Effect of anti-biofilm glass–ionomer cement on Streptococcus mutans biofilms

Dental restorative materials with antimicrobial properties can inhibit bacterial colonization, which may result in a reduction of caries at tooth-filling interaction zones. This study aimed to develop antibacterial glass–ionomer cements (GIC) containing a quaternary ammonium monomer (dimethylaminododecyl methacrylate, DMADDM), and to investigate their effect on material performance and antibacterial properties. Different mass fractions (0, 1.1% and 2.2%) of DMADDM were incorporated into the GIC. The flexure strength, surface charge density, surface roughness and fluoride release were tested. A Streptococcus mutans biofilm model was used. Exopolysaccharides (EPS) staining was used to analyze the inhibitory effect of DMADDM on the biofilm matrix. In addition, biofilm metabolic activity, lactic acid metabolism and the expression of glucosyltransferase genes gtfB, gtfC and gtfD were measured. GIC containing 1.1% and 2.2% DMADDM had flexural strengths matching those of the commercial control (P>0.1). DMADDM was able to increase the surface charge density but reduced surface roughness (P<0.05). The incorporation of 1.1% and 2.2% DMADDM elevated the release of fluoride by the GIC in the first 2 days (P<0.05). The novel DMADDM-modified GIC significantly reduced biofilm metabolic activity (P<0.05) and decreased lactic acid production (P<0.05). The quantitative polymerase chain reaction (qPCR) results showed that the expression of gtfB, gtfC and gtfD decreased when mass fractions of DMADDM increased (P<0.05). EPS staining showed that both the bacteria and EPS in biofilm decreased in the DMADDM groups. The incorporation of DMADDM could modify the properties of GIC to influence the development of S. mutans biofilms. In this study, we investigated the interface properties of antibacterial materials for the first time. GIC containing DMADDM can improve material performance and antibacterial properties and may contribute to the better management of secondary caries. Dental cements containing ammonium-based groups may offer improved material and antibacterial properties for restorative dentistry. Polymers carrying electrically charged chemical groups are known as ionomers and are widely used as dental cements. Unfortunately, secondary decay and fracture cause half of all repairs made using these cements to fail within 10 years. Lei Cheng of Sichuan University, China, and co-workers investigated the effect of adding the ammonium-based compound dimethylaminododecyl methacrylate (DMADDM) to ionomer cements. They identified levels of DMADDM that reduced bacterial microfilm formation and also improved the material properties of the cements. The benefits included better release of protective fluoride ions from the ionomers, good flexibility combined with strength and improved surface texture. Cements with added DMADDM could therefore help avoid secondary decay and fracture after primary decay has been repaired.