Search

Objective: The bonding interface of dental filling therapy is the weak point in resisting secondary caries. Adhesives containing nanoparticles of amorphous calcium phosphate (NACP) and dimethylaminohexadecyl methacrylate (DMAHDM) have been demonstrated in vitro to prevent bacteria from producing acid and to promote tooth remineralization. The present study aimed to evaluate the efficacy of adhesive with NACP and DMAHDM to prevent secondary caries in vivo., Materials and Methods: Artificial cavities were created on the first molar on both sides of the maxillary in a rat model. One side was treated with adhesive containing NACP + DMAHDM, while on the other side, a commercial adhesive served as control. After 24 days of cariogenic feeding, the degree of secondary caries was evaluated by micro-CT and a modified Keyes scoring method. Quantitative real-time PCR (qPCR) and colony-forming unit (CFU) counts were used to evaluate the antibacterial efficacy of the materials. Biocompatibility was also investigated., Results: In the rat model, the adhesive with NACP + DMAHDM showed excellent biocompatibility and effectively decreased the amount of bacteria. The experimental group demonstrated excellent remineralization effectiveness, with a lower modified Keyes score and mineral loss of 34.16 ± 2.13 vol% μm, compared with 77.44 ± 7.22 vol% μm in the control group, according to micro-CT (P < 0.05), showing excellent capacity to inhibit secondary caries., Conclusions: The NACP-DMAHDM-containing adhesive exhibited good performance in preventing secondary caries in vivo., Clinical Relevance: Adhesives containing NACP and DMAHDM have great potential for use in clinical dentistry to prevent secondary caries by inhibiting bacterial growth and promoting remineralization., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The aims are: (a) To develop the first low-shrinkage-stress nanocomposite with antibacterial and remineralization capabilities through the incorporation of dimethylaminododecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP); (b) to investigate the effects of the new composite on biofilm inhibition, mechanical properties, shrinkage stress, and calcium (Ca) and phosphate (P) ion releases. The low-shrinkage-stress resin consisted of urethane dimethacrylate and triethylene glycol divinylbenzyl ether. Composite was formulated with 3% DMAHDM and 20% NACP. Mechanical properties, shrinkage stress, and degree of conversion were evaluated. Streptococcus mutans biofilm growth on composites was assessed. Ca and P ion releases were measured. The shrinkage stress of the low-shrinkage-stress composite containing 3% DMAHDM and 20% NACP was 36% lower than that of traditional composite control (p < 0.05), with similar degrees of conversion of 73.9%. The new composite decreased the biofilm colony-forming unit by 4 log orders and substantially reduced biofilm lactic acid production compared to control composite (p < 0.05). Incorporating DMAHDM to the low-shrinkage-stress composite did not adversely affect the Ca and P ion release. A novel bioactive nanocomposite was developed with low shrinkage stress, strong antibiofilm activity, and high levels of ion release for remineralization, without undermining the mechanical properties and degree of conversion., (© 2021 Wiley Periodicals LLC.)

Caries-related biofilms and associated complications are significant threats in dentistry, especially when biofilms grow over dental restorations. The inhibition of cariogenic biofilm associated with the onset of carious lesions is crucial for preventing disease recurrence after treatment. This in vitro study defined optimized parameters for using a photosensitizer, toluidine blue O (TBO), activated via a red light-emitting diode (LED)-based wireless device to control the growth of cariogenic biofilms. The effect of TBO concentrations (50, 100, 150, and 200 μg/mL) exposed to light or incubated in the dark was investigated in successive cytotoxicity assays. Then, a mature Streptococcus mutans biofilm model under sucrose challenge was treated with different TBO concentrations (50, 100, and 150 μg/mL), different light energy doses (36, 108, and 180 J/cm 2 ), and different incubation times before irradiation (1, 3, and 5 min). The untreated biofilm, irradiation with no TBO, and TBO incubation with no activation represented the controls. After treatments, biofilms were analyzed via S. mutans colony-forming units (CFUs) and live/dead assay. The percentage of cell viability was within the normal range compared to the control when 50 and 100 μg/mL of TBO were used. Increasing the TBO concentration and energy dose was associated with biofilm inhibition ( p < 0.001), while increasing incubation time did not contribute to bacterial elimination ( p > 0.05). Irradiating the S. mutans biofilm via 100 μg/mL of TBO and ≈180 J/cm 2 energy dose resulted in ≈3-log reduction and a higher amount of dead/compromised S. mutans colonies in live/dead assay compared to the control ( p < 0.001). The light energy dose and TBO concentration optimized the bacterial elimination of S. mutans biofilms. These results provide a perspective on the determining parameters for highly effective photo-killing of caries-related biofilms and display the limitations imposed by the toxicity of the antibacterial photodynamic therapy's chemical components. Future studies should support investigations on new approaches to improve or overcome the constraints of opportunities offered by photodynamic inactivation of caries-related biofilms.

Secondary caries often occurs at the tooth-composite margins. This study developed a novel bioactive composite containing DMAHDM (dimethylaminohexadecyl methacrylate) and NACP (nanoparticles of amorphous calcium phosphate), inhibiting caries at the enamel restoration margins in an in vitro saliva-derived biofilm secondary caries model for the first time. Four composites were tested: (1) Heliomolar nanocomposite, (2) 0% DMAHDM + 0% NACP, (3) 3% DMAHDM + 0% NACP, (D) 3% DMAHDM + 30% NACP. Saliva-derived biofilms were tested for antibacterial effects of the composites. Bovine enamel restorations were cultured with biofilms, Ca and P ion release of nanocomposite and enamel hardness at the enamel restoration margins was measured. Incorporation of DMAHDM and NACP into composite did not affect the mechanical properties ( p > 0.05). The biofilms' CFU (colony-forming units) were reduced by 2 logs via DMAHDM ( p < 0.05). Ca and P ion release of the nanocomposite was increased at cariogenic low pH. Enamel hardness at the margins for DMAHDM group was 25% higher than control ( p < 0.05). With DMAHDM + NACP, the enamel hardness was the greatest and about 50% higher than control ( p < 0.05). Therefore, the novel composite containing DMAHDM and NACP was strongly antibacterial and inhibited enamel demineralization, resulting in enamel hardness at the margins under biofilms that approached the hardness of healthy enamel.

Objectives: Polymerization shrinkage stress may lead to marginal damage, microleakage and failure of composite restorations. The objectives of this study were to : (1) develop a novel nanocomposite with low-shrinkage-stress, antibacterial and remineralization properties to reduce marginal enamel demineralization under biofilms; (2) evaluate the mechanical properties of the composite and calcium (Ca) and phosphate (P) ion release; and (3) investigate the cytotoxicity of the new low-shrinkage-stress monomer in vitro., Methods: The low-shrinkage-stress resin consisted of urethane dimethacrylate (UDMA) and triethylene glycol divinylbenzyl ether (TEG-DVBE), and 3 % dimethylaminohexadecyl methacrylate (DMAHDM) and 20 % calcium phosphate nanoparticles (NACP) were added. Mechanical properties, polymerization shrinkage stress, and degree of conversion were evaluated. The growth of Streptococcus mutans (S. mutans) on enamel slabs with different composites was assessed. Ca and P ion releases and monomer cytotoxicity were measured., Results: Composite with DMAHDM and NACP had flexural strength of 84.9 ± 10.3 MPa (n = 6), matching that of a commercial control composite. Adding 3 % DMAHDM did not negatively affect the composite ion release. Under S. mutans biofilm, the marginal enamel hardness was 1.2 ± 0.1 GPa for the remineralizing and antibacterial group, more than 2-fold the 0.5 ± 0.07 GPa for control (p < 0.05). The polymerization shrinkage stress of the new composite was 40 % lower than that of traditional composite control (p < 0.05). The new monomers had fibroblast viability similar to that of traditional monomer control (p > 0.1)., Conclusion: A novel low-shrinkage-stress nanocomposite was developed with remineralizing and antibacterial properties. This new composite is promising to inhibit recurrent caries at the restoration margins by reducing polymerization stress and protecting enamel hardness., Competing Interests: Declaration of Competing Interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Dental caries in children is a leading worldwide oral health concern. Combining antibacterial and remineralizing additives within dental sealants is a promising approach for caries prevention. Saliva contains oral bacteria that are indicative of the whole oral microbiome and may have the ability to reflect the dysbiosis present in patients with dental caries. Here, we used the saliva of children at a low and high risk of caries to culture microcosm biofilms resembling caries-associated microbial communities and investigated the changes in the biofilms promoted by the formulated dental sealants containing dimethylaminohexadecyl methacrylate (DMAHDM), a quaternary ammonium monomer, and nanoparticles of amorphous calcium phosphate (NACP). Ten volunteers were selected from each caries-risk condition for saliva collection. Biofilms were grown on the tested sealant samples using a 48 h-microcosm biofilm model. The biofilm growth, metabolic behavior, and bacterial acid production were combined with 16S rRNA sequencing analysis for the assessment of the biofilm grown over the material. The DMAHDM-NACP dental sealant formulations promoted a significant reduction in the population of mutans streptococci, total streptococci, lactobacilli, and total microorganisms in the biofilms regardless of the risk status of the donor child's saliva (p < 0.05). Metabolic and lactic acid production was greatly reduced when in contact with the DMAHDM-NACP sealants in both the sources of inoculum. The relative abundance of the Streptococcus genera derived from patients at a high risk of caries was reduced on contact with the antibacterial sealant. The dental sealant formulations were effective in modulating the growth of the biofilm derived from the saliva of children at a low and high risk of caries. The sealants formulated herein with dual functions and purpose for biointeractivity to prevent biofilm formation and mineral loss can be a reliable complementary strategy to decrease the incidence of carious lesions in children at a high risk of caries.

Objectives: Antibacterial quaternary ammonium monomers (QAMs) are used in resins. The rnc gene in Streptococcus mutans (S. mutans) plays a key role in resisting antibiotics. The objectives of this study were to investigate for the first time: (1) the effects of rnc deletion on S. mutans biofilms and acid production; (2) the combined effects of rnc deletion with dimethylaminohexadecyl methacrylate (DMAHDM) on biofilm-inhibition efficacy., Methods: Parent S. mutans strain UA159 (ATCC 700610) and the rnc-deleted S. mutans were used. Bacterial growth, minimum inhibitory concentration (MIC), and minimal bactericidal concentration (MBC) were measured to analyze the bacterial susceptibility of the parent and rnc-deleted S. mutans against DMAHDM, with the gold-standard chlorhexidine (CHX) as control. Biofilm biomass, polysaccharide and lactic acid production were measured., Results: The drug-susceptibility of the rnc-deleted S. mutans to DMAHDM or CHX was 2-fold higher than parent S. mutans. The drug-susceptibility did not increase after 10 passages (p < 0.05). Deleting the rnc gene increased the biofilm susceptibility to DMAHDM or CHX by 2-fold. The rnc-deletion in S. mutans reduced biofilm biomass, polysaccharide and lactic acid production, even at no drugs. DMAHDM was nearly 40 % more potent than the gold-standard CHX. The combination of rnc deletion+DMAHDM treatment achieved the greatest reduction in biofilm biomass, polysaccharide synthesis, and lactic acid production., Significance: Gene modification by deleting the rnc in S. mutans reduced the biofilm growth and acid production, and the rnc deletion+DMAHDM method showed the greatest biofilm-inhibition efficacy, for the first time. The dual strategy of antibacterial monomer+bacterial gene modification shows great potential to control biofilms and inhibit caries., (Copyright © 2019 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: Composite restorations are increasingly popular, but recurrent caries is a main reason for composite restoration failures. The objectives of this study were to investigate a dual strategy of combining rnc gene-deletion for Streptococcus mutans (S. mutans) with antibacterial dimethylaminohexadecyl methacrylate (DMAHDM) composite, and determine the effects of rnc gene-deletion alone, DMAHDM composite alone, and rnc-deletion plus DMAHDM composite, on biofilm growth and lactic acid production., Methods: Parent S. mutans (UA159, ATCC 700610) and rnc-deleted S. mutans were used. DMAHDM was incorporated into a composite at mass fractions of 0%, 1.5%, and 3%. Gene expressions for biofilm formation and drug resistance were analyzed using quantitative real-time polymerase chain reaction (qRT-PCR). Biofilms were grown on composite surfaces for 2 days. Live/dead, biomass, polysaccharide, metabolic activity (MTT), colony-forming units (CFU) and lactic acid production of biofilms were evaluated., Results: Compared to the parent S. mutans, the rnc-deletion technique yielded significantly less biofilm biomass, polysaccharides, metabolic activity, CFU, and lactic acid for biofilms grown on control composite (p <  0.05). With no gene modification, the biofilm CFU was decreased by 5-6 logs at 3% DMAHDM, when compared to control composite group. The dual strategy of combining rnc-deletion with 3% DMAHDM composite achieved the strongest biofilm-inhibition, with the greatest reduction in CFU by 8 logs. The combination of rnc-deletion with 3% DMAHDM composite decreased the biofilm lactic acid production by 95% (p <  0.05)., Conclusions: The dual strategy of rnc-deletion plus DMAHDM composite produced synergistic effects and achieved the strongest biofilm-inhibition. This method has great potential to inhibit dental caries and is promising to reduce secondary caries and protect tooth structures., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Persisting apical periodontitis is a primary reason for multiple intervention in root canal. Persisting bacteria in root canal is related with the persisting infection. Despite the advancement in treatment strategies the persisting infection is a major challenge for endodontist. Here we tested two newly developed quaternary ammonium methacrylates (QAMs) against endodontic bacteria and their biofilms. Their antibacterial and antibiofilm efficiency were compared with chlorhexidine (CHX) and sodium hypochlorite (NaOCl). We measured the MIC, MBC and MBIC of DMADDM and DMAHDM respectively. We also detected the ratio of live/dead bacteria and bacterial composition in the biofilms treated by DMADDM and DMAHDM. We found that DMADDM and DMAHDM could inhibit the growth of bacteria and biofilms formation. The result showed that novel QAMs were remarkably efficient than CHX against biofilms. In addition, we found that Streptococcus gordonii (S. gordonii) and Enterococcus faecalis (E. faecalis) were frequent isolates after treatment with antimicrobial compounds.

Oral diseases such as tooth caries, periodontal diseases, endodontic infections, etc., are prevalent worldwide. The heavy burden of oral infectious diseases and their consequences on the patients' quality of life indicates a strong need for developing effective therapies. Advanced understandings of such oral diseases, e.g., inflammatory periodontal lesions, have raised the demand for antibacterial therapeutic strategies, because these diseases are caused by viruses and bacteria. The application of antimicrobial photodynamic therapy (aPDT) on oral infectious diseases has attracted tremendous interest in the past decade. However, aPDT had a minimal effect on the viability of organized biofilms due to the hydrophobic nature of the majority of the photosensitizers (PSs). Therefore, novel nanotechnologies were rapidly developed to target the delivery of hydrophobic PSs into microorganisms for the antimicrobial performance improvement of aPDT. This review focuses on the state-of-the-art of nanomaterials applications in aPDT against oral infectious diseases. The first part of this article focuses on the cutting-edge research on the synthesis, toxicity, and therapeutic effects of various forms of nanomaterials serving as PS carriers for aPDT applications. The second part discusses nanomaterials applications for aPDT in treatments of oral diseases. These novel bioactive nanomaterials have demonstrated great potential to serve as carriers for PSs to substantially enhance the PDT therapeutic effects. Furthermore, the novel aPDT applications not only have exciting therapeutic potential to inhibit bacterial plaque-initiated oral diseases, but also have a wide applicability to other biomedical and tissue engineering applications., Competing Interests: The authors declare no conflicts of interest in this work., (© 2019 Qi et al.)

Peri-implantitis is the most common risk factor for dental implant failure. Nanostructured ceria (nano-CeO 2 ) has anti-inflammatory and antibacterial functions, and different shapes of ceria enclosed by specific crystal planes could be an effective approach to enhance intrinsic catalysis. In the present study, the authors developed a novel implant surface-modification strategy by coating different shapes of nano-CeO 2 onto titanium (Ti) surfaces to enhance their antibacterial and anti-inflammatory properties. The objectives of the study were to: (1) develop novel Ti surfaces modified with different shapes of nano-CeO 2 (nanorod, nanocube and nano-octahedron) for peri-implantitis prevention; (2) investigate and compare the inhibition efficacy of different shapes of CeO 2 -modified surfaces against biofilms of peri-implantitis-related pathogens; and (3) evaluate the different CeO 2 -modified surfaces on cell inflammatory response in vitro and in vivo. The results showed that nanorod CeO 2 -modified Ti had more bacteria attachment of Streptococcus sanguinis in the early stage, compared with other CeO 2 -modified Ti (p < 0.05). They all exhibited similarly substantial CFU reductions against peri-implantitis-related biofilms (p > 0.1). Nanocube and nano-octahedron CeO 2 -modified Ti exerted much better anti-inflammatory effects and ROS-scavenging ability than nanorod CeO 2 in vitro (p < 0.05). In vivo, the mean mRNA expression of TNF-α, IL-6 and IL-1β in the tissues around Ti was decreased by the three shapes of nano-CeO 2 ; nano-octahedron CeO 2 showed the strongest anti-inflammatory effect among all groups (p < 0.05). In conclusion, all three types of CeO 2 -modified Ti exerted equally strong antibacterial properties; nano-octahedron CeO 2 -modified Ti had the best anti-inflammatory effect. Therefore, CeO 2 -modified Ti surfaces are highly promising for enhancing antimicrobial functions for dental implants. Novel nano-octahedron CeO 2 coating on Ti had great therapeutic potential for alleviating and eliminating peri-implantitis. STATEMENT OF SIGNIFICANCE: Peri-implantitis is the most common risk factor for dental implant failure. Nanostructured ceria (nano-CeO 2 ) has anti-inflammatory and antibacterial functions, and different shapes of ceria enclosed by specific crystal planes could be an effective approach to enhance intrinsic catalysis. In the present study, we developed a novel implant surface-modification strategy by coating different shapes of nano-CeO 2 onto titanium surfaces to enhance their antibacterial and anti-inflammatory properties for dental implants. In addition, we found that the nano-octahedron CeO 2 coating on titanium would have great therapeutic potential for alleviating and eliminating peri-implantitis., (Copyright © 2019 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Cariogenic oral biofilms are strongly linked to dental caries around dental sealants. Quaternary ammonium monomers copolymerized with dental resin systems have been increasingly explored for modulation of biofilm growth. Here, we investigated the effect of dimethylaminohexadecyl methacrylate (DMAHDM) on the cariogenic pathogenicity of Streptococcus mutans ( S. mutans ) biofilms. DMAHDM at 5 mass% was incorporated into a parental formulation containing 20 mass% nanoparticles of amorphous calcium phosphate (NACP). S. mutans biofilms were grown on the formulations, and biofilm inhibition and virulence properties were assessed. The tolerances to acid stress and hydrogen peroxide stress were also evaluated. Our findings suggest that incorporating 5% DMAHDM into 20% NACP-containing sealants (1) imparts a detrimental biological effect on S. mutans by reducing colony-forming unit counts, metabolic activity and exopolysaccharide synthesis; and (2) reduces overall acid production and tolerance to oxygen stress, two major virulence factors of this microorganism. These results provide a perspective on the value of integrating bioactive restorative materials with traditional caries management approaches in clinical practice. Contact-killing strategies via dental materials aiming to prevent or at least reduce high numbers of cariogenic bacteria may be a promising approach to decrease caries in patients at high risk.

Objectives: (1) To develop a novel bioactive root canal sealer with antibiofilm and remineralization properties using dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP); (2) investigate the effects on E. faecalis biofilm inhibition, sealer flow and sealing ability, compared with an epoxy-resin-based sealer AH Plus; and (3) investigate the calcium (Ca) and phosphate (P) ion release from the sealers., Methods: A series of dual-cure endodontic sealers were formulated with DMAHDM and NACP at 5% and 20% by mass, respectively. Flow properties and sealing ability of the sealers were measured. Colony-forming units (CFU), live/dead assay, and polysaccharide production of biofilms on sealers were determined. Ca and P ion releases from the sealers were measured., Results: The new sealer containing 20% NACP and 5% DMAHDM yielded a paste flow of (28.99 ± 0.69) mm, within the range of ISO recommendations. The sealing properties of the sealer with 5% DMAHDM and 20% NACP were similar to a commercial control (p > 0.05). The sealer with DMAHDM decreased E. faecalis biofilm CFU by more than 4 orders of magnitude, compared to AH plus and experimental controls. The sealer with 20% NACP and 5% DMAHDM had relatively high levels of Ca and P ion release necessary for remineralization., Conclusions: A new bioactive endodontic sealer was developed with strong antibiofilm activity against E. faecalis biofilms and high levels of Ca and P ion release for remineralization, without compromising the paste flow and sealing properties., Clinical Significance: The bioactive antibacterial and remineralizing root canal sealer is promising to inhibit E. faecalis biofilms to prevent endodontic treatment failure and secondary endodontic infections, while releasing high levels of Ca and P ions that could remineralize and strengthen the tooth structures and potentially prevent future root fractures and teeth extractions., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Quaternary ammonium compounds constitute a large group of antibacterial chemicals with a potential for inhibiting dental plaque. The aims of this study were to evaluate short-time antibacterial and regulating effects of dimethylaminododecyl methacrylate (DMADDM) on multispecies biofilm viability, reformation, and bacterial composition in vitro. DMADDM, chlorhexidine (CHX), and sodium fluoride (NaF) were chosen in the present study. Streptococcus mutans , Streptococcus sanguinis, and Streptococcus gordonii were used to form multispecies biofilm. Cytotoxicity assay was used to determine the optimal tested concentration. 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and resazurin test of biofilm were conducted to study the biomass changes and metabolic changes of controlled multispecies biofilm. Scanning electron microscopy (SEM) was used to observe biofilm images. TaqMan real-time polymerase chain reaction was performed to evaluate the proportion change in multispecies biofilm of different groups. Cytotoxicity assay showed that there existed a certain concentration application range for DMADDM, CHX, and NaF. MTT assay and resazurin test results showed that DMADDM and CHX groups decreased multispecies biofilm growth and metabolic activity ( p < 0.05), no matter after 1 min or 5 min direct contact killing or after 24 h regrowth. The proportion of S. mutans decreased steadily in DMADDM and CHX groups after 1 min and 5 min direct contact killing and 24 h regrowth, compared to control groups. A novel DMADDM-containing solution was developed, achieving effective short-time antibacterial effects and regulation ability of biofilm formation.

Recurrent caries often occurs and is a primary reason for the failure of dental composite restorations. The objectives of this study were to: (1) develop a bioactive composite containing dimethylaminohexadecyl methacrylate (DMAHDM), (2) investigate its antibacterial effects and suppression on biofilm growth, and (3) investigate its ability to modulate biofilm species composition for the first time. DMAHDM was incorporated into a composite at mass% of 0%, 0.75%, 1.5%, 2.25% and 3%. A commercial composite Heliomolar served as a comparative control. A biofilm model consisting of Streptococcus mutans (S. mutans), Streptococcus sanguinis (S. sanguinis) and Streptococcus gordonii (S. gordonii) was tested by growing biofilms for 48 h and 72 h on composites. Colony-forming units (CFUs), metabolic activity and live/dead staining were evaluated. Lactic acid and polysaccharide productions were measured to assess biofilm cariogenicity. TaqMan real-time polymerase chain reaction was used to determine the proportion of each species in the biofilm. DMAHDM-containing composite had a strong anti-biofilm function, reducing biofilm CFU by 2-3 orders of magnitude, compared to control composite. Biofilm metabolic activity, lactic acid and polysaccharides were decreased substantially, compared to control (p < 0.05). At 72 h, the cariogenic S. mutans proportion in the biofilm on the composite with 3% DMAHDM was 19.9%. In contrast, an overwhelming S. mutans proportion of 92.2% and 91.2% existed in biofilms on commercial control and 0% DMAHDM, respectively. In conclusion, incorporating DMAHDM into dental composite: (1) yielded potent anti-biofilm properties; (2) modulated the biofilm species composition toward a non-cariogenic tendency. The new DMAHDM composite is promising for applications in a wide range of tooth cavity restorations to modulate oral biofilm species and combat caries., (Copyright © 2018 Elsevier B.V. All rights reserved.)

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., (Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Cariogenic oral biofilms cause recurrent dental caries around composite restorations, resulting in unprosperous oral health and expensive restorative treatment. Quaternary ammonium monomers that can be copolymerized with dental resin systems have been explored for the modulation of dental plaque biofilm growth over dental composite surfaces. Here, for the first time, we investigated the effect of bis(2-methacryloyloxyethyl) dimethylammonium bromide (QADM) on human overlying mature oral biofilms grown intra-orally in human participants for 7⁻14 days. Seventeen volunteers wore palatal devices containing composite specimens containing 10% by mass of QADM or a control composite without QADM. After 7 and 14 days, the adherent biofilms were collected to determine bacterial counts via colony-forming unit (CFU) counts. Biofilm viability, chronological changes, and percentage coverage were also determined through live/dead staining. QADM composites caused a significant inhibition of Streptococcus mutans biofilm formation for up to seven days. No difference in the CFU values were found for the 14-day period. Our findings suggest that: (1) QADM composites were successful in inhibiting 1⁻3-day biofilms in the oral environment in vivo; (2) QADM significantly reduced the portion of the S. mutans group; and (3) stronger antibiofilm activity is required for the control of mature long-term cariogenic biofilms. Contact-killing strategies using dental materials aimed at preventing or at least reducing high numbers of cariogenic bacteria seem to be a promising approach in patients at high risk of the recurrence of dental caries around composites.

Enamel demineralization is one of the most undesired side effects of fixed orthodontic treatment, which will lead to white spot lesions (WSLs) on tooth surfaces. The development of WSLs is due to prolonged accumulation of bacterial plaque and associated acid production. Self-etching adhesives have been used in orthodontic treatments with several advantages over the more traditional acid-etch method. However, current self-etching adhesives in orthodontic treatments have no antibacterial activity. The objectives of this study were to develop a self-etching and antibacterial orthodontic adhesive, and to investigate its enamel bond strength and antibacterial properties. A novel quaternary ammonium monomer dimethylaminohexadecyl methacrylate (DMAHDM) was incorporated into a commercial self-etching adhesive (Adper Easy One, 3M). It showed that the 5% DMAHDM appeared to be optimal in obtaining the strongest antibacterial function without compromising the enamel bond strength both at 15 min and after 30 days of immersion plus thermal cycling.

Biofilms at the tooth-restoration bonded interface can produce acids and cause recurrent caries. Recurrent caries is a primary reason for restoration failures. The objectives of this study were to synthesize a novel bioactive dental bonding agent containing dimethylaminohexadecyl methacrylate (DMAHDM) and 2-methacryloyloxyethyl phosphorylcholine (MPC) to inhibit biofilm formation at the tooth-restoration margin and to investigate the effects of water-aging for 6 months on the dentin bond strength and protein-repellent and antibacterial durability. A protein-repellent agent (MPC) and antibacterial agent (DMAHDM) were added to a Scotchbond multi-purpose (SBMP) primer and adhesive. Specimens were stored in water at 37 °C for 1, 30, 90, or 180 days (d). At the end of each time period, the dentin bond strength and protein-repellent and antibacterial properties were evaluated. Protein attachment onto resin specimens was measured by the micro-bicinchoninic acid approach. A dental plaque microcosm biofilm model was used to test the biofilm response. The SBMP + MPC + DMAHDM group showed no decline in dentin bond strength after water-aging for 6 months, which was significantly higher than that of the control (P < 0.05). The SBMP + MPC + DMAHDM group had protein adhesion that was only 1/20 of that of the SBMP control (P < 0.05). Incorporation of MPC and DMAHDM into SBMP provided a synergistic effect on biofilm reduction. The antibacterial effect and resistance to protein adsorption exhibited no decrease from 1 to 180 d (P > 0.1). In conclusion, a bonding agent with MPC and DMAHDM achieved a durable dentin bond strength and long-term resistance to proteins and oral bacteria. The novel dental bonding agent is promising for applications in preventive and restorative dentistry to reduce biofilm formation at the tooth-restoration margin.

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., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2017 The Academy of Dental Materials. All rights reserved.)

Antibacterial monomers can combat oral biofilm acids and caries; however, little is known on whether quaternary ammonium monomers (QAMs) would induce drug persistence in oral bacteria. The objectives of this study were to investigate the interactions of Streptococcus mutans (S. mutans) with dimethylaminohexadecyl methacrylate (DMAHDM), and determine for the first time whether DMAHDM could induce persisters in S. mutans. DMAHDM was synthesized using a modified Menschutkin reaction. Dose-dependent killing curves and time-dependent killing curves of planktonic S. mutans and biofilms were determined to evaluate drug persistence, using chlorhexidine (CHX) as control. The inheritability assay, minimum inhibitory concentration (MIC) and live/dead biofilm assay were determined to investigate persister characteristics. DMAHDM matched the killing potency of the gold standard CHX against S. mutans biofilms. DMAHDM and CHX induced drug persistence in S. mutans biofilms but not in planktonic bacteria. S. mutans biofilm persistence was not inheritable in that the tolerance to DMAHDM or CHX of the surviving persisters in the initial population was not transferred to subsequent generations, as displayed by the inheritability assay. The MIC of S. mutans parental strain and induced persisters remained the same. The induced persisters in S. mutans biofilms could be eliminated via higher doses of 300 μg/mL of DMAHDM and CHX. In conclusion, this study showed for the first time that (1) DMAHDM induced persisters only in biofilms, but not in planktonic bacteria; and (2) both DMAHDM-induced and CHX-induced S. mutans persister biofilms could be completely eradicated by even higher concentrations of DMAHDM and CHX. More studies are needed on the induction of persisters in oral biofilms for the development and use of a new generation of antibacterial dental monomers and resins.

The aims of this study were to: (1) synthesize an anti-biofilm and protein-repellent dental composite by combining 2-methacryloyloxyethyl phosphorylcholine (MPC) with quaternary ammonium dimethylaminohexadecyl methacrylate (DMAHDM); and (2) evaluate the effects of water-aging for 180 days on protein resistance, bacteria-killing ability, and mechanical properties of MPC-DMAHDM composite. MPC and DMAHDM were added into a resin composite. Specimens were stored in distilled water at 37 °C for 1, 30, 90, and 180 days. Mechanical properties were measured in three-point flexure. Protein attachment onto the composite was evaluated by a micro bicinchoninic acid approach. An oral plaque microcosm biofilm model was employed to evaluate oral biofilm viability vs. water-aging time. Mechanical properties of the MPC-DMAHDM composite after 180-day immersion matched those of the commercial control composite. The composite with 3% MPC + 1.5% DMAHDM had much stronger resistance to protein adhesion than control ( p < 0.05). MPC + DMAHDM achieved much stronger biofilm-eradicating effects than MPC or DMAHDM alone ( p < 0.05). Biofilm colony-forming units on the 3% MPC + 1.5% DMAHDM composite were three orders of magnitude lower than commercial control. The protein-repellent and antibacterial effects were durable and showed no loss in water-aging from 1 to 180 days. The novel MPC-DMAHDM composite possessed strong and durable resistance to protein adhesion and potent bacteria-eradicating function, while matching the load-bearing ability of a commercial dental composite. The novel MPC-DMAHDM composite represents a promising means of suppressing oral plaque growth, acid production, and secondary caries., Competing Interests: The authors declare no conflict of interest.

Antibacterial dimethylaminododecyl methacrylate (DMADDM) was recently synthesized. The objectives of this study were to: (1) investigate antibacterial activity of DMADDM-containing primer on Streptococcus mutans impregnated into dentin blocks for the first time, and (2) compare the antibacterial efficacy of DMADDM with a previous quaternary ammonium dimethacrylate (QADM). Scotchbond Multi-Purpose (SBMP) bonding agent was used. DMADDM and QADM were mixed into SBMP primer. Six primers were tested: SBMP control primer P, P+2.5% DMADDM, P+5% DMADDM, P+7.5% DMADDM, P+10% DMADDM, and P+10% QADM. S. mutans were impregnated into human dentin blocks, and each primer was applied to dentin to test its ability to kill bacteria in dentinal tubules. Bacteria in dentin were collected via a sonication method, and the colony-forming units (CFU) and inhibition zones were measured. The bacterial inhibition zone of P+10% DMADDM was 10 times that of control primer (P<0.05). CFU in dentin with P+10% DMADDM was reduced by three orders of magnitude, compared with control. DMADDM had a much stronger antibacterial effect than QADM, and antibacterial efficacy increased with increasing DMADDM concentration. Dentin shear bond strengths were similar among all groups (P>0.1). In conclusion, antibacterial DMADDM-containing primer was validated to kill bacteria inside dentin blocks, possessing a much stronger antibacterial potency than the previous QADM. DMADDM-containing bonding agent was effective in eradicating bacteria in dentin, and its efficacy was directly proportional to DMADDM mass fraction. Therefore, DMADDM may be promising for use in bonding agents as well as in other restorative and preventive materials to inhibit bacteria.

Objectives: The occurrence of tooth root caries is increasing as the world population ages and tooth retention in seniors increases. Class V restorations with subgingival margins are difficult to clean and often lead to periodontitis. The objectives of this study were to develop a Class V composite containing dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP), and investigate mechanical properties and the inhibition of six species of periodontitis-related biofilms for the first time., Methods: Ethoxylated bisphenol A dimethacrylate (EBPADMA) and pyromellitic glycerol dimethacrylate (PMGDM) were mixed at 1:1 mass ratio to form the resin matrix. DMAHDM, NACP, and glass particles were incorporated at 3%, 20% and 50% by mass, respectively. Six species were tested: Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum and Enterococcus faecalis. Colony-forming units (CFU), live/dead assay, biomass via crystal violet staining, and polysaccharide production by biofilms were determined on composites., Result: Adding 3% DMAHDM to composite did not affect the flexure strength and elastic modulus (p>0.1). For all six species of periodontal pathogens, the DMAHDM composite had biofilm CFU nearly three orders of magnitude less than that without DMAHDM. The killing efficacy of DMAHDM composite against the six species was: E. faecalis

The objectives of this study were to develop a bioactive dental composite and investigate the effects of 2-methacryloyloxyethyl phosphorylcholine (MPC) and dimethylaminohexadecyl methacrylate (DMAHDM) in Class V composite on mechanical properties, water sorption, protein adsorption, and inhibition of four species of periodontitis-related biofilms for the first time. The resin consisted of ethoxylated bisphenol A dimethacrylate (EBPADMA) and pyromellitic glycerol dimethacrylate (PMGDM). DMAHDM, MPC and nanoparticles of amorphous calcium phosphate (NACP) were incorporated into the resin. Four species (Porphyromonas gingivalis, Prevotella intermedia, Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum) were tested for biofilm colony-forming units (CFU), live/dead, metabolic activity, and polysaccharide production. The results showed that adding DMAHDM and MPC to the composite did not compromise the mechanical properties (p>0.1), with acceptable water sorption values. Composite with 3% MPC reduced protein adsorption to 1/9 that of a commercial composite (p<0.05). For all four species, the composite with 3% DMAHDM+3% MPC had much greater reduction in biofilms than using DMAHDM or MPC alone (p<0.05). Biofilm CFU was reduced by about 4 orders of magnitude via 3% DMAHDM+3% MPC, compared to control. The inhibition efficacy for the four species was: P. gingivalis>P intermedia=A. actinomycetemcomitans>F. nucleatum. In conclusion, a novel bioactive composite with 3% DMAHDM and 3% MPC achieved the greatest reduction in biofilm growth, metabolic activity and polysaccharide of four periodontal pathogens. The new composite is promising for Class V restorations especially with subgingival margins to inhibit periodontal pathogens, combat periodontitis and protect the periodontium., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Objectives: Tooth-restoration interfaces are the weak link with secondary caries causing restoration failure. The objectives of this study were to develop an antimicrobial bonding agent with dimethylaminododecyl methacrylate (DMAHDM), and investigate the effects of quaternary amine charge density on three-dimensional (3D) biofilms on dental resin for the first time., Methods: DMAHDM was synthesized and incorporated into Scotchbond Multi-Purpose bonding agent at mass fractions of 0% (control), 2.5%, 5%, 7.5% and 10%. Streptococcus mutans bacteria were inoculated on the polymerized resin and cultured for two days to form biofilms. Confocal laser scanning microscopy was used to measure biofilm thickness, live and dead biofilm volumes, and live bacteria percentage in 3D biofilm vs. distance from resin surface., Results: Charge density of the resin had a significant effect on the antibacterial efficacy (p<0.05). Biofilms on control resin had the greatest thicknesses. Biofilm thickness and live biofilm volume decreased with increasing surface charge density (p<0.05). There were significant variations in bacterial viability along the 3D biofilm thickness (p<0.05). At 2.5% and 5% DMAHDM, the bacterial inhibition was the greatest on or near the resin surface, and the killing effect decreased away from the resin surface. At 10% DMAHDM, the entire 3D biofilm was dead and the percentage of live bacteria was nearly 0% throughout the biofilm thickness., Conclusions: Adding new antibacterial monomer DMAHDM into dental bonding agent yielded a strong antimicrobial activity, substantially decreasing the 3D biofilm thickness, live biofilm volume, and percentage of live bacteria on cross-sections through the biofilm thickness., Significance: Novel DMAHDM-containing bonding agent with capability of inhibiting 3D biofilms is promising for a wide range of dental restorative and preventive applications to inhibit biofilms at the tooth-restoration margins and prevent secondary caries., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Dental composites are commonly used restorative materials; however, secondary caries due to biofilm acids remains a major problem. The objectives of this study were (1) to develop a composite containing quaternary ammonium dimethacrylate (QADM), nanoparticles of silver (NAg), and nanoparticles of amorphous calcium phosphate (NACP), and (2) to conduct the first investigation of the mechanical properties, biofilm response and acid production vs water-ageing time from 1 day to 12 months. A 4 × 5 design was utilized, with four composites (NACP-QADM composite, NACP-NAg composite, NACP-QADM-NAg composite, and a commercial control composite), and five water-ageing time periods (1 day, and 3, 6, 9, and 12 months). After each water-ageing period, the mechanical properties of the resins were measured in a three-point flexure, and antibacterial properties were tested via a dental plaque biofilm model using human saliva as an inoculum. After 12 months of water-ageing, NACP-QADM-NAg had a flexural strength and elastic modulus matching those of the commercial control (P>0.1). Incorporation of QADM or NAg into the NACP composite greatly reduced biofilm viability, metabolic activity and acid production. A composite containing both QADM and NAg possessed a stronger antibacterial capability than one with QADM or NAg alone (P<0.05). The anti-biofilm activity was maintained after 12 months of water-ageing and showed no significant decrease with increasing time (P>0.1). In conclusion, the NACP-QADM-NAg composite decreased biofilm viability and lactic acid production, while matching the load-bearing capability of a commercial composite. There was no decrease in its antibacterial properties after 1 year of water-ageing. The durable antibacterial and mechanical properties indicate that NACP-QADM-NAg composites may be useful in dental restorations to combat caries.

Dental restorative materials with antimicrobial properties can inhibit bacterial colonization, which may result in a reduction of caries at tooth-filling interaction zones. This study aimed to develop antibacterial glass-ionomer cements (GIC) containing a quaternary ammonium monomer (dimethylaminododecyl methacrylate, DMADDM), and to investigate their effect on material performance and antibacterial properties. Different mass fractions (0, 1.1% and 2.2%) of DMADDM were incorporated into the GIC. The flexure strength, surface charge density, surface roughness and fluoride release were tested. A Streptococcus mutans biofilm model was used. Exopolysaccharides (EPS) staining was used to analyze the inhibitory effect of DMADDM on the biofilm matrix. In addition, biofilm metabolic activity, lactic acid metabolism and the expression of glucosyltransferase genes gtfB, gtfC and gtfD were measured. GIC containing 1.1% and 2.2% DMADDM had flexural strengths matching those of the commercial control (P>0.1). DMADDM was able to increase the surface charge density but reduced surface roughness (P<0.05). The incorporation of 1.1% and 2.2% DMADDM elevated the release of fluoride by the GIC in the first 2 days (P<0.05). The novel DMADDM-modified GIC significantly reduced biofilm metabolic activity (P<0.05) and decreased lactic acid production (P<0.05). The quantitative polymerase chain reaction (qPCR) results showed that the expression of gtfB, gtfC and gtfD decreased when mass fractions of DMADDM increased (P<0.05). EPS staining showed that both the bacteria and EPS in biofilm decreased in the DMADDM groups. The incorporation of DMADDM could modify the properties of GIC to influence the development of S. mutans biofilms. In this study, we investigated the interface properties of antibacterial materials for the first time. GIC containing DMADDM can improve material performance and antibacterial properties and may contribute to the better management of secondary caries.

Our aims of the research were to study the antimicrobial effect of dimethylaminododecyl methacrylate (DMADDM) modified denture base resin on multi-species biofilms and the biocompatibility of this modified dental material. Candida albicans (C. albicans), Streptococcus mutans (S. mutans), Streptococcus sanguinis (S. sanguinis), as well as Actinomyces naeslundii (A. naeslundii) were used for biofilm formation on denture base resin. Colony forming unit (CFU) counts, microbial viability staining, and 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) array were used to evaluate the antimicrobial effect of DMADDM. C. albicans staining and Real-time PCR were used to analyze the morphology and expression of virulence genes of C. albicans in biofilm. Lactate dehydrogenase (LDH) array and Real-time PCR were conducted to examine the results after biofilm co-cultured with epithelial cell. Hematoxylin and eosin (HE) staining followed by histological evaluation were used to study the biocompatibility of this modified material. We found that DMADDM containing groups reduced both biomass and metabolic activity of the biofilm significantly. DMADDM can also inhibit the virulence of C. albicans by means of inhibiting the hyphal development and downregulation of two virulence related genes. DMADDM significantly reduced the cell damage caused by multi-species biofilm according to the LDH activity and reduced the expression of IL-18 gene of the cells simultaneously. The in vivo histological evaluation proved that the addition of DMADDM less than 6.6% in denture material did not increase the inflammatory response (p > 0.05). Therefore, we proposed that the novel denture base resin containing DMADDM may be considered as a new promising therapeutic system against problems caused by microbes on denture base such as denture stomatitis.

The oral environment is considered to be an asperous environment for restored tooth structure. Recurrent dental caries is a common cause of failure of tooth-colored restorations. Bacterial acids, microleakage, and cyclic stresses can lead to deterioration of the polymeric resin-tooth bonded interface. Research on the incorporation of cutting-edge anticaries agents for the design of new, long-lasting, bioactive resin-based dental materials is demanding and provoking work. Released antibacterial agents such as silver nanoparticles (NAg), nonreleased antibacterial macromolecules (DMAHDM, dimethylaminohexadecyl methacrylate), and released acid neutralizer amorphous calcium phosphate nanoparticles (NACP) have shown potential as individual and dual anticaries approaches. In this study, these agents were synthesized, and a prospective combination was incorporated into all the dental materials required to perform a composite restoration: dental primer, adhesive, and composite. We focused on combining different dental materials loaded with multiagents to improve the durability of the complex dental bonding interface. A combined effect of bacterial acid attack and fatigue on the bonding interface simulated the harsh oral environment. Human saliva-derived oral biofilm was grown on each sample prior to the cyclic loading. The oral biofilm viability during the fatigue performance was monitored by the live-dead assay. Damage of the samples that developed during the test was quantified from the fatigue life distributions. Results indicate that the resultant multiagent dental composite materials were able to reduce the acidic impact of the oral biofilm, thereby improving the strength and resistance to fatigue failure of the dentin-resin bonded interface. In summary, this study shows that dental restorative materials containing multiple therapeutic agents of different chemical characteristics can be beneficial toward improving resistance to mechanical and acidic challenges in oral environments.

Composites containing nanoparticles of amorphous calcium phosphate (NACP) remineralize tooth lesions and inhibit caries. A recent study synthesized quaternary ammonium methacrylates (QAMs) with chain lengths (CLs) of 3-18 and determined their effects on a bonding agent. This study aimed to incorporate these QAMs into NACP nanocomposites for the first time to simultaneously endow the material with antibacterial and remineralizing capabilities and to investigate the effects of the CL on the mechanical and biofilm properties. Five QAMs were synthesized: DMAPM (CL3), DMAHM (CL6), DMADDM (CL12), DMAHDM (CL16), and DMAODM (CL18). Each QAM was incorporated into a composite containing 20% NACP and 50% glass fillers. A dental plaque microcosm biofilm model was used to evaluate the antibacterial activity. The flexural strength and elastic modulus of nanocomposites with QAMs matched those of a commercial control composite (n = 6; P > 0.1). Increasing the CL from 3 to 16 greatly enhanced the antibacterial activity of the NACP nanocomposite (P < 0.05); further increasing the CL to 18 decreased the antibacterial potency. The NACP nanocomposite with a CL of 16 exhibited biofilm metabolic activity and acid production that were 10-fold lesser than those of the control composite. The NACP nanocomposite with a CL of 16 produced 2-log decreases in the colony-forming units (CFU) of total microorganisms, total streptococci, and mutans streptococci. In conclusion, QAMs with CLs of 3-18 were synthesized and incorporated into an NACP nanocomposite for the first time to simultaneously endow the material with antibacterial and remineralization capabilities. Increasing the CL reduced the metabolic activity and acid production of biofilms and caused a 2-log decrease in CFU without compromising the mechanical properties. Nanocomposites exhibiting strong anti-biofilm activity, remineralization effects, and mechanical properties are promising materials for tooth restorations that inhibit caries.

Objectives: White spot lesions are the most undesired side-effect of fixed orthodontic treatments. The objectives of this study were to combine nanoparticles of silver (NAg) with 2-methacryloyloxyethyl phosphorylcholine (MPC) to develop a modified resin-modified glass ionomer cement (RMGI) as orthodontic cement with double benefits of antibacterial and protein-repellent capabilities for the first time., Methods: NAg and MPC were incorporated into a commercial RMGI. Another commercial orthodontic adhesive also served as control. Enamel shear bond strengths (SBS) were determined. Protein adsorption was measured via a micro bicinchoninic acid method. A dental plaque microcosm biofilm model with human saliva as inoculum was tested. Biofilms adherent on the cement samples and planktonic bacteria in the culture medium away from the cement surfaces were both evaluated for bacterial metabolic activity, colony-forming units (CFU), and lactic acid production., Results: Adding 0.1% NAg and 3% MPC to RMGI, and water-aging for 30 days, did not adversely affect the SBS, compared to the unmodified RMGI control (p>0.1). The modified RMGI containing 0.1% NAg and 3% MPC achieved the greatest reduction in protein adsorption, bacterial adhesion, CFU, metabolic activity and lactic acid production. The RMGI containing 0.1% NAg and 3% MPC inhibited not only the bacteria on its surface, but also the bacteria away from the surface in the culture medium., Conclusions: The incorporation of double agents (antibacterial NAg+protein-repellent MPC) into RMGI achieved much stronger inhibition of biofilms than using each agent alone. The novel antibacterial and protein-repellent RMGI with substantially-reduced biofilm acids is promising as an orthodontic cement to combat white spot lesions in enamel., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objectives: Biofilm acids contribute to secondary caries which is a reason for restoration failure. Previous studies synthesized nanoparticles of amorphous calcium phosphate (NACP) and dimethylaminohexadecyl methacrylate (DMAHDM). The objectives of this study were to develop DMAHMD-NACP nanocomposite for double benefits of antibacterial and remineralization capabilities, and investigate the DMAHMD mass fraction effects on fracture toughness and biofilm response of NACP nanocomposite for the first time., Methods: DMAHDM was incorporated into NACP nanocomposite at mass fractions of 0% (control), 0.75%, 1.5%, 2.25% and 3%. A single edge V-notched beam method was used to measure fracture toughness K(IC). A dental plaque microcosm biofilm model using human saliva as inoculum was used to measure the antibacterial properties of composites., Results: K(IC) was about 1 MPa×m(1/2) for all composite (mean±sd; n=6). Adding DMAHDM from 0% to 3% did not affect K(IC) (p>0.1). Lactic acid production by biofilms on composite containing 3% DMAHDM was reduced to less than 1% of that on composite control. Metabolic activity of adherent biofilms on composite containing 3% DMAHDM was reduced to 4% of that on composite control. Biofilm colony-forming unit (CFU) counts were reduced by three orders of magnitude on NACP nanocomposite containing 3% DMAHDM., Conclusions: DMAHDM-NACP nanocomposite had good fracture resistance, strong antibacterial potency, and NACP for remineralization (shown in previous studies). The DMAHDM-NACP nanocomposite may be promising for caries-inhibiting dental restorations, and the method of using double agents (DMAHDM and NACP) may have a wide applicability to other dental materials including bonding agents and cements., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: The aim of this study was to investigate antibiofilm effects of a recently developed glass ionomer cement (GIC) containing dimethylaminododecyl methacrylate (DMADDM) under oral conditions., Methods: Biofilms were allowed to form in situ on GIC specimens (n=216) which contained DMADDM (1.1wt.% or 2.2wt.%). Samples without DMADDM served as control (n=108). GIC specimens were fixed on custom made splints and exposed to the oral cavity in six healthy volunteers for 24, 48 and 72h, respectively. Biofilm viability and coverage were analyzed by fluorescence microscopy (FM) and evaluated by red/green ratios and an established scoring system. Bacterial morphology and biofilm accumulation were determined by scanning electron microscopy (SEM). Additionally, material properties as surface charge density of quaternary ammonium groups, surface roughness and DMADDM release were recorded., Results: FM results showed a higher ratio (24h: 0%: 0.5, 1.1%: 1.2, 2.2%: 2.5) of red/green fluorescence on GIC samples containing DMADDM. Biofilm coverage and viability scores were significantly reduced (24h: q1/median/q3 for: 0%: 3/4/5, 1.1%: 2/3/3, 2.2%: 1/2/2) on DMADDM containing samples compared to controls after 24h as well as 48 and 72h in situ (p<0.05). While surface charge density of quaternary ammonium groups and DMADDM release increased with the DMADDM concentration, surface roughness was lowest on specimens containing 2.2wt.% DMADDM., Significance: An in situ dental biofilm model was used to evaluate the novel GIC containing DMADDM. This material strongly inhibited biofilms in situ and is promising to prevent bacterial colonization on the surface of restorations., (Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: Biofilm acids contribute to secondary caries, which is a main reason for dental restoration failures. The objectives of this study were to: (1) develop a protein-repellent and antibacterial composite, and (2) investigate the effects of combining 2-methacryloyloxyethyl phosphorylcholine (MPC) with quaternary ammonium dimethylaminohexadecyl methacrylate (DMAHDM) on composite mechanical properties and biofilm response for the first time., Methods: MPC, DMAHDM and glass particles were mixed into a dental resin composite. Mechanical properties were measured in three-point flexure. Protein adsorption onto the composites was measured by a micro bicinchoninic acid method. A human saliva microcosm model was used to grow biofilms on composites. Colony-forming unit (CFU) counts, live/dead assay, metabolic activity, and lactic acid production of biofilms were determined., Results: Incorporation of 3% MPC and 1.5% DMAHDM into composite achieved protein-repellent and antibacterial capabilities without compromising the mechanical properties. Composite with 3% MPC+1.5% DMAHDM had protein adsorption that was 1/10 that of a commercial composite (p<0.05). The composite with 3% MPC+1.5% DMAHDM had much greater reduction in biofilm growth than using MPC or DMAHDM alone (p<0.05). Biofilm CFU counts on composite with 3% MPC+1.5% DMAHDM were more than three orders of magnitude lower than that of commercial control., Conclusions: Dental composite with a combination of strong protein-repellent and antibacterial capabilities was developed for the first time. Composite containing MPC and DMAHDM greatly reduced biofilm growth and lactic acid production, without compromising mechanical properties of the composite., Clinical Significance: Novel composite with MPC and DMAHDM greatly reduced biofilm activity and is promising to inhibit secondary caries. The dual agents of MPC plus DMAHDM may have wide applicability to other dental materials., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Antibacterial bonding agents and composites containing dimethylaminododecyl methacrylate (DMADDM) have been recently developed. The objectives of this study were to investigate the antibacterial effect of novel adhesives containing different mass fractions of DMADDM on Streptococcus mutans (S. mutans) biofilm at different developmental stages. Different mass fractions of DMADDM were incorporated into adhesives and S. mutans biofilm at different developmetal stages were analyzed by MTT assays, lactic acid measurement, confocal laser scanning microscopy and scanning electron microscopy observations. Exopolysaccharides (EPS) staining was used to analyze the inhibitory effect of DMADDM on the biofilm extracellular matrix. Dentin microtensile strengths were also measured. Cured adhesives containing DMADDM could greatly reduce metabolic activity and lactic acid production during the development of S. mutans biofilms (p < 0.05). In earlier stages of biofilm development, there were no significant differences of inhibitory effects between the 2.5% DMADDM and 5% DMADDM group. However, after 72 h, the anti-biofilm effects of adhesives containing 5% DMADDM were significantly stronger than any other group. Incorporation of DMADDM into adhesive did not adversely affect dentin bond strength. In conclusion, adhesives containing DMADDM inhibited the growth, lactic acid production and EPS metabolism of S. mutans biofilm at different stages, with no adverse effect on its dentin adhesive bond strength. The bonding agents have the potential to control dental biofilms and combat tooth decay, and DMADDM is promising for use in a wide range of dental adhesive systems and restoratives.

Antibacterial adhesives are promising to inhibit biofilms and secondary caries. The objectives of this study were to synthesize and incorporate quaternary ammonium methacrylates into adhesives, and investigate the alkyl chain length effects on three-dimensional biofilms adherent on adhesives for the first time. Six quaternary ammonium methacrylates with chain lengths of 3, 6, 9, 12, 16 and 18 were synthesized and incorporated into Scotchbond Multi-Purpose. Streptococcus mutans bacteria were cultured on resin to form biofilms. Confocal laser scanning microscopy was used to measure biofilm thickness, live/dead volumes and live-bacteria percentage vs. distance from resin surface. Biofilm thickness was the greatest for Scotchbond control; it decreased with increasing chain length, reaching a minimum at chain length 16. Live-biofilm volume had a similar trend. Dead-biofilm volume increased with increasing chain length. The adhesive with chain length 9 had 37% live bacteria near resin surface, but close to 100% live bacteria in the biofilm top section. For chain length 16, there were nearly 0% live bacteria throughout the three-dimensional biofilm. In conclusion, strong antibacterial activity was achieved by adding quaternary ammonium into adhesive, with biofilm thickness and live-biofilm volume decreasing as chain length was increased from 3 to 16. Antibacterial adhesives typically only inhibited bacteria close to its surface; however, adhesive with chain length 16 had mostly dead bacteria in the entire three-dimensional biofilm. Antibacterial adhesive with chain length 16 is promising to inhibit biofilms at the margins and combat secondary caries.

Objective: Quaternary amine charge density is important because when the negatively charged bacteria contact the positive quaternary amine charge, the electric balance is disturbed and the bacterium could be disrupted. There has been no report on the effects of charge density on the antibacterial efficacy of dental bonding agents. The objective of this study was to synthesize a new quaternary ammonium methacrylate, and investigate the effects of charge density of bonding agent on bacteria early-attachment, biofilm colony-forming units (CFU) and dentin bond strength., Methods: Dimethylaminododecyl methacrylate (DMAHDM) with an alkyl chain length of 16 was synthesized and mixed into Scotchbond Multi-Purpose adhesive and primer (SBMP) at mass fractions of 0%, 2.5%, 5%, 7.5%, and 10%. A microtensile dentin bond test was performed. The density of quaternary ammonium groups was measured using a fluorescein dye method. Streptococcus mutans (S. mutans) early-attachment was examined at 4 h, and biofilm colony-forming units (CFU) were measured at 2 days., Results: All groups had similar microtensile bonding strengths (mean±sd; n=40) of about 60 MPa (p>0.1). Quaternary amine charge density of bonding agents monotonically increased with increasing DMAHDM mass fraction. Bacteria early-attachment coverage greatly decreased with increasing DMAHDM content in the resin. Biofilm CFU at 10% DMAHDM was reduced by more than 4 log, compared to SBMP control. Charge density of bonding agent was inversely proportional to bacteria early-attachment coverage and biofilm CFU., Significance: Increasing the quaternary amine charge density of dentin bonding agent resin was shown to greatly reduce S. mutans attachment and decrease biofilm CFU by four orders of magnitude, without compromising the dentin bond strength. The new DMAHDM is promising for use in bonding agents and other antibacterial restorative materials to inhibit caries., (Published by Elsevier Ltd.)

Objectives: Antibacterial primer and adhesive are promising to inhibit biofilms and caries. Since restorations in vivo are exposed to saliva, one concern is the attenuation of antibacterial activity due to salivary pellicles. The objective of this study was to investigate the effects of salivary pellicles on bonding agents containing a new monomer dimethylaminododecyl methacrylate (DMADDM) or nanoparticles of silver (NAg) against biofilms for the first time., Methods: DMADDM and NAg were synthesized and incorporated into Scotchbond Multi-Purpose adhesive and primer. Specimens were either coated or not coated with salivary pellicles. A microcosm biofilm model was used with mixed saliva from ten donors. Two types of culture medium were used: an artificial saliva medium (McBain), and Brain Heart Infusion (BHI) medium without salivary proteins. Metabolic activity, colony-forming units (CFU), and lactic acid production of plaque microcosm biofilms were measured (n=6)., Results: Bonding agents containing DMADDM and NAg greatly inhibited biofilm activities, even with salivary pellicles. When using BHI, the pre-coating of salivary pellicles on resin surfaces significantly decreased the antibacterial effect (p<0.05). When using artificial saliva medium, pre-coating of salivary pellicles on resin did not decrease the antibacterial effect. These results suggest that artificial saliva yielded medium-derived pellicles on resin surfaces, which provided attenuating effects on biofilms similar to salivary pellicles. Compared with the commercial control, the DMADDM-containing bonding agent reduced biofilm CFU by about two orders of magnitude., Significance: Novel DMADDM- and NAg-containing bonding agents substantially reduced biofilm growth even with salivary pellicle coating on surfaces, indicating a promising usage in saliva-rich environment. DMADDM and NAg may be useful in a wide range of primers, adhesives and other restoratives to achieve antibacterial and anti-caries capabilities., (Published by Elsevier Ltd.)

Objectives: Antibacterial bonding agents are promising to combat bacteria and caries at tooth-restoration margins. The objectives of this study were to incorporate new quaternary ammonium methacrylates (QAMs) to bonding agent and determine the effects of alkyl chain length (CL) and quaternary amine charge density on dental plaque microcosm bacteria response for the first time., Methods: Six QAMs were synthesized with CL=3, 6, 9, 12, 16, 18. Each QAM was incorporated into Scotchbond multi-purpose (SBMP). To determine the charge density effect, dimethylaminododecyl methacrylate (DMAHDM, CL=16) was mixed into SBMP at mass fraction=0%, 2.5%, 5%, 7.5%, 10%. Charge density was measured using a fluorescein dye method. Dental plaque microcosm using saliva from ten donors was tested. Bacteria were inoculated on resins. Early-attachment was tested at 4h. Biofilm colony-forming units (CFU) were measured at 2 days., Results: Incorporating QAMs into SBMP reduced bacteria early-attachment. Microcosm biofilm CFU for CL=16 was 4 log lower than SBMP control. Charge density of bonding agent increased with DMAHDM content. Bacteria early-attachment decreased with increasing charge density. Biofilm CFU at 10% DMAHDM was reduced by 4 log. The killing effect was similarly-strong against total microorganisms, total streptococci, and mutans streptococci., Conclusions: Increasing alkyl chain length and charge density of bonding agent was shown for the first time to decrease microcosm bacteria attachment and reduce biofilm CFU by 4 orders of magnitude. Novel antibacterial resins with tailored chain length and charge density are promising for wide applications in bonding, cements, sealants and composites to inhibit biofilms and caries., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objectives: The objectives of this study were to develop bonding agent containing a new antibacterial monomer dimethylaminododecyl methacrylate (DMADDM) as well as nanoparticles of silver (NAg) and nanoparticles of amorphous calcium phosphate (NACP), and to investigate the effects of water-ageing for 6 months on dentine bond strength and anti-biofilm properties for the first time., Methods: Four bonding agents were tested: Scotchbond Multi-Purpose (SBMP) Primer and Adhesive control; SBMP+5% DMADDM; SBMP+5% DMADDM+0.1% NAg; and SBMP+5% DMADDM+0.1% NAg with 20% NACP in adhesive. Specimens were water-aged for 1d and 6 months at 37°C. Then the dentine shear bond strengths were measured. A dental plaque microcosm biofilm model was used to inoculate bacteria on water-aged specimens and to measure metabolic activity, colony-forming units (CFUs), and lactic acid production., Results: Dentine bond strength showed a 35% loss in 6 months of water-ageing for SBMP control (mean±sd; n=10); in contrast, the new antibacterial bonding agents showed no strength loss. The DMADDM-NAg-NACP containing bonding agent imparted a strong antibacterial effect by greatly reducing biofilm viability, metabolic activity and acid production. The biofilm CFU was reduced by more than two orders of magnitude, compared to SBMP control. Furthermore, the DMADDM-NAg-NACP bonding agent exhibited a long-term antibacterial performance, with no significant difference between 1d and 6 months (p>0.1)., Conclusions: Incorporating DMADDM-NAg-NACP in bonding agent yielded potent and long-lasting antibacterial properties, and much stronger bond strength after 6 months of water-ageing than a commercial control. The new antibacterial bonding agent is promising to inhibit biofilms and caries at the margins. The method of DMADDM-NAg-NACP incorporation may have a wide applicability to other adhesives, cements and composites., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Secondary caries remains the main reason for dental restoration failure. Replacement of failed restorations accounts for 50%-70% of all restorations performed. Antibacterial adhesives could inhibit biofilm acids at tooth-restoration margins, and calcium phosphate (CaP) ions could remineralize tooth lesions. The objectives of this study were to: (1) incorporate nanoparticles of silver (NAg), quaternary ammonium dimethacrylate (QADM), and nanoparticles of amorphous calcium phosphate (NACP) into bonding agent; and (2) investigate their effects on dentin bonding and microcosm biofilms. An experimental primer was made with pyromellitic glycerol dimethacrylate (PMGDM) and 2-hydroxyethyl methacrylate (HEMA). An adhesive was made with bisphenol-A-glycerolate dimethacrylate (BisGMA) and triethylene glycol dimethacrylate (TEGDMA). NAg was incorporated into primer at 0.1 wt %. The adhesive contained 0.1% NAg and 10% QADM, and 0%-40% NACP. Incorporating NAg into primer and NAg-QADM-NACP into adhesive did not adversely affect dentin bond strength (p > 0.1). Scanning electron microscopy showed numerous resin tags, and transmission electron microscopy revealed NAg and NACP in dentinal tubules. Viability of human saliva microcosm biofilms on primer/adhesive/composite disks was substantially reduced via NAg and QADM. Metabolic activity, lactic acid, and colony-forming units of biofilms were much lower on the new bonding agents than control (p < 0.05). In conclusion, novel dental bonding agents containing NAg, QADM, and NACP were developed with the potential to kill residual bacteria in the tooth cavity and inhibit the invading bacteria along tooth-restoration margins, with NACP to remineralize tooth lesions. The novel method of combining antibacterial agents (NAg and QADM) with remineralizing agent (NACP) may have wide applicability to other adhesives for caries inhibition., (Copyright © 2012 Wiley Periodicals, Inc.)

Objective: Antibacterial primer and adhesive are promising to help combat biofilms and recurrent caries. The objectives of this study were to compare novel bonding agent containing quaternary ammonium dimethacrylate (QADM) with bonding agent containing nanoparticles of silver (NAg) in antibacterial activity, contact-inhibition vs. long-distance inhibition, glucosyltransferases (gtf) gene expressions, and cytotoxicity for the first time., Methods: QADM and NAg were incorporated into Scotchbond Multi-Purpose adhesive and primer. Microtensile dentin bond strength was measured. Streptococcus mutans (S. mutans) biofilm on resin surface (contact-inhibition) as well as S. mutans in culture medium away from the resin surface (long-distance inhibition) were tested for metabolic activity, colony-forming units (CFUs), lactic acid production, and gtf gene expressions. Eluents from cured primer/adhesive samples were used to examine cytotoxicity against human gingival fibroblasts., Results: Bonding agent with QADM greatly reduced CFU and lactic acid of biofilms on the resin surface (p<0.05), while having no effect on S. mutans in culture medium away from the resin surface. In contrast, bonding agent with NAg inhibited not only S. mutans on the resin surface, but also S. mutans in culture medium away from the resin surface. Bonding agent with QADM suppressed gtfB, gtfC and gtfD gene expressions of S. mutans on its surface, but not away from its surface. Bonding agent with NAg suppressed S. mutans gene expressions both on its surface and away from its surface. Bonding agents with QADM and NAg did not adversely affect microtensile bond strength or fibroblast cytotoxicity, compared to control (p>0.1)., Significance: QADM-containing adhesive had contact-inhibition and inhibited bacteria on its surface, but not away from its surface. NAg-containing adhesive had long-distance killing capability and inhibited bacteria on its surface and away from its surface. The novel antibacterial adhesives are promising for caries-inhibition restorations, and QADM and NAg could be complimentary agents in inhibiting bacteria on resin surface as well as away from resin surface., (Published by Elsevier Ltd.)

Objectives: Secondary caries is the main reason for restoration failure, and replacement of the failed restorations accounts for 50-70% of all restorations. Antibacterial adhesives could inhibit residual bacteria in tooth cavity and invading bacteria along the margins. Calcium (Ca) and phosphate (P) ion release could remineralize the lesions. The objectives of this study were to incorporate nanoparticles of silver (NAg) and nanoparticles of amorphous calcium phosphate (NACP) into adhesive for the first time, and to investigate the effects on dentin bond strength and plaque microcosm biofilms., Methods: Scotchbond multi-purpose adhesive was used as control. NAg were added into primer and adhesive at 0.1% by mass. NACP were mixed into adhesive at 10%, 20%, 30% and 40%. Microcosm biofilms were grown on disks with primer covering the adhesive on a composite. Biofilm metabolic activity, colony-forming units (CFU) and lactic acid were measured., Results: Human dentin shear bond strengths (n=10) ranged from 26 to 34 MPa; adding NAg and NACP into adhesive did not decrease the bond strength (p>0.1). SEM examination revealed resin tags from well-filled dentinal tubules. Numerous NACP infiltrated into the dentinal tubules. While NACP had little antibacterial effect, NAg in bonding agents greatly reduced the biofilm viability and metabolic activity, compared to the control (p<0.05). CFU for total microorganisms, total streptococci, and mutans streptococci on bonding agents with NAg were an order of magnitude less than those of the control. Lactic acid production by biofilms for groups containing NAg was 1/4 of that of the control., Significance: Dental plaque microcosm biofilm viability and acid production were greatly reduced on bonding agents containing NAg and NACP, without compromising dentin bond strength. The novel method of incorporating dual agents (remineralizing agent NACP and antibacterial agent NAg) may have wide applicability to other dental bonding systems., (Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objective: Antibacterial bonding agents are promising to hinder the residual and invading bacteria at the tooth-restoration interfaces. The objectives of this study were to develop an antibacterial bonding agent by incorporation of quaternary ammonium dimethacrylate (QADM) and nanoparticles of silver (NAg), and to investigate the effect of QADM-NAg adhesive and primer on dentin bond strength and plaque microcosm biofilm response for the first time., Methods: Scotchbond Multi-Purpose adhesive and primer were used as control. Experimental adhesive and primer were made by adding QADM and NAg into control adhesive and primer. Human dentin shear bond strengths were measured (n = 10). A dental plaque microcosm biofilm model with human saliva as inoculum was used to investigate biofilm metabolic activity, colony-forming unit (CFU) counts, lactic acid production, and live/dead staining assay (n = 6)., Results: Adding QADM and NAg into adhesive and primer did not compromise the dentin shear bond strength which ranged from 30 to 35MPa (p>0.1). Scanning electron microscopy (SEM) examinations revealed numerous resin tags, which were similar for the control and the QADM and NAg groups. Adding QADM or NAg markedly reduced the biofilm viability, compared to adhesive control. QADM and NAg together in the adhesive had a much stronger antibacterial effect than using each agent alone (p<0.05). Adding QADM and NAg in both adhesive and primer had the strongest antibacterial activity, reducing metabolic activity, CFU, and lactic acid by an order of magnitude, compared to control., Significance: Without compromising dentin bond strength and resin tag formation, the QADM and NAg containing adhesive and primer achieved strong antibacterial effects against microcosm biofilms for the first time. QADM-NAg adhesive and primer are promising to combat residual bacteria in tooth cavity and invading bacteria at the margins, thereby to inhibit secondary caries. QADM and NAg incorporation may have a wide applicability to other dental bonding systems., (Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: Half of dental restorations fail in 10 years, with secondary caries as the main reason. Calcium phosphate composites could remineralize tooth lesions. The objectives of this study were to: (1) impart antibacterial activity to a composite with nanoparticles of amorphous calcium phosphate (NACP); and (2) investigate the effect of quaternary ammonium dimethacrylate (QADM) on mechanical and dental plaque microcosm biofilm properties for the first time., Methods: The NACP and glass particles were filled into a dental resin that contained bis(2-methacryloyloxy-ethyl) dimethyl-ammonium bromide, the QADM. NACP nanocomposites containing 0%, 7%, 14%, and 17.5% of QADM by mass, respectively, were photo-cured. A commercial composite with no antibacterial activity was used as control. Mechanical properties were measured in three-point flexure. A human saliva microcosm model was used to grow biofilms on composites. Live/dead assay, metabolic activity, colony-forming unit (CFU) counts, and lactic acid production of biofilms on the composites were measured., Results: Increasing QADM mass fraction monotonically reduced the biofilm viability, CFU and lactic acid. Biofilms on NACP nanocomposite with 17.5% QADM had metabolic activity that was 30% that on a commercial composite control (p<0.05). Total microorganisms, total streptococci, and mutans streptococci CFU counts (mean ± sd; n = 6) on composite control was 6-fold those on NACP +17.5% QADM nanocomposite. Composite control had long strings of bacterial cells with normal short-rod shapes, while some cells on NACP-QADM nanocomposites disintegrated into pieces. Adding QADM to NACP did not decrease the composite strength and elastic modulus, which matched (p>0.1) those of a commercial composite without Ca-PO(4) or antibacterial activity., Significance: A dental plaque microcosm model was used to evaluate the novel NACP-QADM nanocomposite. The nanocomposite greatly reduced the biofilm viability, metabolic activity and lactic acid, while its mechanical properties matched those of a commercial composite. NACP-QADM nanocomposite with calcium phosphate fillers, good mechanical properties and a strong antibacterial activity may have potential for anti-biofilm and anti-caries restorations., (Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

A dental composite containing amorphous calcium phosphate nanoparticles (NACP) was developed that released calcium (Ca) and phosphate (PO(4)) ions and possessed acid-neutralization capability. There has been little study on incorporation of antibacterial agents into calcium phosphate composites. The objective of this study was to investigate the effect of silver nanoparticle (NAg) mass fraction in NACP nanocomposite on mechanical properties and dental plaque microcosm biofilm for the first time. NACP nanoparticles of 116 nm were synthesized via a spray-drying technique. NAg nanoparticles were synthesized using Ag 2-ethylhexanoate and 2-(tert-butylamino)ethyl methacrylate, yielding NAg of particle size of 2.7 nm that were well-dispersed in the resin. Five NACP nanocomposites were fabricated with NAg mass fractions of 0, 0.028, 0.042, 0.088, and 0.175%, respectively. Mechanical properties of NACP nanocomposites containing 0-0.042% of NAg matched those of a commercial composite without antibacterial activity. Live/dead assay of dental plaque microcosm biofilms showed complete coverage with live bacteria on commercial composite. However, there were increasingly more dead bacteria with higher NAg content in the NACP nanocomposite. Colony-forming unit (CFU) counts for total microorganisms, total streptococci, and mutans streptococci for NACP nanocomposite with 0.042% NAg were about 1/4 those of commercial composite. Lactic acid production on NACP nanocomposite with 0.042% NAg was 1/3 that on commercial composite. In conclusion, novel NACP-NAg nanocomposites were developed which possessed good mechanical properties and potent antibacterial properties, with substantially reduced biofilm viability and lactic acid production. Hence, the NACP-NAg nanocomposites are promising for dental restorations with remineralizing and antibacterial capabilities., (Copyright © 2012 Wiley Periodicals, Inc.)

Tooth caries is a carbohydrate-modified bacterial infectious disease, and recurrent caries is a frequent reason for restoration failure. The objective of this study was to develop a novel antibacterial composite using tetracalcium phosphate (TTCP) fillers and bis(2-methacryloyloxy-ethyl) dimethyl-ammonium bromide, which is a quaternary ammonium dimethacrylate (QADM). QADM was synthesized using 2-(N,N-dimethylamino)ethyl methacrylate and 2-bromoethyl methacrylate and incorporated into a resin. The resin was filled with 40% TTCP and 30% glass particles. The following QADM mass fractions in the composite were tested: 0%, 6%, 12%, and 18%. Streptococcus mutans biofilms were formed on the composites and the colony-forming units (CFUs), metabolic activity, and lactic acid production were measured. The TTCP-QADM composite had flexural strength and elastic modulus similar to those of two commercial composites (p > 0.1). Increasing the QADM content in TTCP composite greatly decreased the bacteria growth and biofilm matrix production. There were significantly more dead bacteria with increasing QADM content. TTCP composite containing 18% QADM had biofilm CFU, metabolic activity, and acid production about half of those without QADM. Inversely linear relationships were established between QADM mass fraction and S. mutans biofilm CFU, metabolic activity, and acid production, with correlation coefficients R(2) ≥ 0.98. In conclusion, TTCP-QADM composites were developed and the effect of QADM mass fraction on the antibacterial properties of the composite was determined for the first time. The novel TTCP-QADM composites possessing a strong antibacterial capability, together with calcium phosphate ion release and good mechanical properties, are promising for dental restorations to reduce biofilm growth and recurrent caries., (Copyright © 2011 Wiley Periodicals, Inc.)

Antimicrobial photodynamic therapy (aPDT) shows promise in eliminating oral pathogens without inducing microbial resistance. Yet, it faces limited biofilm penetration by the photosensitizer, which hinders its efficacy against mature, thick biofilms. This study assesses the effectiveness of the MagTBO (magnetic nanoparticles and toluidine‐blue ortho) nanoplatform against mature Streptococcus mutans biofilms associated with dental caries. The study employs constant‐depth film fermenter (CDFF) models, known as "artificial mouth," to replicate caries processes and allow biofilm growth over teeth. This method enables the evaluation of biofilm‐induced mineral loss under cariogenic challenge over 5 and 10 days. The study shows that MagTBO improves aPDT's effectiveness against highly mature and complex biofilms over 5 and 10 days. However, the biofilm reduction unaffected the mineral content in the underlying dentin. This presents a promising approach for clinical aPDT protocols. However, it is crucial to acknowledge that these findings are based on in vitro studies and may necessitate further clinical confirmation. In summary, our data indicate that magnetic‐based photosensitizers enhance the modulation of pathogenic oral biofilms by aPDT, offering potential advancements in clinical aPDT protocols. [ABSTRACT FROM AUTHOR]