Abstract
Dental caries is prevalent worldwide. Tooth cavity restorations cost more than $46 billion annually in the United States alone. The current generation of esthetic polymeric restorations have unsatisfactory failure rates. Replacing the failed restorations accounts for 50–70% of all the restorations. This article reviewed developments in producing a new generation of bioactive and therapeutic restorations. This includes: Protein-repellent and anti-caries polymeric dental composites, especially the use of 2-methacryloyloxyethyl phosphorylcholine (MPC) and dimethylaminododecyl methacrylate (DMAHDM); protein-repellent adhesives to greatly reduce biofilm acids; bioactive cements to inhibit tooth lesions; combining protein-repellency with antibacterial nanoparticles of silver; tooth surface coatings containing calcium phosphate nanoparticles for remineralization; therapeutic restorations to suppress periodontal pathogens; and long-term durability of bioactive and therapeutic dental polymers. MPC was chosen due to its strong ability to repel proteins. DMAHDM was selected because it had the most potent antibacterial activity when compared to a series of antibacterial monomers. The new generation of materials possessed potent antibacterial functions against cariogenic and periodontal pathogens, and reduced biofilm colony-forming units by up to 4 logs, provided calcium phosphate ions for remineralization and strengthening of tooth structures, and raised biofilm pH from a cariogenic pH 4.5 to a safe pH 6.5. The new materials achieved a long-term durability that was significantly beyond current commercial control materials. This new generation of bioactive and nanostructured polymers is promising for wide applications to provide therapeutic healing effects and greater longevity for dental restorations.
Highlights
Dental caries is the most prevalent human infectious disease worldwide [1,2,3,4]
When methacryloyloxyethyl phosphorylcholine (MPC) and DMAHDM were both used, the biofilm cfu was reduced by more than 4 logs, compared to Scotchbond Multi-Purpose (SBMP) control [51]. This was likely because MPC could repel proteins, thereby exposing the quaternary amine charge density on the adhesive polymer surface to the bacteria
Therapeutic restorations refer to restorations that replace the missing tooth structures, and exert inhibitory effects against oral diseases, such as the suppression of cariogenic and periodontal pathogens, and exert healing effects, such as releasing agents into the pulp to heal the pulp, or remineralizing and regenerating the lost minerals
Summary
Dental caries is the most prevalent human infectious disease worldwide [1,2,3,4]. In the United States alone, nearly 200 million tooth cavity restorations are performed each year, costing more than $46 billion annually [5]. In the mouth in vivo, a clean polymer surface is quickly coated with salivary pellicles that contain salivary proteins [24]. This protein coating is the prerequisite for oral bacteria attachment to the surface [25]. Making the polymer surface protein-repellent would reduce or eliminate biofilm formation. Following this line of thinking, Müller et al immobilized a protein-repellent material, poly(ethylene glycol) (PEG) and two pyridinium group-containing methacrylate monomers, to silicon wafer surfaces, which had much less adsorbed proteins [26]. This article reviews the new generation of nanostructured, bioactive, and therapeutic dental polymeric materials with protein-repellent and anti-caries properties
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