Errors in light-emitting diodes positioning when curing bulk fill and incremental composites: impact on properties after aging.

OBJECTIVES: This study aimed to evaluate the effect of improper positioning single-peak and multi-peak lights on color change, microhardness of bottom and top, and surface topography of bulk fill and incremental composites after artificial aging for 1 year. MATERIALS AND METHODS: Bulk fill and incremental composites were cured using multi-peak and single-peak light-emitting diode (LED) following 4 clinical conditions: (1) optimal condition (no angulation or tip displacement), (2) tip-displacement (2 mm), (3) slight tip angulation (α = 20°) and (4) moderate tip angulation (α = 35°). After 1-year of water aging, the specimens were analyzed for color changes (ΔE), Vickers hardness, surface topography (Ra, Rt, and Rv), and scanning electron microscopy. RESULTS: For samples cured by single-peak LED, the improper positioning significantly increases the color change compared to the optimal position regardless of the type of composite (p < 0.001). For multi-peak LED, the type of resin composite and the curing condition displayed a significant effect on ΔE (p < 0.001). For both LEDs, the Vickers hardness and bottom/top ratio of Vickers hardness were affected by the type of composite and the curing condition (p < 0.01). CONCLUSIONS: The bulk fill composite presented greater resistance to wear, higher color stability, and better microhardness than the incremental composite when subjected to improper curing. The multi-peak LED improves curing under improper conditions compared to single-peak LED. Prevention of errors when curing composites requires the attention of all personnel involved in the patient's care once the clinical relevance of the appropriate polymerization reflects on reliable long-term outcomes.

Titanium dioxide nanotubes with triazine-methacrylate monomer to improve physicochemical and biological properties of adhesives.

OBJECTIVE: Formulate experimental adhesives containing titanium dioxide nanotubes (nt-TiO2) or titanium dioxide nanotubes with a triazine-methacrylate monomer (nt-TiO2:TAT) and evaluate the effect of these fillers on the physical, chemical, and biological properties of the adhesives. METHODS: First, nt-TiO2 were synthesized via a hydrothermal method. The nt-TiO2 were mixed with a triazine-methacrylate monomer (TAT) to formulate nt-TiO2:TAT, which were characterized by transmission electron microscopy (TEM). The nt-TiO2, TAT, and nt-TiO2:TAT were evaluated via Fourier Transform Infrared, Ultraviolet-visible, and micro-Raman spectroscopies. An experimental adhesive resin was formulated with bisphenol A glycerolate dimethacrylates, 2-hydroxyethyl methacrylate, and photoinitiator/co-initiator system. nt-TiO2 or nt-TiO2:TAT were incorporated at 2.5 wt.% and 5 wt.% in the adhesive. The base resin without nt-TiO2 or nt-TiO2:TAT was used as a control group. The adhesives were evaluated for antibacterial activity, cytotoxicity, polymerization kinetics, degree of conversion (DC), Knoop hardness, softening in solvent (ΔKHN%), ultimate tensile strength (UTS), 24 h- and 1 year- microtensile bond strength (µ-TBS). RESULTS: TEM confirmed the nanotubular morphology of TiO2. FTIR, UV-vis, and micro-Raman analyses showed the characteristic peaks of each material, indicating the impregnation of TAT in the nt-TiO2. Adhesives with nt-TiO2:TAT showed antimicrobial activity against biofilm formation compared to control (p < 0.05), without differences in the viability of planktonic bacteria (p > 0.05). All groups showed high percentages of pulp cell viability. The polymerization kinetics varied among groups, but all presented DC above 50%. The addition of 5 wt.% of nt-TiO2 and both groups containing nt-TiO2:TAT showed higher values ​​of Knoop hardness compared to the control (p < 0.05). The groups with nt-TiO2:TAT presented lower ΔKHN% (p < 0.05) and higher UTS (p < 0.05) than the control group. After one year, the group with 5 wt.% of nt-TiO2, as well as both groups containing nt-TiO2:TAT, showed higher µ-TBS than the control (p < 0.05). SIGNIFICANCE: The mixing of a triazine-methacrylate monomer with the nt-TiO2 generated a filler that improved the physicochemical properties of the adhesive resins and provided antibacterial activity, which could assist in preventing carious lesions around tooth-resin interfaces. The set of physical, chemical, and biological properties of the formulated polymer, together with the greater stability of the bond strength over time, make nt-TiO2:TAT a promising filler for dental adhesive resins.

Prospects on Nano-Based Platforms for Antimicrobial Photodynamic Therapy Against Oral Biofilms.

Objective: This review clusters the growing field of nano-based platforms for antimicrobial photodynamic therapy (aPDT) targeting pathogenic oral biofilms and increase interactions between dental researchers and investigators in many related fields. Background data: Clinically relevant disinfection of dental tissues is difficult to achieve with aPDT alone. It has been found that limited penetrability into soft and hard dental tissues, diffusion of the photosensitizers, and the small light absorption coefficient are contributing factors. As a result, the effectiveness of aPDT is reduced in vivo applications. To overcome limitations, nanotechnology has been implied to enhance the penetration and delivery of photosensitizers to target microorganisms and increase the bactericidal effect. Materials and methods: The current literature was screened for the various platforms composed of photosensitizers functionalized with nanoparticles and their enhanced performance against oral pathogenic biofilms. Results: The evidence-based findings from the up-to-date literature were promising to control the onset and the progression of dental biofilm-triggered diseases such as dental caries, endodontic infections, and periodontal diseases. The antimicrobial effects of aPDT with nano-based platforms on oral bacterial disinfection will help to advance the design of combination strategies that increase the rate of complete and durable clinical response in oral infections. Conclusions: There is enthusiasm about the potential of nano-based platforms to treat currently out of the reach pathogenic oral biofilms. Much of the potential exists because these nano-based platforms use unique mechanisms of action that allow us to overcome the challenging of intra-oral and hard-tissue disinfection.

Tooth sealing formulation with bacteria-killing surface and on-demand ion release/recharge inhibits early childhood caries key pathogens.

Herein, we investigated a biointeractive tooth sealing material consisted of dimethylaminohexadecyl methacrylate (DMAHDM) and amorphous calcium phosphate nanoparticles (NACPs) to address the above issues simultaneously. Of note, 5% DMAHDM was incorporated into the resin blend, and 20% NACP was added to inorganic filler content of dental formulations intended as dental sealants. The sealing materials were used to seal human extracted teeth. The sealed teeth were subjected to an early childhood caries (ECC) key pathogen (Candida albicans and Streptococcus mutans) biofilm model using a dynamic caries tooth model (CDC reactor). The biofilm growth over the sealed teeth was assessed via colony-forming unit counting metabolic activity assays. The enamel surface hardness loss, degree of conversion, shear bond strength (SBS), and cytotoxicity were also investigated. Formulations having DMAHDM displayed antibacterial efficiency of 2.8-3.5 and 1.4-4.0 log inhibition for Streptococcus mutans and Candida albicans, respectively. Furthermore, the metabolic activity was reduced on the top of the sealed tooth with the biointeractive sealing materials (p < .05). The degree of conversion values was acceptable. The enamel surface hardness loss decreases (36 ± 9.8%) when in contact with the biointeractive tooth sealing material. The SBS of the combined formulation (5% DMAHDM + 20% NACP) was lower than commercial sealant but similar to experimental control. The investigated sealing material holds valuable dual antibacterial and antifungal activities associated with a reduced mineral loss against the cariogenic challenge promoted by ECC key pathogens.

Evaluation of the Physicochemical and Antibacterial Properties of Experimental Adhesives Doped with Lithium Niobate.

The aim of the present study was to formulate dental adhesives with different concentrations of LiNbO3 and to evaluate their physicochemical and antibacterial properties. A dental adhesive was formulated using methacrylate monomers and photoinitiators and used as a control filler-free group. Subsequently, three experimental adhesives doped with LiNbO3 at different concentrations (1 wt.%, 2 wt.%, and 5 wt.%) were also formulated. All the experimental adhesives were assessed to evaluate the degree of conversion (DC), softening in solvent, immediate and long-term microtensile bond-strength (µ-TBS), radiopacity, ultimate tensile strength, and antibacterial activity. The incorporation of 1 wt.% of LiNbO3 had no negative effect on the DC of the adhesive resin compared to the control group (p > 0.05). We observed a decrease in the percentage of softening in solvent in the group LiNbO3 at 1 wt.% (p < 0.05). The addition of LiNbO3 increased the radiopacity at a concentration above 2 wt.%, and there was also an increase in cohesive strength (p < 0.05). The immediate µ-TBS increased for LiNbO3 at 5 wt.% (p < 0.05), and there was no statistical difference for the other groups compared to the control (p > 0.05). After six months, the group with 5 wt.% still presented the highest µ-TBS (p < 0.05). The adhesives showed no antimicrobial activity (p > 0.05). LiNbO3 was successfully incorporated in dental adhesives, increasing the radiopacity and their resistance to degradation. Although LiNbO3 offered no antibacterial properties, the reliability of LiNbO3 incorporation in the adhesive encourages new tests to better investigate the antimicrobial action of LiNbO3 through temperature variation.

Exploring Needle-Like Zinc Oxide Nanostructures for Improving Dental Resin Sealers: Design and Evaluation of Antibacterial, Physical and Chemical Properties.

This study aimed to evaluate the effect of needle-like zinc oxide nanostructures (ZnO-NN) on the physical, chemical, and antibacterial properties of experimental methacrylate-based dental sealers. ZnO-NN was synthesized and characterized. ZnO-NN was added to a co-monomer blend at 20, 30, and 40 wt.%. One group without ZnO-NN was used as a control. The dental resin sealers were evaluated for their flow, film thickness, water sorption, solubility, radiopacity, degree of conversion (DC), dental-sealer interface characterization via micro-Raman, and antibacterial activity. ZnO-NN presented a mean needle diameter of 40 nm and 16 m2/g of surface area. There was no difference among groups containing ZnO-NN regarding their flow. The ZnO-NN addition significantly increased the film thickness. Water sorption and solubility tests showed no difference among groups. The radiopacity increased, and DC decreased with higher concentrations of ZnO-NN. Micro-Raman suggested that ZnO-NN was in close contact with root canal dentin. Overall, the incorporation of ZnO-NN provided an antibacterial effect against Enterococcus faecalis without a significant detrimental impact on the physical and chemical functionality of the material. The use of ZnO-NN as an inorganic filler is a potential application within dental materials intended for root canal treatment.

Physicochemical and Microbiological Assessment of an Experimental Composite Doped with Triclosan-Loaded Halloysite Nanotubes.

This study is aimed at evaluating the effects of triclosan-encapsulated halloysite nanotubes (HNT/TCN) on the physicochemical and microbiological properties of an experimental dental composite. A resin composite doped with HNT/TCN (8% w/w), a control resin composite without nanotubes (HNT/TCN-0%) and a commercial nanofilled resin (CN) were assessed for degree of conversion (DC), flexural strength (FS), flexural modulus (FM), polymerization stress (PS), dynamic thermomechanical (DMA) and thermogravimetric analysis (TGA). The antibacterial properties (M) were also evaluated using a 5-day biofilm assay (CFU/mL). Data was submitted to one-way ANOVA and Tukey tests. There was no significant statistical difference in DC, FM and RU between the tested composites (p > 0.05). The FS and CN values attained with the HNT/TCN composite were higher (p < 0.05) than those obtained with the HNT/TCN-0%. The DMA analysis showed significant differences in the TAN δ (p = 0.006) and Tg (p = 0) between the groups. TGA curves showed significant differences between the groups in terms of degradation (p = 0.046) and weight loss (p = 0.317). The addition of HNT/TCN induced higher PS, although no significant antimicrobial effect was observed (p = 0.977) between the groups for CFUs and (p = 0.557) dry weight. The incorporation of HNT/TCN showed improvements in physicochemical and mechanical properties of resin composites. Such material may represent an alternative choice for therapeutic restorative treatments, although no significance was found in terms of antibacterial properties. However, it is possible that current antibacterial tests, as the one used in this laboratory study, may not be totally appropriate for the evaluation of resin composites, unless accompanied with aging protocols (e.g., thermocycling and load cycling) that allow the release of therapeutic agents incorporated in such materials.

Influence of addition of 2-[3-(2H-benzotriazol-2-YL)- 4-hydroxyphenyl] ethyl methacrylate to an experimental adhesive system.

The aim of this study was to evaluate the addition of 2-[3-(2HBenzotriazol- 2-yl)-4-hydroxyphenyl]ethyl methacrylate (BTAM) to an experimental adhesive resin. An experimental base adhesive resin was formulated with BisGMA, TEGDMA and HEMA, to which BTAM was added at 1, 2.5 and 5%, in weight. One group with no addition was used as control. The experimental adhesives were evaluated for antibacterial potential (against Streptococcus mutans), degree of conversion with FTIR, softening in solvent and microRaman interface analyses. Data were analyzed by Kruskal-Wallis, paired t test and ANOVA and Tukey, considering a 5% level of significance. The results showed antibacterial activity of 5% BTAM against S. mutans (p<0.05), however, no difference was found among BTAM groups (p> 0.05). The results of degree of conversion and softening of solvent showed no statistical difference between BTAM and control groups (p>0.05). The addition of 5% BTAM showed higher antibacterial activity than the negative control, and copolymerization with comonomer blend of adhesive resin and BTAM was detected at the dentin/ adhesive interface.

Glycerol salicylate-based containing α-tricalcium phosphate as a bioactive root canal sealer.

The use of bioactive materials instead of inert materials to fill the root canal space could be an effective approach to achieve a hermetic seal and stimulate the healing of periapical tissues. The purpose of this study was to develop and characterize an endodontic sealer based on a glycerol salicylate resin and α-tricalcium phosphate (αTCP) at physical and chemical properties. Different sealers were formulated using 70% of a glycerol salicylate resin and 30% of a mixture of calcium hydroxide and αTCP (0, 5, 10, or 15%, in weight). Sealers formulated were characterized based on setting time, in vitro degradation over time, pH, cytotoxicity, and mineral deposition. Sealers presented setting time ranging from 240 to 405 min, and basic pH over 8.21 after 28 days. Higher αTCP concentration leads to sealers with low solubility. Cell viability after 48 h in direct contact with sealers was similar to a commercial sealer used as reference. The 10% and 15% αTCP sealers exhibited a calcium-phosphate layer on the surface after immersion in water and SBF for 7 days. Glycerol salicylate sealers with 10% and 15% α-tricalcium phosphate showed reliable physical-chemical properties and apatite-forming ability.

Methacrylate bonding to zirconia by in situ silica nanoparticle surface deposition.

OBJECTIVE: This study introduces an innovative method to enhance adhesion of methacrylate-based cements to yttria-stabilized zirconia (Y-TZP) by means of a silica-nanoparticle deposition process. METHODS: Two alkoxide organic precursors, tetraethyl-orthosilicate (TEOS) and zirconium tert-butoxide (ZTB) were diluted in hexane at different concentrations in order to obtain several experimental materials to enhance deposition of a SiO(x) reactive layer to Y-TZP. This deposition was attained via sintering alkoxide precursors directly on pre-sintered zirconia (infiltration method­INF) or application on the surface of fully sintered zirconia (coating method­COA). Untreated specimens and a commercial tribochemical silica coating were also tested as controls and all the treated Y-TZP specimens were analyzed using SEM-EDX. Specimens were bonded using silane, adhesive and dual-cure luting cement and submitted to shear bond strength test after different water storage periods (24 h, 3-, 6- and 12-months). RESULTS: SEM-EDX revealed Y-TZP surface covered by silica nanoclusters. The morphology of silica-covered Y-TZP surfaces was influenced by sintering method, employed to deposit nanoclusters. High bond strength (MPa) was observed when using COA method; highest TEOS percentage achieved the greatest bond strengths to Y-TZP surface (36.7±6.3 at 24 h). However, bonds stability was dependent on ZTB presence (32.9±9.7 at 3 months; 32.3±7.1 at 6 months). Regarding INF method, the highest and more stable resin-zirconia bond strength was attained when using experimental solutions containing TEOS and no ZTB. Both sintering methods tested in this study were able to achieve a bonding performance similar to that of classic tribochemical strategies. SIGNIFICANCE: This study demonstrates that it is possible to achieve a reliable and long-lasting bonding between yttria-stabilized zirconia ceramic and methacrylate-based cements when using this novel, simple, and cost-effective bonding approach.