Development of a nonrigid, durable calcium phosphate cement for use in periodontal bone repair.

BACKGROUND: Calcium phosphate cement (CPC) hardens in situ to form hydroxyapatite and has been used in dental and craniofacial restorative applications. However, when CPC was used in periodontal osseous repair, tooth mobility resulted in the fracture and exfoliation of the brittle CPC implant. The objective of the authors' study was to develop a strong and nonrigid CPC to provide compliance for tooth mobility without fracturing the implant. METHODS: The authors used tetracalcium phosphate, dicalcium phosphate anhydrous and biopolymer chitosan to develop a strong and nonrigid CPC. They used a powder:liquid ratio of 2:1, compared with the 1:1 ratio of a previously developed nonrigid CPC control. Specimens were characterized using a flexural test, scanning electron microscopy and powder X-ray diffraction. RESULTS: After 28 days of immersion, the new cement had a flexural strength (mean +/- standard deviation; n = 6) of 5.2 +/- 1.0 megapascals, higher than 1.8 +/- 1.5 MPa for the control (P < .05) and overlapping the reported strengths of sintered hydroxyapatite implants and cancellous bone. This cement showed a high ductility with a strain at peak load of 6.5 +/- 1.3 percent, compared with 4.4 +/- 1.9 percent for the control; both were 20-fold higher than the 0.2 percent of the conventional CPC. Nanosized hydroxyapatite crystals, similar to those in teeth and bones, were formed in the cements. CONCLUSIONS: The new nonrigid cement, containing nanohydroxyapatite crystals, possessed a high ductility and superior fracture resistance. This strong, tough and nonrigid CPC may be useful in periodontal repair to provide compliance for tooth mobility without fracture. CLINICAL IMPLICATIONS: The results of this study may yield the first self-hardening and nonrigid hydroxyapatite composite with high strength and durability and large deformation capability to be useful in the regeneration of periodontal osseous defects.

Shear bond strength of experimental methacrylated beta-cyclodextrin-based formulations.

Previous studies have shown that methacrylated beta-cyclodextrins (MCDs) can be used as comonomers in resin-based dental composites. These MCDs by virtue of having several polymerizable methacrylate groups and hydrophilic hydroxyl groups, may also promote bonding of dental composites to dentin. This study evaluated MCDs as adhesive comonomers, and optimized comonomer and polymerization initiator concentrations for maximum shear bond strength (SBS). Experimental MCD-based bonding formulations in acetone were prepared by mixing 33 mass fraction % MCDs with (10, 20, 30, 40, or 50) mass fraction % of 2-hydroxyethyl methacrylate (HEMA). The MCD/HEMA-based solutions were activated with varied amounts of camphorquinone (CQ) and ethyl 4-dimethylamino benzoate (4E). Samples for SBS were prepared by bonding a composite resin to acid-etched dentin surfaces of extracted human molars with the experimental bonding solutions. The specimens were immersed in 37 degrees C water for 24 h and bond strengths were determined in shear mode. With increasing HEMA concentration, the SBS values of MCD-bonding solutions increased to 16 MPa at a composition of 33% MCD, 30% HEMA, and 37% acetone by mass. Also, SBS values of MCD-bonding solutions varied as a function of the CQ and 4E concentrations and passed through a maximum SBS at 21 MPa, which was comparable to that of a commercial control. This preliminary study indicated that nonacidic MCD monomers could be used as an adhesion-promoting comonomer. Additional modification of MCDs having both polymerizable groups and anionic ligand groups, e.g., polymerizable acidic cyclodextrin derivatives should increase the SBS even further.

Properties of eight methacrylated beta-cyclodextrin composite formulations.

OBJECTIVES: Methacrylated beta-cyclodextrins (MCDs) are novel candidate dental monomers if all or some of the hydroxyl groups of beta-cyclodextrin are substituted with methacrylate groups. The main objective of this study was to evaluate mechanical properties of a number of composite formulations having MCDs as novel dental comonomers. The properties determined were flexural strength (FS), volumetric shrinkage (VS), and degree of conversion (DC). METHODS: A mass fraction of 50% of MCD monomers was mixed with a mass fraction of 50% each of a series of dimethacrylate or monomethacrylate diluent comonomers to produce consistent formulations of a workable viscosity. For comparison a resin mixture of a mass fraction of 50% Bis-GMA and a mass fraction of 50% triethyleneglycol dimethacrylate (a typical dental resin mixture) was also studied. The mixtures were activated with camphorquinone and ethyl 4-dimethylamino benzoate. One part by mass of each activated resin formulation was mixed with three parts by mass of glass filler. Samples for the FS tests were prepared in (2 x 2 x 25) mm3 molds by light-curing the composites for 2 min on each side. The cured samples were immersed in 37 degrees C water for 24 h, and FS was measured with an Instron machine at a crosshead speed of 0.5 mm/min. VS was measured by a computer-controlled mercury dilatometer. DC was measured by near-infrared spectroscopy. RESULTS: The properties of the MCD-based composites depended on the kind of diluent used. With these MCD monomers, diluents of triethyleneglycol dimethacrylate, 1,10-decamethylenediol dimethacrylate, or benzyl methacrylate yielded the best composite properties. SIGNIFICANCE: Although not yet fully optimized, MCD-based composite formulations containing triethyleneglycol dimethacrylate, 1,10-decamethylenediol dimethacrylate, or benzyl methacrylate yielded flexural strength and volumetric shrinkage values were comparable to those of the Bis-GMA/triethyleneglycol dimethacrylate controls. These findings lend support for further development and evaluations of polymerizable cyclodextrin derivatives for use in dental materials.

Effects of polymerization initiator complexation in methacrylated beta-cyclodextrin formulations.

OBJECTIVES: Methacrylated beta-cyclodextrin (MCD) is a candidate dental monomer that can complex molecules within its hydrophobic cavity. This study determined the effects of complexation of polymerization initiators such as camphorquinone (CQ) and ethyl-4-dimethylaminobenzoate (4E) with MCD on the flexural strength (FS) and degree of conversion (DC) of resulting dental composite formulations. METHODS: Complexation of CQ and 4E with MCD was studied by thin layer chromatography. A mass fraction of 44% 2-hydroxyethylmethacrylate or triethyleneglycoldimethacrylate was mixed separately with a mass fraction of 56% MCD to produce a workable formulation. The mixture was activated with varied amounts of CQ and 4E. One part by mass of the activated resin formulation was mixed with three parts by mass of glass filler. Specimens for FS were prepared by filling molds with composites and curing for 2 min. The cured specimens were immersed in 37 degrees C water for 24 h and FS was measured with an Instron machine at a crosshead speed of 0.5 mm/min. DC in MCD-based resin formulations was measured with a differential photocalorimeter under nitrogen. RESULTS: MCD appears to form inclusion complexes with CQ and 4E. As a result, FS and DC of MCD-based composites vary significantly as a function of the concentration of polymerization initiators used in the formulations. SIGNIFICANCE: Complexation of polymerization initiators with MCD can influence the FS and DC in MCD-based dental formulations and should be taken into consideration when evaluating MCD as a dental monomer.