Incorporation of chlorhexidine in self-adhesive resin cements.

The aim of this study was to evaluate the maximum amount of chlorhexidine (CHX) that could be incorporated to self-adhesive resin cements to add antibacterial effect without affecting the physical properties. The CHX was incorporated into a commercial self-adhesive resin cement at mass fractions of 0.5-15 wt%, and the CHX-release profile, antibacterial effect, flexural and bond strengths of experimental cements were evaluated. Increasing the CHX content from 5 to 15 wt% resulted in a higher released concentration of CHX. In agar diffusion tests, experimental cements containing 5, 10, and 15 wt% CHX produced inhibition zones against oral bacteria. In flexural strength and shear bond strength to dentin, no significant reduction was observed with the incorporation of 5 wt% CHX. This in vitro study suggests that the addition of 5 wt% CHX yielded an antibacterial self-adhesive cement and had no adverse effect on the flexural and shear bond strengths.

Development of endodontic sealers containing antimicrobial-loaded polymer particles with long-term antibacterial effects.

OBJECTIVE: The objective of this study is to prepare new dental resins with a long-lasting antimicrobial activity. Specifically, this study evaluates an approach for controlling infection in root canals using sealers containing polyhydroxyethyl methacrylate trimethylolpropane trimethacrylate (polyHEMA/TMPT) particles loaded with cetylpyridinium chloride (CPC). In addition, the physical properties of sealers containing CPC-loaded polyHEMA/TMPT particles (CLP) are determined. METHODS: PolyHEMA/TMPT particles with 10 (10%-CLP) and 25wt.% CPC (25%-CLP) with different particle sizes were fabricated and incorporated in HEMA-based sealers. CPC-release profiles were evaluated over 14 days of immersion in water, followed by 14 days of storage and 14 days of water immersion. The antibacterial activity of these sealers against Enterococcus faecalis in dentinal tubules was assessed using a root-canal-infection model. Their sealing abilities were evaluated by fluid filtration and physical properties were tested according to the ISO 6876 standard. The long-term antibacterial activity of the cured sealer containing 25%-CLP (∼21µm particle diameter) was re-assessed after 1 year of storage. RESULTS: After 28 days of immersion, 25%-CLP exhibited a higher and sustained CPC release unlike 10%-CLP. Residual bacteria in root dentinal tubules were eradicated by obturation with 25%-CLP-containing sealers. The incorporation of 25%-CLP (∼21µm) had no adverse effects on the sealing ability and physical properties of the sealer and resulted in long-term antibacterial activity. SIGNIFICANCE: The incorporation of CPC-loaded particles in HEMA resins yielded endodontic sealers with long-term bactericidal activity against E. faecalis in root canals. These sealers can potentially be used to prevent recurrent apical periodontitis.

Evaluation of physical properties of fiber-reinforced composite resin.

OBJECTIVES: This study aimed to investigate physical properties of a fiber-reinforced CAD/CAM resin disc, which included woven layers of multi-directional glass fibers. METHODS: Fiber orientations of CAD/CAM specimens (TRINIA, SHOFU) were specified as longitudinal (L), longitudinal-rotated (LR), and anti-longitudinal (AL). A fiber-reinforced composite (everX posterior, GC (E)) and a conventional composite (Beauti core flow paste, SHOFU (B)) were also tested. A three-point bending test and a tensile test with notchless prism-shaped specimens were conducted using a universal testing machine (AUTOGRAPH AG-IS, Shimadzu). A water absorption test was also carried out after the specimens were stored in water for 24h or 1 week. Flexural strength and fracture toughness were obtained by conducting a three-point bending test. RESULTS: TRINIA L and LR groups showed significantly high flexural strength (254.2±22.3 and 248.8±16.7MPa, respectively). Those were approximately 2.5 times higher than those in AL, E, and B groups (96.8-98.0MPa) (p<0.05, ANOVA and Tukey HSD test). No significant difference was shown in flexural modulus among the experimental groups. The fracture toughness in L group (9.1±0.4MPa/m1/2) was found to be significantly higher than those in other groups (1.9-3.0MPa/m1/2; p<0.05). TRINIA group demonstrated significantly lower water absorption (4.7±1.9µg/mm3) than did E (16.1±3.1µg/mm3) and B (17.3±3.7µg/mm3) groups (p<0.05). SIGNIFICANCE: TRINIA demonstrated distinct anisotropy. TRINIA can be used as a superior restorative material when specifying directions of its fiber mesh layers.

Development of novel surface coating composed of MDPB and MPC with dual functionality of antibacterial activity and protein repellency.

Resin-based reconstructive/restorative materials with antibacterial effects are potentially useful for preventing dental and oral diseases. To this end, the immobilization of an antibacterial component on the surface of a resin by incorporating polymerizable bactericide such as a quaternary ammonium compound-monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) is an effective technique. However, the effectiveness of immobilized bactericide is reduced by salivary protein coverage. We address this issue by utilizing 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer, which exhibits protein repellency, with MDPB to fabricate a novel copolymer, which served as a surface coating on a methacrylate-based resin. This coating provided a more hydrophilic surface than that provided by MDPB coating and reduced the adsorption of bovine serum albumin and salivary protein. To evaluate bacterial growth on the contact surface, Streptococcus mutans suspension was placed on the coated specimen. After 24-h incubation, MDPB/MPC copolymer exhibited killing effects against S. mutans. Moreover, confocal laser scanning microscopy and scanning electron microscopy were used to evaluate biofilm formation after 48-h incubation in S. mutans suspension, which revealed sparse biofilm and dead bacteria in biofilm on the surface coated with MDPB/MPC. Overall, the proposed surface coating on dental resins exhibited protein-repellent ability and inhibitory effects against bacteria and oral biofilms.

Improving the durability of resin-dentin bonds with an antibacterial monomer MDPB.

The 12-methacryloxydodecylpyridium bromide (MDPB) has been reported to act as a matrix metalloprotease (MMP) inhibitor. In this study, the effects of application of MDPB on resin-dentin bonds were evaluated. The resin-dentin bonded specimens were prepared with a commercial MDPB-containing self-etching primer or a self-etching primer without MDPB, and stored 24 h or 1 year. Surfaces were pretreated with chlorhexidine or MDPB-containing cavity disinfectant. Additionally, we compared the degradation patterns between the two self-etching adhesives and etch and rinse system. Water tree formations were observed as the typical morphological phase of the two tested self-etching adhesives for both 24 h and 1 year groups. The degradation phase of collagen network depletion was observed in the adhesive interface of the etch-and-rinse system in the 1 year group. Pretreatment with chlorhexidine did not prevent bond strength reduction after 1 year. The cavity disinfectant improved the bond durability for the self-etching adhesive.

Antibacterial activity and dentin bonding ability of combined use of Clearfil SE Protect and sodium hypochlorite.

The aim of this study was to evaluate the antibacterial activity and dentin bonding ability of a commercial self-etch adhesive Clearfil SE Protect (Kuraray Noritake Dental, Tokyo, Japan) in combination with sodium hypochlorite (NaOCl). Agar disc diffusion tests and measurement of minimum inhibitory/bactericidal concentrations (MIC/MBC) against Streptococcus mutans were performed to evaluate antibacterial effects. The mixture solution of 5.25% NaOCl and the primer of Clearfil SE Protect demonstrated less antibacterial activity than primer only. In microtensile bond strength tests using non-carious human molars, pretreatment with 5.25% NaOCl aqueous solution had no influence on the bond strength of Clearfil SE Protect. These results indicate that pretreatment with NaOCl does not influence the bonding ability of Clearfil SE Protect, while their combined use does not enhance cavity disinfecting effects.

SiO2-nanocomposite film coating of CAD/CAM composite resin blocks improves surface hardness and reduces susceptibility to bacterial adhesion.

Composite resin blocks for computer-aided design/computer-aided manufacturing (CAD/CAM) applications have recently become available. However, CAD/CAM composite resins have lower wear resistance and accumulate more plaque than CAD/CAM ceramic materials. We assessed the effects of SiO2-nanocomposite film coating of four types of CAD/CAM composite resin blocks: Cerasmart, Katana Avencia block, Lava Ultimate, and Block HC on surface hardness and bacterial attachment. All composite blocks with coating demonstrated significantly greater Vickers hardness, reduced surface roughness, and greater hydrophobicity than those without coating. Adhesion of Streptococcus mutans to the coated specimens was significantly less than those for the uncoated specimens. These reduced levels of bacterial adherence on the coated surface were still evident after treatment with saliva. Surface modification by SiO2-nanocomposite film coating has potential to improve wear resistance and susceptibility to plaque accumulation of CAD/CAM composite resin restorations.

Development of sustained antimicrobial-release systems using poly(2-hydroxyethyl methacrylate)/trimethylolpropane trimethacrylate hydrogels.

Reconstructive materials with sustained antimicrobial effects could be useful for preventing infectious diseases in an environment containing indigenous bacteria or fungi such as the oral cavity. With the objective of applying a non-biodegradable hydrogel to resin-based materials as a reservoir for water-soluble antimicrobials, novel hydrogels consisting of 2-hydroxyethyl methacrylate (HEMA) and trimethylolpropane trimethacrylate (TMPT) were fabricated. Cetylpyridinium chloride (CPC) was loaded into five hydrogels comprising different ratios of HEMA/TMPT, and their ability to release as well as to be recharged with CPC was examined in vitro. A polyHEMA/TMPT hydrogel comprising 50% HEMA/50% TMPT could be effectively loaded and recharged with CPC by immersion into a CPC solution, demonstrating the longest release of CPC, above the concentration required to inhibit bacteria and fungi. The binding of CPC to the hydrogels was mainly through hydrophobic interaction. Loading of CPC into a hydrogel by mixing CPC powder with the HEMA/TMPT monomer before polymerization resulted in marked extension of the initial CPC-release period. The CPC-pre-mixed hydrogel was confirmed to exhibit antibacterial activity by agar diffusion tests. It is possible to achieve a sustained release system for antimicrobials by pre-mix loading and recharging CPC into a 50% HEMA/50% TMPT hydrogel.