Cariogenic oral biofilms are strongly linked to dental caries around dental sealants. Quaternary ammonium monomers copolymerized with dental resin systems have been increasingly explored for modulation of biofilm growth. Here, we investigated the effect of dimethylaminohexadecyl methacrylate (DMAHDM) on the cariogenic pathogenicity of Streptococcus mutans (S. mutans) biofilms. DMAHDM at 5 mass% was incorporated into a parental formulation containing 20 mass% nanoparticles of amorphous calcium phosphate (NACP). S. mutans biofilms were grown on the formulations, and biofilm inhibition and virulence properties were assessed. The tolerances to acid stress and hydrogen peroxide stress were also evaluated. Our findings suggest that incorporating 5% DMAHDM into 20% NACP-containing sealants (1) imparts a detrimental biological effect on S. mutans by reducing colony-forming unit counts, metabolic activity and exopolysaccharide synthesis; and (2) reduces overall acid production and tolerance to oxygen stress, two major virulence factors of this microorganism. These results provide a perspective on the value of integrating bioactive restorative materials with traditional caries management approaches in clinical practice. Contact-killing strategies via dental materials aiming to prevent or at least reduce high numbers of cariogenic bacteria may be a promising approach to decrease caries in patients at high risk.

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Purpose: The objective of this study was to develop novel bio-composite Nanofiller (Quaternary polyethyleneimine\ Hydroxyapatite, QPEI/HAp), which combines the antibacterial activity of polymeric quaternary ammonium salt and the multi-advantages of Hydroxyapatite nanoparticles for improving biological and physico-mechanical properties of Dental Adhesives. Materials and Methods: Hydroxyapatite (HAp) nano rods were produced by hydrothermal process and coated by Polyethyleneimine (PEI) via electrostatic adsorption, followed by two steps polymeric reaction; tertiary amination and quaternization. The resulting powder was characterized using XRD, FTIR and TEM before and after polymer coating, and bioactivity was evaluated after 7 days soaking in simulated body fluid using XRD analysis. An experimental ethanolbased one-bottle adhesive resin was formulated with 0.2, 0.5, 1, 2 and 5% QPEI/HAp nanofiller. The formulated adhesive resins were evaluated for their colloidal stability, antibacterial activity, Ultimate Tensile Strength, and Micro-Shear bond strength to dentin. Results: Powder characterization confirmed successful surface modification of Hydroxyapatite nanoparticles with PEI polymer; the particles presented a high crystallinity with typical chemical groups and mean size around 20 nanometers. XRD analysis revealed nucleation of apatite crystals on the surface of QPEI/HAp nanoparticles after soaking in SBF; confirming their bioactivity. Lower contents of modified nanoparticles showed little or no aggregation tendency and good colloidal stability in the adhesive solution with Zeta potential of 30.6 mV. Antibacterial outcomes of PEI against S. mutans was significantly higher than that of MDPB in Clearfil Protect bond; a commercial adhesive used as control (P<0.05). The addition of 0.2 wt. % modified nano-hydroxyapatite resulted in higher values of Ultimate Tensile and Micro-Shear bond strength than other tested adhesives and commercial Clearfil S3 Bond (all-in-one adhesive); (P<0.05). Conclusion: Incorporation of 0.2 wt. % QPEI-HAp nanoparticles significantly improved the adhesive properties and may be promising multifunctional filler for dental adhesive resin.