title: Novel bioactive root canal sealer to inhibit endodontic multispecies biofilms with remineralizing calcium phosphate ions.
abstract: OBJECTIVE
  The objectives of this study were to: (1) develop a bioactive endodontic sealer via dimethylaminohexadecyl methacrylate (DMAHDM), 2-methacryloyloxyethyl phosphorylcholine (MPC) and nanoparticles of amorphous calcium phosphate (NACP) for the first time; and (2) evaluate inhibition of early-stage and mature multispecies endodontic biofilm, bond strength to root canal dentine, and calcium (Ca) and phosphate (P) ion release.
  
  
  METHODS
  A series of bioactive endodontic sealers were formulated with DMAHDM, MPC, and NACP. Root dentine bond strength was measured via a push-out test. Three endodontic strains, Enterococcus faecalis, Actinomyces naeslundii, and Fusobacterium nucleatum, were grown on endodontic sealer disks to form multispecies biofilms. Biofilms were grown for 3 days (early) and 14 days (mature). Colony-forming units (CFU), live/dead assay, metabolic activity and polysaccharide were determined. Ca and P ion release from endodontic sealer was measured.
  
  
  RESULTS
  Incorporating DMAHDM, MPC and NACP did not decrease the push-out bond strength (p>0.1). Adding DMAHDM and MPC reduced endodontic biofilm CFU by 3 log. DMAHDM or MPC each greatly decreased the biofilm CFU (p<0.05). Endodontic sealer with DMAHDM+MPC had much greater killing efficacy than DMAHDM or MPC alone (p<0.05). Endodontic sealer with DMAHDM+MPC had slightly lower, but not significantly lower, Ca and P ion release compared to that without DMAHDM+MPC (p>0.1).
  
  
  CONCLUSIONS
  A novel bioactive endodontic sealer was developed with potent inhibition of multispecies endodontic biofilms, reducing biofilm CFU by 3 log, while containing NACP for remineralization and possessing good bond strength to root canal dentine walls.
  
  
  CONCLUSIONS
  The new bioactive endodontic sealer is promising for endodontic applications to eradicate endodontic biofilms and strengthen root structures. The combination of DMAHDM, MPC and NACP may be applicable to other preventive and restoration resins.
authors.affiliation: VIP Integrated Department, Stomatological Hospital of Jilin University, Changchun, China; Department of Endodontics, Periodontics and Prosthodontics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Endodontics, Periodontics and Prosthodontics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China.
authors.forename: Xianju
authors.initials: X
authors.lastname: Xie
authors.affiliation: Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Li
authors.affiliation: L.D. Caulk Division, Dentsply Sirona Restorative, Milford, DE 19963, USA.
authors.forename: Huaibing
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Endodontics, Periodontics and Prosthodontics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China. Electronic address: tuzizhangke@163.com.
authors.forename: Ke
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China. Electronic address: zhouym62@126.com.
authors.forename: Yanmin
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Department of Implant Dentistry, School of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China. Electronic address: changxf@mail.xjtu.edu.cn.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Chang
authors.affiliation: Department of Endodontics, Periodontics and Prosthodontics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Department of Mechanical Engineering, University of Maryland Baltimore County, Baltimore County, MD 21250, USA.
authors.forename: Hockin H K
authors.initials: HHK
authors.lastname: Xu
mesh_terms: D000190:Actinomyces / Q000187:drug effects / Q000254:growth & development; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D018441:Biofilms / Q000187:drug effects*; D002118:Calcium / Q000737:chemistry; D002130:Calcium Phosphates / Q000494:pharmacology*; D015169:Colony Count, Microbial; D003481:Cuspid; D003738:Dental Cements / Q000737:chemistry; D003773:Dental Plaque / Q000382:microbiology; D003786:Dental Pulp Cavity / Q000187:drug effects*; D003804:Dentin / Q000737:chemistry; D017220:Dentin-Bonding Agents / Q000737:chemistry; D004338:Drug Combinations; D016967:Fusobacterium nucleatum / Q000187:drug effects / Q000254:growth & development; D006801:Humans; D007477:Ions; D008689:Methacrylates / Q000494:pharmacology; D050296:Microbial Viability / Q000187:drug effects; D053758:Nanoparticles / Q000737:chemistry*; D010710:Phosphates / Q000737:chemistry; D010767:Phosphorylcholine / Q000031:analogs & derivatives / Q000494:pharmacology; D011134:Polysaccharides / Q000032:analysis; D017213:Root Caries / Q000382:microbiology / Q000517:prevention & control; D015035:Zinc Oxide-Eugenol Cement / Q000737:chemistry* / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D002130:Calcium Phosphates; D003738:Dental Cements; D017220:Dentin-Bonding Agents; D004338:Drug Combinations; D007477:Ions; D008689:Methacrylates; D010710:Phosphates; D011134:Polysaccharides; D015035:Zinc Oxide-Eugenol Cement; C519480:amorphous calcium phosphate; C112894:canals sealer; D010767:Phosphorylcholine; C070638:2-methacryloyloxyethyl phosphorylcholine; D002118:Calcium
keywords: Antibacterial; Bond strength; Calcium phosphate remineralization; Endodontic biofilms; Protein repellent; Root canal sealer