Development of antibacterial dual-cure dental resin composites via tetrapod-shaped zinc oxide incorporation

Abstract

Objectives

This study aimed to evaluate the effects of incorporating the 0–20 wt% tetrapod-shaped zinc oxide (tZnO) whiskers on the mechanical, antibacterial, and cytotoxic properties exhibited by experimental dual-cure resin composites.

Methods

Commercially obtained tZnO whiskers underwent surface modification using 3-methacryloxypropyltrimethoxysilane (γ-MPS). Subsequently, four groups of resin composites containing 0, 5, 10, and 20 wt% silanized tZnO along with barium borosilicate glass (BaBSG) fillers were fabricated while maintaining total filler loading at 60 wt%. Mechanical properties were examined utilizing specimens produced adhering to ISO 4049:2019 guidelines where applicable. Depth of cure was quantified immediately, while three-point flexural strength, flexural modulus, fracture toughness, Vickers hardness, compressive strength, and diametral tensile strength were assessed after 24 h of storage in 37 °C distilled water. Planktonic bacteria of Streptococcus mutans (S. mutans) were cultured and tested for antibacterial activity using disk diffusion and microbial anti-adhesion assays. Cytotoxicity was examined by preparing extracts from specimens in a cell culture medium and exposing stem cells from human exfoliated deciduous teeth (SHED) to serial dilutions of these extracts, then assessing cell viability and survival using CCK-8 assay and live/dead staining.

Results

Elevating tZnO loading yielded significant reductions in depth of cure, compressive (from 296.4 to 254.6 MPa), and diametral tensile strength (from 42.7 to 31.0 MPa), while flexural strength (91.3–94.1 MPa), flexural modulus (6.4–6.6 GPa), fracture toughness (0.96–1.04 MPa·m^0.5), and Vickers hardness (36.5–37.4 kgf·mm⁻²) remained the same. Composites integrating tZnO displayed markedly enhanced antibacterial activity against S. mutans, based on anti-adhesion tests and live/dead staining. No cytotoxicity was observed for SHED treated with extracts from resin composites possessing up to 20 wt% tZnO whiskers.

Significance

This study demonstrates that incorporating up to 20 wt% silanized tZnO in place of traditional barium glass particles appreciably enhances dual-cure resin composite antibacterial function against S. mutans without compromising mechanical properties.