Abstract
BackgroundVital pulp preservation in the treatment of deep caries is challenging due to bacterial infection. The objectives of this study were to synthesize a novel, light-cured composite material containing bioactive calcium-silicate (Portland cement, PC) and the antimicrobial quaternary ammonium salt monomer 2-methacryloxylethyl dodecyl methyl ammonium bromide (MAE-DB) and to evaluate its effects on Streptococcus mutans growth in vitro.MethodsThe experimental material was prepared from a 2∶1 ratio of PC mixed with a resin of 2-hydroxyethylmethacrylate, bisphenol glycerolate dimethacrylate, and triethylene glycol dimethacrylate (4∶3∶1) containing 5 wt% MAE-DB. Cured resin containing 5% MAE-DB without PC served as the positive control material, and resin without MAE-DB or PC served as the negative control material. Mineral trioxide aggregate (MTA) and calcium hydroxide (Dycal) served as commercial controls. S. mutans biofilm formation on material surfaces and growth in the culture medium were tested according to colony-forming units (CFUs) and metabolic activity after 24 h incubation over freshly prepared samples or samples aged in water for 6 months. Biofilm formation was also assessed by Live/Dead staining and scanning electron microscopy.Results S. mutans biofilm formation on the experimental material was significantly inhibited, with CFU counts, metabolic activity, viability staining, and morphology similar to those of biofilms on the positive control material. None of the materials affected bacterial growth in solution. Contact-inhibition of biofilm formation was retained by the aged experimental material. Significant biofilm formation was observed on MTA and Dycal.ConclusionThe synthesized material containing HEMA-BisGMA-TEGDMA resin with MAE-DB as the antimicrobial agent and PC to support mineralized tissue formation inhibited S. mutans biofilm formation even after aging in water for 6 months, but had no inhibitory effect on bacteria in solution. Therefore, this material shows promise as a pulp capping material for vital pulp preservation in the treatment of deep caries.
Highlights
Pulpal vitality is critical to the maintenance of the structural integrity and normal physiological function of teeth
The numbers of colony-forming units (CFUs) from S. mutans biofilms on the experimental material and positive control material were significantly less by about an order of magnitude than that for the negative control material (P,0.05)
The CFU counts from S. mutans biofilms on Mineral trioxide aggregate (MTA) and Dycal were significantly greater by about one order of magnitude compared to that for the negative control material (P,0.05) and by about two orders of magnitude compared to those for the experimental and positive control materials (P,0.05 for both)
Summary
Pulpal vitality is critical to the maintenance of the structural integrity and normal physiological function of teeth. As our understanding of the importance of pulp in tooth health increases, methods for preserving pulp vitality during caries treatment even after exposure during caries removal are in great demand [1]. Pulp capping is the primary method for preserving vital pulp, but the success rate of this approach during the treatment of deep caries is low at only 33% [2]. The presence of bacteria is the major reason for failure [3]. Bacteria located in deep caries can induce severe inflammatory reactions in the pulp and even cause pulp necrosis [4]. The prevention of bacterial infections is an important objective for improving pulp capping methods in the treatment of deep caries. Vital pulp preservation in the treatment of deep caries is challenging due to bacterial infection. The objectives of this study were to synthesize a novel, light-cured composite material containing bioactive calcium-silicate (Portland cement, PC) and the antimicrobial quaternary ammonium salt monomer 2-methacryloxylethyl dodecyl methyl ammonium bromide (MAE-DB) and to evaluate its effects on Streptococcus mutans growth in vitro
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