Abstract
Resin-based composite materials have been widely used in restorative dental materials due to their aesthetic, mechanical, and physical properties. However, they still encounter clinical shortcomings mainly due to recurrent decay that develops at the composite-tooth interface. The low-viscosity adhesive that bonds the composite to the tooth is intended to seal this interface, but the adhesive seal is inherently defective and readily damaged by acids, enzymes, and oral fluids. Bacteria infiltrate the resulting gaps at the composite-tooth interface and bacterial by-products demineralize the tooth and erode the adhesive. These activities lead to wider and deeper gaps that provide an ideal environment for bacteria to proliferate. This complex degradation process mediated by several biological and environmental factors damages the tooth, destroys the adhesive seal, and ultimately, leads to failure of the composite restoration. This paper describes a co-tethered dual peptide-polymer system to address composite-tooth interface vulnerability. The adhesive system incorporates an antimicrobial peptide to inhibit bacterial attack and a hydroxyapatite-binding peptide to promote remineralization of damaged tooth structure. A designer spacer sequence was incorporated into each peptide sequence to not only provide a conjugation site for methacrylate (MA) monomer but also to retain active peptide conformations and enhance the display of the peptides in the material. The resulting MA-antimicrobial peptides and MA-remineralization peptides were copolymerized into dental adhesives formulations. The results on the adhesive system composed of co-tethered peptides demonstrated both strong metabolic inhibition of S. mutans and localized calcium phosphate remineralization. Overall, the result offers a reconfigurable and tunable peptide-polymer hybrid system as next-generation adhesives to address composite-tooth interface vulnerability.
Highlights
IntroductionThe high susceptibility of composite restorations to failure is a multifactorial problem involving the patient’s risk for decay, biodegradation by-products that increase the virulence of cariogenic bacteria, and gaps at the composite/tooth interface
We have shown that incorporating a spacer domain enhanced the antimicrobial activity of a bifunctional peptide self-assembled on an implant [20,22]
The average clinical lifespan of the composite dental restorations is limited and recurrent decay at the composite/tooth margin where the adhesive is applied is the primary reason for the short clinical lifespan
Summary
The high susceptibility of composite restorations to failure is a multifactorial problem involving the patient’s risk for decay, biodegradation by-products that increase the virulence of cariogenic bacteria, and gaps at the composite/tooth interface. The composite/tooth interface is initially sealed by a low-viscosity adhesive, but the fragile seal to dentin is readily damaged by acids, enzymes, and oral fluids. This damage leads to crevices that are colonized by cariogenic bacteria such as Streptococcus mutans. Biodegradation by-products accumulate at the dentin/adhesive (d/a) interface and increase the virulence of cariogenic bacteria, provoking a positive feedback loop that escalates the degradation
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