Effect of Chlorhexidine-Encapsulated Nanotube-Modified Adhesive System on the Bond Strength to Human Dentin

Indiana University-Purdue University Indianapolis (IUPUI)Introduction: The resin-dentin interface undergoes degradation by endogenous matrix metalloproteinases (MMPs) after adhesive procedures. Application of several MMP inhibitors such as chlorhexidine (CHX) to the demineralized collagen dentin matrix after acid-etching has been suggested to be a successful approach to prevent degradation of the hybrid layer. Further, nanotubes (HNT) have been used as a reservoir for encapsulation and controlled delivery for several therapeutic drugs with sustained release. Therefore, HNT can be encapsulated with CHX and incorporated into dentin adhesives for the possibility of enhancing the longevity and durability of the hybrid layer. Objective: To evaluate the effect of a CHX-encapsulated nanotube-modified primer/PR and adhesive/ADH on the microtensile resin bond strength (µTBS) to dentin. Materials and Methods: A commercial adhesive and its respective primer were modified by adding CHX-encapsulated nanotubes at two distinct concentrations (10 and 20 wt.%). The experimental adhesives were evaluated by degree of conversion (DC) and viscosity. Meanwhile, only viscosity was determined for the experimental primers. The prepared HNT-encapsulated with CHX (10 and 20 wt.%) powders were incorporated into the primer and/or adhesive according to the groups: ADH (control); HNT (control); 0.2% CHX; PR+CHX10%; PR+CHX20%; ADH+CHX10%; ADH+CHX20%. Human molars were selected and autoclaved; mid-coronal dentin surfaces were exposed for bonding purposes. Dentin surfaces were etched, followed by primer and adhesive application, and restored with a resin composite. After 24 hours, the teeth were sliced into beams for µTBS testing; beams collected for each tooth were equally assigned into two testing condition groups: 24 hours and 6 months. Microtensile bond strength was tested using a universal testing machine, and the types of failure were classified as adhesive, mixed, and cohesive failure. Data from DC and viscosity tests were analyzed using one-way ANOVA. Bond strength data were analyzed by pair-wise comparisons using the Sidak method to control the overall significance level at 5% for each aging time separately. Weibull-distribution survival analysis was used to compare the differences in the microtensile bond strength results among the groups after 24 hours and 6 months. Results and Conclusion: DC analysis revealed no significant differences among adhesive groups. However, ADH group had a significantly lower viscosity than modified adhesive groups, and a significantly higher viscosity than modified primer groups. Test results of stress value (MPa) by each group for each aging time revealed no significant differences among groups after 24 hours. However, after 6-month storage, modified primer groups (PR+CHX10%, PR+CHX20%) and 0.2%CHX group showed a significant difference in µTBS compared to control groups (ADH, HNT) and modified adhesive groups (ADH+CHX10%, ADH+CHX20%) in the same aging time testing (p < 0.05). When comparing the µTBS after 24 hours and 6 months, there were no significant differences among the groups except for the ADH+CHX20% group, for which MPa values were higher after 24 hours than 6 months (p = 0.0487). In conclusion, this study has demonstrated the great potential of modified dental primers with CHX-encapsulated nanotubes in preservation of the resin-dentin bond strength over a 6-month time period. Additionally, modification of dental primers and adhesives was a successful approach that didn’t compromise the characteristics or the mechanical properties of the materials and has a promising long-term effect on resin-dentin bond strength

Chlorhexidine-modified nanotubes and their effects on the polymerization and bonding performance of a dental adhesive

Objectives: The purpose of this study was to synthesize chlorhexidine (CHX)-encapsulated aluminosilicate clay nanotubes (Halloysite®, HNTs) and to incorporate them into the primer/adhesive components of an etch-and-rinse adhesive system (SBMP; Scotchbond Multipurpose, 3M ESPE) and to test their effects on degree of conversion, viscosity, immediate and long-term bonding to dentin. Methods: CHX-modified HNTs were synthesized using 10% or 20% CHX solutions. The primer and the adhesive components of SBMP were incorporated with 15wt.% of the CHX-encapsulated HNTs. Degree of conversion (DC) and viscosity analyses were performed to characterize the modified primers/adhesives. For bond strength testing, acid-etched dentin was treated with one of the following: SBMP (control); 0.2%CHX solution before SBMP; CHX-modified primers+SBMP adhesive; SBMP primer+CHX-modified adhesives; and SBMP primer+CHX-free HNT-modified adhesive. The microtensile bond strength test was performed after immediate (24h) and long-term (6 months) of water storage. Data were analyzed using ANOVA and Tukey (α=5%) and the Weibull analysis. Results: DC was greater for the CHX-free HNT-modified adhesive, whereas the other experimental adhesives showed similar DC as compared with the control. Primers were less viscous than the adhesives, without significant differences within the respective materials. At 24h, all groups showed similar bonding performance and structural reliability; whereas at the 6-month period, groups treated with the 0.2%CHX solution prior bonding or with the CHX-modified primers resulted in greater bond strength than the control and superior reliability. Significance: The modification of a primer or adhesive with CHX-encapsulated HNTs was an advantageous approach that did not impair the polymerization, viscosity and bonding performance of the materials, showing a promising long-term effect on resin-dentin bonds

Parents and guardians perceptions of primary school students accessibility to dental health services in Riyadh City, Saudi Arabia: A cross-sectional study

The success of healthcare delivery systems depends on accessibility. This study aimed to assess parental and guardian perceptions of dental health service accessibility among primary school students in Riyadh, Saudi Arabia. A descriptive cross-sectional survey was conducted among the parents and guardians of primary school students. A 23-item questionnaire was developed on the basis of previous studies. Demographic information, accessibility details, and barriers to dental services were recorded. A total of 385 participants responded to the questionnaire. Approximately 46.2 % of students encountered barriers to accessing dental services. Eighty (20.8 %) male students visited dental facilities more often than female students (72 [18.7 %]) within a 6-month period. Approximately 21 % of students had never visited a dental facility. The lowest number of preventive treatments were administered (15.4 %). Parents and guardians reported that private dental facilities were more accessible (185 [48 %]) than government dental facilities. There was an association between dental facilities and difficulties in accessing dental care services (χ2(4) = 42.753; p < 0.001). In conclusion, parents and guardians reported experiencing difficulties accessing dental services. However, parents and guardians must change their perspectives on accessibility, particularly for preventative care, because primary school children received the lowest

Resin-based dental materials containing 3-aminopropyltriethoxysilane modified halloysite-clay nanotubes for extended drug delivery

OBJECTIVE: To synthesize and characterize a novel resin-based dental material containing 3-aminopropyltriethoxysilane (APTES) surface-modified halloysite-clay nanotubes (HNTs) for long-term delivery of guest molecules. METHODS: The optimal concentrations of HNT (10, 15, 20 wt.%) and silane (0, 2, 4 vol.%sil) to be incorporated into the resin-based materials were determined (15 wt.%HNT, 4 vol.%sil) after assessment of the mechanical properties (DC%, degree of conversion; FS, flexural strength; FM, flexural modulus; and UTS, ultimate tensile strength). The HNTsil-powder was loaded with chlorhexidine (CHX) to evaluate the effect of the silanization on drug release. Resin-discs were prepared for the following groups: RES (resin), HNT (resin+15 wt.%HNT), HNTsil (resin+15 wt.%HNT silanized), HNT-CHX (resin+15 wt.%HNT loaded with chlorhexidine), HNTsil-CHX (resin+15 wt.%HNTsil-CHX), and 0.2 vol.%CHX (resin+0.2 vol.%CHX solution). Specimens were stored in water for 1, 3, 5, 10, and 15 days at 37 °C. Aliquots from each time point and the final 15-day specimens were evaluated for the zone of inhibition (ZOI) against Streptococcus mutans. CHX release was analyzed using spectrophotometry at absorbance of 300 nm. Data were statistically analyzed (α = 0.05). RESULTS: All materials presented similar DC%. Reduced FS but increased FM was detected for 20 wt.%HNT-4%APTES. Groups with 15 wt.% and 20 wt.%HNT with/without APTES presented higher values of UTS. Agar diffusion data indicates that the HNTsil-CHX had a greater ZOI than all other groups over 15 days. HNTsil-CHX had the highest absorbance for day 1 but presented similar values to other groups every time point after. SIGNIFICANCE: Silanization of nanotubes followed by encapsulation of chlorhexidine is a promising technique for long-term delivery of guest molecules

Chlorhexidine-modified nanotubes and their effects on the polymerization and bonding performance of a dental adhesive

Objectives. The purpose of this study was to synthesize chlorhexidine (CHX)-encapsulated aluminosilicate clay nanotubes (Halloysite®, HNTs) and to incorporate them into the primer/adhesive components of an etch-and-rinse adhesive system (SBMP; Scotchbond Mul- tipurpose, 3M ESPE) and to test their effects on degree of conversion, viscosity, immediate and long-term bonding to dentin. Methods. CHX-modified HNTs were synthesized using 10% or 20% CHX solutions. The primer and the adhesive components of SBMP were incorporated with 15 wt.% of the CHX- encapsulated HNTs. Degree of conversion (DC) and viscosity analyses were performed to characterize the modified primers/adhesives. For bond strength testing, acid-etched dentin was treated with one of the following: SBMP (control); 0.2%CHX solution before SBMP; CHX-modified primers + SBMP adhesive; SBMP primer + CHX-modified adhesives; and SBMP primer + CHX-free HNT-modified adhesive. The microtensile bond strength test was performed after immediate (24 h) and long-term (6 months) of water storage. Data were analyzed using ANOVA and Tukey ( ̨ = 5%) and the Weibull analysis. Results. DC was greater for the CHX-free HNT-modified adhesive, whereas the other exper- imental adhesives showed similar DC as compared with the control. Primers were less viscous than the adhesives, without significant differences within the respective materials. At 24 h, all groups showed similar bonding performance and structural reliability; whereas at the 6-month period, groups treated with the 0.2%CHX solution prior bonding or with the CHX-modified primers resulted in greater bond strength than the control and superior reliability. Significance. The modification of a primer or adhesive with CHX-encapsulated HNTs was an advantageous approach that did not impair the polymerization, viscosity and bonding performance of the materials, showing a promising long-term effect on resin-dentin bonds