Abstract

PurposeThe aim was to assess monomer conversion, dimensional stability, flexural strength / modulus, surface apatite precipitation and wear of mono / tri calcium phosphate (CaP) and polylysine (PLS)—containing dental composites. These were formulated using a new, high molecular weight, fluid monomer phase that requires no polymerisation activator.Materials and methodsUrethane and Polypropylene Glycol Dimethacrylates were combined with low levels of an adhesion promoting monomer and a light activated initiator. This liquid was mixed with a hybrid glass containing either 10 wt% CaP and 1 wt% PLS (F1) or 20 wt% CaP and 2 wt% PLS (F2). Powder to liquid mass ratio was 5:1. Commercial controls included Gradia Direct Posterior (GD) and Filtek Z250 (FZ). Monomer conversion and polymerisation shrinkage were calculated using Fourier Transform Infrared (FTIR). Subsequent volume increases in water over 7 weeks were determined using gravimetric studies. Biaxial flexural strength (BFS) / modulus (BFM) reduction and surface apatite precipitation upon 1 and 4 weeks immersion in water versus simulated body fluid (SBF) were assessed using a mechanical testing frame and scanning electron microscope (SEM). Mass / volume loss and surface roughness (Ra) following 7 weeks water immersion and subsequent accelerated tooth-brush abrasion were examined using gravimetric studies and profilometer.ResultsF1 and F2 exhibited much higher monomer conversion (72%) than FZ (54%) and low calculated polymerization shrinkage (2.2 vol%). Final hygroscopic expansions decreased in the order; F2 (3.5 vol%) > F1 (1.8 vol%) ~ Z250 (1.6 vol%) > Gradia (1.0 vol%). BFS and BFM were unaffected by storage medium type. Average BFS / BFM upon 4 weeks immersion reduced from 144 MPa / 8 GPa to 107 MPa / 5 GPa for F1 and 105 MPa / 6 GPa to 82 MPa / 4 GPa for F2. Much of this change was observed in the first week of immersion when water sorption rate was high. Surface apatite layers were incomplete at 1 week, but around 2 and 15 micron thick for F1 and F2 respectively following 4 weeks in SBF. Mass and volume loss following wear were equal. Average results for F1 (0.5%), F2 (0.7%), and FZ (0.5%) were comparable but lower than that of GD (1%). Ra, however, decreased in the order; F1 (15 μm) > F2 (11 μm) > GD (9 μm) > FZ (5 μm).ConclusionsHigh monomer conversion in combination with large monomer size and lack of amine activator should improve cytocompatibility of the new composites. High monomer molecular weight and powder content enables low polymerisation shrinkage despite high conversion. Increasing active filler provides enhanced swelling to balance shrinkage, which, in combination with greater surface apatite precipitation, may help seal gaps and reduce bacterial microleakage. High monomer conversion also ensures competitive mechanical / wear characteristics despite enhanced water sorption. Furthermore, increased active filler could help reduce surface roughness upon wear.

Highlights

  • With the advent of the Minamata Convention [1], amalgam as a dental restorative material is being phased out

  • The CaP consists of mono-calcium phosphate monohydrate (MCPM) and beta-tricalcium phosphate (β-TCP)

  • In contact with simulated body fluids, these precipitates can transform into low density apatite potentially sealing cracks in the material or at the restoration / dentin interface, and remineralize the demineralized dentin [8]

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Summary

Introduction

With the advent of the Minamata Convention [1], amalgam as a dental restorative material is being phased out. Composite restoration failure is primarily due to polymerization shrinkage which can lead to microgap formation that allows nutrient and / or bacterial penetration [3]. Bacteria can subseqently enable continuation of tooth apatite dissolution (demineralization) and decay beneath the composite restoration (recurrent or secondary caries) [4]. The CaP consists of mono-calcium phosphate monohydrate (MCPM) and beta-tricalcium phosphate (β-TCP). These react together with absorbed water to form higher volume dicalcium phosphate precipitates that may enable material expansion to compensate polymerization shrinkage. In contact with simulated body fluids, these precipitates can transform into low density apatite potentially sealing cracks in the material or at the restoration / dentin interface, and remineralize the demineralized dentin [8]

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