Development of an antibacterial and anti-metalloproteinase dental adhesive for long-lasting resin composite restorations.

Despite all the advances in adhesive dentistry, dental bonds are still fragile due to degradation events that start during application of adhesive agents and the inherent hydrolysis of resin-dentin bonds. Here, we combined two outstanding processing methods (electrospinning and cryomilling) to obtain bioactive (antimicrobial and anti-metalloproteinase) fiber-based fillers containing a potent matrix metalloproteinase (MMP) inhibitor (doxycycline, DOX). Poly(ε)caprolactone solutions containing different DOX amounts (0, 5, 25, and 50 wt%) were processed via electrospinning, resulting in non-toxic submicron fibers with antimicrobial activity against Streptococcus mutans and Lactobacillus. The fibers were embedded in a resin blend, light-cured, and cryomilled for the preparation of fiber-containing fillers, which were investigated with antibacterial and in situ gelatin zymography analyzes. The fillers containing 0, 25, and 50 wt% DOX-releasing fibers were added to aliquots of a two-step, etch-and-rinse dental adhesive system. Mechanical strength, hardness, degree of conversion (DC), water sorption and solubility, bond strength to dentin, and nanoleakage analyses were performed to characterize the physico-mechanical, biological, and bonding properties of the modified adhesives. Statistical analyses (ANOVA; Kruskal-Wallis) were used when appropriate to analyze the data (α = 0.05). DOX-releasing fibers were successfully obtained, showing proper morphological architecture, cytocompatibility, drug release ability, slow degradation profile, and antibacterial activity. Reduced metalloproteinases (MMP-2 and MMP-9) activity was observed only for the DOX-containing fillers, which have also demonstrated antibacterial properties against tested bacteria. Adhesive resins modified with DOX-containing fillers demonstrated greater DC and similar mechanical properties as compared to the fiber-free adhesive (unfilled control). Concerning bonding performance to dentin, the experimental adhesives showed similar immediate bond strengths to the control. After 12 months of water storage, the fiber-modified adhesives (except the group consisting of 50 wt% DOX-loaded fillers) demonstrated stable bonds to dentin. Nanoleakage was similar among all groups investigated. DOX-releasing fibers showed promising application in developing novel dentin adhesives with potential therapeutic properties and MMP inhibition ability; antibacterial activity against relevant oral pathogens, without jeopardizing the physico-mechanical characteristics; and bonding performance of the adhesive.

Evaluation of the antimicrobial activity and compressive strength of a dental cement modified using plant extract mixture.

Literature lacks sufficient data regarding addition of natural antibacterial agents to glass ionomer cement (GICs). Hence, the aim of the study was to increase the antimicrobial properties of GICs through its modification with mixture of plant extracts to be evaluated along with an 0.5% chlorohexidine-modified GIC (CHX-GIC) with regard to biological and compressive strength properties. Conventional GIC (freeze-dried version) and CHX were used. Alcoholic extract of Salvadora persica, Olea europaea, and Ficus carcia leaves were prepared using a Soxhlet extractor for 12 h. The plant extract mixture (PE) was added in three different proportions to the water used for preparation of the dental cement (Group 1:1 PE, 2:1 PE, and 1:2 PE). Specimens were then prepared and tested against the unmodified GIC (control) and the 0.5% CHX-GIC. Chemical analysis of the extract mixture was performed using Gas chromatography-mass spectrometry. Antimicrobial activity was evaluated using agar diffusion assay against Micrococcus luteus and Streptoccocus mutans. Compressive strength was evaluated according to ISO 9917-1:2007 using a Zwick testing machine at a crosshead speed of 0.5 mm/min. Antimicrobial activity against Streptoccocus mutans was significantly increased for all the extract-modified materials compared to the unmodified cement, and the highest concentration was comparable to the CHX-GIC mixture. The activity against Micrococcus luteus was also significantly increased, but only for the material with the highest extract concentration, and here the CHX-GIC group showed statistically the highest antimicrobial activity. Compressive strength results revealed that there was no statistically significant difference between the different mixtures and the control except for the highest tested concentration that showed the highest mean values. The plant extracts (PEs) enhanced the antimicrobial activity against S. mutans and also against M. luteus in the higher concentration while compressive strength was improved by addition of the PE at higher concentrations.

Novel rechargeable calcium phosphate nanoparticle-filled dental cement.

The objectives were to develop a novel rechargeable cement containing amorphous calcium-phosphate nanoparticles (nanoACP) to suppress tooth decay. Five cements were made with: (1) 60% glass particles (experimental control); (2) 40% glass+20% nanoACP; (3) 30% glass+30% nanoACP; (4) 20% glass+40% nanoACP; (5) 10% glass+50% nanoACP. Groups 1-4 had enamel bond strengths similar to Transbond XT (3M) and Vitremer (3M) (p>0.1). The nanoACP cement had calcium and phosphate ion release which increased with increasing nanoACP fillers. The recharged cement had substantial ion re-release continuously for 14 days after a single recharge. Ion re-release did not decrease with increasing recharge/re-release cycles. Groups 3-5 maintained a safe pH of medium (>5.5); however, control cements had cariogenic pH of medium (<4.5) due to biofilm acid. Therefore, nanoACP cement (1) had good bond strength to enamel, (2) possessed calcium and phosphate ion recharge/re-release capability, and (3) raised biofilm pH to a safe level to inhibit caries.

Acrylamides and methacrylamides as alternative monomers for dental adhesives.

OBJECTIVE: Synthesize and characterize a methacrylamide monomer for adhesive system and evaluate the physicochemical properties of the adhesive resin. METHODS: The liquid methacrylamide monomer N,N',N″-(nitrilotris(ethane-2,1-dyil)tris(2-methylacrylamide) (TMA) was prepared by reaction of methacrylic anhydride and tris(2-aminoethyl)amine with 60% yields. The TMA structure was analyzed by 1H NMR, 13C NMR, ATR-FTIR and UHPLC-QTOF-MS. Experimental adhesive resin containing bisphenol-A glycidyl methacrylate (BISGMA), 2-hydroxyethylacrylamide (HEAA), 2-hydroxyethylmethacrylate (HEMA) and TMA were formulated. Polymerization kinetics of neat TMA and experimental adhesive resin (TMA33%/HEAA66%, TMA50%/HEAA50%, TMA66%/HEAA33%, TMA50%/HEMA50%, BisGMA/HEAA/TMA and BisGMA/HEMA) were evaluated using Differential Scanning Calorimetry. Physiochemical properties for BisGMA/HEAA/TMA and BisGMA/HEMA adhesives were evaluated by cytotoxicity, ultimate tensile strength (UTS), softening in solvent (ΔKHN), contact angle (θ), microtensile bond strength (µTBS) and failure analysis. A primer was also formulated with H2O/HEAA/AMPS (2-acrylamido-2-methylpropane sulfonic acid) and the pH value was verified and compared to commercial primer. RESULTS: Adhesive resin with only HEAA and TMA (TMA33%/HEAA66%, TMA50%/HEAA50%, TMA66%/HEAA33%) showed lower conversion and polymerization rate after 40s of light activation. Conversion up to 60% was found for BisGMA/HEAA/TMA and BisGMA/HEMA adhesive resin without significant difference between groups, p>0.05. Cytotoxicity, UTS, µTBS, ΔKHN and θ showed no statistical difference, p>0.05, between BisGMA/HEAA/TMA and BisGMA/HEMA adhesive resin. SIGNIFICANCE: In this study, the proposed synthetic route resulted in a tris(methacrylamide). A new primer composed without acrylates or methacrylates was formulated for 3-step etch-and-rinse adhesive system without the presence of HEMA monomer. Physicochemical properties and cell viability of BisGMA/HEAA/TMA adhesive resin represents an alternative adhesive resin without HEMA monomer.

Fluoride containing bioactive glass composite for orthodontic adhesives - Apatite formation properties.

OBJECTIVES: Dental materials that can form apatite offer the potential to not only prevent demineralisation but enhance remineralisation of the enamel. The objective of this study was to investigate the ability of a novel BAG-resin adhesive to form apatite in 3 immersion media. METHODS: A novel fluoride containing BAG-resin adhesive described previously, with 80% by weight filler load, was used to fabricate 90 disks. Each disk was immersed in 10ml of either tris buffer (TB), or artificial saliva at pH=7 (AS7) or pH=4 (AS4). At ten time points (from 6h to 6 months), three disks were taken from each of the solutions and investigated by ATR-FTIR, XRD and SEM. RESULTS: The BAG-resin formed apatite on the disk surface, which increased with time, especially in AS4 and AS7. The apatite crystals formed in AS7 were highly oreintated and the oreintation increased with time. SIGNIFICANCE: This novel BAG-resin adhesive differs from the currently used adhesives by promting apatite formation, particularly under acidic conditions. Thus, applied in the clinical situation to bond orthodontic brackets, it may discourage the frequent occurrence of white spot lesion formation around the brackets.

Effect of nanostructured zirconium dioxide incorporation in an experimental adhesive resin.

OBJECTIVES: The aim of this study was to evaluate the influence of nanostructured zirconium dioxide incorporation in an experimental adhesive resin. METHODS: ZrO2 particles were characterized by X-ray diffraction (XRD), micro-Raman spectroscopy and Brunauer-Emmett-Teller (B.E.T). Experimental adhesive resins were formulated with 0, 0.5, 1, 4.8, and 9.1% ZrO2 in weight. The adhesives were evaluated based on degree of conversion (DC), radiopacity, softening in solvent and microtensile bond strength (µTBS) 24 h and after 1 year of aging. Mineral deposition at the hybrid layer was assessed with micro-Raman spectroscopy at the baseline and after 14 days. RESULTS: XRD showed monoclinic and tetragonal phases of ZrO2.particles. B.E.T data revealed a surface area of 37.41 m2/g, and typical chemical groups were shown on the Raman spectra. The addition of ZrO2 did not influence the radiopacity. The addition of 4.8% and 9.1 wt.% ZrO2 showed higher initial hardness with increased softening in solvent (P < 0.05) and promoted mineral deposition at the dentin interface. DC was significantly increased in the group with 1% ZrO2 (P < 0.05). The µTBS test showed difference on the group with 9.1 wt.% of ZrO2, with a significant reduction after aging. CONCLUSION: The incorporation of ZrO2 promoted mineral deposition on the adhesive interface and the addition of 1 wt.% caused a significant increase on the DC without compromising the other physicochemical characteristics, which may prove promising for the development of new dental adhesive systems. CLINICAL RELEVANCE: The mineral deposition on the hybrid layer can result in a longer stability of the adhesive, thus delaying the hydrolytic degradation.

The anti-caries effects of dental adhesive resin influenced by the position of functional groups in quaternary ammonium monomers.

OBJECTIVES: A new quaternary ammonium monomer (QAM), triethylaminododecyl acrylate (TEADDA) was synthesized, in which the position of the functional groups was different from that of dimethylaminododecyl methacrylate (DMADDM). The objectives were to: (1) investigate the effect of the changed position of the functional groups on the mechanical properties, anti-biofilm activity and biocompatibility of adhesive resin, and (2) study the anti-bacterial mechanism of QAM to improve the performance of the adhesive system modified by QAM. METHODS: TEADDA and DMADDM were added into adhesives. Microtensile bond strength and surface charge density were measured. Multi-species biofilms were incubated on specimens for 16h, 48h and 72h and analyzed via MTT assay, lactic acid measurement and confocal laser scanning microscopy. The ratio of different species of bacteria was measured by real-time polymerase chain reaction. Cytotoxicity and biocompatibility were analyzed by eluents cytotoxicity test and histological images of H&E staining via an animal study in rats. RESULTS: The mass fraction of TEDDA allowed to be added into adhesive was higher than that of DMADDM. However, even 10% TEADDA did not yield a strong anti-biofilm effect on biofilm growth, lactic acid production and bacteria compositions. TEADDA added into adhesives showed better mechanical properties but weaker anti-bacterial effect. There was no significant difference on cytotoxicity and biocompatibility between DMADDM and TEADDA. SIGNIFICANCE: The study could be helpful for the investigation of the anti-caries mechanism of QAMs, the design of new QAMs and the improvement of the anti-caries activity of the modified dental materials.

Antibacterial effect and bond strength of a modified dental adhesive containing the peptide nisin.

This study attempted to incorporate the antibacterial peptide nisin into an etch-and-rinse dental adhesive to evaluate the antibacterial activity of the modified adhesive against Streptococcus mutans and the bond strength. Single Bond 2 was used as a negative control, and nisin was incorporated at 1%, 3%, and 5% (w/v). The antibacterial activity against S. mutans was evaluated using the film contact test, the agar diffusion test, XTT assays and confocal laser scanning microscopy (CLSM). The microtensile bond strength (µTBS) of the modified dental adhesive was also evaluated. The cured nisin-incorporated dental adhesive exhibited a significant inhibitory effect on the growth of S. mutans (P<0.05), and the inhibitory effect was strengthened as the nisin concentration increased (P<0.05). However, no significant differences in the agar diffusion test were found for the cured nisin-incorporated adhesives compared with the control group. Based on XTT results and CLSM images, the cured nisin-incorporated adhesive interfered with the adherence of S. mutans and the integrity of its biofilms (P<0.05). Compared with the control group, the 1% nisin group did not exhibit a significant difference in µTBS (P>0.05), whereas the 3% and 5% nisin groups displayed decreased bond strength (P<0.05).

Assessment of Heat Hazard during the Polymerization of Selected Light-Sensitive Dental Materials.

Introduction. Polymerization of light-cured dental materials used for restoration of hard tooth tissue may lead to an increase in temperature that may have negative consequence for pulp vitality. Aim. The aim of this study was to determine maximum temperatures reached during the polymerization of selected dental materials, as well as the time that is needed for samples of sizes similar to those used in clinical practice to reach these temperatures. Materials and Methods. The study involved four composite restorative materials, one lining material and a dentine bonding agent. The polymerization was conducted with the use of a diode light-curing unit. The measurements of the external surface temperature of the samples were carried out using the Thermovision®550 thermal camera. Results. The examined materials significantly differed in terms of the maximum temperatures values they reached, as well as the time required for reaching the temperatures. A statistically significant positive correlation of the maximum temperature and the sample weight was observed. Conclusions. In clinical practice, it is crucial to bear in mind the risk of thermal damage involved in the application of light-cured materials. It can be reduced by using thin increments of composite materials.

Rechargeable calcium phosphate orthodontic cement with sustained ion release and re-release.

White spot lesions (WSL) due to enamel demineralization are major complications for orthodontic treatments. Calcium phosphate (CaP) dental resins with Ca and P ion releases are promising for remineralization. However, previous Ca and P releases lasted for only weeks. Experimental orthodontic cements were developed using pyromellitic glycerol dimethacrylate (PMGDM) and ethoxylated bisphenol A dimethacrylate (EBPADMA) at mass ratio of 1:1 (PE); and PE plus 10% of 2-hydroxyethyl methacrylate (HEMA) and 5% of bisphenol A glycidyl dimethacrylate (BisGMA) (PEHB). Particles of amorphous calcium phosphate (ACP) were incorporated into PE and PEHB at 40% filler level. Specimens were tested for bracket-enamel shear bond strength, water sorption, CaP release, and ion recharge and re-release. PEHB+40ACP had higher bracket-enamel bond strength and ion release and rechargeability than PE+40ACP. ACP incorporation into the novel orthodontic cement did not adversely affect the bracket-enamel bond strength. Ion release and re-release from the novel ACP orthodontic cement indicated favorable release and re-release patterns. The recharged orthodontic cement could release CaP ions continuously for four weeks without further recharge. Novel rechargeable orthodontic cement containing ACP was developed with a high bracket-enamel bond strength and the ability to be repeatedly recharged to maintain long-term high levels of CaP ion releases.

Probing the dual function of a novel tertiary amine compound in dentin adhesive formulations.

OBJECTIVES: A novel tertiary amine compound containing three methacrylate-urethane groups was synthesized for application in dentin adhesives. The synthesis, photopolymerization kinetics, and leaching were examined in an earlier study using this novel compound as the co-initiator (0.5 and 1.75wt% based on the total resin mass). The objective of this work was to investigate the potential of TUMA (8-(2-(((2-(methacryloyloxy)ethyl)carbamoyl)oxy)propyl)-6,10-dimethyl-4,12-dioxo-5,11-dioxa-3,8,13-triazapentadecane-1,15-diyl bis(2-methylacrylate)) to serve simultaneously as a co-initiator and co-monomer (15-45wt% based on the total resin mass) in dentin adhesive formulations. The polymerization kinetics, water sorption and dynamic mechanical properties of these novel formulations were determined. MATERIALS AND METHOD: The monomer system contained Bisphenol A glycerolate dimethacrylate (BisGMA), 2-hydroxyethylmethacrylate (HEMA) and TUMA (synthesized in our lab) at the mass ratio of 45/(55-x)/x. Two photoinitiator (PI) systems were compared. One initiator system contains three components: camphorquinone (CQ), diphenyliodonium hexafluorophosphate (DPIHP) and ethyl-4-(dimethylamino) benzoate (EDMAB) and the second initiator system contains CQ and DPIHP. The control adhesive formulations are: C0-3: HEMA/BisGMA 45/55 (w/w) and 3-component PI and C0-2: HEMA/BisGMA 45/55 (w/w) and 2-component PI. These controls were used as a comparison to the experimental adhesive resins (Ex-3 or Ex-2), in which x represents the weight percentage of synthesized co-monomer (TUMA) to replace part of BisGMA. The control and experimental adhesive formulations were photo-polymerized and compared with regard to the degree of conversion (DC), polymerization rate (Rp), water sorption and dynamic mechanical analysis (DMA) under both dry and wet conditions. RESULTS: C0-3 and Ex-3 formulations had similar DC, while the DC of Ex-2 formulation was higher than C0-2. The DC was similar when comparing the two- component with the three-component photoinitiator system when TUMA was used at the same concentration. DMA under dry conditions shows higher rubbery storage modulus for all experimental formulations, while storage modulus at rubbery region under wet conditions was decreased as compared with control (C0-3). There was no statistically significant difference for the DMA results under both dry and wet conditions when comparing two- and three-component initiator systems with the same TUMA concentration. SIGNIFICANCE: The newly synthesized TUMA could serve simultaneously as a co-monomer and co-initiator in the absence of commercial co-initiator. This study provides information for the future development of new co-monomer/co-initiator for dentin adhesives and dental composites.

Luting of CAD/CAM ceramic inlays: direct composite versus dual-cure luting cement.

The aim of this study was to investigate bonding effectiveness in direct restorations. A two-step self-etch adhesive and a light-cure resin composite was compared with luting with a conventional dual-cure resin cement and a two-step etch and rinse adhesive. Class-I box-type cavities were prepared. Identical ceramic inlays were designed and fabricated with a computer-aided design/computer-aided manufacturing (CAD/CAM) device. The inlays were seated with Clearfil SE Bond/Clearfil AP-X (Kuraray Medical) or ExciTE F DSC/Variolink II (Ivoclar Vivadent), each by two operators (five teeth per group). The inlays were stored in water for one week at 37°C, whereafter micro-tensile bond strength testing was conducted. The micro-tensile bond strength of the direct composite was significantly higher than that from conventional luting, and was independent of the operator (P<0.0001). Pre-testing failures were only observed with the conventional method. High-power light-curing of a direct composite may be a viable alternative to luting lithium disilicate glass-ceramic CAD/CAM restorations.

Catechol-Functionalized Synthetic Polymer as a Dental Adhesive to Contaminated Dentin Surface for a Composite Restoration.

This study reports a synthetic polymer functionalized with catechol groups as dental adhesives. We hypothesize that a catechol-functionalized polymer functions as a dental adhesive for wet dentin surfaces, potentially eliminating the complications associated with saliva contamination. We prepared a random copolymer containing catechol and methoxyethyl groups in the side chains. The mechanical and adhesive properties of the polymer to dentin surface in the presence of water and salivary components were determined. It was found that the new polymer combined with an Fe(3+) additive improved bond strength of a commercial dental adhesive to artificial saliva contaminated dentin surface as compared to a control sample without the polymer. Histological analysis of the bonding structures showed no leakage pattern, probably due to the formation of Fe-catechol complexes, which reinforce the bonding structures. Cytotoxicity test showed that the polymers did not inhibit human gingival fibroblast cells proliferation. Results from this study suggest a potential to reduce failure of dental restorations due to saliva contamination using catechol-functionalized polymers as dental adhesives.

Rechargeable dental adhesive with calcium phosphate nanoparticles for long-term ion release.

OBJECTIVES: The tooth-resin bond is the weak link of restoration, with secondary caries as a main reason for failure. Calcium phosphate-containing resins are promising for remineralization; however, calcium (Ca) and phosphate (P) ion releases last only a couple of months. The objectives of this study were to develop the first rechargeable CaP bonding agent and investigate the key factors that determine CaP ion recharge and re-release. METHODS: Nanoparticles of amorphous calcium phosphate (NACP) were synthesized. Pyromellitic glycerol dimethacrylate (PMGDM), ethoxylated bisphenol-A dimethacrylate (EBPADMA), 2-hydroxyethyl methacrylate (HEMA), and bisphenol-A glycidyl dimethacrylate (BisGMA) were used to synthesize three adhesives (denoted PE, PEH and PEHB). NACP were mixed into adhesive at 0-30% by mass. Dentin shear bond strengths were measured. Adhesive specimens were tested for Ca and P initial ion release. Then the ion-exhausted specimens were immersed in Ca and P solution to recharge the specimens, and the recharged specimens were then used to measure ion re-release for 7 days as one cycle. Then these specimens were again recharged and the re-release was measured for 7 days as the second cycle. Three recharge/re-release cycles were tested. RESULTS: PEHB had the highest dentin bond strength (p<0.05). Increasing NACP content from 0 to 30% did not affect dentin bond strength (p>0.1), but increased CaP release and re-release (p<0.05). PEHB-NACP had the greatest recharge/re-release, and PE-NACP had the least (p<0.05). Ion release remained high and did not decrease with increasing the number of recharge/re-release cycles (p>0.1). After the third cycle, specimens without further recharge had continuous CaP ion release for 2-3 weeks. SIGNIFICANCE: Rechargeable CaP bonding agents were developed for the first time to provide long-term Ca and P ions to promote remineralization and reduce caries. Incorporation of NACP into adhesive had no negative effect on dentin bond strength. Increasing NACP filler level increased the ion recharge and re-release capability. The new CaP recharge method and PMGDM-EBPADMA-NACP composition may have wide application in adhesives, composites and cements, to combat caries and remineralize lesions.

Polypropylene glycol phosphate methacrylate as an alternative acid-functional monomer on self-etching adhesives.

OBJECTIVES: The aim of this study was to synthesize an alternative acidic monomer (polypropylene glycol phosphate methacrylate--Poly-P) to constitute experimental two-step self-etch adhesive systems and also to evaluate its influence on the pH and microshear bond strength (µSBS) to enamel. METHODS: Primers containing Poly-P (10, 15, 30 or 50wt.%), HEMA, ethanol, and water were prepared and allocated in subgroups according to a buffered or non-buffered pH. One experimental control and one commercial (Clearfill™ SE Bond) references were used. µSBS protocol was performed at human enamel, followed by mechanical testing. Scanning electron microscopy (SEM) was performed after each primer application. Data was analysed by one-way Kruskal-Wallis and Student-Newman-Keuls tests (p<0.05) and by linear regression predictive models. RESULTS: As greater the Poly-P content, the lower the primer's pH. Buffered groups showed lower µSBS values than non-buffered groups. Groups with Poly-P content equal or higher than 30wt.% showed similar µSBS results when compared to the controls. SEM images demonstrated that primers with high Poly-P content etched enamel with prisms exposure. CONCLUSIONS: The pH of the primer was directly influenced by the concentration of acidic monomer, which directly affected the adhesion to enamel. Both the acidity and the type of acid-functional monomer present in the adhesive influenced the bond strength results. CLINICAL SIGNIFICANCE: Poly-P synthesis was easy and effective, and considering the good bond strength results obtained, this acid-functional monomer may be potentially used in the formulation of self-etch dental adhesive systems.

Synthesis and evaluation of novel dental monomer with branched carboxyl acid group.

To enhance the water miscibility and increase the mechanical properties of dentin adhesives, a new glycerol-based monomer with vinyl and carboxylic acid, 4-((1,3-bis(methacryloyloxy)propan-2-yl)oxy)-2-methylene-4-oxobutanoic acid (BMPMOB), was synthesized and characterized. Dentin adhesive formulations containing 2-hydroxyethyl methacrylate (HEMA), 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy) phenyl]propane (BisGMA), and BMPMOB were characterized with regard to real-time photopolymerization behavior, water sorption, dynamic mechanical analysis, and microscale three-dimensional internal morphologies and compared with HEMA/BisGMA controls. The experimental adhesive copolymers showed higher glass transition temperature and rubbery moduli, as well as improved water miscibility compared to the controls. The enhanced properties of the adhesive copolymers indicated that BMPMOB is a promising comonomer for dental restorative materials.

Dental primer and adhesive containing a new antibacterial quaternary ammonium monomer dimethylaminododecyl methacrylate.

OBJECTIVES: The main reason for restoration failure is secondary caries caused by biofilm acids. Replacing the failed restorations accounts for 50-70% of all operative work. The objectives of this study were to incorporate a new quaternary ammonium monomer (dimethylaminododecyl methacrylate, DMADDM) and nanoparticles of silver (NAg) into a primer and an adhesive, and to investigate their effects on antibacterial and dentin bonding properties. METHODS: Scotchbond Multi-Purpose (SBMP) served as control. DMADDM was synthesized and incorporated with NAg into primer/adhesive. A dental plaque microcosm biofilm model with human saliva was used to investigate metabolic activity, colony-forming units (CFU), and lactic acid. Dentin shear bond strengths were measured. RESULTS: Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the new DMADDM were orders of magnitude lower than those of a previous quaternary ammonium dimethacrylate (QADM). Uncured primer with DMADDM had much larger inhibition zones than QADM (p<0.05). Cured primer/adhesive with DMADDM-NAg greatly reduced biofilm metabolic activity (p<0.05). Combining DMADDM with NAg in primer/adhesive resulted in less CFU than DMADDM alone (p<0.05). Lactic acid production by biofilms was reduced by 20-fold via DMADDM-NAg, compared to control. Incorporation of DMADDM and NAg into primer/adhesive did not adversely affect dentin bond strength. CONCLUSIONS: A new antibacterial monomer DMADDM was synthesized and incorporated into primer/adhesive for the first time. The bonding agents are promising to combat residual bacteria in tooth cavity and invading bacteria at tooth-restoration margins to inhibit caries. DMADDM and NAg are promising for use into a wide range of dental adhesive systems and restoratives.

The effect of various mixing and placement techniques on the compressive strength of mineral trioxide aggregate.

INTRODUCTION: The aim of this study was to evaluate the effect of various mixing techniques including mechanical and manual mixing as well as the effect of ultrasonic agitation during placement on the compressive strength of mineral trioxide aggregate (MTA). METHODS: Tooth-colored ProRoot MTA (Dentsply Maillefer, Ballaigues, Switzerland) and white MTA Angelus (Angelus Soluções Odontologicas, Londrina, Brazil) were used. One gram of each powder was mixed with a 0.34-g aliquot of distilled water. Specimens were mixed either by mechanical mixing of capsules for 30 seconds at 4,500 rpm or by a saturation technique and the application of a condensation pressure of 3.22 MPa for 1 minute. Half of the specimens were placed in stainless steel molds and agitated using indirect ultrasonic activation. All specimens were subjected to compressive strength testing after 4 days. RESULTS: The compressive strength values of ProRoot MTA were significantly greater than those of MTA Angelus (P < .05). The highest compressive strength values were recorded from ProRoot MTA samples that were mixed mechanically and placed using ultrasonic activation (mean = 101.71 MPa), whereas the lowest values were recorded for MTA Angelus samples that were mixed manually and placed without ultrasonic activation (mean = 53.47 MPa). Ultrasonically agitated groups had higher compressive strength values (P < .001). The specimens mixed mechanically had higher compressive strength values than those mixed manually (P < .05). CONCLUSIONS: The compressive strength values of ProRoot MTA were significantly greater than those of MTA Angelus. Mechanical mixing enhanced the compressive strength of the material. Regardless of the mixing techniques applied, ultrasonic agitation improved the compressive strength of the material.

Multiple coatings can improve the bond durability of one-step self-etching adhesive to primary dentin.

OBJECTIVE: To investigate whether multiple coatings can improve the bond durability of one-step self-etching adhesive to primary dentin. METHODS: Twelve caries-free human primary molars were randomly divided into 2 groups. In group 1, each tooth was hemisected into 2 halves. One half was assigned to the control subgroup 1, which was bonded with a commercially available one-step self-etching adhesive according to the manufacturer's instructions; the other half was assigned to experimental subgroup 1, in which the adhesive was applied three times before light curing. In group 2, one split half tooth was bonded with a commercially available one-step self-etching adhesive according to the manufacturer's instructions; for the other half, three layers of adhesive were applied with each successive layer of light curing. Specimens were stored in 0.9% NaCl containing 0.02% sodium azide at 37℃ for 18 months and then were subjected to microtensile bond strength test and the fracture mode analysis. RESULTS: When the adhesive was applied three times before light curing, the bond strength of the experimental subgroup 1 was significantly higher than that of the control subgroup 1 (47.46∓13.91 vs. 38.12∓11.21 MPa, P<0.05). When using the technique of applying multiple layers of adhesive with each successive layer of light curing, no difference was observed in bond strength between the control subgroup and the experimental subgroup (39.40±8.87 vs. 40.87±9.33 MPa, P>0.05). CONCLUSION: Multiple coatings can improve the bond durability of one-step self-etching adhesive to primary dentin when using the technique of light-curing after applying 3 layers of adhesive.