Walters, NJ; (2016) Remineralising composites with improved cytocompatibility and containing antimicrobial agents for conservative treatment of caries. Doctoral thesis , UCL (University College London).

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Abstract

Objectives: To develop a remineralising dental composite with high strength, conversion and cytocompatibility and antimicrobial potential for more conservative treatment of dental caries. / Methods: The effect of glass filler particle size distributions and glass fibres on wetpoint, handling and mechanical properties was assessed. The effect of two photoinitiators at varying concentrations and four co-initiators on conversion, cytocompatibility and mechanical properties was determined. The conversion, depth of cure, shrinkage, mechanical properties, water sorption and cytocompatibility of composites containing varying bulk (urethane dimethacrylate (UDMA), bisphenol A glycidyl methacrylate (Bis-GMA)) and diluent monomers (poly(propylene glycol) dimethacrylate (PPGDMA), tri(ethylene glycol) dimethacrylate (TEGDMA)) were characterised. The conversion, water sorption, calcium precipitation, mechanical properties and shear bond strength of composites containing remineralising and antimicrobial agents (monocalcium phosphate (MCP), tricalcium phosphate (TCP), ε- poly-L-lysine (εPL)) were assessed (storage in water, simulated body fluid (SBF), artificial saliva (AS)). Techniques included Fourier transform infrared spectroscopy, mass and volume determination, biaxial flexural testing, shear bond testing, scanning electron microscopy, energy-dispersive X-ray spectroscopy, Raman spectroscopy, resazurin, WST-8 and MTS assays. / Results: An optimal combination of fillers was established. Conversion was affected by co-initiator to a greater extent than photoinitiator. Composites containing UDMA and PPGDMA had the optimal balance of conversion, mechanical properties, depth of cure and cytocompatibility without increased shrinkage. Composites containing MCP with either TCP or εPL induced rapid hydroxyapatite formation on the surface of the composite within one week in SBF but not in AS or water. / Significance: Composites containing the newly developed liquid phase had high conversion and strength, slightly improved cytocompatibility and acceptable shrinkage. Whilst composites containing MCP and TCP were stronger, the added possible antimicrobial action of those containing MCP and εPL have great potential to defend against recurrent caries by preventing microbial microleakage.

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