Novel Bio-interactive Fixed Dental Restoration Cement with Potent Antibacterial and Remineralization Properties

Abstract

Resin-based cement is increasingly used in clinical practice due to its excellent mechanical and physical properties. The cementation and accurate placement of fixed dental restorations with an ideal marginal adaptation to the tooth structure remains a challenging laboratory and clinical task. The marginal gap of fixed dental restoration increases the opportunity for microleakage, plaque accumulation, and tooth demineralization by increasing the potential for food buildup around the margin and exposing the tooth-cement interface to the oral cavity. Thus, there is an increased need to develop a new generation of bio-interactive dental cement with antibacterial, long-term remineralization abilities, and excellent mechanical properties. Therefore, this dissertation aims to invent new bio-interactive resin-based cement containing dimethylaminohexadecyl methacrylate (DMAHDM), nanoparticles of amorphous calcium phosphate (NACP), and nanoparticles of calcium fluoride (nCaF2), which could be a promising approach to increase the chances of success of fixed dental restoration and strengthen tooth structures. All new cement formulations were subjected to a series of mechanical, antibacterial, and ion release assessments. In the first manuscript, we found that the new NACP+DMAHDM cement has excellent potential for fixed restoration cementation, as it efficiently inhibited S. mutans biofilm commonly associated with secondary caries and maintained an excellent mechanical property with high levels of Ca and P ions released. In the second manuscript, we found that incorporating DMAHDM and NACP into resin-based cement provides strong antibacterial action against saliva microcosm biofilm and presents a high level of Ca and P ion recharge abilities. In the third manuscript, we found that the new cement with both NACP and nCaF2 demonstrated the advantages of both types of bio-interactive fillers as it could release a higher level of ions than the resin cement with only nCAF2 and exhibits a better rechargeability compared to the resin cement with only NACP. Lastly, in the fourth manuscript, we found that the novel antibacterial low-shrinkage-stress resin-based cement provided strong antibacterial action and maintained excellent mechanical properties with reduced polymerization shrinkage stress, which could improve the long-term success of the fixed dental restoration.