Antibacterial properties of mesoporous silica coated with cerium oxide nanoparticles in dental resin composite.

Cerium oxide nanoparticles are known for their antibacterial effects resulting from Ce3+ to Ce4+ conversion. Application of such cerium oxide nanoparticles in dentistry has been previously considered but limited due to deterioration of mechanical properties. Hence, this study aimed to examine mesoporous silica (MCM-41) coated with cerium oxide nanoparticles and evaluate the antibacterial effects and mechanical properties when applied to dental composite resin. Cerium oxide nanoparticles were coated on the MCM-41 surface using the sol-gel method by adding cerium oxide nanoparticle precursor to the MCM-41 dispersion. The samples were tested for antibacterial activity against Streptococcus mutans via CFU and MTT assays. The mechanical properties were assessed by flexural strength and depth of cure according to ISO 4049. Data were analyzed using a t-test, one-way ANOVA, and Tukey's post-hoc test (p = 0.05). The experimental group showed significantly increased antibacterial properties compared to the control groups (p < 0.005). The flexural strength exhibited a decreasing trend as the amount of cerium oxide nanoparticle-coated MCM-41 increased. However, the flexural strength and depth of cure values of the silane group met the ISO 4049 standard. Antibacterial properties increased with increasing amounts of cerium oxide nanoparticles. Although the mechanical properties decreased, silane treatment overcame this drawback. Hence, the cerium oxide nanoparticles coated on MCM-41 may be used for dental resin composite.

Investigation of mechanical properties, remineralization, antibacterial effect, and cellular toxicity of composite orthodontic adhesive combined with silver-containing nanostructured bioactive glass.

BACKGROUND: The formation of white spots, which represent early carious lesions, is a major issue with fixed orthodontics. The addition of remineralizing agents to orthodontic adhesives may prevent the formation of white spots. The aim of this study was to produce a composite orthodontic adhesive combined with nano-bioactive glass-silver (nBG@Ag) for bracket bonding to enamel and to investigate its cytotoxicity, antimicrobial activity, remineralization capability, and bond strength. METHODS: nBG@Ag was synthesized using the sol-gel method, and characterized using transmission electron microscopy (TEM), X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy with an attenuated total reflectance attachment (ATR-FTIR). The cytotoxicity test (MTT) and antimicrobial activity of adhesives containing 1%, 3%, and 5% (wt/wt) nBG@Ag were evaluated, and the shear bond strength of the adhesives was measured using a universal testing machine. Remineralization was assessed through microhardness testing with a Vickers microhardness tester and scanning electron microscopy (SEM). Statistical analyses were conducted using the Shapiro-Wilk test, Levene test, one-way ANOVA, Robust-Welch test, Tukey HSD method, and two-way ANOVA. RESULTS: The biocompatibility of the adhesives was found to be high, as confirmed by the lack of significant differences in the cytotoxicity between the sample and control groups. Discs made from composites containing nBG@Ag exhibited a significant reduction in the growth of Streptococcus mutans (p < 0.05), and the antibacterial activity increased with higher percentages of nBG@Ag. The shear bond strength of the adhesives decreased significantly (p < 0.001) after the addition of nanoparticles, but it remained above the recommended value. The addition of nBG@Ag showed improvement in the microhardness of the teeth, although the differences in microhardness between the study groups were not statistically significant. The formation of hydroxyapatite deposits on the tooth surface was confirmed through SEM and energy-dispersive X-ray spectroscopy (EDX). CONCLUSION: Adding nBG@Ag to orthodontic adhesives can be an effective approach to enhance antimicrobial activity and reduce enamel demineralization around the orthodontic brackets, without compromising biocompatibility and bond strength.

Ionic Liquid-Based Silane for SiO2 Nanoparticles: A Versatile Coupling Agent for Dental Resins.

The current longevity of dental resins intraorally is limited by susceptibility to acidic attacks from bacterial metabolic byproducts and vulnerability to enzymatic or hydrolytic degradation. Here, we demonstrate synthesizing an ionic liquid-based antibiofilm silane effective against Streptococcus mutans, a major caries pathogen. Furthermore, we incorporate this silane into dental resins, creating antibiofilm- and degradation-resistant materials applicable across resin types. FTIR, UV-vis, and NMR spectroscopy confirmed the synthesis of the expected ionic liquid-based silane. The characterization of SiO2 after the silanization indicated the presence of the silane and how it interacted with the oxide. All groups achieved a degree of conversion similar to that found for commercial resin composites immediately and after two months of storage in water. The minimum of 2.5 wt % of silane led to lower softening in solvent than the control group (GCTRL) (p < 0.05). While the flexural strength indicated a lower value from 1 wt % of silane compared to GCTRL (p < 0.05), the ultimate tensile strength did not indicate differences among groups (p > 0.05). There was no difference within groups between the immediate and long-term tests of flexural strength (p > 0.05) or ultimate tensile strength (p > 0.05). The addition of at least 5 wt % of silane reduced the viability of S. mutans compared to GCTRL (p < 0.05). The fluorescence microscopy analysis suggested that the higher the silane concentration, the higher the amount of bacteria with membrane defects. There was no difference among groups in the cytotoxicity test (p > 0.05). Therefore, the developed dental resins displayed biocompatibility, proper degree of conversion, improved resistance against softening in solvent, and stability after 6 months of storage in water. This material could be further developed to produce polymeric antimicrobial layers for different surfaces, supporting various potential avenues in developing novel biomaterials with enhanced therapeutic characteristics using ionic liquid-based materials.

Synthesis of polymerizable betulin maleic diester derivative for dental restorative resins with antibacterial activity.

OBJECTIVE: Bisphenol A glycidyl methacrylate (Bis-GMA) is of great importance for dental materials as the preferred monomer. However, the presence of bisphenol-A (BPA) core in Bis-GMA structure causes potential concerns since it is associated with endocrine diseases, developmental abnormalities, and cancer lesions. Therefore, it is desirable to develop an alternative replacement for Bis-GMA and explore the intrinsic relationship between monomer structure and resin properties. METHODS: Here, the betulin maleic diester derivative (MABet) was synthesized by a facile esterification reaction using plant-derived betulin and maleic anhydride as raw materials. Its chemical structure was confirmed by 1H and 13C NMR spectra, FT-IR spectra, and HR-MS, respectively. The as-synthesized MABet was then used as polymerizable comonomer to partially or completely substitute Bis-GMA in a 50:50 Bis-GMA: TEGDMA resin (5B5T) to formulate dental restorative resins. These were then determined for the viscosity behavior, light transmittance, real-time degree of conversion, residual monomers, mechanical performance, cytotoxicity, and antibacterial activity against Streptococcus mutans (S. mutans) in detail. RESULTS: Among all experimental resins, increasing the MABet concentration to 50 wt% made the resultant 5MABet5T resin have a maximum in viscosity and appear dark yellowish after polymerization. In contrast, the 1MABet4B5T resin with 10 wt% MABet possessed comparable shear viscosity and polymerization conversion (46.6 ± 1.0% in 60 s), higher flexural and compressive strength (89.7 ± 7.8 MPa; 345.5 ± 14.4 MPa) to those of the 5B5T control (48.5 ± 0.6%; 65.7 ± 6.7 MPa; 223.8 ± 57.1 MPa). This optimal resin also had significantly lower S. mutans colony counts (0.35 ×108 CFU/mL) than 5B5T (7.6 ×108 CFU/mL) without affecting cytocompatibility. SIGNIFICANCE: Introducing plant-derived polymerizable MABet monomer into dental restorative resins is an effective strategy for producing antibacterial dental materials with superior physicochemical property.

The mechanical, wear, antibacterial properties and biocompatibility of injectable restorative materials under wet challenge.

OBJECTIVES: To evaluate the mechanical, wear, antibacterial properties, and biocompatibility of injectable composite materials. METHODS: Two injectable composite resins (GU and BI), one flowable composite resin (FS), and one flowable compomer (DF), in A2 shade, were tested. Mechanical properties were tested via three-point bending test immediately after preparation and after 1-day, 7-day, 14-day, and 30-day water storage. Under water-PMMA slurry immersion, specimens were subjected to a 3-body wear test (10,000 cycles) against stainless steel balls, while the roughness, wear depth, and volume loss were recorded. After 1-day and 3-day MC3T3-E1 cell culture, cell viability was evaluated with CCK-8 test kits, while the cell morphology was observed under CLSM and SEM. Antibacterial properties on S. mutans were assessed via CFU counting, CLSM, and SEM observation. SPSS 26.0 was used for statistical analysis (α = 0.05). RESULTS: The mechanical properties were material-dependent and sensitive to water storage. Flexural strength ranked GU > FS > BI > DF at all testing levels. Three nanocomposites had better wear properties than DF. No significant difference on 1-day cell viability was found, but DF showed significantly lower cell proliferation than nanocomposites on 3-day assessment. GU and FS had more favourable cell adhesion and morphology. CFU counting revealed no significant difference, while FS presented a slightly thicker biofilm and BI showed relatively lower bacteria density. CONCLUSIONS: Injectable nanocomposites outperformed the compomer regarding mechanical properties, wear resistance, and biocompatibility. The tested materials presented comparable antibacterial behaviours. Flowable resin-based composites' performances are affected by multiple factors, and their compositions can be attributed. CLINICAL SIGNIFICANCE: A profound understanding of the mechanical, wear, and biological properties of the restorative material is imperative for the clinical success of dental restorations. The current study demonstrated superior properties of highly filled injectable composite resins, which imply their wider indications and better long-term clinical performances.

Evaluation of dental pulp stem cells response to flowable nano-hybrid dental composites: A comparative analysis.

BACKGROUND: Flowable resin composites (FRC) are tooth-colored restorative materials that contain a lower filler particle content, and lower viscosity than their bulk counterparts, making them useful for specific clinical applications. Yet, their chemical makeup may impact the cellular population of the tooth pulp. This in-vitro study assessed the cytocompatibility and odontogenic differentiation capacity of dental pulp stem cells (DPSCs) in response to two recent FRC material extracts. METHODS: Extracts of the FRC Aura easyflow (AEF) and Polofil NHT Flow (PNF) were applied to DPSCs isolated from extracted human teeth. Cell viability of DPSCs was assessed using MTT assay on days 1, 3 and 7. Cell migration was assessed using the wound healing assay. DPSCs' capacity for osteo/odontogenic differentiation was assessed by measuring the degree of mineralization by Alizarin Red S staining, alkaline phosphatase enzyme (ALP) activity, and monitoring the expression of osteoprotegerin (OPG), RUNX Family Transcription Factor 2 (RUNX2), and the odontogenic marker dentin sialophosphoprotein (DSPP) by RT-PCR. Monomer release from the FRC was also assessed by High-performance liquid chromatography analysis (HPLC). RESULTS: DPSCs exposed to PNF extracts showed significantly higher cell viability, faster wound closure, and superior odontogenic differentiation. This was apparent through Alizarin Red staining of calcified nodules, elevated alkaline phosphatase activity, and increased expression of osteo/odontogenic markers. Moreover, HPLC analysis revealed a higher release of TEDGMA, UDMA, and BISGMA from AEF. CONCLUSIONS: PNF showed better cytocompatibility and enhancement of odontogenic differentiation than AEF.

Biological Effects of PMMA and Composite Resins on Human Gingival Fibroblasts: An In Vitro Comparative Study.

The use of temporary resin for provisional restorations is a fundamental step to maintain the position of prepared teeth, to protect the pulpal vitality and the periodontal health as well as the occlusion. The present study aimed at evaluating the biological effects of two resins used in dentistry for temporary restorations, Coldpac (Yates Motloid) and ProTemp 4™ (3M ESPE ™), and their eluates, in an in vitro model of human gingival fibroblasts (hGFs). The activation of the inflammatory pathway NFκB p65/NLRP3/IL-1ß induced by the self-curing resin disks was evaluated by real-time PCR, Western blotting and immunofluorescence analysis. The hGFs adhesion on resin disks was investigated by means of inverted light microscopy and scanning electron microscopy (SEM). Our results suggest that hGF cells cultured in adhesion and with eluate derived from ProTemp 4™ (3M ESPE ™) resin evidenced a downregulation in the expression of the inflammatory mediators such as NFκB p65, NLRP3 and IL-1ß compared to the cells cultured with Coldpac (Yates Motloid) after 24 h and 1 week of culture. Furthermore, the cells cultured with ProTemp 4™ (3M ESPE ™) after 24 h and 1 week of culture reported a higher cell viability compared to the cells cultured with Coldpac (Yates Motloid), established by MTS cell analysis. Similar results were obtained when hGFs were placed in culture with the eluate derived from ProTemp 4™ (3M ESPE ™) resin which showed a higher cell viability compared to the cells cultured with eluate derived from Coldpac (Yates Motloid). These results highlighted the lower pro-inflammatory action and improved cell biocompatibility of ProTemp 4™ (3M ESPE ™), suggesting a better performance in terms of cells-material interaction.

Characterisation of experimental flowable composites containing fluoride-doped calcium phosphates as promising remineralising materials.

OBJECTIVE: Remineralising composites with antibacterial properties may seal the cavity and prevent secondary caries. This study aimed at developing experimental flowable composites containing different concentrations of fluoride-doped calcium phosphate fillers and evaluating their remineralising and antibacterial properties. METHODS: Experimental resin-based composites containing different concentrations (0-20 %) of fluoride-doped calcium phosphate fillers (VS10/VS20) were formulated. The release of calcium (Ca), phosphate (PO) and fluoride (F) ions was assessed for 30 days. Remineralisation properties were evaluated through ATR-FTIR and SEM/EDX after storage in simulated body fluid (SBF). The metabolic activity and viability of Streptococcus gordonii was also evaluated through ATP, CFU and live/dead confocal microscopy. The evaluation of specific monomer elution from the experimental composites was conducted using high-performance liquid chromatography (HPLC). RESULTS: The composites containing VS10 showed the highest release of Ca, those containing VS20 released more F over time (p < 0.05), while there was no significant difference in terms of PO ions release between the groups (p > 0.05). A quick 7-day mineral precipitation was observed in the tested composites containing VS10 or VS20 at 10 %; these materials also showed the greatest antibacterial activity (p < 0.05). Moreover, the tested composites containing VS10 presented the lowest elution of monomers (p < 0.05). CONCLUSIONS: Innovative composites were developed with low monomers elution, evident antibacterial activity against S. gordonii and important remineralisation properties due to specific ions release. CLINICAL SIGNIFICANCE: Novel composites containing fluoride-doped calcium phosphates may be promising to modulate bacteria growth, promote remineralisation and reduce the risk of cytotoxicity related to monomers' elution.

Adhesion of tooth fragment after trauma: effect of adhesion strategy and storage in the rescue box.

This study aims to investigate the impact of storage conditions for crown fragments (specifically, whether they were stored within a tooth rescue box or in tap water) on their adhesion to fractured teeth when subjected to two different adhesive systems (namely, total etch and self etch). Sixty maxillary premolars were sectioned to obtain tooth fragments. These fragments were stored briefly (2 hours) and reattached in the following groups: Group 1 (fragments stored in tooth rescue box and reattached with etch and rinse (E&R) technique), Group 2 (fragments stored in tap water and reattached with E&R technique), Group 3 (fragments stored in tooth rescue box and reattached with self-etch (SE) technique), and Group 4 (fragments stored in tap water and reattached SE technique). After reattachment, the bonded tooth fragments underwent thermal cycling (500 cycles, 5-55 °C) and bond strength testing using a universal testing machine. Two-way Analysis of Variance (ANOVA) and Tukey's tests were used for bond strength comparison (p ≤ 0.05). A two-parameter Weibull distribution was conducted to evaluate the reliability of the storage medium and adhesion modality on bond strength. The results showed that measured shear bond values (MPa ± Standard deviation (SD); arranged in descending order) for each group were: Group 2 (Tap water/E&R = 6.5 ± 2.1), Group 1 (Rescue box/E&R = 6.0 ± 2.5), Group 4 (Tap water/E&R = 5.1 ± 2.8), and Group 3 (Rescue box/SE = 3.6 ± 3.2). Significant differences were found only between Groups 2 and 3 (p = 0.002). In conclusion, storing crown fragments in a tooth rescue box did not significantly affect the shear bond strength of the restored tooth. However, fragments reattached using the self-etch technique showed comparable shear bond strength but a higher rate of adhesive failures compared to the E&R technique.

Effect of antioxidants on adhesive bond strength to bleached enamel.

OBJECTIVE: To evaluate the influence of antioxidants (ATX) resveratrol, winter's bark, green tea and yerba mate on the bond strength between bleached enamel and the nanohybrid composite resin. METHODOLOGY: Bovine incisor crowns (n = 132) were randomly divided into 22 groups (n = 6) according to the application times (5, 10, 15, 30, and 60 min) of each antioxidant. Teeth restored without previous bleaching or ATX constituted the non-bleached control group (NB Ctrl) (n = 6), and teeth restored after bleaching and without ATX represented the bleached control group (B Ctrl) (n = 6). The 35 % hydrogen peroxide was applied for 45 min (3 application of 15 min) to the buccal enamel surface. ATX was used after bleaching for the specified time of each group and removed with air-water spray. The enamel was etched with 37 % phosphoric acid (30 s) and rinsed with air-water spray. The adhesive resin was applied to the enamel dry surface. Teeth were restored using 1 mm composite resin increments (10 × 10 × 3 mm) and sectioned in test specimens of 6 mm in length and 1 mm2 in cross-sectional area submitted to microtensile bond strength test (0.5 mm/min). The load (N) at failure was recorded, and the bond strength (σt) was calculated (MPa). The fracture area was analyzed under optical microscopy, and failures were classified as cohesive, mixed, or adhesive. Data was evaluated by Kruskal-Wallis and Dunn tests (p ≤ 0.05). RESULTS: B Ctrl group presented lower σt than NB Ctrl (p < 0.001). Applying resveratrol for 5 or 10 min, winter's bark for 10 or 15 min, green tea for less than 15 min, and yerba mate for 15 min provided similar σt between bleached enamel and nanohybrid composite to the control group. CONCLUSION: Restorative procedures performed immediately after tooth bleaching compromises adhesion. Experimental antioxidants applied to bleached enamel can increase the immediate bond strength of restorations performed directly after bleaching, with similar values to those observed in unbleached enamel. CLINICAL SIGNIFICANCE: This study presents promising results to support the use of antioxidants on the recently bleached enamel to allow adhesive tooth restorations. The immediate bonding obtained using antioxidants was similar to the one achieved in non-bleached enamel in brief application times. Green tea extract and resveratrol were able to restore the bond strength to bleached enamel in a short application time of 5 min. The reduction in the required application time holds the potential to decrease the overall duration of the clinical section, offering clinical advantages and improving the feasibility of using antioxidants on the bleached enamel prior to adhesive procedures.

Mechanical and Antimicrobial Properties of Boron Nitride/Methacrylic Acid Quaternary Ammonium Composites Reinforced Dental Flowable Resins.

Dental resin composites (DRCs) are commonly used to restore teeth affected by dental caries or defects. These materials must possess excellent properties to withstand the complex oral environment. The objective of this study was to prepare and characterize Boron nitride nanosheets (BNN)/ dimethyl amino hexadecyl methacrylate (DMAHDM) composites (BNN/DMA), and to evaluate them as functional fillers to enhance the mechanical and antimicrobial properties of dental resins. The BNN/DMA composites were successfully prepared under the theoretical guidance of molecular dynamics (MD), and then the physicochemical and morphological characterization of the BNN/DMA composites were carried out by using various test methods, such as FT-IR, XRD, UV-vis spectroscopy, SEM, TEM, and AFM. It was doped into the dental flowable resin in a certain proportion, and the results showed that the flexural strength (FS), elastic modulus (EM), compressive strength (CS), and microhardness (MH) of the modified resin composites were increased by 53.29, 47.8, 97.59, and 37.1%, respectively, with the addition of 0.8 wt % of BNN/DMA composite fillers. It has a good inhibition effect on Streptococcus mutans, with an inhibition rate as high as 90.43%. Furthermore, this effect persists even after one month of aging. In conclusion, the modification of flowable resins with low-concentration BNN/DMA composites favorably integrates the mechanical properties and long-term antimicrobial activity of dental resins. At the same time, they have good biocompatibility and do not affect the aesthetics. The BNN/DMA composite modified flowable resin has the potential to become a new type of antimicrobial dental restorative material.

Antimicrobial photodynamic therapy against a dual-species cariogenic biofilm using a ruthenium-loaded resin-based dental material.

BACKGROUND: Streptococcus mutans and Candida albicans are associated with caries recurrence. Therefore, this study evaluated the combination of a Ru(II)-loaded resin-based dental material (RDM) and antimicrobial photodynamic therapy (aPDT) against a dual-species biofilm of S. mutans and C. albicans. METHODS: An aPDT protocol was established evaluating Ru(II)'s photocatalytic activity and antimicrobial potential under blue LED irradiation (440-460 nm, 22.55 mW/cm2) at different energy densities (0.00, 6.25, 20.25, 40.50 J/cm2). This evaluation involved singlet oxygen quantification and determination of minimum inhibitory concentration (MIC) and minimum bactericidal/fungicidal concentration (MBC/MFC). The biofilm was grown (72 h) on resin disks prepared with Ru(II)-doped RDM (0.00, 0.56, or 1.12 %) and samples were exposed to aPDT or dark conditions. The biofilm was then harvested to analyze cell viability (CFU counts) and formation of soluble and insoluble exopolysaccharides. RESULTS: The photocatalytic activity of Ru(II) was concentration and energy density dependent (p < 0.05), and MIC/MBC values were reduced for the microorganisms after LED irradiation (40.5 J/cm2); therefor, this energy density was chosen for aPDT. Although incorporation of Ru(II) into RDM reduced the biofilm growth compared to Ru(II)-free RDM for both species in dark conditions (p < 0.05), aPDT combined with an Ru(II)-loaded RDM (0.56 or 1.12 %) potentialized CFU reductions (p < 0.05). Conversely, only 1.12 % Ru(II) with LED irradiation showed lower levels of both soluble and insoluble exopolysaccharides compared to Ru(II)-free samples in dark conditions (p < 0.05). CONCLUSIONS: When the Ru(II)-loaded RDM was associated with blue LED, aPDT reduced cell viability and lower soluble and insoluble exopolysaccharides were found in the cariogenic dual-species biofilm.

A low-shrinkage-stress and anti-bacterial adherent dental resin composite: physicochemical properties and biocompatibility.

Polymerisation shrinkage and biofilm accumulation are the two main problems associated with dental resin composites (DRCs) that induce secondary caries, which can cause restoration failure. Polymerisation shrinkage can lead to microleakage gaps between the tooth and the DRCs, causing the aggregation of bacteria and development of secondary caries. Reducing the shrinkage stress (SS) and improving the resistance to bacterial adhesion have always been the focus of this field in modifying DRCs. A thiol-ene resin system can effectively reduce the polymerisation SS via its step-growth mechanism for delaying the gel point. Fluorinated compounds can reduce the surface free energies, thereby reducing bacterial adhesion. Thus, in this study, a range of mass fractions (0, 10, 20, 30, and 40 wt%) of a fluorinated thiol-ene resin system were added to a fluorinated dimethacrylate resin system/tricyclo decanedimethanol diacrylate to create a fluorinated methacrylate-thiol-ene ternary resin matrix. DRCs were prepared using the obtained ternary resin matrix, and their physical and chemical properties, effect on bacterial adhesion, and biocompatibility were investigated. The results demonstrated that the volumetric shrinkage and SS of the DRCs were reduced with no reduction in conversion degree even after the thiol-ene resin system was added. All DRC-based fluorinated resin systems exhibited an excellent anti-bacterial adhesion effect, as evidenced by the colony-forming unit counts, live/dead bacterial staining, and crystal violet staining tests against Streptococcus mutans (S. mutans). The genetic expressions associated with the bacterial adhesion of S. mutans were substantially affected after being cultured with fluorinated DRCs. All fluorinated DRCs demonstrated good biocompatibility through the in vitro cytotoxicity test and live/dead staining images of the L-929 cells. The above results illustrate that the DRCs based on the fluorinated methacrylate-thiol-ene resin matrix can be potentially applied in clinical practice due to their low SS and anti-bacterial adhesion effect.

Antimicrobial dental composites with K18-methyl methacrylate and K18-filler.

OBJECTIVE: To determine the effects of using K18-methyl methacrylate (K18-MMA) and K18-Filler on composite cure, esthetic, mechanical, polymerization shrinkage, and antimicrobial properties. METHODS: K18-MMA (0-20% w/w) was used to replace TEGDMA in a 70:30 Bis-GMA:TEGDMA composite filled to 70% w/w with barium glass or K18-Filler. Composite degree of cure (Rockwell15T hardness and near Infrared FTIR), hydrophilicity (contact angle measurements), translucency (transparency parameter measurements, TP), mechanical (3-point bend test), polymerization shrinkage (volumetric shrinkage and shrinkage stress), and antimicrobial properties (colony counting assay) against Streptococcus mutans, Streptococcus sanguinis, and Candida albicans were determined. RESULTS: All experimental groups had comparable degrees of cure (near Infrared FTIR and Rockwell15T Hardness), TP, moduli, polymerization volumetric shrinkages and shrinkage stresses to those of controls (Bonferroni corrected p > 0.0018). Only one group (15% K18-MMA+K18-Filler) had significantly different (lower) contact angles as compared to that of controls (Bonferroni corrected p < 0.0018). Most of the K18-Filler-containing composites had significantly lower ultimate transverse strengths (UTS) than controls (Bonferroni corrected p < 0.0018). Controls had significantly greater S mutans colony counts than 15% and 20% w/w K18-MMA+K18-Filler groups, and greater S sanguinis and C albicans colony counts than K18-containing groups. Of the composites with that provided significant antimicrobial properties against S. mutans, S. sanguinis, and C. albicans, only the 20% K18-MMA+K18-Filler group had significantly lower UTS than controls. SIGNIFICANCE: Composites with K18-MMA and K18-Filler with comparable physical properties to control composites and significant antimicrobial properties have been developed. K18-MMA and K18-Filler seem to be suitable for incorporation into commercial dental resins.

Epigallocatechin gallate-immobilized antimicrobial resin with rechargeable fluorinated synergistic composite for enhanced caries control.

OBJECTIVES: Given the global prevalence of dental caries, impacting 2.5 billion individuals, the development of sophisticated prevention filling materials is crucial. Streptococcus mutans, the principal caries-causing strain, produces acids that demineralize teeth and initiate dental caries. To address this issue, we aimed to develop a synergistic resin-based composite for enhancing caries control. METHODS: The synergistic resin composite incorporates fluorinated kaolinite and silanized Al2O3 nanoparticle fillers into an epigallocatechin gallate (EGCG) immobilized urethane-modified epoxy acrylate (U-EA) resin matrix, referred to the as-prepared resin composite. The EGCG-modified TPGDA/U-EA network was synthesized by preparing methacrylate-functionalized isocyanate (HI), reacting it with EGCG to form HI-EGCG, and then incorporating HI-EGCG into the TPGDA/U-EA matrix. The lamellar space within the kaolinite layer was expanded through the intercalation of acrylamide into kaolinite, enhancing its capability to adsorb and release fluoride ions (F-). The layered structure of acrylamide/ kaolinite in the U-EA resin composite acts as a F- reservoir. RESULTS: The physico-mechanical properties of the as-prepared resin composites are comparable to those of commercial products, exhibiting lower polymerization shrinkage, substantial F- release and recharge and favorable diametral tensile strength. The immobilized EGCG in the composite exhibits potent antimicrobial properties, effectively reducing the biofilm biomass. Furthermore, the synergistic effect of EGCG and fluorinated kaolinite efficiently counteracts acid-induced hydroxyapatite dissolution, thereby suppressing demineralization and promoting enamel remineralization. SIGNIFICANCE: Our innovative EGCG and fluoride synergistic composite provides enhanced antimicrobial properties, durable anti-demineralization, and tooth remineralization effects, positioning it as a promising solution for effective caries control and long-term dental maintenance.

Evaluating the effect of three fissure preparation techniques on microleakage of a colored flowable composite used as a fissure sealant.

Pit and fissure sealants play an essential role in preventive dentistry. This study evaluates the microleakage levels of a new and colored flowable composite applied as a sealant after three preparation techniques. A total of 24 non-carious mandibular permanent molars with deep pits and fissures were included in the study. Pit and fissures were prepared with 37% phosphoric acid, tungsten carbide bur and fissurotomy burs (SS WHITE Dental, New Jersey, USA) using conventional, enameloplasty and fissurotomy techniques. All samples were thermocycled following the placement of Rainbow Flow (PPH CERKAMED Wojciech Pawlowski, Poland) as a sealant and sections were taken after immersion in methylene blue dye. The microleakage levels of the samples were examined under a stereomicroscope (Olympus SZX-7 Olympus SZ-61 Stereo Microscope) at 2.8× magnification to analyze the dye penetration of the flowable composite. The 144 sections were examined and scoring for microleakage was done by examining the dye penetration from the occlusal border to the base of the fissure. Considering all sections regardless of the preparation technique, it was found that 16.6% of the sections have no leakage. Regarding the microleakage scores, the mean score of the conventional group was 1.87 ± 0.98, the mean score of the enameloplasty group was 1.88 ± 1.14, and the mean score of the fissurotomy group was 1.81 ± 1.1. The median scores of the conventional, enameloplasty and fissurotomy groups were 2, 2 and 1.5, respectively. The present study reports no difference between the microleakage level of a colored flowable composite material used as a pit and fissure sealant following three fissure preparation techniques and supports the clinical use of this material.

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.

Making graphene oxide (GO)-cladded SiO2 spheres (SiO2 @GO) as inorganic fillers for dental restorative resin composites.

OBJECTIVE: Graphene oxide (GO) is of great interest in dentistry as the functional filler, mainly owing to its ability to inhibit the formation of cariogenic bacteria and possess low cytotoxicity to different cells, such as human dental pulp cells, HeLa cells, etc. However, its typical brown color limits the practical application. METHODS: Here, the refractive-index-matched monodisperse SiO2 were used as the supporting substrates to synthesize GO-cladded SiO2 spheres (xSiO2 @ yGO) through a mild electrostatic self-assembly process, where x and y represent the amount of SiO2 and GO in the reaction mixture, respectively. The morphology and the optical performance of the obtained xSiO2 @ yGO particles were modulated by varying the mass ratio of SiO2 and GO (5:1, 10:1, 50:1, and 100:1). All developed hybrid particles were silanized and formulated with dimethacrylate-based resins. These were tested for curing depth, polymerization conversion, mechanical performance, in vitro cell viability, and antibacterial activity. RESULTS: Of all xSiO2 @ yGO materials, increasing the mass ratio to 100:1 made the 100SiO2 @GO particles appear light brown and possess the lowest light absorbance from 300 to 800 nm. The results of CIEL*a*b* system showed that all these hybrid particles exhibited obvious discoloration compared with SiO2 and GO, where 100SiO2 @GO possessed the smallest color difference. Furthermore, following the results of curing depth, polymerization conversion, and mechanical performance of dental composites, the optimal filler composition was 100SiO2 @GO at 5 wt% filler loading. The resultant 100SiO2 @GO-filled composite produced the highest flexural strength (115 ± 12 MPa) and the lowest bacterial concentration (6.7 × 108 CFU/mL) than those of the resin matrix (78 ± 11 MPa; 9.2 × 108 CFU/mL) and 5 wt% SiO2-filled composite (106 ± 9 MPa; 9.1 × 108 CFU/mL), respectively, without affecting in vitro cell viability. SIGNIFICANCE: The facile and mild synthesis of xSiO2 @ yGO hybrid particles provided a convenient way to tune their optical property. The optimal 100SiO2 @GO particles could be considered as the promising antibacterial filler to be applied in dental care and therapy.

Effect of composite resin containing antibacterial filler on sugar-induced pH drop caused by whole saliva bacteria.

STATEMENT OF PROBLEM: Secondary caries around restorations is a major problem and can be attributed to bacteria invading microgaps formed at the tooth-restoration interface. An antibacterial composite resin containing quaternary ammonium silica (QASi) filler has been reported to inhibit enamel demineralization in situ. However, whether the prevention of enamel demineralization by QASi-containing composite resin is because of the reduced metabolic activity of acid-producing saliva bacteria is unclear. PURPOSE: The purpose of this study was to compare the effects of QASi-containing composite resin and 2 other restorative materials on the viability of salivary bacteria and sugar-induced acid production. MATERIAL AND METHODS: Whole saliva from each of the 30 study participants, 14 at high risk and 16 at low risk for caries, was brought into contact with quadruplicate specimens of 3 restorative materials, Infinix Flowable Composite, an anti-bacterial composite resin containing 1.5% QASi filler (Nobio), Filtek Supreme Flowable Restorative (3M), a conventional flowable composite resin, and dental amalgam (Silmet). Bacterial growth and sugar-induced acid production on each restorative material were measured every 20 minutes for 18 hours. Caries risk groups were compared using the t test and repeated measures analysis of variance (α=.05). When significant, Bonferroni multiple comparisons were used. RESULTS: On average, the saliva with the QASi-containing composite resin specimens maintained a near-neutral pH, not dropping below pH 6.0. The saliva associated with both conventional restorative materials exhibited a pH drop below 5.5 (P<.001), the critical threshold for tooth demineralization according to the Stephan curve. Virtually no growth was measured on the surface of the antibacterial composite resin, whereas bacteria grew on the conventional composite resin and dental amalgam (P<.001). No differences were observed between participants at high and low risk of caries. CONCLUSIONS: Unlike amalgam and conventional composite resin, the QASi-containing composite resin showed a near-complete shutdown of the metabolic activity of salivary bacteria upon contact and virtually no bacterial viability. This suggests that the prevention of tooth demineralization by QASi-containing restoratives is associated with a significant reduction in bacterial metabolic activity.

The effect of zinc oxide (ZnO) nanoparticle concentration on the adhesion of mucin and Streptococcus mutans to heat-cured acrylic resin.

Incorporating zinc oxide (ZnO) nanoparticles as antibacterial fillers in heat-cured acrylic resin could decrease mucin and Streptococcus mutans (S. mutans) adhesion, reducing the incidence of dental caries in the baseplates of orthodontic patients. Here, ZnO nanoparticles were modified using 3-(trimethoxysilyl)propyl methacrylate with various concentrations, added to acrylic resin powder, homogenized, mixed with acrylic resin liquid, and processed. The composite systems interfered well with mucin and S. mutans adhesion. The lowest mean of the amount of mucin adhered was on heat-cured acrylic resin with 7.5% ZnO nanoparticles, with a standard deviation of 18.07±0.80 mg/mL. The ZnO nanoparticles with a concentration of 7.5% showed an 87.09±0.88% S. mutans adhesion in control groups with no additives. These composite systems were proven to have better physicochemical characteristics and antibacterial abilities. Combining ZnO nanoparticles with heat-cured acrylic resin has great potential for self-cleaning baseplates of orthodontic patients in the future.