A major reason for dental resin composite restoration replacement is related to secondary caries promoted by acid production from bacteria including Streptococcus mutans (S. mutans). We hypothesized that S. mutans has esterase activities that degrade dental resin composites and adhesives. Standardized specimens of resin composite (Z250), total-etch (Scotchbond Multipurpose, SB), and self-etch (Easybond, EB) adhesives were incubated with S. mutans UA159 or uninoculated culture medium (control) for up to 30 days. Quantification of the BisGMA-derived biodegradation by-product, bishydroxy-propoxy-phenyl-propane (BisHPPP), was performed by high-performance liquid chromatography. Surface analysis of the specimens was performed by scanning electron microscopy (SEM). S. mutans was shown to have esterase activities in levels comparable with those found in human saliva. A trend of increasing BisHPPP release throughout the incubation period was observed for all materials and was more elevated in the presence of bacteria vs. control medium for EB and Z250, but not for SB (p < .05). SEM confirmed the increased degradation of all materials with S. mutans UA159 vs. control. S. mutans has esterase activities at levels that degrade resin composites and adhesives; degree of degradation was dependent on the material’s chemical formulation. This finding suggests that the resin-dentin interface could be compromised by oral bacteria that contribute to the progression of secondary caries.

Bis-GMA-containing resin composites and adhesives undergo biodegradation by human-saliva-derived esterases, yielding Bis-hydroxy-propoxy-phenyl-propane (Bis-HPPP). The hypothesis of this study is that the exposure of dental restorations to saliva-like esterase activities accelerates marginal bacterial microleakage. Resin composites (Scotchbond, Z250, 3M) bonded to human dentin were incubated in either buffer or dual-esterase media (pseudocholinesterase/cholesterol-esterase; PCE+CE), with activity levels simulating those of human saliva, for up to 90 days. Incubation solutions were analyzed for Bis-HPPP by high-performance liquid chromatography. Post-incubation, specimens were suspended in a chemostat-based biofilm fermentor cultivating Streptococcus mutans NG8, a primary species associated with dental caries, for 7 days. Bacterial microleakage was assessed by confocal laser scanning microscopy. Bis-HPPP production and depth and spatial volume of bacterial cell penetration within the interface increased with incubation time and were higher for 30- and 90-day PCE+CE vs. buffer-incubated groups, suggesting that biodegradation can contribute to the formation of recurrent decay.

In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.