Toward dental caries: Exploring nanoparticle-based platforms and calcium phosphate compounds for dental restorative materials

Abstract

Millions of people worldwide suffer from a toothache due to tooth cavity, and often permanent tooth loss. Dental caries, also known as tooth decay, is a biofilm-dependent infectious disease that damages teeth by minerals loss and presents a high incidence of clinical restorative polymeric fillings (tooth colored fillings). Until now, restorative polymeric fillings present no bioactivity. The complexity of oral biofilms contributes to the difficulty in developing effective novel dental materials. Nanotechnology has been explored in the development of bioactive dental materials to reduce or modulate the activities of caries-related bacteria. Nano-structured platforms based on calcium phosphate and metallic particles have advanced to impart an anti-caries potential to restorative materials. The bioactivity of these platforms induces prevention of mineral loss of the hard tooth structure and antibacterial activities against carries-related pathogens. It has been suggested that this bioactivity could minimize the incidence of caries around restorations (CARS) and increase the longevity of such filling materials. The last few years witnessed growing numbers of studies on the preparation evaluations of these novel materials. Herein, the caries disease process and the role of pathogenic caries-related biofilm, the increasing incidence of CARS, and the recent efforts employed for incorporation of bioactive nanoparticles in restorative polymer materials as useful strategies for prevention and management of caries-related-bacteria are discussed. We highlight the status of the most advanced and widely explored interaction of nanoparticle-based platforms and calcium phosphate compounds with an eye toward translating the potential of these approaches to the dental clinical reality.

Novel Bioactive and Therapeutic Root Canal Sealers with Antibacterial and Remineralization Properties

“…Quaternary ammonium compounds have been developed and chemically incorporated into various polymeric resin matrices of dental materials [50][51][52][53][54]. These compounds can produce long term antibacterial effects without leaching out and becoming depleted over time through the formation of cross-links with other compounds [54,55]. The mechanism of action of QACs is identified as contact-inhibition [55].…”

“…Their major benefits are to produce high pH and calcium and phosphate ion release to promote mineralized tissue formation [70]. Recently, Inorganic fillers were incorporated into polymeric resin matrices and tested for their potential to release high levels of Ca and P ions and strengthen the tooth root structure [54]. Fillers such as dicalcium phosphate dihydrate (DCPD), dicalcium phosphate anhydrous (DCPA) and tetracalcium phosphate (TTCP), alpha tricalcium phosphate (α-TCP) have previously shown their potential to release high levels of calcium and phosphate ions and remineralize enamel and dentin lesions [32,[71][72][73].…”

“…Amorphous calcium phosphate (ACP) particles have been previously incorporated into various dental resins [53,58,75,76]. ACP is the initial phase that forms and then transfers into the more stable Hydroxyapatite [HA: Ca 10 (PO 4 ) 6 (OH) 2 ], through the precipitation of calcium and phosphate ions in supersaturated levels [54]. In fact, previous studies have shown the ability of ACP containing materials to release high levels of Ca and PO 4 ions in aqueous environments, necessary to remineralize the enamel lesions and dentin lesions [77].…”

Application of Antibiotics/Antimicrobial Agents on Dental Caries

“…e primary evidence in support of this view can be traced back to the results of a number of classic experiments, such as (1) bacteria isolated from the oral cavity can demineralize the enamel and dentin in vitro; (2) in a hamster model, extensive caries can develop in erupted molars, while unerupted molars remain caries-free until they were exposed to the oral microbiota; and (3) germ-free rats failed to develop caries even when maintained on a cariogenic diet, while control animals developed extensive decay when fed the same diet. In light of these data, the use of antibiotics or antimicrobial agents is an effective strategy for the prevention and treatment of dental caries [17][18][19][20][21].…”

Efeito de sistemas elétricos de escovação sobre a superfície do esmalte e do cemento hígido e desmineralizados: Estudo in vitro

“…Apesar dos avanços tecnológicos atuais, aplicados à manutenção da saúde bucal, a desmineralização dos tecidos dentais mineralizados, especialmente o esmalte e a dentina, ainda é um problema crescente (Abou Neel et al, 2016). A lesão de mancha branca constitui a primeira manifestação clínica da doença cárie e se apresenta como uma opacidade localizada no esmalte, decorrente de eventos físico-químicos causados por ácidos produzidos pelas bactérias cariogênicas (Roveri et al, 2009;Cohen-Carneiro et al, 2014;Subramaniam et al, 2014; Enax e Epple, 2018) que, se não tratada, pode evoluir para cavitação (Papadimitriou et al, 2016;Schwendicke et al, 2016;Balhaddad et al, 2018;Leitão et al, 2018). A escovação dentária constitui-se em um procedimento mecânico diário, para controle do biofilme dentáro cariogênico (Hovliaras et al 2015;de Jager et al, 2017) que pode, no entanto, ocasionar desgaste nos tecidos dentais mineralizados (Ganss et al, 2009).…”