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Novel Metformin-Containing Antibacterial Composite for Root Caries Restorations
Ayman Altamimi1,2,3, Ibrahim Ba-Armah4, Heba Alqarni1,2,5
1Dental Biomedical Sciences PhD Program, Graduate School, University of Maryland, Baltimore, MD 21201, USA.
Background:
Tooth root caries and periodontal tissue loss remain major challenges in elderly and periodontally compromised patients, while current restorative materials lack combined antibacterial and regenerative properties.
Objective:
The objective of this study was to develop a novel metformin-containing antibacterial composite for root cavity restorations to prevent recurrent caries and potentially promote periodontal tissue regeneration.
Methods:
Experimental composites contained 5% dimethylaminohexadecyl methacrylate (DMAHDM), varying metformin concentrations (2.5-15%), and glass fillers. Mechanical and antibacterial properties as well as cytocompatibility toward human periodontal ligament stem cells (hPDLSCs) were investigated.
Results:
The experimental composites achieved flexural strengths of 67.9 to 50.1 MPa (n = 6), significantly higher than (41.3 ± 3.4 MPa) of commercial control Vitremer (p < 0.05), while maintaining clinically acceptable elastic moduli of 3.7-3.1 GPa. Experimental composites achieved an 8-log reduction in Streptococcus mutans (S. mutans) biofilms and significantly reduced lactic acid production and metabolic activity compared to biofilms on commercial controls. The composite containing 15% metformin demonstrated acceptable cytocompatibility toward hPDLSCs under clinically relevant diluted conditions, matching commercial controls (p > 0.1).
Conclusions:
These findings suggest that this novel composite possesses potent antibacterial activity, acceptable cytocompatibility, and adequate mechanical properties, making it promising for multifunctional root caries restorations.
