Effect of Dietary Simulating Solvents on the CAD-CAM Provisional Restorative Materials' Microhardness and Color Stability Properties: An in vitro Study.

Purpose: This in vitro study investigated the effects of dietary solvents on the microhardness and color stability of CAD/CAM provisional restorations compared to conventional materials. Methods: Disc-shaped specimens (n=200) were fabricated from self-cured acrylic resin, two 3D-printing resins (FormLabs, NextDent), and a milled material (TelioCAD). Randomization assigned specimens (n=10/group) to immersion solutions: artificial saliva, citric acid, heptane, coffee, and tea. Microhardness and color stability were evaluated. One-way and three-way ANOVA with Tukey's post hoc test analyzed the data. Results: Dietary solvents significantly reduced the surface microhardness of all tested materials (p<0.05). Unpolished surfaces exhibited greater color changes compared to polished ones (p<0.05) across all materials. Coffee and tea induced the most substantial reductions in hardness and the most significant color alterations (p<0.05), whereas saliva and citric acid had minimal effects. Conclusion: Milled provisional restorations exhibited superior hardness and color stability. Dietary solvents significantly affected material properties over time, highlighting the importance of material selection for clinical applications.

The demineralization resistance and mechanical assessments of different bioactive restorative materials for primary and permanent teeth: an in vitro study.

OBJECTIVES: This article examines the efficacy of two bioactive dental composites in preventing demineralization while preserving their mechanical and physical properties. MATERIALS AND METHODS: The study compares Beautifil Kids and Predicta® Bioactive Bulk-Fill (Predicta) composites with conventional dental composite. Flexural strength and elastic modulus were evaluated using a universal testing machine. A pH-cycling model assessed the composites' ability to prevent dentin demineralization. Color stability and surface roughness were measured using a spectrophotometer and non-contact profilometer, respectively, before and after pH-cycling, brushing simulation, and thermocycling aging. RESULTS: Beautifil Kids exhibited the highest flexural strength and elastic modulus among the materials (p < 0.05). Predicta demonstrated the highest increase in dentin surface microhardness following the pH-cycling model (p < 0.05). All groups showed clinically significant color changes after pH-cycling, with no significant differences between them (p > 0.05). Predicta exhibited greater color change after brushing and increased surface roughness after thermocycling aging (p < 0.05). While Beautifil Kids had higher surface roughness after pH-cycling (p < 0.05). DISCUSSION/CONCLUSION: Bioactive restorative materials with ion-releasing properties demonstrate excellent resistance to demineralization while maintaining mechanical and physical properties comparable to the control group.

Evaluation of the Effects of Different Polishing Protocols on the Surface Characterizations of 3D-Printed Acrylic Denture Base Resins: An In Vitro Study.

Chairside polishing kits are an alternative to laboratory polishing techniques. The effects of using a chairside polishing kit on a three-dimensional (3D)-printed acrylic denture base (ADB) have not been reported previously. Thus, this study aimed to evaluate the effects of different chairside polishing techniques on the surface characterizations of ABD, including surface roughness average (Ra), average maximum profile height (Rz), and scanning electron microscopy (SEM) representations. One hundred and twenty disc-shaped specimens were fabricated from one conventional heat-polymerized (HP) ADB resin and two 3D-printed (Asiga (AS) and NextDent (ND)) ADB resins (n = 40 per material). Each group was further divided based on the polishing protocol (n = 10) as follows: conventional polishing protocol (C), microdont chairside polishing kit (M), shofu chairside polishing kit (S), and an unpolished group (U). The Ra and Rz values were measured using an optical profilometer. Two-way ANOVA and post hoc tests were used for data analysis (α = 0.05) at significant levels. In unpolished groups, there was a statistically significant difference between HP-U vs. AS-U and ND-U groups (p < 0.0001). For Ra, the lowest values were observed in HP-C, AS-S, and ND-C. While the highest values were shown in all unpolished groups. Within the material, there were statistically significant differences between the three polishing protocols (C, M, and S) vs. unpolished (p < 0.0001), while there was no significant between C, M, and S groups (p = 0.05). The Rz values had the same pattern as the Ra values. The two chairside polishing kits were comparable to conventional polishing techniques, and they can be recommended for clinical application.

Clinical outcomes of single full-coverage lithium disilicate restorations: A systematic review.

Introduction: Lithium disilicate glass-ceramic (LDC) restorations exhibit microorganism infiltration, recurrent caries, pulpal lesions, periodontal inflammation, and cement exposure to the oral environment over time. All these factors lead to restoration failure. This systematic review aimed to investigate the clinical outcomes of LDC full-coverage crowns (FCC) in permanent teeth compared with those of other full-coverage restoration materials. Materials & Methods: Search strategies were developed for four databases: Web of Science, OVID, PubMed, and Scopus. Data extraction and quality appraisals were performed by two independent reviewers. Data on the presence of caries, post-operative sensitivity, and periodontal changes were extracted from the included clinical studies. In addition to the outcome measures, data on the sample size, study groups, method of restoration fabrication, type of impression, and type of abutment were recorded. Results: We retrieved 3989 records for the title and abstract screening. Of these, 19 clinical studies met the inclusion criteria. The overall quality of the included studies indicates a low risk of bias. Most studies reported no pulpal involvement, recurrent caries, or post-operative sensitivity and presented a favorable periodontal response after the cementation of LDC-FCC during different follow-up periods. Conclusion: Based on the endodontic and periodontic clinical responses of natural tooth abutments and their supporting periodontium, LDC-FCC can be considered a clinically successful restorative option.

Inorganic Compounds as Remineralizing Fillers in Dental Restorative Materials: Narrative Review.

Secondary caries is one of the leading causes of resin-based dental restoration failure. It is initiated at the interface of an existing restoration and the restored tooth surface. It is mainly caused by an imbalance between two processes of mineral loss (demineralization) and mineral gain (remineralization). A plethora of evidence has explored incorporating several bioactive compounds into resin-based materials to prevent bacterial biofilm attachment and the onset of the disease. In this review, the most recent advances in the design of remineralizing compounds and their functionalization to different resin-based materials' formulations were overviewed. Inorganic compounds, such as nano-sized amorphous calcium phosphate (NACP), calcium fluoride (CaF2), bioactive glass (BAG), hydroxyapatite (HA), fluorapatite (FA), and boron nitride (BN), displayed promising results concerning remineralization, and direct and indirect impact on biofilm growth. The effects of these compounds varied based on these compounds' structure, the incorporated amount or percentage, and the intended clinical application. The remineralizing effects were presented as direct effects, such as an increase in the mineral content of the dental tissue, or indirect effects, such as an increase in the pH around the material. In some of the reported investigations, inorganic remineralizing compounds were combined with other bioactive agents, such as quaternary ammonium compounds (QACs), to maximize the remineralization outcomes and the antibacterial action against the cariogenic biofilms. The reviewed literature was mainly based on laboratory studies, highlighting the need to shift more toward testing the performance of these remineralizing compounds in clinical settings.

Influence of Denture Cleansers on the Retention Loss of Attachment Systems Retained Implant Overdenture.

Background: This study aimed to evaluate the effects of different denture cleansing solutions (DCSs) on the retention of Locator and Locator R-Tx attachment systems of implant retained overdentures (IRO). Methods: Two part acrylic resin blocks were fabricated, upper part contained metal housing and plastic inserts and lower part contained implant analogs and abutments. Eighty pink plastic inserts (40/attachment, 10/solution) were immersed in Corega, Fittydent, sodium hypochlorite, and water for a time simulating upto 1-year of clinical usage. Acrylic blocks were held on a universal testing machine for a pull-out test to record the dislodgement force. Measurements were conducted after 6 months (T1) and 12 months (T2). One-way ANOVA followed by Tukey's HSD test was used to analyze the results (α = 0.05). Results: For both attachments, retention significantly decreased after immersion in different solutions at T2 (P < 0.001). Locator R-Tx attachment in NaOCl showed a significant decrease in retention compared with other solutions at T1. At T2, there was a significant decrease in retention for all DCS compared with water (P < 0.001). Locator R-TX showed higher retention values per solution compared to Locator attachment (P < 0.001). In terms of retention loss %, NaOCl recorded the highest (61.87%) loss, followed by Corega (55.54%) and Fittydent (43.13%), whereas water demonstrated the best retention (16.13%) in both groups. Conclusion: Locator R-TX has better retention with different DCS immersion. The loss of retention varied with different types of DCS and NaOCl recorded the highest retention loss. Therefore, denture cleanser selection must be guided by the type of IRO attachment.

Impact of Metformin on Periodontal and Peri-Implant Soft and Hard Tissue.

Periodontal and peri-implant soft and hard tissue in diabetic patients have always been a topic of interest for researchers and clinicians alike. Among which, a subtopic that has attracted more attention is the beneficial effect of metformin (MF) on periodontal and peri-implant soft and hard tissue. This review aimed to assess the impact of MF on the periodontal and peri-implant soft- and hard-tissue healing among diabetic patients. Research was conducted using the keywords 'metformin', 'diabetes', 'periodontitis', 'implant', and 'peri-implantitis' via the Medline (PubMed) and Google Scholar databases. Selected articles were reviewed. A total of 21 articles, discussing the impact on periodontal health (six animal studies, seven clinical studies, and three systematic reviews) and five studies on peri-implant health (four animal studies and one clinical study) were included. All have reported a positive impact of MF on decreasing the inflammatory response, oxidative stress, and ultimate bone loss. Similarly, human studies reported a positive effect of MF on clinical and radiographic parameters compared with controls. Despite systematic reviews reporting heterogeneity among the included studies, MF has shown a positive impact on periodontal health. In animal, clinical studies, and systematic reviews, MF showed a protective impact on periodontal and peri-implant health.

Effect of Printing Orientation and Postcuring Time on the Flexural Strength of 3D-Printed Resins.

PURPOSE: To evaluate the effect of printing orientation combined with different postcuring times on the flexural strength of 3D-printed resins. MATERIALS AND METHODS: A total of 480 rectangular specimens with the dimensions of 64×10×3.3 mm were designed and fabricated from two 3D-printed acrylic resins and one heat-polymerized resin (HP). 3D-printed groups were divided into 3 groups according to printing orientations (0-, 45-, 90-degree); each group was subdivided into 4 groups according to postcuring time (30, 60, 90, 120 min.). All specimens were subjected to thermal cycling (10,000 cycles) before testing flexural strength. Fractured surfaces were examined under a scanning electron microscope (SEM). ANOVA and Tukey's post hoc tests were used for data analysis (α = 0.05). RESULTS: The result of this study showed that the highest flexural strength values of 3D-printed resin (NextDent, and ASIGA) were in 0-degree groups. Also, the flexural strength values increased when postcuring time was increased, regardless of the printing orientation; the highest flexural strength was recorded at 120 minutes postcuring time in all orientations. SEM analysis showed a rougher surface with irregular lamellae which represented a ductile fracture confirming that high energy is required for crack propagation and these features markedly increased as postcuring time increased. CONCLUSION: The results showed that the 0-degree orientation groups showed higher flexural strength compared to other groups. Similarly, with increased postcuring time, the flexural strength increased.

Comparative Evaluation of Surface Roughness and Hardness of 3D Printed Resins.

The effect of printing parameters on the surface characteristics of three-dimensional (3D)-printed denture base resins (DBRs) is neglected. Therefore, this study investigated the effect of printing orientation and post-curing time on the surface roughness and hardness. One conventional heat-polymerized (HP) resin and two 3D-printing resins (NextDent (ND) and ASIGA (AS)) were used to fabricate a total of 250-disc (10 × 2.5 mm) specimens. ND and AS specimens were printed with different orientations (0-, 45-, and 90-degree) and each orientation group was subjected to four post-curing times (30, 60, 90, 120 min). Printed specimens were thermo-cycled (10,000 cycles) followed by the measuring of surface roughness (Profilometer (Ra)) and hardness (a Vickers hardness (VH)). ANOVA and post hoc tests were used for data analysis (α = 0.05) at significant levels. AS and ND showed no significant changes in Ra when compared with HP (p ˃ 0.05), except the 45-degree orientation (AS/90 min and AS/120 min) significantly increased surface roughness (p ˂ 0.001). There was no significant difference in Ra with different orientations and post-curing time for both materials AS and ND (p ˃ 0.05). Compared with HP, 3D-printed DBRs showed low VH values (p ˂ 0.001). For AS, 90-degree orientation showed a significant decrease in VH at 60, 90, and 120 min when compared with 0- and 45-degree orientation (p ˂ 0.001), while ND showed no significant difference in VH with different printing orientations (p ˃ 0.05). The VH of AS and ND improved when increasing post-curing time to 120 min (p ˂ 0.001), and the printing orientations and post-curing time did not affect the Ra of 3D-printed DBRs.

Impact of Polymerization Technique and ZrO2 Nanoparticle Addition on the Fracture Load of Interim Implant-Supported Fixed Cantilevered Prostheses in Comparison to CAD/CAM Material.

ZrO2 nanoparticles (ZNPs) have excellent physical properties. This study investigated the fracture load of implant-supported, fixed cantilevered prosthesis materials, reinforced with ZNPs and various polymerization techniques, compared with conventional and CAD/CAM materials. Sixty specimens were made from two CAD/CAM; milled (MIL) (Ceramill TEMP); and 3D-printed (NextDent Denture 3D+). Conventional heat-polymerized acrylic resin was used to fabricate the other specimens, which were grouped according to their polymerization technique: conventionally (HP) and autoclave-polymerized (AP); conventionally cured and reinforced with 5 wt% ZNPs (HPZNP); and autoclave reinforced with 5 wt% ZNPs (APZNP). The specimens were thermocycled (5000 cycles/30 s dwell time). Each specimen was subjected to static vertical loading (1 mm/min) using a universal Instron testing machine until fracture. Scanning electron microscopy was used for fracture surface analyses. The ANOVA showed significant fracture load differences between all the tested groups (p = 0.001). The Tukey post hoc tests indicated a significant difference in fracture load between all tested groups (p ˂ 0.001) except HP vs. HPZNP and AP vs. MIL. APZNP had the lowest mean fracture load value (380.7 ± 52.8 N), while MIL had the highest (926.6 ± 82.8 N). The CAD/CAM materials exhibited the highest fracture load values, indicating that they could be used in long-term interim prostheses. Autoclave polymerization improved fracture load performance, whereas ZrO2 nanoparticles decreased the fracture load performance of cantilevered prostheses.

Novel calcium phosphate ion-rechargeable and antibacterial adhesive to inhibit dental caries.

OBJECTIVES: This study aimed to develop an antibacterial and calcium (Ca) and phosphate (P) rechargeable adhesive and investigate the effects of dimethylaminododecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP) on dentin bonding, biofilm response, and repeated Ca and P ion recharge and re-release capability for the first time. MATERIALS AND METHODS: Pyromellitic glycerol dimethacrylate (PMGDM), ethoxylated bisphenol A dimethacrylate (EBPADMA), 2-hydroxyethyl methacrylate (HEMA), and bisphenol A glycidyl dimethacrylate (BisGMA) formed the adhesive (PEHB). Three groups were tested: (1) Scotchbond (SBMP, 3 M) control, (2) PEHB + 30% NACP, and (3) PEHB + 30% NACP + 5% DMAHDM. Specimens were tested for dentin shear bond strength, and Ca and P ion release, recharge, and re-release. Biofilm lactic acid production and colony-forming units (CFU) on resins were analyzed. RESULTS: The four groups had similar dentin shear bond strengths (p > 0.1). Adhesive with DMAHDM showed significant decrease in metabolic activity, lactic acid production, and biofilm CFU (p < 0.05). The adhesives containing NACP released high levels of Ca and P ions initially and after being recharged. CONCLUSION: This study developed the first Ca and P ion-rechargeable and antibacterial adhesive, achieving strong antibacterial activity and Ca and P ion recharge and re-release for long-term remineralization. CLINICAL RELEVANCE: Considering the restoration-tooth bonded interface being the weak link and recurrent caries at the margins being the primary reason for restoration failures, this novel calcium phosphate-rechargeable and antibacterial adhesive is promising for a wide range of tooth-restoration applications to inhibit caries.

Polymethylmethacrylate Incorporating Nanodiamonds for Denture Repair: In Vitro Study on the Mechanical Properties.

OBJECTIVE: This study aimed to evaluate the effect of nanodiamond (ND) addition to repair resin with repair gap modifications on the flexural and impact strength of repaired polymethylmethacrylate denture base. MATERIALS AND METHODS: Heat-polymerized acrylic resin specimens (N = 100/test) were prepared and sectioned to half creating two repair gaps: 2.5- and 0 mm with 45 degrees beveling. They were further divided into subgroups (n = 20) according to ND concentration (control, 0.25%ND, and 0.50%ND), thermocycling (500 cycles) was done to half the specimens in each subgroup. Flexural strength was tested using 3-point bending test and impact strength was tested by Charpy's impact test. Analysis of variance and post-hoc Tukey's tests were performed for data analysis (α = 0.05). Scanning electron microscope was employed for fracture surface analysis and ND distribution. RESULTS: Before and after thermocycling, the addition of ND significantly increased the flexural strength and elastic modulus in comparison to control group (p ˂ 0.001), while 0 mm repair gap showed insignificant difference between ND-reinforced groups (p ˃ 0.05). Regarding impact strength, ND addition increased the impact strength with 0 mm gap in comparison to control and 2.5 mm with ND (p˂0.001), while later groups showed no significant in between (p ˃ 0.05). Comparing thermocycling effect per respective concentration and repair gap, thermocycling adversely affected all tested properties except elastic modulus with 0 mm-0.25 and 0 mm-0.5% and impact strength with 2.5 mm, 2.5 mm-0.25%, 2.5 mm- 0.5% (p ˃ 0.05). CONCLUSION: ND addition combined with decreased repair gap improved the flexural strength, elastic modulus, and impact strength of repaired denture resin, while thermocycling has a negative effect on denture repair strength.

Prospects on Tuning Bioactive and Antimicrobial Denture Base Resin Materials: A Narrative Review.

Denture base resin (DBR) materials are used in dentistry in constructing removable dentures and implant-supported prostheses. A plethora of evidence has demonstrated that DBR materials are associated with a high risk of denture stomatitis, a clinical complication where the soft oral tissues underneath the resin-based material are inflamed. The prevalence of denture stomatitis among denture wearers is high worldwide. Plaque accumulation and the infiltration of oral microbes into DBRs are among the main risk factors for denture stomatitis. The attachment of fungal species, mainly Candida albicans, to DBRs can irritate the underneath soft tissues, leading to the onset of the disease. As a result, several attempts were achieved to functionalize antimicrobial compounds and particles into DBRs to prevent microbial attachment. This review article explored the advanced approaches in designing bioactive and antimicrobial DBR materials. It was reported that using monomer mixtures, quaternary ammonium compounds (QACs), and organic and inorganic particles can suppress the growth of denture stomatitis-related pathogens. This paper also highlighted the importance of characterizing bioactive DBRs to be mechanically and physically sustainable. Future directions may implement a clinical translational model to attempt these materials inside the oral cavity.

Effect of Ageing Process and Brushing on Color Stability and Surface Roughness of Treated White Spot Lesions: An in vitro Analysis.

PURPOSE: To evaluate the effect of ageing process and brushing on the color stability and surface roughness of white spot lesions treated with resin infiltration or remineralization. PATIENTS AND METHODS: Artificial white spot lesions were created on the facial surface of extracted bovine teeth. Specimens were divided into three main groups based on treatment received: resin infiltration (Icon), MI Paste Plus (MI) or no treatment (control). Specimens underwent pH cycling for 7 days, followed by brushing with toothbrush simulator. Specimens were then immersed in three different solutions (water, cranberry juice, or coffee) for 7 days. Surface roughness (SR) and color stability (CS) assessments were performed at baseline and after each test. One-way and two-way ANOVA were used to calculate the statistical comparisons between the groups and significance considered at P <0.05. RESULTS: Icon group had the least color change after pH cycling, while MI showed the least color change after brushing test. Immersion in coffee produced the highest color change in all groups, followed by cranberry juice. Icon group had the best color stability when immersed in cranberry juice or coffee. Control and the MI treated specimens showed gradual increase of SR after pH cycling and brushing test, while Icon group had improved surface properties. Brushing test alone produced less color change in comparison with immersion in cranberry juice and coffee; however, brushing increased SR. CONCLUSION: Icon treatment showed superior color stability and surface roughness, compared to the control and the MI treated teeth. Brushing had less influence on color change compared to the immersion in cranberry juice or coffee.

Acid Effects on the Physical Properties of Different CAD/CAM Ceramic Materials: An in Vitro Analysis.

PURPOSE: To evaluate the flexural strength, elastic modulus, microhardness, and surface roughness of monolithic zirconia, lithium disilicate ceramics, and feldspathic ceramics after being exposed to different acidic solutions. MATERIALS AND METHODS: Rectangular specimens (n = 180) were prepared from three different ceramic materials: lithium disilicate, monolithic zirconia, and feldspathic porcelain. Initial Surface roughness of ninety specimens (n = 30/material) was evaluated using an optical noncontact profilometer. Thirty specimens of each material were immersed in one of the following solutions (n = 10/group): citric acid; acidic beverage; and artificial saliva, which served as the control. Post immersion surface roughness, flexural strength, and elastic modulus were determined using an optical noncontact profilometer and three-point bending test. Another thirty specimens of each material were immersed in the aqueous solutions (n = 10/group) following the same protocol and subjected to microhardness test using a Vickers diamond microhardness tester. A scanning electron microscope (SEM) was used to examine the surface characteristics changes. ANOVA and Post-hoc Tukey's Kramer tests were used for data analysis (α = 0.05). RESULTS: Immersion in different solutions did not affect the flexural strength and elastic modulus of lithium disilicate or zirconia. Microhardness and surface roughness were significantly affected in all groups (p < 0.05). For feldspathic porcelain groups, the flexural strength and elastic modulus were significantly decreased in the citric acid group (p = 0.045 and p = 0.019). Also, there were significant differences among all feldspathic porcelain groups (p = 0.001) in terms of microhardness and surface roughness values. CONCLUSIONS: The tested acidic agents significantly affected the flexural strength, elastic modulus, surface roughness, and microhardness of feldspathic porcelain. However, the flexural strength and elastic modulus of evaluated lithium disilicate and zirconia did not change significantly.

Knowledge of dentists, dental auxiliaries, and students regarding the COVID-19 pandemic in Saudi Arabia: a cross-sectional survey.

BACKGROUND: This study aimed to assess the knowledge of dental professionals in Saudi Arabia regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19). METHODS: A questionnaire was developed to assess various dental professionals from both governmental and private sectors through online and social media outlets. RESULTS: A total of 1,033 questionnaires were collected (273 dental students, 193 dental auxiliary personnel, 544 dentists). In all, 63.4% of the respondents worked in hospitals. Of all the respondents, 44.9%, 33.4%, and 21.7% worked in governmental clinics, academia, and the private sector, respectively. Overall knowledge of the incubation period and route of transmission of SARS-CoV-2 was consistent across all dental professions. Knowledge of hand-soap cleaning time was significantly different among dental professionals (p < 0.001). Dental professionals displayed significant disagreement on the survival of SARS-CoV-2 outside the host (p < 0.001). Furthermore, 75.1% of the respondents were reluctant to treat a suspected COVID-19 patient, and 92% of the participants believed that the mode of transmission was droplet inhalation. Fever, coughing, and shortness of breath were identified as the most common symptoms of COVID-19. Most standard methods of prevention in the dental office were selected by at least 50% of the participants. CONCLUSIONS: Dental professionals seem to be consistent regarding their knowledge of the incubation period of SARS-CoV-2. However, knowledge of viral survivability and recommended hand-soap washing time was significantly variable among the professionals. A high degree of apprehension toward suspected COVID-19 patients existed among all dental professionals. Pandemic-awareness campaigns are essential among healthcare providers.

Protein-repellent nanocomposite with rechargeable calcium and phosphate for long-term ion release.

OBJECTIVE: There has been no report on the effect of incorporating protein repellent 2-methacryloyloxyethyl phosphorylcholine (MPC) into a composite containing nanoparticles of amorphous calcium phosphate (NACP) on calcium (Ca) and phosphate (P) ion rechargeability. The objectives of this study were to develop a Ca and P ion-rechargeable and protein-repellent composite for the first time, and investigate the effects of MPC and NACP on mechanical properties, protein-repellency, anti-biofilm effects, and Ca and P ion recharge and re-release. METHODS: NACP were synthesized using a spray-drying technique. The resin contained ethoxylated bisphenol A dimethacrylate (EBPADMA) and pyromellitic glycerol dimethacrylate (PMGDM). Three NACP composites were made with 0 (control), 1.5%, and 3% of MPC. NACP (20%) and glass particles (50%) were also added into the resin. Protein adsorption was measured using a micro-bicinchoninic acid (BCA) method. A human saliva microcosm biofilm model was used to determine biofilm metabolic activity, lactic acid, and colony-forming units (CFU). Ca and P ion recharge and re-release were measured using a spectrophotometric method. RESULTS: Flexural strengths and moduli of CaP-rechargeable composites matched those of a commercial composite without CaP rechargeability (p>0.1). Adding 1.5% and 3% MPC reduced protein adsorption to 1/3 and 1/5, respectively, that of commercial composite (p<0.05). Adding 3% MPC suppressed biofilm metabolic activity and lactic acid production, and reduced biofilm CFU by nearly 2 logs. All three NACP composites had excellent ion rechargeability and higher levels of ion re-releases. One recharge yielded continuous ion release for 21 days. The release was maintained at the same level with increasing number of recharge cycles, indicating long-term ion release. Incorporation of MPC did not compromise the CaP ion rechargeability. SIGNIFICANCE: Incorporating 3% MPC into NACP nanocomposite greatly reduced protein adsorption, biofilm growth and lactic acid, decreasing biofilm CFU by nearly 2 logs, without compromising Ca and P recharge. This protein-repellent NACP-MPC rechargeable composite with long-term remineralization is promising for tooth restorations to inhibit secondary caries.

Tuning Nano-Amorphous Calcium Phosphate Content in Novel Rechargeable Antibacterial Dental Sealant.

Dental sealants with antibacterial and remineralizing properties are promising for caries prevention among children and adolescents. The application of nanotechnology and polymer development have enabled nanoparticles of amorphous calcium phosphate (NACP) and dimethylaminohexadecyl methacrylate (DMAHDM) to emerge as anti-caries strategies via resin-based dental materials. Our objectives in this study were to (1) incorporate different mass fractions of NACP into a parental rechargeable and antibacterial sealant; (2) investigate the effects on mechanical performance, and (3) assess how the variations in NACP concentration would affect the calcium (Ca) and phosphate (PO4) ion release and re-chargeability over time. NACP were synthesized using a spray-drying technique and incorporated at mass fractions of 0, 10, 20 and 30%. Flexural strength, flexural modulus, and flowability were assessed for mechanical and physical performance. Ca and PO4 ion release were measured over 70 days, and three ion recharging cycles were performed for re-chargeability. The impact of the loading percentage of NACP upon the sealant's performance was evaluated, and the optimized formulation was eventually selected. The experimental sealant at 20% NACP had flexural strength and flexural modulus of 79.5 ± 8.4 MPa and 4.2 ± 0.4 GPa, respectively, while the flexural strength and flexural modulus of a commercial sealant control were 70.7 ± 5.5 MPa (p > 0.05) and 3.3 ± 0.5 GPa (p < 0.05), respectively. A significant reduction in flow was observed in the experimental sealant at 30% NACP (p < 0.05). Increasing the NACP mass fraction increased the ion release. The sealant formulation with NACP at 20% displayed desirable mechanical performance and ideal flow and handling properties, and also showed high levels of long-term Ca and PO4 ion release and excellent recharge capabilities. The findings provide fundamental data for the development of a new generation of antibacterial and rechargeable Ca and PO4 dental sealants to promote remineralization and inhibit caries.

Nanostructured Polymeric Materials with Protein-Repellent and Anti-Caries Properties for Dental Applications.

Dental caries is prevalent worldwide. Tooth cavity restorations cost more than $46 billion annually in the United States alone. The current generation of esthetic polymeric restorations have unsatisfactory failure rates. Replacing the failed restorations accounts for 50⁻70% of all the restorations. This article reviewed developments in producing a new generation of bioactive and therapeutic restorations. This includes: Protein-repellent and anti-caries polymeric dental composites, especially the use of 2-methacryloyloxyethyl phosphorylcholine (MPC) and dimethylaminododecyl methacrylate (DMAHDM); protein-repellent adhesives to greatly reduce biofilm acids; bioactive cements to inhibit tooth lesions; combining protein-repellency with antibacterial nanoparticles of silver; tooth surface coatings containing calcium phosphate nanoparticles for remineralization; therapeutic restorations to suppress periodontal pathogens; and long-term durability of bioactive and therapeutic dental polymers. MPC was chosen due to its strong ability to repel proteins. DMAHDM was selected because it had the most potent antibacterial activity when compared to a series of antibacterial monomers. The new generation of materials possessed potent antibacterial functions against cariogenic and periodontal pathogens, and reduced biofilm colony-forming units by up to 4 logs, provided calcium phosphate ions for remineralization and strengthening of tooth structures, and raised biofilm pH from a cariogenic pH 4.5 to a safe pH 6.5. The new materials achieved a long-term durability that was significantly beyond current commercial control materials. This new generation of bioactive and nanostructured polymers is promising for wide applications to provide therapeutic healing effects and greater longevity for dental restorations.

Novel rechargeable calcium phosphate nanocomposite with antibacterial activity to suppress biofilm acids and dental caries.

OBJECTIVE: Rechargeable calcium phosphate (CaP) composites were developed recently. However, none of the rechargeable CaP composites was antibacterial. The objectives of this study were to develop the first rechargeable CaP composite that was antibacterial, and to investigate the effects of adding dimethylaminohexadecyl methacrylate (DMAHDM) into rechargeable CaP composite on ion rechargeability and re-release as well as biofilm properties. METHODS: DMAHDM was synthesized via a Menschutkin reaction. Nanoparticles of amorphous calcium phosphate (NACP) were synthesized using a spray-drying technique. The resin contained ethoxylated bisphenol A dimethacrylate (EBPADMA) and pyromellitic glycerol dimethacrylate (PMGDM). Two composites were fabricated: rechargeable NACP composite, and rechargeable NACP-DMAHDM composite. Mechanical properties and ion release and recharge were measured. A dental plaque microcosm biofilm model using saliva was tested. RESULTS: Flexural strength and elastic modulus of rechargeable NACP and NACP-DMAHDM composites matched commercial control composite (p > 0.1). NACP-DMAHDM inhibited biofilm metabolic activity and lactic acid, and reduced biofilm colony-forming units (CFU) by 3-4 log. NACP and NACP-DMAHDM showed similar Ca and P ion recharge and re-release (p > 0.1). Therefore, adding DMAHDM did not compromise the ion rechargeability. One recharge yielded continuous release for 42 d. The release was maintained at the same level with increasing number of recharge cycles, indicating long-term ion release and remineralization capability. CONCLUSIONS: The first CaP rechargeable and antibacterial composite was developed. Adding DMAHDM into the rechargeable NACP composite did not adversely affect the Ca and P ion release and recharge, and the composite had much less biofilm growth and lactic acid production, with CFU reduction by 3-4 log. CLINICAL SIGNIFICANCE: This novel CaP rechargeable composite with long-term remineralization and antibacterial properties is promising for tooth restorations to inhibit caries.