Designing Bioactive Polymeric Materials For Restorative Dentistry

Mary Anne Sampaio de Melo, Mary Anne Sampaio de Melo

• Éditeur: CRC Press
• Année: 2020
• ISBN:
  9780429532634
• Édition: 1
• Sujet: Medizin
• Sous-sujet: Mundhygiene & Zahnchirurgie

Restorative biomaterials in dentistry are designed to restore the shape and function of teeth. Their applicability is related to restorative procedures such as dental restorations, dentures, dental implants, and endodontic materials. Designing Bioactive Polymeric Materials for Restorative Dentistry reviews the current state of the art for restorative biomaterials and discusses the near-future trends in this field. The book examines the biomaterials utilized in restorative dental applications (bonding, composites, cements, and ceramics) and assesses the design for these materials and the role of nanotechnology.

All of the contributors are active clinical dentists and researchers in this field.

FEATURES

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• Overviews the major ongoing research efforts on developing bioactive bonding systems and composites in dental biomaterials

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• Focuses on emerging trends in restorative dental biomaterials

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• Incorporates evidence-based data on new restorative dental materials throughout the book

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• Features extensive references at the end of each chapter to enhance further study

Mary Anne S. Melo, DDS, MSc, PhD FADM, is an Associate Professor and Division Director of Operative Dentistry at the School of Dentistry, University of Maryland, Baltimore, Maryland.

1
An Introduction to Bioactivity via Restorative Dental Materials

Mary Anne S. Melo and Ashley Reid

University of Maryland School of Dentistry

Abdulrahman A. Balhaddad

University of Maryland School of Dentistry
Imam Abdulrahman Bin Faisal University

Contents

1.1 What Does It Mean “Bioactivity” in the Context of Restorative Materials?

1.1.1 Forecast Market for Bioactive Restorative Materials

1.1.2 Designing Bioactive Polymeric Material

1.2 Bioactivity Concepts and Properties in Clinical Dentistry

1.2.1 Bioactivity in Restorative Dentistry

1.2.2 Bioactive Restorative Material as Sources of Deflated Ions for Mineral Content

1.2.3 Bioactive Restorative Material as a Suppressor for Bacterial Growth

1.2.4 Bioactivity in Other Dental Disciplines

1.2.4.1 Prosthodontics

1.2.4.2 Pediatrics

1.2.4.3 Orthodontics

1.2.4.4 Endodontics

1.2.4.5 Periodontics

1.2.4.6 Implantology

1.3 Future Trends

References

1.1 What Does It Mean “Bioactivity” in the Context of Restorative Materials?

“Bioactive” material is not a new term to dentistry, but inexperienced for direct restorative materials, especially for resin-based dental composites. Over the past decade, the search for a response to clinical needs imposed by an increased rate of secondary caries around faulty restorations has led to a growing exploration of this topic. The search for impairment of bioactivity in resin-based restorative material has led to a broad perspective about how a material can be defined as bioactive (Chatzistavrou et al. 2018).

The current meaning extends well beyond the medical-based description for bioactive materials. It is known as a material that can have a biological effect or be biologically active and form a bond between the tissues and the material (Dziadek et al. 2015). Under the umbrella of biomaterials, the ability to form a surface apatite-containing material (ACM), including hydroxyapatite, in a simulated body fluid (SBF) is defined as “bioactivity” (Kokubo et al. 1990). Under a dental restorative perspective, “bioactivity” describes a dynamic, positive biological process. A bioactive restorative material would be able to restore missing tooth structure, re-establish an enhanced esthetic appearance, and additionally, stimulate specific tissue responses or modulate interactions with microbiological species, for instance (Lawson and Robles 2017).

Concerning polymeric restorative materials, here, referred to as methacrylate resin-based materials that have preventive and dental restorative applications has extended the concept of bioactivity (Pratap et al. 2019). Currently, bioactive materials generally refer to biomaterials that can induce a response to the biological system upon interacting. They could have the following bioactivities as illustrated in Figure 1.1:

Figure 1.1 (1) A surface that may nucleate the formation of biological-like calcium phosphates or release components involved in the induction of the bioapatite-like material when in contact with saliva or tissue fluids; (2) the release of critical ions, such as calcium ions to assist in the chemical equilibrium of the mineral net into the hard dental tissues such as enamel and dentin; and (3) the release or contact of components of agents that can modulate or suppress bacterial biofilms.

1. A surface that may nucleate the formation of biological-like calcium phosphates or released components involved in the induction of the bioapatite-like material when in contact with saliva or tissue fluids.
2. The release of key ions, such as calcium ions to assist in the chemical equilibrium of the mineral net into the hard dental tissues, such as enamel and dentin.
3. The release or contact of components of agents that can modulate or suppress bacterial metabolism, consequentially reducing biofilm growth.

Figure 1.2 indicates the pathways of bioactivity toward dental caries prevention via dental restorative materials.

Figure 1.2 Pathways of bioactivity toward dental caries prevention via dental restorative materials can involve: Pathway #1: The use of materials that are capable of inducing bioapatite-like material, Pathway #2: Materials with remineralizing ion release, such as fluoride, calcium, and phosphate ions, to restore the minerals, and Pathway #3: Materials with contact or releasing mechanisms to modulation the dental biofilms and limit the growth of microorganisms.

1.1.1 Forecast Market for Bioactive Restorative Materials

Globally, millions of people suffer from toothache due to tooth cavities and often permanent tooth loss. Dental caries, also known as tooth decay is a biofilm-dependent infectious disease that damages teeth by loss of minerals and presents high incidence around restorative polymeric fillings (tooth-colored fillings) (Askar et al. 2020). Untreated caries results in severe pulpal pathologies, which proceeds to tooth loss because the dental enamel cannot regenerate. Also, dental caries is highly prevalent among the elderly population due to unhealthy dietary habits and poor oral hygiene. According to the World Dental Federation, approximately 3.9 billion individuals are affected by dental caries annually, which affects almost half of the world’s population (Martins et al. 2017; Edelstein 2006).

The global dental fillings market size was estimated at USD 5.2 billion in 2018 and is projected to register a compound annual growth rate of 7.2% over the forecast period. The growing occurrence of secondary carious lesions, due to dental caries, is the major driving factor. Moreover, a high prevalence of other dental conditions such as trauma, dental erosion due to unhealthy eating habits, and the growing geriatric population is expected to fuel the market (“Dental Fillings Market Size & Share | Industry Report, 2019–2026” n.d.).

The interface between dental fillings and a restored tooth is at a higher risk of pathogenic bacterial colonization. Until now, the majority of commercially available restorative polymeric filling materials present no bioactivity. The complexity of the oral biofilm and the barriers imparted for them contribute to the difficulty in developing effective novel dental materials. Nevertheless, the clinical need is pushing the market to develop new restorative products that present bioactivity.

In a similar growing trend, the bioactive materials market has been projected to exceed USD 3.29 billion in 2025. This market comprises a wide range of materials including implants, ceramics, Bioglass, and composites for medical and dental fields (“Bioactive Materials Market Analysis | Global Industry Report, 2014–2025” n.d.). The growth of the orthopedic and dental surgeries on account with these restorative treatments can offer better oral health status and quality of life, which has resulted in a rise in the demand for implants. Additionally, the demand for superior properties of the bioactive materials has facilitated the rising substitution of the traditionally used implants, thereby driving growth. Figure 1.3 illustrates the growing trend in both dental fillings and bioactive market in the United States according to the Global Industry reports retrieved in 2019 (“Dental Fillings Market Size & Share | Industry Report, 2019–2026” n.d.; “Bioactive Materials Market Analysis | Global Industry Report, 2014–2025” n.d.).

Figure 1.3 The growing trend in both dental fillings and bioactive market in the United States, according to Global Industry reports retrieved in 2019. (“Dental Fillings Market Size & Share | Industry Report, 2019–2026” n.d.; “Bioactive Materials Market Analysis | Global Industry Report, 2014–2025” n.d.)

Remarkably, the dental applications represented by restorative materials are the favorable demanding driver for the bioactive materials sector (“Bioactive Materials Market Analysis | Global Industry Report, 2014–2025” n.d.). The dental materials that are in high demand are pulp capping, apexification, root resorption, and root-end filling predicted over the forecast period. However, the unpredictable sizable contribution of the COVID-19 pandemic in the U.S. stock market should be considered (Baker et al. 2020).

1.1.2 Designing Bioactive Polymeric Material

Rapid advances in our understanding of cell and materials interactions provide the basis for an extensive change in the forthcoming of dental treatment, in particular the prevention of dental caries recurrence. Instead of repeatedly replacing damaged dental restorations compromised by carious lesions as illustrated in Figure 1.4, the future goal of our dental restorative intervention will be to use bioactive reconstructive filling materials that will assist the restoration and the surrounding dental hard tissue to survive under harsh intraoral conditions (Melo et al. 2013).

Figure 1.4 Photograph showing secondary carious lesions around polymeric restorations (resin composites). Repetitively replacing damaged dental restorations compromised by carious lesions reduces the life cycle of the teeth. Retrieved from Balhaddad, A. A., A. A. Kansara, D. Hidan, M. D. Weir, H. H. K. Xu, and M. A. S. Melo. 2019. “Toward Dental Caries: Exploring Nanoparticle-Basedplatforms and Calcium Phosphate Compounds for Dental Restorative Materials.” Bioactive Materials 4 (1):43–55.

In principle, the design of bioactive polymeric dental materials needs to be closely related to the end clinical use, when the bioactive elements or compounds incorporated into dental material reach the target area. For pulp repair in the management of deep carious lesions, a product, such as a liner, needs to be applied in close proximity to the target tissue. In this case, the dental pulp promotes the release of calcium (Ca) and hydroxyl (OH) ions. This gradient of calcium ions triggers the recruitment and proliferation of undifferentiated cells from the pulp and activates stem cells (Gandolfi et al. 2015).

The polymer composition is the key parameter determining the bioactivity properties as the physicomechanical bulk properties of the intended polymeric restorative materials. For dental polymers, such as resin composites, the bioactive elements included in the compositions could be present in the inorganic composition or in the resin blend composition, as illustrated in Figure 1.5. Elements ...

Table des matières

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Preface
• Acknowledgments
• Editor
• Contributors
• 1. An Introduction to Bioactivity via Restorative Dental Materials
• 2. Current Status and Role of Dental Polymeric Restorative Materials
• 3. Impact of Dental Caries on Survival of Polymeric Restorations
• 4. Interactions between Oral Bacteria and Antibacterial Polymer-Based Restorative Materials
• 5. Biomaterial, Host, and Microbial Interactions: Factors to Consider When Developing Resin-Based Restorative Materials
• 6. Advances in the Development of Antibacterial Composites
• 7. Nanotechnology and Delivery System for Bioactive Antibiofilm Dental Materials
• 8. Antibacterial, pH Neutralizing, and Remineralizing Fillers in Polymeric Restorative Materials
• 9. Methods for Characterization of Bioactivity Using Confocal Microscopy
• 10. Quantum Dots as Biointeractive and Non-Agglomerated Nanoscale Fillers for Dental Resins
• Index