Effect of Bioactive Primers on Bacterial-Induced Secondary Caries at the Tooth-Resin Interface

Abstract

Summary Secondary caries at the tooth-resin interface is the primary reason for replacement of resin composite restorations. The tooth-resin interface is formed by the interlocking of resin material with hydroxyapatite crystals in enamel and collagen mesh structure in dentin. Efforts to strengthen the tooth-resin interface have identified chemical agents with dentin collagen cross-linking potential and antimicrobial activities. The purpose of the present study was to assess protective effects of bioactive primer against secondary caries development around enamel and dentin margins of class V restorations, using an in vitro bacterial caries model. Class V composite restorations were prepared on 60 bovine teeth (n=15) with pretreatment of the cavity walls with control buffer solution, an enriched fraction of grape seed extract (e-GSE), 1-ethyl-3-(3-dimethyl aminopropyl)-carbodiimide/N-hydroxysuccinimide, or chlorhexidine digluconate. After incubating specimens in a bacterial model with Streptococcus mutans for four days, dentin and enamel were assessed by fluorescence microscopy. Results revealed that only the naturally occurring product, e-GSE, significantly inhibited the development of secondary caries immediately adjacent to the dentin-resin interface, as indicated by the caries inhibition zone. No inhibitory effects were observed in enamel margins. The results suggest that the incorporation of e-GSE into components of the adhesive system may inhibit secondary caries and potentially contribute to the protection of highly vulnerable dentin-resin margins.

Dimeric Proanthocyanidins on the Stability of Dentin and Adhesive Biointerfaces

“…In the present study, PACs were not incorporated into the adhesive resin blend; instead, their use as rinse-out primer enabled unbound PACs to be removed. This approach can reinforce and stabilize the anchoring ECM and underlying dentin (Leme et al 2015) and minimize the risk of secondary caries adjacent to the restoration margins (Kim et al 2017).…”

Adhesive systems modified with antimicrobial agents: a literature review

“…59 The use of antimicrobial agents pre-treating the dentin before adhesive procedures are poly (ɛ-prolactone) nanocapsules loaded with chlorhexidine (nano PCL/ CHX), 47 nanoparticles of poly (lactic-co-glycolic acid) loaded with chlorhexidine (nano PLGA-CHX), 46 and grape seed extract (e-GSE). 60…”

“…44,46,47 Another agent previously used for the application of the adhesive was the grape seed extract, which inhibited secondary caries in the adhesive interface. 60 On the other hand, it increases the number of operative steps, possibly overlapping the benefits with the increasing clinical time.…”

Evidence to the role of interflavan linkages and galloylation of proanthocyanidins at sustaining long-term dentin biomodification

“…In addition to the mechanical enhancement of the dentin matrix, there is considerable evidence for the direct effect of PACs in the inactivation of key endogenous dentin proteases [4,7] involved in caries progression and degradation of the dentin-resin interface [8,9]. Matrix metalloproteinases (MMPs) [10,11] are compromising the stability of collagen at the dentin-resin interface and, thus, can shorten the service-life of resin composite restorations [12].…”