Review on fluoride-releasing restorative materials--fluoride release and uptake characteristics, antibacterial activity and influence on caries formation.

Recent research has led to a better but as yet incomplete understanding of the complex roles osteopontin plays in mammalian physiology. A soluble protein found in all body fluids, it stimulates signal transduction pathways (via integrins and CD44 variants) similar to those stimulated by components of the extracellular matrix. This appears to promote the survival of cells exposed to potentially lethal insults such as ischemia/reperfusion or physical/chemical trauma. OPN is chemotactic for many cell types including macrophages, dendritic cells, and T cells; it enhances B lymphocyte immunoglobulin production and proliferation. In inflammatory situations it stimulates both pro- and anti-inflammatory processes, which on balance can be either beneficial or harmful depending on what other inputs the cell is receiving. OPN influences cell-mediated immunity and has been shown to have Th1-cytokine functions. OPN deficiency is linked to a reduced Th1 immune response in infectious diseases, autoimmunity and delayed type hypersensitivity. OPN's role in the central nervous system and in stress responses has also emerged as an important aspect related to its cytoprotective and immune functions. Evidence suggests that either OPN or anti-OPN monoclonal antibodies (depending on the circumstances) might be clinically useful in modulating OPN function. Manipulation of plasma OPN levels may be useful in the treatment of autoimmune disease, cancer metastasis, osteoporosis and some forms of stress.

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Osteopontin: Role in immune regulation and stress responses

Direct comparison of the bond strength results of the different test methods: A critical literature review

Purpose: This overview presents a description of organofunctional trialkoxysilane coupling agents (silanes), their chemistry, properties, use, and some of the main clinical experiences in dentistry. Materials and Methods: The main emphasis was on major dental journals that have been reviewed from 1958 up to the latest research news from 2002. A MEDLINE search with the key words “dental silanes” was used. Special silane literature and journals outside dentistry were also cited. Results: The main emphasis is on the use of silanes in prosthetic and restorative dentistry. Clinical relevance was based mainly on either short- or long-term tests. The interpretation of various results is not given, mainly because of controversial observations that may be very difficult to explain. Nevertheless, the majority of the clinical results pointed to silanes playing a significant role in the adhesion process. Silane reaction mechanisms were not entirely understood, and there exist several theories for bonding mechanisms for silanes and substrates. Conclusion: Dental materials offer a continuously challenging forum for silanes, and silanes will play an essential role in material development. Publ. in: Int J Prosthodont 2004;17:155–164.

An Introduction to Silanes and Their Clinical Applications in Dentistry

Biomaterials for the restoration of oral function are prone to biofilm formation, affecting oral health. Oral bacteria adhere to hydrophobic and hydrophilic surfaces, but due to fluctuating shear, little biofilm accumulates on hydrophobic surfaces in vivo. More biofilm accumulates on rough than on smooth surfaces. Oral biofilms mostly consist of multiple bacterial strains, but Candida species are found on acrylic dentures. Biofilms on gold and amalgam in vivo are thick and fully covering, but barely viable. Biofilms on ceramics are thin and highly viable. Biofilms on composites and glass-ionomer cements cause surface deterioration, which enhances biofilm formation again. Residual monomer release from composites influences biofilm growth in vitro, but effects in vivo are less pronounced, probably due to the large volume of saliva into which compounds are released and its continuous refreshment. Similarly, conflicting results have been reported on effects of fluoride release from glass-ionomer cements. Finally, biomaterial-associated infection of implants and devices elsewhere in the body is compared with oral biofilm formation. Biomaterial modifications to discourage biofilm formation on implants and devices are critically discussed for possible applications in dentistry. It is concluded that, for dental applications, antimicrobial coatings killing bacteria upon contact are more promising than antimicrobial-releasing coatings.

Biofilm Formation on Dental Restorative and Implant Materials

Fluoride release and recharge in giomer, compomer and resin composite

Determination of fluoride ions released from resin-based dental materials using ion-selective electrode and ion chromatograph

The purpose of this study was to analyse quantitatively the early bacterial plaque formed on resin composite and human enamel in vivo, using a confocal laser scanning microscope. Test pieces of resin composite and human enamel were retained at the buccal surfaces of the upper first molars of three volunteers for 4, 8 and 24 h to allow plaque formation. Then, the specimens were immersed in propidium iodide in phosphate-buffered saline to stain adherent bacteria and observed with a confocal laser scanning microscope. The ratios of the area occupied by microorganisms to the whole area of the optical field were calculated using a photo-image analysis system. The thickness of the plaque was also measured. Quantitative analysis revealed that the resin composite showed significantly higher bacterial adherence than human enamel throughout the test period. A difference was noticed in the morphology of the bacteria between the two groups. Our findings suggest that resin composite shows higher bacteria adherence during early plaque formation compared with human enamel. In addition, the present findings may suggest a presence of the difference in bacterial composition of plaque in both specimens.

Confocal laser scanning microscopic analysis of early plaque formed on resin composite and human enamel

This investigation evaluated the fluoride-releasing properties of various fluoride-releasing restorative materials, including resin-modified glass-ionomer cements (Fuji ionomer TypeII LC, Photac-Fil Aplicap, Vitremer), compomers (Ionosit FIL, Compoglass, Dyract) and fluoride-releasing resin composites (Heliomolar radiopaque, Degufill mineral). The study also estimated the effects of those materials on the inhibition of artificial secondary caries around restorations using a bacterial caries-inducing system. The amount of fluoride released from the materials in deionized water was measured every one week for 10 weeks. Class V cavities with the gingival margin located in the root were prepared in extracted human premolars and restored with each of the materials. The restored teeth were incubated in the bacterial artificial caries chamber, and the artificial lesion created around the restoration was observed microradiographically. The resin-modified glass-ionomer cements released the largest amount of fluoride and created a thick radio-opaque zone in the artificial lesion along the restoration-dentin interface. These results indicated that the fluoride-releasing restorative materials have the potential to inhibit secondary caries formation around restorations. Resin-modified glass-ionomer cements presented a particularly strong effect, compared with compomers and fluoride-releasing resin composites.

Inhibition of artificial secondary caries in root by fluoride-releasing restorative materials.

This study investigated the influence of natural saliva of varying pH on surface biofilm formation of restorative materials and how this influenced fluoride release. Columnar specimens of glass ionomer cement (GIC), resin modified glass ionomer cement (RMGIC), compomer, giomer and composite, were prepared, matured for 24 h at 37 °C and 100% humidity, lapped and then placed in natural stimulated saliva with a pH of 3.8 or 7.1. Fluoride release was determined daily using an ion-selective electrode. The surfaces of selected specimens were observed using Confocal Laser Scanning Microscopy in conjunction with a fluorescent dye. The surface biofilm formation and bacterial growth was most dominant under neutral conditions and on the surfaces of GICs compared with other materials. GICs released significantly higher amounts of fluoride than other materials. The results suggest that the increased fluoride release of GICs did not reduce the amount of bacterial growth and biofilm formation on the surfaces of these materials when stored in natural saliva.

Toshiyuki Itota

Papers

Fluoride release and recharge in giomer, compomer and resin composite

Determination of fluoride ions released from resin-based dental materials using ion-selective electrode and ion chromatograph

Confocal laser scanning microscopic analysis of early plaque formed on resin composite and human enamel

Inhibition of artificial secondary caries in root by fluoride-releasing restorative materials.

Fluoride release for restorative materials and its effect on biofilm formation in natural saliva