Biodegradation Mechanisms of Restorative Dental Resin Composites

  Vol. 64, No. 1, Januari-April 2015 | Hal. 25-29 | ISSN 0024-9548

Biodegradation Mechanisms of Restorative Dental

Resin Composites

  H.D.K. Yulianto Department of Biomedical Science and Technology Faculty of Den stry, Universitas Gadjah Mada Yogyakarta-Indonesia Correspondence

  : H.D.K. Yulianto, c/o: Bagian Biomedik, Fakultas Kedokteran Gigi Universitas Gadjah Mada. Jl. Denta I, Sekip Utara Yogyakarta 55281, Indonesia. E-mail: dedykusuma@ugm.ac.id ABSTRACT

Bacground: Sometime di ffi cult question related with the survival time of dental resin composite restoration arises from our patient

a ft er their teeth has been restored with dental resin composites. Of course, precise time of the dental resin composite restoration

maintained in their original shape cannot exactly be estimated. Although there are a number of di ff erent reasons as to why we cannot

precisely estimate the survival time of dental resin composite restoration, the summarizing answer is brief: “The biodegradation

process of dental resin composite is complex and includes several various factors.” Purpose: to review the relationship of mechanical,

physical and mechanical factors in the role of the biodegradation of restorative dental resin composites. Literature review:

Combinations of mechanical, chemical, and biological factors in oral environment have been identifi ed as the important factors

associated with decreasing surface properties and lost of their original shape. Initially during the biodegradation process of dental

resin composite, small fraction of material component are detached from the surface, leaving various rough in the surface of the

restoration. Surface roughness above the critical threshold value leads the adhesion of bacterial and biofi lm formation on the dental

resin composite surface. Once again, the question associated with the precise mechanism of bacterial adhesion and biofi lm formations

on the dental resin composite surface have not yet been identifi ed. Since the knowledge currently available about the biodegradation

mechanism of dental resin composite still limited, more research is needed in this fi eld. Conclusion: Oral environmental changes

within a restorative dental resin composites may a ff ect the longevity of the composite restoration. The combination of mechanical

and chemical factors is an important key to the role of the biodegradation material in oral environment.

  Keywords: Dental resin composite; biodegradation; surface properties; oral environment ABSTRAK

Latar belakang: Beberapa pasien sering menanyakan “berapa lama restorasi resin komposit tetap bertahan dan tidak terlepas ?”.

  

Pertanyaan ini tidak bisa d ij awab secara akurat dalam satuan waktu karena proses biodegradasi restorasi resin komposit dalam

rongga mulut sangat komplek dan melibatkan interaksi dari banyak faktor. Tujuan: Studi pustaka ini bertujuan untuk mempelajari

hubungan antara faktor mekanis, fi sik, dan kimiawi terhadap proses biodegradasi tumpatan resin komposit di dalam rongga mulut.

  

Tinjauan pustaka: Kombinasi antara faktor mekanik, fi sik dan kimia di lingkungan rongga mulut telah diidentifi kasi sebagai

faktor penting yang terkait dengan perubahan struktur dan komposisi permukaan material restorasi resin komposit, sehingga

secara klinis akan terlihat perubahan bentuk secara anatomi yang sedikit berbeda dari bentuk aslinya. Proses awal yang terjadi

selama proses biodegradasi restorasi resin komposit gigi adalah terlepasnya sebagian kecil dari komponen material dari permukaan

restorasi, sehingga meninggalkan kekasaran permukaan yang bervariasi tingkat kekasarannya di seluruh permukaan restorasi.

  

Kekasaran permukaan mempunyai nilai ambang batas kritis yang mampu menyebabkan bakteri terakumulasi dan membentuk

biofi lm. Adhesi bakteri dan pembentukan biofi lm merupakan proses yang cukup rumit dan diprediksi mempunayi keterkaitan

dengan proses biodegradasi restorasi resin komposit. Pertanyaan terkait dengan mekanisme yang tepat dari proses adhesi bakteri

dan pembentukan biofi lm pada permukaan restorasi resin komposit belum mendapat jawaban yang akurat, karena pengetahuan

  Yulianto: Biodegrada on Mechanisms of Restora ve Dental Resin Composites Jurnal PDGI 64 (1) Hal. 25-29 © 2015

tentang mekanisme biodegradasi restorasi resin komposit masih terbatas, sehingga penelitian lebih lanjut diperlukan di bidang ini.

  Composites allow the possibility of preserving sound tooth structure during cavity preparation.

  that clinically resulted various phenomena of failure, such as: discoloration, wear, ditching at the margins, delamination or simply fracture which may result in secondary dental caries.

1 Currently, composite resin

  12,13 Ini Ɵ al biologic responses to resin composite surfaces

  The dental enamel and resin composite surface is a part that is always in contact with internal environment of oral cavity. Saliva, biofilm, and mastication force are identified as important contributing factors on dental resin composite biodegradation process. Resin composite surface is always encircled with saliva and form a thin layer of salivary pellicle, in which will promote adherence of oral bacteria. Adhesion of oral bacteria to salivary pellicle-coated tooth surface is critical step for oral bacteria colonization to form biofi lm.

  the ability to bind to the dental hard tissues through the adhesive material.

  3,4

  

Simpulan: Perubahan lingkungan rongga mulut terhadap restorasi resin komposit diprediksi mempunyai pengaruh yang signifi kan

terhadap “keawetan” restorasi resin komposit. Kombinasi antara faktor mekanik, fi sik dan kimia merupakan kunci penting yang

berperan terhadap proses biodegradasi restorasi resin komposit di rongga mulut.

  called minimal invasive dentistry.

  2

  is still the main option for restoring dental hard tissue damage due to the process of caries. It is not only brought a change in materials and techniques but also a change in treatment philosophy

  Dental caries is a major cause of tooth decay for most of Indonesian population. The main cause of dental caries is the a tt achment of bacteria that form biofi lms on the surface layers of hard and so ft tissues oral cavity.

  INTRODUCTION

  Kata kunci: Material restorasi resin komposit; biodegradasi; sifat dan karakter permukaan; lingkungan rongga mulut

  10,19

5 Composites resins have

6 Furthermore, composite

  8

  of numerous species of cariogenic bacteria will promote maturation of biofi lm. These biofi lm will easily trapped on the groove of rough surface that is resulted from degradation process by salivary enzyme like cholinesterase (CE),

  resin represents a signifi cant aesthetic treatment option, enabling the fabrication of restorations with a natural appearance.

  7 Table 1. Summary of the improvement of dental resin composite for which di ff erent material proper es has been found ¹⁴ Year

  25-27

  explanation are: (1) microbial binding strength is lower on low-energy surfaces. (2) High surface- free energy microorganism binds with high-energy surfaces and vice versa. (3) The surface free energy regulates the adhesive strength of pellicle against the shear detachment forces. (4) The increased surface area and decreased protruding height of well-spread cells may produce a geometric confi guration with

  24 The possible

  studies showed that in supragingival regions, roughness contribute more to plaque formation than does the surface free energy.

  vivo

  thereby promoting maturation. The a tt achment of bacteria on the teeth/ resin composite/ other restorative materials depend on surface roughness and surface free energy. In

  17

  23 Adhesion and maturation

  i.e.: mechanical degradation,

  Biofilm adsorption depends on biologic flow rate at the site of contact, the type of interfacial interaction involved, and attachment strength with the substrate.

  15,20-22

  Material Improvement 1950 glass fi lled PMMA 1960

  PMMA Æ Bis GMA 1970 Filler: macrofi ll Æ microfi ll 1980 macrofi ll Æ hybrid; direct Æ indirect; hybrid Æsmall particles

  1990 fl owables and packable 2000 microfi ll Æ nanofi ll 2010 self adhesive 2011

  Nanofi ller 2012-2014 nanofi ller hybrid, nanocluster fi ller

  Dynamic changes of oral environment are infl uenced by food components, beverages, temperature changes, chewing, saliva and bacterial activity. Those factors have important role in the degradation of composite

  10,11

  Table 1 summarizes the improvement of physical and mechanical properties of dental resin composite. As can be seen, although marked improvements have been noted in terms of physical and mechanical properties during the last 10-20 years, several factors in dynamic oral environment can degrade the composite matrix via three principal modes,

  9

  physical degradation and chemical degradation.

  Yulianto: Biodegrada on Mechanisms of Restora ve Dental Resin Composites Jurnal PDGI 64 (1) Hal. 25-29 © 2015 Prolonged biologic responses

  Mastication forces during mastication process will result various degree of surface roughness on the dental resin composite surface. Surface roughness and porosity are important factors to be determined when the material is subject to the oral biological environment. At high fl ow rate, surface roughness and porosity produce local fl uid motions of enhanced or reduced shear and will a

  Numerous different in vitro models were developed to evaluate the effect of the oral environment on dental resin composite and each model proposed to simulate different factors. However, In vitro aging models for composites study only single factors thus lacking the synergy of factors operative in the oral cavity. Some studies has been widely demonstrated the bacterial a tt achment on the dental resin composite surfaces, however the molecular and physical interactions that govern bacterial adhesion to dental resin composite have not been understood in detail. Conditioning fi lm is likely to change the physicochemical properties of resin composite and infl uence bacterial a tt achment.

  Aging of composite resins in the oral cavity is very complex as depicted in Figure 1. Thermal changes, food, beverages, saliva, temperature will degrade composite restoration.

  DISCUSSION

  di ff er among brands, the salivary adsorption of composite may result di ff erent amount and patt ern. Once in contact with resin composite surface, saliva is able to form adsorbed layers that are termed as conditioning fi lm. Development of conditioning surface is considered as an initial stage in the process of biofi lm formation.

  29 As the composition of composite may

  the amount and the pa tt ern of protein adsorbtion onto the material surface is specifi c to the type of material,

  35 Previous study showed that

  Cholesterol esterase (CE) and pseudocholinesterase (PCE) can hydrolyze bis-GMA and TEGDMA matrix synthetics monomer.

  32-34

  ff ect bacterial adhesion mediated by hydrophobic interactions.

  salivary esterase, sucrose (glucan)-independent, aglutinins, proline-rich proteins, and mucins. Albumin plays a role in the adsorption and accumulation of bacteria on hard surfaces. Albumin is an inhibitor of hydrophobic interactions and will a

  29

  role in a tt achment of bacteria and biodegradation process are: albumin,

  31 The component of saliva that plays an important

  The a tt ached biofi lm on resin composite and tooth surface can be classifi ed as “retained biofi lm” and “detached biofi lm”. Biofi lm a tt achment is predicted not only by single factor but might be come from several factors that will contribute together, like fi ller size, type of matrix monomer, surface roughness, and amount of unpolymerized monomers. The fi ller size and type of matrix monomer are depending on the type of resin composite material.

27 The role of surface roughness in biofi lm formation

24 Hydrophobic surface located supraginggivaly

  The progression of a rough dental resin composite caused by mechanically wear process (adhesion, abrasion, fatigue, corrosion) has also been associated with biofi lm formation.

  ff ect the shape, distribution, and aggregation of the a tt aching particles. At low fl ow rate or under static conditions, the grooves of rough surface may act as stagnation points, therefore promoting biofi lm maturation.

  has been widely investigated. Smooth polished surface of restoration have been shown to a tt ract less biofi lm in vivo compared to rough surface.

  a tt ract less biofi lm in vivo than more hydrophilic surfaces over a 9-day period. Increasing both surface energy and surface roughness above the threshold value were found to result more biofi lm accumulation on dental resin composite surfaces.

18 Bioadhesive activity of biofilm in biological

  29,30,31

  environment depends on composition of outer monolayer and surface reactivity of outer monolayer. It can be explained that the material with high bioadhesive will increase surface tension and vice versa.

  29 Interaction between mastication force–saliva–

  biofilm is illustrated as chain “positive feedback

  loop”

  , which can be explained if there is one factor diminished, the chain will be broken.

  Effect of surface properties on biofilm forma Ɵ on

  Initial bacterial adhesion is the fi rst step in the plaque formation and is facilitated by electrostatic i n t e r a c t i o n s , h y d r o d y n a m i c i n t e r a c t i o n s , thermodynamic binding parameters, specifi c binding mechanism, and cementation by polysaccharide matrices or glucans. Extracellular polysaccharide or glucan is produced by bacteria and will provide barrier protection for trapped organic acid. Organic acid that is trapped within glucan barrier, resulting prolonged low pH around resin composite and tooth surfaces.

  28 High adhesion capability is one of the factors that determine the virulence of bacteria.

  Yulianto: Biodegrada on Mechanisms of Restora ve Dental Resin Composites Jurnal PDGI 64 (1) Hal. 25-29 © 2015

  40 chlorhexidine diacetate.

  Figure 1. Three essential factors that contribute to the biodegrada on of dental resin composites.

  8. Ferracane JL. Elution of leachable components from composite. J Oral Rehabil 1994; 21: 441-52. ^{Mechanical Factors (Brushing, Toothpaste, oclusion wear, tongue friction, food friction) Physical Factors (Hydrolitic degradation: Sorption,} Dissolution, Elution) ^{Chemical Factors (Enzym from saliva, Bacterial, pH, Food & Beverages)}

  7. Gordan V, Mjør I, Blum I, Wilson N. Teaching students the repair of resin-based composite restorations: a survey of North American dental schools. J Am Dent Assoc 2003; 134: 317-23.

  6. Imazato S. Antibacterial properties of resin composites and dentin bonding systems. Dental Materials 2003; 19: 449–57.

  5. Leinfelder K. A conservative approach to placing posterior composite resin restorations. J Am Dent Assoc 1997; 127:743-8.

  4. Tyas MJ, Anusavice KJ, Frencken JE, Mount GJ. Minimal intervention dentistry - a review - FDI Commission Project 1-97. Int Dent J 2000; 50:1-12.

  3. Murdoch-Kinch MA, McLean ME. Minimally invasive dentistry. J Am Dent Assoc 2003; 134: 87-95.

  2. Roeters FJM, Opdam NJM, Loomans BAC. The amalgam- free dental school. J Dent 2004; 32: 371-7.

  1. Khalichi P, Cvitkovitcha DG, Santerre JP. Effect of composite resin biodegradation products on oral streptococcal growth. Biomaterials 2004; 25: 5467–72.

  REFERENCES

  Considering the fact that biodegradation of dental resin composites as a result of aging challenges their integrity and longevity over time the properties of composite still need to be improved. The information derived from role of biodegradation dental resin composite under in situ and in vitro aging model and the e ff ect of antibacterial agent will give scientifi c contribution on the development of antibacterial material to achieve clinically e ff ective materials and to develop an agent that in the future can be minimized the a tt achment of bacterial on dental resin composite restoration.

  several antibacterial agents are proved to have an antimicrobial effect, there are still problems introducing these antimicrobial agents into composites, such as the problem associated with reducing mechanical properties, polymer leakage, decrease of antimicrobial properties with time and reduced ability of the composite to light cure.

  Microorganisms in the oral environment not only form a biofi lm on all available surfaces, including hard and so ft tissue surfaces, but also on the surface of materials used for restoration of function or aesthetics.

  41 Although

  alkylated ammonium chloride derivatives,

  39

  43

42 Exposure to saliva and biofi lm

  lead to degradation of composite surfaces that may have increased roughness, sometimes accompanied by decreased microhardness and increased exposure of fi ller particles or matrix swelling.

  44,45

  The amount of unpolymerized monomer released is caused by hydrolase activity cholin esterase-like of saliva. The leaching of unpolymerized monomer in specifi c amount is the marker that indicates the composite biodegradation process.

36 Previous study showed that exposure to biofi lm

  is the best choice for in vitro aging of dental resin composite surfaces.

  in the oral environment, in situ studies that is used as a golden standard also has been done.

  both of exposure to biofi lm and in situ study still has limitations. The biofi lm study did not evaluate the role of each bacteria involved and the pa tt ern of biofi lm adsorption that may infl uence the aging of composite in these study. In the in situ study, the authors did not evaluate the e ff ect of saliva protein and enzyme and the effect of teeth/restoration cleaning on the aging of composite. Based on the limitation of biofi lm and in situ study, both of those studies is potential to be extended in the future research.

  Several strategies have been done to reduce or avoid formation of biofi lm on the dental resin composite surface by introducing antibacterial agents into dental composite.

  37

  i.e.: silver and titanium,

  38

  quaternary ammonium polyethylenimine nanoparticles,

16 To refl ect what actually occurs

16 However,

  Yulianto: Biodegrada on Mechanisms of Restora ve Dental Resin Composites Jurnal PDGI 64 (1) Hal. 25-29 © 2015

  J Dent Res 2004; 83(1): 22-6.

  29. Steinberg D, Eyal S. Early formation of Streptococcus sobrinus biofi lm on various dental restorative materials.

  Journal of Dentistry 2002; 30: 47-51.

  30. Schilling KM, Bowen WH. Glucans synthesized in situ in experimental salivary pellicle function as specifi c binding sites for Streptococcus mutans. Infect Immun 1992; 60: 284 -95.

  31. Ikeda M, Matin K, Nikaido T, Foxton RM, Tagami J. E ff ect of surface characteristics on adherence of S. mutans biofi lms to indirect resin composites. Dent Mater J 2007; 26(6): 915-23.

  32. Satou J, Fukunaga A, Morikawa A, Matsumae I, Satou N, Shintani H. Streptococcal adherence to uncoated and saliva-coated restoratives. J Oral Rehabil 1991; 18: 421-9.

  33. Gibbons RJ, Etherden I. Albumin as a blocking agent in studies of streptococcal adsorption to experimental salivary pellicles. Infect Immun 1985; 50: 592-4.

  34. Rosenberg M, Buivids IA, Ellen RP. Adhesion of Actinomyces viscosus to porphyromonas (bacteriodes) gingivalis-coated hexadecane droplets. Bacteriology 1991; 173: 2581-9.

  35. Finer Y, Santerre JP. Salivary esterase activity and its association with the biodegradation of dental composite.

  36. Khalichi P, Cvitkovitch DG, Santerre JP. Effect of composite resin biodegradation products on oral streptococcal growth. Biomaterials 2004; 25: 5467-72.

  Surface properties determine bioadhesive outcomes: methods and results. J Biomed Mater Res 1984; 18: 337-

  37. Jandt KD, Sigusch BW. Future perspective of resin-based materials. Dental Material 20092; 5: 1001-6.

  38. Jandt KD, Al-Jasser AMO, Al-Ateeq K, Vowles RW, Allen GC. Mechanical properties and radiopacity of experimental glass-silica–metal hybrid composites. Dent Mater 2002; 6: 429–35.

  39. Beyth N, Yudovin-Farber I, Bahir R, Domb AJ, Weissa E.

  Antibacterial activity of dental composites containing quaternary ammonium polyethylenimine nanoparticles against Streptococcus mutans. Biomaterials 2006; 21: 3995–4002.

  40. Kim O, Shim WJ. Studies on the preparation and dental properties of antibacterial polymeric dental restorative composites containing alkylated ammonium chloride derivatives. J Polym Res Taiwan 2001; 1: 49–57.

  41. Leung D, Spra tt DA, Pratt en J, Gulabivala K, Mordan NJ, Young AM. Chlorhexidine-releasing methacrylate dental composite materials. Biomaterials 2005; 34: 7145–53.

  42. Bouschlicher MR, Reindhardt JW, Vargas MA. Surface treatment techniques for resin composite repair. Am J Dent 1997; 10: 279-83.

  43. Fúcio Z, Carvalho FG, Sobrinho LC, Sinhoreti M, Puppin- Rontani RM. The infl uence of 30-day-old Streptococcus mutans biofi lm on the surface of esthetic restorative materials--An in vitro study. J Dent 2008; 36: 833-9.

  44. Göpferich A. Mechanisms of polymer degradation and erosion. Biomaterials 1996; 17: 103-14.

  55.

  28. Baier RE, Mayer AE, Natiella JR, Natiella PR, Carter JM.

  9. Mair L, Stolarski T, Vowlest R, Lloyd C. Wear: mechanisms, manifestations and measurement. Report of a workshop. J Dent 1996; 24: 141-8.

  J Dent Res 2004; 83(1): 22-6.

  10. Oilo G. Biodegradation of dental composites/glass- ionomer cements. Adv Dent Res 1992; 6: 50-4.

  11. Winkler M, Greener E, Lautenschlager E. No-linear in vitro wear of posterior composites with time. Dent Mater 1991; 7: 258-62.

  12. Roulet JF. The problems associated with substituting composite resins for amalgam: a status report on posterior composites. J Dent 1988; 16: 101-13.

  13. Swi ft EJ. Wear of composite resins in permanent posterior teeth. J Am Dent Assoc 1987; 115: 584-8.

  14. Ferracane JL. Resin composite-state of the art. Dental Materials 2011; 27: 29-38.

  15. Beytha N, Bahira R, Matalona S, Dombb AJ, Weiss EI. Streptococcus mutans biofilm changes surface- topography of resin composites. Dent 2008; 24: 732–6.

  16. Rinastiti M. The e ff ect of aging on composite-to-composite repair strength. Thesis. Universiteit Groningen, Netherland, 2009.

  17. Finer Y, Santerre JP. Salivary esterase activity and its association with the biodegradation of dental composite.

  18. Sakaguchi RL, Power JM. Craig’s restorative dental materials. 13 ^th Ed. St. Louis: Mosby Inc; 2012,

  27. Eliades G, Eliades T, Vavuranakis M. General aspect of biomaterial surface alterations following exposure to biologic fl uids. In: Eliades G, editor. Dental material in vivo: aging and related phenomena. Carol Stream Illinois, Quintessence Publishing Co, Inc; 2003. p. 3-20.

  19. Akova T, Ozkomur A, Uysal H. E ff ect of food-simulating liquids on the mechanical properties of provisional restorative materials. J Dent 2004; 22: 1130-4.

  20. Eick S, Glockmann E, Brandl B, Pfi ster W. Adherence of Streptococcus mutans to various restorative materials in a continuous fl ow system. J Oral Rehabil 2004; 31: 278–85.

  21. Eliades G, Eliades T, Brantley WA, Wa tt s DC. Dental material in vivo: aging and related phenomena. Carol Stream Illinois, Quintessence Publishing Co, Inc; 2004.

  61-99

  22. Filoche SK, Zhu M, Wu CD. In situ Biofi lm formation by multi-species oral bacteria under fl owing and anaerobic conditions. J Dent Res 2009; 83: 802.

  23. Ho ff man A. Modifi cation of material surfaces to aff ect how they interact with blood. Ann N Y Acad Sci 1987; 516: 96-101.

  24. Quirynen M, Marechal M, Busscher HJ, Weerkamp AH, Darius PL, Van Steenberghe D. The infl uence of surface free energy and surface roughness on early plaque formation. J Clin Periodontol 1990; 17: 138-44.

  25. Quirynen M, Marecal M, Busscher HJ. The infl uence of surface free-energy on planimetric plaque growth in man. J Dent Res 1989; 68: 796-9.

  26. Weerkamp AH, Quirynen M, Marechal M, van der Mei HC, Van Steenberghe D, Busscher, HJ. The role of surface energy in the early in vivo formation of dental plaque on human enamel and polymeric substrata. Microb Ecol Health Disease 1989; 2: 11-8.

  45. Soderholm KJ. Degradation of glass fi ller in experimental composites. J Dent Res 1981; 60: 1867-75.