Dual function of proanthocyanidins as both MMP inhibitor and crosslinker in dentin biomodification: A literature review

Abstract

Proanthocyanidin, a natural phytochemical bioactive agent, simultaneously can silence the activity of dentinal proteases and crosslink the collagen matrix; both of these phenomena would be the fundamentals for bio-stability of resin-dentin interface which is essential for a promising adhesive dentistry. This review provides an overview of the data developed by different groups of researchers and highlighted topics are proanthocyanidin chemistry, natural resources and the unique interactions between proanthocyanidincollagen and proanthocyanidin-MMPs in dentin. Besides, clinical applications of proanthocyanidin in the form of proanthocyanidincontaining adhesives, preconditioners and etchants have been reviewed. One hundred and twelve studies have been published in peer-reviewed journals from 1981 to 2017, all were comprised in this review, some of them have been actually proven to be promising from clinical point of view and others need further assessment before their adoption as clinically practicable protocols.

Effect of proanthocyanidin mediated immediate and delayed dentin sealing on the strength of premolars restored with composite resin inlay

“…However, a previous study (Brigagão et al) indicated that in the case of DDS technique, rinsing after etching (with acid or polyacrylic) could remove contaminants from the temporary cement and improve adhesion and bond strength to dentin (21). Moreover, since the bio-modification effect of PA is on demineralized dentin, it might not be applicable with SE adhesives (15). Accordingly, a PA/acid-etch group (with total etching of the enamel and dentin surfaces) was included in this study, based on the possible beneficial effect of acid-etching.…”

“…Therefore, including an antibacterial agent in the IDS technique could have beneficial effects. In addition to its antibacterial effect, the multifunctionality of proanthocyanidin from grape seed extract (PA) as a matrix metalloproteinase (MMP) inhibitor, collagen cross-linker, and antioxidant could make it attractive during cementation (13)(14)(15). The proanthocyanidin from grape seed extract (PA) is a flavanol compound that has a high affinity for proline-rich proteins, such as collagen.…”

“…The interaction mechanism of PA with collagen is covalent and hydrophobic bonds, ionic interaction and hydrogen bonding. In additon to its antibacterial effect, multifunctionality of PA as a matrix metalloproteinase (MMP) inhibitor, collagen cross-linker and antioxidant, could make it attractive during cementation (13,15). PA can improve the elastic modulus and stiffness of the collagen matrix and increase the mechanical properties of demineralized dentin (13,15).…”

“…In additon to its antibacterial effect, multifunctionality of PA as a matrix metalloproteinase (MMP) inhibitor, collagen cross-linker and antioxidant, could make it attractive during cementation (13,15). PA can improve the elastic modulus and stiffness of the collagen matrix and increase the mechanical properties of demineralized dentin (13,15). In this sense, dentin pretreatment with PA was found to enhance the bond strength of etch-and-rinse (E&R) adhesives (15).…”

“…PA can improve the elastic modulus and stiffness of the collagen matrix and increase the mechanical properties of demineralized dentin (13,15). In this sense, dentin pretreatment with PA was found to enhance the bond strength of etch-and-rinse (E&R) adhesives (15). On the other hand, some authors suggested the application of E&R adhesive system before to SA cements to improve dentin bond strength (16).…”