental adhesive (EA) and EA with 5 wt.% β-TCP nanoparticles (β-TCP-5%). These filler nanoparticles were synthesized and then characterized with scanning electron microscopy (SEM) and micro-Raman spectroscopy. The β-TCP nanoparticles were incorporated in the adhesives to form two groups: gp-1: EA (control) and gp-2: β-TCP-5%. These adhesives were characterized by SEM, energy-dispersive X-ray (EDX) spectroscopy and were also assessed for their micro-tensile bond strength (μTBS) with (TC) and without thermocycling (NTC). Fourier Transform Infrared (FTIR) spectroscopy was performed to evaluate the degree of conversion (DC) of two adhesives. The β-TCP filler was seen as irregularly shaped agglomerates on SEM. The micro-Raman spectra revealed characteristic peaks associated with β-TCP nanoparticles. Both adhesives presented suitable dentin interaction, which was demonstrated by the formation of resin tags of variable depths. The EDX analysis verified the existence of calcium (Ca) and phosphate (P) for the β-TCP-5% group. The greatest μTBS values were shown by β-TCP-5% group samples when they were non-thermocycled (NTC) (β-TCP-5%-NTC: 34.11 ± 3.46) followed by the thermocycled (TC) samples of the same group (β-TCP-5%-TC: 30.38 ± 3.66), compared with the EA group. Although the DC presented by β-TCP-5% group was comparable to the EA group, it was still lower. The addition of β-TCP nanoparticles in the adhesive improved its μTBS and resulted in a suitable dentin interaction, seen in the form of hybrid layer and resin tag formation. Nonetheless, a decreased DC was observed for the β-TCP-5% adhesive. Future studies probing the effect of different filler concentrations on various properties of the adhesive are warranted.

Cytotoxic Evaluation and Determination of Organic and Inorganic Eluates from Restorative Materials

Over the last years, diverse commercial resin-based composites have dominated as dental filling materials. The purpose of the present study was to determine organic and inorganic eluates from five restorative materials using GC/MS and ICP–OES and to compare the effect on cell survival of human gingival fibroblasts of a conventional and a bioactive resin. Five commercially available restorative materials were employed for this study: Activa^TM Bioactive Restorative, ENA HRi, Enamel plus HRi Biofunction, Fuji II LC Capsule, and Fuji IX Capsule. Disks that were polymerized with a curing LED light or left to set were immersed in: 1 mL methanol or artificial saliva for GC/MS analysis, 5mL deionized water for ICP–OES, and 5mL of culture medium for cell viability. Cell viability was investigated with a modified staining sulforhodamine B assay.The following organic substances were detected: ACP, BHT, BPA, 1,4-BDDMA, CQ, DBP, DMABEE, HEMA, MCE, MeHQ, MOPA, MS, TMPTMA, and TPSb and the ions silicon, aluminum, calcium, sodium, and barium. Activa Bioactive Restorative was found to be biocompatible. Elution of organic substances depended on material’s composition, the nature of the solvent and the storage time. Ions’ release depended on material’s composition and storage time. The newly introduced bioactive restorative was found to be more biocompatible.

Assessment of Bond Integrity, Durability, and Degree of Conversion of a Calcium Fluoride Reinforced Dentin Adhesive

Our study aimed to synthesize and compare the mechanical properties and dentin interaction of two adhesives; experimental adhesive (EA) and EA containing 5 wt.% calcium fluoride (CaF₂) nano-crystals (CaF₂ adhesive-CAFA). CaF₂ nano-crystals were synthesized by reacting two solutions (containing calcium and fluoride) in a glass chamber using a heated air system. The EA was produced using a mix of monomers, photo-initiators, camphorquinone, and electron initiators. The synthesized CaF₂ nano-crystals were centrifuged to guarantee that inside the adhesive there is homogenized dispersion of the filler particles. Their integration in the EA yielded two groups; Gp-1: EA (without CaF₂, control) and Gp-2: (5 wt.% CaF₂ containing adhesive, CAFA). Sixty teeth were prepared and set to form bonded specimens using the two adhesives. The CaF₂ nano-crystals were irregularly shaped with an average particle size of 30–200 nm. The highest μTBS values were obtained for CAFA-non-thermocycled (NTC) samples (32.63 ± 3.15), followed by EA-NTC (31.80 ± 3.75) specimens. On thermocycling (TC), both adhesive groups presented lower μTBS values (CAFA-TC: 29.47 ± 3.33 and EA-TC: 24.04 ± 3.69). Hybrid layer (HL) formation and resin tags of varying depths were perceived for both adhesive groups. The EDX analysis demonstrated the presence of carbon (C), silica (Si), calcium (Ca), and fluoride (F) for CAFA group. Micro-Raman spectroscopy revealed distinct peaks for CaF₂ nano-crystals. The CAFA group presented the greatest DC. The addition of CaF₂ nano-crystals in the adhesive caused improved bond μTBS and DC. The incorporation also demonstrated suitable dentin interaction, depicted by appropriate HL and resin tag development.

Dental Applications of Systems Based on Hydroxyapatite Nanoparticles—An Evidence-Based Update

Hydroxyapatite is one of the most studied biomaterials in the medical and dental field, because of its biocompatibility; it is the main constituent of the mineral part of teeth and bones. In dental science, hydroxyapatite nanoparticles (HAnps) or nano-hydroxyapatite (nano-HA) have been studied, over the last decade, in terms of oral implantology and bone reconstruction, as well in restorative and preventive dentistry. Hydroxyapatite nanoparticles have significant remineralizing effects on initial enamel lesions, and they have also been used as an additive material in order to improve existing and widely used dental materials, mainly in preventive fields, but also in restorative and regenerative fields. This paper investigates the role of HAnps in dentistry, including recent advances in the field of its use, as well as their advantages of using it as a component in other dental materials, whether experimental or commercially available. Based on the literature, HAnps have outstanding physical, chemical, mechanical and biological properties that make them suitable for multiple interventions, in different domains of dental science. Further well-designed randomized controlled trials should be conducted in order to confirm all the achievements revealed by the in vitro or in vivo studies published until now.

Influence of ER-CR-YSGG Laser and Photodynamic Therapy on the Dentin Bond Integrity of Nano-Hydroxyapatite Containing Resin Dentin Adhesive: SEM-EDX, Micro-Raman, Micro-Tensile, and FTIR Evaluation

The study aimed to analyze the effect of the addition of nano-hydroxyapatite (nano-HA) particles on the mechanical properties of experimental adhesive (EA). Furthermore, dentin interaction of EA (without nano-HA) and EA with nano-HA (hereon referred to as HA-10%) were also investigated and equated. Methods consisting of scanning electron microscopy (SEM)-energy-dispersive X-ray spectroscopy (EDX), micro-Raman spectroscopy, micro-tensile bond strength (µTBS) test, and Fourier transform infrared (FTIR) spectroscopy were employed to study nano-HA particles shape, dentin bond strength, degree of conversion (DC), and adhesive-dentin interaction. Ninety teeth (N = 90) were collected, and pre-bonding, conditioning of dentin was performed utilizing phosphoric acid (H₃PO₄) etching, photodynamic therapy (PDT), and ER-CR-YSGG (ECY) laser. The teeth were set to form bonded specimens using two adhesives. Nano-HA particles were spherical-shaped, and EDX confirmed the presence of oxygen, calcium, and phosphorus. Micro-Raman spectroscopy revealed distinct phosphate and carbonate peaks for nano-HA. The µTBS test demonstrated highest values for HA-10% group on the H₃PO₄ conditioned dentin. The greatest DC was observed for the EA group. The addition of nano-HA-10 wt.% particles in dentin adhesive resulted in improved bond strength. The incorporation also demonstrated acceptable DC (although lower than EA group), suitable dentin interaction, and resin tag formation.

Cell behavior on silica-hydroxyapatite coaxial composite

Progress in the manufacture of scaffolds in tissue engineering lies in the successful combination of materials such as bioceramics having properties as porosity, biocompatibility, water retention, protein adsorption, mechanical strength and biomineralization. Hydroxyapatite (HA) is a ceramic material with lots of potential in tissue regeneration, however, its structural characteristics need to be improved for better performance. In this study, silica-hydroxyapatite (SiO2-HA) non-woven ceramic electrospunned membranes were prepared through the sol-gel method. Infrared spectra, scanning electron microscopy and XRD confirmed the structure and composition of composite. The obtained SiO2-HA polymeric fibers had approximately 230±20 nm in diameter and were then sintered at 800°C average diameter decreased to 110±17 nm. Three configurations of the membranes were obtained and tested in vitro, showing that the composite of SiO2-HA fibers showed a high percentage of viability on a fibroblast cell line. It is concluded that the fibers of SiO2-HA set in a coaxial configuration may be helpful to develop materials for bone regeneration.

Glass Ionomer Cement Modified by Resin with Incorporation of Nanohydroxyapatite: In Vitro Evaluation of Physical-Biological Properties

Resin-modified glass ionomer cement (RMGIC) has important properties. However, like other restorative materials, it has limitations such as decreased biocompatibility. The incorporation of nanoparticles (NP) in the RMGIC resulted in improvements in some of its properties. The aim of this study was to evaluate the physical-biological properties of RMGIC with the addition of nanohydroxyapatite (HANP). Material and Methods: Vitremer RMGIC was used, incorporating HANP by amalgamator, vortex and manual techniques, totaling ten experimental groups. The distribution and dispersion of the HANP were evaluated qualitatively by field emission scanning electron microscope (SEM-FEG). The evaluation of image porosity (SEM-FEG) with the help of imageJ. Cell viability 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl tetrazoline bromide (MTT) and cell morphology analyses were performed on MDPC-23 odontoblastoid cells at 24 and 72 h. Results: It was possible to observe good dispersion and distribution of HANP in the samples in all experimental groups. The incorporation of 5% HANP into the vortex stirred RMGIC resulted in fewer pores. The increase in the concentration of HANP was directly proportional to the decrease in cytotoxicity. Conclusions: It is concluded that the use of a vortex with the incorporation of 5% HANP is the most appropriate mixing technique when considering the smallest number of pores inside the material. A higher concentration of HANP resulted in better cell viability, suggesting that this association is promising for future studies of new restorative materials.

Comprehensive In Vitro Testing of Calcium Phosphate-Based Bioceramics with Orthopedic and Dentistry Applications

Recently, a large spectrum of biomaterials emerged, with emphasis on various pure, blended, or doped calcium phosphates (CaPs). Although basic cytocompatibility testing protocols are referred by International Organization for Standardization (ISO) 10993 (parts 1-22), rigorous in vitro testing using cutting-edge technologies should be carried out in order to fully understand the behavior of various biomaterials (whether in bulk or low-dimensional object form) and to better gauge their outcome when implanted. In this review, current molecular techniques are assessed for the in-depth characterization of angiogenic potential, osteogenic capability, and the modulation of oxidative stress and inflammation properties of CaPs and their cation- and/or anion-substituted derivatives. Using such techniques, mechanisms of action of these compounds can be deciphered, highlighting the signaling pathway activation, cross-talk, and modulation by microRNA expression, which in turn can safely pave the road toward a better filtering of the truly functional, application-ready innovative therapeutic bioceramic-based solutions.

In Vitro Evaluation of the Biological Effects of ACTIVA Kids BioACTIVE Restorative, Ionolux, and Riva Light Cure on Human Dental Pulp Stem Cells

This study aimed to analyze the biological effects of three new bioactive materials on cell survival, migration, morphology, and attachment in vitro. ACTIVA Kids BioACTIVE Restorative (Pulpdent, Watertown, MA, USA) (Activa), Ionolux (Voco, Cuxhaven, Germany), and Riva Light Cure UV (SDI, Bayswater, Australia) (Riva) were handled and conditioned with a serum-free culture medium. Stem cells from human dental pulp (hDPSCs) were exposed to material extracts, and metabolic activity, cell migration, and cell morphology were evaluated. Cell adhesion to the different materials was analyzed by scanning electron microscopy (SEM). The chemical composition of the materials was evaluated by energy-dispersive X-ray (EDX). One-way analysis of variance followed by a Tukey test was performed (p < 0.05). Ionolux promoted a drastic reduction in metabolic activity and wound closure compared to the control (p < 0.05), whereas Activa induced adequate metabolic activity and cell migration. Moreover, SEM and immunofluorescence analysis showed abundant cells exposed to Activa. The materials showed different surface morphologies, and EDX spectra exhibited different peaks of C, O, Si, S, Ca, and F ions in glass ionomer cements. The results showed that Activa induced cell migration, cell attachment, and cell viability to a greater extent than Riva and Ionolux.

The Biological Evaluation of Conventional and Nano-Hydroxyapatite-Silica Glass Ionomer Cement on Dental Pulp Stem Cells: A Comparative Study

BACKGROUND

Despite their lower strength, glass ionomer cements (GICs) are widely used as restorative materials because of their anti-cariogenic properties, direct adhesion to tooth structure and good biocompatibility. Recently, the addition of nano-hydroxyapatite (nano-HA)-silica to conventional GIC (cGIC) has been shown to improve the strength of cGIC. However, the biocompatibility and cell attachment properties of this material are unknown.

AIMS

This study aims to evaluate and compare the cytotoxicity and cell attachment properties of cGIC and nano-HA-silica-GIC on dental pulp stem cells (DPSCs).

METHODS AND MATERIALS

Material extracts of nano-HA-silica-GIC and cGIC were prepared into seven serial dilutions and applied to 96 well plates seeded with DPSCs. After 72 h, the cell viability was determined using MTT assay. The DPSCs cell attachment properties were examined under scanning electron microscope (SEM) after 24 and 72 h. Kruskal-Wallis test was used to analyse the data for MTT assay (P < 0.05). SEM images of cell attachment properties were also described.

RESULTS

Nano-HA-silica-GIC and cGIC was shown to be slight to non-cytotoxic at all concentrations, except 200 mg/ml. Moderate cytotoxicity has been observed at 200 mg/ml concentration where nano-HA-silica-GIC and cGIC revealed cell viability values of 44.38 and 42.15%, respectively. Nano-HA-silica-GIC demonstrated better cell viability values than cGIC at all concentrations except for 6.25 and 12.5 mg/ml. Nevertheless, the results were not statistically significant (P > 0.05). SEM examination revealed the increasing numbers of DPSCs attached to both groups with prominent filopodia, especially after 72 h.

CONCLUSIONS

Nano-HA-silica-GIC exhibited good biocompatibility which is comparable to cGIC and favoured the attachment of DPSCs.