β-pyrophosphate: A potential biomaterial for dental applications

Physiologically engineered porous titanium/brushite scaffolds for critical-size bone defects: A design and manufacturing study

Repairing critical-size bone defects still represents a critical clinical challenge in the field of trauma surgery. This study focuses on a physiological design and manufacturing of porous composite scaffold (titanium Ti with 10 % mole iron doped brushite DCPD-Fe3+) which can mimic the biomechanical properties of natural cortical bone, specifically for the purpose of repairing critical-size defects. To achieve this, the principle of design of experiments (DOE) was applied for investigating the impact of sintering temperature, mineral ratio, and volume fraction of porosity on the mechanical properties of the fabricated scaffolds. The fabricated scaffolds had open porosity up to 60 %, with pore size approximately between 100 μm and 850 μm. The stiffness of the porous composite scaffolds varied between 3.30 GPa and 20.50 GPa, while the compressive strength ranged from approximately 130 MPa-165 MPa at sintering temperatures equal to or exceeding 1000 °C. Scaffolds with higher porosity and mineral content demonstrated lower stiffness values, resembling natural bone. Numerical simulation was employed by Ansys Workbench to investigate the stress and strain distribution of a critical size defect in mid-shaft femur which was designed to be replaced with the fabricated scaffold. The fabricated scaffolds showed flexible biomechanical behaviour at the bone/scaffold interface, generating lower stress levels and indicating a better match with the femoral shaft stiffness. The experimental and numerical findings demonstrated promising applications for manufacturing a patient-specific bone scaffold for critical and potentially large defects for reducing stress shielding and minimizing non-union risk.

Effects of Fam83h truncation mutation on enamel developmental defects in male C57/BL6J mice

Truncation mutations in family with sequence similarity, member H (FAM83H) gene are considered the main cause of autosomal dominant hypocalcified amelogenesis imperfecta (ADHCAI); however, its pathogenic mechanism in amelogenesis remains poorly characterized. This study aimed to investigate the effects of truncated FAM83H on developmental defects in enamel. CRISPR/Cas9 technology was used to develop a novel Fam83h c.1186C > T (p.Q396*) knock-in mouse strain, homologous to the human FAM83H c.1192C > T mutation in ADHCAI. The Fam83h^{Q396⁎/Q396⁎} mice showed poor growth, a sparse and scruffy coat, scaly skin and early mortality compared to control mice. Moreover, the forelimbs of homozygous mice were swollen, exhibiting a significant inflammatory response. Incisors of Fam83h^{Q396⁎/Q396⁎} mice appeared chalky white, shorter, and less sharp than those of control mice, and energy dispersive X-ray spectroscopy (EDS) analysis and Prussian blue staining helped identify decreased iron and increased calcium (Ca) and phosphorus (P) levels, with an unchanged Ca/P ratio. The expression of iron transportation proteins, transferrin receptor (TFRC) and solute carrier family 40 member 1 (SLC40A1), was decreased in Fam83h-mutated ameloblasts. Micro-computed tomography revealed enamel defects in Fam83h^{Q396⁎/Q396⁎} mice. Fam83h^{Q396⁎/Q396⁎} enamel showed decreased Vickers hardness and distorted enamel rod structure and ameloblast arrangement. mRNA sequencing showed that the cell adhesion pathway was most notably clustered in LS8-Fam83h-mutated cells. Immunofluorescence analysis further revealed decreased protein expression of desmoglein 3, a component of desmosomes, in Fam83h-mutated ameloblasts. The FAM83H-casein kinase 1α (CK1α)-keratin 14 (K14)-amelogenin (AMELX) interaction was detected in ameloblasts. And K14 and AMELX were disintegrated from the tetramer in Fam83h-mutated ameloblasts in vitro and in vivo. In secretory stage ameloblasts of Fam83h^{Q396⁎/Q396⁎} mice, AMELX secretion exhibited obvious retention in the cytoplasm. In conclusion, truncated FAM83H exerted dominant-negative effects on gross development, amelogenesis, and enamel biomineralization by disturbing iron transportation, influencing the transportation and secretion of AMELX, and interfering with cell-cell adhesion in ameloblasts.

Fiber-Templated 3D Calcium-Phosphate Scaffolds for Biomedical Applications: The Role of the Thermal Treatment Ambient on Physico-Chemical Properties

A successful bone-graft-controlled healing entails the development of novel products with tunable compositional and architectural features and mechanical performances and is, thereby, able to accommodate fast bone in-growth and remodeling. To this effect, graphene nanoplatelets and Luffa-fibers were chosen as mechanical reinforcement phase and sacrificial template, respectively, and incorporated into a hydroxyapatite and brushite matrix derived by marble conversion with the help of a reproducible technology. The bio-products, framed by a one-stage-addition polymer-free fabrication route, were thoroughly physico-chemically investigated (by XRD, FTIR spectroscopy, SEM, and nano-computed tomography analysis, as well as surface energy measurements and mechanical performance assessments) after sintering in air or nitrogen ambient. The experiments exposed that the coupling of a nitrogen ambient with the graphene admixing triggers, in both compact and porous samples, important structural (i.e., decomposition of β-Ca3(PO4)2 into α-Ca3(PO4)2 and α-Ca2P2O7) and morphological modifications. Certain restrictions and benefits were outlined with respect to the spatial porosity and global mechanical features of the derived bone scaffolds. Specifically, in nitrogen ambient, the graphene amount should be set to a maximum 0.25 wt.% in the case of compact products, while for the porous ones, significantly augmented compressive strengths were revealed at all graphene amounts. The sintering ambient or the graphene addition did not interfere with the Luffa ability to generate 3D-channels-arrays at high temperatures. It can be concluded that both Luffa and graphene agents act as adjuvants under nitrogen ambient, and that their incorporation-ratio can be modulated to favorably fit certain foreseeable biomedical applications.

Mechanical and thermal properties of PMMA resin composites for interim fixed prostheses reinforced with calcium β-pyrophosphate

Interim restorations are essential in fixed prosthodontics as they provide temporary protection of teeth before the insertion of the permanent restoration. Poly(methyl methacrylate) (PMMA) is widely used in the fabrication of interim-fixed restorations as it is a biocompatible material with a lot of convenient properties. However, it exhibits low impact and tensile strength and therefore it is necessary to be reinforced. Calcium β-pyrophosphate (β-CPP) is considered a promising reinforcing material for dental applications, especially for enamel regeneration due to its stability at low pH and its low wear rate. The aim of this study was to manufacture PMMA/β-CPP composites suitable for fixed-interim restorations and to study their mechanical and thermal properties. In order to enhance β-CPP dispersion into PMMA matrix, ball-milling was performed for 1 or 6 h. Three-point bending test was performed to study flexural strength, Dynamic Mechanical Analysis (DMA) to reveal the elastic and viscous moduli along with T_g, Fourier Transform Infrared Spectroscopy (FTIR) and X-Ray Diffraction Analysis (XRD) to investigate the structure of the materials and SEM for the morphological evaluation of both composite powders and polymerized specimens. Thermogravimetric Analysis (TGA) and Differential Scanning Calorimetry (DSC) experiments were performed to study their thermal properties. A statistically significant increase in flexural strength was found in the 0.5, 0.75 and 1% composite groups after 6 h ball-milling, relative to the control, with the 6 h ball milling mixed specimens, presenting the highest flexural strength values. The brittle fracture type was common to all groups. An obvious improvement of the mechanical properties and a slight improvement in the thermal stability of the composite materials values were also observed as β-CPP content was increased, while T_g values were statistically not-affected.

Analysis of the osteogenic and mechanical characteristics of iron (Fe2+/Fe3+)-doped β‑calcium pyrophosphate

The calcium phosphate is the main mineral constituent of bone. Although there has been significant amount of research on finding ideal synthetic bone, no suitable scaffold material has yet been found. In this investigation, the iron doped brushite (CaHPO₄·2H₂O) has been investigated for osteogenic potential and mechanical properties. The synthesis of iron-oxide doping in the form of Fe^2+,3+-ions were carried out using the solution based method in which the ammonium hydrogen phosphate and calcium nitrate solutions were used in stoichiometric ratio for synthesizing CaHPO₄·2H₂O, with doping concentrations of Fe^2+,3+-ions between 5 mol% and 30 mol%. The synthesized powders were analysed using X-ray powder diffraction, FTIR, SEM and Raman spectroscopic techniques. The heat treatment of synthesized powder was carried out at 1000 °C in air for 5 h, and it was found that the dominant crystalline phase in samples with <20 mol% was β-CPP, which also formed an iron-rich solid solution phase. Increasing the concentrations of Fe^2+,3+-ions enhances the phase fraction of FePO₄ and amorphous phase. Amongst the Fe^2+,3+-doped β-CPP minerals, it was found that the 10 mol% Fe^2+,3+-doped β-CPP offers the best combination of bio-mechanical and osteogenic properties as a scaffold for bone tissue regenerative engineering.

Antibacterial properties and regenerative potential of Sr2+ and Ce3+ doped fluorapatites; a potential solution for peri-implantitis

Scaffolds and implants in orthopaedics and regenerative dentistry usually fail because of bacterial infections. A promising solution would be the development of biomaterials with both significant regenerative potential and enhanced antibacterial activity. Working towards this direction, fluorapatite was synthesised and doped with Sr2+ and Ce3+ ions in order to tailor its properties. After experiments with four common bacteria (i.e. E. Coli, S. Aureus, B. Subtilis, B. Cereus), it was found that the undoped and the Ce3+ doped fluorapatites present better antibacterial response than the Sr2+ doped material. The synthesised minerals were incorporated into chitosan scaffolds and tested with Dental Pulp Stem Cells (DPSCs) to check their regenerative potential. As was expected, the scaffolds containing Sr2+-doped fluorapatite, presented high osteoconductivity leading to the differentiation of the DPSCs into osteoblasts. Similar results were obtained for the Ce3+-doped material, since both the concentration of osteocalcin and the RUNX2 gene expression were considerably higher than that for the un-doped mineral. Overall, it was shown that doping with Ce3+ retains the good antibacterial profile of fluorapatite and enhances its regenerative potential, which makes it a promising option for dealing with conditions where healing of hard tissues is compromised by bacterial contamination.

The Effectiveness of Remineralizing Agents on Dentinal Permeability

The effectiveness of remineralizing agents in reducing dentine permeability by tubule occlusion using fluid filtration device functioning at 100 cmH₂O (1.4 psi) pressure and SEM/EDX analysis were evaluated and compared. Seventy (n = 70) dentine discs of 1±0.2 mm width were prepared from sound permanent human molars. Fifty (n = 50) dentine discs were randomly divided into 5 groups (n = 10): Group 1: GC Tooth Mousse Plus (Recaldent GC Corporation Tokyo, Japan), Group 2: Clinpro™ White Varnish (3M ESPE, USA), Group 3: Duraphat® Varnish (Pharbil Waltrop GmbH, Germany), Group 4: Colgate Sensitive Pro-Relief™ dentifrice (Colgate Palmolive, Thailand), and Group 5: Biodentine™ (Septodont/UK). Dentine permeability was measured after treatment application at 10 minutes, artificial saliva immersion at 7 days, and citric acid challenge for 3 minutes. Data were analyzed by two-way repeated measures ANOVA. Dentine specimens (n = 20) were used for SEM/EDX analyses to obtain qualitative results on dentine morphology and surface deposits. Each treatment agent significantly reduced dentine permeability immediately after treatment application and created precipitates on treated dentine surfaces. All agents increased permeability values after 7 days of artificial saliva immersion except Clinpro White Varnish and Biodentine. Clinpro White Varnish exhibited significant resistance to acid challenge compared to others. Colgate Sensitive Pro-Relief dentifrice has a dual mechanism of action in reducing the dentine sensitivity.

Exogenous mineralization of hard tissues using photo-absorptive minerals and femto-second lasers; the case of dental enamel

A radical new methodology for the exogenous mineralization of hard tissues is demonstrated in the context of laser-biomaterials interaction. The proposed approach is based on the use of femtosecond pulsed lasers (fs) and Fe³⁺-doped calcium phosphate minerals (specifically in this work fluorapatite powder containing Fe₂O₃ nanoparticles (NP)). A layer of the synthetic powder is applied to the surface of eroded bovine enamel and is irradiated with a fs laser (1040 nm wavelength, 1 GHz repetition rate, 150 fs pulse duration and 0.4 W average power). The Fe₂O₃ NPs absorb the light and may act as thermal antennae, dissipating energy to the vicinal mineral phase. Such a photothermal process triggers the sintering and densification of the surrounding calcium phosphate crystals thereby forming a new, dense layer of typically ∼20 μm in thickness, which is bonded to the underlying surface of the natural enamel. The dispersed iron oxide NPs, ensure the localization of temperature excursion, minimizing collateral thermal damage to the surrounding natural tissue during laser irradiation. Simulated brushing trials (pH cycle and mechanical force) on the synthetic layer show that the sintered material is more acid resistant than the natural mineral of enamel. Furthermore, nano-indentation confirms that the hardness and Young's modulus of the new layers are significantly more closely matched to enamel than current restorative materials used in clinical dentistry. Although the results presented herein are exemplified in the context of bovine enamel restoration, the methodology may be more widely applicable to human enamel and other hard-tissue regenerative engineering.

STATEMENT OF SIGNIFICANCE

In this work we provide a new methodology for the mineralisation of dental hard tissues using femtosecond lasers and iron doped biomaterials. In particular, we demonstrate selective laser sintering of an iron doped fluorapatite on the surface of eroded enamel under low average power and mid-IR wavelength and the formation of a new layer to substitute the removed material. The new layer is evaluated through simulated brushing trials and nano-indentation. From the results we can conclude that is more acid resistant than natural enamel while, its mechanical properties are superior to that of current restorative materials. To the best of our knowledge this is the first time that someone demonstrated, laser sintering and bonding of calcium phosphate biomaterials on hard tissues. Although we here we discuss the case of dental enamel, similar approach can be adopted for other hard tissues, leading to new strategies for the fixation of bone/tooth defects.