A review on potential toxicity of dental material and screening their biocompatibility

In Vitro Cytotoxicity Evaluation of Nanosized Hydroxyapatite and Fluorapatite on Cell Lines and Their Relevance to the Alveolar Augmentation Process

Background/Objectives: Materials with an apatite structure were investigated in vitro in dental bone augmentation procedures. This scientific study aimed to compare nanosized hydroxyapatite (nHAp) and fluorapatite (nFAp) materials in the form of tablets in in vitro studies, including cytotoxicity assessment and fluoride release. Methods: The nHAp and nFAp nanosized materials were obtained using the microwave hydrothermal method. Subsequently, the tablets were prepared from these nanosized powders as further studied materials. Cytotoxicity tests were conducted on Balb/3T3 fibroblast cells and L929 cells. Fluoride ion release was tested at 3, 24, 48, 72, and 168 h periods. Results: Both materials presented viability levels above 70%, indicating a lack of cytotoxic potential. The amount of fluoride (F-) ions released and accumulated from nFAp was greatly higher than from nHAp. The release of F- ions in both samples was the highest in the first 3 h of exposition. The accumulation of F- ions reached the highest values in the deionized water. The most significant differences in the released or cumulated fluoride ions were observed between deionized water and lower 4.5 pH AS (artificial saliva) samples. Conclusions: Both nanosized hydroxyapatite and fluorapatite materials are biocompatible, and their in vitro examination showed promising results for their future in vivo application.

Proposal of a Modular Classification System for Direct Dental Resin Composites Based on Clinical Applications

The adhesive-resin composite pair has been the cornerstone of direct restorations in dentistry for many years. Resin composites are traditionally classified in three ways based on their inorganic structure, their organic composition and their viscosity. While these classifications have long been associated with the optical, mechanical, and clinical properties of resin composites, recent studies indicate that this classification is not always valid. In recent years, a significant expansion of the range of clinical resin composite families has occurred, each with varying degrees of validation through in vitro and clinical studies. As a result, new resin composites with distinct structures, viscosities, and clinical indications have emerged. Despite this progress, a formal classification of the clinical features of all resin composites is still lacking, leading to terminological inconsistencies in research and potential confusion among clinicians. This brief review, supported by an exhaustive search of the dental literature, proposes a new clinical classification system for resin composites based on their key clinical features to help clinicians and researchers easily identify the key clinical characteristics of formulations. This modular classification, encompassing eight main families and 14 characteristics, is particularly suited to future developments, as current trends aim to simplify procedures by integrating multiple formulations into single products.

Influence of Soft and Stiff Matrices on Cytotoxicity in Gingival Fibroblasts: Implications for Soft Tissue Biocompatibility

The biocompatibility of dental materials is critical for ensuring safety in clinical applications. However, standard in vitro cytotoxicity assays often rely on stiff tissue culture plastic (TCP), which does not accurately replicate the biomechanical properties of soft oral tissues. In this study, we compared human gingival fibroblasts (HGFs) cultured on soft, gel-based substrates mimicking gingival tissue stiffness (0.2 kPa) with those cultured on conventional TCP (3 GPa) to assess the influence of substrate stiffness on the cytotoxicity of methyl methacrylate (MMA), as well as other cytotoxic agents, including DMSO and H2O2. The results demonstrated that cells cultured on softer substrates exhibited enhanced resistance to cytotoxic stress, with increased viability and decreased apoptosis and DNA damage following exposure to MMA, DMSO, and H2O2. Notably, HGFs on soft substrates showed significantly greater resilience to MMA-induced cytotoxicity compared to those cultured on TCP. These findings emphasize the critical role of substrate stiffness in modulating cellular responses to toxic agents and highlight the necessity of using physiologically relevant models for cytotoxicity testing of dental materials. This study provides valuable insights for improving biocompatibility assessment protocols in clinical settings.

Natural Antibacterial Compounds with Potential for Incorporation into Dental Adhesives: A Systematic Review

Dental adhesives are essential in modern restorative dentistry and are constantly evolving. However, challenges like secondary caries from bacterial infiltration at the adhesive-tooth interface persist. While synthetic antibacterial agents in adhesives show promise, safety concerns have shifted interest toward natural options that are biocompatible, sustainable, and effective. Therefore, this study evaluated whether natural antibacterial compounds in dental adhesives can provide effective antimicrobial activity without compromising their integrity. This systematic review followed PRISMA 2020 statement guidelines. Four databases were screened, PubMed, Scopus, EMBASE, and Web of Science, without language or publication date restrictions until July 2024. The selection criteria were in vitro studies in which natural antimicrobial substances were incorporated into dental adhesives and the resulting composites were tested for their antibacterial and physicochemical properties. A quality assessment was conducted on the selected studies. Most of the studies reviewed reported significant antibacterial activity while retaining the adhesive's integrity, generally achieved with lower concentrations of the natural agents. Higher concentrations increase the antimicrobial effectiveness but negatively impact the adhesive's properties. This review highlights the promising role of natural antibacterial compounds in enhancing the functionality of dental adhesives while also pointing to the need for continued research to address current challenges.

Bioactive Compounds Enhance the Biocompatibility and the Physical Properties of a Glass Ionomer Cement

In order to characterize a novel restorative material, knowledge about the toxicological effect on human cells and the physical behavior of a glass ionomer cement (GIC) containing flavonoids was established. The flavonoids apigenin, naringenin, quercetin, and liquiritigenin were manually incorporated into a GIC. In the control group, no incorporation was performed. Two cell culture assays evaluated the toxicity of GICs: SRB and MTT. For both assays, the keratinocyte cell line (HaCaT) was exposed to GIC (n = 3/group) for 24 h. The physical properties of the GICs were evaluated by compressive strength (n = 10), surface roughness (n = 10), and hardness (n = 10) tests. Cell viability by SRB ranged from 103% to 97%. The control revealed a significant decrease in the metabolism of cells (61%) by MTT, while the GIC+apigenin slightly increased the succinic dehydrogenase activity (105%; p > 0.05), also confirmed microscopically. The compressive strength and roughness values were similar among groups, but the hardness increased after the incorporation of naringenin and quercetin into GIC (p < 0.05). The incorporation of flavonoids positively altered the biological and physical properties of the GICs.

Evaluation of Random and Aligned Polycaprolactone Nanofibrous Electrospun Scaffold for Human Periodontal Ligament Engineering in Biohybrid Titanium Implants

Background: Stem cells are introduced to regenerate some living tissue to restore function and longevity. The study aims to isolate in vitro human periodontal ligament stem cells (hPDLSCs) and investigate their proliferation rate on plasma-treated aligned and random polycaprolactone (PCL) nanofibrous scaffolds made via an electrospinning technique to attempt periodontal-like tissue in dental implants. Materials and Methods: hPDLSCs were isolated from extracted human premolars and cultured on plasma-treated or untreated PCL-aligned and random scaffolds to enhance adhesion of periodontal ligament (PDL) cells as well as interaction and proliferation. Cell morphology, adhesion, and proliferation rate were evaluated using field emission scanning electron microscopy (FESEM) and the methyl tetrazolium (MTT) assay. The wettability of PCL scaffolds was tested using a goniometer. Results: The hydrophilicity of plasma-treated scaffolds was significantly increased (p ≤ 0.05) in both aligned and random nanofibers compared to the nontreated nanofibrous scaffold. Cells arranged in different directions on the random nanofiber scaffold, while for aligned scaffold nanofibers, the cells were arranged in a pattern that followed the direction of the aligned electrospun nanofibres. The rate of hPDLSC proliferation on an aligned PCL nanofiber scaffold was significantly higher than on a random PCL nanofibrous scaffold with a continuous, well-arranged monolayer of cells, as shown in FESEM. Conclusion: The aligned PCL nanofiber scaffold is superior to random PCL when used as an artificial scaffold for hPDLSC regeneration in PDL tissue engineering applications.

Surface alterations and compound release from aligner attachments in vitro

AIM

The aim of the present study was to assess the alterations in morphology, roughness, and composition of the surfaces of a conventional and a flowable composite attachment engaged with aligners, and to evaluate the release of resin monomers and their derivatives in an aqueous environment.

METHODS

Zirconia tooth-arch frames (n = 20) and corresponding thermoformed PET-G aligners with bonded attachments comprising two composite materials (universal-C and flowable-F) were fabricated. The morphological features (stereomicroscopy), roughness (optical profilometry), and surface composition (ATR-FTIR) of the attachments were examined before and after immersion in water. To simulate intraoral use, the aligners were removed and re-seated to the frames four times per day for a 7-day immersion period. After testing, the eluents were analyzed by LC-MS/MS targeting the compounds Bis-GMA, UDMA, 2-HEMA, TEGDMA and BPA and by LC-HRMS for suspect screening of the leached dental material compounds and their degradation products.

RESULTS

After testing, abrasion-induced defects were found on attachment surfaces such as scratches, marginal cracks, loss of surface texturing, and fractures. The morphological changes and debonding rate were greater in F. Comparisons (before-after testing) revealed a significantly lower Sc roughness parameter in F. The surface composition of the aligners after testing showed minor changes from the control, with insignificant differences in the degree of C = C conversion, except for few cases with strong evidence of hydrolytic degradation. Targeted analysis results revealed a significant difference in the compounds released between Days 1 and 7 in both materials. Insignificant differences were found when C was compared with F in both timeframes. Several degradation products were detected on Day 7, with a strong reduction in the concentration of the targeted compounds.

CONCLUSIONS

The use of aligners affects the surface characteristics and degradation rate of composite attachments in an aqueous environment, releasing monomers, and monomer hydrolysates within 1-week simulated use.

Embryotoxicity and teratogenesis of orthodontic acrylic resin in zebrafish

Objectives

This study investigated the in vivo embryotoxicity, teratogenic potential, and additional effects of orthodontic acrylic resin as well as its components, utilizing zebrafish as a model organism. The research focused on morphological, cardiac, behavioral, and cognitive evaluations that were performed on embryos and larval-stage animals subjected to chronic exposure.

Materials and methods

Embryo and larval-stage zebrafish were categorized into five experimental groups, which were further subdivided into five subgroups. These subgroups included three specific doses for each tested substance, a control with the vehicle (0.1 % dimethyl sulfoxide in water), and an absolute control (water). Assessments were performed on day 5 post-fertilization, which included morphological, cardiac, behavioral, and cognitive evaluations. All experiments had a sample size of ten animals and were performed in triplicate. Survival and hatching rates were analyzed using the Kaplan-Meier test, while other measurements were assessed using one-way analysis of variance (ANOVA), followed by the Tukey post hoc test.

Results

Statistically significant differences were observed between the control and treatment groups across all the tested substances for heart rate, cognitive responsiveness, and cellular apoptosis. However, survival, hatching rate, and other parameters exhibited no significant variation, except for the highest dose in the dibutyl phthalate group, which demonstrated a notable difference in survival.

Conclusions

Chronic exposure to acrylic resin and its components may be associated with decreased cognitive ability and cardiac rhythm, as well as an increase in the level of cellular apoptosis in zebrafish.

In silico assessment of biocompatibility and toxicity: molecular docking and dynamics simulation of PMMA-based dental materials for interim prosthetic restorations

AIM

This study aimed to comprehensively assess the biocompatibility and toxicity profiles of poly(methyl methacrylate) (PMMA) and its monomeric unit, methyl methacrylate (MMA), crucial components in dental materials for interim prosthetic restorations.

METHODOLOGY

Molecular docking was employed to predict the binding affinities, energetics, and steric features of MMA and PMMA with selected receptors involved in bone metabolism and tissue development, including RANKL, Fibronectin, BMP9, NOTCH2, and other related receptors. The HADDOCK standalone version was utilized for docking calculations, employing a Lamarckian genetic algorithm to explore the conformational space of ligand-receptor interactions. Furthermore, molecular dynamics (MD) simulations over 100 nanoseconds were conducted using the GROMACS package to evaluate dynamic actions and structural stability. The LigandScout was utilized for pharmacophore modeling, which employs a shape-based screening approach to identify potential ligand binding sites on protein targets.

RESULTS

The molecular docking studies elucidated promising interactions between PMMA and MMA with key biomolecular targets relevant to dental applications. MD simulation results provided strong evidence supporting the structural stability of PMMA complexes over time. Pharmacophore modeling highlighted the significance of carbonyl and hydroxyl groups as pharmacophoric features, indicating compounds with favorable biocompatibility profiles.

CONCLUSION

This study underscores the potential of PMMA in dental applications, emphasizing its structural stability, molecular interactions, and safety considerations. These findings lay a foundation for future advancements in dental biomaterials, guiding the design and optimization of materials for enhanced biocompatibility. Future directions include experimental validation of computational findings and the development of PMMA-based dental materials with improved biocompatibility and clinical performance.

Analysis of Resin-Based Dental Materials' Composition Depending on Their Clinical Applications

The objective of this study was to detail the monomer composition of resin-based dental materials sold in the market in 2023 and to evaluate the proportion of bisphenol A (BPA)-derivatives in relation to their applications. A search on manufacturers' websites was performed to reference resin-based dental materials currently on the European market (including the European Union (EU) and United Kingdom (UK). Their monomer composition was determined using material-safety data sheets and was completed by a search on the PubMed database. Among the 543 material compositions exploitable, 382 (70.3%) contained BPA derivatives. Among them, 56.2% contained BisGMA and 28% BisEMA, the most frequently reported. A total of 59 monomers, of which six were BPA derivatives, were found. In total, 309 materials (56.9%) contained UDMA and 292 (53.8%) TEGDMA. Less than one third of materials identified contained no BPA derivatives. These proportions vary a lot depending on their applications, with materials dedicated to the dental care of young populations containing the highest proportions of BPA-derivative monomers. The long-term effects on human health of the different monomers identified including BPA-derivative monomers is a source of concern. For children and pregnant or lactating women arises the question of whether to take a precautionary principle and avoid the use of resin-based dental materials likely to release BPA by opting for alternative materials.

Application of photosensitive dental materials as a novel antimicrobial option in dentistry: A literature review

The formation of dental plaque is well-known for its role in causing various oral infections, such as tooth decay, inflammation of the dental pulp, gum disease, and infections of the oral mucosa like peri-implantitis and denture stomatitis. These infections primarily affect the local area of the mouth, but if not treated, they can potentially lead to life-threatening conditions. Traditional methods of mechanical and chemical antimicrobial treatment have limitations in fully eliminating microorganisms and preventing the formation of biofilms. Additionally, these methods can contribute to the development of drug-resistant microorganisms and disrupt the natural balance of oral bacteria. Antimicrobial photodynamic therapy (aPDT) is a technique that utilizes low-power lasers with specific wavelengths in combination with a photosensitizing agent called photosensitizer to kill microorganisms. By inducing damage through reactive oxygen species (ROS), aPDT offers a new approach to addressing dental plaque and associated microbial biofilms, aiming to improve oral health outcomes. Recently, photosensitizers have been incorporated into dental materials to create photosensitive dental materials. This article aimed to review the use of photosensitive dental materials for aPDT as an innovative antimicrobial option in dentistry, with the goal of enhancing oral health.

Cell viability and cytotoxicity assays: Biochemical elements and cellular compartments

Cell viability and cytotoxicity assays play a crucial role in drug screening and evaluating the cytotoxic effects of various chemicals. The quantification of cell viability and proliferation serves as the cornerstone for numerous in vitro assays that assess cellular responses to external factors. In the last decade, several studies have developed guidelines for defining and interpreting cell viability and cytotoxicity based on morphological, biochemical, and functional perspectives. As this domain continues to experience ongoing growth, revealing new mechanisms orchestrating diverse cell cytotoxicity pathways, we suggest a revised classification for multiple assays employed in evaluating cell viability and cell death. This classification is rooted in the cellular compartment and/or biochemical element involved, with a specific focus on mechanistic and essential aspects of the process. The assays are founded on diverse cell functions, encompassing metabolic activity, enzyme activity, cell membrane permeability and integrity, adenosine 5'-triphosphate content, cell adherence, reduction equivalents, dye inclusion or exclusion, constitutive protease activity, colony formation, DNA fragmentation and nuclear splitting. These assays present straightforward, reliable, sensitive, reproducible, cost-effective, and high-throughput approaches for appraising the effects of newly formulated chemotherapeutic biomolecules on the cell survival during the drug development process.

Preparation, characterization, and in vitro/vivo evaluation of a multifunctional electrode coating for cochlear implants

Cochlear implantation (CI) is the primary intervention for patients with sensorineural hearing loss to restore their hearing. However, approximately 90 % of CI recipients experience unexpected fibrosis around the inserted electrode arrays due to acute and chronic inflammation. This fibrosis leads to progressive residual hearing loss. Addressing this complication is crucial for enhancing CI outcomes, yet an effective treatment has not yet been found. In this study, we developed a multifunctional dexamethasone (DXM)-loaded polytrimethylene carbonate (PTMC) electrode coating to mitigate inflammatory reactions and fibrosis after CI. This thin and flexible coating could preserve the mechanical performance of the electrode and reduce the implantation resistance for CI. The in vitro release studies demonstrated the DXM-PTMC coating's efficient drug loading and sustained release capability over 90 days. DXM-PTMC also showed long-term stability, high biocompatibility, and effective anti-inflammatory effects in vitro and in vivo. Compared with the uncoated group, DXM-PTMC coating significantly inhibited the expression of inflammatory factors, such as NO, TNF-α, IL-1β, and IL-6. DXM-PTMC coating suppressed fibrosis in rat implantation models for 3 weeks by reducing both acute and chronic inflammation. Our findings suggest that DXM-PTMC coating is a novel strategy to improve the outcomes of CI.

A review of the therapeutic potential of dental stem cells as scaffold-free models for tissue engineering application

In the realm of regenerative medicine, tissue engineering has introduced innovative approaches to facilitate tissue regeneration. Specifically, in pulp tissue engineering, both scaffold-based and scaffold-free techniques have been applied. Relevant articles were meticulously chosen from PubMed, Scopus, and Google Scholar databases through a comprehensive search spanning from October 2022 to December 2022. Despite the inherent limitations of scaffolding, including inadequate mechanical strength for hard tissues, insufficient vents for vessel penetration, immunogenicity, and suboptimal reproducibility-especially with natural polymeric scaffolds-scaffold-free tissue engineering has garnered significant attention. This methodology employs three-dimensional (3D) cell aggregates such as spheroids and cell sheets with extracellular matrix, facilitating precise regeneration of target tissues. The choice of technique aside, stem cells play a pivotal role in tissue engineering, with dental stem cells emerging as particularly promising resources. Their pluripotent nature, non-invasive extraction process, and unique properties render them highly suitable for scaffold-free tissue engineering. This study delves into the latest advancements in leveraging dental stem cells and scaffold-free techniques for the regeneration of various tissues. This paper offers a comprehensive summary of recent developments in the utilization of dental stem cells and scaffold-free methods for tissue generation. It explores the potential of these approaches to advance tissue engineering and their effectiveness in therapies aimed at tissue regeneration.

Preparation, Characterization, and Evaluation of the Anticancer Effect of Mesoporous Silica Nanoparticles Containing Rutin and Curcumin

AIMS AND OBJECTIVE

The aim of this study was the preparation of mesoporous silica nanoparticles co-loaded with rutin and curcumin (Rut-Cur-MSNs) and the assessment of its physicochemical properties as well as its cytotoxicity on the head and neck cancer cells (HN5). Besides, ROS generation of HN5 cells exposed to Rut-Cur-MSNs was evaluated. Several investigations showed that rutin and curcumin have potential effects as anticancer phytochemicals; however, their low aqueous solubility and poor bioavailability limited their applications. The assessment of physicochemical properties and anticancer effect of prepared nanoparticles was the objective of this study.

METHODS

The physicochemical properties of produced nanoparticles were evaluated. The toxicity of Rut-Cur-MSNs on HN5 cells was assessed. In addition, the ROS production in cells treated with Rut- Cur-MSNs was assessed compared to control untreated cells.

RESULTS

The results showed that Rut-Cur-MSNs have mesoporous structure, nanometer size and negative surface charge. The X-ray diffraction pattern showed that the prepared nanoparticles belong to the family of silicates named MCM-41. The cytotoxicity of Rut-Cur-MSNs at 24 h was significantly higher than that of rutin-loaded MSNs (Rut-MSNs) and curcumin-loaded MSNs (Cur-MSNs) (p<0.05).

CONCLUSION

The achieved results recommend that the prepared mesoporous silica nanoparticles containing rutin and curcumin can be a useful nanoformulation for the treatment of cancer. The produced nanomaterial in this study can be helpful for cancer therapy.

Development of cobalt-incorporated chitosan scaffold for regenerative potential in human dental pulp stem cells: An in vitro study

The aim of the study was to comparatively evaluate chitosan and Cobalt incorporated chitosan (CoCH) scaffold at varying concentrations in terms of their material characteristics, cytotoxicity and cell adhesion potential. In the present study, cobalt incorporated chitosan scaffolds at varying concentrations were prepared and dried. The synthesised scaffolds were characterised using XRD, FTIR, SEM-EDX and BET which revealed amorphous, porous surface of CoCH scaffolds and FTIR analysis showed the complexation confirming the chelation of cobalt with chitosan. The experimental scaffolds proved to be non-cytotoxic when compared to chitosan scaffolds on XTT analysis. Cell-seeding assay revealed enhanced adherence of hDPSCs to CoCH scaffold at 1:1 ratio in the concentration of 100 mL of 100 μmol/L cobalt chloride solution in 100mL of 2% chitosan solution, when compared to other groups. The results highlighted that 100 μmol/L concentration of cobalt chloride when incorporated in 1:1 ratio into 2 % CH solution yields a promising porous, biocompatible scaffold with enhanced cellular adhesion for dentin-pulp regeneration.

Considerations about Cytotoxicity of Resin-Based Composite Dental Materials: A Systematic Review

The dental material industry is rapidly developing resin-based composites (RBCs), which find widespread use in a variety of clinical settings. As such, their biocompatibility has gained increasing interest. This literature review presents a summary of research into the cytotoxicity of methacrylate-based composites published from 2017 to 2023. Subject to analysis were 14 in vitro studies on human and murine cell lines. Cytotoxicity in the included studies was measured via MTT assay, LDH assay, and WST-1 assay. The QUIN Risk of Bias Tool was performed to validate the included studies. Included studies (based entirely on the results of in vitro studies) provide evidence of dose- and time-dependent cytotoxicity of dental resin-based composites. Oxidative stress and the depletion of cellular glutathione (GSH) were suggested as reasons for cytotoxicity. Induction of apoptosis by RBCs was indicated. While composites remain the golden standard of dental restorative materials, their potential cytotoxicity cannot be ignored due to direct long-term exposure. Further in vitro investigations and clinical trials are required to understand the molecular mechanism of cytotoxicity and produce novel materials with improved safety profiles.

Potential applications of medicinal herbs and phytochemicals in oral and dental health: Status quo and future perspectives

OBJECTIVE

Herbal therapies are utilized to treat a broad diversity of diseases all over the globe. Although no clinical studies have been conducted to demonstrate the antibacterial, antimicrobial, and antiplaque characteristics of these plants, this does not imply that they are ineffectual as periodontal treatments or anti-cariogenic drugs. However, there is a scarcity of research confirming their efficacy and worth.

SUBJECT

Herbs are utilized in dentistry as antimicrobial, antineoplastic, antiseptic, antioxidant, and analgesics agents as well as for the elimination of bad breath. In addition, the application of herbal agents in tissue engineering improved the regeneration of oral and dental tissues. This study reviews the application of medicinal herbs for the treatment of dental and oral diseases in different aspects.

METHODS

This article focuses on current developments in the use of medicinal herbs and phytochemicals in oral and dental health. An extensive literature review was conducted via an Internet database, mostly PubMed. The articles included full-text publications written in English without any restrictions on a date.

CONCLUSION

Plants have been suggested, as an alternate remedy for oral-dental problems, and this vocation needs long-term dependability. More research on herbal medicine potential as pharmaceutical sources and/or therapies is needed.

Green Synthesis of Silver Nanoparticles Derived from Papaver rhoeas L. Leaf Extract: Cytotoxic and Antimicrobial Properties

In the last few decades, the search for metal nanoparticles as an alternative to cancer treatments and antibiotics has increased. In this article, the spectroscopic (ultraviolet-visible (UV-vis), electron-dispersing X-ray (EDX), and Fourier transform infrared (FT-IR)), microscopic (field emission scanning electron microscope (FE-SEM), transmission electron microscope (TEM), and atomic force microscope (AFM)), structural (X-ray diffractometer (XRD) and zetasizer), and analytic (thermogravimetric/differential thermal analyzer (TGA-DTA)) characterization of the silver nanoparticles (AgNPs) produced from Papaver rhoeas (PR) L. leaf extract are presented. PR-AgNPs are generally spherical and have a maximum surface plasmon resonance of 464.03 nm. The dimensions of the manufactured nanomaterial are in the range of 1.47-7.31 nm. PR-AgNPs have high thermal stability and a zeta potential of -36.1 mV. The minimum inhibitory concentration (MIC) values (mg L-1) of PR-AgNPs on Staphylococcus aureus, Escherichia coli, Bacillus subtilis, Pseudomonas aeruginosa, and Candida albicans are 1.50, 0.75, 3.00, 6.00, and 0.37, respectively. In the study, the cytotoxic and proliferative effects of PR-AgNPs using the MTT (3-(4,5-dimethylthiazol-2-yl)-diphenyltetrazolium bromide) method on various cancer cell lines (CACO-2 (human colon adenocarcinoma cell), MCF-7 (human breast cancer cell), T98-G (glioblastoma multiforme cell), and healthy HUVEC (human umbilical vein endothelial cell)) cell lines are presented. After 24 and 48 h of the application, the half-maximum inhibitory concentration (IC50) values (μg mL-1) of PR-AgNPs on HUVEC, CACO-2, MCF-7, and T98-G lines are 2.365 and 2.380; 2.526 and 2.521; 3.274 and 3.318; 3.472 and 3.526, respectively. Comprehensive in vivo research of PR-AgNPs is proposed to reveal their potential for usage in sectors such as nanomedicine and nanochemistry.

Anti-multispecies microbial biofilms and anti-inflammatory effects of antimicrobial photo-sonodynamic therapy based on acrylic resin containing nano-resveratrol

BACKGROUND

Polymethylmethacrylate (PMMA)-based removable orthodontic appliances are susceptible to microbial colonization due to the surface porosity, and accumulating the biofilms causes denture stomatitis. the present study evaluated the anti-biofilm and antiinflammatory effects of antimicrobial photo-sonodynamic therapy (aPSDT) against multispecies microbial biofilms (Candida albicans, Staphylococcus aureus, Streptococcus sobrinus, and Actinomyces naeslundii) formed on acrylic resin modified with nanoresveratrol (NR).

MATERIALS AND METHODS

Following the determination of the minimum biofilm inhibitory concentration (MBIC) of NR, in vitro anti-biofilm activity of NR was evaluated. The antibiofilm efficacy against multispecies microbial biofilm including C. albicans, S. aureus, S. sobrinus, and A. naeslundii, were assessed by biofilm inhibition test and the results were measured. To reveal the anti-inflammatory effects of aPSDT on human gingival fibroblast (HGF) cells, the gene expression levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were evaluated via quantitative real-time polymerase chain reaction (qRT-PCR).

RESULTS

According to the results, the MBIC dose of NR against multispecies microbial biofilm was considered 512 µg/mL. The highest biofilm reduction activity was observed in MBIC treated with aPSDT and 2 × MBIC exposed to light emitting diode (LED) and ultrasound waves (UW). The expression level of TNF-α and IL-6 genes were significantly increased when HGF cells were exposed to multispecies microbial biofilms (P<0.05), while after treatment with aPSDT, the expression levels of genes were significantly downregulated in all groups (P<0.05).

CONCLUSION

Overall, NR-mediated aPSDT reduced the growth of the multispecies microbial biofilm and downregulated the expression of TNF-α and IL-6 genes. Therefore, modified PMMA with NR can be serving as a promising new orthodontic acrylic resin against multispecies microbial biofilms and the effect of this new material is amplified when exposed to LED and UW.

Nanohydroxyapatite in dentistry: A comprehensive review

Enamel, being the hardest and the highest mineralized tissue of the human body, contains nearly 96% inorganic components and 4% organic compounds and water. Dentin contains 65% inorganic components and 35% organic and water content. The translucency and white appearance of enamel are attributed to Hydroxyapatite (HA), which constitutes the major part of the inorganic component of dental hard tissue. With the advent of nanotechnology, the application of Nanohydroxyapatite (nHA) has piqued interest in dentistry due to its excellent mechanical, physical, and chemical properties. Compared to HA, nHA is found to have superior properties such as increased solubility, high surface energy and better biocompatibility. This is due to the morphological and structural similarity of nanosized hydroxyapatite particles to tooth hydroxyapatite crystals. These nanoparticles have been incorporated into various dental formulations for different applications to ensure comprehensive oral healthcare. To prevent dental caries, several nHA based dentifrices, mouth rinsing solutions and remineralizing pastes have been developed. nHA-based materials, such as nanocomposites, nano impression materials, and nanoceramics, have proven to be very effective in restoring tooth deformities (decay, fracture, and tooth loss). The nHA coating on the surface of the dental implant helps it bind to the bone by forming a biomimetic coating. A recent innovative strategy involves using nHA to reduce dentinal hypersensitivity and to reconstruct periodontal bone defects. The purpose of the present review is to discuss the different applications of nHA in dentistry, especially in preventive and restorative dentistry, dental implantology, bleaching and dentine hypersensitivity management.

Biomimetic Enamel Regeneration Using Self-Assembling Peptide P11-4

The recent understanding of the etiology and pathology of dental caries has shifted its treatment from invasive drill and fill conventional strategies to noninvasive and/or minimally invasive approaches. Guided tissue regeneration (GTR) is a well-established therapeutic approach in medicine and periodontal and oral surgery. Recently, the concept of biomimetic regeneration has been further expanded to treat the loss of hard dental tissues. Self-assembling peptides have emerged as a promising biomaterial for biomimetic regeneration due to their ability to construct a protein scaffold in the body of early carious lesions and provide a matrix that promotes remineralization. This review article accompanies the development of self-assembling peptide P11-4 for the treatment of initial carious lesions. In vitro and in vivo studies on the safety, clinical applicability, and efficacy of P11-4 are discussed. Furthermore, different treatment options and potential areas of application are presented.

Cleaning Strategies of Synthesized Bioactive Coatings by PEO on Ti-6Al-4V Alloys of Organic Contaminations

The effect of various cleaning methods on coating morphology and their effectiveness in removing organic contaminants has been studied in this research. Bioactive coatings containing titanium oxides and hydroxyapatite (HAP) were obtained through plasma electrolytic oxidation in aqueous electrolytes and molten salts. The cleaning procedure for the coated surface was performed using autoclave (A), ultraviolet light (UV), radio frequency (RF), air plasma (P), and UV-ozone cleaner (O). The samples were characterized using scanning electron microscopy (SEM) with an EDS detector, X-ray photoelectron spectroscopy (XPS), X-ray phase analysis (XRD), and contact angle (CA) measurements. The conducted studies revealed that the samples obtained from molten salt exhibited a finer crystalline structure morphology (275 nm) compared to those obtained from aqueous electrolytes (350 nm). After applying surface cleaning methods, the carbon content decreased from 5.21 at.% to 0.11 at.% (XPS), which directly corresponds to a reduction in organic contaminations and a decrease in the contact angle as follows: A > UV > P > O. This holds true for both coatings obtained in molten salt (25.3° > 19.5° > 10.5° > 7.5°) and coatings obtained in aqueous electrolytes (35.2° > 28.3° > 26.1° > 16.6°). The most effective and moderate cleaning method is ozone treatment.

The Clinical Potential of 3D-Printed Crowns Reinforced with Zirconia and Glass Silica Microfillers

The development of 3D-printed crown resin materials with improved mechanical and physical properties is an area of growing interest in dentistry. This study aimed to develop a 3D-printed crown resin material modified with zirconia glass (ZG) and glass silica (GS) microfillers to enhance overall mechanical and physical properties. A total of 125 specimens were created and divided into five groups: control unmodified resin, 5% either ZG or GS reinforced 3D-printed resin, and 10% either ZG or GS reinforced 3D-printed resin. The fracture resistance, surface roughness, and translucency parameter were measured, and fractured crowns were studied under a scanning electron microscope. The results showed that 3D-printed parts that were strengthened with ZG and GS microfillers demonstrated comparable mechanical performance to unmodified crown resin but resulted in greater surface roughness, and only the group that contained 5% ZG showed an increase in translucency. However, it should be noted that increased surface roughness may impact the aesthetics of the crowns, and further optimisation of microfillers concentrations may be necessary. These findings suggest that the newly developed dental-based resins that incorporate microfillers could be suitable for clinical applications, but further studies are necessary to optimise the nanoparticle concentrations and investigate their long-term clinical outcomes.

Assessment of Microhardness of Conventional and Bulk-Fill Resin Composites Using Different Light-Curing Intensity

(1) Background: This study evaluates the effect of a conventional/low-voltage light-curing protocol (LV protocol) (10 s with 1340 mW/cm²) and high-voltage light-curing protocol (HV protocol) (3 s with 3440 mW/cm²) on the microhardness (MH) of dental resin-based composites (RBCs). Five resin composites were tested: conventional Evetric (EVT), Tetric Prime (TP), Tetric Evo Flow (TEF), bulk-fill Tetric Power Fill (PFL), and Tetric Power Flow (PFW). (2) Materials and Methods: Two tested composites (PFW and PFL) were designed for high-intensity light curing. The samples were made in the laboratory in specially designed cylindrical molds; diameter = 6 mm and height = 2 or 4 mm, depending on the type of composite. Initial MH was measured on the top and bottom surfaces of composite specimens 24 h after light curing using a digital microhardness tester (QNESS 60 M EVO, ATM Qness GmbH, Mammelzen, Germany). The correlation between the filler content (wt%, vol%) and the MH of the RBCs was tested. For the calculation of depth-dependent curing effectiveness, the bottom/top ratio for initial MH was used. (3) Conclusions: MH of RBCs is more dependent on material composition than on light-curing protocol. Filler wt% has a greater influence on MH values compared to filler vol%. The bottom/top ratio showed values over 80% for bulk composites, while for conventional sculptable composites, borderline or suboptimal values were measured for both curing protocols.

Biocompatibility and osseointegration properties of a novel high strength and low modulus β- Ti10Mo6Zr4Sn3Nb alloy

Introduction: Ti6Al4V titanium alloy is widely used in producing orthopedic and maxillofacial implants, but drawbacks include high elastic modulus, poor osseointegration performance, and toxic elements. A new medical titanium alloy material with better comprehensive performance is urgently needed in the clinic. Methods: Ti10Mo6Zr4Sn3Nb titanium alloy (referred to as Ti-B12) is a unique medical ß titanium alloy material developed by us. The mechanical properties of Ti-B12 depict that it has advantages, such as high strength, low elastic modulus, and fatigue resistance. In our study, the biocompatibility and osseointegration properties of Ti-B12 titanium alloy are further studied to provide theoretical guidance for its clinical transformation. Results and Discussion: The titanium alloy Ti-B12 displays no significant effect on MC3T3-E1 cell morphology, proliferation, or apoptosis in vitro. Neither Ti-B12 titanium alloy nor Ti6Al4V titanium alloy depicts a significant difference (p > 0.05); Ti-B12 material extract injected into the abdominal cavity of mice does not cause acute systemic toxicity. The skin irritation test and intradermal irritation test reveal that Ti-B12 does not cause skin allergic reactions in rabbits. Compared to Ti6Al4V, Ti-B12 titanium alloy material has more advantages in promoting osteoblast adhesion and ALP secretion (p < 0.05). Although there is no significant difference in OCN and Runx2 gene expression between the three groups on the 7th and 14th days of differentiation induction (p > 0.05), the expression of Ti-B12 group is higher than that of Ti6Al4V group and blank control group. Furthermore, the rabbit in vivo test present that 3 months after the material is implanted in the lateral epicondyle of the rabbit femur, the Ti-B12 material fuses with the surrounding bone without connective tissue wrapping. This study confirms that the new β-titanium alloy Ti-B12 not only has low toxicity and does not cause rejection reaction but also has better osseointegration performance than the traditional titanium alloy Ti6Al4V. Therefore, Ti-B12 material is expected to be further promoted in clinical practice.

Dental Implants and Implant Coatings: A Focus on Their Toxicity and Safety

Dental implants are medical devices that are surgically inserted into the patient's jawbone by an orthodontist to act as roots of missing teeth. After the implantation, the maxilla or mandible integrates with the surface of the dental implant. This process, called "osseointegration," is an important period to ensure the long-term use of dental implants and prevent implant failures. Metal implants are the most used implant materials. However, they have disadvantages such as corrosion, metal ion release from metal implant surfaces and associated toxicity. To avoid these adverse effects and improve osseointegration, alternative dental implant materials such as ceramics, polymers, composites, and novel surface modification technologies have been developed. The safety of these materials are also of concern for toxicologists. This review will give general information about dental implant materials, osseointegration and successful implantation process. Moreover, we will focus on the new surface coatings materials for of dental implants and their toxicity and safety concerns will be discussed.

Evaluation of the cell viability and antimicrobial effects of orthodontic bands coated with silver or zinc oxide nanoparticles: An in vitro study

Objective

We aimed to evaluate the cell viability and antimicrobial effects of orthodontic bands coated with silver or zinc oxide nanoparticles (nano-Ag and nano-ZnO, respectively).

Methods

In this experimental study, 30 orthodontic bands were divided into three groups (n = 10 each): control (uncoated band), Ag (silver-coated band), and ZnO (zinc oxide-coated band). The electrostatic spray-assisted vapor deposition method was used to coat orthodontic bands with nano-Ag or nano-ZnO. The biofilm inhibition test was used to assess the antimicrobial effectiveness of nano-Ag and nano-ZnO against Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans. Biocompatibility tests were conducted using the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay. The groups were compared using oneway analysis of variance with a post-hoc test.

Results

The Ag group showed a significantly higher reduction in the number of L. acidophilus, C. albicans, and S. mutans colonies than the ZnO group (p = 0.015, 0.003, and 0.005, respectively). Compared with the control group, the Ag group showed a 2-log₁₀ reduction in all the microorganisms' replication ability, but only S. mutants showed a 2-log₁₀ reduction in replication ability in the ZnO group. The lowest mean cell viability was observed in the Ag group, but the difference between the groups was insignificant (p > 0.05).

Conclusions

Coating orthodontic bands with nano-ZnO or nano-Ag induced antimicrobial effects against oral pathogens. Among the nanoparticles, nano-Ag showed the best antimicrobial activity and nano-ZnO showed the highest biocompatibility.

Prediction of Bone Healing around Dental Implants in Various Boundary Conditions by Deep Learning Network

Tissue differentiation varies based on patients' conditions, such as occlusal force and bone properties. Thus, the design of the implants needs to take these conditions into account to improve osseointegration. However, the efficiency of the design procedure is typically not satisfactory and needs to be significantly improved. Thus, a deep learning network (DLN) is proposed in this study. A data-driven DLN consisting of U-net, ANN, and random forest models was implemented. It serves as a surrogate for finite element analysis and the mechano-regulation algorithm. The datasets include the history of tissue differentiation throughout 35 days with various levels of occlusal force and bone properties. The accuracy of day-by-day tissue differentiation prediction in the testing dataset was 82%, and the AUC value of the five tissue phenotypes (fibrous tissue, cartilage, immature bone, mature bone, and resorption) was above 0.86, showing a high prediction accuracy. The proposed DLN model showed the robustness for surrogating the complex, time-dependent calculations. The results can serve as a design guideline for dental implants.

Anti-Periodontitis Effects of Dendropanax morbiferus H.Lév Leaf Extract on Ligature-Induced Periodontitis in Rats

Periodontitis is caused by pathogens in the oral cavity. It is a chronic infectious disease that causes symptoms including gingival bleeding and tooth loss resulting from the destruction of periodontal tissues coupled with inflammation. Dendropanax morbiferus H.Lév (DM) is a natural product that exhibits various biological activities with few side effects. In this study, the potential of DM leaf hot-water extracts (DMWE) as a treatment for periodontitis was determined and its anti-oxidant and anti-inflammatory effects were evaluated. Compounds in DMWE were identified by high-performance liquid chromatography (HPLC) and nitric oxide (NO) and prostaglandin E₂ (PGE₂) production was measured in RAW 264.7 cells. We measured the gingival index and gingival sulcus depth, and micro-CT was performed in vivo using a ligature-induced periodontitis rat model, which is similar to human periodontitis. The DMWE-treated group exhibited a decrease in cytokine concentration and relieved the gingival index and gingival sulcus depth compared with the periodontitis-induced control group. In addition, micro-CT and histological analysis revealed that DMWE exhibited anti-inflammatory effects and improved alveolar bone loss in periodontitis-induced rats. These findings suggest that DMWE has excellent anti-oxidant and anti-inflammatory effects that protect and prevent periodontal tissue damage and tooth loss caused by the inflammatory response.

Anti-biofilm and bystander effects of antimicrobial photo-sonodynamic therapy against polymicrobial periopathogenic biofilms formed on coated orthodontic mini-screws with zinc oxide nanoparticles

BACKGROUND

The present study evaluated the anti-biofilm and bystander effects of antimicrobial photo-sonodynamic therapy (aPSDT) on the polymicrobial periopathogenic biofilms formed on mini-screws coated with zinc oxide nanoparticles (ZnONPs).

MATERIALS AND METHODS

Thirty orthodontic identical mini-screws were divided into 6 groups (n = 5) as follows: 1. negative control: uncoated mini-screw + phosphate-buffered saline (PBS), 2. positive control: uncoated mini-screw + 0.2% CHX, 3. coating control: coated mini-screw + PBS, 4. antimicrobial photodynamic therapy (aPDT): coated mini-screw+light emitting diode (LED), 5. Antimicrobial sonodynamic therapy (aSDT): coated mini-screw+ultrasound waves, and 6. aPSDT: coated mini-screw+LED+ultrasound waves. Electrostatic spray-assisted vapor deposition was employed to coat ZnONPs on titanium mini-screws. The biofilm inhibition test was used to assess the anti-biofilm efficacy against polymicrobial periopathogenic biofilms including Porphyromonas gingivitis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans, and the results were shown as the percent reduction of Log₁₀ colony-forming unit (CFU)/mL. Following each treatment, the gene expression levels of TNF-α, IL-1β, and IL-6 were evaluated on human gingival fibroblast (HGF) cells via quantitative real-time polymerase chain reaction (qRT-PCR) to reveal the bystander effects of aPSDT on HGF cells.

RESULTS

A significant reduction in log₁₀ CFU/mL of periopathogens was observed in groups treated with aPDT, aSDT, aPSDT, and 0.2% CHX up to 6.81, 6.63, 5.02, and 4.83 log, respectively, when compared with control groups (P<0.05). 0.2% CHX and aPSDT groups demonstrated significantly higher capacity in eliminating the periopathogen biofilm compared with other groups (P<0.05). The qRT-PCR showed that the expression level of inflammatory cytokines was significantly down regulated in aPDT, aSDT, and aPSDT groups (P<0.05).

CONCLUSION

It was found that the ZnONPs-mediated aPSDT could significantly reduce periopathogen biofilm as well as the expression level of inflammatory cytokines.

Application of Tribology Concept in Dental Composites Field: A Scoping Review

Tribology is the discipline concerning the application of friction, lubrication, and wear concepts of interacting surfaces in relative motion. A growing interest has developed in tribology application in medical biomaterials, such as resin composites used in restorative dentistry. Yet, the keywords "tribology" and "biotribology" are little applied in the pertinent publications. The aim of this scoping review was to offer an overview of tribology application in dental composites research and to identify knowledge gaps and address future research. A literature search was conducted on Pubmed and Scopus databases and the studies investigating the tribological behavior of resin composites were included for qualitative synthesis. The majority of studies on dental tribology were published in the research areas of mechanical engineering/nanotechnology and differed in several methodological aspects. The preponderant engineering approach and the lack of standardized testing make the laboratory findings poorly informative for clinicians. Future research should focus on the tribological behavior of dental materials composites by means of an integrated approach, i.e., engineering and clinical, for improving development and advancement in this field of research.

Bioactive Inorganic Materials for Dental Applications: A Narrative Review

Over time, much attention has been given to the use of bioceramics for biomedical applications; however, the recent trend has been gaining traction to apply these materials for dental restorations. The bioceramics (mainly bioactive) are exceptionally biocompatible and possess excellent bioactive and biological properties due to their similar chemical composition to human hard tissues. However, concern has been noticed related to their mechanical properties. All dental materials based on bioactive materials must be biocompatible, long-lasting, mechanically strong enough to bear the masticatory and functional load, wear-resistant, easily manipulated, and implanted. This review article presents the basic structure, properties, and dental applications of different bioactive materials i.e., amorphous calcium phosphate, hydroxyapatite, tri-calcium phosphate, mono-calcium phosphate, calcium silicate, and bioactive glass. The advantageous properties and limitations of these materials are also discussed. In the end, future directions and proposals are given to improve the physical and mechanical properties of bioactive materials-based dental materials.

Comparative Study of Salivary pH, Buffer Capacity, and Flow in Patients with and without Gastroesophageal Reflux Disease

The oral cavity has specific and individualized characteristics, with pH, saliva flow, buffer capacity, temperature, and microorganisms content influencing oral health. Currently, the prevalence of gastroesophageal reflux disease (GERD) is constantly increasing. The objective of this study was to evaluate and compare the saliva quantity at 5 min, salivary pH, and salivary buffer capacity in patients with and without GERD, necessary for establishing the correct dental treatment plan. A Saliva-Check Buffer (GC) kit was used for the determination of salivary variables. The total number of 80 patients included in the study were divided into a study group and a control group, each containing 40 patients. Saliva quantity at 5 min was lower in patients suffering from GERD. The salivary pH of these patients turned to acid values compared to the salivary pH of controls, where the values were within the normal range. In patients with GERD, the determined salivary buffer capacity was low or very low. The use of the Saliva-Check Buffer (GC) kit is a simple, easy, non-invasive and patient-accepted method, which can also be used in the dentist's office to assess the saliva buffer capacity and pH, variables that are important for establishing a correct dental treatment plan.

Effect of temperature-sensitive nanogel combined with angioplasty on sICAM-1 and VE-cadherin in lower extremity arterial occlusion rabbits

The study was to explore the effect of subintimal angioplasty (SIA) on the levels of soluble intercellular adhesion molecule-1 (sICAM-1) and vascular endothelial cadherin (VE-cadherin) in the rabbit model of lower extremity arterial occlusion. Specifically, the poly(N-isopropylacrylamide-co-butyl methacrylate) (PIB) temperature-sensitive nanogel was prepared, and the cytotoxicity of direct and indirect contact with PIB temperature-sensitive gel was analyzed then. Subsequently, the PIB temperature-sensitive gel was injected to the New Zealand white rabbit to prepare the lower extremity arterial occlusion model. The healthy control, model group, and SIA group were compared for the serum lipids, fibrinogen (Fbg), fibrinogen (Fbg), and fibrinogen (Fbg) levels. The results showed that the cell proliferation activity and survival rate were always higher than 90% under different concentrations of PIB temperature-sensitive gels. Compared with the model group, the SIA group had increased total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), and Fbg levels, but decreased high-density lipoprotein (HDL) level (P < 0.05); decreased TXB2, ET-1, and ICAM-1 levels, but increased levels of 6-Keto-PGF1α and NO (P < 0.05); and decreased sICAM-1 and VE-cadherin levels (P < 0.05). It showed that PIB temperature-sensitive nanogel can elicit vascular embolism, and SIA is suggested in the treatment of lower extremity arterial occlusion.

A Novel Developed Bioactive Composite Resin Containing Silver/Zinc Oxide (Ag/ZnO) Nanoparticles as an Antimicrobial Material against Streptococcus mutans, Lactobacillus, and Candida albicans

Aim

The objectives of this study were to develop a new bioactive composite resin containing silver/zinc oxide (Ag/ZnO) nanoparticles and investigate the effects on mechanical, cytotoxic, biocompatibility, and antimicrobial properties.

Materials and Methods

Disc-shaped specimens were prepared from composite with and without nanoparticles in separate culture media containing Streptococcus mutans, Lactobacillus, and Candida albicans. Bracket bonding evaluation was performed on composite without nanoparticles (O), composite containing ZnO (Z) nanoparticles, composite containing ZnO nanoparticles and silver ions (A&Z), and composite containing Ag/ZnO nanoparticles (AZ) synthesized using optical precipitation.

Results

Composite resin with nanoparticles (AZ, A&Z, and Z) showed significant antimicrobial properties (P < 0.05). The mean shear bond strength of A&Z composite resin (13.61 ± 0.73 MPa) was significantly less than that of conventional composite resin (19.03 ± 4.12 MPa) (P < 0.05). In addition, the mean shear bond strength of AZ composite resin (20.49 ± 1.03 MPa) was significantly higher than that of Z (16.35 ± 1.03 MPa) and A&Z composite resins.

Conclusions

Incorporation of ZnO nanoparticles and their compounds into orthodontic composite resins induced antibacterial properties against oral pathogens, and of all these nanoparticles, the AZ group exhibited the best antimicrobial activity and highest shear bond strength.

Experimental EDX analysis of different periodontal splinting systems

Physiological/normal tooth mobility may be defined as the slight displacement of the clinical crown of a tooth, which is allowed by the resilience of an intact and healthy periodontium, under the application of a moderate force. The factors influencing the success and longevity of dental splinting are the type of material used for the splint, the type of composite resin, the number and location of the dental units included for splinting (maxillary or mandibular arch). In periodontology, the term 'splint' is defined as the joining of two or more teeth into a rigid unit through restorations or fixed or removable devices. The purpose of using periodontal splints for tooth immobilization is to provide a period of rest in the areas where the healing process has begun and to allow normal functioning there where the tissues alone would not be able to withstand occlusal forces. The aim of the present study was to evaluate comparatively, by means of energy dispersive electron spectrometry (EDX), the chemical composition in the case of in vitro samples that structurally reproduce direct periodontal immobilization systems using fiberglass strips and fluid composite resins. The differences in the chemical composition of the investigated materials can influence their physiochemical properties, but also their biological and toxicological reliability. Elements such as C, O, Al, Si and Ba were identified as common elements among the resins tested in the present study. The only difference in terms of the component elements was found in the case of the fluid composite Clearfil Majesty ES Flow, which, apart from the elements mentioned, also presented Co in its structure.

Comparison of Rat Connective Tissue Response to BioMTA, Angelus MTA, and Root MTA

Due to the widespread use of MTA in dentistry and various brands of this product, we decided to compare the three brands available in the country market by their biocompatibility. We divided 20 male Wistar rats into four groups. After local anesthesia and washing, we made two incisions on both sides (4 incisions in total). The experimental groups were Angelus MTA (Angelus, Brazil), BioMTA (CERKAMED, Poland), Root MTA (Dr. Lotfi, Tabriz, Iran), and the control group. The resulting paste was placed in a tube and implanted subcutaneously into male Wistar rats. Wistar rats were sacrificed 7, 15, 30, and 60 days later, with high anesthetic doses. The sample implanted in 10% formalin was stabilized after tissue processing and H&E staining under a microscope. The inflammatory reaction in the tissues received different scores at the beginning of the tube opening. BioMTA had the highest inflammatory response among the groups, but the difference was not statistically significant (p > 0.05). Also, there was no significant difference between the groups' granulation and calcification (p < 0.05). There was a significant difference between BioMTA, Angelus MTA, Root MTA, and control groups in fibrous capsule formation (p < 0.05). Angelus MTA showed the lowest mean fibrous capsule formation in all periods. The effects of Angelus MTA, Root MTA, and BioMTA on connective tissue were investigated and compared. According to this study, these materials have good biocompatibility. According to the findings and statistical analysis, Angelus MTA has the most biocompatibility.

The Role of Biomaterials and Biocompatible Materials in Implant-Supported Dental Prosthesis

The dental implant is one of the appropriate instances of the different dental materials and their application, which is the combined procedure of technology and science in physics, biomechanics, and surface chemistry from macroscale to nanoscale surface engineering and manufactured technologies. In recent decades, biomaterials in implant therapy promote bone response and biomechanical ability, which is long-term from surgical equipment to final prosthetic restoration. Biomaterials have a crucial role in rehabilitating the damaged structure of the tooth and supplying acceptable outcomes correlated with clinical performance. There are some challenges in implantation such as bleeding, mobility, peri-implant infections, and the solution associated with modern strategies which are regarded to biomaterials. Various materials have been known as promising candidates for coatings of dental implants which contain polyhydroxyalkanoates, calcium phosphate, carbon, bisphosphonates, hydroxyapatite, bone stimulating factors, bioactive glass, bioactive ceramics, collagen, chitosan, metal and their alloys, fluoride, and titanium/titanium nitride. It is pivotal that biomaterials should be biodegradable; for example, polyhydroxyalkanoates are biodegradable; also, they do not have bad effects on tissues and cells. Despite this, biomaterials have important roles in prosthetic conditions such as dental pulp regeneration, the healing process, and antibacterial and anti-inflammatory effects. In this review study, the role of biocompatible materials in dental implants is investigated in in vitro and in vivo studies.

Effects of local application of the ankaferd blood stopper on osseointegration in three different surface titanium implants

Objective

Researchs of the effects of ankaferd blood stopper (ABS) on bone healing metabolism have revealed that it affects bone regeneration positively. The exact mechanism by which this positive effect on bone tissue metabolism is not known. The aim of this study is to biomechanic and biochemical analysis of the effects of the local ABS application on osseointegration of 3 different surfaced titanium implants.

Material & Methods

Spraque dawley rats were divided machined surfaced (MS) (n ​= ​10), sandblasted and large acid grid (SLA) (n ​= ​10) and resorbable blast material (RBM) (n ​= ​10) surfaced implants. ABS applied locally during the surgical application of the titanium implant before insertion in bone sockets. After 4 weeks experimental period the rats sacrificed and implants with surrounding bone tissues were removed to reverse torque analysis (Newton), blood samples collected to biochemical analysis (ALP, calcium, P).

Results

Biomechanic bone implant contact ratio detected higher in SLA surfaced implants compared with the RBM and controls (P ​< ​0,05). Phosphor levels detected lower in RBM implant group compared with the controls and SLA (P ​< ​0,05). Additionally; phosphor levels detected highly in controls compared with the RBM implants.

Conclusion

According the biomechanical parameters ABS may be more effective in SLA and RBM surfaced implants when locally applied.

Toxicological Assessment of Bromochlorophene: Single and Repeated-Dose 28-Day Oral Toxicity, Genotoxicity, and Dermal Application in Sprague-Dawley Rats

Bromochlorophene (BCP) has shown good properties in sterilization and antibacterial activity and is widely used as a household chemical. We evaluated the genotoxicity, single and repeated-dose 28-day oral toxicity, and dermal application of a BCP suspension in Sprague–Dawley (SD) rats. For the single-dose toxicity study, a dose of 25–1,000 mg per kg of bodyweight (mg/kg b.w.) of BCP was given once orally to SD rats. Mortality and clinical signs were observed and recorded for the first 30 min after treatment, at 4 h post-administration, and then at least once daily for 14 days after administration. For the repeated-dose 28-day toxicity study, the high dose was set at 1,000 mg/kg b.w. and the middle, middle-low, and low dose were set to 500, 250, and 125 mg/kg, respectively. Hematology and biochemistry parameters were examined. Gross pathologic and histopathologic examinations were performed on selected tissues from all animals. A bacterial reverse mutation assay, in vitro chromosomal aberration assay, and in vivo micronucleus assay were performed to assess genotoxicity-dermal application exposure assessment of BCP in rats. A high oral approximate lethal dose (ALD) of 1,000 mg/kg was observed in the single-dose toxicity test. During the repeated-dose 28-day time period, most animal deaths after administration occurred during the first 3 weeks. The 1,000 mg/kg b.w. oral dose caused the death of six male rats (6/7) and four female rats (4/7). At 500 mg/kg b.w., the female rats showed mortality (1/7). For the biochemistry assays, cholesterol was increased significantly compared to vehicle in both sexes in the 250 and 500 mg/kg groups. Histopathological changes with treatment-related findings were observed in the pancreas in female rats treated with a high dose of BCP compared with the vehicle group. BCP showed no genotoxic effect. These data suggested that the ALD of BCP, estimated as a non-genotoxic substance, was over 1,000 mg/kg b.w. in the single-dose toxicity study, and the NOAEL of BCP was considered to be 250 mg/kg b.w. for male and female rats after repeated oral administration for 28 days under the present study conditions.

Recent Progress in Antimicrobial Strategies for Resin-Based Restoratives

Repairing tooth defects with dental resin composites is currently the most commonly used method due to their tooth-colored esthetics and photocuring properties. However, the higher than desirable failure rate and moderate service life are the biggest challenges the composites currently face. Secondary caries is one of the most common reasons leading to repair failure. Therefore, many attempts have been carried out on the development of a new generation of antimicrobial and therapeutic dental polymer composite materials to inhibit dental caries and prolong the lifespan of restorations. These new antimicrobial materials can inhibit the formation of biofilms, reduce acid production from bacteria and the occurrence of secondary caries. These results are encouraging and open the doors to future clinical studies on the therapeutic value of antimicrobial dental resin-based restoratives. However, antimicrobial resins still face challenges such as biocompatibility, drug resistance and uncontrolled release of antimicrobial agents. In the future, we should focus on the development of more efficient, durable and smart antimicrobial dental resins. This article focuses on the most recent 5 years of research, reviews the current antimicrobial strategies of composite resins, and introduces representative antimicrobial agents and their antimicrobial mechanisms.

One-year evaluation of a new restorative glass ionomer cement for the restoration of non-carious cervical lesions in patients with systemic diseases: a randomized, clinical trial

OBJECTIVE

This randomized and clinical trial aimed to evaluate the performance of a new restorative Glass Ionomer Cement (GIC) for the restoration of non-carious cervical lesions (NCCLs) of patients with systemic diseases compared with a posterior resin composite after 12 months.

METHODOLOGY

134 restorations were placed at 30 patients presenting systemic diseases by a single clinician. NCCLs were allocated to two groups according to restorative system used: a conventional restorative GIC [Fuji Bulk (GC, Tokyo Japan) (FB)] and a posterior resin composite [G-ænial Posterior (GC, Tokyo Japan) (GP)] used with a universal adhesive using etch&rinse mode. All restorative procedures were conducted according to manufacturer's instructions. Restorations were scored regarding retention, marginal discoloration, marginal adaptation, secondary caries, surface texture, and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after 1 week (baseline), 6, and 12 months. Descriptive statistics were performed using chi-square tests. Cochran Q and Mc Nemar's tests were used to detect differences over time.

RESULTS

After 12 months, recall rate was 93% and the rates of cumulative retention failure for FB and GP were 4.9% and 1.6% respectively. Both groups presented similar alpha rates for marginal adaptation (FB 86.2%, GP 95.5%) and marginal discoloration (FB 93.8%, GP 97%) at 6-month recall, but FB restorations showed higher bravo scores than GP restorations for marginal adaptation and marginal discoloration after 12 months (p<0.05). Regarding surface texture, 2 FB restorations (3.1%) were scored as bravo after 6 months. All restorations were scored as alpha for secondary caries and postoperative sensitivity after 12 months.

CONCLUSION

Although the posterior resin composite demonstrated clinically higher alpha scores than the conventional GIC for marginal adaptation and discoloration, both materials successfully restored NCCLs at patients with systematic disease after a year.

CLINICAL RELEVANCE

Due to its acceptable clinical results, the tested conventional restorative GIC can be used for the restoration of NCCLs of patients with systemic diseases.

Application of Antimicrobial Polymers in the Development of Dental Resin Composite

Dental resin composites have been widely used in a variety of direct and indirect dental restorations due to their aesthetic properties compared to amalgams and similar metals. Despite the fact that dental resin composites can contribute similar mechanical properties, they are more likely to have microbial accumulations leading to secondary caries. Therefore, the effective and long-lasting antimicrobial properties of dental resin composites are of great significance to their clinical applications. The approaches of ascribing antimicrobial properties to the resin composites may be divided into two types: The filler-type and the resin-type. In this review, the resin-type approaches were highlighted. Focusing on the antimicrobial polymers used in dental resin composites, their chemical structures, mechanical properties, antimicrobial effectiveness, releasing profile, and biocompatibility were included, and challenges, as well as future perspectives, were also discussed.

Mitochondrial Function and Root-Filled Teeth - Detrimental and Unknown Interfaces in Systemic Immune Diseases

BACKGROUND

Mitochondriopathy has recently been linked to several immune system diseases. Historically, there have been many conversations regarding the possible toxic effects of root-filled teeth (RFT), although discussions about the possible decreases in adenosine triphosphate (ATP) activity on the mitochondrial membrane, as caused by dental toxins, are rare. In fact, only a few methods currently exist to assess toxin release in teeth.

OBJECTIVE

An experimental clinical study design is used to investigate the extent to which RFT release toxins in a solution created specifically following extraction (Tox-sol). Our laboratory is investigating the extent to which these Tox-sols reduce ATP activity in patients.

PATIENTS AND METHODS

RFTs were identified and extracted to assess their local toxin release using a semi-quantitative volatile sulfur compound indicator (VSCI). These RFTs are placed in an aqueous solution at room temperature for 24 hours and subsequently removed. The resulting solution (Tox-sol) is diluted to 1:100; peripheral blood mononuclear cells (PBMCs) obtained from patients were added to the solution in the laboratory. The remaining ATP activity was measured on the mitochondrial membrane and was compared with the baseline ATP activity of each patient.

RESULTS

The total population (n=30) showed a ~10% reduction in ATP activity following 24 hours of exposure to the Tox-sol. Three groups emerged with greatly reduced (n=16), neutral (n=10), and increased (n=4) ATP activity. In four different disease groups (rheumatism, neurological disorders, allergies, and tumors), a non-disease specific inhibition of ATP activity was observed.

DISCUSSION

The study design was limited, as patients were exposed to the Tox-sol and PBMC fraction for only 24 hours. The actual exposure time in a patient's mouth can continue for years and the actual levels can increase over time. Disease-specific effects of Tox-sol were not found.

CONCLUSION

Within the short exposure time of 24 hours, and at a dilution of 1:100, the Tox-sol caused a median decrease in ATP activity of ~15% in 50% of test subjects. A practical VSCI reliably showed the effects of toxic sulfur compounds on the RFT. The toxic degradation products of biogenic amines from RFT can thus serve as possible contributing factors in the development of mitochondriopathies.

Antimicrobial Effects against Oral Pathogens and Cytotoxicity of Glycyrrhiza uralensis Extract

We aimed to evaluate the antimicrobial effects of Glycyrrhiza uralensis extract on Streptococcus mutans and Candida albicans and its biocompatibility for dental applications. The antimicrobial activity of the G. uralensis extracts at concentrations of 50, 100, 150, and 200 µg/mL was assessed using agar disk diffusion tests, counting the total number of colony-forming units (CFUs), spectrophotometric growth inhibitory assays, and microbial morphology observations using scanning electron microscopy (SEM; Merin, Carl Zeiss, Oberkochen, Germany). We measured the polyphenol and flavonoid contents of G. uralensis extracts using ultraviolet–visible spectrometry and the cytotoxicity of these extracts using an MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. We identified that G. uralensis extracts had significant antimicrobial effects against S. mutans and C. albicans. The optical density of the experimental groups significantly decreased compared with that of the control group. SEM images revealed that the G. uralensis extract affected the morphology and density of S. mutans and C. albicans. The extract concentration of flavonoids, but not polyphenols, increased with increasing concentrations of the G. uralensis extract. Furthermore, cell viabilities were more than 70% for G. uralensis extracts with concentrations of 50 and 100 μg/mL. Naturally derived G. uralensis is biocompatible and exhibits an excellent antimicrobial effect against oral pathogens such as S. mutans and C. albicans. Thus, G. uralensis extracts can be used for the development of oral products that treat and prevent oral diseases.

Influence of the degree of conversion and Bis-GMA residues of bulk fill resins on tissue toxicity in an subcutaneous model in rats

AIM

To analyse the influence of the degree of conversion (DC) and light curing residues of different bulk fills (BFs) composites on the inflammatory profile in the subcutaneous tissue of rats.

MATERIALS AND METHODS

Resin disks of BF-resins and their active conventional resins (CR; 3M®, Ivoclar®, and Kerr®) were light-cured at 2 mm (BF-superficial) and 4 mm (BF-deep) thicknesses and analyzed by infrared spectroscopy (FTIR; n = 3/group; DC and light curing residues). Then, the disks were implanted in four quadrants in the subcutaneous tissue of Wistar rats (sham, CR, BF-superficial and RF-deep), and after 7, 14, and 28 days, the animals (n = 6/day) were euthanized for histological analysis of the intensity of the inflammatory process (scores 0-3). Kruskal-Wallis/Dunn and ANOVA/Bonferroni tests were used (p < 0.05, Graph Pad Prism 5.0).

RESULTS

The DC of CR 3M® did not differ significantly compared to BF-superficial and BF-deep resins (p = 0.235). The Ivoclar® and Kerr® resins showed a higher DC with CR and BF-superficial compared to the BF-deep (p = 0.005 and p = 0.011, rctively). Kerr® resins showed a higher Bis-GMA/UDMA ratio, especially in BF-deep resin (p < 0.05). 3M® and Ivoclar resins did not show high inflammation scores, but for Kerr® BF resins (superficial and deep), the inflammatory process was significantly higher than that in the CR and sham quadrants (p = 0.031).

CONCLUSION

The tissue inflammatory response after resin inoculation depends on the DC and light curing residues of Bis-GMA.

Effect of core materials for core fabrication for dental implants on in-vitro cytocompatibility of MC3T3-E1 cells

Background

Despite the wide use of dental materials for CAD/CAM system in prosthetic treatment, the effect of the materials, which are used as dental implants core fabricated, on cells involved in dental implant osseointegration is uncertain. This study aimed to investigate and compare the effect of single core materials used for dental implants fabricated by the dental prostheses fabrication process and the CAD/CAM milling method on MC3T3-E1 cells.

Methods

The materials used for prostheses restoration in this experiment were Porcelain Fused Gold (P.F.G), Lithium disilicate glass ceramic (LiSi₂), Zirconia (ZrO₂), Nickel-Chromium (Ni-Cr) and Cobalt-Chromium (Co-Cr). MC3T3-E1 cells were cultured and used, the cell adhesion and morphology were observed and analyzed using confocal laser scanning microscopy (CLSM). Methoxyphenyl tetrazolium salt (MTS) and alkaline phosphatase (ALP) assay were used to observe the cell proliferation and differentiation.

Results

CLSM revealed irregular cell adhesion and morphology and the filopodia did not spread in the Ni-Cr specimen group. Significantly high cell proliferation was observed in the ZrO₂ specimen group. The LiSi₂ specimen group presented significantly high cell differentiation. Intergroup comparison of cell proliferation and differentiation between the Ni-Cr specimen group and all other specimen groups showed significant differences (p < .05).

Conclusion

Cell proliferation and differentiation were observed from the cores, which were fabricated with all specimen groups on cytocompatibility except the Ni-Cr specimen group.