Novel Bioactive Low-Shrinkage-Stress Composite with Antibacterial and Remineralization Properties

Abstract

Methacrylate-based resin composites are frequently employed in dentistry for their aesthetic qualities, durability, and adhesive properties. Nevertheless, these restorations generally exhibit a lifespan of 5 to 10 years, with recurrent caries and tooth fractures being primary failure factors. Marginal integrity and the absence of bioactivity at the tooth-restoration junction contribute to recurrent caries development. Consequently, this dissertation endeavors to introduce a novel bioactive low-shrinkage-stress nanocomposite, featuring dimethylaminododecyl methacrylate (DMADDM) as an antibacterial agent, as well as remineralization nanoparticles of calcium fluoride (nCaF2) and nanoparticles of amorphous calcium phosphate (NACP), with the potential of increase the longevity of dental restoration and protect tooth structure. All novel formulations of low-shrinkage-stress composite were subjected to a series of mechanical, antibacterial, cytocompatibility, and ion release assessments. First, we investigated the optimum concentration of DMADDM that can be incorporated with a low-shrinkage-stress composite without compromising mechanical properties. We found that incorporation of up to 5% DMADDM into a low-shrinkage stress composite efficiently inhibited Streptococcus mutans (S. mutans) biofilm commonly associated with secondary caries. This potent antibacterial effect is achieved while maintaining excellent mechanical properties and minimizing polymerization shrinkage stress, potentially improving the long-term success of dental restorations. Next, we investigated the antibacterial and cytocompatibility of the incorporation of 3% DMADDM with 20% nCaF2 or 20% NCAP into a low-shrinkage-stress nanocomposite. We found that incorporating DMADDM with either nCaF2 or NACP into a low-shrinkage-stress nanocomposite provides a potent antibacterial effect against S. mutans biofilm while maintaining excellent mechanical properties. In addition, the novel formulations demonstrated excellent biocompatibility against human gingival fibroblasts and dental pulp stem cells. Lastly, we investigated the ions release and antibacterial properties against a salivary biofilm for our innovative formulations. The innovative mixture of DMADDM, NACP, and nCaF2 demonstrated strong antibiofilm effects on salivary biofilm, while concomitantly releasing a significant amount of remineralizing ions. This nanocomposite is a promising dental material with antibiofilm and remineralization capacities, with the potential to reduce polymerization-related microleakage and recurrent caries.